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Dent. J., Volume 6, Issue 4 (December 2018)

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Open AccessArticle Dental Attendance in Undocumented Immigrants before and after the Implementation of a Personal Assistance Program: A Cross-Sectional Observational Study
Dent. J. 2018, 6(4), 73; https://doi.org/10.3390/dj6040073
Received: 27 October 2018 / Revised: 30 November 2018 / Accepted: 11 December 2018 / Published: 14 December 2018
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Abstract
Undocumented immigrants are a high-risk social group with low access to care. The present study aims to increase awareness and dental attendance in this subgroup, assisted by community health workers (CHW). Starting from 2015, two trained dentists volunteered to perform free oral health
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Undocumented immigrants are a high-risk social group with low access to care. The present study aims to increase awareness and dental attendance in this subgroup, assisted by community health workers (CHW). Starting from 2015, two trained dentists volunteered to perform free oral health examinations and further dental care referral in a welfare organisation in Ghent, Belgium. In 2016 and 2017, a two-day oral health training was added, enabling social workers to operate as community oral health workers and to provide personal oral health advice and assistance. Over the three years, an oral health examination was performed on 204 clients from 1 to 69 years old, with a mean age of 36.7 (SD = 15.9), showing high levels of untreated caries (71.6%; n = 146) and a Dutch Periodontal Screening Index (DPSI) score of 3 or 4 in 62.2% of the sample (n = 97). Regarding dental attendance, the total number of missed appointments decreased significantly, with 40.9% in 2015, 11.9% in 2016 and 8.0% in 2017 (p < 0.001). Undocumented immigrants can be integrated into professional oral health care. Personal assistance by community health workers might be an effective method, although this requires further investigation. Full article
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Open AccessReview Commitment of Oral-Derived Stem Cells in Dental and Maxillofacial Applications
Dent. J. 2018, 6(4), 72; https://doi.org/10.3390/dj6040072
Received: 7 November 2018 / Revised: 30 November 2018 / Accepted: 11 December 2018 / Published: 13 December 2018
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Abstract
Tissue engineering is based on the interaction between stem cells, biomaterials and factors delivered in biological niches. Oral tissues have been found to be rich in stem cells from different sources: Stem cells from oral cavity are easily harvestable and have shown a
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Tissue engineering is based on the interaction between stem cells, biomaterials and factors delivered in biological niches. Oral tissues have been found to be rich in stem cells from different sources: Stem cells from oral cavity are easily harvestable and have shown a great plasticity towards the main lineages, specifically towards bone tissues. Dental pulp stem cells (DPSCs) are the most investigated mesenchymal stem cells (MSCs) from dental tissues, however, the oral cavity hosts several other stem cell lineages that have also been reported to be a good alternative in bone tissue engineering. In particular, the newly discovered population of mesenchymal stem cells derived from human periapical inflamed cysts (hPCy-MSCs) have showed very promising properties, including high plasticity toward bone, vascular and neural phenotypes. In this topical review, the authors described the main oral-derived stem cell populations, their most interesting characteristics and their ability towards osteogenic lineage. This review has also investigated the main clinical procedures, reported in the recent literature, involving oral derived-MSCs and biomaterials to get better bone regeneration in dental procedures. The numerous populations of mesenchymal stem cells isolated from oral tissues (DPSCs, SHEDs, PDLSCs, DFSCs, SCAPs, hPCy-MSCs) retain proliferation ability and multipotency; these features are exploited for clinical purposes, including regeneration of injured tissues and local immunomodulation; we reported on the last studies on the proper use of such MSCs within a biological niche and the proper way to storage them for future clinical use. Full article
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Open AccessArticle Multicenter Retrospective Analysis of Implant Overdentures Delivered with Different Design and Attachment Systems: Results Between One and 17 Years of Follow-Up
Dent. J. 2018, 6(4), 71; https://doi.org/10.3390/dj6040071
Received: 20 September 2018 / Revised: 5 November 2018 / Accepted: 19 November 2018 / Published: 11 December 2018
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Abstract
Purpose: To analyze implant and prosthetic survival rates, complications, patient satisfaction, and biological parameters of patients rehabilitated with implant overdentures (IOV) on splinted and nonsplinted implants and different attachment systems, in function for one to 17 years. Methods: This retrospective study evaluated data
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Purpose: To analyze implant and prosthetic survival rates, complications, patient satisfaction, and biological parameters of patients rehabilitated with implant overdentures (IOV) on splinted and nonsplinted implants and different attachment systems, in function for one to 17 years. Methods: This retrospective study evaluated data collected from patients rehabilitated with implant overdentures between January 2001 and December 2016 in nine different centers. Outcome measures were implant and prosthetic success rates, mechanical complications, marginal bone loss (MBL), oral health impact profile (OHIP), bleeding on probing, and plaque index. Results: A total of 581 implants were installed in 194 patients. Patients were followed for a mean period of 60.6 months (range 6–206). Eighty-nine patients received 296 low profile attachment (OT Equator), 62 patients received 124 ball attachments, and 43 patients received 107 Locator attachments. In eighty-three patients the implants were splinted with computer aided design/computer aided manufacturing (CAD/CAM) or casted bar. At the last follow-up, 10 implants failed in eight patients. Statistical significance was found for failed prostheses (P = 0.0723) and complications (P = 0.0165), with better values for splinted implants. No statistically significant differences were found in proportion of implant and prosthetic failure (P > 0.05). At a five-year follow-up, proportion of complications (P = 0.0289) and failed prostheses (P = 0.0069) were statistically higher for IOV on Locator attachments. No difference was founded in MBL at one- and two-year follow-up between different attachment systems (P > 0.05). Statistically significant improvement in all the OHIP categories was reported in all the patients, after one year of function. Conclusions: Implant overdenture showed high implant and prosthetic survival rates, low complications, high patient satisfaction, and good biological parameters in the long-term follow-up. Splinting the implants may reduce number of mechanical complications. Locator attachments showed higher number of complications. Further studies are needed to confirm these preliminary results. Full article
(This article belongs to the Section Restorative Dentistry and Traumatology)
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Open AccessArticle Phosphophoryn and Dentin Sialoprotein Effects on Dental Pulp Cell Migration, Proliferation, and Differentiation
Dent. J. 2018, 6(4), 70; https://doi.org/10.3390/dj6040070
Received: 26 October 2018 / Revised: 24 November 2018 / Accepted: 5 December 2018 / Published: 10 December 2018
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Abstract
Phosphophoryn (PP) and dentin sialoprotein (DSP) are two of the most abundant dentin matrix non-collagenous proteins, and are derived from dentin sialoprotein-phosphophoryn (DSP-PP) mRNA. Mutations in the DSP-PP gene are linked to dentinogenesis imperfecta II and III. Previously, we reported transient DSP-PP expression
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Phosphophoryn (PP) and dentin sialoprotein (DSP) are two of the most abundant dentin matrix non-collagenous proteins, and are derived from dentin sialoprotein-phosphophoryn (DSP-PP) mRNA. Mutations in the DSP-PP gene are linked to dentinogenesis imperfecta II and III. Previously, we reported transient DSP-PP expression in preameloblast cells first, followed by co-expression in preameloblasts and young odontoblasts, and finally sustained expression in odontoblasts. This phenomenon raised the possibility that DSP/PP proteins secreted by preameloblasts might promote dental pulp cell migration toward the dental pulp border and promote dental pulp cell differentiation. To examine the effects of DSP/PP proteins on dental pulp cell development, we investigated:(1) native PP effects on dental pulpcell migration and matrix protein expression; and (2) recombinant DSP/PP protein effects on cell proliferation and differentiation. We found that PP promoted cell migration and the expression of high levels of Col type I and PP in dental pulp cells. The addition of recombinant DSP/PP proteins affected cell proliferation and differentiation in a dental pulp cell line. These findings strongly suggest that DSP/PP may modulate cell migration, cell proliferation and differentiation, thus leading to dentin formation. DSP/PP protein may be useful clinically for pulp tissue regeneration. Full article
(This article belongs to the Special Issue Restorative and Esthetic Dentistry)
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Open AccessArticle Characterization and Antimicrobial Susceptibility of Lactococcus lactis Isolated from Endodontic Infections in Ouagadougou, Burkina Faso
Dent. J. 2018, 6(4), 69; https://doi.org/10.3390/dj6040069
Received: 1 November 2018 / Revised: 2 December 2018 / Accepted: 5 December 2018 / Published: 10 December 2018
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Abstract
Background: This study aimed to characterize and test the antimicrobial susceptibility of Lactococcus lactis isolated in endodontic infections in Burkina Faso. Material and methods: This was a prospective study conducted at the Municipal Oral Health Center of Ouagadougou, Burkina Faso, from June to
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Background: This study aimed to characterize and test the antimicrobial susceptibility of Lactococcus lactis isolated in endodontic infections in Burkina Faso. Material and methods: This was a prospective study conducted at the Municipal Oral Health Center of Ouagadougou, Burkina Faso, from June to October 2014. Clinical data were collected using a questionnaire form. The method of streaking on selective medium was used to isolate bacteria. Identification was made using the API 20 Strep gallery. Antibiotic susceptibility was performed by the diffusion method on solid medium. Results: One hundred and twenty-five (125) patients were received with a significant proportion from the age group of 19 to 40 years (55.2%). Apical periodontitis accounted for 50.4% and cellulitis for 49.6% of cases. Lactococcus lactis ssp. lactis was identified in five exudate samples. Isolates were 100% resistant to cefixime and metronidazole, 80% to ceftriaxone, cefuroxime, cefotaxime, chloramphenicol and 60% to penicillin G, amoxicillin, amoxicillin clavulanic acid. A multidrug resistance of more than three families of antibiotics was noticed. No strains produced extended spectrum ß-lactamases. Conclusion: Lactococcus lactis is part of endodontic biofilm. The reported strong antibiotic resistance involving endodontic therapy will focus on the effect of the disinfectant solution and the mechanical action of the canal instruments. Full article
(This article belongs to the Special Issue Endodontic Microbiology)
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Open AccessArticle Implementing an Oral Health Intervention for People Experiencing Homelessness in Scotland: A Participant Observation Study
Dent. J. 2018, 6(4), 68; https://doi.org/10.3390/dj6040068
Received: 3 October 2018 / Revised: 4 November 2018 / Accepted: 19 November 2018 / Published: 1 December 2018
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Abstract
Smile4life is an intervention aimed at improving the oral health of people experiencing homelessness in Scotland. The purpose of this research was to determine how this intervention was being translated from guidance into action. Data concerning Smile4life working practices were collected in three
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Smile4life is an intervention aimed at improving the oral health of people experiencing homelessness in Scotland. The purpose of this research was to determine how this intervention was being translated from guidance into action. Data concerning Smile4life working practices were collected in three NHS Boards using participant observation. Fieldnotes taken during these observations were analysed using content analysis. This analysis revealed that there were working alliances between the oral health practitioner, the Third Sector staff, and the homeless service users, and that these alliances were affected by various barriers and enablers. The observation sessions also highlighted variations in working practices. Full article
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Open AccessArticle Homeless in Scotland: An Oral Health and Psychosocial Needs Assessment
Dent. J. 2018, 6(4), 67; https://doi.org/10.3390/dj6040067
Received: 3 October 2018 / Revised: 13 November 2018 / Accepted: 13 November 2018 / Published: 1 December 2018
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Abstract
The aim of this research was to conduct an oral health and psychosocial needs assessment of a homeless population in Scotland to determine the levels of unmet need and provide recommendations for oral health improvement. A non-probability convenience sample of homeless people residing
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The aim of this research was to conduct an oral health and psychosocial needs assessment of a homeless population in Scotland to determine the levels of unmet need and provide recommendations for oral health improvement. A non-probability convenience sample of homeless people residing in seven Scottish Health Boards was collected. All consenting participants were asked to complete a questionnaire assessing their health and psychosocial needs, dental anxiety, and oral health-related quality of life. The participants’ oral health was examined by a trained and calibrated dentist and dental nurse. Eight hundred and fifty-three homeless people consented to take part. Participants had a mean D3cvMFT score of 16.9 (95% CI: 16.3, 17.6). Dental anxiety was high, with 20% scoring as dentally phobic. Respondents with higher dental anxiety were found to have significantly greater mean numbers of filled teeth than those with lower dental anxiety (t = −2.9, p < 0.05). Common oral health impacts were painful aching and discomfort while eating, experienced occasionally by 31% and 27% of the respondents, respectively. Fifty-eight percent of participants were found to have a depressive illness, and obvious decay experience was significantly higher among this section of participants (t = −4.3, p < 0.05). Homeless people in Scotland were found to be in need of a more accessible dental service than is currently available. An enhanced service should meet the oral health and psychosocial needs of this population to improve their oral health and quality of life. Full article
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Open AccessArticle Decontamination of Dental Implant Surfaces by the Er:YAG Laser Beam: A Comparative in Vitro Study of Various Protocols
Dent. J. 2018, 6(4), 66; https://doi.org/10.3390/dj6040066
Received: 23 September 2018 / Revised: 16 November 2018 / Accepted: 19 November 2018 / Published: 1 December 2018
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Abstract
Oral rehabilitation with dental implants has revolutionized the field of dentistry and has been proven to be an effective procedure. However, the incidence of peri-implantitis has become an emerging concern. The efficacy of the decontamination of the implant surface, by means of lasers,
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Oral rehabilitation with dental implants has revolutionized the field of dentistry and has been proven to be an effective procedure. However, the incidence of peri-implantitis has become an emerging concern. The efficacy of the decontamination of the implant surface, by means of lasers, is still controversial. Previous studies have revealed a reduction in osteoblast adhesion to carbon-contaminated implant surfaces. This in-vitro study aimed to evaluate the decontamination of failed implants by assessing the carbon proportion, after irradiation by low-energy erbium yttrium-aluminum-garnet laser (Er:YAG) (Fotona; 2940 nm, Ljubljana, Slovenia) for a single and for multiple passages, until getting a surface, free of organic matters; to find the appropriate procedure for dental-implant surface-decontamination. Ninety implants were used. Thirty sterile implants were kept as a negative control. Thirty failed implants were irradiated by the Er:YAG laser, for a single passage, and the other thirty, for multiple passages. The parameters used in our experiments were an irradiation energy of 50 mJ, frequency of 30 Hz, and an energy density of 3.76 J/cm2. A sapphire tip, with a length of 8 mm, was used with concomitant water spray irrigation, under air 6 and water spray 4. Super short pulse mode (SSP) was of 50 μs; irradiation speed being 2 mm/s. We used energy-dispersive X-ray spectroscopy (EDX) to evaluate the carbon proportion on the surfaces of the sterile implants, the contaminated, and the lased implants, with one (LX1) and with three passages (LX3). Statistical analysis was performed by ANOVA. Results showed mean difference between the three groups (contaminated, LX1, and LX3) with p < 0.0001, as between LX1 and Group A (p < 0.0001), while the difference between LX3 and the control group was not statistically significant. The decontamination of the implant surfaces with a low-energy Er:YAG laser with three passages, appeared to be an encouraging approach. Full article
(This article belongs to the collection Light and Laser Dentistry)
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Open AccessArticle Parental Perception of Children Affected by Amelogenesis Imperfecta (AI) and Dentinogenesis Imperfecta (DI): A Qualitative Study
Dent. J. 2018, 6(4), 65; https://doi.org/10.3390/dj6040065
Received: 8 October 2018 / Revised: 6 November 2018 / Accepted: 13 November 2018 / Published: 17 November 2018
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Abstract
This qualitative study was conducted to explore parental attitudes and values regarding aesthetics and treatment needs of children in primary dentition affected by AI and DI. A purposive sample of parents of young children attended two focus groups: mothers (n = 7) and
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This qualitative study was conducted to explore parental attitudes and values regarding aesthetics and treatment needs of children in primary dentition affected by AI and DI. A purposive sample of parents of young children attended two focus groups: mothers (n = 7) and fathers (n = 6). A topic guide with open-ended questions was formulated and standardised photographs showing primary teeth affected by varying severity of AI/DI and photographs of different aesthetic treatments were utilised to stimulate discussion. Data was audio-recorded and transcribed verbatim. A cross-sectional thematic analysis was performed which identified six main themes; the impact on affected children, the impact on parents, the life course of the disease, coping mechanisms, treatment need, and experience of treatment. Parents believed that young children were aware of their altered dental appearance. A feeling of guilt was evident among fathers affected by the same condition. Most parents sought dental treatment before starting school due to worries of bullying at school. Parents appeared to rely solely on the professional advice of the paediatric dentist in making all treatment related decisions. The personal experience of parents affected by AI/DI played a pivotal role in parent’s judgements of their children’s teeth and perceived need for treatment. Full article
(This article belongs to the Special Issue Psychosocial Impacts of Dental Conditions in Childhood)
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Open AccessCase Report Photobiomodulation Therapy in the Treatment of Oral Mucositis, Dysgeusia and Oral Dryness as Side-Effects of Head and Neck Radiotherapy in a Cancer Patient: A Case Report
Dent. J. 2018, 6(4), 64; https://doi.org/10.3390/dj6040064
Received: 29 September 2018 / Revised: 5 November 2018 / Accepted: 7 November 2018 / Published: 10 November 2018
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Abstract
Successful management of oral mucositis, dysgeusia and oral dryness was made with five sessions of photobiomodulation. The severity of oral mucositis was measured according to the World Health Organization scale for the assessment of oral mucositis. Dysgeusia testing was performed according to the
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Successful management of oral mucositis, dysgeusia and oral dryness was made with five sessions of photobiomodulation. The severity of oral mucositis was measured according to the World Health Organization scale for the assessment of oral mucositis. Dysgeusia testing was performed according to the International Standards Organization (ISO). For the assessment of oral dryness or hyposalivation, quantity of the total resting and stimulated saliva (Q-sal, mL/min) was measured. Photobiomodulation parameters, applications, and treatment protocol used were suggested by an international multidisciplinary panel of clinicians and researchers with expertise in the area of supportive care in cancer and/or PBM clinical application and dosimetry. This case report confirms the effectiveness of photobiomodulation therapy in the management of oral mucositis, dysgeusia, and oral dryness. Full article
(This article belongs to the Special Issue Photobiomodulation)
Open AccessCase Report Development and Implementation of an Intraoral Device for Occlusal Stability during Sports Performance: A Case Report
Dent. J. 2018, 6(4), 63; https://doi.org/10.3390/dj6040063
Received: 6 September 2018 / Revised: 18 October 2018 / Accepted: 2 November 2018 / Published: 8 November 2018
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Abstract
Introduction: Sports dentistry assumes a clinical relevance, not only in the prevention of orofacial trauma by the use of mouthguards, but also with the development of intraoral devices that aim to provide greater occlusal stability, as well as a greater balance in the
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Introduction: Sports dentistry assumes a clinical relevance, not only in the prevention of orofacial trauma by the use of mouthguards, but also with the development of intraoral devices that aim to provide greater occlusal stability, as well as a greater balance in the level of certain structures of the cranio-cervical-mandibular complex. In this way, the dentistry can have an intervention action on sports performance. Objectives: The objective of this research was to verify the existence of a correlation between occlusal stability and an eventual balance of some facial structures during sports performance using a specially developed Occlusal Stability Sports Performance Device. Methodology: An individualized mandibular intraoral device was manufactured and evaluated on an athlete canoeing. Infrared thermography was the complementary diagnostic method used for this purpose. Results: Greater symmetry of certain regions of interest of the cranio-cervico-mandibular complex was observed with the implementation of the Occlusal Stability Sports Performance Device. These areas were the anterior temporal muscle, the masseter muscle and the temporomandibular joint. No asymmetry decrease was found in the anterior triangle region of the neck. Conclusion: The use of this type of intraoral devices may allow greater occlusal stability and consequent balance of anatomical structures constituting the cranio-cervical-mandibular complex. Infrared thermography is an effective diagnostic tool for studying the results of the intraoral device on the cranio-cervico-mandibular complex use during canoeing. Full article
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Open AccessArticle Thermographic Study of the Orofacial Structures Involved in Clarinetists Musical Performance
Dent. J. 2018, 6(4), 62; https://doi.org/10.3390/dj6040062
Received: 7 September 2018 / Revised: 15 October 2018 / Accepted: 22 October 2018 / Published: 1 November 2018
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Abstract
Introduction: Wind instrumentalists like clarinetists, may present a muscular hyperactivity on certain groups of the cranio-cervico-mandibular complex, due to their musical activity. Therefore, the use of infrared thermography can be used to assess and characterize the orofacial structures involved in clarinet performance. Aim:
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Introduction: Wind instrumentalists like clarinetists, may present a muscular hyperactivity on certain groups of the cranio-cervico-mandibular complex, due to their musical activity. Therefore, the use of infrared thermography can be used to assess and characterize the orofacial structures involved in clarinet performance. Aim: The objective of this study was to analyze and record the thermal patterns using the thermographic camera Flir® E60sc to evaluate anatomically and physiologically certain orofacial structures of the cranio-cervical-mandibular complex, such as the masticatory muscles and the region of the temporomandibular joint. Methodology: A sample of 30 clarinetists completed an individual questionnaire composed of two components (musical and clinical history of the participant), and were subjected to a clinical examination. Four thermographic images were taken of the cranio-cervical-mandibular complex at a rest position with frontal, right lateral, left lateral and anterior dentoalveolar components views. Each musician performed a piece of music for an uninterrupted period of 10 min. New thermographic images were captured with the same incidences, after the performance, respecting the same protocol. Results: There were statistically significant differences in the areas corresponding to the left temporal muscle, the orbicularis muscle (labial component), the left and right perioral teguments, as well as in the upper central incisors. There was also statistical evidence regarding the initial and final temperature asymmetries regarding temporal muscle and orbicular muscles (labial and marginal components). Conclusion: Infrared thermography has been shown to be an effective complementary diagnostic tool in the monitorization of the cranio-cervical-mandibular complex of clarinetists. Full article
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Open AccessArticle Change in Oral Health-Related Quality of Life Following Minimally Invasive Aesthetic Treatment for Children with Molar Incisor Hypomineralisation: A Prospective Study
Dent. J. 2018, 6(4), 61; https://doi.org/10.3390/dj6040061
Received: 18 September 2018 / Revised: 11 October 2018 / Accepted: 19 October 2018 / Published: 1 November 2018
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Abstract
Molar incisor hypomineralisation (MIH) is a common enamel condition, presenting with incisor opacities, which may be of psychosocial concern to children. This clinical study sought to determine whether minimally invasive treatment, aiming to improve incisor aesthetics, would also improve children’s oral health-related quality
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Molar incisor hypomineralisation (MIH) is a common enamel condition, presenting with incisor opacities, which may be of psychosocial concern to children. This clinical study sought to determine whether minimally invasive treatment, aiming to improve incisor aesthetics, would also improve children’s oral health-related quality of life (OHRQoL). 111 MIH patients, aged 7–16 years, referred to a UK Dental Hospital, were invited to complete the Child Oral Health Impact Profile (C-OHIP-SF19) prior to any intervention (T0) and again at one-month following the intervention (T1) for MIH. Treatment regimens included one or more of the following: Microabrasion; resin infiltration; tooth whitening; resin composite restoration. Data were obtained for 93 children with a mean age of 11 years. Mean total C-OHIP-SF19 score at T0 was 47.00 (SD = 9.29; range = 0–76) and this increased significantly at T1 to 58.24 (SD = 9.42; range = 0–76; p < 0.001, paired t-test), indicating a marked improvement in self-reported OHRQoL. There were no statistically significant differences according to gender. This is the first study to show that simple, minimally invasive dental treatment, to reduce the visibility of enamel opacities, in MIH, can have a positive impact on children’s wellbeing. Full article
(This article belongs to the Special Issue Psychosocial Impacts of Dental Conditions in Childhood)
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Open AccessFeature PaperArticle The Influence of Stress and Anxiety on the Expectation, Perception and Memory of Dental Pain in Schoolchildren
Dent. J. 2018, 6(4), 60; https://doi.org/10.3390/dj6040060
Received: 30 June 2018 / Revised: 14 September 2018 / Accepted: 11 October 2018 / Published: 22 October 2018
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The aim of this study was to investigate the association of stress and anxiety with the expectation, perception and memory of dental pain among schoolchildren. A follow-up study involving 46 children aged 9 to 12 years was conducted in a public school in
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The aim of this study was to investigate the association of stress and anxiety with the expectation, perception and memory of dental pain among schoolchildren. A follow-up study involving 46 children aged 9 to 12 years was conducted in a public school in the city of Petropolis (RJ), Brazil. Demographic characteristics, stress (children’s stress scale), and state and trait anxiety (state–trait anxiety inventory) were recorded before a dental procedure to restore the occlusal surface of a permanent first molar under local anaesthetic. Dental pain was assessed using the faces pain scale before (dental pain expectation), immediately after (dental pain perception) and six weeks after (memory of dental pain) the dental procedure. Dental pain expectation scores were significantly higher than dental pain perception, independent of the levels of stress, state anxiety and trait anxiety. Children with high scores of stress (OR 1.05 95%CI 1.02–1.09), state anxiety (OR 1.15 95%CI 1.05–1.27) and trait anxiety (OR 1.18 95%CI 1.07–1.30) were more likely to report greater scores of dental pain expectation. Children anticipated more dental pain than what was actually perceived after the dental restoration. Children with greater levels of stress and anxiety have a distorted evaluation of expected dental pain before the dental procedure. Full article
(This article belongs to the Special Issue Psychosocial Impacts of Dental Conditions in Childhood)
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Open AccessReview Comparing the Antimicrobial In Vitro Efficacy of Amoxicillin/Metronidazole against Azithromycin—A Systematic Review
Dent. J. 2018, 6(4), 59; https://doi.org/10.3390/dj6040059
Received: 16 August 2018 / Revised: 19 September 2018 / Accepted: 25 September 2018 / Published: 20 October 2018
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On account of its proven clinical efficacy, the combination of systemically administered amoxicillin and metronidazole is frequently adjuncted to non-operative periodontal therapy and well documented. Potential drawbacks of this regimen, e.g., side effects and problems with the compliance, led to an ongoing search
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On account of its proven clinical efficacy, the combination of systemically administered amoxicillin and metronidazole is frequently adjuncted to non-operative periodontal therapy and well documented. Potential drawbacks of this regimen, e.g., side effects and problems with the compliance, led to an ongoing search for alternatives. Azithromycin, an antibiotic extensively used in general medicine, has recently found its niche in periodontal therapy as well. This systematic review aimed to analyze the in vitro antimicrobial efficacy of amoxicillin plus metronidazole versus azithromycin. For this purpose, a systematic literature search was performed, and studies published up to 29 March 2018 referenced in Medline, Embase, Cochrane, and Biosis were independently screened by two authors. An additional hand search was performed and studies focusing on the evaluation of in vitro antimicrobial efficacy of amoxicillin + metronidazole or azithromycin on bacteria from the subgingival biofilm were included. English and German language research reports were considered. From 71 identified articles, only three articles were eligible for inclusion. These studies showed heterogeneity in terms of analytical methods and strains explored. However, all studies used multispecies biofilm models for analysis of the antimicrobial activity. Unanimously, studies reported on more pronounced antimicrobial effects when applying the combination of amoxicillin + metronidazole, compared to azithromycin. Based on the few studies available, the combination of amoxicillin + metronidazole seemed to display higher antimicrobial efficacy in vitro than azithromycin. Full article
(This article belongs to the Section Oral Hygiene, Periodontology and Peri-implant Diseases)
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Open AccessArticle Substantial Differences in the Subgingival Microbiome Measured by 16S Metagenomics According to Periodontitis Status in Older Women
Dent. J. 2018, 6(4), 58; https://doi.org/10.3390/dj6040058
Received: 11 September 2018 / Revised: 2 October 2018 / Accepted: 12 October 2018 / Published: 19 October 2018
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Abstract
Aging invokes physiological changes, such as immunosenescence and inflammation, that could increase host susceptibility to oral microbiome shifts that enable periodontitis progression in later life. At present, there is a dearth of studies specifically evaluating the oral microbiome and periodontitis in older adults.
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Aging invokes physiological changes, such as immunosenescence and inflammation, that could increase host susceptibility to oral microbiome shifts that enable periodontitis progression in later life. At present, there is a dearth of studies specifically evaluating the oral microbiome and periodontitis in older adults. We used high-throughput untargeted sequencing methods and functional metagenomic analyses to assess and compare the subgingival biofilm of postmenopausal women (mean age 71 years) according to periodontitis status. Subgingival plaque samples were obtained from 15 postmenopausal women with no periodontitis, and from 15 women with severe periodontitis, determined by probing measures. The 16S rRNA gene (V1–V3 region) was sequenced on the 454 FLX platform. The PICRUSt technique was used to provide information on what the potential functional characteristics of microbiota might be in healthy, compared with diseased, periodontium. The subgingival microbiome associated with periodontitis showed clear differences to that associated with health. Of the 464 species identified, 22.8% had elevated abundance in disease, while only 6.3% had elevated abundance in health. Among the 12 most prevalent organisms in periodontitis, one-half have previously been recognized as periodontal pathogens by other investigators. The subgingival microbiome in periodontitis contained genes that could code for specific activities, including microbial mobility, synthesis of endotoxin, and proteolytic degradation. The healthy microbiome included genes that could code for sustaining microbial life, including encoding for transporters, glycolysis, gluconeogenesis, the Krebs cycle, and protein kinases. In the present study on postmenopausal women, aged 60 and older, the subgingival microbiome differed in composition and potential function between those with and without periodontitis. Studies of functional gene expression, such as transcriptomics, are needed to definitively identify the molecules carrying out functions associated with pathogenic subgingival complexes. This, in turn, could lead to identification of targets for enhanced management of periodontitis and, possibly, other diseases, in later life. Full article
(This article belongs to the Special Issue Pathogenesis of Periodontal Disease)
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Open AccessArticle Twist1 Suppresses Cementoblast Differentiation
Dent. J. 2018, 6(4), 57; https://doi.org/10.3390/dj6040057
Received: 19 September 2018 / Revised: 4 October 2018 / Accepted: 15 October 2018 / Published: 17 October 2018
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Abstract
The transcription factor Twist1 is known to be closely associated with the formation of bone by mesenchymal stem cells and osteoblasts; however, the role of Twist1 in cementogenesis has not yet been determined. This study was undertaken to elucidate the roles of Twist1
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The transcription factor Twist1 is known to be closely associated with the formation of bone by mesenchymal stem cells and osteoblasts; however, the role of Twist1 in cementogenesis has not yet been determined. This study was undertaken to elucidate the roles of Twist1 in cementoblast differentiation by means of the gain- or loss-of-function method. We used alkaline phosphatase (ALP) and alizarin red S staining and quantitative real-time reverse transcriptase polymerase chain reaction (qRT-PCR) to determine whether the forced transient expression or knock-down of Twist1 in a mouse cementoblast cell line, OCCM-30, could affect cementogenic differentiation. Silencing Twist1 with small interference RNA (siRNA) enhanced the formation of mineralized tissue. The expression of several cementogenesis markers, such as bone sialoprotein (BSP), osteopontin (OPN), dentin matrix protein1 (DMP1), and dentin sialophosphoprotein (DSPP) mRNA, were upregulated. Transient Twist1 overexpression in OCCM-30 consistently suppressed mineralization capacity and downregulated the differentiation markers. These results suggest that the Twist1 transcription factor may play a role in regulating cementoblast differentiation. Full article
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Open AccessFeature PaperArticle Early Life Professional and Layperson Support Reduce Poor Oral Hygiene Habits in Toddlers—A Prospective Birth Cohort Study
Dent. J. 2018, 6(4), 56; https://doi.org/10.3390/dj6040056
Received: 23 August 2018 / Revised: 2 October 2018 / Accepted: 5 October 2018 / Published: 8 October 2018
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Abstract
Oral health behaviours of children are formulated from a very young age. Formation of those behaviours among very young children is dependent on their mothers/caregivers who may themselves require support from the health profession or laypersons. The study aimed to investigate if early
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Oral health behaviours of children are formulated from a very young age. Formation of those behaviours among very young children is dependent on their mothers/caregivers who may themselves require support from the health profession or laypersons. The study aimed to investigate if early life visits for check-up and dental advice and perceived support improved oral health behaviours as practiced by mothers of toddlers aged 24–30 months old. Data from a population-base birth cohort study in South Australia was used. The study recruited and followed mothers of newborn children from birth to age 24–30 months. Parental questionnaires collected information about socioeconomic factors, dental visiting patterns, and oral health behaviours as practiced by the mothers for their child. Self-reported putting a child to bed with a bottle and brushing a child’s teeth were the outcome variables. The two main exposures of this study were (1) early visiting for a dental advice, and (2) layperson support that a mother received in the first two years of having the child. Data were analysed progressively from bivariate to multivariable regression models. A total of 1183 mother/child dyads had complete data. The retained sample was representative of the population. Approximately 36% of mothers put their child to bed with a bottle and 26% of mothers did not brush their child’s teeth the night before. Around 29% of children had a visit for dental check-up and 80% of mothers reported having lay support. There were gradients in the outcome variables by socioeconomic factors and the main exposures. Multivariable regression models reported that having no dental visit for advice and having no lay support were associated with 1.30 and 1.21 imes higher rates of putting a child to bed with a bottle, respectively. Having no dental visit for advice was associated with a 1.37-times higher rate of not brushing a child’s teeth, controlling for other factors. This population-based birth cohort study confirmed importance of early life dental visit for check-up and support for mothers of young children in establishing oral health behaviours of young children. Full article
(This article belongs to the Special Issue Dental Hygiene and Epidemiology)
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Open AccessArticle Examining the Effect of Radiant Exposure on Commercial Photopolimerizable Dental Resin Composites
Dent. J. 2018, 6(4), 55; https://doi.org/10.3390/dj6040055
Received: 31 August 2018 / Revised: 2 October 2018 / Accepted: 4 October 2018 / Published: 7 October 2018
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Abstract
The objective of this study was to evaluate the effect of radiant exposure on the chemical and physical properties of four commercial dental resin composites. The four dental resin composites used were Kalore, Admira, Tetric N-Ceram Bulk Fill, and Filtek Z350 XT. The
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The objective of this study was to evaluate the effect of radiant exposure on the chemical and physical properties of four commercial dental resin composites. The four dental resin composites used were Kalore, Admira, Tetric N-Ceram Bulk Fill, and Filtek Z350 XT. The composites were subjected to three curing protocols: 1000 mW/cm2 for 5 s, 1000 mW/cm2 for 10 s, and 400 mW/cm2 for 25 s. The flexural strength, elastic modulus, water sorption, water solubility, degree of conversion, and polymerization shrinkage were evaluated. The results were analyzed by means of ANOVA and Tukey tests. For Admira and Kalore, significant differences between light exposure protocols were observed for the elastic modulus (p < 0.001), which was higher when a higher amount of radiant exposure was used. For Filtek Z350, differences were only observed for the degree of conversion (p < 0.001), and a higher amount of radiant exposure allowed us to obtain higher values. The Tetric N-Ceram Bulk Fill analysis showed significant differences for the elastic modulus and water sorption (p < 0.001), and specimens that had been subject to a radiant exposure of 10 J/cm2 showed a higher elastic modulus. In most cases, the physical and mechanical properties analyzed were not affected by different radiant exposure values. Other resin-based composite (RBC) characteristics seem to have a greater influence on material properties. Full article
(This article belongs to the Section Dental Materials)
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Open AccessCase Report Restoring Large Defect of Posterior Tooth by Indirect Composite Technique: A Case Report
Dent. J. 2018, 6(4), 54; https://doi.org/10.3390/dj6040054
Received: 20 September 2018 / Revised: 2 October 2018 / Accepted: 4 October 2018 / Published: 7 October 2018
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Abstract
Advances in adhesive dentistry have led to increased use of indirect restorations. In some situations, indirect composite techniques are more advantageous than direct composite filling techniques, such as establishing proper occlusal and interproximal anatomy, reducing polymerization shrinkage stress, and promoting the degree of
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Advances in adhesive dentistry have led to increased use of indirect restorations. In some situations, indirect composite techniques are more advantageous than direct composite filling techniques, such as establishing proper occlusal and interproximal anatomy, reducing polymerization shrinkage stress, and promoting the degree of conversion. This article presents a case about restoring the lower right first molar with extensive loss of tooth structure by the composite onlay to achieve a proper anatomic form and rehabilitate chewing function. This one-year clinical case encourages clinicians to manage large decay of posterior tooth conservatively. The given functional and esthetic outcomes demonstrate the promising applicability of the indirect composite technique. Full article
(This article belongs to the Special Issue Restorative and Esthetic Dentistry)
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Open AccessCase Report Glycogen Storage Disease Ib and Severe Periodontal Destruction: A Case Report
Dent. J. 2018, 6(4), 53; https://doi.org/10.3390/dj6040053
Received: 1 August 2018 / Revised: 27 September 2018 / Accepted: 28 September 2018 / Published: 3 October 2018
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Abstract
Background: Glycogen storage diseases (GSDs) are genetic disorders that result from defects in the processing of glycogen synthesis or breakdown within muscles, liver, and other cell types. It also manifests with impaired neutrophil chemotaxis and neutropenic episodes which results in severe destruction
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Background: Glycogen storage diseases (GSDs) are genetic disorders that result from defects in the processing of glycogen synthesis or breakdown within muscles, liver, and other cell types. It also manifests with impaired neutrophil chemotaxis and neutropenic episodes which results in severe destruction of the supporting dental tissues, namely the periodontium. Although GSD Type Ib cannot be cured, associated symptoms and debilitating oral manifestations of the disease can be managed through collaborative medical and dental care where early detection and intervention is of key importance. This objective of the case report was to describe a child with GSD Ib and its associated oral manifestations with microbial, immunological and histological appearances. Case Presentation: An eight-year-old Hispanic male with a history of GSD type Ib presented with extensive intraoral generalized inflammation of the gingiva, ulcerations and bleeding, and intraoral radiographic evidence of bone loss. Tannerella forsythia was readily identifiable from the biofilm samples. Peripheral blood neutrophils were isolated and a deficient host response was observed by impaired neutrophil migration. Histological evaluation of the soft and hard tissues of the periodontally affected primary teeth showed unaffected dentin and cementum. Conclusions: This case illustrates the association between GSD Ib and oral manifestations of the disease. A multi-disciplinary treatment approach was developed in order to establish healthy intraoral conditions for the patient. Review of the literature identified several cases describing GSD and its clinical and radiographic oral manifestations; however, none was identified where also microbial, immunological, and histological appearances were described. Full article
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Open AccessArticle Effects of Amorphous Calcium Phosphate Administration on Dental Sensitivity during In-Office and At-Home Interventions
Dent. J. 2018, 6(4), 52; https://doi.org/10.3390/dj6040052
Received: 4 July 2018 / Revised: 12 September 2018 / Accepted: 17 September 2018 / Published: 1 October 2018
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Abstract
Background. Tooth bleaching is the most frequently employed whitening procedure in clinics. The major side effect of tooth bleaching is dental sensitivity during and after the treatment. Here, we evaluated whether the administration of amorphous calcium phosphate (ACP), during in-office and at-home procedures
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Background. Tooth bleaching is the most frequently employed whitening procedure in clinics. The major side effect of tooth bleaching is dental sensitivity during and after the treatment. Here, we evaluated whether the administration of amorphous calcium phosphate (ACP), during in-office and at-home procedures may impact on dental sensitivity. Methods. Eighty patients, responding to the study requirements were enrolled according to the following criteria. Group 1 (n = 40), received in-office, 10% ACP prior to 30% professional hydrogen peroxide application. The whitening procedure continued at home using 10% carbamide peroxide with 15% ACP for 15 days. Group 2 (n = 40) received only 30% hydrogen peroxide application and continued the whitening procedures at home, using 10% carbamide hydroxide, without ACP- Casein phosphopeptides (CPP), for 15 days. Dental sensitivity was recorded with a visual analogue scale (VAS) at baseline, immediately after, and at 15 days after treatment in the two groups. Results. We observed that patients receiving ACP in the bleaching mixture experienced decreased dental sensitivity (* p ≤ 0.05), as detected by VAS scale analysis immediately following the procedures. Patients receiving ACP-CPP during at-home procedures showed a statistically significant (*** p ≤ 0.0001) reduction of dental sensitivity. Conclusions. We demonstrated that ACP-CPP administration, while exerting the same whitening effects as in control subjects receiving potassium fluoride (PF), had an impact on the reduction of dental sensitivity, improving patient compliance. Full article
(This article belongs to the Special Issue Dental Hygiene and Epidemiology)
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Open AccessPerspective Knowledge, Attitudes, and Practices of Mothers of Preschool Children About Oral Health in Qatar: A Cross-Sectional Survey
Dent. J. 2018, 6(4), 51; https://doi.org/10.3390/dj6040051
Received: 27 May 2018 / Revised: 2 September 2018 / Accepted: 17 September 2018 / Published: 1 October 2018
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Abstract
Health-related behaviors are influenced by knowledge and awareness, with oral health being no exception. It is well-known that oral diseases are influenced by social determinants. There is an association between the oral health knowledge of mothers and the status of their children’s oral
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Health-related behaviors are influenced by knowledge and awareness, with oral health being no exception. It is well-known that oral diseases are influenced by social determinants. There is an association between the oral health knowledge of mothers and the status of their children’s oral health. In Qatar, the knowledge and practices of oral health in preschool children have not been previously reported. The aim of this study was to assess the knowledge, attitude, and related practices of mothers of preschool children about oral health in Qatar. A total of 400 questionnaires were distributed by the principals of kindergarten to mothers of children attending 16 government kindergartens in Qatar. The questionnaire included 38 close-ended questions grouped into nine categories, addressing different aspects of knowledge and practices related to early childhood oral health. The questionnaire was constructed in English, before being translated into Arabic, which is the local language in Qatar. The questionnaire instrument was pre-tested on mothers with demographic characteristics matching the main population. These participants were not included in the main study. The questionnaire study was associated with a clinical epidemiological study to assess dental caries and enamel defects of the sampled children. The dmft caries index (decayed, missing and filled teeth) was used for that purpose according to the World Health Organization criteria. For the questionnaire administered to mothers with clinical survey variables, a binary logistic regression analysis was performed to determine the associations between the measures of oral health status (dmft, Dental index) and mothers’ oral health knowledge and practices. A total of 48% mothers thought that children should have their teeth brushed from the age of three years and 42% chose younger than two years as a starting age for brushing. More than half (54%) of the mothers thought that children should not have their teeth flossed. In general, no significant statistical association was found between dmft and any other variables, except for whether or not the child had visited the dentist. Logistic regression analyses were performed to determine the association between the measures of oral health status (dmft, DI) and mothers’ oral health knowledge and practices. After controlling for the other independent variables included in this model, the test of the model was not statistically significant, which indicated that none of the variables represent a significant risk for occurrence of caries. The only exception was whether or not the child had visited the dentist (odds ratio = 2.51, 95% confidence interval 1.091–5.774). Despite the existence of good knowledge of oral health care, there were deficiencies in the oral health care provided to children. This may reflect that seeking dental care is either not very important or it is challenging to obtain access to a child-friendly dentist in the public health system in Qatar. The results of this study suggest that there is a need for an oral health promotion program to fill the gaps in knowledge for mothers regarding oral health care for young children. Full article
(This article belongs to the Special Issue Pediatric Dentistry 2018)
Open AccessCase Report Combination Therapy for Reconstructive Periodontal Treatment in the Lower Anterior Area: Clinical Evaluation of a Case Series
Dent. J. 2018, 6(4), 50; https://doi.org/10.3390/dj6040050
Received: 27 August 2018 / Revised: 7 September 2018 / Accepted: 20 September 2018 / Published: 1 October 2018
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Abstract
Clinically, periodontal regeneration may be achieved by the application of barrier membranes, grafts, wound-healing modifiers, and their combinations. Combination therapy refers to the simultaneous application of various periodontal reconstructive treatment alternatives to obtain additive effects. This approach may lead to assemblage of different
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Clinically, periodontal regeneration may be achieved by the application of barrier membranes, grafts, wound-healing modifiers, and their combinations. Combination therapy refers to the simultaneous application of various periodontal reconstructive treatment alternatives to obtain additive effects. This approach may lead to assemblage of different regenerative principles, such as conductivity and inductivity, space provision and wound stability, matrix development and cell differentiation. The application of autogenous connective tissue grafts during periodontal regenerative treatment with enamel matrix proteins derivative (EMD) has been previously reported. The present case series present a modified approach for treatment of severe periodontally involved lower incisors presenting with thin gingival biotype, gingival recession, minimal attached and keratinized gingiva width and muscle and/or frenum pull. In all cases a combination therapy consisting of a single buccal access flap, root conditioning, EMD application on the denuded root surfaces and a free connective tissue graft was performed. Clinical and radiographic outcomes were consistently satisfactory, leading to probing depth reduction, clinical attachment gain, minimal gingival recession, increased attached and keratinizing gingival width, elimination of frenum and/or muscle pull together with radiographic bone fill of the defects. It may be concluded that the present combination therapy for reconstructive periodontal treatment in the lower anterior area is a valuable alternative for indicated cases. Full article
(This article belongs to the Special Issue Soft and Hard Tissue Regeneration)
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Open AccessReview Historical and Contemporary Perspectives on the Microbiological Aspects of Endodontics
Dent. J. 2018, 6(4), 49; https://doi.org/10.3390/dj6040049
Received: 30 August 2018 / Revised: 20 September 2018 / Accepted: 20 September 2018 / Published: 22 September 2018
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Abstract
The microbiota of the oral cavity plays a significant role in pulpal and periapical diseases. Historically, 100 years ago little was known on microbiota, but after a century of investigations, only now can many of the intimate secrets of microbial growth, expansion, persistence,
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The microbiota of the oral cavity plays a significant role in pulpal and periapical diseases. Historically, 100 years ago little was known on microbiota, but after a century of investigations, only now can many of the intimate secrets of microbial growth, expansion, persistence, communal activities, and virulence be revealed. However, with the capabilities of the microbiota for mutation, quorum sensing, and information transference, researchers are hard-pressed to keep up with both the changes and challenges that an amazingly wide range of bacterial species pose for both the scientist and clinician. Fortunately, the development and expansion of a vast array of molecular biological investigative techniques have enabled dentistry and its associated medical fields to attempt to keep pace with the wide and fascinating world of oral microbiology. Full article
(This article belongs to the Special Issue Endodontic Microbiology)
Open AccessBrief Report The Effect of Commercially Available Endodontic Cements and Biomaterials on Osteogenic Differentiation of Dental Pulp Pluripotent-Like Stem Cells
Dent. J. 2018, 6(4), 48; https://doi.org/10.3390/dj6040048
Received: 27 May 2018 / Revised: 3 August 2018 / Accepted: 21 August 2018 / Published: 22 September 2018
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Abstract
The aim of this study is to compare the osteogenic differentiation capacity of the dental pulp pluripotent-like stem cells (DPPSCs) using conditional media pretreated with ProRoot-MTA, Biodentine (BD) or the newly manufactured pure Portland cement Med-PZ (MZ). DPPSCs, isolated from human third molars,
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The aim of this study is to compare the osteogenic differentiation capacity of the dental pulp pluripotent-like stem cells (DPPSCs) using conditional media pretreated with ProRoot-MTA, Biodentine (BD) or the newly manufactured pure Portland cement Med-PZ (MZ). DPPSCs, isolated from human third molars, are the most relevant cell model to draw conclusions about the role of biomaterials on dental tissue regeneration. Cytotoxicity, alkaline phosphatase (ALP) activity, and calcium deposition analysis were evaluated at different differentiation time points. Gene expression of key osteogenic markers (RUNX2, Collagen I and Osteocalcin) was determined by qRT-PCR analysis. The osteogenic capacity of cells cultured in conditioned media prepared from MZ or MTA cements was comparable. BD conditioned media supported cell proliferation but failed to induce osteogenesis. Relative to controls and other cements, high osteogenic gene expression was observed in cultures pre-treated with the novel endodontic cement MZ. In conclusion, the in vitro behavior of a MZ- endodontic cement was evaluated, showing similar enhanced cell proliferation compared to other commercially available cements but with an enhanced osteogenic capacity with prospective potential as a novel cement for endodontic treatments. Full article
(This article belongs to the Section Oral Hygiene, Periodontology and Peri-implant Diseases)
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