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Dent. J., Volume 12, Issue 5 (May 2024) – 29 articles

Cover Story (view full-size image): Despite reductions in bacterial infection and an enhanced success rate, the widespread use of systemic antibiotic prophylaxis in implant dentistry is controversial. The excessive use of antibiotics has contributed to antimicrobial resistance, with significant health and economic burdens. This review aims to summarize advanced biomaterial strategies applied to implant components based on anti-pathogenic mechanisms and immune balance mechanisms. The fundamental pathogenic mechanisms underlying implant infection serve as targets for innovative preventive and therapeutic strategies that can also lead to the reduction in systemic antibiotic exposure and its associated adverse effects. Modifying the dental implant surface and regulating the early immune response are promising strategies, which may further prevent or slow the development of peri-implant infection, and subsequent failure. View this paper
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14 pages, 3604 KiB  
Systematic Review
The Treatment and Management of Oroantral Communications and Fistulas: A Systematic Review and Network Metanalysis
by Stefano Oliva, Felice Lorusso, Antonio Scarano, Maurizio D’Amario and Giovanna Murmura
Dent. J. 2024, 12(5), 147; https://doi.org/10.3390/dj12050147 - 20 May 2024
Viewed by 547
Abstract
Objectives: The aim of this work was to systematically review and carry out a statistical metanalysis to identify the best treatment for close oroantral communications and fistulas and to avoid the risk of recurrence. Materials and Methods: An electronic search was conducted on [...] Read more.
Objectives: The aim of this work was to systematically review and carry out a statistical metanalysis to identify the best treatment for close oroantral communications and fistulas and to avoid the risk of recurrence. Materials and Methods: An electronic search was conducted on the MEDLINE database (Pubmed), Scopus, and Google scholar using the following keywords: “oro antral communication (OAC)” OR “oro antral fistula (OAF)” OR “antro-oral communication” OR “communication between maxillary sinus and oral cavity” OR “oro-sinusal communication” OR “oro-sinusal fistula” OR “sinus communication” OR “sinus fistula” OR “antral communication” AND “treatment” OR “management” OR “surgical treatment” OR “surgical interventions”. This work was performed in accordance with the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses). After article screening, 9 RCTs (randomized controlled trials), comparing two or more techniques, were included in this review. Results: A statistically significant difference was detected in favor of the buccal fat pad compared to the buccal advancement flap and palatal rotational flap. Conclusions: With the limitations of this study, the buccal fat pad showed the best results in terms of communication closure and reducing the risk of relapse. Full article
(This article belongs to the Section Oral and Maxillofacial Surgery)
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16 pages, 1466 KiB  
Article
Glycolysis and Automated Plaque Regrowth Method for Evaluation of Antimicrobial Performance
by Robert L. Karlinsey and Tamara R. Karlinsey
Dent. J. 2024, 12(5), 146; https://doi.org/10.3390/dj12050146 - 17 May 2024
Viewed by 623
Abstract
Purpose: This study explored the potential of a new in vitro method in evaluating antiplaque benefits from five sets of antimicrobial systems including cetylpyridinium chloride (CPC), stannous fluoride (SnF2), Listerine essential oil mouthwashes (+/− alcohol), zinc chloride (ZnCl2), and [...] Read more.
Purpose: This study explored the potential of a new in vitro method in evaluating antiplaque benefits from five sets of antimicrobial systems including cetylpyridinium chloride (CPC), stannous fluoride (SnF2), Listerine essential oil mouthwashes (+/− alcohol), zinc chloride (ZnCl2), and sodium fluoride. (NaF). Methods: Gingival dental plaque was collected and propagated using sterilized tryptic soy broth and sucrose, and then allocated into separate glycolysis and regrowth recipes for antiplaque evaluations. Glycolysis measurements (in duplicate) were recorded via pH microelectrode on plaque-treatment samples thermomixed (1200 rpm, 37 °C) for 4 h. For plaque regrowth, optical densities (in duplicate) were automatically collected on plaque-treatment samples using a microplate reader (linear shaking, 37 °C) from baseline to 4 h. Results: Calculations of percent change in pH and optical density were performed and analyzed for each set of antimicrobial treatment groups. Statistical analysis (one-way ANOVA, Student–Newman–Keuls stepwise comparison tests) revealed dose responses and significant differences (p < 0.05) among treatment groups, including between negative and clinically relevant positive controls. Conclusions: This lab method produces results consistent with published clinical observations. This glycolysis and plaque growth method is sensitive to antimicrobial mechanisms of action, and may offer a convenient and clinically relevant screening tool in the evaluation of putative antimicrobial agents and formulations. Full article
(This article belongs to the Special Issue Preventive Dentistry and Dental Public Health)
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16 pages, 2528 KiB  
Systematic Review
Orally Derived Stem Cell-Based Therapy in Periodontal Regeneration: A Systematic Review and Meta-Analysis of Randomized Clinical Studies
by Alessandro Campagna, Giacomo Baima, Federica Romano, Federico Amoroso, Federico Mussano, Giacomo Oteri, Mario Aimetti and Matteo Peditto
Dent. J. 2024, 12(5), 145; https://doi.org/10.3390/dj12050145 - 16 May 2024
Viewed by 611
Abstract
The present systematic review was performed to assess the application of orally derived stem cells in periodontal regenerative therapy, and because of this, the following PICO question was proposed: “In patients with periodontitis, can the adjunctive use of orally derived stem cells provide [...] Read more.
The present systematic review was performed to assess the application of orally derived stem cells in periodontal regenerative therapy, and because of this, the following PICO question was proposed: “In patients with periodontitis, can the adjunctive use of orally derived stem cells provide additional clinical and radiographic benefits for periodontal regeneration?”. Randomized clinical studies were electronically and manually searched up until December 2023. Quantitative analyses were performed with the aim of evaluating the mean differences (MDs) between the treatment and control groups in terms of clinical attachment level (CAL) gain, probing pocket depth (PPD) reduction, gingival recession (GR), and radiographic bone gain (RBG) using random effect models. A total of seven studies were selected for the systematic review. Meta-analyses excluding studies with a high risk of bias highlighted a non-statistically significant result for the use of stem cells when compared to the control groups in terms of CAL gain [MD = 1.05; 95% CI (−0.88, 2.97) p = 0.29] and PPD reduction [MD = 1.32; 95% CI (−0.25, 2.88) p = 0.10]. The same also applied to GR [MD = −0.08; 95% CI (−0.79, 0.63) p = 0.83] and RBG [MD = 0.50; 95% CI (−0.88, 1.88) p = 0.48]. Based on the high heterogeneity, there is not enough evidence to consider the adjunctive application of orally derived mesenchymal stem cells as a preferential approach for periodontal regenerative treatment, as compared to standard procedures. Full article
(This article belongs to the Special Issue Periodontal Health: Disease Prevention and Treatment)
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18 pages, 1457 KiB  
Article
A Low-Cost Protocol Using the Adjunctive Action of Povidone–Iodine Irrigations and Sodium Hypochlorite Rinsing Solution in Step 2 of Periodontal Therapy for Patients with Stage III–IV Periodontitis: A Single-Blind, Randomized Controlled Trial
by Georgios Kardaras, Ruxandra Christodorescu, Marius Boariu, Darian Rusu, Alla Belova, Salvatore Chinnici, Octavia Vela, Viorelia Radulescu, Simina Boia and Stefan-Ioan Stratul
Dent. J. 2024, 12(5), 144; https://doi.org/10.3390/dj12050144 - 15 May 2024
Viewed by 724
Abstract
In severe stages of periodontitis, conventional periodontal therapy and maintenance care are usually insufficient due to the viral and bacterial etiology; thus, a mechanical approach alone may not be sufficient to eliminate a substantial portion of subgingival pathogens, especially in deep periodontal sites. [...] Read more.
In severe stages of periodontitis, conventional periodontal therapy and maintenance care are usually insufficient due to the viral and bacterial etiology; thus, a mechanical approach alone may not be sufficient to eliminate a substantial portion of subgingival pathogens, especially in deep periodontal sites. Background and Objectives: This single-blind, randomized clinical trial aimed to compare the clinical and microbiological efficacy of a low-cost protocol using povidone–iodine and sodium hypochlorite formulations as adjuncts to non-surgical therapy for patients with stage IV periodontitis when compared with chlorhexidine, the most commonly employed substance to date for antimicrobial regimens in periodontal therapy. Materials and Methods: Forty-five patients were randomly divided into two groups: control (subgingival instrumentation, chlorhexidine-assisted) and test (antiviral medication, subgingival instrumentation with povidone–iodine, sodium hypochlorite rinsing solution, and antibiotics). Clinical measurements and microbiological analyses were performed at baseline and after three months. Results: After three months, notable differences were found in the bacterial detection scores for Porphyromonas gingivalis (a significant reduction in detection frequency was observed in the test compared to the control (p = 0.021)), and there were significant reductions in detection in the test group for Tannerella forsythia and Treponema denticola, showing undetectable levels (p < 0.0001 for both). In the test group, the pocket probing depth median value was reduced significantly (p = 0.0005); similarly, bleeding on probing showed a marked decrease (p < 0.0001). However, changes in clinical attachment loss and full-mouth plaque score were not statistically significant. Conclusions: Using the proposed protocol, substantial improvements in clinical and microbiological parameters were obtained when compared with the current antimicrobial recommendations. Full article
(This article belongs to the Special Issue Advances in Periodontal and Peri-Implant Tissues Health Management)
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18 pages, 3218 KiB  
Systematic Review
Is There Variation in the Morphology of the Frontal Sinus in Individuals with Different Craniofacial Patterns? A Systematic Review with Meta-Analysis
by Erika Calvano Küchler, Maria Beatriz Carvalho Ribeiro de Oliveira, Isabela Ribeiro Madalena, Christian Kirschneck, Svenja Beisel-Memmert, Daniela Silva Barroso de Oliveira, Ângela Graciela Deliga Schroder, César Penazzo Lepri, Maria Angélica Hueb de Menezes-Oliveira and Guido Artemio Marañón-Vásquez
Dent. J. 2024, 12(5), 143; https://doi.org/10.3390/dj12050143 - 15 May 2024
Viewed by 535
Abstract
To evaluate differences in the morphology of the frontal sinus in adolescents and adults with different craniofacial patterns, searches up to April 2024 were conducted in six databases and other information sources to identify observational studies. Study selection, data extraction, and quality assessment [...] Read more.
To evaluate differences in the morphology of the frontal sinus in adolescents and adults with different craniofacial patterns, searches up to April 2024 were conducted in six databases and other information sources to identify observational studies. Study selection, data extraction, and quality assessment using the NOS scale were performed independently by two reviewers. Random effects meta-analyses were conducted to estimate the difference in frontal sinus measurements between different craniofacial skeletal patterns (α = 0.05). The certainty of the evidence was evaluated according to GRADE. Fourteen studies were included in the review. All studies had methodological limitations that affected their quality. The syntheses showed that skeletal Class II subjects presented a significantly smaller width of the frontal sinus than skeletal Class I subjects (MD = 0.56; 95% CI: 0.38, 0.74; p < 0.0001; I2 = 3%). Skeletal Class III subjects showed a frontal sinus width (MD = −0.91; 95% CI: −1.35, −0.47; p < 0.0001; I2 = 36%) and area (MD = −28.13; 95% CI: −49.03, −7.23; p = 0.0084; I2 = 66%) significantly larger than those of the skeletal Class I subjects. The available evidence suggests a positive relationship between mandibular and frontal sinus size. There is limited evidence to make reliable estimates of the association of other craniofacial patterns and frontal sinus characteristics. These reported results are not conclusive and should be evaluated carefully due to the very low certainty of the evidence. The current evidence is scarce and consists of studies with methodological limitations; the results of the studies are often inconsistent, and the pooled estimates are imprecise. New high-quality research is still necessary. Full article
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11 pages, 1161 KiB  
Article
Enamel Remineralisation with a Novel Sodium Fluoride-Infused Bristle Toothbrush
by Xiaotian Liu, Chun Lok Bryan Lau, Hao Ding, Jukka Pekka Matinlinna and James K. H. Tsoi
Dent. J. 2024, 12(5), 142; https://doi.org/10.3390/dj12050142 - 15 May 2024
Viewed by 520
Abstract
This study aims to investigate whether toothbrushes with fluoride-infused bristles have any (re)mineralisation effects on bovine enamel. Bovine incisors (N = 160) were extracted, and the buccal side of the crown was cut into dimensions of ~5 mm × 5 mm with a [...] Read more.
This study aims to investigate whether toothbrushes with fluoride-infused bristles have any (re)mineralisation effects on bovine enamel. Bovine incisors (N = 160) were extracted, and the buccal side of the crown was cut into dimensions of ~5 mm × 5 mm with a low-speed saw. These specimens were randomly allocated into four groups: half (80 teeth) were stored in demineralising solution (DM), and the other half were stored in deionised water (DW) for 96 h. Then, they were brushed with a force of 2.0 ± 0.1 N for five min with a manual toothbrush with either fluoride-infused (TF) or regular (TR) bristles. Microhardness (Vickers), X-ray diffraction (XRD), energy-dispersive X-ray spectroscopy (EDS), and scanning electron microscopy (SEM) were used to investigate the surfaces of the bovine enamel specimens before and after brushing. Two-way ANOVA was used to analyse the hardness data, and the pairwise comparison method was used to analyse the Ca/P ratio, for each group at α = 0.05. The results show that brushing with either of these toothbrushes increased the Vickers microhardness on DM and DW enamel (p < 0.001), whereas hydroxyapatite was revealed in all groups by XRD. The DM samples showed a significant increase (p < 0.05) in the Ca/P ratios after brushing with TR and TF. Conversely, under DW conditions, these ratios decreased significantly after brushing. In terms of the F atomic%, TF increased significantly. SEM revealed mineral deposition in the DM groups after toothbrushing. To conclude, toothbrushing effectively induces the microhardness of sound and demineralised enamel, while fluoride-infused bristles might be able to retain fluoride on the enamel surface. Full article
(This article belongs to the Special Issue Studies on Dental Enamel)
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10 pages, 3587 KiB  
Article
Effect of Dentifrice Ingredients on Volume and Vitality of a Simulated Periodontal Multispecies Biofilm
by Jelena Karacic, Moritz Ruf, Johannes Herzog, Monika Astasov-Frauenhoffer and Philipp Sahrmann
Dent. J. 2024, 12(5), 141; https://doi.org/10.3390/dj12050141 - 13 May 2024
Viewed by 926
Abstract
The aim of this in vitro study was to investigate the effect of different toothpaste ingredients on biofilm volume and vitality in an established non-contact biofilm removal model. A multi-species biofilm comprising Porphyromonas gingivalis, Streptococcus sanguinis, and Fusobacterium nucleatum was grown [...] Read more.
The aim of this in vitro study was to investigate the effect of different toothpaste ingredients on biofilm volume and vitality in an established non-contact biofilm removal model. A multi-species biofilm comprising Porphyromonas gingivalis, Streptococcus sanguinis, and Fusobacterium nucleatum was grown on protein-coated titanium disks. Six disks per group were exposed to 4 seconds non-contact brushing using a sonic toothbrush. Four groups assessed slurries containing different ingredients, i.e., dexpanthenol (DP), peppermint oil (PO), cocamidopropyl betaine (CB), and sodium hydroxide (NaOH), one positive control group with the slurry of a toothpaste (POS), and a negative control group with physiological saline (NEG). Biofilm volume and vitality were measured using live-dead staining and confocal laser scanning microscopy. Statistical analysis comprised descriptive statistics and inter-group differences. In the test groups, lowest vitality and volume were found for CB (50.2 ± 11.9%) and PO (3.6 × 105 ± 1.8 × 105 µm3), respectively. Significant differences regarding biofilm vitality were found comparing CB and PO (p = 0.033), CB and NEG (p = 0.014), NaOH and NEG (p = 0.033), and POS and NEG (p = 0.037). However, no significant inter-group differences for biofilm volume were observed. These findings suggest that CB as a toothpaste ingredient had a considerable impact on biofilm vitality even in a non-contact brushing setting, while no considerable impact on biofilm volume was found. Full article
(This article belongs to the Special Issue Periodontal Health: Disease Prevention and Treatment)
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20 pages, 1799 KiB  
Systematic Review
Effect of Bleaching Agents on Healthy Enamel, White Spots, and Carious Lesions: A Systematic Review and Meta-Analysis
by Grigoria Gkavela, Vlassios Kakouris, Eftychia Pappa and Christos Rahiotis
Dent. J. 2024, 12(5), 140; https://doi.org/10.3390/dj12050140 - 11 May 2024
Viewed by 589
Abstract
This systematic review examines studies focusing on tooth bleaching and its effects on healthy enamel or incipient caries and bacterial adhesion. The aim is to explore the impact of different bleaching agents on incipient caries lesions and healthy enamel. Clinical studies, in vitro [...] Read more.
This systematic review examines studies focusing on tooth bleaching and its effects on healthy enamel or incipient caries and bacterial adhesion. The aim is to explore the impact of different bleaching agents on incipient caries lesions and healthy enamel. Clinical studies, in vitro studies, and observational studies that compared at least two groups were included. A search strategy was used to select studies from the MEDLINE via Pubmed and Scopus databases. Two evaluators performed data extraction, screening, and quality assessment independently. Only studies written in English were included. From 968 initial records, 28 studies were selected for a full-text evaluation. Of these, 7 studies were classified as cluster 1 (bacterial adherence on teeth), 12 studies as cluster 2 (no bacteria involved), 4 studies as cluster 3 (no teeth deployment), and 5 clinical studies were cluster 4. Of the selected studies, 6 (21.4%) supported increased bacterial attachment capacity and cariogenic dynamics, 4 (14.3%) decreased adhesion and cariogenic activity, 7 (25%) showed no difference, and 11 (39.3%) followed a different methodological approach and could not be categorized. The risk of bias appeared to be high, mainly because of the different methodologies in the studies, so we cannot reach a confident conclusion. Nevertheless, as far as carbamide peroxide bleaching is concerned, there does not seem to be a clinically significant alteration, neither in microorganism counts nor in enamel microstructure. Full article
(This article belongs to the Special Issue Feature Review Papers in Dentistry)
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10 pages, 1460 KiB  
Article
Clinical Experience Comparison of Foreign-Trained Dentists and Domestic Dental Students: One Institution’s Experience
by Zabihulla Ahmadi, Judy Chia-Chun Yuan, Michael Spector, Adriana Semprum-Clavier, Cortino Sukotjo and Fatemeh S. Afshari
Dent. J. 2024, 12(5), 139; https://doi.org/10.3390/dj12050139 - 11 May 2024
Viewed by 591
Abstract
This study compared the clinical experiences of foreign-trained dentists (FTDs) enrolled in an Advance Standing DMD Dental Program (DMDAS) with those of the domestic dental students (DMD) at the University of Illinois Chicago, College of Dentistry (UIC-COD). A cross-sectional retrospective chart review of [...] Read more.
This study compared the clinical experiences of foreign-trained dentists (FTDs) enrolled in an Advance Standing DMD Dental Program (DMDAS) with those of the domestic dental students (DMD) at the University of Illinois Chicago, College of Dentistry (UIC-COD). A cross-sectional retrospective chart review of patients treated by 295 DMD and 253 DMDAS predoctoral dental students was completed at the UIC-COD. The data were retrieved from the electronic health record system (axiUm) for the graduated classes of 2018, 2019, 2020, 2021, and 2022 on various performed clinical procedures as measured by relative value units (RVUs). The retrieved data were used to compare the clinical experiences of DMDAS vs. DMD students. Descriptive (mean) and statistical (independent t-test) analyses were used (α = 0.05). The results indicated that DMD and DMDAS students had comparable clinical experiences in several disciplines, including diagnosis, prevention, direct/indirect restorations, endodontics, periodontics, complete dentures, removable partial dentures, implants/fixed partial dentures, and oral surgery. There was a statistical difference in total RVUs for diagnosis (p = 0.002) and direct restorations (p < 0.001), in which DMD students had more experience. The 28 month program for FTDs appeared to be a reasonable timeframe to obtain an adequate number of varied clinical experiences as compared with the traditional four-year program at the UIC-COD. Full article
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13 pages, 1083 KiB  
Article
Proposal and Validation of a New Index to Assess the Difficulty of Lower Third Molar Extraction
by Paula Hermida-Cabrera, Belén Lima-Sánchez, Vanessa Montoya-Salazar, Luis-Guillermo Oliveros-López, Pedro Alomar-Velasco, José-Luis Gutiérrez-Pérez, Daniel Torres-Lagares and María Baus-Domínguez
Dent. J. 2024, 12(5), 138; https://doi.org/10.3390/dj12050138 - 9 May 2024
Viewed by 894
Abstract
There is no current consensus on the parameters that determine the difficulty of mandibular third molar extraction in terms of the time required, which is essential to prevent complications and optimize the time of the intervention. This study aims to obtain, using the [...] Read more.
There is no current consensus on the parameters that determine the difficulty of mandibular third molar extraction in terms of the time required, which is essential to prevent complications and optimize the time of the intervention. This study aims to obtain, using the mathematical method of multiple linear regression, an equation that allows estimating the extraction time of a lower third molar according to its complexity, as well as to validate this equation in a sample of external wisdom teeth. Methods: A prospective cohort study on a sample of patients of the Master of Oral Surgery of the University of Seville in which multiple linear regression coefficients were calculated with a subsequent validation study of the results in the sample of patients operated in the Hospital Palmaplanas of Mallorca. Results: The regression line obtained after applying the statistical methodology to the cohort of patients from the University of Seville obtained significant dependent variables such as depth, roots, and odontosection. Once applied to the cohort of patients from the Palmaplanas Hospital in Mallorca, a regression coefficient was obtained between the data received and the estimated 0.770. Conclusions: The formula proposed in this article presents significant validity in the prediction of the surgical time of extraction of the lower third molars included. Full article
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14 pages, 5507 KiB  
Article
A Comparison of Guided Bone Regeneration vs. the Shell Technique Using Xenogeneic Bone Blocks in Horizontal Bone Defects: A Randomized Clinical Trial
by Paolo De Angelis, Camilla Cavalcanti, Paolo Francesco Manicone, Margherita Giorgia Liguori, Edoardo Rella, Giuseppe De Rosa, Alberto Palmieri and Antonio D’Addona
Dent. J. 2024, 12(5), 137; https://doi.org/10.3390/dj12050137 - 9 May 2024
Viewed by 663
Abstract
In cases of severe horizontal atrophy, implant placement requires bone reconstruction procedures. The aim of this randomized controlled trial is to compare the outcomes of bone augmentation with simultaneous implant placement using the shell technique to the outcomes of guided bone regeneration (GBR) [...] Read more.
In cases of severe horizontal atrophy, implant placement requires bone reconstruction procedures. The aim of this randomized controlled trial is to compare the outcomes of bone augmentation with simultaneous implant placement using the shell technique to the outcomes of guided bone regeneration (GBR) in cases of severely horizontal bone atrophy. This study was designed as a monocentric, parallel-group, randomized controlled trial with a six-month follow-up. Among the primary outcomes of this study, peri-implant bone regeneration and peri-implant bone defect closure were selected. Forty-four patients were recruited and equally divided between two groups. In the GRB group, a horizontal regeneration of 2.31 ± 0.23 mm was observed opposed to a horizontal regeneration of 2.36 ± 0.17 mm in the shell group (p = 0.87). A volumetric increase was observed in both groups, with an increase of 0.30 ± 0.12 cm3 in the GBR group and an increase of 0.39 ± 0.09 cm3 in the shell group, highlighting a significant difference between the two groups (p = 0.02). In conclusion, bone augmentation with simultaneous implant placement using the shell technique or guided bone regeneration in horizontal bone atrophy are both predictable therapeutic options. Full article
(This article belongs to the Special Issue Oral Implantology and Bone Regeneration)
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12 pages, 1491 KiB  
Article
Assessing the Impact of Various Decontamination Instruments on Titanium and Zirconia Dental Implants: An In Vitro Study
by Louisa Vierling, Chun Ching Liu, Daniel Wiedemeier, Andrea Gubler and Patrick R. Schmidlin
Dent. J. 2024, 12(5), 136; https://doi.org/10.3390/dj12050136 - 9 May 2024
Viewed by 623
Abstract
This study investigates the impact of various instrumentation techniques on material removal and surface changes in titanium (Ti)- and zirconia (Zr) implant discs. Ti- and Zr discs were subjected to standardized experiments using various instruments including airflow, ultrasound, carbide, and diamond burs. Instrumentation [...] Read more.
This study investigates the impact of various instrumentation techniques on material removal and surface changes in titanium (Ti)- and zirconia (Zr) implant discs. Ti- and Zr discs were subjected to standardized experiments using various instruments including airflow, ultrasound, carbide, and diamond burs. Instrumentation was performed for 60 s with continuous automatic motion. Abrasion and changes in surface roughness were assessed using profilometry, while scanning electron microscopy was used to examine morphological changes and particle size. Carbide burs predominantly caused abrasion on Ti discs, while diamond burs caused more abrasion on Zr discs. The Ti discs were more susceptible to surface changes. However, among the materials tested, machined Zr discs treated with diamond burs produced the largest particle. In certain cases, a statistical significance (p < 0.05) was observed between the groups, while in others, there was no considerable difference among the means (p > 0.05). These results highlighted the statistical significance of our findings. These results found diverse alterations in surface characteristics of Ti- and Zr discs due to different instruments, with carbide and diamond burs causing notable effects. The findings highlight the need for a careful balance between promoting healing and minimizing harm during implantoplasty. Full article
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14 pages, 9114 KiB  
Article
Platelet-Rich Fibrin in Non-Surgical Periodontal Therapy: A Split-Mouth Randomized Controlled Clinical Trial
by Simran R. Parwani, Kaustubh S. Thakare, Kshipra P. Kawadkar, Nishita Jaju Soni, Rajkumar Parwani, Himanshu Dadlani, Dhanashree S. Chaudhary, Dipanshu Pahuja, Gianrico Spagnuolo and Niccolò Giuseppe Armogida
Dent. J. 2024, 12(5), 135; https://doi.org/10.3390/dj12050135 - 9 May 2024
Viewed by 844
Abstract
This clinical trial investigated the efficacy of platelet-rich fibrin (PRF) as an adjunct to conventional scaling and root planing (SRP) in non-surgical periodontal therapy. In a split-mouth randomized controlled trial with 13 patients and 26 periodontal pocket sites, PRF was inserted in test [...] Read more.
This clinical trial investigated the efficacy of platelet-rich fibrin (PRF) as an adjunct to conventional scaling and root planing (SRP) in non-surgical periodontal therapy. In a split-mouth randomized controlled trial with 13 patients and 26 periodontal pocket sites, PRF was inserted in test group pockets alongside SRP, while control group pockets received SRP alone. Measurements at baseline and six weeks included probing pocket depths (PPDs), clinical attachment loss (CAL), gingival recession (GR), the plaque index, and the gingivitis index. The wound healing index was assessed at six weeks. The results show statistically significant improvements in the SRP+PRF group compared to SRP alone, demonstrating a better CAL gain (SRP+PRF group: 2.69 ± 0.63; SRP alone group: 4.15 ± 0.69—p-value: 0.001), PPD reduction (SRP+PRF group: 2.62 ± 0.65; SRP alone group: 3.85 ± 0.80—p-value: 0.001), and GR minimization (SRP+PRF group: 0.46 ± 0.62; SRP alone group: 0.81 ± 0.72—p-value: 0.21). The adjunctive use of PRF enhanced healing, reduced pocket depths, decreased tissue morbidity, and minimized gingival recession. This study concludes that PRF placement is effective in 5–6 mm pockets, potentially reducing the number of periodontal treatment sessions needed for pocket closure. Full article
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13 pages, 234 KiB  
Article
Dentist Involvement in the Treatment of Radiation-Induced Oral Mucositis—A Pilot Cross-Sectional Study
by Monika Burja Vladić, Ana Andabak-Rogulj, Krešimir Gršić, Vlaho Brailo, Božana Lončar Brzak, Ivana Škrinjar and Danica Vidović Juras
Dent. J. 2024, 12(5), 134; https://doi.org/10.3390/dj12050134 - 8 May 2024
Viewed by 592
Abstract
Objectives: Oral mucositis (OM) occurs in more than 95% of patients irradiated in the head and neck area. This paper aims to determine the occurrence and characteristics of OM in patients with head and neck cancer (HNC), as well as the involvement of [...] Read more.
Objectives: Oral mucositis (OM) occurs in more than 95% of patients irradiated in the head and neck area. This paper aims to determine the occurrence and characteristics of OM in patients with head and neck cancer (HNC), as well as the involvement of dentists/oral medicine specialists in treating such patients. Methods: This study was conducted at the Department of Otorhinolaryngology and Department of Oral Medicine, University Hospital Center Zagreb, from April to August 2022, on patients irradiated in the head and neck area. A unique OM questionnaire was created on the incidence, characteristics, oral care, and involvement of dentists in the overall care. Results: Thirty patients filled out the questionnaire. Of the 22 patients who had developed OM, 14 had grade-three OM. Ten patients were treated for OM in line with the instructions of an oral medicine specialist, eight based on the instructions of a specialist responsible for monitoring of the underlying disease, and four were not treated at all. Sixteen patients had not been referred to a dentist before the start of RT. Conclusions: These results showed insufficient care and treatment of OM, as well as insufficient involvement of dentists in the oncology team. Full article
14 pages, 1701 KiB  
Article
Effects of Oleanolic Acid Derived from Wine Pomace on Periodontopathic Bacterial Growth in Healthy Individuals: A Randomized Placebo-Controlled Study
by Kyoko Shimazu, Kouta Ookoshi, Satoshi Fukumitsu, Hiroyuki Kagami, Chieko Mitsuhata, Ryota Nomura and Kazuhiko Aida
Dent. J. 2024, 12(5), 133; https://doi.org/10.3390/dj12050133 - 8 May 2024
Viewed by 596
Abstract
Periodontal disease is caused by oral pathogenic bacteria and is associated with systemic disease and frailty. Therefore, its prevention is crucial in extending healthy life expectancy. This study aimed to evaluate the effect of orally administered oleanolic acid, extracted from wine pomace, on [...] Read more.
Periodontal disease is caused by oral pathogenic bacteria and is associated with systemic disease and frailty. Therefore, its prevention is crucial in extending healthy life expectancy. This study aimed to evaluate the effect of orally administered oleanolic acid, extracted from wine pomace, on periodontopathic bacterial growth in healthy individuals. In this randomized, placebo-controlled, double-blind, parallel-group comparison study, 84 healthy adults were assigned to a placebo (n = 29), low-dose (n = 29, 9 mg oleanolic acid), or high-dose (n = 26, 27 mg oleanolic acid) groups. The number of oral bacteria in their saliva, collected before and 5 h after administration, was determined using the polymerase chain reaction-invader technique. The proportion of periodontopathic bacteria among the total oral bacteria in the saliva was calculated. Oleanolic acid significantly decreased the proportion of Porphyromonas gingivalis among the total oral bacteria in a dose-dependent manner (p = 0.005 (low-dose) and p = 0.003 (high-dose) vs. placebo, Williams’ test). Moreover, high-dose oleanolic acid decreased the proportion of Tannerella forsythia (p = 0.064 vs. placebo, Williams’ test). Periodontopathic bacteria are closely associated with the development and progression of periodontal disease; thus, the continuous daily intake of oleanolic acid derived from pomace may be helpful in maintaining a healthy oral microbiome by controlling the proportion of periodontopathic bacteria. Full article
(This article belongs to the Special Issue Oral Microbiology and Related Research)
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22 pages, 452 KiB  
Systematic Review
Impact of Orthodontic-Surgical Treatments on the Signs and Symptoms of Temporomandibular Disorders: A Systematic Review
by Elodie Ehrmann, Marie Bernabeu, Yannick Tillier, Julien Camia, Corentin Ecalle, Charles Savoldelli and Carole Charavet
Dent. J. 2024, 12(5), 132; https://doi.org/10.3390/dj12050132 - 8 May 2024
Viewed by 714
Abstract
Introduction: Some patients exhibit temporomandibular joint or muscular disorders of the masticatory system before, during, or after orthognathic surgery (OS). These are collectively referred to as temporomandibular disorders (TMDs). This systematic literature review aimed to determine the relationship between orthodontic-surgical treatment and TMDs. [...] Read more.
Introduction: Some patients exhibit temporomandibular joint or muscular disorders of the masticatory system before, during, or after orthognathic surgery (OS). These are collectively referred to as temporomandibular disorders (TMDs). This systematic literature review aimed to determine the relationship between orthodontic-surgical treatment and TMDs. Methods: An electronic search of the PubMed database, supplemented by a manual search, was performed; the search included any studies published between 2021 (date of the last search in a systematic review of the literature on the subject) and June 2023 that evaluate the prevalence of TMDs during orthodontic-surgical treatment. The diagnosis of TMDs had to be established using the diagnostic algorithm “diagnostic criteria for temporomandibular disorders (DC/TMDs)”, and the diagnosis of disc displacement had to be confirmed using magnetic resonance imaging (MRI). The data were extracted and statistically analyzed. Results: Of the 100 results, seven eligible articles were included, representing a total of 529 cases undergoing orthodontic-surgical treatment. A reduction in joint noises (64.8%), arthralgia (57 to 77%), and myalgia (73 to 100%) was found after orthodontic-surgical treatment despite the fact that a minority of patients exhibited these signs and symptoms even though they were asymptomatic before treatment. The effects of OS on disc position were objectively unpredictable. After surgery, the presence of headaches decreased without significance and the risk of their occurrence was very low (1%). The studies converged toward a reduction in the amplitudes of mouth opening and lateral/protrusion movements. Finally, after the treatment, mandibular function was improved. Conclusion: Under the conditions of this study, OS seems to have a positive impact on the signs and symptoms of TMDs; however, it is not possible to predict the consequential effects on the position of the TMJ disc, whether it is initially in a normal position or displaced. Full article
(This article belongs to the Section Oral and Maxillofacial Surgery)
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13 pages, 10814 KiB  
Article
Dental Implants with External Hex Inclined Shoulder in Full-Arch Immediate Loading Rehabilitations of the Maxilla
by Francesco Bagnasco, Paolo Pesce, Domenico Baldi, Francesco Motta, Francesco Pera, Nicola De Angelis and Maria Menini
Dent. J. 2024, 12(5), 131; https://doi.org/10.3390/dj12050131 - 8 May 2024
Viewed by 854
Abstract
Background: Coaxial implants with an inclined neck might overcome some problems related to angulation of the implant axis when using tilted implants. Therefore, the aim of the present work was to conduct a narrative review of the current literature and to present a [...] Read more.
Background: Coaxial implants with an inclined neck might overcome some problems related to angulation of the implant axis when using tilted implants. Therefore, the aim of the present work was to conduct a narrative review of the current literature and to present a case series comparing traditional and coaxial external hex implants in full-arch immediate loading rehabilitations of the maxilla. Methods: A total of 13 external hex tapered implants (Southern Implants) was inserted in the upper jaw of 3 patients. Each patient received two tilted implants in distal sites. In one randomly selected quadrant, the tilted implant was a standard implant, while a Co-Axis® implant with a 24° inclination of the implant shoulder was inserted on the other hemi-arch. Straight conical abutments were screwed on coaxial implants while multiunit abutments of appropriate inclination were screwed as needed on the other implants to correct their axes. Peri-implant bone level was recorded radiographically at T0 (delivery of the immediate loading prosthesis), and at 3, 6, 12, and 24 months of healing and then annually. Plaque index, probing depth, and bleeding on probing were also evaluated. Cumulative implant survival rate (CSR) was calculated, and biological or technical complications were recorded as well as the operator satisfaction towards the use of coaxial implants. Results: The preliminary data collected did not show significant differences in peri-implant tissues health and maintenance over time between the two implant types. No implants failed, and both implant types proved to be favorable for full-arch rehabilitation using tilted implants. Coaxial implants facilitated the prosthodontic procedures. However, a learning curve is required in order to optimize their insertion. Conclusions: Both implants proved to be reliable and suitable for achieving clinical success in full-arch immediate loading rehabilitations, but further research with longer follow-up and larger sample size is needed to confirm these preliminary outcomes. Full article
(This article belongs to the Special Issue Advanced Research on Oral Cancer and Dental Implants)
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15 pages, 25720 KiB  
Case Report
Full-Mouth Rehabilitation of a 15-Year-Old Girl Affected by a Rare Hypoparathyroidism (Glial Cell Missing Homolog 2 Mutation): A 3-Year Follow-Up
by Yohann Flottes, Eléonore Valleron, Bruno Gogly, Claudine Wulfman and Elisabeth Dursun
Dent. J. 2024, 12(5), 130; https://doi.org/10.3390/dj12050130 - 7 May 2024
Viewed by 562
Abstract
Objective: Familial isolated hypoparathyroidism is a rare genetic disorder due to no or low production of the parathyroid hormone, disturbing calcium and phosphate regulation. The resulting hypocalcemia may lead to dental abnormalities, such as enamel hypoplasia. The aim of this paper was to [...] Read more.
Objective: Familial isolated hypoparathyroidism is a rare genetic disorder due to no or low production of the parathyroid hormone, disturbing calcium and phosphate regulation. The resulting hypocalcemia may lead to dental abnormalities, such as enamel hypoplasia. The aim of this paper was to describe the full-mouth rehabilitation of a 15-year-old girl with chronic hypocalcemia due to a rare congenital hypoparathyroidism. Clinical considerations: In this patient, in the young adult dentition, conservative care was preferred. Onlays or stainless-steel crowns were performed on the posterior teeth, and direct or indirect (overlays and veneerlays) were performed on the maxillary premolars, canines, and incisors, using a digital wax-up. The mandibular incisors were bleached. The treatment clearly improved the patient’s oral quality of life, with fewer sensitivities, better chewing, and aesthetic satisfaction. The difficulties were the regular monitoring and the limited compliance of the patient. Conclusion: Despite no clinical feedback in the literature, generalized hypomineralized/hypoplastic teeth due to hypoparathyroidism in a young patient can be treated as amelogenesis imperfecta (generalized enamel defects) with a conservative approach for medium-term satisfactory results. Highlights: This study provides new insights into the management of enamel hypoplasia caused by familial isolated hypoparathyroidism, helping to improve patient outcomes in similar cases. Full article
(This article belongs to the Special Issue Current Advances in Pediatric Odontology)
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12 pages, 1499 KiB  
Article
Treatment Outcomes in Patients with Muscular Temporomandibular Joint Disorders: A Prospective Case-Control Study
by Rossana Izzetti, Elisabetta Carli, Stefano Gennai, Maria Rita Giuca, Filippo Graziani and Marco Nisi
Dent. J. 2024, 12(5), 129; https://doi.org/10.3390/dj12050129 - 7 May 2024
Viewed by 581
Abstract
Muscular temporomandibular joint disorders (M-TMDs) encompass a wide range of painful muscular conditions, which can provoke functional limitation and severely affect quality of life. The aim of the present study was to assess the treatment outcomes in patients affected by M-TMDs in terms [...] Read more.
Muscular temporomandibular joint disorders (M-TMDs) encompass a wide range of painful muscular conditions, which can provoke functional limitation and severely affect quality of life. The aim of the present study was to assess the treatment outcomes in patients affected by M-TMDs in terms of pain scores assessed with pressure pain threshold (PPT). The levels of depression, anxiety, and the Oral Health Impact Profile were also assessed and compared to healthy controls. Patients with a clinical diagnosis of M-TMDs and a control group of healthy subjects were enrolled. At baseline, OHIP-14, PHQ-9, and GAD-7 were administered. PPT was registered at the level of masseter and temporalis muscles. The patients affected by M-TMDs were then treated with oral splints and physio-kinesiotherapy following a standardized treatment protocol. At the 6-month follow-up of M-TMD-affected patients, PPT was registered, and the questionnaires were re-administered to evaluate treatment outcomes. In total, sixty patients and sixty controls were enrolled. The treatment of M-TMDs produced a significant improvement in PPT at the level of the masseter muscle. OHIP-14 at baseline in the M-TMD group was significantly higher compared to the control group (p < 0.05). At the 6-month follow-up, a significant reduction in OHIP-14 scores was registered, although with higher scores compared to the control group (p < 0.05). PHQ-9 was significantly higher at baseline in the M-TMD group (p < 0.05) and decreased to values comparable to the control group after treatment. GAD-7 presented statistically significant differences between the control group and M-TMD patients at baseline (p < 0.05) and between pre- and post-treatment in the M-TMD group. Following treatment, the GAD-7 scores were comparable to the control group. The symptom burden associated with M-TMDs negatively affects quality of life, with higher oral health impairment and a tendency towards depression and anxiety compared to healthy subjects. Following treatment, an improvement in both PPT and quality of life was observed. Full article
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15 pages, 2691 KiB  
Article
Influence of Cavity Lining on the 3-Year Clinical Outcome of Posterior Composite Restorations: A Randomized Controlled Clinical Trial
by Anh Duc Nguyen, Natalie Pütz, Mary Michaelis, Kerstin Bitter and Christian Ralf Gernhardt
Dent. J. 2024, 12(5), 128; https://doi.org/10.3390/dj12050128 - 7 May 2024
Viewed by 625
Abstract
The purpose of this randomized, split-mouth-designed controlled and single-blinded clinical study was to evaluate the 3-year clinical performance of Class I and Class II resin composite restorations placed with or without cavity lining with a flowable composite. Fifty patients with treatment needs in [...] Read more.
The purpose of this randomized, split-mouth-designed controlled and single-blinded clinical study was to evaluate the 3-year clinical performance of Class I and Class II resin composite restorations placed with or without cavity lining with a flowable composite. Fifty patients with treatment needs in two premolars or molars were included. One of the teeth was restored using the nanohybrid composite (Grandio®SO, control group), in the test group a high viscosity flowable composite was additionally applied as a first layer. In both groups, the same self-etch adhesive system was applied. Clinical evaluation after 3 years was carried out using the modified USPHS/Ryge criteria. At the 3-year follow-up the recall rate was 92%. Four restorations failed in the test group (8.7%), three due to the loss of vitality and one after fracture. The control group exhibited a cumulative success rate of 100%, while the test group achieved a success rate of 91.3%. This led to significant differences in the annual failure rate (AFR) between the two groups, with rates of 0% and 2.9% (p < 0.05; Mann–Whitney U-test). After 3 years the cumulative survival rate including all restorations was 95.7%. Statistical analysis revealed significant differences for the parameters: tooth vitality, marginal discoloration, success rate, and AFR. The other parameters exhibited no significant differences. Consequently, the nanohybrid composite demonstrated excellent performance over a 3-year period, whereas the utilization of a flowable composite for the cavity lining did not appear to exert a beneficial influence on clinical outcomes. Full article
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13 pages, 394 KiB  
Review
Leveraging Dental Stem Cells for Oral Health during Pregnancy: A Concise Review
by Aida Meto, Ana Sula, Samuele Peppoloni, Agron Meto and Elisabetta Blasi
Dent. J. 2024, 12(5), 127; https://doi.org/10.3390/dj12050127 - 7 May 2024
Viewed by 829
Abstract
Pregnancy induces significant changes in oral health because of hormonal fluctuations, making it a crucial period for preventive measures. Dental stem cells (DSCs), particularly those derived from the dental pulp and periodontal ligaments, offer promising avenues for regenerative therapies and, possibly, preventive interventions. [...] Read more.
Pregnancy induces significant changes in oral health because of hormonal fluctuations, making it a crucial period for preventive measures. Dental stem cells (DSCs), particularly those derived from the dental pulp and periodontal ligaments, offer promising avenues for regenerative therapies and, possibly, preventive interventions. While the use of DSCs already includes various applications in regenerative dentistry in the general population, their use during pregnancy requires careful consideration. This review explores recent advancements, challenges, and prospects in using DSCs to address oral health issues, possibly during pregnancy. Critical aspects of the responsible use of DSCs in pregnant women are discussed, including safety, ethical issues, regulatory frameworks, and the need for interdisciplinary collaborations. We aimed to provide a comprehensive understanding of leveraging DSCs to improve maternal oral health. Full article
(This article belongs to the Special Issue Regenerative Approaches in Dental Sciences)
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14 pages, 5813 KiB  
Article
Biological Evaluation of Oral Care Products Using 3D Tissue-Engineered In Vitro Models of Plaque-Induced Gingivitis
by Emilia Barker, Lina AlQobaly, Zahab Shaikh, Kirsty Franklin, Johanna Thurlow, Behfar Moghaddam, Jonathan Pratten and Keyvan Moharamzadeh
Dent. J. 2024, 12(5), 126; https://doi.org/10.3390/dj12050126 - 6 May 2024
Viewed by 1291
Abstract
Background: The aim of this study was to investigate and visualize the anti-inflammatory and anti-bacterial effects of different oral care products using an infected and inflamed 3D tissue-engineered gingival mucosal model. Methods: A 3D full-thickness oral mucosal model was engineered inside tissue culture [...] Read more.
Background: The aim of this study was to investigate and visualize the anti-inflammatory and anti-bacterial effects of different oral care products using an infected and inflamed 3D tissue-engineered gingival mucosal model. Methods: A 3D full-thickness oral mucosal model was engineered inside tissue culture inserts using collagen hydrogels populated with human gingival fibroblasts and THP-1 monocytes and layered with oral epithelial cell lines. Oral saliva bacteria were cultured and added to the surface of the models and inflammation was further simulated with lipopolysaccharide (LPS) of Escherichia coli. The 3D models were exposed to three different types of toothpastes, a chlorhexidine antiseptic mouthwash, different antibiotics, and a mechanical rinse with phosphate-buffered saline (PBS) prior to biological evaluation using the PrestoBlue tissue viability assay, histology, optical coherence tomography (OCT), confocal microscopy, and measurement of the release of the inflammatory markers IL-1β, IL-6, and IL-8 with ELISA. Results: Multiple-endpoint analyses of the infected oral mucosal models treated with different anti-bacterial agents showed consistent outcomes in terms of tissue viability, histology, OCT, and confocal microscopy findings. In terms of anti-inflammatory testings, the positive control group showed the highest level of inflammation compared with all other groups. Depending on the anti-bacterial and anti-inflammatory potential of the test groups, different levels of inflammation were observed in the test groups. Conclusions: The inflamed 3D oral mucosal model developed in this study has the potential to be used as a suitable in vitro model for testing the biocompatibility, anti-inflammatory, and anti-bacterial properties of oral care products including mouthwashes and toothpastes. The results of this study indicate that the chlorhexidine mouthwash has both anti-bacterial and cytotoxic effects on the 3D oral mucosal model. Hyaluronic-acid-containing toothpaste has significant anti-bacterial and anti-inflammatory effects on the 3D oral mucosal model. Full article
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18 pages, 1014 KiB  
Review
Advanced Antimicrobial and Anti-Infective Strategies to Manage Peri-Implant Infection: A Narrative Review
by Yihan Li, Cameron A. Stewart and Yoav Finer
Dent. J. 2024, 12(5), 125; https://doi.org/10.3390/dj12050125 - 6 May 2024
Viewed by 954
Abstract
Despite reductions in bacterial infection and enhanced success rate, the widespread use of systemic antibiotic prophylaxis in implant dentistry is controversial. This use has contributed to the growing problem of antimicrobial resistance, along with creating significant health and economic burdens. The basic mechanisms [...] Read more.
Despite reductions in bacterial infection and enhanced success rate, the widespread use of systemic antibiotic prophylaxis in implant dentistry is controversial. This use has contributed to the growing problem of antimicrobial resistance, along with creating significant health and economic burdens. The basic mechanisms that cause implant infection can be targeted by new prevention and treatment methods which can also lead to the reduction of systemic antibiotic exposure and its associated adverse effects. This review aims to summarize advanced biomaterial strategies applied to implant components based on anti-pathogenic mechanisms and immune balance mechanisms. It emphasizes that modifying the dental implant surface and regulating the early immune response are promising strategies, which may further prevent or slow the development of peri-implant infection, and subsequent failure. Full article
(This article belongs to the Special Issue Oral Implantology and Rehabilitation)
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9 pages, 3051 KiB  
Case Report
Computer-Guided Surgery Can Avoid Prophylactic Endodontic Treatment in Autologous Tooth Transplantation: A 5-Year Follow-Up Case Report
by Luca Boschini, Amerigo Giudice, Michele Melillo, Francesco Bennardo, Francesc Abella Sans, Matteo Arcari and Luigi Tagliatesta
Dent. J. 2024, 12(5), 124; https://doi.org/10.3390/dj12050124 - 25 Apr 2024
Viewed by 1381
Abstract
Autotransplantation is a successful technique to replace compromised teeth. This study presents a computer-guided surgical approach for preparing the receiving socket for a mature mandibular third molar donor tooth with a wait-and-see approach instead of prophylactic endodontic treatment. A 42-year-old woman developed root [...] Read more.
Autotransplantation is a successful technique to replace compromised teeth. This study presents a computer-guided surgical approach for preparing the receiving socket for a mature mandibular third molar donor tooth with a wait-and-see approach instead of prophylactic endodontic treatment. A 42-year-old woman developed root resorption of tooth 3.7. Extraction of 3.7 and autotransplantation of 3.8 was planned, following a 6-week orthodontic phase for periodontal ligament activation and teeth mobilization. Due to the different root morphology between the compromised and donor teeth and the high mandibular bone density, the receiving socket preparation was performed using guided surgery templates. Two surgical splints were designed with a surgical planning software. Tooth 3.7 was extracted, the recipient site was guided-milled, and tooth 3.8 was transplanted into the new socket in approximately one second of extra-alveolar time. The rapidity of the extra-alveolar time facilitated complete healing without resorting to root canal treatment. Five-year radiological control does not show any periapical lesion or root resorption. The surgical procedure for tooth autotransplantation is fundamental: it must be as atraumatic as possible to preserve the periodontal ligament of the tooth and the receiving socket, and the dentist must minimize the extra-alveolar time. Guided surgery is a reliable solution to combine all these aspects. Full article
(This article belongs to the Special Issue Endodontics and Restorative Sciences)
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21 pages, 6726 KiB  
Article
Quantity and Size of Titanium Particles Released from Different Mechanical Decontamination Procedures on Titanium Discs: An In Vitro Study
by Anthony Kao, Andrew Tawse-Smith, Sunyoung Ma, Warwick J. Duncan, Malcolm Reid and Momen A. Atieh
Dent. J. 2024, 12(5), 123; https://doi.org/10.3390/dj12050123 - 24 Apr 2024
Viewed by 757
Abstract
Complications such as peri-implantitis could ultimately affect the survival of a dental implant. The prevention and treatment of peri-implant diseases require managing bacterial biofilm and controlling environmental risks, including the presence of pro-inflammatory titanium (Ti) particles in the peri-implant niche. Objectives included the [...] Read more.
Complications such as peri-implantitis could ultimately affect the survival of a dental implant. The prevention and treatment of peri-implant diseases require managing bacterial biofilm and controlling environmental risks, including the presence of pro-inflammatory titanium (Ti) particles in the peri-implant niche. Objectives included the evaluation of the size and quantity of Ti particles released from moderately roughened Ti surfaces during common mechanical surface decontamination methods. One hundred and forty moderately roughened Ti discs were divided into seven groups (n = 20 per group); six groups received mechanical decontamination procedures (ultrasonic scaling (US) with a metal tip and poly-ether-ketone (PEEK) under low and medium power settings, air-polishing with erythritol powder, and Ti brush), and the control group underwent air–water spray using a dental triplex. The rinsing solution was collected for Ti mass analysis using inductively coupled plasma mass spectrometry (ICPMS), as well as for Ti particle size and count analysis under scanning electron microscopy (SEM) with energy-dispersive spectroscopy (EDS). US metal tip instrumentation generated 34.00 ± 12.54 μg and 34.44 ± 6.08 μg of Ti under low and medium power settings, respectively. This amount of Ti generation was significantly higher than other instrumentation methods. The mean Ti particle size of the US groups ranged from 0.89 ± 0.27 μm to 1.25 ± 0.24 μm. No statistically significant difference was found in the particle size among US groups and Ti brush group (1.05 ± 0.11 μm), except for US with the PEEK tip, where a significantly smaller mean particle diameter was found at the low power setting (0.89 ± 0.27 μm). Mechanical instrumentation can produce Ti particulates and modify the implant surfaces. US using a metal tip generated the highest amount of Ti with smaller Ti size particles compared to all other commonly used mechanical surface instrumentations. The EDS analysis confirmed Ti in PEEK US tips. It can be suggested that deterioration from the PEEK US tip and Ti brush, as observed under SEM, is an additional source of Ti release during Ti surface decontamination. Full article
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17 pages, 2108 KiB  
Article
Plasma Rich in Growth Factors in Bone Regeneration: The Proximity to the Clot as a Differential Factor in Osteoblast Cell Behaviour
by Eduardo Anitua, Mar Zalduendo, Roberto Tierno and Mohammad Hamdan Alkhraisat
Dent. J. 2024, 12(5), 122; https://doi.org/10.3390/dj12050122 - 24 Apr 2024
Viewed by 789
Abstract
The osteogenic differentiation process, by which bone marrow mesenchymal stem cells and osteoprogenitors transform into osteoblasts, is regulated by several growth factors, cytokines, and hormones. Plasma Rich in Growth Factors (PRGF) is a blood-derived preparation consisting of a plethora of bioactive molecules, also [...] Read more.
The osteogenic differentiation process, by which bone marrow mesenchymal stem cells and osteoprogenitors transform into osteoblasts, is regulated by several growth factors, cytokines, and hormones. Plasma Rich in Growth Factors (PRGF) is a blood-derived preparation consisting of a plethora of bioactive molecules, also susceptible to containing epigenetic factors such as ncRNAs and EVs, that stimulates tissue regeneration. The aim of this study was to investigate the effect of the PRGF clot formulation on osteogenic differentiation. Firstly, osteoblast cells were isolated and characterised. The proliferation of bone cells cultured onto PRGF clots or treated with PRGF supernatant was determined. Moreover, the gene expression of Runx2 (ID: 860), SP7 (ID: 121340), and ALPL (ID: 249) was analysed by one-step real-time quantitative polymerase chain reaction (RT-qPCR). Additionally, alkaline phosphatase (ALPL) activity determination was performed. The highest proliferative effect was achieved by the PRGF supernatant in all the study periods analysed. Concerning gene expression, the logRGE of Runx2 increased significantly in osteoblasts cultured with PRGF formulations compared with the control group, while that of SP7 increased significantly in osteoblasts grown on the PRGF clots. On the other hand, despite the fact that the PRGF supernatant induced ALPL up-regulation, significantly higher enzyme activity was detected for the PRGF clots in comparison with the supernatant formulation. According to our results, contact with the PRGF clot could promote a more advanced phase in the osteogenic process, associated to higher levels of ALPL activity. Furthermore, the PRGF clot releasate stimulated a higher proliferation rate in addition to reduced SP7 expression in the cells located at a distant ubication, leading to a less mature osteoblast stage. Thus, the spatial relationship between the PRGF clot and the osteoprogenitors cells could be a factor that influences regenerative outcomes. Full article
(This article belongs to the Special Issue Regenerative Approaches in Dental Sciences)
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9 pages, 1170 KiB  
Article
Long-Term Volumetric Stability of Maxillary Sinus Floor Augmentation Using a Xenograft Bone Substitute and Its Combination with Autologous Bone: A 6+ Year Retrospective Follow-Up Study Using Cone Beam Computed Tomography
by Liene Zamure-Damberga, Oskars Radzins, Girts Salms, Maksims Zolovs, Zanda Bokvalde and Laura Neimane
Dent. J. 2024, 12(5), 121; https://doi.org/10.3390/dj12050121 - 24 Apr 2024
Viewed by 813
Abstract
Deproteinised bovine bone (DBB) is widely used as bone substitute in maxillary sinus floor augmentation (MSFA) surgery. No previous studies have shown the long-term volumetric changes in the augmented bone when using DBB. The selected patients had MFSA performed using a lateral window [...] Read more.
Deproteinised bovine bone (DBB) is widely used as bone substitute in maxillary sinus floor augmentation (MSFA) surgery. No previous studies have shown the long-term volumetric changes in the augmented bone when using DBB. The selected patients had MFSA performed using a lateral window technique and a xenograft, alone or in combination with the patient’s autologous bone from the mandible. Cone beam computed tomography (CBCT) images were used to compare the volumetric changes in the augmented bone for patients over a period of 6 or more years. No significant bone reduction was seen in the augmented bone region when comparing MSFA after 7 months and 6 or more years after dental implantation. Full article
(This article belongs to the Special Issue Oral Implantology and Bone Regeneration)
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12 pages, 343 KiB  
Systematic Review
Artificial Intelligence through Wireless Sensors Applied in Restorative Dentistry: A Systematic Review
by Carlos M. Ardila and Annie Marcela Vivares-Builes
Dent. J. 2024, 12(5), 120; https://doi.org/10.3390/dj12050120 - 24 Apr 2024
Viewed by 869
Abstract
The integration of wireless sensors with artificial intelligence could represent a transformative approach in restorative dentistry, offering a sophisticated means to enhance diagnostic precision, treatment planning, and patient outcomes. This systematic review was conducted to pinpoint and assess the efficacy of wireless sensors [...] Read more.
The integration of wireless sensors with artificial intelligence could represent a transformative approach in restorative dentistry, offering a sophisticated means to enhance diagnostic precision, treatment planning, and patient outcomes. This systematic review was conducted to pinpoint and assess the efficacy of wireless sensors in restorative dentistry. The search methodology followed the guidelines outlined by PRISMA and involved the utilization of prominent scientific databases. Following the final phase of evaluating eligibility, the systematic review included six papers. Five experiments were conducted in vitro, while one was a randomized clinical trial. The investigations focused on wireless sensors for cavity diagnosis, toothbrush forces, facial mask applications, and physiological parameter detection from dental implants. All wireless sensors demonstrated efficacy in achieving the objectives established by each study and showed the validity, accuracy, and reproducibility of this device. The investigations examined in this systematic review illustrate the potential of wireless sensors in restorative dentistry, especially in the areas of caries detection, dental implant systems, face masks, and power brushes. These technologies hold promise for enhancing patient outcomes and alleviating the workload of dental practitioners. Full article
(This article belongs to the Special Issue Feature Review Papers in Dentistry)
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12 pages, 919 KiB  
Article
Evaluating the Effects of Carriere Motion Appliance and Twin Block Appliances in Class II Correction—A Retrospective Study
by Gilad Har Zion, Eyal Katzhendler, Amal Bader Farraj, Miryam Rabin and Shmuel Einy
Dent. J. 2024, 12(5), 119; https://doi.org/10.3390/dj12050119 - 23 Apr 2024
Viewed by 757
Abstract
This retrospective study compared Class II orthodontic non-extraction treatment using Carriere Motion Appliance (CMA) and Twin Block (TB) appliances. Methods: The treatment of 38 patients was assessed. Pre- and post-treatment cephalometric radiographs were analyzed to evaluate skeletal, dental, and soft tissue treatment outcomes [...] Read more.
This retrospective study compared Class II orthodontic non-extraction treatment using Carriere Motion Appliance (CMA) and Twin Block (TB) appliances. Methods: The treatment of 38 patients was assessed. Pre- and post-treatment cephalometric radiographs were analyzed to evaluate skeletal, dental, and soft tissue treatment outcomes and efficacy. Results: Both appliances effectively corrected the Class II molar relationship. When measured at the distal aspect of the first molar, TB achieved 4.22 mm, while CMA had a 2.55 mm correction. When measured in the mesial aspect, the CMA achieved a 3.9 mm correction. The changes in SNB and ANB were statistically significant only in the TB group. The CMA appliance demonstrated statistically significantly less protrusion of the mandibular incisors and less upper incisor retrusion without vertical changes compared to the TB appliance. The TB demonstrated statistically significant lower lip protrusion compared to the CMA. Conclusion: The CMA corrects Class II malocclusions only by exerting a dentoalveolar influence and does not demonstrate the added effects associated with TB, such as elongation of lower facial height (LFH) and less loss of lower anchorage. Nonetheless, the correction in the TB group comprised both dentoalveolar and skeletal components. The CMA promotes a multidirectional upper and lower molar movement, and despite our 2D cephalometric analysis, we were able to estimate the extent of upper molar derotation. Full article
(This article belongs to the Special Issue Current Research Topics in Orthodontics)
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