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4 pages, 214 KiB

Open AccessEditorial

Clinical Applications for Dentistry and Oral Health

by Paola Gandini and Andrea Scribante

Appl. Sci. 2023, 13(4), 2428; https://doi.org/10.3390/app13042428 - 14 Feb 2023

Cited by 1 | Viewed by 1207

Abstract

In the last few years, dentistry has expanded the scope of its research and increased its cooperation with other disciplines [...] Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

Research

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8 pages, 1401 KiB

Open AccessArticle

Salivary Test Assessment in an Oncohematological Pediatric Sample: A Case Control Study

by Matteo Saccucci, Gabriele Di Carlo, Katia Grandi, Giulia Zumbo, Luigi Stamegna, Nihad Malikzade, Fiorina Giona, Antonella Polimeni and Iole Vozza

Appl. Sci. 2022, 12(7), 3501; https://doi.org/10.3390/app12073501 - 30 Mar 2022

Cited by 2 | Viewed by 1545

Abstract

Background: In recent years, the incidence of neoplastic diseases in children has increased significantly. Immunodepression triggers undesirable effects in the oral cavity such as mucositis, opportunistic infections, oral bleeding, xerostomia, dysgeusia, decay, dental malformations and pain. Objective: We aim to assess, through salivary [...] Read more.

Background: In recent years, the incidence of neoplastic diseases in children has increased significantly. Immunodepression triggers undesirable effects in the oral cavity such as mucositis, opportunistic infections, oral bleeding, xerostomia, dysgeusia, decay, dental malformations and pain. Objective: We aim to assess, through salivary tests, the quality of saliva in pediatric patients affected by oncohematological diseases and treated with chemo/radiotherapy compared to non-treated subjects. Methods: A total of 20 subjects aged between 5 and 18 years, with oncological pathologies undergoing radio and/or chemotherapy, were evaluated. The control group consisted of 20 healthy children of the same age. The two groups of subjects were asked to undergo salivary tests. Descriptive statistics were computed for each item. Fisher’s exact test was conducted to compare case and control groups. Results: Subjects treated with chemo/radiotherapy had a lower pH and therefore a higher salivary acidity that predisposes to caries and the oral hygiene of children with oncohematological diseases was more deficient than that of the control group. Conclusions: The early detection of these indicators, and the prevention carried out to limit their severity, is an important aspect of the comprehensive care of oncohematological subjects. Pediatric dentists can play a crucial a role enabling good quality of life during cancer therapy. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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11 pages, 1377 KiB

Open AccessArticle

Profilometer Comparison of the Surface Roughness of Four Denture Base Resins: An In Vitro Study

by Biagio Rapone, Sebastian Pedone, Antonio Carnevale, Pasquale Plantamura, Antonio Scarano, Antonio Demelio, Giuseppe Pompeo Demelio and Massimo Corsalini

Appl. Sci. 2022, 12(4), 1837; https://doi.org/10.3390/app12041837 - 10 Feb 2022

Cited by 37 | Viewed by 2709

Abstract

Background: The roughness of denture base materials is mainly affected by inherent material features, the polishing technique, and the operator’s manual skills. The surface irregularities of the denture base resin’s roughness profile is one of the components characterizing the superficial topography of dental [...] Read more.

Background: The roughness of denture base materials is mainly affected by inherent material features, the polishing technique, and the operator’s manual skills. The surface irregularities of the denture base resin’s roughness profile is one of the components characterizing the superficial topography of dental prostheses, and it is a critical parameter for describing surface morphology. Generally, the increment of the surface roughness minimizes cleanability and promotes the rate of bacterial adherence, affecting the expression of bacterial adhesins. The purpose of this in vitro study was to investigate the roughness of four commercially available denture base resins employed for removable prosthodontics. Methods: Twenty-five specimens were realized and submitted to observation for three dimensions (vertically, horizontally, 45°). Average surface roughness (Ra), Rv, Rp, and Rq were measured with a calibrated mechanical roughness tester (Taylor Hobson Surtronic 25; Taylor Hobson, Leicester, UK). Data were analyzed through a Kruskal–Wallis test. Results: Significant differences in Ra between the groups were assessed. Baltic Denture System™ (Merz Dental GmbH; Lütjenburg, Germania) showed a lower surface roughness coefficient and a more homogeneous surface. Conclusions: The functional importance of surface roughness parameters for denture base materials must be explored, not only considering recognized surface features. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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12 pages, 2132 KiB

Open AccessArticle

Assessment of Mineralization, Oxidative Stress, and Inflammation Mechanisms in the Pulp of Primary Teeth

by Konstantina Kritikou, Marina Imre, Mihaela Tanase, Arina Vinereanu, Alexandra Ripszky Totan, Tudor-Claudiu Spinu, Daniela Miricescu, Iulia-Ioana Stanescu-Spinu, Marilena Bordea and Maria Greabu

Appl. Sci. 2022, 12(3), 1554; https://doi.org/10.3390/app12031554 - 31 Jan 2022

Cited by 4 | Viewed by 2583

Abstract

Inflammation in primary teeth (PT) is commonly associated with a lower sensibility to painful stimuli, compared to permanent teeth, and usually leads to late presentation for dental treatment. Data obtained on the molecular assessments of dental pulp and clinical examinations could guide practitioners [...] Read more.

Inflammation in primary teeth (PT) is commonly associated with a lower sensibility to painful stimuli, compared to permanent teeth, and usually leads to late presentation for dental treatment. Data obtained on the molecular assessments of dental pulp and clinical examinations could guide practitioners to conduct precise diagnoses and correct treatments. The aim of our pilot study was to assess the levels of several biomarkers (e.g., mineralization, oxidative stress, and inflammation) in primary teeth. The research included 46 dental pulp specimens collected from the primary teeth of children and adolescents between the ages of 6 and 12. The experimental groups consisted of 18 samples collected from primary teeth with acute pulpitis and 15 samples from chronically inflamed pulp tissues. The control group was represented by 13 specimens acquired from clinically healthy primary teeth. The enzyme-linked immunosorbent assay (ELISA) technique was used to determine the protein expression of tumor necrosis factor-α (TNF-α), superoxide dismutase-3 (SOD-3), osteocalcin, and transforming growth factor-β1 (TGF-β1) in the lysates. Our results revealed that all of the studied parameters presented statistically significant (p ≤ 0.05) increased levels in both experimental groups compared to the control samples. Furthermore, osteocalcin presented statistically significant increased concentrations in chronically- versus acute-inflamed pulp samples (p ≤ 0.05). The studied molecules may have an influential role in acute and chronic pulp inflammation in primary teeth. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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10 pages, 264 KiB

Open AccessArticle

by Marielle Bazzo Di Domênico, Kauê Farias Collares, César Dalmolin Bergoli, Mateus Bertolini Fernandes dos Santos, Pedro Henrique Corazza and Mutlu Özcan

Appl. Sci. 2021, 11(23), 11197; https://doi.org/10.3390/app112311197 - 25 Nov 2021

Cited by 5 | Viewed by 2211

Abstract

This study evaluated the effect of clinical and patient-related factors on marginal bone loss. The sample was composed of individuals who were treated at two dental schools in southern Brazil. The variables evaluated were divided into individual (age, sex, diabetes, hypertension and antihypertensive [...] Read more.

This study evaluated the effect of clinical and patient-related factors on marginal bone loss. The sample was composed of individuals who were treated at two dental schools in southern Brazil. The variables evaluated were divided into individual (age, sex, diabetes, hypertension and antihypertensive use), and implant levels (arch, position, brand, protection, torque, time). After implant installation and following the second stage, periapical radiographs were obtained to measure the distance between the peri-implant bone crest and implant platform. Measurements were performed using ImageJ software. Data were analyzed using linear and Poisson multilevel regression. Fifty-eight patients with 113 implants were evaluated. The mean marginal bone loss was 0.45 ± 0.48 mm. Considering the linear multivariate model, age, diabetes, torque and time between surgery and reopening were found to be significant (p < 0.05). In the dichotomous model (bone loss <0.2 mm and ≥0.2 mm), only high torques resulted in higher marginal bone loss (p = 0.033). Marginal bone loss occurred before the second surgical stage and was greater in implants with high torque. Torque below 20 N, reopening performed after six months, diabetic status and young age all resulted in higher marginal bone loss, but these values are probably not clinically significant. These variables must be better explored in future studies. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

9 pages, 643 KiB

Open AccessArticle

Evaluation of Two Different Types of Mineral Trioxide Aggregate Cements as Direct Pulp Capping Agents in Human Teeth

by Nidambur Vasudev Ballal, Sheetal Rao, Nirmala Rao, Arun Urala, Jun-Sang Yoo, Nadin Al-Haj Husain and Mutlu Özcan

Appl. Sci. 2021, 11(21), 10455; https://doi.org/10.3390/app112110455 - 7 Nov 2021

Cited by 3 | Viewed by 2700

Abstract

Traumatic human dental injuries involving the pulp might necessitate direct capping procedures. This clinical study aimed to analyse the histological outcomes using two different direct capping materials. Twenty patients with bilateral premolars, scheduled for orthodontic extraction, were selected. The teeth were treated either [...] Read more.

Traumatic human dental injuries involving the pulp might necessitate direct capping procedures. This clinical study aimed to analyse the histological outcomes using two different direct capping materials. Twenty patients with bilateral premolars, scheduled for orthodontic extraction, were selected. The teeth were treated either using ProRoot MTA or RetroMTA. All patients were recalled after 30 and 60 days for teeth extraction. The histopathologically stained specimens were blindly evaluated using hard tissue bridge formation, inflammatory reaction and pulpal findings criteria. Data were evaluated statistically. Results: After 60 days, only the parameter for hard tissue bridge formation showed significant difference in the ProRoot MTA group (p = 0.010), while both direct capping materials performed similarly regarding inflammatory pulp reaction and pulpal findings. Although, during the first 30 days, RetroMTA presented better results in terms of continuity, morphology, hard tissue bridge localisation, and extension/general state of the inflammatory reaction, the continuity was better at 60 days when ProRoot MTA was applied. Treatment with RetroMTA healed the pulpal tissue faster compared with ProRoot MTA but it seemed to be rather a reparative process. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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15 pages, 2775 KiB

Open AccessArticle

Biochemical Mapping of the Inflamed Human Dental Pulp

by Konstantina Kritikou, Marina Imre, Mihaela Tanase, Arina Vinereanu, Alexandra Ripszky Totan, Tudor-Claudiu Spinu, Radu Ilinca, Daniela Miricescu, Iulia-Ioana Stanescu-Spinu and Maria Greabu

Appl. Sci. 2021, 11(21), 10395; https://doi.org/10.3390/app112110395 - 5 Nov 2021

Cited by 4 | Viewed by 2982

Abstract

Dental pulp inflammation, caused by the evolution of caries, involves numerous interrelated activities at a cellular and molecular level. Cytokines, proteases, growth factors, and other biomarkers of the host response may take part in dental pulp’s immune defense. The aim of this pilot [...] Read more.

Dental pulp inflammation, caused by the evolution of caries, involves numerous interrelated activities at a cellular and molecular level. Cytokines, proteases, growth factors, and other biomarkers of the host response may take part in dental pulp’s immune defense. The aim of this pilot study was to determine the levels of inflammation, oxidative stress, and extracellular matrix degradation biomarkers in healthy and symptomatic irreversibly inflamed dental pulp samples from children and adolescents. Twenty-three dental pulp samples were collected from permanent teeth with irreversible inflammation, while nineteen healthy dental pulp samples were obtained from teeth extracted for orthodontic reasons. Pulp lysates were obtained and the levels of IL-2, IL-17, TNF-α, SOD3, TGF-β1, catalase, osteocalcin, MMP-7, and MMP-9 were determined using the enzyme-linked immunosorbent assay (ELISA) technique. We detected significantly higher levels (p < 0.001) of IL-2, IL-17, TNF-α, SOD3, osteocalcin, and TGF-β1 in pulp samples with irreversible inflammation than in controls. Catalase and MMP-7 showed higher levels in the experimental group, while MMP-9 showed slightly increased levels in the control group, but none of these differences were statistically significant (p = 0.064/p = 0.061/p = 0.625). Inflamed dental pulp samples showed an up-regulation of IL-2, IL-17, TNF-α, SOD3, osteocalcin, and TGF-β1. These biomarkers appear to have a powerful role in the inflammation process of human dental pulp. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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11 pages, 1369 KiB

Open AccessArticle

Evaluation of Smart Chromatic Technology for a Single-Shade Dental Polymer Resin: An In Vitro Study

by Eman M. AlHamdan, Amr Bashiri, Faisal Alnashmi, Samar Al-Saleh, Khalid Al-shahrani, Saad Al-shahrani, Abdullah Alsharani, Khaled M. Alzahrani, Firas K. Alqarawi, Fahim Vohra and Tariq Abduljabbar

Appl. Sci. 2021, 11(21), 10108; https://doi.org/10.3390/app112110108 - 28 Oct 2021

Cited by 20 | Viewed by 4542

Abstract

The aim of the study was to assess the color matching ability and color stability of a single-shade resin-based composite (Omnichroma—OM) in comparison to a conventional dental composite. One hundred and sixty lower molar acrylic teeth in four different shades (B1, B2, A3, [...] Read more.

The aim of the study was to assess the color matching ability and color stability of a single-shade resin-based composite (Omnichroma—OM) in comparison to a conventional dental composite. One hundred and sixty lower molar acrylic teeth in four different shades (B1, B2, A3, and C3) were prepared with class I cavities. Eighty teeth were divided into two groups based on the two resin composite materials (OM and Filtek Z-350 (FT)) for cavity restoration. Three groups were included in the color matching assessment, namely Gp 1-FT, Gp 2-OM-light cured (C), and Gp 3-OM-uncured (UC) groups. The color assessment was performed prior to cavity restoration and after cavity filling and before and after light curing to detect color matching. The 80 remaining teeth were restored with OM (n = 40) and FT (n = 40); half (n = 40) were submerged in coffee and the other half (n = 40) were submerged in cola for 2 weeks. The color stability was assessed by calculating material color (spectrophotometry) changes (∆E) before and after staining in immersion medium. The means and standard deviations of the ∆E values relating to color matching and color stability (stain resistance) among the study groups were analyzed using ANOVA and Tukey’s post hoc test. FT showed significantly better color matching (lower ΔE) in comparison to OM-UC specimens for shades B1, B2, and A3 (p < 0.01). Regarding the color stability in cola, the FT samples showed significantly lower ΔE values (indicating better color stability) compared to OM samples for all four shades (p < 0.01). The ΔE values of OM and FT samples in coffee were comparable (p > 0.01), showing comparable color stability. The color matching ability of the single-shade resin composite (OM) was influenced by the tooth color. The conventional resin composite showed better color matching than the single-shade composite (OM). The color stability of the single-shade resin composite (OM) was dependent on the staining medium. The OM composite showed more compromised color stability than the conventional resin composite in cola and comparable color stability to conventional resin composite in coffee. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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11 pages, 3995 KiB

Open AccessArticle

Histological Aspects Regarding Dental Pulp of Diabetic Patients

by Cristina Gabriela Puşcaşu, Corina Laura Ștefănescu, Rodica Maria Murineanu, Mircea Grigorian, Lucian Cristian Petcu, Elena Dumea, Liliana Sachelarie and Radu Andrei Puşcaşu

Appl. Sci. 2021, 11(20), 9440; https://doi.org/10.3390/app11209440 - 11 Oct 2021

Cited by 7 | Viewed by 3082

Abstract

Background: The possible histological changes in dental pulp in teeth of diabetic patients are important to be understood, as the clinician will consider the best treatment choice for those teeth, especially if they are affected by decay. The aim of this paper is [...] Read more.

Background: The possible histological changes in dental pulp in teeth of diabetic patients are important to be understood, as the clinician will consider the best treatment choice for those teeth, especially if they are affected by decay. The aim of this paper is to assess if there are effects of diabetes-associated hyperglycemia on the nervous and vascular system of the dental pulp. Methods: Twenty-three dental pulp specimens of patients aged 36–70 years old were analyzed. All patients had been diagnosed with type 2 diabetes for at least 5 years. Results: Most of the patients had poorly controlled hyperglycemia, deep caries, but no clinical signs of pulpitis. The histological aspects of pulp specimens included frequently seen inflammatory infiltrate, degeneration of the nerves, thickened blood vessel walls, pulp sclerosis and frequent pulp calcifications, and even small necrotic areas. Conclusion: The analyzed dental pulp specimens of carious teeth of type 2 diabetic patients show fibrotic transformation of the dental pulp, with the presence of calcifications, arteriosclerosis and inflammatory infiltrate. In this situation, the attitude of the dentist in pulp vitality preservation in the case of carious teeth of diabetic patients should be limited. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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8 pages, 1826 KiB

Open AccessArticle

An Assessment of the Influence of Dental Porcelain Slurry Preparation on Flexural Strength of Different Feldspathic Porcelains

by Abdulmonem Alshihri, Nadin Al-Haj Husain, Kai Vogeler and Mutlu Özcan

Appl. Sci. 2021, 11(20), 9385; https://doi.org/10.3390/app11209385 - 9 Oct 2021

Cited by 2 | Viewed by 1726

Abstract

Chipping remains a big challenge during the clinical application of glass ceramics in dentistry. The fabrication procedure used affects the mechanical properties of dental feldspathic porcelain and is associated with technical failures. This study aimed to compare the effect of the use of [...] Read more.

Chipping remains a big challenge during the clinical application of glass ceramics in dentistry. The fabrication procedure used affects the mechanical properties of dental feldspathic porcelain and is associated with technical failures. This study aimed to compare the effect of the use of manufacturers’ liquids versus H₂O on the flexural strength of glass ceramics. Specimens (n = 120, n = 15 per group) (25 × 4 × 1.2 mm) were obtained using four porcelain powders (Creation CC, IPS InLine, Noritake EX-3, and Vita VM 13). Four groups were produced using porcelain powder and modeling liquid, and four groups using distilled water. The specimens were fired, sintered, and polished. Flexural strength was measured using a universal testing machine. Statistical analyses were conducted using post hoc Tukey’s, two-way ANOVA, and Weibull analysis. Flexural strength values (mean ± SD) of the ceramic-manufacturer’s liquid mixture ranged between 67.2 ± 10.2 and 85.8 ± 12.8 MPA (NR < VT < IV < CR), while flexural strength values of the ceramic–water mixture were between 72.2 ± 6.9 and 95.2 ± 12 MPA (CR < NR < VT < IV). While the choice of the ceramic type significantly affected flexural strength, the use of water vs. manufacturers’ liquid showed in almost all cases no significance. To achieve better flexural strength results, InLine should be used with distilled water mixtures, while all ceramic powders except for Noritake can be used with the manufacturer’s liquid mixtures. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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12 pages, 2307 KiB

Open AccessArticle

Risk Factors Associated with Cusp Fractures in Posterior Permanent Teeth—A Cross-Sectional Study

by Susana Morimoto, Wilma K. C. Lia, Flavia Gonçalves, Denis Yudi Nagase, Thais Gimenez, Daniela Procida Raggio and Mutlu Özcan

Appl. Sci. 2021, 11(19), 9299; https://doi.org/10.3390/app11199299 - 7 Oct 2021

Cited by 7 | Viewed by 4282

Abstract

Objectives: This cross-sectional study aimed to evaluate the frequency and risk factors associated with cusp fractures in posterior permanent teeth. Methods: Patients presented cusp fractures on posterior permanent teeth, clinically assessed in up to 7 days after the event, and requesting dental treatment [...] Read more.

Objectives: This cross-sectional study aimed to evaluate the frequency and risk factors associated with cusp fractures in posterior permanent teeth. Methods: Patients presented cusp fractures on posterior permanent teeth, clinically assessed in up to 7 days after the event, and requesting dental treatment at two public services were included in this cross-sectional study. Fractured teeth already treated, with antagonist absence, or with prosthesis (total or removable) were excluded. Demographic and clinical data were collected to draw the patient profiles and establish how teeth were affected individually. Statistical analysis was performed by the Fisher exact test, and uni- and multivariate logistic regression (α = 0.05). Results: One hundred and seventy-seven (177) patients from 16 to 66 years old (±41.56), from 1998 to 2016, were included in this study. Non-functional and lingual cusps presented a higher fracture than functional and buccal cusps, respectively. Fractures were more common in teeth with isthmus wider than 1/3 of the intercuspid distance and/or more than three restored surfaces. Teeth with endodontic treatment presented a higher subgingival fracture. On lingual cusps, fracture type and location were significantly associated, being that total fractures were 3.2 times more likely to occur than partial fractures, and subgingival were 3.62 times more likely to occur than supragingival fractures. Conclusion: Indications of classic protection on functional cusps (LUBL) was refuted since, generally, nonfunctional cusps fractured more than the functional cusps. However, upper pre-molars showed more fractures in functional cusps and lower molars presented more fractures on the nonfunctional cusps. In general, lingual cusps were the most fractured and were associated with a higher prevalence of severe fractures (total fractures at the subgingival level). Fractures were more common in teeth where the restoration had an isthmus wider than 1/3 of the intercuspid distance and/or involved more than three restored surfaces. Most of the patients did not show previous symptoms and signs. Overall, teeth with endodontic treatment presented a higher subgingival fracture. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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8 pages, 10519 KiB

Open AccessArticle

Comparison of Casein Phosphopeptide with Potassium Nitrate and Sodium Monofluorophosphate Desensitizing Efficacy after In-Office Vital Bleaching—A Randomized Trial

by Hafiz Muhammad Adil, Rizwan Jouhar, Muhammad Adeel Ahmed, Sakeenabi Basha, Naseer Ahmed, Maria Shakoor Abbasi, Afsheen Maqsood, Anil Kumar Nagarajappa and Mohammad Khursheed Alam

Appl. Sci. 2021, 11(19), 9291; https://doi.org/10.3390/app11199291 - 6 Oct 2021

Cited by 4 | Viewed by 2523

Abstract

Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), potassium nitrate, and sodium monofluorophosphate are desensitizing agents that help in reducing teeth sensitivity. However, indecisive evidence exists regarding their efficacy. Therefore, this study was conducted to compare the desensitizing efficacy of casein phosphopeptide-amorphous calcium phosphate and potassium [...] Read more.

Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), potassium nitrate, and sodium monofluorophosphate are desensitizing agents that help in reducing teeth sensitivity. However, indecisive evidence exists regarding their efficacy. Therefore, this study was conducted to compare the desensitizing efficacy of casein phosphopeptide-amorphous calcium phosphate and potassium nitrate with sodium monofluorophosphate agents after in-office vital bleaching. A randomized controlled trial was conducted on 2011 patients. The patients were randomly and equally divided into the CPP-ACP group (group 1), potassium nitrate with sodium monofluorophosphate group (group 2), and placebo gel (group 3). The upper and lower anterior teeth including the first premolar were isolated with a rubber dam, then the bleaching agents were applied on the labial surface of all the teeth, followed by light activation for 15 min. The procedure was repeated 3 times with an interval of 5 min in-between. After carrying out the bleaching procedure, patients were given a desensitizing gel or placebo gel in unmarked syringes with an instruction to apply it every 12 h for up to 3 days. The intensity of pain was recorded using a discomfort interval scale (DIS). A decrease in pain was observed 24 h after the application of the desensitizing gel in groups 1 and 2. However, in group 3, the pain persisted, with 46 (69.69%) patients having moderate pain and 14 (21.21%) developing severe pain over time. A significant difference in discomfort level with time was noted in group 1 (p = 0.015) and group 2 (p = 0.036). However, no significant difference was found in group 3 (p = 0.085). It was concluded that both desensitizing agents performed exceptionally well in reducing teeth sensitivity. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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13 pages, 1798 KiB

Open AccessArticle

Research on the Mechanical Properties, Fluoride and Monomer Release of a New Experimental Flowable Giomer in Comparison to Three Commercial Flowable Giomers

by Mara Elena Rusnac, Doina Prodan, Marioara Moldovan, Stanca Cuc, Miuţa Filip, Cristina Prejmerean and Diana Dudea

Appl. Sci. 2021, 11(19), 8921; https://doi.org/10.3390/app11198921 - 24 Sep 2021

Cited by 2 | Viewed by 2375

Abstract

Giomers are hybrid dental materials with controlled fluoride release properties. The aim of this study was to characterise a new experimental flowable giomer (G) in comparison to three commercial flowable giomers: Beautifil flow Plus X F00 (B-F00), Beautifil flow F02 (B-F02) and Beautifil [...] Read more.

Giomers are hybrid dental materials with controlled fluoride release properties. The aim of this study was to characterise a new experimental flowable giomer (G) in comparison to three commercial flowable giomers: Beautifil flow Plus X F00 (B-F00), Beautifil flow F02 (B-F02) and Beautifil flow Plus X F03 (B-F03), Shofu, Kyoto, Japan. The studied properties are fluoride ion release, residual monomers release and mechanical properties. The data analysis was performed using the ANOVA test and Tukey test for post hoc comparisons between groups. During the first day of the fluoride releasing measurement, the following classification resulted: B-F02 ˃ B-F03 ˃ B-F00 ˃ G and at the end of the investigation period, at 60 days: B-F02 ˃ B-F03 ˃ G ˃ B-F00. The experimental giomer released a lower percentage of total residual monomers than the commercial giomers. The highest value for the mechanical properties was recorded for the commercial giomers. The experimental giomer registered the lowest values for mechanical properties but higher than the imposed standard limit. There were statistically significant differences between the analyzed materials, in terms of fluoride releasing, residual monomer releasing and mechanical properties. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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8 pages, 28364 KiB

Open AccessArticle

High-Grade B-Cell Lymphoma Not Otherwise Specified (HGBL, NOS) in the Maxillary Sinus Mimicking Periapical Inflammation: Case Report and Review of the Literature

by Andrea Brody, Csaba Dobo-Nagy, Karoly Mensch, Zsuzsanna Oltyan, Judit Csomor, Mariana Pacurar and Adrienn Dobai

Appl. Sci. 2021, 11(19), 8803; https://doi.org/10.3390/app11198803 - 22 Sep 2021

Cited by 3 | Viewed by 3329

Abstract

High-grade B-cell lymphoma not otherwise specified is listed as a new group in the WHO 2017 statement as a subtype of aggressive, mature B-cell lymphomas with a poor prognosis. To our knowledge, no description of this genetic type of maxillary lymphoma has appeared [...] Read more.

High-grade B-cell lymphoma not otherwise specified is listed as a new group in the WHO 2017 statement as a subtype of aggressive, mature B-cell lymphomas with a poor prognosis. To our knowledge, no description of this genetic type of maxillary lymphoma has appeared in the literature until now; thus, our case provides valuable data on its symptoms, clinical behavior, response to treatment and survival rate. The present report describes the early diagnosis and treatment of an extremely rare histological subtype of B-cell lymphoma, a case of high-grade B-cell lymphoma not otherwise specified, localized in the maxillary sinus and mimicking signs and symptoms of periapical inflammation. After chemotherapy, the presented patient showed complete remission without relapse and systemic spread. As far as we know, this is the first reported case of this rare type of lymphoma associated with the maxillary sinus. Considering that high-grade B-cell lymphomas are aggressive tumors with rapid growth and poor prognosis, which are often misdiagnosed in the early stages as inflammatory disease, it is relevant to highlight the importance of a detailed evaluation of clinical signs and radiological findings during diagnosis, especially if they contradict each other. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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11 pages, 690 KiB

Open AccessArticle

Management of Gingival Bleeding in Periodontal Patients with Domiciliary Use of Toothpastes Containing Hyaluronic Acid, Lactoferrin, or Paraprobiotics: A Randomized Controlled Clinical Trial

by Andrea Butera, Simone Gallo, Carolina Maiorani, Camilla Preda, Alessandro Chiesa, Francesca Esposito, Maurizio Pascadopoli and Andrea Scribante

Appl. Sci. 2021, 11(18), 8586; https://doi.org/10.3390/app11188586 - 15 Sep 2021

Cited by 53 | Viewed by 5705

Abstract

Periodontitis is an irreversible oral disease causing the destruction of tooth-supporting tissues. In addition to scaling and root planing (SRP) procedures, patients should achieve a correct domiciliary oral hygiene in order to maintain a healthy status. The aim of the present study was [...] Read more.

Periodontitis is an irreversible oral disease causing the destruction of tooth-supporting tissues. In addition to scaling and root planing (SRP) procedures, patients should achieve a correct domiciliary oral hygiene in order to maintain a healthy status. The aim of the present study was to evaluate the efficacy of different toothpastes in reducing gingival bleeding in periodontal patients. In addition to a professional treatment of SRP, 80 patients were randomly divided into four groups according to the toothpaste assigned for the daily domiciliary use using an electric toothbrush: Group 1 (Biorepair Gum Protection), Group 2 (Biorepair Plus Parodontgel), Group 3 (Biorepair Peribioma PRO), and Group 4 (Meridol Gum Protection) (control group). After baseline (T0), patients were visited after 15 days (T1), 3 months (T2), and 6 months (T3). At each appointment, the following periodontal indexes were assessed: bleeding on probing (BoP), full-mouth bleeding score (FMBS), and modified sulcus bleeding index (mSBI). All the experimental toothpastes caused an immediate significant modification of the three clinical indexes measured, except for the control product. Biorepair Peribioma PRO, with its paraprobiotic content, was also the only toothpaste causing a prolonged effect, reducing BoP even at T3. Accordingly, both hyaluronic acid and lactoferrin appear as reliable supports for the domiciliary management of periodontal disease. In spite of this, paraprobiotics are likely to show the most important benefit thanks to their immunomodulating mechanism of action. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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11 pages, 1734 KiB

Open AccessArticle

Accuracy and Feasibility of a Zero-Setup Implant Guide System Made of a Light-Cured Composite Resin with Simultaneous Flapless Sinus Augmentation: A Pilot Study

by Jin-Young Park, Joo-Yeon Lee, Joo-Nyeon Kim, Jeong-Won Paik, Jung-Seok Lee, Ui-Won Jung, Seong-Ho Choi and Jae-Kook Cha

Appl. Sci. 2021, 11(17), 8085; https://doi.org/10.3390/app11178085 - 31 Aug 2021

Cited by 2 | Viewed by 1923

Abstract

The aim of this study was to evaluate the accuracy and feasibility of flapless implant placement using a light-cured surgical template made of composite resin comprising dimethacrylate and diurethane, performed simultaneously with crestal sinus augmentation. This pilot study was a prospective, single-armed, controlled [...] Read more.

The aim of this study was to evaluate the accuracy and feasibility of flapless implant placement using a light-cured surgical template made of composite resin comprising dimethacrylate and diurethane, performed simultaneously with crestal sinus augmentation. This pilot study was a prospective, single-armed, controlled clinical trial. Four patients having an edentulous region in the posterior maxilla with 4 to 8 mm of residual ridge height were enrolled. Flapless fully-guided implant placement was performed using a zero-setup surgical template with simultaneous crestal sinus graft. Horizontal, vertical, and angular deviations of the placed implants from the planned positions were measured. Clinical observations were made, and implant stability was measured up to 3 months postoperatively. All four implants were placed and maintained successfully without complication. The mean deviations of the four implants were 1.27 and 1.85 mm horizontally at platform and apex, respectively, 0.84 mm vertically at apex, and 4.76° in angle. Satisfactory implant stability was obtained in all implants at placement and 3 months. Fully-guided implant placement and crestal sinus graft using a zero-setup surgical template can be a safe and feasible method with acceptable accuracy. A randomized controlled trial should be performed in the future to validate its clinical performance in terms of surgical time, accuracy, and patient-reported outcomes. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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13 pages, 6502 KiB

Open AccessArticle

Flabby Ridge, a Challenge for Making Complete Dentures

by Corina-Laura Ştefănescu, Agripina Zaharia, Rodica Maria Murineanu, Cristina Gabriela Puşcaşu, Liliana Sachelarie and Mircea Grigorian

Appl. Sci. 2021, 11(16), 7386; https://doi.org/10.3390/app11167386 - 11 Aug 2021

Cited by 5 | Viewed by 9352

Abstract

In the case of old mobile denture wearers, one of the main problems is related to the dentures’ retention and insufficient stability. Our goal was to improve support and stability using a different type of final impression, with different types of impression materials. [...] Read more.

In the case of old mobile denture wearers, one of the main problems is related to the dentures’ retention and insufficient stability. Our goal was to improve support and stability using a different type of final impression, with different types of impression materials. In this study we chose a number of three complete edentulous patients who presented for complete oral rehabilitation. They were wearing full acrylic dentures with poor support and stability. Complete examination revealed the presence of the flabby ridge. The impression methods for the prosthetic fields with a flabby ridge differ from the classical method by using techniques that involve the use of at least two impression materials with fluid consistency to record all the details of the prosthetic fields in the final impression, this being done in two steps; the impression of the flabby ridge areas must be done without pressure, in its resting position. The impression methods we applied led to the expected results, and the dentures succeeded in offering the patient the desired functional comfort. Using fluid impression material for the flabby ridge in a resting position, and a fenestrated custom tray, offered a good quality in adaptation, maintenance and stability of the final dentures. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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13 pages, 1228 KiB

Open AccessArticle

The Influence of Hard- and Software Improvement of Intraoral Scanners on the Implant Transfer Accuracy from 2012 to 2021: An In Vitro Study

by Alexander Schmidt, Maximiliane Amelie Schlenz, Haoyu Liu, Holger Sebastian Kämpe and Bernd Wöstmann

Appl. Sci. 2021, 11(15), 7166; https://doi.org/10.3390/app11157166 - 3 Aug 2021

Cited by 10 | Viewed by 3089

Abstract

This study aimed to investigate the transfer accuracy (trueness and precision) of three different intraoral scanning families using different hardware and software versions over the last decade from 2012 to 2021, compared to a conventional impression. Therefore, an implant master model with a [...] Read more.

This study aimed to investigate the transfer accuracy (trueness and precision) of three different intraoral scanning families using different hardware and software versions over the last decade from 2012 to 2021, compared to a conventional impression. Therefore, an implant master model with a reference cube was digitized and served as a reference dataset. Digital impressions of all three scanning families (True definition, TRIOS, CEREC) were recorded (n = 10 per group), and conventional implant impressions were taken (n = 10). The conventional models were digitized, and all models (conventional and digital) were measured. Therefore, it was possible to obtain the deviations between the master model and the scans or conventional models in terms of absolute three-dimensional (3D) deviations, deviations in rotation, and angulation. The results for deviations between the older and newer scanning systems were analyzed using pairwise comparisons (p < 0.05; SPSS 26). The absolute 3D deviations increased with increasing scan path length, particularly for the older hardware and software versions (old vs. new (MW ± SD) True Definition: 355 ± 62 µm vs. 483 ± 110 µm; TRIOS: 574 ± 274 µm vs. 258 ± 100 µm; and CEREC: 1356 ± 1023 µm vs. 110 ± 49 µm). This was also true for deviations in rotation and angulation. The conventional impression showed an advantage only regarding the absolute 3D deviation compared to the older systems. Based on the data of the present study, the accuracy of intraoral scanners is decisively related to hardware and software; though, newer systems or software do not necessarily warrant improvement. Nevertheless, to achieve high transfer accuracy, regular updating of digital systems is recommended. The challenge of increasing errors with increasing scan paths is overcome in the most recent systems. The combination of two different scanning principles in a single device seems to be beneficial. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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8 pages, 1359 KiB

Open AccessArticle

The Effect of Mouthrinse with 0.05% Dexamethasone Solution on the Oral Bacterial Community of Oral Lichen Planus Patients: Prospective Pilot Study

by Jeong-Kui Ku, Shin-Young Park, Kyung-Gyun Hwang and Pil-Young Yun

Appl. Sci. 2021, 11(14), 6286; https://doi.org/10.3390/app11146286 - 7 Jul 2021

Cited by 5 | Viewed by 3932

Abstract

Few studies have already been performed to assess oral bacteria during steroid therapy for oral lichen planus (OLP). Thus, the aim of our study was to analyze the effect of dexamethasone mouthrinse treatment on the oral bacteria of OLP patients. This prospective study [...] Read more.

Few studies have already been performed to assess oral bacteria during steroid therapy for oral lichen planus (OLP). Thus, the aim of our study was to analyze the effect of dexamethasone mouthrinse treatment on the oral bacteria of OLP patients. This prospective study was conducted on patients who were diagnosed with OLP and treated with 0.05% dexamethasone mouthrinse twice per day for 4 weeks. Using unstimulated saliva of the patients before and after treatment, the qualitative and quantitative changes in oral bacteria were analyzed using quantitative real-time polymerase chain reaction (qPCR). The qPCR results were analyzed using Wilcoxon signed-rank test to the quantitative changes with dexamethasone mouthrinse. The statistical significance was considered at a level of 0.05. In total, 20 patients were enrolled in this study, wherein all were noted to show improved symptoms of OLP. Fifteen patients (75%) had a qualitative change in the oral microbial species and an improved relative periodontitis risk score (from 26.1 ± 10.7 to 20.9 ± 9.2; p = 0.008). However, quantitative changes in all species were determined to be not statistically different before and after the treatment. Most OLP patients had a changed microbial community composition after 0.05% dexamethasone mouthrinse for 4 weeks. In particular, the composition of the periodontopathic bacteria was improved after the treatment. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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13 pages, 1381 KiB

Open AccessArticle

Comparative Analysis of the Filling Capacity of Simulated Lateral Canals of Two Bioactive Root Canal Sealers Using Warm Gutta-Percha Technique

by Jesús Mena-Álvarez, Juliette Theophanie Sevrain, Mario Zorita-García and Cristina Rico-Romano

Appl. Sci. 2021, 11(14), 6270; https://doi.org/10.3390/app11146270 - 7 Jul 2021

Cited by 2 | Viewed by 2501

Abstract

The aim of this study was to evaluate ex vivo the sealing achieved at simulated lateral canals (SLC) and the quality of filling according to their position in the root canal after using the same filling technique. SLC were created at three levels [...] Read more.

The aim of this study was to evaluate ex vivo the sealing achieved at simulated lateral canals (SLC) and the quality of filling according to their position in the root canal after using the same filling technique. SLC were created at three levels in 55 teeth and divided into two groups depending on the root canal sealer used (1: BioRoot^® RCS, 2: GuttaFlow^® bioseal). They filled them with the continuous wave technique and submitted to a diaphanization technique. The samples were analyzed using a magnifying lens (20×), pictures were taken, which proceeded to linear measurement with the ImageJ^® program and used a filling score system with five grades (0 to 4, 0 and 1 not acceptable, 2 to 4 acceptable); BioRoot^® RCS has got a greater proportion than GuttaFlow^® bioseal for SLC filled acceptably at 10 mm from the apex (p < 0.05). The highest proportion of SLC filled acceptably was found in the middle third (6 mm) (p < 0.05), followed by the apical third (3 mm) and the coronal third (10 mm). The difference between apical and coronal third could be significant; BioRoot^® RCS has been better than GuttaFlow^® bioseal for filling SLC in the coronal third of the teeth. Studies on the characteristics of these cements are missing to explain these differences. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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9 pages, 2510 KiB

Open AccessArticle

Are Saliva Tests Important in the Prediction of Carious Disease?

by Daniela Luminita Ichim, Liliana Sachelarie, Gabriela Calin and Alexandra Burlui

Appl. Sci. 2021, 11(13), 5932; https://doi.org/10.3390/app11135932 - 25 Jun 2021

Cited by 5 | Viewed by 2675

Abstract

(1) Background: The appearance and progression of carious lesions represent a complex phenomenon of interactions of microbial factors (the action of bacteria on the tooth), of the factors related to the host, to the diet, and to the time factor. Which hasan influence [...] Read more.

(1) Background: The appearance and progression of carious lesions represent a complex phenomenon of interactions of microbial factors (the action of bacteria on the tooth), of the factors related to the host, to the diet, and to the time factor. Which hasan influence on the rate of microbismof the oral cavity on the installation of carious disease? (2) Methods: In order to correctly assess the cariogenic risk of an individual, it is recommended to perform twoor more tests based on different principles (microbiological, clinical, epidemiological). The representative data series for the investigation were analyzed statistically and by applying the Pearson correlation test considering the coefficient of determination R for all pairs of data series. (3) Results: Salivary tests played animportant role in establishing control sessions, in carrying out prophylactic caries therapy, and establishing prognosis. The existence of a statistical associationwas confirmed between the prevalence of dental caries and the results of salivary tests for the study group. (4) Conclusions: The results of the saliva tests can be used in oral health promotion. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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13 pages, 2161 KiB

Open AccessArticle

A New Method to Evaluate Trueness and Precision of Digital and Conventional Impression Techniques for Complete Dental Arch

by KweonSoo Seo and Sunjai Kim

Appl. Sci. 2021, 11(10), 4612; https://doi.org/10.3390/app11104612 - 18 May 2021

Cited by 5 | Viewed by 2472

Abstract

Purpose: The aim of this study was to present a new method to analyze the three-dimensional accuracy of complete-arch dental impressions and verify the reliability of the method. Additionally, the accuracies of conventional and intraoral digital impressions were compared using the new method. [...] Read more.

Purpose: The aim of this study was to present a new method to analyze the three-dimensional accuracy of complete-arch dental impressions and verify the reliability of the method. Additionally, the accuracies of conventional and intraoral digital impressions were compared using the new method. Methods: A master model was fabricated using 14 milled polyetheretherketone cylinders and a maxillary acrylic model. Each cylinder was positioned and named according to its corresponding tooth position. Twenty-five definitive stone casts were fabricated using conventional impressions of the master model. An intraoral scanner was used to scan the master model 25 times to fabricate 25 digital models. A coordinate measuring machine was used to physically probe each cylinder in the master model and definitive casts. An inspection software was used to probe cylinders of digital models. A three-dimensional part coordinate system was defined and used to compute the centroid coordinate of each cylinder. Intraclass correlation coefficient (ICC) was evaluated to examine the reliability of the new method. Independent two sample t-test was performed to compare the trueness and precision of conventional and intraoral digital impressions (α = 0.05). Results: ICC results showed that, the new method had almost perfect reliability for the measurements of the master model, conventional and digital impression. Conventional impression showed more accurate absolute trueness and precision than intraoral digital impression for most of the tooth positions (p < 0.05). Conclusions: The new method was reliable to analyze the three-dimensional deviation of complete-arch impressions. Conventional impression was still more accurate than digital intraoral impression for complete arches. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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13 pages, 1477 KiB

Open AccessArticle

Effectiveness of an App-Based Mobile Intervention for Precision Oral Self-Care in Patients with Periodontitis from Initial Therapy to Re-Evaluation

by Wen-Jen Chang, Yen-Li Wang, Yen-Hsiang Chang and Shih-Yin Lo

Appl. Sci. 2021, 11(9), 4229; https://doi.org/10.3390/app11094229 - 7 May 2021

Cited by 4 | Viewed by 2621

Abstract

Good oral hygiene is essential to oral health and oral disease prevention. Strengthening the adherence of patients with periodontitis to oral hygiene behaviors (OHBs) is crucial for the success of periodontal treatment. This study aims to investigate the intervention effectiveness of a novel [...] Read more.

Good oral hygiene is essential to oral health and oral disease prevention. Strengthening the adherence of patients with periodontitis to oral hygiene behaviors (OHBs) is crucial for the success of periodontal treatment. This study aims to investigate the intervention effectiveness of a novel mobile app for precision oral self-care, which was developed to help patients with periodontitis improving their oral hygiene through daily oral self-care. One-hundred and fifty eligible patients were recruited into this study and randomly allocated to the control (n = 75) or intervention group (n = 75), and their oral hygiene status (OHS) and OHBs were recorded at baseline and re-evaluation. The participants in the intervention group were required to perform daily oral self-care using our oral self-care app (OSCA) and the functional preferences and overall likeability of the OSCA were evaluated through a questionnaire survey. In total, 39 patients from the control group and 49 from the intervention group completed clinical examinations at baseline and re-evaluation. The results demonstrated that there was no significant difference in OHS improvement between the two groups. However, OHS improvement significantly differed between low-, moderate-, and high-frequency users, with frequency of use being positively correlated to the likeability of the app. Further investigation of the effectiveness of the OSCA intervention revealed that behavioral change in oral hygiene, frequency of OSCA use, and smoking affected OHS improvement. These outcomes indicate that our app-based mobile intervention may be of value for precision oral self-care in patients with periodontitis. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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8 pages, 966 KiB

Open AccessArticle

Effects of Lithium Chloride and Nitric Oxide Inhibitor on Orthodontic Tooth Movement in the Rat

by Reza Talebian, Farhad Jafari, Ahmad Reza Dehpour and Reinhard Gruber

Appl. Sci. 2021, 11(8), 3607; https://doi.org/10.3390/app11083607 - 16 Apr 2021

Cited by 2 | Viewed by 2532

Abstract

Orthodontic tooth movement in a rodent model is reduced by lithium chloride (LiCl), a mood-stabilizing agent with antithyroid effects. Considering the established inhibitory effect of N(omega)-nitro-L-arginine methyl ester (L-NAME) on orthodontic tooth movement and the possible role of nitric oxide synthase in LiCl [...] Read more.

Orthodontic tooth movement in a rodent model is reduced by lithium chloride (LiCl), a mood-stabilizing agent with antithyroid effects. Considering the established inhibitory effect of N(omega)-nitro-L-arginine methyl ester (L-NAME) on orthodontic tooth movement and the possible role of nitric oxide synthase in LiCl mechanism of action, the question arises if these two mechanisms are synergistic. To answer this question, 70 male Sprague Dawley rats were randomly divided into seven groups: untreated group without any interventions (i), and the orthodontic tooth movement groups receiving daily saline injection (ii), 300 (iii), and 600 mg/kg (iv) of LiCl per os, 10 mg/kg of L-NAME (v) and the combinations of 300 (vi) and 600 mg/kg LiCl (vii) with L-NAME. The first molar was moved towards the incisor with 60 g of mesial tipping force applied by an activated fixed coil spring for two weeks. The resulted distance between the first and the second molar was measured using a feeler gauge. The serum parameters were also determined. We report here that both concentrations of LiCl significantly decreased tooth movement. Even though L-NAME was capable of reducing orthodontic tooth movement, no synergistic effects with LiCl were observed. Moreover, L-NAME had no impact on the robust and significant increase of thyroid-stimulating hormone (TSH) and decrease of triiodothyronine (T3) and thyroxine (T4) in the LiCl treated rats. These findings suggest LiCl significantly decreases the orthodontic tooth movement in rats; however, this ability seems not to be principally mediated through nitric oxide synthase. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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14 pages, 3145 KiB

Open AccessArticle

A Repeatable and Reproducible Digital Method to Quantify the Cement Excess and Enamel Loss after Debonding Lingual Multibracket Appliance Therapy

by Alba Belanche Monterde, Alberto Albaladejo Martínez, Alfonso Alvarado Lorenzo, Adrián Curto, Jorge Alonso Pérez-Barquero, Clara Guinot-Barona and Álvaro Zubizarreta-Macho

Appl. Sci. 2021, 11(3), 1295; https://doi.org/10.3390/app11031295 - 1 Feb 2021

Cited by 2 | Viewed by 2276

Abstract

The aim of the present study is to present a repeatable, reproductible, and accurate morphometric measurement method for measuring and quantifying the area and volume of cement that remains after fixed lingual multibracket appliance debonding, enamel loss after fixed lingual multibracket appliance debonding, [...] Read more.

The aim of the present study is to present a repeatable, reproductible, and accurate morphometric measurement method for measuring and quantifying the area and volume of cement that remains after fixed lingual multibracket appliance debonding, enamel loss after fixed lingual multibracket appliance debonding, and the volume of cement used to adhere fixed lingual multibracket appliances. Ten conventional lingual brackets were cemented in 10 extracted teeth embedded into an epoxy resin model simulating a dental arch. This model was scanned before and after bonding the lingual brackets, after debonding, and after polishing the surfaces. We also performed a Micro-Computed Tomography scan of the lingual brackets used. Afterward, the standard tessellation language (STL) digital file was aligned, each tooth was segmented individually, and the file was re-aligned using engineer morphometry software. Inter-operator and intra-operator comparative analyses were performed using the ANOVA test, and the repeatability and reproducibility of the morphometric measurement technique were analyzed using Gage R&R statistical analysis. Repeatability showed 0.07% and 0.16% variability associated with the area and volume measures, respectively, while reproducibility showed 0.00% variability associated with the area and volume measures, respectively. In conclusion, the morphometric measurement technique is a repeatable, reproductible, and accurate morphometric measurement method for quantifying the area and volume of cement that remains after fixed lingual multibracket appliance debonding, enamel loss after fixed lingual multibracket appliance debonding, and the volume of cement used to adhere fixed lingual multibracket appliances. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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11 pages, 2397 KiB

Open AccessArticle

A Novel Digital Technique to Quantify the Area and Volume of Enamel Removal after Interproximal Enamel Reduction

by Martina Triduo, Álvaro Zubizarreta-Macho, Jorge Alonso Pérez-Barquero, Clara Guinot Barona, Alfonso Alvarado Lorenzo, Purificación Vicente-Galindo and Alberto Albaladejo Martínez

Appl. Sci. 2021, 11(3), 1274; https://doi.org/10.3390/app11031274 - 30 Jan 2021

Cited by 3 | Viewed by 2164

Abstract

The aim of this study was to show a novel and accurate digital measurement protocol by analyzing the area and volume for interproximal tooth enamel surface reduction. In total, 14 lower teeth from all dental sectors were embedded into an epoxy resin and [...] Read more.

The aim of this study was to show a novel and accurate digital measurement protocol by analyzing the area and volume for interproximal tooth enamel surface reduction. In total, 14 lower teeth from all dental sectors were embedded into an epoxy resin and distributed as the lower dental arch, keeping the contact points. The experimental model was submitted to an intraoral digital impression before and after interproximal tooth enamel surface reduction using air-rotor strips and then re-contouring and polishing the interproximal enamel surfaces. These steps helped obtain standard tessellation language (STL) digital files. Furthermore, each tooth in the preoperative and postoperative full-arch STL digital files was segmented individually and aligned to analyze the area and volume of the interproximal tooth enamel surface reduction using engineering morphometry software. Descriptive analysis of the area and volume of the interproximal tooth enamel surface reduction was performed using a Student t-test. Higher enamel reduction area (3.53 ± 3.08 mm²) and volume (0.32 ± 0.22 mm³) values were shown on the distal surface compared with the area (2.97 ± 3.05 mm²) and volume (0.22 ± 0.16 mm³) of the enamel reduction on the mesial surface measured using the morphometric measurement digital protocol. The morphometric measurement protocol is an accurate digital measurement protocol for analyzing the area and volume of interproximal enamel surface reduction. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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16 pages, 2137 KiB

Open AccessArticle

Anatomical Risk Factors of Inferior Alveolar Nerve Injury Association with Surgical Extraction of Mandibular Third Molar in Korean Population

by Hee Jin Kim, Ye Joon Jo, Jun Seok Choi, Hyo Joon Kim, Jin Kim and Seong Yong Moon

Appl. Sci. 2021, 11(2), 816; https://doi.org/10.3390/app11020816 - 16 Jan 2021

Cited by 15 | Viewed by 17701

Abstract

The purpose of this study was to analyze the incidence and risk factors of possible inferior alveolar nerve (IAN) injury after extraction of the mandibular third molars. A total of 6182 patients were examined for 10,310 mandibular third molar teeth. Panoramic radiography and [...] Read more.

The purpose of this study was to analyze the incidence and risk factors of possible inferior alveolar nerve (IAN) injury after extraction of the mandibular third molars. A total of 6182 patients were examined for 10,310 mandibular third molar teeth. Panoramic radiography and patients’ medical records were used to analyze age, gender, and impaction pattern of the mandibular third molar. Cone beam computed tomography (CBCT) was used to investigate the detailed pathway of the inferior alveolar nerve and evaluated the presence of symptoms of nerve damage after tooth extraction. In CBCT, 6283 cases (61%) of the inferior alveolar nerve were actually in contact with the root of the mandibular third molar. The correlation with the panoramic signs of root darkening (p < 0.001), root deflection (p < 0.001), interruption of the IAN (p < 0.001), diversion of the IAN (p < 0.001), and narrowing of the IAN (p < 0.001) had statistical significance. Of the 4708 patients who underwent surgical extraction, 31 (0.658%) complained of nerve damage. Among them, 30 patients (0.637%) complained of symptoms of inferior alveolar nerve damage, and 1 patient (0.02%) complained of symptoms of lingual nerve damage. There was a significant correlation with IAN injury in cases where the roots became dark at the IAN area (p = 0.018) and there was diversion of the IAN at the root area (p = 0.041). When the narrowing of the IAN and the lingual driving pathway of the inferior alveolar nerve appeared simultaneously in CBCT, the risk of IAN injury was high. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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14 pages, 2303 KiB

Open AccessEditor’s ChoiceArticle

The Effect of Chairside Verbal Instructions Matched with Instagram Social Media on Oral Hygiene of Young Orthodontic Patients: A Randomized Clinical Trial

by Andrea Scribante, Simone Gallo, Karin Bertino, Stefania Meles, Paola Gandini and Maria Francesca Sfondrini

Appl. Sci. 2021, 11(2), 706; https://doi.org/10.3390/app11020706 - 13 Jan 2021

Cited by 30 | Viewed by 4116

Abstract

Objective: To investigate the effectiveness of Instagram in improving oral hygiene compliance and knowledge in young orthodontic patients compared to traditional chairside verbal instructions. Design: Single-center, parallel, randomized controlled trial. Setting: Section of Dentistry of University of Pavia. Participants: 40 patients having fixed [...] Read more.

Objective: To investigate the effectiveness of Instagram in improving oral hygiene compliance and knowledge in young orthodontic patients compared to traditional chairside verbal instructions. Design: Single-center, parallel, randomized controlled trial. Setting: Section of Dentistry of University of Pavia. Participants: 40 patients having fixed appliances in both arches were recruited and randomly divided into an intervention (n = 20) and a control group (n = 20). Intervention: At a first appointment, both groups were given verbal instructions and motivated to oral hygiene. In addition, multimedia contents on Instagram were sent weekly to trial participants for six months. Main outcome measures: For all participants, the bleeding index (BI), modified gingival index (MGI), and plaque index (PI) were assessed at baseline (T0), after one (T1), three (T2), and six months (T3). A questionnaire was administered at the beginning (T0) and at the end of the study (T3) to assess participants’ knowledge. Results: In both groups, BI, MGI, and PI significantly decreased (p < 0.05) at T1 (means control group: BI 0.26 ± 0.22, MGI 0.77 ± 0.36, PI 0.53 ± 0.20; means test group: BI 0.24 ± 0.22, MGI 0.65 ± 0.46, PI 0.49 ± 0.21) compared to baseline (means control group: BI 0.56 ± 0.27, MGI 1.23 ± 0.41, PI 0.87 ± 0.23; means test group: BI 0.54 ± 0.26, MGI 1.18 ± 0.39, PI 0.93 ± 0.20) but no significant differences in clinical measures were showed between T1, T2, and T3 (p > 0.05) (intragroup differences). Trial patients demonstrated significant improvements in knowledge with respect to controls comparing scores at T0 and T3 (p < 0.05) but despite this result in the test group clinical outcomes did not report significant intergroup differences at any time (p > 0.05). Conclusions: Presenting multimedia information through Instagram resulted in a significant improvement in knowledge. Therefore, this social media represents an aid to the standard verbal motivation performed by orthodontists towards young patients under an orthodontic treatment. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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12 pages, 2018 KiB

Open AccessArticle

Evaluation of IL1β and IL6 Gingival Crevicular Fluid Levels during the Early Phase of Orthodontic Tooth Movement in Adolescents and Young Adults

by Simina Chelărescu, Petra Șurlin, Mioara Decusară, Mădălina Oprică, Eugen Bud, Elina Teodorescu, Mahmoud Nabil Elsaafin and Mariana Păcurar

Appl. Sci. 2021, 11(2), 521; https://doi.org/10.3390/app11020521 - 7 Jan 2021

Cited by 5 | Viewed by 2763

Abstract

Background: The crevicular fluid analysis represents a useful diagnosis tool, with the help of which noninvasive cellular metabolic activity can be analyzed. The aim of the study is to investigate comparatively IL1β and IL6 in the gingival crevicular fluid of clinically healthy adolescents [...] Read more.

Background: The crevicular fluid analysis represents a useful diagnosis tool, with the help of which noninvasive cellular metabolic activity can be analyzed. The aim of the study is to investigate comparatively IL1β and IL6 in the gingival crevicular fluid of clinically healthy adolescents and young adults during the acute phase of orthodontic treatment. Methods: Gingival crevicular fluid was collected from 20 patients (aged between 11 and 28) undergoing orthodontic treatment. Measurements were taken before (T0) and after 24 h after distalization forces were activated (T1). IL1β and IL 6 were analyzed using Elisa tests. The statistical tests used were two-sided t tests. Results: Between the two time periods there was a significant raise both in the crevicular fluid rate (0.57 µL at T0 vs. 0.95 µL at T1, p = 0.001) and in IL1β levels (15.67 pg/µL at T0 vs. 27.94 pg/µL at T1, p = 0.009). We were able to identify IL6 only in a third of the sites. There is a significantly increased level of ILβ at T1 in adolescents, more than in young adults (42.96 pg/µL vs. 17.93 pg/µL, p = 0.006). Conclusions: In the early stage of orthodontic treatment, the periodontal tissues of adolescents are more responsive to orthodontic forces than those of young adults. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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Review

Jump to: Editorial, Research, Other

15 pages, 939 KiB

Open AccessReview

BMP-2 Delivery through Liposomes in Bone Regeneration

by Noemi Dirzu, Ondine Lucaciu, Dan Sebastian Dirzu, Olga Soritau, Diana Cenariu, Bogdan Crisan, Lucia Tefas and Radu Septimiu Campian

Appl. Sci. 2022, 12(3), 1373; https://doi.org/10.3390/app12031373 - 27 Jan 2022

Cited by 10 | Viewed by 3665

Abstract

Bone regeneration is a central focus of maxillofacial research, especially when dealing with dental implants or critical sized wound sites. While bone has great regeneration potential, exogenous delivery of growth factors can greatly enhance the speed, duration, and quality of osseointegration, making a [...] Read more.

Bone regeneration is a central focus of maxillofacial research, especially when dealing with dental implants or critical sized wound sites. While bone has great regeneration potential, exogenous delivery of growth factors can greatly enhance the speed, duration, and quality of osseointegration, making a difference in a patient’s quality of life. Bone morphogenic protein 2 (BMP-2) is a highly potent growth factor that acts as a recruiting molecule for mesenchymal stromal cells, induces a rapid differentiation of them into osteoblasts, while also maintaining their viability. Currently, the literature data shows that the liposomal direct delivery or transfection of plasmids containing BMP-2 at the bone wound site often results in the overexpression of osteogenic markers and result in enhanced mineralization with formation of new bone matrix. We reviewed the literature on the scientific data regarding BMP-2 delivery with the help of liposomes. This may provide the ground for a future new bone regeneration strategy with real chances of reaching clinical practice. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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11 pages, 296 KiB

Open AccessReview

Review of Professionally Applied Fluorides for Preventing Dental Caries in Children and Adolescents

by Aneta Munteanu, Alina-Maria Holban, Mihaela-Rodica Păuna, Marina Imre, Alexandru-Titus Farcașiu and Cătălina Farcașiu

Appl. Sci. 2022, 12(3), 1054; https://doi.org/10.3390/app12031054 - 20 Jan 2022

Cited by 27 | Viewed by 14626

Abstract

This review aims to evaluate the effectiveness of professional topical fluoride application on the prevention of dental caries in primary and permanent dentition. A web search was conducted for English papers published from 2000 to 2020, using various digital resources (Pubmed, Google Scholar, [...] Read more.

This review aims to evaluate the effectiveness of professional topical fluoride application on the prevention of dental caries in primary and permanent dentition. A web search was conducted for English papers published from 2000 to 2020, using various digital resources (Pubmed, Google Scholar, Cochrane Library, and ResearchGate). The keywords were “professionally applied fluoride”, “fluoride gel”, “fluoride varnish”, “fluoride foam”, “fluoride mouthrinses”, and “non-cavitated caries lesions”. Inclusion criteria: (a) participants: children and adolescents, treated in a dental care setting; (b) intervention: professionally applied fluorides (gel, varnish, foam, mouthrinse); (c) comparator: no professional treatment or other preventive treatments; (d) outcomes: clinical effectiveness (e.g., caries reduction, tooth remineralization); (e) study design: randomized controlled trials, systematic reviews, meta-analyses; (f) publication period: 1 January 2000–31 December 2021. Clinical studies about home-use fluoride products, discussion papers, in-vitro studies, case reports, non-English articles, and studies with unclear methodology were excluded. Topical fluoride applications are indicated for patients with active smooth surface caries and for patients in high caries risk groups. Both APF gel and fluoride varnish are effective and can be recommended for caries prevention in primary and permanent teeth. For children under the age of 6, only 2.26% fluoride varnish is recommended. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

17 pages, 398 KiB

Open AccessReview

Antibiotic Prophylaxis in the Prevention of Postoperative Infections in Mandibular Third Molar Extractions: Systematic Review and Meta-Analysis

by Saturnino Marco Lupi, Giorgia Olivieri, Jessica Landini, Andrea Ferrigno, Plinio Richelmi, Claudia Todaro and Ruggero Rodriguez y Baena

Appl. Sci. 2021, 11(20), 9449; https://doi.org/10.3390/app11209449 - 12 Oct 2021

Cited by 3 | Viewed by 2657

Abstract

Background: This systematic review and meta-analysis aims to evaluate the effectiveness of antibiotic prophylaxis in the prevention of surgical wound infection (SWI) following mandibular third molar extraction. Methods: A systematic search on electronic databases and a manual search on paper journals was carried [...] Read more.

Background: This systematic review and meta-analysis aims to evaluate the effectiveness of antibiotic prophylaxis in the prevention of surgical wound infection (SWI) following mandibular third molar extraction. Methods: A systematic search on electronic databases and a manual search on paper journals was carried out. Two independent reviewers selected the studies. The onset of SWI was used as the main outcome. The data from the studies were analyzed, both with the fixed and the random models, according to the type of antibiotic and the method of administration; a further stratification was adopted, if possible, based on surgical difficulty. The risk of bias and heterogeneity were evaluated. Results: 15 studies were included. Antibiotic prophylaxis, especially in pre-surgical administration and in case of osteotomy, is effective in the prevention of SWI in case of mandibular third molar extraction. Post-surgical administration of prophylaxis, although effective, does not seem to be fully supported by the literature. Pre- and post-surgical prophylaxis did not demonstrate superiority compared to pre-surgical administration alone. Conclusions: Antibiotic prophylaxis is effective in reducing SWI after third molar extraction; pre-surgical administration, minimizing antibiotics administration, allows one to reduce complications related to antibiotic and risk of onset of antibiotic resistance. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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8 pages, 2255 KiB

Open AccessCase Report

Removal of Inflammatory Tissue/Product by Sinus Membrane Puncturing during Lateral Sinus Augmentation in Asymptomatic Patients with Severely Opacified Sinuses: A Case Series

by Won-Bae Park, Jung Soo Park, Ji-Young Han, Seung-Il Shin and Hyun-Chang Lim

Appl. Sci. 2021, 11(24), 11831; https://doi.org/10.3390/app112411831 - 13 Dec 2021

Cited by 3 | Viewed by 2784

Abstract

It is generally recommended that severe sinus membrane (SM) thickening should be treated prior to maxillary sinus augmentation (MSA), but during lateral MSA, inflammatory tissue/product may be removed by puncturing the SM. The present case report demonstrates surgical experience of lateral MSA with [...] Read more.

It is generally recommended that severe sinus membrane (SM) thickening should be treated prior to maxillary sinus augmentation (MSA), but during lateral MSA, inflammatory tissue/product may be removed by puncturing the SM. The present case report demonstrates surgical experience of lateral MSA with simultaneous inflammatory tissue/product removal for sinuses with severe opacification. In three patients requiring dental implant placement in the posterior maxilla, severe SM thickening was observed, but they were asymptomatic. The SM was gently elevated, followed by puncturing the SM, removing inflammatory tissue via the punctured site, draining, and thorough saline irrigation. Then, bone grafting and implant placement were performed with extra care not to spread bone substitute material into the punctured area. The postoperative pain following this procedure was more severe as compared to conventional MSA. Nasal bleeding was reported for 2–3 days. All implants were successfully integrated and demonstrated adequate function. Tissue samples retrieved during the surgery showed advanced inflammatory cell infiltration. The follow-up cone-beam computed tomographic scans revealed a significant reduction in SM thickening. In conclusion, inflammatory tissue/product removal by puncturing the SM can be applied during lateral MSA. However, more data should be needed due to the empirical nature of the present outcomes. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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14 pages, 579 KiB

Open AccessSystematic Review

Application of Immediate Loaded Mini Dental Implants for Retaining Mandibular Overdenture Prosthesis in Edentulous Patients: A Systematic Review

by Abdulaziz A. AlHelal

Appl. Sci. 2021, 11(22), 10724; https://doi.org/10.3390/app112210724 - 13 Nov 2021

Cited by 2 | Viewed by 2178

Abstract

The aim was to systematically review the efficacy of immediate loaded mini dental implants (MDIs) to retain mandibular overdentures in regards to survival rates of MDIs, peri-implant clinical and radiographic tissue response and associated factors. A literature search of English literature was performed [...] Read more.

The aim was to systematically review the efficacy of immediate loaded mini dental implants (MDIs) to retain mandibular overdentures in regards to survival rates of MDIs, peri-implant clinical and radiographic tissue response and associated factors. A literature search of English literature was performed using Google Scholar, Scopus, Web of Science, MEDLINE (OVID), EMBASE, and PubMed using predetermined inclusion criteria. Specific terms were utilized in searching from the inception of the respective databases up to April 2021. The focused question was: Do immediate loaded MDIs supporting mandibular overdentures present favorable treatment options for prosthetic rehabilitation? The 11 articles included in the present review examined 349 patients (198 males + 171 females [66.65 ± 6.28 years]) in which 1190 MDIs were placed to retain mandibular overdentures. The mean follow-up duration was 24.5 months. The cumulative survival rate of MDIs was 97.3%. The mean scores of plaque index, gingival index, probing depth, and bleeding on probing ranged between 0–3, 0–3, and 1.203–1.76 respectively, whereas the mean marginal bone loss values ranged from 0.42 ± 0.56 mm to 1.26 ± 0.64 mm. The results identified that the application of immediate loaded MDIs to retain mandibular overdentures are a potential treatment modality for edentulous patients. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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9 pages, 3619 KiB

Open AccessCase Report

Radiographic and Histologic Analysis 1–2 Years after Alveolar Ridge Preservation in Maxillary Premolar and Molar: A Case Report

by Sung-Wook Yoon, Young Woo Song, Ui-Won Jung and Jae-Kook Cha

Appl. Sci. 2021, 11(14), 6591; https://doi.org/10.3390/app11146591 - 17 Jul 2021

Cited by 1 | Viewed by 2265

Abstract

After tooth extraction, notable ridge alterations occur due to resorption of bundle bones during the healing process. In areas with thin or damaged socket walls and multiple adjacent tooth extraction, dimensional changes are more prominent in the marginal proportion. In addition to the [...] Read more.

After tooth extraction, notable ridge alterations occur due to resorption of bundle bones during the healing process. In areas with thin or damaged socket walls and multiple adjacent tooth extraction, dimensional changes are more prominent in the marginal proportion. In addition to the marginal changes, upper molar teeth are also vulnerable to pneumatization of the maxillary sinus. To reduce dimensional changes in extraction sockets, alveolar ridge preservation (ARP) is favored by many clinicians in areas where a large amount of dimensional change is expected. This case report presents two cases of ARP using collagenated demineralized bovine bone mineral and demineralized porcine bone mineral in the apically involved upper premolar and molar, respectively. Implants were placed one and two years, respectively, after the ARP. Radiographic analyses of residual bone height and volume were measured using cone-beam-computed tomography (CBCT) and histologic analysis of newly formed mineralized bone and residual graft material percentages were measured from the collected tissue samples using a trephine bur. Implants were placed using a simple technique, without any additional bone grafts at the marginal proportion. The ARP technique could maintain the alveolar bone height and volume, as well as minimize the invasiveness of surgical procedures during implant surgery. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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7 pages, 2096 KiB

Open AccessCase Report

Excision of Lower Lip Mucocele Using Injection of Hydrocolloid Dental Impression Material in a Pediatric Patient: A Case Report

by Gianluca Botticelli, Marco Severino, Gianmaria Fabrizio Ferrazzano, Pedro Vittorini Velasquez, Carlo Franceschini, Carlo Di Paolo, Roberto Gatto and Giovanni Falisi

Appl. Sci. 2021, 11(13), 5819; https://doi.org/10.3390/app11135819 - 23 Jun 2021

Cited by 3 | Viewed by 11904

Abstract

Oral mucocele is a benign cystic exophytic lesion affecting the minor salivary gland and is especially present in pediatric patients (3% under 14 years). It is characterized by an extravasation or retention of fluid or mucus in the submucosal tissue of the minor [...] Read more.

Oral mucocele is a benign cystic exophytic lesion affecting the minor salivary gland and is especially present in pediatric patients (3% under 14 years). It is characterized by an extravasation or retention of fluid or mucus in the submucosal tissue of the minor salivary glands. Several surgical techniques have been proposed over the years, including the excision of the mucocele by using the injection of a hydrocolloid impression material in the light of the cyst to prevent the collapse of the cystic wall and solidify the lesion, resulting in a better cleavage plan. The combined clinical approach between the combination of Shira’s technique and the surgical excision of the cystic lesion results in a conservative surgical removal of the lesion. Here, we reported the removal of a labial mucocele in a 14-year-old male patient, using the injection of a hydrocolloid impression material. At a 12 months follow up, the patient showed complete healing of the surgical site, showing a pinkish lip lining mucosa without scarring or recurrence of the primary lesion. The combined therapeutic approach between Shira’s technique and surgical excision allows a safe and predictable excision of the labial mucocele, minimizing the risk of recurrence. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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14 pages, 4471 KiB

Open AccessCase Report

Clinical Outcome of a New Surgical Technique for the Treatment of Peri-Implant Dehiscence in the Esthetic Area. A Case Report

by Norberto Quispe-López, Carmen García-Faria, Jesús Mena-Álvarez, Yasmina Guadilla, Pablo Garrido Martínez and Javier Montero

Appl. Sci. 2021, 11(11), 4781; https://doi.org/10.3390/app11114781 - 23 May 2021

Cited by 3 | Viewed by 4836

Abstract

This study describes the clinical and esthetic outcome of n apical surgical treatment on peri-implant soft tissue dehiscence in an implant with a poor prognosis in the esthetic area. The patient presented a compromised situation of clinical attachment loss both in the 1.2 [...] Read more.

This study describes the clinical and esthetic outcome of n apical surgical treatment on peri-implant soft tissue dehiscence in an implant with a poor prognosis in the esthetic area. The patient presented a compromised situation of clinical attachment loss both in the 1.2 implant and in the adjacent teeth. A biphasic approach consisted firstly of a connective tissue graft accessed by apical and then, 11 months later, a palatal flap technique plus a connective tissue graft. After 20 months of healing, surgical approaches without vertical releasing incisions showed a gain in recession reduction over the implant ranging from 0.3 to 2.7 mm (CI 95%), in addition to a gain in width (2 mm) and thickness (2.3 mm) of the keratinized mucosa. With respect to the white esthetic score, 4 points were gained, and with respect to the pink esthetic score, 3 points were gained. With the use of the apical approach technique and the palatal flap technique, satisfactory results are obtained in the treatment of recessions on implants, improving the amount of keratinized mucosa and the esthetic result in an objective manner in the anterior area. Full article

(This article belongs to the Special Issue Clinical Applications for Dentistry and Oral Health)

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