Dent. J., Volume 7, Issue 4 (December 2019) – 23 articles

Background: We hypothesized that access to dental care could be improved by the conceptualization of a new type of consultation: The walk-in dental encounter for non-emergency situations (WIDENESS). The aim of this study was to assess patient perspectives regarding walk-in dental consultations, with a particular focus on non-emergency situations. Methods: We followed a qualitative research approach using a semi-structured interview guide in a sample of random participants recruited from the dental department of the Toulouse University Hospital, France. We performed a thematic analysis of the interview transcripts. Data saturation was obtained after interviewing 11 participants. Results: When asked about walk-in dental consultations, three main topics emerged: (1) Walk-in dental consultation in general is important for emergency situations, but WIDENESS did not correspond to any specific long-standing need from participants; (2) WIDENESS could be a way to improve access to oral care (facilitating access to care relative to time constraints, reduction of dentist-related anxiety, better overall follow-up for the care pathway, and the complementary nature of consultations with and without appointments); and (3) WIDENESS has some potential drawbacks—apprehension about long waiting times was mentioned by several participants. Conclusions: Participants found the idea of WIDENESS promising, despite spontaneously mentioned reservations, which constitute major challenges to its implementation. Full article

Background: To assess the effect of chlorhexidine (CHX) chip application in patients with peri-implant mucositis as compared to CHX gel application. Methods: In peri-implant sites with mucositis, CHX gel was applied in the control group (GC) and CHX chips in the test group (CC) at baseline and after three months. At baseline and after six months, peri-implant pocket depths (PPD), bleeding-on-probing (BOP) and activated matrix metalloproteinase-8 (aMMP8) were assessed. Longitudinal changes were tested for inter-group differences. Results: Thirty-two patients were treated. BOP was more reduced (p = 0.006) in CC than in GC, with means and standard deviations of 46 ± 28% and 17 ± 27%, respectively. PPD was more reduced (p = 0.002) in CC than in GC with 0.65 ± 0.40 mm and 0.18 ± 0.32 mm, respectively. Regarding BOP, the percentages of improved, unchanged and worsened sites accounted for 32%, 61% and 7% in GC and 46%, 53% and 1% in CC, respectively. For probing pocket depth, the according values were 26%, 66% and 8% (GC) versus 57%, 38% and 5% (CC). Conclusions: During supportive therapy, repeated CHX chip application might resolve marginal peri-implant inflammation in terms of bleeding better than CHX gel. Full article

In recent scientific literature, oral infections and systemic manifestations, or correlations between oral health and systemic diseases are a topic of discussion. Porphyromonas gingivalis is one of the bacteria implicated in the biofilm formation of bacterial plaque, and plays an important role in the progression of periodontal disease. In this systematic review authors have evaluated the literature of the last 10 years on P. gingivalis and all the systemic implications proven. This study therefore evaluates all the districts of the organism in which this bacterium may have implications. From the results it emerges that P. gingivalis has implications in the onset of different systemic pathologies, including rheumatoid arthritis, cardiovascular pathologies, and neurodegenerative pathologies. Surely, understanding the mechanisms of diffusion of this bacterium, it would be possible to prevent a series of pathologies. Thus, putting the dentist clinician at the center of prevention for these diseases. Full article

This in vitro study determined the effectiveness of violet-blue light on Streptococcus mutans (UA159) biofilm induced dentinal lesions. Biofilm was formed on human dentin specimens in a 96-well microtiter plate and incubated for 13 h in the presence of tryptic soy broth (TSB) or TSB supplemented with 1% sucrose (TSBS). Violet-blue light (405 nm) from quantitative light-induced fluorescence (QLF^TM) was used to irradiate the biofilm. Supernatant liquid was removed, and the biofilm was irradiated continuously with QLF for 5 min twice daily with an interval of 6 h for 5 d, except with one treatment on the final day. Colony forming units (CFU) of the treated biofilm, changes in fluorescence (∆F; QLF-Digital Biluminator^TM), lesion depth (L), and integrated mineral loss (∆Z; both transverse microradiography) were quantified at the end of the fifth day. Statistical analysis used analysis of variance (ANOVA), testing at a 5% significance level. In the violet-blue light irradiated groups, there was a significant reduction (p < 0.05) of bacterial viability (CFU) of S. mutans with TSB and TSBS. Violet-blue light irradiation resulted in the reduction of ∆F and L of the dentinal surface with TSBS. These results indicate that violet-blue light has the capacity to reduce S. mutans cell numbers. Full article

The history of dentistry, of course, has followed a constant development since the dawn of society. The dental profession, reserved in ancient times to people with special skills and high rank, after the Middle Ages was diminished and practiced by barbers. The pharmacological evolution of oral surgery techniques has led this branch, today as never before, to obtain a level of specialization and preparation comparable to all other specialist medical branches. Some milestones in the history of dentistry will be considered so as to finally understand how the importance of anesthetic drugs was of primary importance, and which drugs are used today. Full article

The aim of this study was to evaluate the accuracy, invasiveness and impact on clinical results of a digital oral impression protocol in the pre-surgical orthopedic treatment (PSOT) of newborn cleft lip and palate (CLP) patients undergoing primary alveolar surgical repair. Six patients were divided, according to impression technique used, into a digital (intraoral scanner (IOS)) and a non-digital (tray and putty (T&P)) group. Parents considered IOS impressions to be less invasive, compared to T&P impressions. The clinician that took all the impressions considered the IOS to be less stressful compared to the T&P method. In two T&P patients, the impression was repeated because some important anatomical details were missing, in one case due to patient regurgitation during the first attempt. No impression was repeated, and any adverse event was reported in the IOS group. There were no significant differences between these two protocols in pre-surgical alveolar gap reduction and surgical challenge. The study results indicate that this digital protocol can accelerate the production process of the passive molding plate with an instantaneous transmission of the digital impression to the dental lab, maintaining the same accuracy level and clinical outcomes of classical techniques and reducing the invasiveness of impression taking, avoiding any risk of impression material ingestion or inhalation. Full article

Restoring subgingival class-V cavities successfully, demand special biological properties from a restorative material. This study aimed to assess the effects of incorporating bioactive materials to glass ionomer cement (GIC) on its mechanical and biological properties. Hydroxyapatite, chitosan, chondroitin sulphate, bioglass, gelatine and processed bovine dentin were incorporated into a GIC restorative material. Compressive strength, biaxial flexural strength (BFS), hardness, setting and working time measurements were investigated. Biocompatibility of the new materials was assessed using both monolayer cell cultures of normal oral fibroblasts (NOF) and TR146 keratinocytes, and a 3D-tissue engineered human oral mucosa model (3D-OMM) using presto-blue tissue viability assay and histological examination. Significant reduction in the compressive strength and BFS of gelatine-modified discs was observed, while chondroitin sulphate-modified discs had reduced BFS only (p value > 0.05). For hardness, working and setting times, only bioglass caused significant increase in the working time. NOF viability was significantly increased when exposed to GIC-modified with bovine dentine, bioglass and chitosan. Histological examination showed curling and growth of the epithelial layer toward the disc space, except for the GIC modified with gelatine. This study has highlighted the potential for clinical application of the modified GICs with hydroxyapatite, chitosan, bioglass and bovine dentine in subgingival class-V restorations. Full article

Recent progress in the industrial development of dental implants has improved their surface bio-affinity, while clinical implantologists attempt to improve it through coating with various compounds, including platelet-rich plasma (PRP) in clinical settings. However, it is poorly understood how PRP acts on titanium surfaces. To validate this surface modification method and demonstrate how platelet-derived soluble biomolecules released from the activated adherent platelets act on plain, commercially pure-titanium (cp-Ti) plates, we evaluated the distribution of biomolecules by immunofluorescence. PPARγ, PDGF-B, and TGFβ1 were similarly released at immunofluorescence levels from activated adherent platelets, retained in the surrounding extra-platelet spaces for a while, and did not immediately diffuse away to distant spaces. Exogenously added CaCl₂ augmented release and retention of those biomolecules along with activation and aggregation. Taken together with our previous data regarding platelet adhesion, these findings suggest that especially when treated with CaCl₂, platelets immediately adhere on cp-Ti plates to release their stored biomolecules in the absence of plasma proteins and that these biomolecules do not diffuse away, but stay longer in extra-platelet spaces around the platelets by newly formed, immature fibrin fiber fragments. Consequently, these retained biomolecules are anticipated to cooperatively stabilize implants by stimulating alveolar bone regeneration and integration. Full article

Periodontal disease can be treated in several ways. This paper reviewed whether antimicrobial photodynamic therapy (aPDT) in addition to scaling and root planing (SRP) produces improved clinical results over systemic antibiotics (ABs) in conjunction with SRP in adults with periodontitis. Studies were searched using the following electronic databases: MEDLINE, the Cochrane Database of Systematic Reviews, and the Web of Science Core Collection up to and including November 2018. Four randomized controlled trials (RCTs) were reviewed to maximise the reliability of the evidence. All participants suffered from either chronic or aggressive periodontitis and each study contained SRP as an adjunct to ABs or aPDT. To determine whether groups showed improvement after treatment, the outcome parameters chosen were probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP). Despite finding significant improvements in all groups, the differences among groups were not consistently statistically significant. The lack of homogeneity in the results among these studies indicates that it was not possible to determine a conclusion about whether aPDT or AB as an adjunct to SRP provides better improvements in periodontitis as measured by PD, CAL, and BOP. Further studies with more similar study designs are required before firm conclusions can be deduced. Full article

This controlled in vitro study compared the effects of varying the thickness of a TiO₂ layer on cellular activity using commercially available miniscrew samples with identical surface features to derive information with direct clinical impact. Titanium grade V plates with four different thicknesses of TiO₂ layer/color were used: absent/gray (Control group), 40–50 nm/pink (Pink group), 130 nm/gold (Gold group) and 140 nm/rosé (Rosé group). In vitro experiments used Saos-2 cells and included cell growth analysis, phospho-Histone H3 and procollagen I staining, cell viability analysis, and a cell migration assay at 12, 24, 40 and to 48 h. Few differences were seen among the groups, with no clear behavior of cellular activity according to the TiO₂ thickness. The Control group showed a greater cell count. Phospho-Histone H3 staining was similar among the groups and procollagen I staining was greater in the Rosé group. Cell viability analysis showed a significant difference for live cell counts (greater in the Rosé group) and no difference for the dead cell counts. The cell migration assay showed a delay for the Rosé group up to 40 h, where full repopulation of cell-free areas was obtained at 48 h. The results suggest that the TiO₂ layers of the commercial miniscrews have minimal biological effects, including cytotoxicity, with possibly negligible or minimal clinical implications. Full article

Primary care and healthcare providers can facilitate children’s timely referral to a dental home. However, there are few studies of providers’ oral health knowledge and clinical skills. This study aims to improve future healthcare providers’ knowledge, confidence, attitude, and clinical competence in assessing children’s oral health. Sixty-five health professional students participated in a 10-week didactic and clinical curriculum on children’s oral health. Fifty students completed pre- and post-training questionnaires and were assessed in their knowledge, confidence, and attitude. Calibrated examiners graded students’ clinical skills on a 24-point grading criterion. Descriptive statistics, paired sample t-test, and Pearson correlation were used in data analyses. Students were in dentistry (46%), nursing (28%), medicine (22%), and pharmacy (3%). Students significantly improved in knowledge (t = −7.71, p < 0.001), confidence (t = −10.30, p = <0.001), and attitude (t = −4.24, p = <0.001). Students on average scored 83% on clinical competence, with the highest average for fluoride varnish application (96%) and lowest for providing anticipatory guidance (69%). There was a moderate correlation between improvement in knowledge and their clinical skills (r = 0.39, p = 0.010). Interprofessional education improves students’ knowledge, confidence, attitude, and clinical competence in assessing children’s oral health. Such education is necessary in guiding future providers to gain adequate competence in serving children’s oral health needs. Full article

The purpose of this study was to investigate the bonding capacity of composite core build-up materials with prefabricated glass fiber-reinforced posts possessing different coronal morphologies. Five post types (Archimede Line (ARL), Fibrekleer (FBK), Glassix (GLX), Matrix Plus (MTP), and ParaPost White (PRW) and three core build-up materials (ClearfilPhoto Core (CPC), ClearfilDC Core (CDC), ClearfilNew Bond (CNB) of different curing modes (light-, self-, dual-cured respectively) were selected. The coronal part was embedded in the core build-up materials and the specimens were loaded under tensile force up to failure. The reliability (β) and characteristic life (σο, in Ν) of the debonding force were evaluated by Weibull statistics and the debonded specimens were subjected to failure mode analysis. The results showed that ARL, MPT posts were the most and GLX the least retentive, despite the core build-up material used. CPC provided the highest retention with four posts (FBK, GLX, MTP, and PRW), without statistically significant differences from CDC in two (FBK and MTP) and CNB in one (PRW). CPC and CDC were the most reliable core materials for two posts (ARL and PRW), with no statistically significant difference from CNB in three (FBK, GLX, and MTP). GLX and PRW demonstrated the highest (93%) incidence of post detachment from core, whereas FBK demonstrated the highest percentage of core material fracture, with most fractures occurring in CDC (57%). Post fractures were most prominent in MTP when combined with CNB. The presence of specific coronal retentive features did not essentially ensure increased strength with the core material, due to their delamination. Full article

The condylion-gonion-menton angle (CoGoMe^) is commonly used as a pre-treatment indicator of responsiveness in Class II patients treated with functional appliances. The distribution of this angle in the Caucasian population is still unknown. This study aimed to determine the distribution of the CoGoMe^ and its relationship with age, sagittal jaw relationship (ANPg^), and mandibular inclination (SN^GoGn) in patients from Southern Italy. The sample included 290 subjects (median14 years of age; Interquartile range, IQR, 12–17) with lateral cephalograms taken before the orthodontic treatment. The distribution of the CoGoMe^ was assessed with the Shapiro–Wilk test, and the differences according to the ANPg^ and the SN^GoGn were estimated using one-way ANOVA. Linear regression analysis was performed to evaluate how the CoGoMe^ varied according to age. The statistical significance was set at P < 0.05. The results showed that the CoGoMe^ was normally distributed (P = 0.290) with a mean value of 127.2° ± 7.7°. The distribution of the CoGoMe^ in groups with different SN^GoGn angles was significantly different (P < 0.001). These angles showed a positive association (Beta coefficient B = 0.6; 95% CI: 0.51, 0.67; P < 0.001). In growing patients, the CoGoMe^ decreased every year by 0.6° (B = −0.6; 95% CI: −1.05, −0.12; P = 0.014). In conclusion, the CoGoMe^ was associated with mandibular inclination and could be considered to be a predictor of vertical growth patterns. Full article

Background: The effects of publishing case reports on journal impact factor and their impact on future research in pediatric dentistry has not been clearly evaluated yet. Aim. To assess the relevance and role of case reports in pediatric dentistry. Methods: A systematic review (PROSPERO registration number: CRD42018108621) of all case reports published between 2011 and 2012 in the three major pediatric dentistry journals was performed manually. Data regarding citations of each report were acquired from the Institute for Scientific Information database available online. The authors analyzed information regarding citations (number, percentage, and mean) received by each case report and considered their relation with the 2013 journal impact factor. Results: Case reports accounted for almost sixteen per cent of all articles published between 2011 and 2012. The citation rate of case reports was generally low and the highest mean citation was 0.5. This review revealed that 6 (9.52%) case reports had at least 5 citations and that the majority of the citing articles were also case reports (27.78%) or narrative reviews (25%). Conclusions: The publication of case reports affected the journal impact factor in a negative way, this influence is closely related to the percentage of the published case reports. Case reports about innovative topics, describing rare diseases, syndromes, and pathologies were more frequently cited. Full article

Pulmonary nodules are frequently considered to be a metastatic disease or primary lung tumors in oral cancer patients. We present a case of pulmonary cryptococcosis in a 68-year-old man with oral and lung cancer. This lung cancer was treated with thoracoscopic resection of the right inferior lobe and mediastinal lymph node dissection. Lower gingival cancer was treated with a mandibulectomy, neck dissection, and reconstruction after chemoradiotherapy. A 20 mm cavitary nodule appeared at the left lung S6 one-month after surgery, during post-operative computed tomography. Thoracoscopic partial resection of the left inferior lobe was performed under the suspicion of lung metastasis. Pathology results revealed a pseudo-epithelial granuloma with necrosis and many yeast-shaped fungi with capsules. A pathological diagnosis of Cryptococcus infection was made. The patient was prescribed the antifungal agent fosfluconazole, which was administered intravenously for 1 week and intraoral fluconazole for 12 months. No recurrence of the Cryptococcus infection has been noted after 1.5 years. Full article

Introduction: Recreational and sport activities, traffic accidents and human behaviour represent the main causes of trauma in young people. Case presentation: This report describes a case of a 15.2-year-old male who suffered uncomplicated crown fracture and avulsion of tooth 11 and uncomplicated crown fracture of tooth 21 due to a bicycle accident. Tooth 11 was dry stored and it was replanted 18 h after the trauma. The root was planed to remove the necrotic periodontal tissue, the pulp was extirpated before replantation and a flexible splint was applied to tooth 13 to tooth 23 for 3 weeks. A replacement root resorption of replanted tooth was suspected at the 3-month radiographic control and suffered a dramatic increase later; minimal infraocclusion, about 1 mm, was observed due to its ankylosis. Sixteen years after the trauma the patient was scheduled for an orthodontic and implanto-prosthetic rehabilitation. Conclusion: Delayed replantation usually has a long-term poor prognosis, so it is very important to promote awareness regarding emergency management modalities in dental traumatology especially among parents, school teachers, and coaches that are usually present at the site of the accident. Full article

Peri-implantitis (PI) is an inflammatory disease of peri-implant tissues, it represents the most frequent complication of dental implants. Evidence revealed that microorganisms play the chief role in causing PI. The purpose of our study is to evaluate the cleaning of contaminated dental implant surfaces by means of the Q-switch Nd:YAG (Neodymium-doped Yttrium Aluminum Garnet) laser and an increase in temperature at lased implant surfaces during the cleaning process. Seventy-eight implants (titanium grade 4) were used (Euroteknika, Sallanches, France). Thirty-six sterile implants and forty-two contaminated implants were collected from failed clinical implants for different reasons, independent from the study. Thirty-six contaminated implants were partially irradiated by Q-switch Nd:YAG laser (1064 nm). Six other contaminated implants were used for temperature rise evaluation. All laser irradiations were calibrated by means of a powermetter in order to evaluate the effective delivered energy. The irradiation conditions delivered per pulse on the target were effectively: energy density per pulse of 0.597 J/cm², pick powers density of 56 mW/cm², 270 mW per pulse with a spot diameter of 2.4 mm, and with repetition rate of 10 Hz for pulse duration of 6 ns. Irradiation was performed during a total time of 2 s in a non-contact mode at a distance of 0.5 mm from implant surfaces. The parameters were chosen according to the results of a theoretical modeling calculation of the Nd:YAG laser fluency on implant surface. Evaluation of contaminants removal showed that the cleaning of the irradiated implant surfaces was statistically similar to those of sterile implants (p-value ≤ 0.05). SEM analysis confirmed that our parameters did not alter the lased surfaces. The increase in temperature generated at lased implant surfaces during cleaning was below 1 °C. According to our findings, Q-switch Nd:YAG laser with short pulse duration in nanoseconds is able to significantly clean contaminated implant surfaces. Irradiation parameters used in our study can be considered safe for periodontal tissue. Full article

This study aimed to assess whether dental aesthetics had a different impact on the psychosocial domains of adolescents with juvenile idiopathic arthritis (JIA) as compared with healthy peers. Fifty JIA patients and eighty controls aged between 13 and 17 years were enrolled. The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) was administered along with tools for the self-assessment of malocclusion and self-esteem. An objective evaluation of malocclusion severity was performed through a clinical evaluation with the Dental Aesthetic Index (DAI). The sample was divided according to the DAI stages of malocclusion severity; a two-way analysis of variance (ANOVA) was performed to assess whether there was a difference in the studied variables according to the malocclusion and the presence of JIA. The results showed no interaction between the malocclusion severity and the presence of JIA in all analyzed variables (all p > 0.05). According to the DAI stages, the Dental Self-Confidence domain of the PIDAQ and the Perception of Occlusion Scale showed statistically significant differences only within the controls (p = 0.027 and p = 0.014, respectively). Therefore, JIA adolescents seem to be less concerned about their dental aesthetics compared with healthy peers, and clinicians should take particular care when proposing orthodontic treatments aiming only to improve dental aesthetics. Full article

Background: Minorities’ diminished returns (MDRs) refer to systemically weaker effects of socioeconomic status (SES), particularly educational attainment, on the health of non-Whites compared to Whites. Aim: Using a nationally representative sample, we aimed to investigate ethnic differences in the effect of SES (educational attainment) on the self-rated oral health of Hispanic older adults in the US. Methods: This study analyzed the University of Michigan National Poll on Healthy Aging (UM-NPHA) 2017 data, which included 2131 older adults who were 50 to 80 years old (202 Hispanics and 1929 non-Hispanics). Ethnicity, race, educational attainment (SES), age, gender, employment, retirement, and self-rated oral health (single item) were measured. Logistic regressions were applied for data analysis. Results: High educational attainment was associated with lower odds of poor oral health in the pooled sample, net of all covariates. The effect of educational attainment on poor self-rated oral health was found to be weaker for Hispanics than for non-Hispanics. Conclusion: We observed MDRs of educational attainment (SES) on oral health for Hispanic older adults. In other words, compared to non-Hispanics, Hispanics gain less oral health from their educational attainment (SES). Full article

The prevalence of malocclusion and a need for orthodontic treatment is high. Orthodontic appliances increase biofilm accumulation by expanding plaque retention sites. The aim of this study was to investigate the self-reported changes in oral hygiene habits among adolescents receiving orthodontic treatment. A cross-sectional study of 291 patients aged 10–17 years (mean (M) = 12.98; standard deviation (SD) = 2.36) was conducted in the Department of Orthodontics, Lithuanian University of Medical Sciences (LSMU) Hospital (Kaunas, Lithuania) during the fall semester (October–January) of the 2017/2018 study year. An anonymous self-administered questionnaire covered background information, experience of orthodontic treatment, oral hygiene habits and the seeking of professional dental care. Statistical data analysis was performed using SPSS version 22. To establish relationships between categorical variables, Chi-squared tests (χ²) were used. A p-value ≤ 0.05 was set to indicate statistically significant difference. The univariate logistic regression analysis evaluated the probability of an event given a certain risk indicator, including odds ratio (OR) and its confidence interval (95% CI). Associations were found between the usage of auxiliary measures (OR = 1.797 (1.118–2.887), p = 0.015), tongue cleaning (OR = 1.712 (1.059–2.767), p = 0.028), mouth rinsing after meals (OR = 1.707 (1.048–2.781), p = 0.032) and experience of orthodontic treatment, respectively. More orthodontic patients underwent professional oral hygiene regularly than non-orthodontic patients (p = 0.024). More patients with fixed orthodontic appliances reported significantly changed oral hygiene habits, while more orthodontic patients with removable appliances did not change their oral hygiene habits. Full article

The introduction of digital dentistry and CAD/CAM technology has redefined treatment concepts in implant dentistry—computer guided implant placement has become routine practice, and CAD/CAM prostheses are now commonplace. These advances in treatment options and modalities has led to a paradigm shift in the workflow of surgical and restorative treatments. This case report presents a customized staged treatment protocol that involves the strategic retention of teeth to serve as transitional abutments, which will support a computer guided implant surgical guide as well as a fixed interim prosthesis. The treatment protocol also describes an integrated digital and conventional workflow for full mouth implant-supported fixed prosthetic rehabilitations to provide improved patient care with more predictable outcomes and fewer complications. Full article

Early Childhood Caries (ECC) are one of the major oral diseases affecting children. ECC adversely affects the children’s as well as their parent/caregivers quality of life. The present study aims to assess the quality of life in children with Early Childhood Caries aged 6–72 months using the Early Childhood Oral Health Impact Scale. It also aims to compare the quality of life between children with pufa scores of > 0 and a pufa score = 0. A total of 238 children aged 6 months to 72 months with ECC and their parent/caregiver were included in the present study. Oral examinations of the children were performed by the principal examiner using the defs and pufa index, which was followed by a personal interview of the 13 items in the Early Childhood Oral Health Impact scale among the 238 parents/caregivers. The results showed that, overall, Early Childhood Caries have a negative impact on children’s quality of life, as assessed by the parent/caregiver. The overall Early Childhood Oral Health Impact scale score ranged from 0–32 (mean ± SD, 14.12 ± 6.72). Children with a pufa score > 0 (mean ± SD, 16.14 ± 6.27, p < 0.001) have significantly lower quality of life than children with pufa score = 0 (mean ± SD, 9.07 ± 4.94, p < 0.001). Early Childhood Caries had a negative impact on the quality of life of children aged 6–72 months. Children with a pufa score of “0” had better oral health-related quality of life than children with a pufa score > 0. Full article

Background: The aim of this split-mouth study is to compare the results of 24 months’ clinical performance of primary molar Class I restorations with a nano-ceramic composite, Ceram•X mono (Dentsply) with a flowable bulk-fill material regular viscosity, SDR (Dentsply). Methods: Following the ethical approval, 27 patients with at least two class I cavities in primary molars were included in the study. A total number of 54 restorations were conducted (n = 27 for Ceram X and n = 27 for SDR). Restorations were evaluated at baseline, 6, 18, and 24 months, according to the modified Ryge criteria. The cavosurface marginal discoloration and color match were evaluated visually after air-drying the tooth and after removing the plaque (if necessary). Results: At 24 months’ follow-up, 54 restorations showed similar clinical performance. The statistical analysis did not reveal any statistical significance in the values between the groups in 7 out of 7 modified Ryge criteria. However, two restorations in both groups received Bravo ratings in the cavosurface marginal discoloration scoring. No side effects were reported by the participants of the study. Conclusion: Restorations with both materials (Ceram•X mono and SDR) have provided almost identical results. Full article