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Dent. J., Volume 12, Issue 7 (July 2024) – 36 articles

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21 pages, 4449 KiB  
Article
Microbial Leakage through Three Different Implant–Abutment Interfaces on Morse Taper Implants In Vitro
by Ricardo Faria Ribeiro, Victor Barboza da Mata, Lucas de Oliveira Tomaselli, Anselmo Agostinho Simionato, Emerson de Souza Santos, Adriana Cláudia Lapria Faria, Renata Cristina Silveira Rodrigues and Cássio do Nascimento
Dent. J. 2024, 12(7), 226; https://doi.org/10.3390/dj12070226 (registering DOI) - 19 Jul 2024
Abstract
The objective of this study was to evaluate microbial leakage by means of genome counts, through the implant–abutment interface in dental implants with different Morse taper abutments. Fifty-six samples were prepared and divided in four groups: CMC TB (14 Cylindrical Implants–14 TiBase Abutments), [...] Read more.
The objective of this study was to evaluate microbial leakage by means of genome counts, through the implant–abutment interface in dental implants with different Morse taper abutments. Fifty-six samples were prepared and divided in four groups: CMC TB (14 Cylindrical Implants–14 TiBase Abutments), CMX TB (14 Conical Implants–14 TiBase Abutments), CMX PU (14 Conical Implants–14 Universal Abutment) and CMX U (14 Tapered Implants–14 UCLA Abutments). Assemblies had their interface submerged in saliva as the contaminant. Samples were subjected either to thermomechanical cycling (2 × 106 mechanical cycles with frequency of 5 Hz and load of 120 N simultaneously with thermal cycles of 5–55 °C) or thermal cycling (5–55 °C). After cycling, the contents from the inner parts of assemblies were collected and analyzed using the Checkerboard DNA–DNA hybridization technique. Significant differences in the total genome counts were found after both thermomechanical or thermal cycling: CMX U > CMX PU > CMX TB > CMC TB. There were also significant differences in individual bacterial counts in each of the groups (p < 0.05). Irrespective of mechanical cycling, the type of abutment seems to influence not only the total microbial leakage through the interface, but also seems to significantly reflect differences considering individual target species. Full article
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8 pages, 200 KiB  
Article
The Incidence of Obstructive Sleep Apnea in Patients with Dento-Skeletal Malformation
by Giuseppe D’Amato, Mattia Todaro, Gianmarco Saponaro, Paolo De Angelis, Alessandro Moro, Francesca Azzuni, Benedetta Capasso and Giulio Gasparini
Dent. J. 2024, 12(7), 225; https://doi.org/10.3390/dj12070225 (registering DOI) - 19 Jul 2024
Abstract
Purpose: The aim of this article is to analyze the incidence of undiagnosed obstructive sleep apnea (OSA) in patients affected by dento-skeletal malformation. We also evaluated the patterns most affected by the condition and calculated the post surgical changes. Methods: We conducted a [...] Read more.
Purpose: The aim of this article is to analyze the incidence of undiagnosed obstructive sleep apnea (OSA) in patients affected by dento-skeletal malformation. We also evaluated the patterns most affected by the condition and calculated the post surgical changes. Methods: We conducted a retrospective cohort study on 71 patients including 35 men and 36 women. The patients studied were affected by dento-skeletal class II and III malformations and underwent bimaxillary orthognathic surgery in all cases. Patients were evaluated with polysomnography before surgery and at least 6 months after surgery to assess any improvement or worsening of the apnea hypopnea index (AHI) index. Regarding AHI evaluation criteria, an AHI > 5 was considered indicative of OSA, 4 < AHI < 5 was considered borderline and AHI < 4 was considered indicative of non-OSA. We also considered demographic variables like age at the time of intervention and gender, and anatomical variables like the pattern of the dento-skeletal deformity and the presence or absence of maxillary hypoplasia. Qualitative variables were described as absolute and relative frequencies, while quantitative variables were summarized as mean and standard deviation. To quantitatively express the relationship between two variables, the correlation coefficient was calculated. The covariance array was used to evaluate multiple correlations. Results: Our study shows that there is a significant percentage (33%) of patients who undergo orthognathic surgery with an AHI > 5 and also a percentage of patients (11%) who can be considered to be “borderline.” It emerges that the pattern most at risk is the one characterized by retruded maxilla and patients with dento-skeletal class II. Considering the post surgical period, the statistical analysis shows that after surgery, only 8% of malformed patients present an AHI > 5, compared to the 20.5% described in the Italian population. Conclusions: In patients who receive orthognathic surgery, the presence of obstructive sleep apnea is significantly higher than in the general population. When planning the surgical correction of a dento-skeletal malformation, the surgeon must aim not only for the esthetics results, but also for proper stomatognathic and respiratory function; this cannot be achieved without taking polysomnography information into account. Full article
(This article belongs to the Section Oral and Maxillofacial Surgery)
8 pages, 441 KiB  
Article
Post and Core Treatment to Refit Telescopic Crown-Retained Dentures after Abutment Tooth Fracture: An Evaluation of Therapy by Retrospective Survival Analysis
by Jonas Adrian Helmut Vogler, William Abrahamian, Sarah Marie Reich, Bernd Wöstmann and Peter Rehmann
Dent. J. 2024, 12(7), 224; https://doi.org/10.3390/dj12070224 (registering DOI) - 19 Jul 2024
Abstract
Telescopic crown-retained dentures (TCDs) are one of the most common types of prosthetic restorations for partially edentulous patients; however, post and core (PC) treatment shows the worst survival probability if the tooth is used as an abutment for the TCD. Due to extra [...] Read more.
Telescopic crown-retained dentures (TCDs) are one of the most common types of prosthetic restorations for partially edentulous patients; however, post and core (PC) treatment shows the worst survival probability if the tooth is used as an abutment for the TCD. Due to extra axial forces, abutment tooth fracture is a common cause of failure for TCDs; thus, PC treatment is often needed to refit the existing telescopic crown (TC). However, there are no clinical survival data on whether the PC treatment was used to refit the TC after abutment tooth fracture (PC2) or the PC was already fitted at the time of TCD treatment (PC1). A total of 246 patients with 399 PC treatments were retrospectively evaluated for follow-ups up to 17.33 years. The files were analysed for PC1 and PC2. Furthermore, the influence of the jaw, type of tooth, luting material, PC material, bone attachment, therapist and cause of failure was recorded. For statistical analysis, Kaplan–Meier and Cox regression analyses were conducted. PC2 showed highly significant lower survival probabilities than PC1 (p < 0.001). Moreover, the bone attachment and the age of the patient at the time of fitting the PC crown had an influence on the survival (p < 0.001). Therefore, PC2 should be carefully discussed with the patient and PC1 should be favoured in endodontically treated abutment teeth for TCDs. Full article
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9 pages, 2156 KiB  
Case Report
Failed Orthodontic PEEK Retainer: A Scanning Electron Microscopy Analysis and a Possible Failure Mechanism in a Case Report
by Piero Antonio Zecca, Salvatore Bocchieri, Andrea Carganico, Margherita Caccia, Rosamaria Fastuca, Marina Borgese, Luca Levrini and Marcella Reguzzoni
Dent. J. 2024, 12(7), 223; https://doi.org/10.3390/dj12070223 - 18 Jul 2024
Viewed by 64
Abstract
This study presents a scanning electron microscopy analysis of a failed PEEK retainer in an orthodontic patient. After 15 months of use, the patient reported a gap opening between teeth 41 and 42. The PEEK retainer was removed and sent for electron microscope [...] Read more.
This study presents a scanning electron microscopy analysis of a failed PEEK retainer in an orthodontic patient. After 15 months of use, the patient reported a gap opening between teeth 41 and 42. The PEEK retainer was removed and sent for electron microscope analysis. To investigate the failure, scanning electron microscopy was employed to assess the microstructure and composition of the retainer at various magnifications. These findings suggest that the failure of the PEEK retainer was multifaceted, implicating factors such as material defects, manufacturing flaws, inadequate design, environmental factors, and patient-related factors. In conclusion, this scanning electron microscopy analysis offers valuable insights into the failure mechanisms of PEEK retainers in orthodontic applications. Further research is necessary to explore preventive strategies and optimize the design and fabrication of PEEK retainers, minimizing the occurrence of failures in orthodontic practice. Full article
(This article belongs to the Topic Advances in Dental Materials)
13 pages, 1152 KiB  
Article
A Three-Month Probiotic (the Streptococcus salivarius M18 Strain) Supplementation Decreases Gingival Bleeding and Plaque Accumulation: A Randomized Clinical Trial
by Ksenia Babina, Dilara Salikhova, Irina Makeeva, Alexandr Zaytsev, Inna Sokhova, Sevil Musaeva, Maria Polyakova and Nina Novozhilova
Dent. J. 2024, 12(7), 222; https://doi.org/10.3390/dj12070222 - 18 Jul 2024
Viewed by 114
Abstract
S. salivarius M18 administration has been proven to provide positive effects on periodontal health; however, there is still no consensus on the optimum duration of probiotic administration. This study aimed to evaluate the effect of three months of probiotic supplementation on bleeding on [...] Read more.
S. salivarius M18 administration has been proven to provide positive effects on periodontal health; however, there is still no consensus on the optimum duration of probiotic administration. This study aimed to evaluate the effect of three months of probiotic supplementation on bleeding on probing, signs of gingival inflammation, and dental biofilm. Sixty-two eligible individuals with gingivitis were enrolled in this placebo-controlled, double-blind trial and randomly allocated to the M18 or control groups. Primary outcomes were changes in gingival condition (gingival index, GI; gingival bleeding index, GBI) after 1, 2, and 3 months of lozenges administration and after a one-month washout. Secondary outcomes included changes in the Quigley–Hein plaque index (modified by Turesky et al.) after 1, 2, and 3 months of lozenges administration and after a washout. In total, 60 individuals completed the study (31 and 29 in the M18 group and the control group, respectively). No severe adverse events were reported. Probiotic supplementation resulted in a significant decrease in gingival bleeding at 1 month (effect size 1.09 [CI95%: 0.55–1.63]), 2 months (effect size 0.78 [CI95%: 0.26–1.30]), and 3 months (effect size 0.67 [CI95%: 0.15–1.18]) and a significant reduction in dental plaque accumulation at 2 months (effect size 0.63 [CI95%: 0.12–1.14]) and 3 months (effect size 0.55 [CI95%: 0.03–1.05]). A three-month supplementation with the probiotic resulted in a significant reduction in gingival bleeding and biofilm accumulation; however, a long-lasting effect is not expected, indicating the need for probiotic intake on a long-term basis. Full article
(This article belongs to the Special Issue Preventive Dentistry and Dental Public Health)
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21 pages, 9535 KiB  
Article
Insights into the Cytotoxicity and Irritant Potential of Chlorhexidine Digluconate: An In Vitro and In Ovo Safety Screening
by Stefania Dinu, Anamaria Matichescu, Roxana Buzatu, Iasmina Marcovici, Andreea Geamantan-Sirbu, Alexandra Denisa Semenescu, Remus Christian Bratu and Dana-Cristina Bratu
Dent. J. 2024, 12(7), 221; https://doi.org/10.3390/dj12070221 - 17 Jul 2024
Viewed by 187
Abstract
Chlorhexidine (CHX) represents one of the most commonly used antiseptics in dentistry and other medical–pharmaceutical fields due to its broad-spectrum antimicrobial activity. However, the potential toxic events arising from its common use in practice has become a subject of increasing concern. Thus, the [...] Read more.
Chlorhexidine (CHX) represents one of the most commonly used antiseptics in dentistry and other medical–pharmaceutical fields due to its broad-spectrum antimicrobial activity. However, the potential toxic events arising from its common use in practice has become a subject of increasing concern. Thus, the present study was designed to investigate the potential toxicity of CHX digluconate at concentrations covering its antibacterial properties (0.0002–0.2%) in HGF primary gingival fibroblasts, HaCaT immortalized human keratinocytes, and JB6 Cl 41-5a epidermal cells, as well as its irritant action in ovo. Our results indicate that CHX exerted a concentration- and time-dependent cytotoxicity in all cell lines, which was evidenced by the reduction in cell viability, number, and confluence, damaged cell membrane integrity, impaired cell morphology, and specific apoptotic nuclear shape. The highest cytotoxicity was caused by CHX digluconate 0.02% and 0.2%, concentrations, at which an irritant effect on the chorioallantoic membrane was also observed. The novel findings revealed in this research contribute to the overall safety profile of CHX and stand as a basis for further investigations in this regard. Full article
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14 pages, 5660 KiB  
Article
Assessing the Volume of the Head of the Mandibular Condyle Using 3T-MRI—A Preliminary Trial
by Alessandro Mosca Balma, Davide Cavagnetto, Lorenzo Pavone and Federico Mussano
Dent. J. 2024, 12(7), 220; https://doi.org/10.3390/dj12070220 - 16 Jul 2024
Viewed by 262
Abstract
Due to potentially harmful exposure to X-rays, condylar growth in response to orthodontic treatment is poorly studied. To overcome this limitation, here, the authors have proposed high-resolution MRI as a viable alternative to CBCT for clinical 3D assessment of TMJ. A male subject [...] Read more.
Due to potentially harmful exposure to X-rays, condylar growth in response to orthodontic treatment is poorly studied. To overcome this limitation, here, the authors have proposed high-resolution MRI as a viable alternative to CBCT for clinical 3D assessment of TMJ. A male subject underwent both MRI and CBCT scans. The obtained three-dimensional reconstructions of the TMJ were segmented and superimposed by a semiautomatic algorithm developed in MATLAB R2022a. The condylar geometries were reconstructed using dedicated software for image segmentation. Two geometrical parameters, i.e., the total volume and surface of the single condyle model, were selected to quantify the intraclass and interclass variability from the mean of each DICOM series (CBCT and MRI). The final comparison between the reference standard model of CBCT and 3T MRI showed that the former was more robust in terms of reproducibility, while the latter reached a higher standard deviation compared to CBCT, but these values were similar between the operators and clinically not significant. Within the inherent limitation of image reconstruction on MRI scans due to the current lower resolution of this technique, the method proposed here could be considered as a nucleus for developing future completely automatic AI algorithms, owing to its great potential and satisfactory consistency among different times and operators. Full article
(This article belongs to the Special Issue Regenerative Approaches in Dental Sciences)
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14 pages, 2965 KiB  
Article
Bonding Effectiveness of Veneering Ceramic to Zirconia after Different Grit-Blasting Treatments
by Francesca Zicari, Carlo Monaco, Marcio Vivan Cardoso, Davide Silvestri and Bart Van Meerbeek
Dent. J. 2024, 12(7), 219; https://doi.org/10.3390/dj12070219 - 15 Jul 2024
Viewed by 276
Abstract
Objective: To determine the effect of grit-blasting before and after sintering on the surface roughness of zirconia and the micro-tensile bond strength of a pressable veneering ceramic to zirconia. Methods: Pre-sintered zirconia blocks (IPS e.max ZirCAD, Ivoclar) were divided into four test groups [...] Read more.
Objective: To determine the effect of grit-blasting before and after sintering on the surface roughness of zirconia and the micro-tensile bond strength of a pressable veneering ceramic to zirconia. Methods: Pre-sintered zirconia blocks (IPS e.max ZirCAD, Ivoclar) were divided into four test groups of three specimens each and a control group (‘CTR’; no surface treatment). Pre-S-30, Pre-S-50, and Pre-S-110 were grit-blasted with 30-µm SiO2-coated Al2O3, 50-µm Al2O3 and 110-µm Al2O3 particles, respectively, before sintering. Post-S-30 was grit-blasted with 30-µm SiO2-coated Al2O3 after sintering. For each treatment, the surface roughness was measured (Ra, Perthometer M4P, Mahr Perthen). After sintering the zirconia blocks, a liner was applied and a pressable ceramic (IPS e.max ZirPress, Ivoclar) was heat-pressed. Sixteen microbars were obtained from each block and submitted to micro-tensile bond-strength (µTBS) testing. Data were analyzed with one-way ANOVA. Any correlation between Ra and µTBS was evaluated (Sperman test). Results: Grit-blasting before sintering with 110-µm Al2O3 (RaPre-S-110 = 3.4 ± 0.4 µm), 50-µm Al2O3 (RaPre-S-50 = 2.3 ± 0.5 µm), and 30-µm SiO2-coated Al2O3 (RaPre-S-30 = 1.2 ± 0.2 µm) resulted in significantly higher roughness than grit-blasting after sintering with 30-µm SiO2-coated Al2O3 (RaPost-S-30 = 0.5 ± 0.1 µm). The highest µTBS was measured when the sintered zirconia was grit-blasted with 30-μm SiO2-coated Al2O3 (µTBSPost-S-30 = 28.5 ± 12.6 MPa), which was significantly different from that of specimens that were grit-blasted before sintering (µTBSPre-S-30 = 21.8 ± 10.4; µTBSPre-S-50 = 24.1 ± 12.6; µTBSPre-S-110 = 26.4 ± 14.1) or were not grit-blasted (µTBSCTR = 20.2 ± 11.2). Conclusions: Grit-blasting zirconia before sintering enhanced the surface roughness proportionally to the particle size of the sand used. Grit-blasting with 30-µm SiO2-coated Al2O3 after sintering improved bonding of the veneering ceramic to zirconia. Clinical Significance: As grit-blasting with 30-µm SiO2-coated Al2O3 after sintering improved bonding of the veneering ceramic to zirconia, it may reduce veneering ceramic fractures/chipping. Full article
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14 pages, 5876 KiB  
Case Report
Combining Orthodontic and Restorative Care with Novel Workflows
by Francisco Garcia-Torres, Carlos A. Jurado, Silvia Rojas-Rueda, Susana Sanchez-Vazquez, Franciele Floriani, Nicholas G. Fischer and Akimasa Tsujimoto
Dent. J. 2024, 12(7), 218; https://doi.org/10.3390/dj12070218 - 15 Jul 2024
Viewed by 237
Abstract
This report describes multidisciplinary care combining orthodontics and restorative dentistry for a patient with Class II occlusion and stained mandibular and maxillary resin composite veneers. The orthodontic treatment improved severe overjet and malocclusion prior to restorative care. Occlusal assessment was provided with a [...] Read more.
This report describes multidisciplinary care combining orthodontics and restorative dentistry for a patient with Class II occlusion and stained mandibular and maxillary resin composite veneers. The orthodontic treatment improved severe overjet and malocclusion prior to restorative care. Occlusal assessment was provided with a novel digital device (PlaneSystem, Zirkonzahn) that is integrated with digital workflows for the evaluation of the occlusal plane and condylar path inclination. Diagnostic digital impressions and digital wax-up for intraoral mock-ups led to the patient’s treatment acceptance. Minimally invasive tooth preparation, final digital impressions, and bonding under dental dam isolation fulfilled the patient’s esthetic and functional demands with all-ceramic restorations. Full article
(This article belongs to the Special Issue Feature Papers in Digital Dentistry)
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14 pages, 251 KiB  
Article
Assessment of Food Masticatory Capability with Clear Aligners
by Luca Levrini, Nicola Giannotta, Rodolfo Francesco Mastrapasqua, Davide Farronato, Vittorio Maurino, Alessandro Deppieri, Federico Tasquier and Stefano Saran
Dent. J. 2024, 12(7), 217; https://doi.org/10.3390/dj12070217 - 15 Jul 2024
Viewed by 283
Abstract
Nowadays, aligners represent a possible therapeutical approach that combines both esthetic and function in order to address dental malocclusion. However, they require a significant level of compliance from the patient. According to the manufacturer, at least 22 h of wearing a day is [...] Read more.
Nowadays, aligners represent a possible therapeutical approach that combines both esthetic and function in order to address dental malocclusion. However, they require a significant level of compliance from the patient. According to the manufacturer, at least 22 h of wearing a day is demanded to reach the optimal therapeutical level; hence, aligners can only be removed during meals. Patients’ compliance might increase and the duration of the treatment might decrease if they were allowed to eat with aligners on. The idea of patients keeping the aligners on during meals has been contemplated, not only to favor patients’ compliance but also treatment effectiveness. This study aims to assess the degree of chewing difficulty that aligners cause when eating certain kinds of food and the quantity of residue left. Material and Methods: A questionnaire titled “Questionnaire for the Assessment of Masticatory Function with Aligners” was administered using Google Forms to 240 patients in treatment with clear aligners. The survey was validated through the reliability test using the test–retest method. This method had a higher correlation coefficient of 0.9 across all items (with a cutoff of 0.8) with statistical significance, and an excellent internal correlation coefficient (α > 0.9). The statistical analysis performed consisted of descriptive analysis, frequencies, percentages, Pearson’s correlation test and Friedman’s test. Results: Pearson’s test showed a statistically significant correlation between all items except between meat or clams and yogurt or ice cream and with mozzarella or soft cheese regarding food chewing difficulties. Pearson’s test showed a statistically significant correlation between all items regarding food residues. A total of 69.2% of the cohort reported some movements of aligners during mastication. In total, 88.3% of them affirmed not to have perceived deformations or breakage of aligners during chewing. Furthermore, 79.2% of them declared that they would continue to eat if eating with aligners was proven to speed up treatment. Conclusions: Wearing clear aligners while chewing foods such as yogurt, ice cream, soft cheese, bread, rice, etc., can be possible and can help shorten the duration of orthodontic treatment, benefiting both the patient and the orthodontist. However, further research using qualitative methods is needed to understand the barriers and facilitators to chewing food with aligners. Full article
(This article belongs to the Special Issue Orthodontics and New Technologies: 2nd Edition)
11 pages, 59241 KiB  
Hypothesis
An Enigmatic Soft-Tissue Creeping Phenomenon: The Spontaneous Peri-Implant Mucosa Margin and Papilla Growth, Part Two—A Scientifically Supported Hypothesis Article
by Ivo Agabiti, Karol Alí Apaza Alccayhuaman, Zenzaburo Taniguchi, Kazuhisa Kuwano and Daniele Botticelli
Dent. J. 2024, 12(7), 216; https://doi.org/10.3390/dj12070216 - 12 Jul 2024
Viewed by 241
Abstract
In our previous article, we observed and measured a spontaneous growth in the coronal direction of the keratinized tissues present around implants. This growth involved both free margins and interdental papillae, and we indicated our hypothesis on the probable cause of this still-unexplained [...] Read more.
In our previous article, we observed and measured a spontaneous growth in the coronal direction of the keratinized tissues present around implants. This growth involved both free margins and interdental papillae, and we indicated our hypothesis on the probable cause of this still-unexplained phenomenon. The growth of oral soft tissues involves several other structures, such as the linea alba and tongue indentation. Our idea holds that growth of these tissues is generated by the negative intraoral pressure created in the oral phase of swallowing and the subsequent resting position, which through the resulting suction causes a shift of these soft structures in the gaps around the dental crowns. Other hypotheses have been suggested in the past to understand this phenomenon of soft tissue growth, which still lacks data supporting etiological evidence. The purpose of this article is to thoroughly analyze and verify our model by comparing the clinical observations with citations and examples from the literature, combined with notions of physiology, biology, and physics that help in clarifying these events. To better explain the mechanisms of oral soft tissue growth, photographs of clinical cases paradigmatic of the phenomenon are shown. Full article
(This article belongs to the Special Issue Advances in Periodontal and Peri-Implant Tissues Health Management)
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13 pages, 790 KiB  
Systematic Review
The Correlation between Oral Health and Air Pollution: A Systematic Review
by Bruna Sinjari, Manlio Santilli, Piero Di Carlo, Eleonora Aruffo and Sergio Caputi
Dent. J. 2024, 12(7), 215; https://doi.org/10.3390/dj12070215 - 11 Jul 2024
Viewed by 399
Abstract
This systematic review assessed to evaluate the potential correlation between oral health and air pollution. To the best of the authors’ knowledge, this is the first systematic review endeavoring to compare air pollution and oral health. A systematic search was performed according to [...] Read more.
This systematic review assessed to evaluate the potential correlation between oral health and air pollution. To the best of the authors’ knowledge, this is the first systematic review endeavoring to compare air pollution and oral health. A systematic search was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) statement and employed the PICO(S) approach (Patient or Population, Intervention, Control or Comparison, Outcome, and Study types). The search was limited to English-language articles, and publications within a 15-year timeframe were included in the electronic search. A comprehensive search was conducted across PubMed, Scopus, Embase, and Web of Science databases, spanning the years 2008 to 2023, resulting in a total of 4983 scientific articles. A final selection of 11 scientific papers was made based on their study type and the specific air pollutants examined. The selected papers analyzed various air pollutants associated with health-related diseases, including Ozone, Nitrogen Dioxide, Nitrogen Monoxide, Carbon Monoxide, sulfur dioxide, and particulate matter. Three out of eleven of the reviewed studies assert a strong correlation between air pollutants and oral diseases, specifically periodontitis. However, the exact biological mechanisms underlying this correlation do not seem to be fully understood, indicating the need for further comprehensive investigation in this regard. Dentists can contribute to the collective effort by educating their patients about the oral health implications of air pollution, thereby supporting initiatives aimed at promoting environmental and health sustainability. Full article
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25 pages, 1899 KiB  
Review
Conspiracy of Silence in Head and Neck Cancer Diagnosis: A Scoping Review
by Cristina Saldivia-Siracusa, Erison Santana Dos Santos, Wilfredo Alejandro González-Arriagada, Ana Carolina Prado-Ribeiro, Thaís Bianca Brandão, Adepitan Owosho, Marcio Ajudarte Lopes, Joel B. Epstein and Alan Roger Santos-Silva
Dent. J. 2024, 12(7), 214; https://doi.org/10.3390/dj12070214 - 11 Jul 2024
Viewed by 262
Abstract
Cancer disclosure represents a complex healthcare dynamic. Physicians or caregivers may be prompted to withhold diagnosis information from patients. This study aims to comprehensively map and synthesize available evidence about diagnosis nondisclosure regarding head and neck cancer (HNC) patients. Following the Joanna Briggs [...] Read more.
Cancer disclosure represents a complex healthcare dynamic. Physicians or caregivers may be prompted to withhold diagnosis information from patients. This study aims to comprehensively map and synthesize available evidence about diagnosis nondisclosure regarding head and neck cancer (HNC) patients. Following the Joanna Briggs Institute guidelines, a scoping review was conducted across major databases without period restriction, yielding 9238 publications. After screening and selection, a descriptive synthesis was conducted. Sixteen studies were included, primarily conducted in academic settings (75%) from Europe and Asia, with a total population of 662 patients predominantly diagnosed with brain, oral, pharyngeal, or laryngeal tumors. Remarkably, 22.51% of patients were unaware of their diagnosis. Although physicians were the main source of diagnostic information (35%), they reported to often use vague terms to convey malignancy. Additionally, 13.29% of patients were aware of their diagnosis from sources other than doctors or caregivers. Caregivers (55%) supported diagnosis concealment, and physicians tended to respect family wishes. A high diagnosis-to-death interval, education, and age significantly influenced diagnosis disclosure. HNC patients expressed a desire for personalized open communication. Multiple factors influenced the decision on diagnosis disclosure. Current evidence on this topic varies significantly, and there is limited research on the consequences of nondisclosure. These findings reflect the underestimation of the patients’ outlook in the diagnosis process and highlight the need for further research, aiming to establish open communication and patient autonomy during the oncological journey. Full article
(This article belongs to the Special Issue Feature Review Papers in Dentistry)
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11 pages, 259 KiB  
Article
The Role of Malocclusion and Oral Parafunctions in Predicting Signs and Symptoms of Temporomandibular Disorders—A Cross-Sectional Study
by Luka Šimunović, Marina Lapter Varga, Dubravka Negovetić Vranić, Ivana Čuković-Bagić, Lana Bergman and Senka Meštrović
Dent. J. 2024, 12(7), 213; https://doi.org/10.3390/dj12070213 - 10 Jul 2024
Viewed by 281
Abstract
Background: The aim of this study was to examine to what extent malocclusion and parafunctional habits contribute to the development of signs and symptoms associated with temporomandibular disorders (TMD) in schoolchildren with mixed dentition in Croatia in a sample of 338 children, aged [...] Read more.
Background: The aim of this study was to examine to what extent malocclusion and parafunctional habits contribute to the development of signs and symptoms associated with temporomandibular disorders (TMD) in schoolchildren with mixed dentition in Croatia in a sample of 338 children, aged 9 to 15 years. Methods: TMD signs and symptoms assessed by the clinician were joint function and pain, masticatory muscles tenderness, range of mandibular motion, and joint sounds. To evaluate subjective symptoms and parafunctions, children and parents were asked about the presence of headaches, jaw locking, temporomandibular joint (TMJ) sounds, pain during mouth opening, or bruxism, as well as parafunctions like biting pencils or nails, chewing hard candies or ice, daily gum chewing, opening bottles with teeth, engaging in jaw play, thumb-sucking, and clenching/grinding teeth. Results: At least one symptom of a TMD was pronounced in 142 participants (42.0%). The most commonly reported parafunction was pencil or nail biting, present in 25.1% of participants. Class II malocclusion increased the likelihood by 2.6 times, pencil or nail biting by 2.34 times, and clenching/grinding teeth by 8.9 times that the subject would exhibit at least one TMD symptom. Conclusions: Every child with mixed dentition should undergo a brief examination of the TMJ, especially in cases of Class II malocclusion, pencil or nail biting, and teeth clenching or grinding, as these have all been identified as significant risk factors that increase the likelihood of experiencing TMD symptoms. This highlights the need for proactive screening and assessment by healthcare providers to reduce the risk and prevalence of TMDs in affected children and ensure timely diagnosis and treatment. Full article
11 pages, 1223 KiB  
Article
Prevalence and Classification of C-Shaped Canal and Radix in Mandibular Molars Using Cone-Beam Computed Tomography on Mexican Population
by Hugo Bojorquez Armenta, Angel Gustavo Romo Mireles, Javier Solis Martinez, Jesus Pescador Alvarez, Yarely Ramos Herrera, Omar Tremillo Maldonado, Oscar Almeda Ojeda, Jose Salas Pacheco, Gamaliel Ortiz Sarabia, Francisco Xavier Castellanos-Juarez and Sergio Salas Pacheco
Dent. J. 2024, 12(7), 212; https://doi.org/10.3390/dj12070212 - 10 Jul 2024
Viewed by 261
Abstract
The diverse morphological configurations in teeth present clinical challenges in root canal treatment, complicating instrumentation and irrigation processes, which can lead to treatment failure. Understanding anatomical variations, such as C-shaped canals and radix entomolaris, enhances clinical skills and improves long-term endodontic treatment success [...] Read more.
The diverse morphological configurations in teeth present clinical challenges in root canal treatment, complicating instrumentation and irrigation processes, which can lead to treatment failure. Understanding anatomical variations, such as C-shaped canals and radix entomolaris, enhances clinical skills and improves long-term endodontic treatment success rates. Cone-beam computed tomography (CBCT) offers superior diagnostic capabilities over conventional radiography, enabling the pre-operative detection of root configurations and canal numbers, facilitating personalized endodontic treatments. A total of 2173 teeth of a Mexican population, including 1057 first mandibular molars and 1116 s mandibular molars, were studied using only CBCT to identify C-shaped canals and radix configurations of patients who were treated from 2018 to 2023 at the Department of Radiology at the Faculty of Dentistry, Juarez University of the State of Durango, Mexico. C-shaped canals were identified in 160 teeth, with a prevalence of 0.2% in first mandibular molars and 14.1% in second mandibular molars. The highest frequency was in the left second mandibular molar (3.7) at 14.8%. Gender differences were significant, with higher prevalence in females (27.3%) compared to males (13.3%). The most common C-shaped canal configuration was type C2 (39.3%). Radix entomolaris was found in 52 teeth, with a prevalence of 3.4% in first mandibular molars and 1.4% in second mandibular molars. This research on a Mexican population using cone-beam computed tomography (CBCT) highlights significant findings in the prevalence and types of C-shaped canals and radix entomolaris in mandibular molars for this population. The left second mandibular molar (3.7) showed the highest prevalence at 14.8%, followed closely by the right second mandibular molar (4.7) at 13.5%, with a significant difference (p < 0.001). We found a significant difference in the prevalence of C-shaped canals between genders (p = 0.004, OR 1.78). Additionally, radix entomolaris (p < 0.001) was more frequently identified in first mandibular molars to a significant degree. These insights underscore the importance of CBCT in diagnosing complex root anatomies, which can greatly enhance the success rates of endodontic procedures by allowing for more tailored and precise treatments for this population. Full article
(This article belongs to the Special Issue Endodontics: From Technique to Regeneration)
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15 pages, 1319 KiB  
Article
Investigation of Oral Health in Children from Urban Slums of Nairobi, Kenya
by Gianni Di Giorgio, Simona De Pasquale, Enrico Battaglia, Giulia Zumbo, Cristina Mollica, Rita D’Ecclesia, Antonella Polimeni and Maurizio Bossù
Dent. J. 2024, 12(7), 211; https://doi.org/10.3390/dj12070211 - 10 Jul 2024
Viewed by 424
Abstract
For children living in the urban slums of Nairobi (Kenya), primary health conditions are not guaranteed, and oral diseases add further concern at social and institutional levels beyond the general poverty conditions. This study aims at determining the factors that influence the oral [...] Read more.
For children living in the urban slums of Nairobi (Kenya), primary health conditions are not guaranteed, and oral diseases add further concern at social and institutional levels beyond the general poverty conditions. This study aims at determining the factors that influence the oral health status of children living in Nairobi slums. A cross-sectional study on school-aged subjects was conducted in June 2022 in three urban slum areas of Nairobi through a pediatric dental screening. The PI (Plaque Index), CPITN (Community Periodontal Index of Treatment Needs), and dmft (decayed, missing, and filled teeth index—deciduous) were considered as primary outcomes of dental health. Multivariate statistical analysis, based on ordinal and zero-inflated negative binomial regression models, was conducted to identify determinants of the oral outcomes in a wide set of potential predictors. A sample of 359 children aged 2–17 was examined. The PI was significantly associated with age, the type of bite, and the use of a toothbrush. The CPITN is influenced by different types of malocclusions, abnormal frenulum, dental trauma, and fluorosis. Dietary habits were found to significantly impact the susceptibility to dental caries. Fluorosis and a dental visit in the last year were highlighted as risk and protective factors, respectively, against higher rates of caries. The oral health features of children living in Nairobi slums are differently affected by socio-demographic conditions, dietary habits, dental characteristics, and oral care practices. Full article
(This article belongs to the Special Issue Preventive Dentistry and Dental Public Health)
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9 pages, 214 KiB  
Article
Demographic and Radiographic Characteristics Associated with the Occurrence of Impacted Third Molars in Indonesian Patients: A Retrospective Study
by Indra Hadikrishna, Melita Sylvyana, Madhuri Pattamatta, Folli Mulyawati and Tantry Maulina
Dent. J. 2024, 12(7), 210; https://doi.org/10.3390/dj12070210 - 9 Jul 2024
Viewed by 308
Abstract
An impacted third molar is one of the most common abnormalities of the tooth position, impacting patients and their quality of life. Based on the impact and the invasive removal procedure, this study aimed to evaluate the characteristics of impacted third molars based [...] Read more.
An impacted third molar is one of the most common abnormalities of the tooth position, impacting patients and their quality of life. Based on the impact and the invasive removal procedure, this study aimed to evaluate the characteristics of impacted third molars based on their radiographic features as well as their association with demographic characteristics. Outpatient dental records of the oral and maxillofacial surgery department of Hasan Sadikin Hospital, Bandung, Indonesia, from 1 January 2018 to 31 December 2019, were sorted, and relevant clinical and demographic data and panoramic radiographic examination results were extracted from these records. All data were then tabulated and analyzed by using SPSS version 29. As many as 3019 impacted third molars were identified. Our findings suggested the association between age to the occurrence of impacted third molars where patients aged between 17 and 29 years old showed high occurrences of impacted third molars. Male patients with impacted third molars are more likely to have multiple impacted third molars, while this risk decreases in females. Radiographic examination showed that the mesioangular position is the most common position for mandibular third molars. The variation in high occurrences of the impacted third molar is associated with several demographic factors. Full article
18 pages, 1666 KiB  
Article
Evaluation of Biomarkers of Bone Metabolism on Salivary Matrix in the Remodeling of Periodontal Tissue during Orthodontic Treatment
by Angela Pia Cazzolla, Vincenzo Brescia, Roberto Lovero, Antonietta Fontana, Arcangela Giustino, Mario Dioguardi, Maria Severa Di Comite, Francesca Di Serio, Domenico Ciavarella and Vito Crincoli
Dent. J. 2024, 12(7), 209; https://doi.org/10.3390/dj12070209 - 9 Jul 2024
Viewed by 275
Abstract
The aim of this study was to evaluate changes in the concentration of N-terminal type I collagen extension pro-peptide (PINP), tartrate-resistant acid phosphatase (TRAcP), and parathyroid hormone-related protein (PTHrP) in saliva during orthodontic treatment in order to evaluate whether changes in bone turnover [...] Read more.
The aim of this study was to evaluate changes in the concentration of N-terminal type I collagen extension pro-peptide (PINP), tartrate-resistant acid phosphatase (TRAcP), and parathyroid hormone-related protein (PTHrP) in saliva during orthodontic treatment in order to evaluate whether changes in bone turnover marker (BTM) concentration can help highlight the effects of orthodontic mechanical loading in the absence of clinical evidence of tooth movement in terms of tooth movement. Saliva samples from 25 apparently healthy young subjects (10 females and 15 males) were collected using Salivette® (Sarstedt) with cotton swabs and the concentrations of PTHrP, TRAcP 5b, and PINP were analyzed at time 0 (T1), 25 days (T2), and at 45 days (T3). Differences in the median value of biomarker levels between baseline T1 and follow-up of the different groups (T2 and T3) were assessed using the non-parametric Mann–Whitney U test. Trough concentrations of P1NP, PTHrP, and TRAcP were 0.80 µg/L, 0.21 ng/mL, and 0.90 U/L above the method LOD. The non-parametric Mann–Whitney U test confirmed a statistically significant difference in T1 versus concentrations of T2 and T3. All subjects evaluated had a statistically significant difference between T1 vs. T3. when compared with the specific critical difference (RCV) for the analyte The results obtained demonstrate that the evaluation of BTM changes in saliva can help the evaluation of orthodontic procedures and the monitoring of biomechanical therapy. Full article
(This article belongs to the Special Issue Tradition and Innovation in Orthodontics)
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14 pages, 2946 KiB  
Article
Gingival Enlargement Associated with Orthodontics Appliance Increases Protein Carbonylation and Alters Phosphorylation of Salivary Proteome
by Zulieth Lopez Arrieta, Erika Rodríguez-Cavallo and Darío Méndez-Cuadro
Dent. J. 2024, 12(7), 208; https://doi.org/10.3390/dj12070208 - 8 Jul 2024
Viewed by 299
Abstract
Gingival enlargement is a common clinical sign in the gingival diseases associated with orthodontic treatment. Its biological mechanisms are not completely understood; nevertheless, the biochemical changes associated with these inflammatory and overgrowth processes could alter the post-translational protein modifications occurring in various locations [...] Read more.
Gingival enlargement is a common clinical sign in the gingival diseases associated with orthodontic treatment. Its biological mechanisms are not completely understood; nevertheless, the biochemical changes associated with these inflammatory and overgrowth processes could alter the post-translational protein modifications occurring in various locations within the mouth. Here, changes in the profiles of the carbonylated and phosphorylated proteins in saliva were examined in donors with gingival enlargement (seven men and seven women) and healthy donors (six men and eight women). The sociodemographic characteristics of both groups did not present significant differences. Carbonylation was measured by a quantitative immunoassay (Dot Blot), whereas the profiles of the phosphorylated proteins were visualized by SDS-PAGE with quercetin staining. Some phosphopeptides were also identified using a typical LC-MS-MS approach. Our results showed that gingival enlargement induced a significant increase in oxidative damage in salivary proteins. While a significant reduction in phosphorylation was observed at the stain level in SDS-PAGE, there was a slight increase in the number of phosphorylated proteins identified by MS in samples with gingival enlargement. Full article
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11 pages, 235 KiB  
Article
Clinical Management of Facemasks for Early Treatment of Class III Malocclusion: A Survey among SIDO Members
by Lorenzo Franchi, Michele Nieri, Patrizia Marti, Annamaria Recupero, Alessandra Volpe, Alessandro Vichi and Cecilia Goracci
Dent. J. 2024, 12(7), 207; https://doi.org/10.3390/dj12070207 - 5 Jul 2024
Viewed by 348
Abstract
To evaluate whether there are differences among orthodontists in the clinical management of facemask treatment for early treatment of Class III malocclusion, a survey consisting of 16 questions was conducted among members of the Italian Society of Orthodontics (SIDO). Sixty percent of the [...] Read more.
To evaluate whether there are differences among orthodontists in the clinical management of facemask treatment for early treatment of Class III malocclusion, a survey consisting of 16 questions was conducted among members of the Italian Society of Orthodontics (SIDO). Sixty percent of the respondents were Specialists in Orthodontics (S) whereas 40% were General Dentists practicing Orthodontics (GD). Descriptive statistics were calculated to summarize the collected data. Differences in answers between S and GD were assessed with the Fisher’s exact test for dichotomous variables, chi-square test for qualitative variables, and Mann–Whitney test for ordinal variables. A total of 151 clinicians participated in this survey. As for treatment timing, about 80% of the participants reported treating Class III patients with RPE and facemask between 5 and 8 years of age. Most of the participants requested the patients to wear the facemask in the afternoon and at night for a period of 9 or 12 months with recommended forces of 500 g per side. Comparisons between S and GD showed that S preferred the Petit facemask whereas GD favored the Delaire’s type facemask (Fisher’s Exact test, p = 0.0005). S and GD also differed significantly in their judgment of the most critical time of treatment, which for the majority of GD was the initial period but for the S was the final period (Chi-square test p = 0.0188). This survey showed that the facemask is not well received by the patients who, along with their parents, express concerns regarding its tolerability. Full article
(This article belongs to the Special Issue Current Research Topics in Orthodontics)
12 pages, 1048 KiB  
Article
Adhesive Performance of Pit and Fissure Sealants on Deproteinized Enamel with Different Proteolytic Agents: In Vitro Study
by Luis Francisco García-Mota, Miguel-Ángel Fernández-Barrera, Rene Garcia-Contreras, Guillermo Grazioli, Juan Eliezer Zamarripa-Calderón, José Alejandro Rivera-Gonzaga and Carlos Enrique Cuevas-Suárez
Dent. J. 2024, 12(7), 206; https://doi.org/10.3390/dj12070206 - 4 Jul 2024
Viewed by 309
Abstract
The objective of this work was to assess the efficacy of different proteolytic agents on the bond strength of pit and fissure sealants to bovine enamel. Eighty-four bovine enamel specimens were randomly assigned in groups according to the pit and fissure sealant applied [...] Read more.
The objective of this work was to assess the efficacy of different proteolytic agents on the bond strength of pit and fissure sealants to bovine enamel. Eighty-four bovine enamel specimens were randomly assigned in groups according to the pit and fissure sealant applied (HelioSeal F or Dyad Flow). Then, the specimens were subdivided according to the proteolytic agent used (n = 7): Group 1, distilled water (control); Group 2, 10 wt.% Tergazyme®; Group 3, 10 wt.% ZYME®; Group 4, 10% papain gel; Group 5, 10% bromelain gel; and Group 6, 5.25 wt.% sodium hypochlorite. The cell viability of the proteolytic solutions was assessed through the MTT assay. The proteolytic agents were applied on the enamel surface prior to the acid-etching procedure; then, the pit and fissure sealants were placed. The micro-shear bond strength was evaluated after 24 h or 6 months of water storing at 37 °C. Representative SEM images were taken for each experimental group. The bond strength data were statistically analyzed by a three-way ANOVA test using a significance level of α = 0.05. Bromelain and papain proteolytic solutions did not exert any cytotoxic effect on the human dental pulp cells. After 24 h and 6 months of aging, for both pit and fissure sealants, sodium hypochlorite, papain, bromelain, and Tergazyme® achieved statistically significant higher bond strength values (p < 0.05). Irrespective of the deproteinizing agent used, Dyad Flow resulted in a better bond strength after 6 months of aging. The type 1 etching pattern was identified for sodium hypochlorite, papain, and bromelain. Tergazyme®, papain, and bromelain demonstrated efficacy in deproteinizing enamel surfaces prior to acid etching, leading to the improved bond strength of pit and fissure sealants. Clinically, this suggests that these proteolytic agents can be considered viable alternatives to traditional methods for enhancing sealant retention and longevity. Utilizing these agents in dental practice could potentially reduce sealant failures. Full article
(This article belongs to the Special Issue Prevention of Dental Caries and Erosive Tooth Wear)
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11 pages, 698 KiB  
Article
Rehabilitation Using Implants with Sloped Platform Edge vs. Standard Platform with Guided Bone Regeneration: A Randomized Control Clinical Trial
by Igor Ashurko, Andrey Samsonov, Anna Galyas, Marina Petukhova, Svetlana Tarasenko and Alexey Unkovskiy
Dent. J. 2024, 12(7), 205; https://doi.org/10.3390/dj12070205 - 4 Jul 2024
Viewed by 285
Abstract
The purpose of this study was to evaluate the vertical bone loss after using different techniques: sloped implants or standard implants with guided bone regeneration. Patients with tooth gap and horizontal bone deficiency were randomly allocated to the test group (implants with sloped [...] Read more.
The purpose of this study was to evaluate the vertical bone loss after using different techniques: sloped implants or standard implants with guided bone regeneration. Patients with tooth gap and horizontal bone deficiency were randomly allocated to the test group (implants with sloped platform—SLP) and control group (standard design implants with guided bone regeneration—GBR). The primary outcome was bone loss (6 months after finishing the prosthetic treatment). Secondary outcomes included the following: patient-reported outcome measures (PROMs), post-operative edema, keratinized mucosa width, and pink aesthetic score (PES). The average bone loss at 6 months was 0.23 ± 0.15 mm and 1.03 ± 0.37 mm in the SLP and GBR groups, respectively. The SLP group was characterized by lower pain intensity the first 7 days (p < 0.001), lower post-operative edema (p < 0.001), lower consumption of NSAIDs on days 1, 3, 5, and 7 (p = 0.002, <0.001, <0.001, and 0.008), and lower total OHIP-14 (p = 0.047) on day 7. The keratinized mucosa width was 3.7 (3.4–4.0) mm and 2 (1.4–2.0) mm in the SLP and GBR groups, respectively. The preservation of the mesial, distal papillae, and the level of soft tissue correspondence were significantly higher in the SLP group (p = 0.003, 0.038, <0.001). In the SLP group, more natural color and better texture of soft tissues were found (p = 0.048, p = 0.041). The use of implants with a sloped platform resulted in superior outcomes compared to the standard-design implants with GBR. Full article
(This article belongs to the Section Dental Implantology)
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15 pages, 2163 KiB  
Article
Computerized Axiographic Findings in a Cohort of Migraine Patients: A Cross-Sectional Study
by Nikolaos Zokaris, Marcus Greven, Michail Tzakis and Vasileios Psarras
Dent. J. 2024, 12(7), 204; https://doi.org/10.3390/dj12070204 - 30 Jun 2024
Viewed by 380
Abstract
Background: The objective of this work was to investigate the association between the function of the stomatognathic system and migraine presence through an instrumental functional analysis in a group of diagnosed migraine patients and a control group. Methods: This study included 50 individuals [...] Read more.
Background: The objective of this work was to investigate the association between the function of the stomatognathic system and migraine presence through an instrumental functional analysis in a group of diagnosed migraine patients and a control group. Methods: This study included 50 individuals in each group. A jaw-tracking analysis was performed using Cadiax 4. Tracings of the following movements were recorded: open/close, protrusion/retrusion, mediotrusion, speech, bruxing, and mastication. The tracings were evaluated for their quantity, quality, transversal characteristics, speed, curvature pattern, and condylar stability. Results: Statistically significant differences between the groups were established for several aspects of the evaluation. Migraineurs presented with (a) higher values of mandibular lateral translation in protrusion/retrusion (p = 0.001), open/close (p = 0.031), and mastication (p = 0.016); (b) transient velocity losses in open/close (p = 0.001) and protrusive movements (p = 0.018); (c) a compromised condylar stability for protrusion/retrusion (p = 0.001) and mediotrusion (p = 0.003); (d) a compromised quality for protrusion/retrusion (p < 0.001) and mediotrusion (p = 0.003); and (e) a more frequent “figure-eight” curvature in open/close (p = 0.012). Conclusions: The importance of the stomatognathic function in migraine pathogenesis and treatment should be considered by using a patient-centered and interdisciplinary approach. Full article
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9 pages, 15648 KiB  
Case Report
Gingivectomy–Gingivoplasty for Oral Physiological Melanosis Depigmentation: A Case Report Involving Human Papillomavirus
by Leslie Villa-Martínez, Blanca Itzel Mendoza-Espinosa, Luis Fernando Jacinto-Alemán, Adriana Molotla-Fragoso, Claudia Patricia Mejía-Velázquez, Alejandro Alonso-Moctezuma, Carla Monserrat Ramírez-Martínez, David Alonso Trejo-Remigio and Elsa Mónica Toriz-Pichardo
Dent. J. 2024, 12(7), 203; https://doi.org/10.3390/dj12070203 - 30 Jun 2024
Viewed by 348
Abstract
Gingiva hyperpigmentation resulting from physiological melanosis causes aesthetic discomfort and is usually perceived as a disease by patients because healthy attached gingiva is typically characterized by coral pink coloring with stippling and scalloped contours. When physiological melanosis compromises the aesthetics of smiling, it [...] Read more.
Gingiva hyperpigmentation resulting from physiological melanosis causes aesthetic discomfort and is usually perceived as a disease by patients because healthy attached gingiva is typically characterized by coral pink coloring with stippling and scalloped contours. When physiological melanosis compromises the aesthetics of smiling, it may induce insecurity in patients, who usually seek out alternatives for reducing or eliminating hyperpigmentation. We present a case report of a surgical procedure combining gingivectomy with gingivoplasty for the management of physiological melanosis. The surgical procedure was performed on a 40-year-old female patient with bilateral pigmentation in both arches. The results of the histological analysis confirm the diagnoses of melanotic macula, with papillary hyperplasia and cytopathic changes being suggestive of HPV infection, which was verified using an immunohistochemistry analysis based on the detection of a major capsid protein of HPV. Acceptable functional and aesthetic results were obtained for the patient without major discomfort during the postoperative period. In cases when HPV infection is present, long-term follow-up becomes necessary. Full article
(This article belongs to the Special Issue Advances in Periodontal and Peri-Implant Tissues Health Management)
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15 pages, 2316 KiB  
Article
A Novel Device for the Evaluation of In Vitro Bacterial Colonization in Membranes for Guided Tissue and Bone Regeneration
by Ana Clara Kuerten Gil, Eugenio A. D. Merino, Diogo Pontes Costa, César Nunes Giracca, Ricardo Mazzon, Gabriel Leonardo Magrin, Josiane de Almeida and Cesar Augusto Magalhães Benfatti
Dent. J. 2024, 12(7), 202; https://doi.org/10.3390/dj12070202 - 29 Jun 2024
Viewed by 398
Abstract
Purpose: To evaluate, in vitro, the efficiency of a novel apparatus to test the adherence and penetration of bacteria on different membranes for guided regeneration. Methodology: To create the 3D device, Computer Aided Design/Computer Aided Manufacturing (CAD/CAM) systems were used. Three types of [...] Read more.
Purpose: To evaluate, in vitro, the efficiency of a novel apparatus to test the adherence and penetration of bacteria on different membranes for guided regeneration. Methodology: To create the 3D device, Computer Aided Design/Computer Aided Manufacturing (CAD/CAM) systems were used. Three types of biomaterials were tested (n = 6): (DT) a collagen membrane; (DS) a polymer membrane; and (LP) a dense polytetrafluoroethylene barrier. The biomaterials were adapted to the apparatuses and challenged with two different monospecies bacterial culture of A. actinomycetemcomitans b and S. mutans. After 2 h, bacterial adherence and penetration were quantified by counting the number of colony-forming units (CFUs). Two specimens from each group were used for image analysis using Confocal Laser Scanning Microscopy. Statistical analysis was performed. Findings: The DS group had a higher adherence of S. mutans compared to A. actinomycetemcomitans b (p = 0.05). There was less adherence of A. actinomycetemcomitans b in the DS group, compared to the LP (p = 0.011) and DT (p < 0.001) groups. Only the membranes allowed penetration, which was blocked by barriers. The DT group allowed a greater penetration of S. mutans to occur compared to A. actinomycetemcomitans b (p = 0.009), which showed a higher penetration into the DS membranes compared to S. mutans (p = 0.016). The penetration of A. actinomycetemcomitans b through DS was higher compared to its penetration through DT and LP (p < 0.01 for both). DT and DS allowed a greater penetration of S. mutans to occur compared to LP, which prevented both bacterial species from penetrating. Conclusion: The apparatus allowed for the settlement and complete sealing of the biomaterials, enabling standardization. Full article
(This article belongs to the Special Issue Rising Stars: Oral Infections and Microbes)
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11 pages, 2048 KiB  
Article
Root Canal Dentin Microhardness after Contact with Antibiotic Medications: An In Vitro Study
by Amanda Palmeira Arruda Nogueira, Renata Grazziotin-Soares, Adriana Marques Mesquita Leal, Sérgio Alves Guida Freitas Júnior, Bruna Laís Lins Gonçalves, José Bauer, Meire Coelho Ferreira and Ceci Nunes Carvalho
Dent. J. 2024, 12(7), 201; https://doi.org/10.3390/dj12070201 - 29 Jun 2024
Viewed by 552
Abstract
Background: Antibiotic pastes used as intracanal medication in cases of revascularization therapy might cause negative effects on tooth properties, such as a reduction in dentin microhardness. This in vitro study investigated dentin microhardness in three different locations distancing from the canal lumen after [...] Read more.
Background: Antibiotic pastes used as intracanal medication in cases of revascularization therapy might cause negative effects on tooth properties, such as a reduction in dentin microhardness. This in vitro study investigated dentin microhardness in three different locations distancing from the canal lumen after 20 days of treatment with a tri-antibiotic paste (ciprofloxacin, metronidazole, and minocycline), and with a double-antibiotic paste (ciprofloxacin and metronidazole), with calcium hydroxide [Ca(OH)2] UltracalTM XS-treated dentin as comparison. Material and Methods: Human mandibular premolars (n = 48) had the root canals cleaned and shaped and were used to produce dentin slices. Dentin slices remained immersed in the medications for 20 days. The Knoop microhardness (KHN) test was performed before (baseline/Day-0) and after treatment (Day-20) with the medications. Indentations were made at 25 µm, 50 µm, and 100 µm distances from the root canal lumen. The KHN was compared intra-group using Wilcoxon’s test. Independent groups were compared using Mann–Whitney’s and Kruskal–Wallis’ tests, at α = 5%. Results: The microhardness in all the tested groups was reduced at Day-20 in comparison with Day-0 (p < 0.001) (intra-group comparison/same distances). The Day-0 values were similar, and the Day-20 values were higher for the Ca(OH)2 group (p < 0.05) (comparison between groups/same distances). Conclusions: Calcium hydroxide for 20 days would be preferred rather than antibiotic pastes to minimize the expected reduction in dentin microhardness during regenerative procedures. Full article
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18 pages, 707 KiB  
Systematic Review
Clinical Factors on Dental Implant Fractures: A Systematic Review
by Mattia Manfredini, Pier Paolo Poli, Luca Giboli, Mario Beretta, Carlo Maiorana and Matteo Pellegrini
Dent. J. 2024, 12(7), 200; https://doi.org/10.3390/dj12070200 - 28 Jun 2024
Viewed by 416
Abstract
Dental implant fractures pose a significant challenge to long-term treatment success. This systematic review aims to comprehensively examine the clinical factors influencing dental implant fractures (IFs). Furthermore, strategies to choose the right type of implant and prevent this complication are addressed. A systematic [...] Read more.
Dental implant fractures pose a significant challenge to long-term treatment success. This systematic review aims to comprehensively examine the clinical factors influencing dental implant fractures (IFs). Furthermore, strategies to choose the right type of implant and prevent this complication are addressed. A systematic search was conducted across PubMed, Scopus, and Web of Science databases. Eligible studies included retrospective case–control, prospective cohort studies, and clinical trials. The initial search yielded 361 articles, of which 312 were excluded being these reviews, case reports, irrelevant, or written in languages other than English. This left 49 articles, with only 6 meeting the eligibility criteria for an in-depth review. These studies, all retrospective case–control, examine implant characteristics, patient demographics, surgical and prosthetic variables, biomechanical and functional factors, clinical and procedural variables, complications and maintenance issues. The risk of bias was assessed as low using the ROBINS-I tool. Key findings suggest a correlation between implant diameter and structural resistance, with wider implants demonstrating reduced fracture risk. Additionally, posterior regions, especially molars and premolars, exhibit higher susceptibility to IFs due to increased masticatory forces. Implant design and material may considerably influence fracture risk, with conical implants and screw-retained prostheses showing higher vulnerability. Biomechanical overload, particularly in patients with bruxism, emerges as a primary contributing factor to IFs. Prosthesis type significantly influences fracture incidence, with cantilever prostheses posing a higher risk due to increased stress. Peri-implant bone loss is strongly associated with IFs, emphasizing the need for meticulous preoperative assessments and individualized management strategies. Future research should prioritize larger and heterogeneous populations with long-term follow-up and standardized methodologies to enhance the generalizability and comparability of findings. Randomized controlled trials and biomechanical studies under controlled conditions are also essential to elucidate the complex interactions contributing to IFs and developing effective prevention strategies. Additionally, integrating patient-reported outcomes may offer a comprehensive understanding of the impact of IFs on quality of life. Full article
(This article belongs to the Special Issue Risk Factors in Implantology)
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10 pages, 2875 KiB  
Article
Implementation of Patient-Individualized 3D-Printed Models in Undergraduate Students’ Education for Various Prosthetic Treatments: A Cross-Sectional Survey Study
by Andrea Klink, Fabian Engelskirchen, Pablo Kaucher-Fernandez, Fabian Huettig and Ariadne Roehler
Dent. J. 2024, 12(7), 199; https://doi.org/10.3390/dj12070199 - 27 Jun 2024
Viewed by 344
Abstract
Background: Due to rapid changes in dental practice, digital technologies have become prominent in undergraduate dental education at German universities in recent years. This shift has prompted a re-evaluation of content as well as teaching methods, particularly in courses where students are prepared [...] Read more.
Background: Due to rapid changes in dental practice, digital technologies have become prominent in undergraduate dental education at German universities in recent years. This shift has prompted a re-evaluation of content as well as teaching methods, particularly in courses where students are prepared for patient treatment. Traditional training on standardized models with resin teeth cannot cover the complexity of individual dental arch configuration encountered in patient situations. This study explores the use of 3D printing technology to create individualized models for prosthetic treatment simulations, aiming to evaluate students’ feedback towards their experience with this training setting. Methods: First, the study describes the design and fabrication of individualized models with exchangeable teeth based on intraoral scans, mounted on connected plates with distance holders that can be fixed to standard phantom heads. Second, students provided feedback through a questionnaire, assessing various aspects such as the effectiveness of the 3D-printed models compared to traditional frasaco models for preparation exercises. Results: The results indicated that the design of the realized models was feasible for preparation training (question no. 4: 93% positive rating) and showed positive perceptions of the 3D-printed models, with students finding them effective for preparation exercises and beneficial in bridging the gap between simulation and real patient situations (question no. 6: 69% positive rating). Conclusions: The study suggests that 3D printing technology offers a valuable tool in dental education, providing realistic and patient-specific scenarios for students to enhance their skills and readiness for clinical practice. Further improvements in material properties in hand with cost-effective approaches are essential for widespread implementation. Full article
(This article belongs to the Special Issue Feature Papers in Digital Dentistry)
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12 pages, 1462 KiB  
Article
Effect of Different Graft Material Consistencies in the Treatment of Minimal Bone Dehiscence: A Retrospective Pilot Study
by Maria Menini, Luigi Canullo, Roberta Iacono, Alessio Triestino, Vito Carlo Alberto Caponio, Paolo Savadori, Paolo Pesce, Andrea Pedetta and Fabrizio Guerra
Dent. J. 2024, 12(7), 198; https://doi.org/10.3390/dj12070198 - 27 Jun 2024
Viewed by 525
Abstract
Among different therapeutic strategies proposed in the case of bone volume deficit, guided bone regeneration (GBR) is a consolidated surgical procedure. The objective of this study is to retrospectively evaluate the behavior of two bone grafts with different consistencies in the GBR procedure [...] Read more.
Among different therapeutic strategies proposed in the case of bone volume deficit, guided bone regeneration (GBR) is a consolidated surgical procedure. The objective of this study is to retrospectively evaluate the behavior of two bone grafts with different consistencies in the GBR procedure by measuring the volumetric tissue changes 1 year after surgery. For this retrospective analysis, 25 cases of GBR with simultaneous implant insertion were selected. A total of 13 were grafted with a porcine cortico-cancellous bone mix (CCBM group), and 12 were grafted with a pre-hydrated granulated cortico-cancellous bone mix of porcine origin blended with 20% TSV gel (Collagenated-CCBM). A collagen membrane was fixed to cover the bone defect. A total of 42 implants were placed with computer-guided surgery. Preoperative and 12-month postoperative digital impressions were used to evaluate dimensional changes. Student’s t-test used for independent samples showed no statistically significant differences between the integrated distance (p = 0.995) and mean distance (p = 0.734). The mean integrated distance in the CCBM group was 41.80 (SD. 101.18) compared to a mean of 42.04 (SD. 66.71) in the Collagenated-CCBM group. Given the limitations of this study, in patients with peri-implant bone dehiscence, simple heterologous and collagenated heterologous cortico-cancellous bone grafts are suitable for filling the bone defect to promote bone regeneration, although further studies are needed. Full article
(This article belongs to the Special Issue Oral Implantology and Bone Regeneration)
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Article
Safety and Effectiveness of a Novel Color Corrector Serum for Causing Temporary Changes to Tooth Shade: A Randomized Controlled Clinical Study
by Mauro Pascolutti, Alex Tomic, Kimberly R. Milleman, Jeffery L. Milleman and Laurence J. Walsh
Dent. J. 2024, 12(7), 197; https://doi.org/10.3390/dj12070197 - 27 Jun 2024
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Abstract
Tooth color is a major driver of facial esthetics. While permanent changes in tooth shade can be achieved by bleaching and restorations, there is a need for cosmetic products that can cause reversible color changes. This randomized controlled clinical study assessed the effectiveness [...] Read more.
Tooth color is a major driver of facial esthetics. While permanent changes in tooth shade can be achieved by bleaching and restorations, there is a need for cosmetic products that can cause reversible color changes. This randomized controlled clinical study assessed the effectiveness and safety of a novel color-correcting product (Hismile™ V34 Color Corrector Serum™) versus a placebo (vehicle control lacking the color-change dyes). A single-center, randomized, controlled, examiner-blind, two-group, parallel design, single-use study design was followed. The test products were applied on a cotton bud for 30 s, and then, rinsed off. Tooth shade for maxillary central incisors was measured at baseline, immediately, and at 30 and 60 min, using the Vita Bleachedguide 3D-Master® Shade Guide and the EasyShade Advanced 4.0 spectrophotometer (for determining values of L*a*b*). The subjects (N = 60) had a baseline shade of 1M2 (rank 9) or darker. A single application of the test product resulted in an immediate and significant (p < 0.001) three shade improvement (26.2%) according to the shade guide, and the same significant benefits extended to 30 and 60 min. The placebo product did not alter tooth shade (p = 0.326). These changes were accompanied by significant improvements in the L value (whiteness) up to 30 min, and a reduction in b* (yellowness) for up to 60 min. Two-thirds of subjects using the test product stated in a survey that their teeth appeared both whiter and brighter. No safety issues arose from the use of the test product or vehicle control. These results indicate that using a color corrector can achieve worthwhile changes to tooth shade for up to 60 min. Full article
(This article belongs to the Topic Advances in Dental Health)
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