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Dent. J., Volume 7, Issue 3 (September 2019) – 31 articles

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Review
Early Diagnosis on Oral and Potentially Oral Malignant Lesions: A Systematic Review on the VELscope® Fluorescence Method
Dent. J. 2019, 7(3), 93; https://doi.org/10.3390/dj7030093 - 04 Sep 2019
Cited by 18 | Viewed by 3077
Abstract
The fluorescence method is an innovative technique used by pathologists for examining body mucosa, and for the abnormalities tissue screening, potentially leading to the earlier discovery of pre-cancer, cancer or other disease processes. The early detection is one of the best mechanisms for [...] Read more.
The fluorescence method is an innovative technique used by pathologists for examining body mucosa, and for the abnormalities tissue screening, potentially leading to the earlier discovery of pre-cancer, cancer or other disease processes. The early detection is one of the best mechanisms for enabling treatment success, increasing survival rates and maintaining a high quality of life. The purpose of this review is to evaluate the clinical efficiency of this diagnostic tool applied to the oral cavity (VELscope®). A literature systematic review has been performed. The initial research provided 53 results after applying the inclusion and exclusion criteria, and after a manual screening of the abstracts by the authors, only 25 results were eligible for review. The results and data contained in all the researches, no older than 10 years, were manually evaluated, and provided useful information on this diagnostic method. The VELscope® mean value about sensitivity and specificity resulted of 70.19% and 65.95%, respectively, by results analysis, but despite this some studies disagree about its clinical effectiveness, and this diagnostic method is still much debated in scientific and clinical medical literature. Surely being able to have efficient and effective tools from this point of view could help the clinician in the diagnosis, and also make timelier the pharmacological or surgical therapy, improving the quality of life of the patient, and in some cases guaranteeing a longer survival term. Full article
(This article belongs to the Special Issue Oral Cancer: Diagnosis and Treatment)
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Article
Oral Health in Women with a History of High Gestational Diabetes Risk
Dent. J. 2019, 7(3), 92; https://doi.org/10.3390/dj7030092 - 03 Sep 2019
Cited by 4 | Viewed by 1910
Abstract
We studied oral health in 115 women with and without a history of gestational diabetes (GDM), expecting poorer oral health in the GDM group. Full-mouth examinations were performed 5 years postpartum and the number of teeth, total dental index (TDI) and decayed, missing, [...] Read more.
We studied oral health in 115 women with and without a history of gestational diabetes (GDM), expecting poorer oral health in the GDM group. Full-mouth examinations were performed 5 years postpartum and the number of teeth, total dental index (TDI) and decayed, missing, filled teeth (DMFT) index were calculated. Bleeding on probing (BOP), probing depth (PD), visible plaque index (VPI), and clinical attachment level (CAL) were recorded. The periodontal inflammatory burden index (PIBI) was calculated. Panoramic radiographs were taken and signs of infections recorded. Oral health habits, symptoms and participants’ own opinion of oral health were recorded with questionnaires. At the time of examination, 45% of the women had a history of GDM in the index pregnancy. Mild periodontitis (62%) and bleeding on probing (46%) were common. VPI (13% and 17%, p = 0.009) and PIBI (13.1 and 17.5, p = 0.041) were lower among women with a history of GDM compared with those with no history of GDM. There was no difference between groups in DMFT scores. All women reported good subjective oral health. Thus, contrary to our hypothesis, women with a history of GDM showed better oral health parameters than women without a history of GDM. Full article
(This article belongs to the Special Issue Dental Hygiene and Epidemiology Volume 2)
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Article
Remineralization of Demineralized Enamel and Dentine Using 3 Dentifrices—An InVitro Study
Dent. J. 2019, 7(3), 91; https://doi.org/10.3390/dj7030091 - 02 Sep 2019
Cited by 7 | Viewed by 1991
Abstract
Objectives: To monitor the electrical resistance of artificially demineralized enamel and root dentine after exposure to different fluoridated dentifrices and, using transversal microradiography, to quantify remineralization. Materials and methods: This in-vitro blind investigation used 20 extracted teeth (four groups of five each). Each [...] Read more.
Objectives: To monitor the electrical resistance of artificially demineralized enamel and root dentine after exposure to different fluoridated dentifrices and, using transversal microradiography, to quantify remineralization. Materials and methods: This in-vitro blind investigation used 20 extracted teeth (four groups of five each). Each group was exposed to one test dentifrice [Colgate PreviDent (5000 ppm F), Colgate Winterfresh gel (1100 ppm F), Fluocaril Bi-Fluoré (2500 ppm F) and placebo (without fluoride)] three times daily for three minutes for 4 weeks. In between exposure to the test dentifrices, teeth were stored in a saliva storage solution. An Electrical Caries Monitor measured the electrical resistance at baseline and during the four-week test period at weekly intervals. The measurements were log transformed and Duncan’s multiple range test applied. Remineralization was quantified using transversal microradiography. Results: Log mean (SD) electronic carries monitor (ECM) measurements in enamel at baseline and after 4 weeks of exposure to the test dentifrices were 4.07(1.53) and 3.87(0.90) (Placebo-Fluocaril), 4.11(1.86) and 4.64(1.43) (Colgate Winterfresh gel), 4.81(0.9) and 4.21(1.20) (Fluocaril Bi-Fluoré), and 4.60(0.88) and 3.76(0.9) (Colgate PreviDent). Corresponding measurements in dentine were 2.13(0.89) and 3.06(0.87) (Placebo-Fluocaril), 1.87(0.63) and 2.88(1.32) (Colgate Winterfresh gel), 2.47(1.20) and 1.65(0.60) (Fluocaril), and 2.16(0.00), and 2.34(1.07) for Colgate PreviDent. Lesion depth (µm) after microradiography in enamel was 100.1 (Placebo), 50.6 (Colgate Winterfresh gel), and 110.2 (Fluocaril, and 97.1 (Colgate PreviDent), and corresponding values in dentine were 169.7, 154.8, 183.7, and 153.5. The correlation of ECM and microradiographic parameters was negative (p < 0.05). Conclusion: Exposure of artificially demineralized enamel and root dentine to fluoridated dentifrices and saliva storage solution resulted in remineralization as follows: Colgate Winterfresh > Colgate PreviDent > Placebo-Fluocaril > Fluocaril Bi-Fluoré. Remineralization in teeth of the Placebo dentifrice group may be attributed to the presence of calcium and phosphate ions in the saliva storage solution. Full article
(This article belongs to the Section Dental Materials)
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Review
Monolithic Zirconia: An Update to Current Knowledge. Optical Properties, Wear, and Clinical Performance
Dent. J. 2019, 7(3), 90; https://doi.org/10.3390/dj7030090 - 02 Sep 2019
Cited by 33 | Viewed by 3078
Abstract
The purpose of this paper was to update the knowledge concerning the wear, translucency, as well as clinical performance of monolithic zirconia ceramics, aiming at highlighting their advantages and weaknesses through data presented in recent literature. New ultra-translucent and multicolor monolithic zirconia ceramics [...] Read more.
The purpose of this paper was to update the knowledge concerning the wear, translucency, as well as clinical performance of monolithic zirconia ceramics, aiming at highlighting their advantages and weaknesses through data presented in recent literature. New ultra-translucent and multicolor monolithic zirconia ceramics present considerably improved aesthetics and translucency, which, according to the literature reviewed, is similar to those of the more translucent lithium disilicate ceramics. A profound advantage is their high strength at thin geometries preserving their mechanical integrity. Based on the reviewed articles, monolithic zirconia ceramics cause minimal wear of antagonists, especially if appropriately polished, although no evidence still exists regarding the ultra-translucent compositions. Concerning the survival of monolithic zirconia restorations, the present review demonstrates the findings of the existing short-term studies, which reveal promising results after evaluating their performance for up to 5 or 7 years. Although a significant increase in translucency has been achieved, new translucent monolithic zirconia ceramics have to be further evaluated both in vitro and in vivo for their long-term potential to preserve their outstanding properties. Due to limited studies evaluating the wear properties of ultra-translucent material, no sound conclusions can be made, whereas well-designed clinical studies are urgently needed to enlighten issues of prognosis and long-term survival. Full article
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Review
Cone-Beam Computed Tomography in Orthodontics
Dent. J. 2019, 7(3), 89; https://doi.org/10.3390/dj7030089 - 02 Sep 2019
Cited by 15 | Viewed by 3991
Abstract
Unlike patients receiving implants or endodontic treatment, most orthodontic patients are children who are particularly sensitive to ionizing radiation. Cone-beam computed tomography (CBCT) carries risks and benefits in orthodontics. The principal risks and limitations include ionizing radiation, the presence of artifacts, higher cost, [...] Read more.
Unlike patients receiving implants or endodontic treatment, most orthodontic patients are children who are particularly sensitive to ionizing radiation. Cone-beam computed tomography (CBCT) carries risks and benefits in orthodontics. The principal risks and limitations include ionizing radiation, the presence of artifacts, higher cost, limited accessibility, and the need for additional training. However, this imaging modality has several recognized indications in orthodontics, such as the assessment of impacted and ectopic teeth, assessment of pharyngeal airway, assessment of mini-implant sites, evaluation of craniofacial abnormalities, evaluation of sinus anatomy or pathology, evaluation of root resorption, evaluation of the cortical bone plate, and orthognathic surgery planning and evaluation. CBCT is particularly justified when it brings a benefit to the patient or changes the outcome of the treatment when compared with conventional imaging techniques. Therefore, CBCT should be considered for clinical orthodontics for selected patients. Prescription of CBCT requires judicious and sound clinical judgment. The central question of this narrative review article is: when does CBCT add value to the practice of orthodontics? To answer this question, this article presents discussion on radiation dosage of CBCT and other imaging techniques used in orthodontics, limitations of CBCT in orthodontics, justifying the use of CBCT in orthodontics, and the benefits and evidence-based indications of CBCT in orthodontics. This review summarizes the central themes and topics in the literature regarding CBCT in orthodontics and presents ten orthodontic cases in which CBCT proved to be valuable. Full article
(This article belongs to the Special Issue Imaging Science in Dentistry)
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Article
An Insight into Acute Pericoronitis and the Need for an Evidence-Based Standard of Care
Dent. J. 2019, 7(3), 88; https://doi.org/10.3390/dj7030088 - 02 Sep 2019
Cited by 6 | Viewed by 3435
Abstract
Background: Pericoronitis is inflammation of the operculum associated with a partially erupted third molar. It is a highly prevalent infection of the oral cavity and presents as a painful sensation of the soft tissue encompassing the crown of the involved tooth. Though pericoronitis [...] Read more.
Background: Pericoronitis is inflammation of the operculum associated with a partially erupted third molar. It is a highly prevalent infection of the oral cavity and presents as a painful sensation of the soft tissue encompassing the crown of the involved tooth. Though pericoronitis is common, there is no evidence-based standard-of-care for treatment of emergency patients with acute pericoronitis. Study Design: In this study, anonymous clinicians were asked to participate in an online survey with questions formulated to identify professional clinical background, emergency treatment preferred for acute pericoronitis, number of associated complications, frequency of third molar extraction, and patient satisfaction. Results and Conclusion: A statistical analysis of the collected data regarding the variance among different treatment plans and associated complications revealed little consensus in the treatment of pericoronitis. The lack of consistency of the responses focusing on the preferred treatment for emergency patients with acute pericoronitis reinforces the need for developing a standard-of-care to train future dental professionals based on well-designed randomized controlled clinical trials and meta-analyses. Practical Implications: The ultimate goal is developing a treatment option with the fewest complications to provide the best health care for patients with pericoronitis. This issue is seen not only as an acute infection but also has the potential to impact overall health. Full article
(This article belongs to the Special Issue Pathogenesis of Periodontal Disease)
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Review
Layered Double Hydroxide Fluoride Release in Dental Applications: A Systematic Review
Dent. J. 2019, 7(3), 87; https://doi.org/10.3390/dj7030087 - 02 Sep 2019
Cited by 8 | Viewed by 1636
Abstract
This systematic review appraises studies conducted with layered double hydroxides (LDHs) for fluoride release in dentistry. LDH has been used as antacids, water purification in removing excess fluoride in drinking water and drug delivery. It has great potential for controlled fluoride release in [...] Read more.
This systematic review appraises studies conducted with layered double hydroxides (LDHs) for fluoride release in dentistry. LDH has been used as antacids, water purification in removing excess fluoride in drinking water and drug delivery. It has great potential for controlled fluoride release in dentistry, e.g., varnishes, fissure sealants and muco-adhesive strips, etc. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement was followed with two reviewers performing a literature search using four databases: PubMed, Web of Science, Science Direct and Ovid Medline with no date restrictions. Studies including any LDH for ion/drug release in dentistry were included, while assessing the application of LDH and the value of the methodology, e.g., ion release protocol and the LDH production process. Results: A total of 258 articles were identified and four met the inclusion criteria. Based on two in vitro studies and one clinical study, LDH was previously studied in dental materials, such as dental composites and buccal muco-adhesive strips for fluoride release, with the latter studied in a clinical environment. The fourth study analysed LDH powder alone (without being incorporated into dental materials). It demonstrated fluoride release and the uptake of volatile sulphur compounds (VSC), which may reduce halitosis (malodour). Conclusion: LDHs incorporated in dental materials have been previously evaluated for fluoride release and proven to be clinically safe. LDHs have the potential to sustain a controlled release of fluoride (or other cariostatic ions) in the oral environment to prevent caries. However, further analyses of LDH compositions, and clinical research investigating any other cariostatic effects, are required. Full article
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Article
Early Wound Healing Score (EHS): An Intra- and Inter-Examiner Reliability Study
Dent. J. 2019, 7(3), 86; https://doi.org/10.3390/dj7030086 - 01 Sep 2019
Cited by 5 | Viewed by 1347
Abstract
The early wound healing score (EHS) was introduced to assess early wound healing of periodontal soft tissues after surgical incision. The purpose of this study is to evaluate the intra- and inter-examiner reliability of the EHS. Six examiners with different levels of training [...] Read more.
The early wound healing score (EHS) was introduced to assess early wound healing of periodontal soft tissues after surgical incision. The purpose of this study is to evaluate the intra- and inter-examiner reliability of the EHS. Six examiners with different levels of training and clinical focus were enrolled. Each examiner was trained on the use of the EHS before starting the study. Thereafter, 63 photographs of three different types of surgical incisions taken at day 1, 3 or 7 post-operatively were independently evaluated according to the proposed assessment method. A two-way random intra-class correlation coefficient (ICC) and 95% confidence interval (CI) were used to analyze the intra- and inter-examiner reliability for the EHS. The inter-examiner reliability for the EHS was 0.828 (95% CI: 0.767–0.881). The intra-examiner reliability ranged between 0.826 (95% CI: 0.728–0.891) and 0.915 (95% CI: 0.856–0.950). The results therefore show an “almost perfect agreement” for intra- and inter-examiner reliability. The EHS provides a system for reproducible repeated ratings for the early healing assessment of incisions of periodontal soft tissues. Even when used by examiners with different clinical experience and specialty, it shows a high correlation coefficient. Full article
(This article belongs to the Section Oral Hygiene, Periodontology and Peri-implant Diseases)
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Review
Microbiological and Clinical Aspects of Cervicofacial Actinomyces Infections: An Overview
Dent. J. 2019, 7(3), 85; https://doi.org/10.3390/dj7030085 - 01 Sep 2019
Cited by 18 | Viewed by 1781
Abstract
Similarly to other non-spore-forming Gram-positive anaerobes, members of the Actinomyces genus are important saprophytic constituents of the normal microbiota of humans. Actinomyces infections are considered to be rare, with cervicofacial infections (also known as ‘lumpy jaw syndrome’) being the most prevalent type in [...] Read more.
Similarly to other non-spore-forming Gram-positive anaerobes, members of the Actinomyces genus are important saprophytic constituents of the normal microbiota of humans. Actinomyces infections are considered to be rare, with cervicofacial infections (also known as ‘lumpy jaw syndrome’) being the most prevalent type in the clinical practice. Actinomycoses are characterized by a slowly progressing (indolent) infection, with non-specific symptoms, and additionally, the clinical presentation of the signs/symptoms can mimic other pathologies, such as solid tumors, active Mycobacterium tuberculosis infections, nocardiosis, fungal infections, infarctions, and so on. The clinical diagnosis of actinomycosis may be difficult due to its non-specific symptoms and the fastidious, slow-growing nature of the pathogens, requiring an anaerobic atmosphere for primary isolation. Based on 111 references, the aim of this review is to summarize current advances regarding the clinical features, diagnostics, and therapy of cervicofacial Actinomyces infections and act as a paper for dentistry specialists, other physicians, and clinical microbiologists. Full article
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Article
Effectiveness of Ball Attachment Systems in Implant Retained- and Supported-Overdentures: A Three- to Five-Year Retrospective Examination
Dent. J. 2019, 7(3), 84; https://doi.org/10.3390/dj7030084 - 01 Sep 2019
Cited by 4 | Viewed by 1283
Abstract
Purpose: To evaluate implant and prosthetic survival rates, complications, patient satisfaction, and biological outcomes of patients rehabilitated with a ball attachment system for implant retained- and supported-overdentures (IOV), which was in function for 3 to 5 years. Methods: This retrospective study evaluated data [...] Read more.
Purpose: To evaluate implant and prosthetic survival rates, complications, patient satisfaction, and biological outcomes of patients rehabilitated with a ball attachment system for implant retained- and supported-overdentures (IOV), which was in function for 3 to 5 years. Methods: This retrospective study evaluated data collected from patients treated between April 2001 and May 2018 with IOV on splinted and non-splinted implants and a ball attachment system. Patients were followed for 36 to 206 months (mean follow-up was 128.1 ± 51.9 months). Data were collected at the 3- and 5-year follow-up examination. Outcome measures were implant and prosthetic survival rates, technical complications, marginal bone loss (MBL), oral health impact profile (OHIP), and periodontal parameters (bleeding on probing and plaque index). Results: A total of 46 patients (16 males and 30 females) with 124 implants were included in this study. Twenty-five implant-retained overdentures were delivered on 53 unsplinted implants, while the other 21 patients received an implant-supported overdentures and the implants were splinted. At the five-year follow-up examination, one implant and one prosthesis failed in the unsplinted group, resulting in a cumulative survival rate of 97.8% at the patient level. Two minor technical complications were experienced. Conclusions: Implant overdenture retained or supported by ball attachment systems showed high implant and prosthetic survival and success rates. A low number of complications, high patient satisfaction, and successful biological parameters were experienced in the mid-term follow-up. Data need to be confirmed by further randomized trials. Full article
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Article
Knowledge and Attitude of Midwifery Students on Oral Health Care
Dent. J. 2019, 7(3), 83; https://doi.org/10.3390/dj7030083 - 01 Aug 2019
Cited by 4 | Viewed by 2067
Abstract
Midwifery students can have an important role in transferring oral health care information to expecting mothers. The aim of this study was to assess the effect of an educational intervention on knowledge and attitudes of midwifery students on oral health in pregnancy. Study [...] Read more.
Midwifery students can have an important role in transferring oral health care information to expecting mothers. The aim of this study was to assess the effect of an educational intervention on knowledge and attitudes of midwifery students on oral health in pregnancy. Study population consisted of 60 midwifery students in a Midwifery School in Iran who were randomly allocated into case and control groups. Self-administered questionnaires were distributed before, immediately after the intervention and also three months later. The validity and reliability of the questionnaire was confirmed at the beginning. Mean total pre-test knowledge scores from total 10 in the interventional and control groups were 4.63 ± 0.25 (Standard Error, SE) and 4.79 ± 0.31 (SE) respectively. After three months scores reached to 8.87 ± 0.15 (SE) in the interventional and 5.57 ± 0.29 (SE) in the control groups. Mean attitude pre-test scores in the interventional group was 27.23 ± 0.75 (SE) and after the intervention reached to 31.13 ± 0.25 (SE). Lecture-based educational intervention improved the knowledge and attitudes of midwifery students on oral health care in pregnancy. Incorporating courses on oral health in pregnancy into the curricula of midwifery programs can be effective in promoting oral health care in pregnant women. Full article
(This article belongs to the Special Issue Inter-Professional Oral Health Education)
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Article
Effect of Surface Treatments on Shear Bond Strength of Polyetheretherketone to Autopolymerizing Resin
Dent. J. 2019, 7(3), 82; https://doi.org/10.3390/dj7030082 - 01 Aug 2019
Cited by 5 | Viewed by 1779
Abstract
These days, new prosthodontic materials are appearing with the development of digitalization. Among these, the use of polyetheretherketone (PEEK) as the clasp of removable partial dentures has been proposed. The adhesive strength between the PEEK and acrylic resin influences the probability of denture [...] Read more.
These days, new prosthodontic materials are appearing with the development of digitalization. Among these, the use of polyetheretherketone (PEEK) as the clasp of removable partial dentures has been proposed. The adhesive strength between the PEEK and acrylic resin influences the probability of denture fracture. To investigate the effect of PEEK surface treatments on the shear bond strength to acrylic resin, five surface treatment conditions of PEEK were analyzed: 1. no treatment; 2. ceramic primer application; 3. Al2O3 sandblasting; 4. Rocatec; and 5. Rocatec with ceramic primer application, comparing with a metal primer-treated Co-Cr alloy. Two kinds of autopolymerizing resin (Unifast II and Palapress Vario) were used as bonding materials. The specimens were evaluated to determine the bond strength. Rocatec treatment with ceramic primer application yielded the highest bond strengths (12.71 MPa and 15.32 MPa, respectively, for Unifast II and Palapress Vario). When compared to a metal primer-treated Co-Cr alloy, the bond strength of PEEK to Unifast II was similar, whereas it was about 60% of that to Palapress Vario. Rocatec treatment, combined with ceramic primer, showed the highest bond strength of PEEK to acrylic resin. Treatment of PEEK will enable its use as the clasp of removable dentures and the fixation of PEEK prostheses. Full article
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Article
Dimensional Stability of a Preliminary Vinyl Polysiloxane Impression Material
Dent. J. 2019, 7(3), 81; https://doi.org/10.3390/dj7030081 - 01 Aug 2019
Cited by 1 | Viewed by 1376
Abstract
Oral rehabilitation success depends upon the accuracy and dimensional stability of the impressions. The purpose of this study is to evaluate the dimensional changes of a first impression type VPS (Vinyl Polysiloxane) (Imprint™ 4 Preliminary Penta™ Super Quick, 3M ESPE™, St Paul, MN, [...] Read more.
Oral rehabilitation success depends upon the accuracy and dimensional stability of the impressions. The purpose of this study is to evaluate the dimensional changes of a first impression type VPS (Vinyl Polysiloxane) (Imprint™ 4 Preliminary Penta™ Super Quick, 3M ESPE™, St Paul, MN, USA). 10 samples were obtained from this silicone with an automatic mixing machine (Pentamix 2, 3M ESPE™, Seefeld, Germany) according to International Organization for Standardization (ISO) 4823:2000 and stored in the IPQ (Portuguese Institute for Quality) for one week. The measurements were performed by laser interferometry, according to the Michelson technique. The dimensional stability was calculated according to the formula specified in ISO (International Organization for Standardization) 4823:2000. A statistical analysis via a one-way repeated measures ANOVA was performed. The material shrinkage was 0.29 ± 0.15% after setting, 0.32 ± 0.21% at 24 h and 0.30 ± 0.23% after 1 week. No significant shrinkage of the silicone under investigation was found over time. This material can be stored for a week without the risk of clinically significant dimensional changes. Full article
(This article belongs to the Section Dental Materials)
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Article
Adhesion of Two New Glass Fiber Post Systems Cemented with Self-Adhesive Resin Cements
Dent. J. 2019, 7(3), 80; https://doi.org/10.3390/dj7030080 - 01 Aug 2019
Cited by 5 | Viewed by 1868
Abstract
The aim of this in vitro study was to evaluate the adhesion strength of two new fiber post systems (FiberSite™ Post and Cytec™ Blanco Post) cemented with two different adhesive resin cements (Panavia™ SA and Maxcem™ Elite). Root canals of sixty extracted human [...] Read more.
The aim of this in vitro study was to evaluate the adhesion strength of two new fiber post systems (FiberSite™ Post and Cytec™ Blanco Post) cemented with two different adhesive resin cements (Panavia™ SA and Maxcem™ Elite). Root canals of sixty extracted human mandibular premolars were prepared using ProTaper Universal™ rotary files (Dentsply Sirona Endodontics, York, PA, USA). The root canals were irrigated with 5.25% sodium hypochlorite (NaOCl) during instrumentation. After root canal preparation, the canals were irrigated with 2 mL of 17% EDTA (1 min), followed by 2 mL of 5.25% (5 min) NaOCI, and 2 mL saline. The root canals were dried with paper points and divided randomly into two study groups (n = 30) according to the type of post system: Group 1, FiberSite™ Post (MegaDental, Partanna, Italy); and group 2, Cytec™ Blanco Post (Hahnenkratt, Königsbach-Stein, Germany), with one of the two adhesive resin cements: Subgroup A, Panavia™ SA Cement Plus Automix (Kuraray, Osaka, Japan); subgroup B, Maxcem™ Elite (Kerr, Orange, CA, USA). Following thermocycling, the adhesion strength was evaluated using the push-out adhesion (bond) strength test. Fractographic analysis was performed using stereomicroscope. The data were analyzed using two-way analysis of variance (p = 0.05). The adhesion strength values of both the posts were significantly higher when cemented with subgroup B (Maxcem™ Elite). The highest adhesion strength value was demonstrated by group 1B (FiberSite™ post cemented with Maxcem™ Elite cement). The type of post did not have a significant impact on the bond strength values for either cement material. Full article
(This article belongs to the Section Oral Hygiene, Periodontology and Peri-implant Diseases)
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Review
A Critical Review of Modern Concepts for Teeth Whitening
Dent. J. 2019, 7(3), 79; https://doi.org/10.3390/dj7030079 - 01 Aug 2019
Cited by 28 | Viewed by 9077
Abstract
Besides prevention of caries and periodontitis, an increasing number of oral care products focus on teeth whitening. The aim of this review is to summarize and discuss frequently used whitening agents and their efficacy from a chemical viewpoint. Therefore, a comprehensive literature survey [...] Read more.
Besides prevention of caries and periodontitis, an increasing number of oral care products focus on teeth whitening. The aim of this review is to summarize and discuss frequently used whitening agents and their efficacy from a chemical viewpoint. Therefore, a comprehensive literature survey on teeth whitening agents and products was conducted. The current whitening methods are analyzed and discussed from a chemist’s viewpoint. Frequently used whitening agents are abrasives (mechanical removal of stains), antiredeposition agents (prevention of deposition of chromophores), colorants (intended to lead to a white color), proteases (degradation of proteins), peroxides (oxidation of organic chromophores), and surfactants (removal of hydrophobic compounds from tooth surface). In-office bleaching using peroxides is effective, but side effects like tooth sensitivity or a damage of the natural organic matrix of enamel and dentin may occur. The applicability of abrasives in teeth whitening is limited due to potential tooth wear, especially when toothpastes with high RDA values are used. The effect of other whitening agents in vivo is often unclear because of a shortage of placebo-controlled clinical trials. Full article
Article
Reactivity and Bond Strength of Universal Dental Adhesives with Co-Cr Alloy and Zirconia
Dent. J. 2019, 7(3), 78; https://doi.org/10.3390/dj7030078 - 01 Aug 2019
Cited by 1 | Viewed by 1523
Abstract
The aim of this study was to evaluate (a) the reactivity of six universal dental adhesives with polished cobalt-chrome (Co-Cr) alloy and zirconia (3Y-TZP) surfaces; and (b) to assess the shear bond strength (SBS) of a resin composite with polished and alumina-blasted surfaces [...] Read more.
The aim of this study was to evaluate (a) the reactivity of six universal dental adhesives with polished cobalt-chrome (Co-Cr) alloy and zirconia (3Y-TZP) surfaces; and (b) to assess the shear bond strength (SBS) of a resin composite with polished and alumina-blasted surfaces as mediated by these adhesives. The products tested were Adhese Universal (AD), All-Bond Universal (AB), Clearfill Universal Bond (CB), G-Premio Bond (GP), Prelude One (PO) and Scotchbond Universal (SB). The reactivity on polished substrates was evaluated by reflection infrared microscopy (RFTIRM). The roughness parameters of polished and 50 μm alumina grit-blasted surfaces were assessed by optical profilometry. The SBS of the composite bonded to the substrates treated with each adhesive (n = 10/product) was evaluated after 1 week of storage (H2O/37 °C) by Weibull statistics. Evidence of phosphate interaction with polished substrates was obtained by FTIRM, with higher peaks on the alloy. Alumina-blasting increased all roughness parameters with higher values on the alloy. AD, CB were the strongest (σ0) treatments on alloy surfaces and AD, CB, AB, SB on zirconia. GP was the weakest on both substrates and the least reliable (β) on alloy. On polished alloy GP, PO performed better (σ0), whereas on zirconia there were no significant differences. All adhesives showed more prominent reaction with the Co-Cr alloy than with 3Y-TZP. Full article
(This article belongs to the Section Dental Materials)
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Case Report
A Preshaped Titanium Mesh for Guided Bone Regeneration with an Equine-Derived Bone Graft in a Posterior Mandibular Bone Defect: A Case Report
Dent. J. 2019, 7(3), 77; https://doi.org/10.3390/dj7030077 - 01 Aug 2019
Cited by 3 | Viewed by 1891
Abstract
One of the most often used bone augmentation techniques is the guided bone regeneration procedure. The authors report the case of a 75-year-old man with an atrophic right posterior mandible who underwent bone augmentation through guided bone regeneration with a preshaped titanium mesh [...] Read more.
One of the most often used bone augmentation techniques is the guided bone regeneration procedure. The authors report the case of a 75-year-old man with an atrophic right posterior mandible who underwent bone augmentation through guided bone regeneration with a preshaped titanium mesh adapted on a stereolithographic model of the patient’s jaw. The graft volume was simulated with a light-curing resin. The actual site was grafted with a mixture of autogenous and equine-derived bone. Five months later, the mesh was retrieved, three cylindrical implants were positioned, and a bone biopsy was collected for histomorphometric analysis. A provisional prosthesis was delivered three and a half months later. Definitive rehabilitation was accomplished after one additional month. The graft allowed for effective bone formation (newly formed bone, residual biomaterial, and medullar spaces were, respectively, 39%, 10%, and 51% of the core volume). The patient has functioned successfully throughout six and a half years of follow-up. Using the preshaped titanium mesh in association with the enzyme-treated equine bone substitute provided effective bone regeneration. Full article
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Case Report
Unusual Imaging Features of Dentigerous Cyst: A Case Report
Dent. J. 2019, 7(3), 76; https://doi.org/10.3390/dj7030076 - 01 Aug 2019
Cited by 4 | Viewed by 5570
Abstract
Dentigerous cysts (DC) are cystic lesions radiographically represented by a well-defined unilocular radiolucent area involving an impacted tooth crown. We present an unusual radiographic feature of dentigerous cyst related to the impacted mandibular right second molar, in a 16-year-old patient, which suggested an [...] Read more.
Dentigerous cysts (DC) are cystic lesions radiographically represented by a well-defined unilocular radiolucent area involving an impacted tooth crown. We present an unusual radiographic feature of dentigerous cyst related to the impacted mandibular right second molar, in a 16-year-old patient, which suggested an ameloblastoma or odontogenic keratocyst (OKC) because of its multilocular appearance seen on the panoramic radiography. A multi-slice computed tomography (MSCT), however, revealed a unilocular lesion without septations, with an attenuation coefficient from 3.9 to 22.9 HU suggesting a cystic lesion. Due to its extension, a marsupialization was performed together with the histopathological analysis of the fragment removed which suggested a dentigerous cyst. Nine months later, the lesion was reduced in size and then totally excised. The impacted mandibular right second molar was also extracted. Histopathological examination confirmed the diagnosis of a dentigerous cyst. One year later, the panoramic radiography showed a complete mandible bone healing. Large dentigerous cysts can sometimes suggest other more aggressive pathologies. Precise diagnosis is important to avoid mistakes since DC, OKC and ameloblastoma require different treatments. Histological examination is, therefore, essential to establish a definitive diagnosis. In our case, MSCT and the tissue attenuation coefficient analysis contributed to guide the diagnosis and management of the dentigerous cyst. Full article
(This article belongs to the Special Issue Pathogenesis of Periodontal Disease)
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Commentary
Reaching Vulnerable Populations through Portable and Mobile Dentistry—Current and Future Opportunities
Dent. J. 2019, 7(3), 75; https://doi.org/10.3390/dj7030075 - 01 Aug 2019
Cited by 3 | Viewed by 1855
Abstract
The Action for Dental Health Act of 2017 bill is intended to prevent dental disease and divert dental emergencies from high-cost centers (like hospital emergency rooms) to dental offices. Lines 15–17 of the bill include grant funding to support portable or mobile dental [...] Read more.
The Action for Dental Health Act of 2017 bill is intended to prevent dental disease and divert dental emergencies from high-cost centers (like hospital emergency rooms) to dental offices. Lines 15–17 of the bill include grant funding to support portable or mobile dental equipment, and this should lead to an expansion of opportunities to deliver and receive care through the use of portable dental equipment and mobile dental vans, i.e., portable and mobile dentistry (PMD). Historically, PMD has been valuable to bridge the access gap for those for whom transport can be a challenge, like children and the elderly. However, PMD could be valuable to large employers, allowing the employees to receive dental care with minimal disruption to their workday. Oral pain is known to affect work and school attendance, and improving access to dental care could benefit individuals, families, organizations, and communities. Full article
(This article belongs to the Special Issue Efficiency and Quality in Dental Medicine)
Review
Adhesion to Zirconia: A Systematic Review of Current Conditioning Methods and Bonding Materials
Dent. J. 2019, 7(3), 74; https://doi.org/10.3390/dj7030074 - 01 Aug 2019
Cited by 25 | Viewed by 3883
Abstract
Background. Reliable bonding between resin composite cements and high strength ceramics is difficult to achieve because of their chemical inertness and lack of silica content that makes etching impossible. The purpose of this review is to classify and analyze the existing methods and [...] Read more.
Background. Reliable bonding between resin composite cements and high strength ceramics is difficult to achieve because of their chemical inertness and lack of silica content that makes etching impossible. The purpose of this review is to classify and analyze the existing methods and materials suggested to improve the adhesion of zirconia to dental substrate by using composite resins, in order to explore current trends in surface conditioning methods with predictable results. Methods. The current literature, examining the bond strength of zirconia ceramics, and including in vitro studies, clinical studies, and a systematic review, was analyzed. The research in the literature was carried out using PubMed and Cochrane Library databases, only papers in English, published online from 2013 to 2018. The following keywords and their combinations were used: Zirconia, 3Y-TZP, Adhesion, Adhesive cementation, Bonding, Resin, Composite resin, Composite material, Dentin, Enamel. Results. Research, in PubMed and Cochrane Library databases, provided 390 titles with abstracts. From these, a total of 93 publications were chosen for analysis. After a full text evaluation, seven articles were discarded. Therefore, the final sample was 86, including in vitro, clinical studies, and one systematic review. Various adhesive techniques with different testing methods were examined. Conclusions. Airborne-particle abrasion and tribo-chemical silica coating are the pre-treatment methods with more evidence in the literature. Increased adhesion could be expected after physico-chemical conditioning of zirconia. Surface contamination has a negative effect on adhesion. There is no evidence to support a universal adhesion protocol. Full article
(This article belongs to the Special Issue Advanced Dental Biomaterials)
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Article
Bone Density and Implant Primary Stability. A Study on Equine Bone Blocks
Dent. J. 2019, 7(3), 73; https://doi.org/10.3390/dj7030073 - 01 Jul 2019
Cited by 4 | Viewed by 1627
Abstract
Previous results on synthetic blocks mimicking bone indicate that bone density can be measured by the friction encountered by a rotating probe while it descends into bone, and that primary implant stability may be measured through the integral (I) of the torque–depth curve [...] Read more.
Previous results on synthetic blocks mimicking bone indicate that bone density can be measured by the friction encountered by a rotating probe while it descends into bone, and that primary implant stability may be measured through the integral (I) of the torque–depth curve at implant insertion. This study aims to repeat those tests on collagen-preserving equine bone blocks as they better reproduce the mechanical properties of natural bone. Fifteen cancellous equine blocks had their density measured using a measuring probe. This was compared to their known physical density through linear regression analysis. Implant placement was carried out into six cancellous equine blocks and primary stability was measured using (I), as well as the insertion torque (IT), the implant stability quotient (ISQ), and the reverse torque (RT). The relation between (I), (IT), (ISQ), and (RT) was investigated by correlation analysis. Bone density measured using the probe correlated significantly with actual density, both with (r = 0.764) and without irrigation (r = 0.977). (I) correlated significantly with IT and RT under all irrigation conditions, and with ISQ only without irrigation (r = 0.886). The results suggest that the probe provides actual bone density measurements. They also indicate that (I) measures primary implant stability and is more sensitive to density variations than IT, RT, and ISQ. Results are consistent with those obtained on synthetic blocks but suggest that equine bone blocks may better reproduce the mechanical properties of human cancellous alveolar bone. This should be the subject of additional studies. Full article
(This article belongs to the Special Issue Advanced Dental Biomaterials)
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Review
Antibacterial Additives in Epoxy Resin-Based Root Canal Sealers: A Focused Review
Dent. J. 2019, 7(3), 72; https://doi.org/10.3390/dj7030072 - 01 Jul 2019
Cited by 11 | Viewed by 2930
Abstract
Dental materials used in root canal treatment have undergone substantial improvements over the past decade. However, one area that still remains to be addressed is the ability of root canal fillings to effectively entomb, kill bacteria, and prevent the formation of a biofilm, [...] Read more.
Dental materials used in root canal treatment have undergone substantial improvements over the past decade. However, one area that still remains to be addressed is the ability of root canal fillings to effectively entomb, kill bacteria, and prevent the formation of a biofilm, all of which will prevent reinfection of the root canal system. Thus far, no published review has analysed the literature on antimicrobial additives to root canal sealers and their influence on physicochemical properties. The aim of this paper was to systematically review the current literature on antimicrobial additives in root canal sealers, their anti-fouling effects, and influence on physicochemical properties. A systematic search was performed in two databases (PubMed and Scopus) to identify studies that investigated the effect of antimicrobial additives in epoxy resin-based root canal sealers. The nature of additives, their antimicrobial effects, methods of antimicrobial testing are critically discussed. The effects on sealer properties have also been reviewed. A total of 31 research papers were reviewed in this work. A variety of antimicrobial agents have been evaluated as additives to epoxy resin-based sealers, including quaternary ammonium compounds, chlorhexidine, calcium hydroxide, iodoform, natural extracts, antibiotics, antifungal drugs, and antimicrobial agent-functionalised nanoparticles. Antimicrobial additives generally improved the antimicrobial effect of epoxy resin-based sealers mainly without deteriorating the physicochemical properties, which mostly remained in accordance with ISO and ANSI/ADA specifications. Full article
(This article belongs to the Special Issue Endodontic Microbiology)
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Review
Adhesive Systems Used in Indirect Restorations Cementation: Review of the Literature
Dent. J. 2019, 7(3), 71; https://doi.org/10.3390/dj7030071 - 01 Jul 2019
Cited by 11 | Viewed by 2912
Abstract
New technologies are changing the therapeutical options to do indirect restorations and new adhesive systems are continuously introduced to be used by clinicians. Different interactions between restorations, adhesive systems components, enamel and dentin require having criteria based on the selection of the adhesive [...] Read more.
New technologies are changing the therapeutical options to do indirect restorations and new adhesive systems are continuously introduced to be used by clinicians. Different interactions between restorations, adhesive systems components, enamel and dentin require having criteria based on the selection of the adhesive system, ensuring the longevity of the restorations and the preservation of the biological remnant. The adhesion force to the dental tissue is one of the indicatives of the behavior of the adhesive systems and influences the behavior of the treatments with direct and indirect restorations. The objective of this search was to find the adhesive systems with the best results in terms of the adhesion strength of indirect restorations on the dental tissues. The search was conducted in two MEDLINE digital databases (PubMed), and the Cochrane Library with a search strategy based on the combination of MeSH (Medical Subject Headings) keywords. This systematic review used the PRISMA guide (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). According to this review, the 3-step adhesive systems were the best performing and still are the gold standard for the cementing of indirect restorations. In addition, it can be concluded that self-etched adhesive systems reduce the time spent in clinical practice, however at the interface level they behave as permeable membranes more susceptible to degradation. Full article
(This article belongs to the Special Issue Restorative and Esthetic Dentistry)
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Article
Chemical, Clinical and Histomorphometric Comparison between Equine Bone Manufactured through Enzymatic Antigen-Elimination and Bovine Bone Made Non-Antigenic Using a High-Temperature Process in Post-Extractive Socket Grafting. A Comparative Retrospective Clinical Study
Dent. J. 2019, 7(3), 70; https://doi.org/10.3390/dj7030070 - 01 Jul 2019
Cited by 4 | Viewed by 1442
Abstract
Enzyme-deantigenic equine bone (EDEB) and anorganic bovine bone (ABB) are two xenografts made non-antigenic through different processing methods. This study aimed to characterize them for the presence of native bone collagen and other proteins and to compare their histomorphometric outcome when they were [...] Read more.
Enzyme-deantigenic equine bone (EDEB) and anorganic bovine bone (ABB) are two xenografts made non-antigenic through different processing methods. This study aimed to characterize them for the presence of native bone collagen and other proteins and to compare their histomorphometric outcome when they were used to graft post-extractive sockets. The records of 46 patients treated with EDEB (n = 22) or ABB (n = 24) and followed-up for at least four months after delayed implant placement, were retrospectively collected. Samples of EDEB and ABB were analyzed using Attenuated Total Reflection Fourier Transform Infrared and Sodium Dodecyl Sulfate-Polyacrylamide Gel Electrophoresis for the presence of collagen and other proteins. For histomorphometric analysis on bone specimens, newly formed bone and residual biomaterial percentages were calculated. Results of the present study show that EDEB contains type I bone collagen in its native conformation, while no proteins were detected in ABB. Grafting EDEB resulted in a significantly greater quantity of newly formed bone and less residual biomaterial. Our findings suggest that the manufacturing process can greatly affect the graft behavior and a process preserving collagen in its native form may favor bone tissue regeneration. Full article
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Article
‘Message to Dentist’: Facilitating Communication with Dentally Anxious Children
Dent. J. 2019, 7(3), 69; https://doi.org/10.3390/dj7030069 - 01 Jul 2019
Cited by 1 | Viewed by 3369
Abstract
Dental anxiety affects children worldwide and can have negative consequences on oral health. This study aimed to evaluate a novel communication aid ‘message to dentist’ (MTD), as part of a wider cognitive behavioural therapy approach to reduce dental anxiety in young patients. Dentally [...] Read more.
Dental anxiety affects children worldwide and can have negative consequences on oral health. This study aimed to evaluate a novel communication aid ‘message to dentist’ (MTD), as part of a wider cognitive behavioural therapy approach to reduce dental anxiety in young patients. Dentally anxious children, aged 9–16 years, were invited to complete the MTD proforma, before and following their course of treatment. They scored how worried they were and their anticipated pain levels on a scale of 1–10 (10 being the worst outcome). They also wrote down their coping plans and post-treatment reflections. One hundred and five children, from a UK general dental practice and a hospital clinic, were included. They had a mean age of 11.6 years, and 65% were female. There was a significant reduction in self-report worry (from 4.9 to 2.1) and anticipated pain (from 5.1 to 2.0) scores (p < 0.05, paired t-test). Many children (30%) used listening to music/audiobook as a coping strategy. Thematic analysis revealed concerns around pain, uncertainty, errors and specific procedures. The MTD proforma proved an effective means of facilitating communication between anxious children and the dental team, allowing them to identify their worries and make personalised coping plans. Full article
(This article belongs to the Special Issue Psychosocial Impacts of Dental Conditions in Childhood, Volume Ⅱ)
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Article
Factors Associated with Dental Fear and Anxiety in Children Aged 7 to 9 Years
Dent. J. 2019, 7(3), 68; https://doi.org/10.3390/dj7030068 - 01 Jul 2019
Cited by 13 | Viewed by 3117
Abstract
The aim was to investigate changes in dental fear and anxiety (DFA) and verify factors associated with DFA in children. A longitudinal cohort study that included 160 children aged 7 years was carried out. A questionnaire was completed by parents at two time [...] Read more.
The aim was to investigate changes in dental fear and anxiety (DFA) and verify factors associated with DFA in children. A longitudinal cohort study that included 160 children aged 7 years was carried out. A questionnaire was completed by parents at two time points and evaluated the immigrant background, maternal education, whether the child had ever had toothache, and whether the parents had dental fear. The oral clinical examination evaluated decayed, extracted, and filled primary teeth (deft). The children’s fear survey schedule dental subscale (CFSS-DS) was used to assess the dental fear of the children. Multilevel mixed-effects logistic regressions analyses were used. The CFSS-DS found that 7% of the children had dental fear at age 7 and mean CFSS-DS was 22.9. At 9 years of age, 8% reported dental fear and the mean increased to 25.4. Parental dental fear, experience of toothache, and report of painful dental treatment and caries development between 7 and 9 years of age were factors that were significantly related to development of DFA. There was a change in DFA between 7 and 9 years of age. Dental fear and anxiety is a dynamic process in growing individuals and is significantly related to painful symptoms and experiences of dental care as well as parental dental fear. Full article
(This article belongs to the Special Issue Psychosocial Impacts of Dental Conditions in Childhood, Volume Ⅱ)
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Article
The Relationship between Caries-Specific Quality of Life and Generic Wellbeing in a Dutch Pediatric Population
Dent. J. 2019, 7(3), 67; https://doi.org/10.3390/dj7030067 - 01 Jul 2019
Cited by 1 | Viewed by 1559
Abstract
Dental caries has significant negative impacts on the lives of children and young people. Whilst the impacts on children’s oral health-related quality of life (OHRQoL) have been increasingly investigated, the effect on children’s overall wellbeing remains largely unknown. Data were obtained from a [...] Read more.
Dental caries has significant negative impacts on the lives of children and young people. Whilst the impacts on children’s oral health-related quality of life (OHRQoL) have been increasingly investigated, the effect on children’s overall wellbeing remains largely unknown. Data were obtained from a survey conducted across four cities in the Netherlands. Children and their parents completed a series of questionnaires, which included Dutch versions of a caries-specific pediatric measure of OHRQoL (CARIES-QC-NL) and a generic pediatric health utility measure (CHU9D-NL). The participating children underwent dental examinations to determine their caries status. A total of 486 11-year-old children participated in the study, of which 184 had caries experience (38%). The mean number of decayed, missing and filled teeth (DMFT) was 0.71. The CARIES-QC-NL was found to have statistically significant correlations with the DMFT and CHU9D-NL. There were no statistically significant correlations between the CHU9D and the clinical variables. The CARIES-QC-NL had acceptable internal consistency and construct validity in this population despite the low prevalence of active caries. A relationship was demonstrated between OHRQoL and generic wellbeing in this population. Despite this, the CHU9D did not show any correlation with the clinical data, which may limit its application in studies of the impact of dental caries. Full article
(This article belongs to the Special Issue Psychosocial Impacts of Dental Conditions in Childhood, Volume Ⅱ)
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Article
Investigating Eating Behaviors and Symptoms of Oral Frailty Using Questionnaires
Dent. J. 2019, 7(3), 66; https://doi.org/10.3390/dj7030066 - 29 Jun 2019
Cited by 2 | Viewed by 1430
Abstract
A questionnaire survey was conducted to investigate eating behavior and the subjective symptoms of oral frailty, and to examine the relationship between them. A total of 744 subjects with ages over 65 years were included. The questionnaire comprised 18 question items indicating eating [...] Read more.
A questionnaire survey was conducted to investigate eating behavior and the subjective symptoms of oral frailty, and to examine the relationship between them. A total of 744 subjects with ages over 65 years were included. The questionnaire comprised 18 question items indicating eating behavior and seven question items indicating oral frailty. All items were assessed according to 4 grades on a scale of 1 (not applicable) to 4 (applicable). The total score of oral frailty gradually increased with age. Regarding the scores for “eating recognition” and “eating habits”, no changes were observed, however the scores for “eating action” demonstrated a decreasing tendency with age and the scores of ≥ 85 years age group was significantly lower than the 65–69, 70–74, and 75–79 years age groups. As a result of multiple regression analysis, among the significant independent variable, the scores of “I do not chew foods well” under the category of “eating action” showed the highest standard partial regression coefficients for dependent variable of symptoms of oral frailty. The significant association was found between the eating behavior and subjective symptoms of oral frailty, and this study suggests that the good chewing habit might be an important criterion for the prevention of oral frailty. Full article
(This article belongs to the Special Issue Dental Hygiene and Epidemiology Volume 2)
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Case Report
Dental Rehabilitation for Free Fibula Flap-Reconstructed Mandible with Scar Contracture: A Technical Note
Dent. J. 2019, 7(3), 65; https://doi.org/10.3390/dj7030065 - 29 Jun 2019
Cited by 2 | Viewed by 1838
Abstract
Dental rehabilitation with osseointegrated implants in reconstructed mandibles is a common procedure, but the technique still requires improvement, especially in its reliability and technical simplification. We herein report dental rehabilitation of a free fibula-reconstructed mandible with scar contracture. A vestibuloplasty technique with application [...] Read more.
Dental rehabilitation with osseointegrated implants in reconstructed mandibles is a common procedure, but the technique still requires improvement, especially in its reliability and technical simplification. We herein report dental rehabilitation of a free fibula-reconstructed mandible with scar contracture. A vestibuloplasty technique with application of a polyglycolic acid (PGA) sheet is described. The implants were inserted into a viable fibula flap with severe scar contracture of the overlying epithelium resulting from vascular instability in skin paddle. Only the fibula periosteum was sutured after implant insertion; exposed surfaces were covered with a combination of PGA sheet and fibrin sealant. The area with PGA sheet coverage gradually healed with moderate contracture. The epithelium around the almost implants became immobilized. The implant-supported removable partial denture with custom titanium bar was acceptable. Dental rehabilitation is possible for reconstructed mandibles with severe scar contracture. Application of a PGA sheet may be useful for vestibuloplasty in patients with reconstructed mandibles. Full article
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Article
Impact of Different Irrigant Agitation Methods on Bacterial Elimination from Infected Root Canals
Dent. J. 2019, 7(3), 64; https://doi.org/10.3390/dj7030064 - 27 Jun 2019
Cited by 13 | Viewed by 1947
Abstract
Activation techniques are essential for root canal disinfection but may result in incomplete removal of bacteria. The aim of our study was to assess the antibacterial action of sonically, ultrasonically and laser-activated irrigation and 5.25% sodium hypochlorite (NaOCl) on Enterococcus faecalis in an [...] Read more.
Activation techniques are essential for root canal disinfection but may result in incomplete removal of bacteria. The aim of our study was to assess the antibacterial action of sonically, ultrasonically and laser-activated irrigation and 5.25% sodium hypochlorite (NaOCl) on Enterococcus faecalis in an infected tooth. Forty-four extracted mandibular premolars were mechanically prepared, sterilized, and inoculated with E. faecalis for 1 week. Bacterial counts after inoculation were evaluated in 4 randomly chosen teeth, remaining root canals were divided into 4 groups. Group A: laser-activated irrigation by photon-induced photoacoustic streaming, Group B: the sonic irrigation by EDDY, Group C: ultrasonic irrigation by EndoUltra, and Group D: 5.25% NaOCl. Colony forming unit (CFU) counts were measured and Kolmogorov–Smirnov, Wilcoxon, Kruskal–Wallis and Mann–Whitney tests were used to determine differences. The mean of CFU was found to significantly decrease in group D, 2110 ± 1015.93 (p < 0.001). Changes in measurement levels followed the same trend over time in groups A 27.40 ± 30.15, B 81.3 ± 85.68 and C 44.40 ± 67.12 (p = 0.141). The average CFU after irrigation in all groups was significantly greater than 0. Within the limitations of this study, all activation techniques were superior to NaOCl 5.25% in reducing E. faecalis from the infected tooth model. Full article
(This article belongs to the Special Issue Laser in Endodontics)
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