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Dent. J., Volume 8, Issue 4 (December 2020) – 24 articles

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Open AccessCase Report
Surgical Sealing of Laterally Localized Accessory Root Canal with Resin Containing S-PRG Filler in Combination with Non-Surgical Endodontic Treatment: A Case Report
Dent. J. 2020, 8(4), 131; https://doi.org/10.3390/dj8040131 - 20 Nov 2020
Viewed by 189
Abstract
The spread of root canal infection to surrounding periodontal tissue through accessory root canals reduces the success rate of endodontic treatment. In this case, cone-beam computed tomography revealed a lesion (4 mm from the apex) resulting from an accessory root canal of the [...] Read more.
The spread of root canal infection to surrounding periodontal tissue through accessory root canals reduces the success rate of endodontic treatment. In this case, cone-beam computed tomography revealed a lesion (4 mm from the apex) resulting from an accessory root canal of the maxillary left central incisor. First, non-surgical endodontic treatment was conducted but the sinus tract remained. Surgical preparation of the root cavity was then conducted to remove potentially infected dentin surrounding the accessory root canal. The cavity was filled and the foramen was sealed with resin containing bioactive surface pre-reacted glass (S-PRG) filler. The photopolymerized resin was then contoured and polished. In combination with subsequent supportive non-surgical endodontic treatment, a good clinical outcome with the disappearance of the sinus tract and clinical symptoms such as discomfort and pressure pain and the regeneration of the alveolar bone hanging over the cavity was obtained. In this case, the good clinical outcome may have been due to the dentin-adhesive property and durability of the pre-adhesive system and composite resin. The better biocompatibility of S-PRG fillers presumably facilitated periodontal tissue healing. Full article
(This article belongs to the Section Dental Materials)
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Open AccessReview
Periodontal Health and Systemic Conditions
Dent. J. 2020, 8(4), 130; https://doi.org/10.3390/dj8040130 - 19 Nov 2020
Viewed by 260
Abstract
According to the new classification proposed by the recent 2017 World Workshop on Periodontal and Peri-implant Diseases and Conditions, periodontitis, necrotizing periodontal diseases, periodontitis as a manifestation of systemic diseases, and systemic diseases or conditions affecting the periodontal supporting tissues, are considered as [...] Read more.
According to the new classification proposed by the recent 2017 World Workshop on Periodontal and Peri-implant Diseases and Conditions, periodontitis, necrotizing periodontal diseases, periodontitis as a manifestation of systemic diseases, and systemic diseases or conditions affecting the periodontal supporting tissues, are considered as separate entities. Scientific evidence has demonstrated that periodontal diseases are not just simple bacterial infections but rather complex diseases of multifactorial complexity that interplay with the subgingival microbes, the host immune, and inflammatory responses. Despite dental plaque biofilm being considered the primary risk factor for periodontitis in the vast majority of patients that dentists encounter on a daily basis, there are other factors that can also contribute and/or accelerate pathologic progressive attachment loss. In this article, the authors aim to briefly review and discuss the present evidence regarding the association between periodontal diseases and systemic diseases and conditions. Full article
(This article belongs to the Special Issue Study of Relationship between Oral Health and Systemic Health)
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Open AccessCase Report
Uprighting Impacted Mandibular Second Molar Using a Skeletal Anchorage: A Case Report
Dent. J. 2020, 8(4), 129; https://doi.org/10.3390/dj8040129 - 18 Nov 2020
Viewed by 201
Abstract
The aim of this case report is to present an innovative combined orthodontic-surgical technique to disimpact mandibular second molar (MM2) using an orthodontic miniscrew and an elastic chain. The impact on the Oral health-related quality of life (OHRQoL) was also evaluated. Using the [...] Read more.
The aim of this case report is to present an innovative combined orthodontic-surgical technique to disimpact mandibular second molar (MM2) using an orthodontic miniscrew and an elastic chain. The impact on the Oral health-related quality of life (OHRQoL) was also evaluated. Using the present techinique, it is possible to expose the impacted tooth, insert a self-drilling miniscrew in the retromolar area, and remove the bud of third mandibular molar. At the same time the orthodontic force is applied with the use of an elastomeric chain that connects the head of miniscrew and vestibular and oral buttons bonded on MM2. A close traction is performed for the whole treatment time without the reactivation of the elastic force. The use of skeletal anchorage allowed the disimpaction of impacted MM2 in a short treatment time (about three months) avoiding the typical biomechanical side effects of traditional orthodontic appliance and increasing the effectiveness of the treatment. Further studies are necessary to evaluate the real advantages and disadvantages of this combined orthodontic-surgical approach. Full article
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Open AccessReview
Laser Analgesia Associated with Restorative Dental Care: A Systematic Review of the Rationale, Techniques, and Energy Dose Considerations
Dent. J. 2020, 8(4), 128; https://doi.org/10.3390/dj8040128 - 12 Nov 2020
Viewed by 339
Abstract
It is a common experience amongst laser dentists and patients that mid-IR wavelength application in cavity preparation may be achieved without causing any associated pain. The erbium family of lasers (Er,Cr:YSGG 2780 nm and Er:YAG 2940 nm) are frequently used without employing injectable [...] Read more.
It is a common experience amongst laser dentists and patients that mid-IR wavelength application in cavity preparation may be achieved without causing any associated pain. The erbium family of lasers (Er,Cr:YSGG 2780 nm and Er:YAG 2940 nm) are frequently used without employing injectable local anesthesia as an adjunct: the phenomenon arising from the application of these devices is known as laser analgesia. This review seeks to apply a systematic approach to the examination of appropriate published studies but also to highlight the need for much more structured clinical investigations that consolidate photonic dose and methodology. A search of published data using PRISMA criteria was carried out to examine clinical trials into laser analgesia in conjunction with restorative dentistry, applying inclusion and exclusion criteria. From this, 10 published articles were selected for analysis. Suitability assessment was carried out, using a modified Cochrane risk of bias methodology. In 8/10 of the included studies, laser-induced analgesia is claimed to be better and effective, while in 2/10 of the studies, no difference was exhibited compared to the control group. Statistical analysis of three split mouth studies concluded that only one of these investigations reviewed demonstrated a significant analgesic effect for laser treatment while the other two did not support this observation. From this data, it is inconclusive to assess the predictability of laser analgesia in cavity preparation. A possible rationale and laser operating parametry has been discussed. Successful implementation of this treatment modality remains technique sensitive and subject to further investigation. Full article
(This article belongs to the Special Issue Lasers in Dentistry: Hard and Soft Tissues)
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Open AccessArticle
The Anchorage of Bone Cells onto an Yttria-Stabilized Zirconia Surface with Mild Nano-Micro Curved Profiles
Dent. J. 2020, 8(4), 127; https://doi.org/10.3390/dj8040127 - 10 Nov 2020
Viewed by 271
Abstract
The high biocompatibility, good mechanical properties, and perfect esthetics of ceramic dental materials motivate investigation into their suitability as an endosseous implant. Osseointegration at the interface between bone and implant surface, which is a criterion for dental implant success, is dependent on surface [...] Read more.
The high biocompatibility, good mechanical properties, and perfect esthetics of ceramic dental materials motivate investigation into their suitability as an endosseous implant. Osseointegration at the interface between bone and implant surface, which is a criterion for dental implant success, is dependent on surface chemistry and topography. We found out earlier that osteoblasts on sharp-edged micro-topographies revealed an impaired cell phenotype and function and the cells attempted to phagocytize these spiky elevations in vitro. Therefore, micro-structured implants used in dental surgery should avoid any spiky topography on their surface. The sandblasted, acid-etched, and heat-treated yttria-stabilized zirconia (cer.face®14) surface was characterized by scanning electron microscopy and energy dispersive X-ray. In vitro studies with human MG-63 osteoblasts focused on cell attachment and intracellular stress level. The cer.face 14 surface featured a landscape with nano-micro hills that was most sinusoidal-shaped. The mildly curved profile proved to be a suitable material for cell anchorage. MG-63 cells on cer.face 14 showed a very low reactive oxygen species (ROS) generation similar to that on the extracellular matrix protein collagen I (Col). Intracellular adenosine triphosphate (ATP) levels were comparable to Col. Ceramic cer.face 14, with its sinusoidal-shaped surface structure, facilitates cell anchorage and prevents cell stress. Full article
(This article belongs to the Section Dental Materials)
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Open AccessReview
Application of Nanotechnology in Orthodontic Materials: A State-of-the-Art Review
Dent. J. 2020, 8(4), 126; https://doi.org/10.3390/dj8040126 - 09 Nov 2020
Viewed by 293
Abstract
Nanotechnology refers to the science that manipulates matter at molecular and atomic levels, and studies matter at the nanoscale level to detect and exploit the useful properties that derive from these dimensions; materials with components less than 100 nm in at least one [...] Read more.
Nanotechnology refers to the science that manipulates matter at molecular and atomic levels, and studies matter at the nanoscale level to detect and exploit the useful properties that derive from these dimensions; materials with components less than 100 nm in at least one dimension are called nanomaterials. Nanotechnology is applied in many fields, such as medicine (nanomedicine) and dentistry (nano-dentistry). The purpose of these innovations and research in this field is to improve human life and health. This article aims to summarize and describe what the most recent and known innovations of nanotechnology in dentistry are, focusing on and paying particular attention to the branch that is orthodontics, and on the application of new nanomaterials in the realization, for example, of orthodontic elastomeric ligatures, orthodontic power chains, and orthodontic miniscrews. We also address a very important topic in orthodontics, which is how to reduce the friction force. Full article
(This article belongs to the Special Issue Applied Science and Technology in Orthodontics)
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Open AccessArticle
Condylar Neck and Sub-Condylar Fractures: Surgical Consideration and Evolution of the Technique with Short Follow-Up on Five Cases
Dent. J. 2020, 8(4), 125; https://doi.org/10.3390/dj8040125 - 03 Nov 2020
Viewed by 274
Abstract
Condylar neck and sub-condylar fractures of the mandible are a frequent occurrence in maxillofacial surgery. The indication for surgical treatment of these fractures has changed over time, and several techniques have been developed with different results in the attempt to avoid the most [...] Read more.
Condylar neck and sub-condylar fractures of the mandible are a frequent occurrence in maxillofacial surgery. The indication for surgical treatment of these fractures has changed over time, and several techniques have been developed with different results in the attempt to avoid the most worrisome adverse event, i.e., facial nerve injury. In this study, we present a new technique that combines an intraoral and a cutaneous pre-auricular access, which allows for easy and safe access to the surgical site, preventing facial nerve injury and avoiding surgical scars in high-impact aesthetic areas of the neck. Five consecutive patients affected by condylar neck or sub-condylar fractures were treated at a single institution using a combined intraoral and pre-auricular access. Results were evaluated after three months from surgery in terms of mandibular mobility, occurrence of complications, and patient’s satisfaction. All five patients had good outcome, with complete healing of the fracture and no occurrence of complications, including no facial nerve palsy. A key point of the technique is the safe reduction of the two mandibular fragments realized by a combined intraoral and a cutaneous pre-auricular surgical access. The periosteal plan of the ramus can be widely and safely elevated with the intraoral approach and connected to the condylar bone plane by the pre-auricular cutaneous approach without any need for soft tissue dissection at the fracture rim, thereby avoiding facial nerve injuries. Wide ramus periosteum elevation creates an “optical space”, allowing fragment reduction and fixation under direct oblique view without any endoscopic need. Our results strongly suggest that with our technique it is possible to treat sub-condylar and condylar neck fractures safely, avoiding facial nerve injury, which is an unacceptable complication due to its heavy impact on a patient’s life. Full article
(This article belongs to the Section Restorative Dentistry and Traumatology)
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Open AccessArticle
Adjunctive Antiseptic Irrigation of Periodontal Pockets: Effects on Microbial and Cytokine Profiles
Dent. J. 2020, 8(4), 124; https://doi.org/10.3390/dj8040124 - 02 Nov 2020
Viewed by 386
Abstract
To evaluate the effect of adjunctive antiseptic irrigation of periodontal pockets on microbial and cytokine profiles. Fifty-nine patients with severe periodontitis were allocated to one of three groups for scaling and root planing facilitated with different adjunctive antiseptics: 1% polyhexamethyleneguanidine phosphate (PHMG-P) (n [...] Read more.
To evaluate the effect of adjunctive antiseptic irrigation of periodontal pockets on microbial and cytokine profiles. Fifty-nine patients with severe periodontitis were allocated to one of three groups for scaling and root planing facilitated with different adjunctive antiseptics: 1% polyhexamethyleneguanidine phosphate (PHMG-P) (n = 19), 0.2% chlorhexidine (CHX) (n = 21) or distilled water (n = 19). Gingival crevicular fluid and subgingival bacterial samples were collected at baseline, and at 2 weeks, and 1 and 4 months. The levels of interleukin (IL)-1β, IL-8, IL-10, and IL-17A, matrix metalloproteinase (MMP)-8, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Fusobacterium nucleatum,Aggregatibacter actinomycetemcomitans, and Prevotella intermedia were determined. There were no intergroup differences in cytokine concentrations and bacterial counts at any follow-up, however, varying patterns were observed. In the PHMG-P and water groups IL-1β expression peaked at 2 weeks and then gradually declined. In all three groups, the dynamics of MMP-8 concentration were non-linear, increasing by 2 weeks and then declining to below baseline (p > 0.05). P. gingivalis and T. forsythia declined within the first month and increased thereafter, not regaining the baseline level. Adjunctive antiseptic treatment was associated with changes in biomarkers and bacterial counts in the course of the study. The effects of adjunctive antiseptic irrigation were limited in the applied protocol. Full article
(This article belongs to the Section Oral Hygiene, Periodontology and Peri-implant Diseases)
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Open AccessArticle
Impact of Local Drug Delivery of Minocycline on the Subgingival Microbiota during Supportive Periodontal Therapy: A Randomized Controlled Pilot Study
Dent. J. 2020, 8(4), 123; https://doi.org/10.3390/dj8040123 - 27 Oct 2020
Viewed by 367
Abstract
The aim of this study was to examine the effect of adjunct local minocycline administration on the microbiological parameters of subgingival plaque samples in the residual periodontal pockets. Ten chronic periodontitis patients under a supportive periodontal therapy regimen were recruited. After subgingival debridement, [...] Read more.
The aim of this study was to examine the effect of adjunct local minocycline administration on the microbiological parameters of subgingival plaque samples in the residual periodontal pockets. Ten chronic periodontitis patients under a supportive periodontal therapy regimen were recruited. After subgingival debridement, either 2% minocycline gel, Periocline™, (Test Group) or a placebo (Control Group) was administered to the selected sites once a week for three weeks. Subgingival plaque was collected at baseline, and at four weeks and eight weeks. The microbiological composition was analyzed by 16S ribosomal RNA sequencing. In the Test Group, α-diversity (evenness) decreased compared to the baseline (p = 0.005) and was lower compared to the control group at four weeks (p = 0.003). The microbial community composition between the two groups was significantly different at four weeks (p = 0.029). These changes were attributable to a decrease in the bacteria associated with periodontitis and an increase in the bacteria associated with periodontal health. Additionally, the improvement in bleeding on probing continued at eight weeks; however, there were little microbial effects of 2% minocycline gel observed at eight weeks. The control group demonstrated no change throughout the eight-week experimental period. Thus, local minocycline administration can change the subgingival microbial community of residual periodontal pockets. Full article
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Open AccessArticle
Effectiveness of a Novel Dentifrice Containing Stabilized Chlorine Dioxide, Sarkosyl, and Sodium Fluoride
Dent. J. 2020, 8(4), 122; https://doi.org/10.3390/dj8040122 - 27 Oct 2020
Viewed by 457
Abstract
This in vitro study evaluated the effectiveness of a novel dentifrice containing stabilized chlorine dioxide, sodium lauroyl sarcosinate (sarkosyl), and sodium fluoride in enhancing enamel fluoride uptake, remineralization, pellicle cleaning and inhibiting biofilm regrowth. Remineralization was measured by fluoride uptake and surface microhardness [...] Read more.
This in vitro study evaluated the effectiveness of a novel dentifrice containing stabilized chlorine dioxide, sodium lauroyl sarcosinate (sarkosyl), and sodium fluoride in enhancing enamel fluoride uptake, remineralization, pellicle cleaning and inhibiting biofilm regrowth. Remineralization was measured by fluoride uptake and surface microhardness assessment tests. Artificial stains were removed and scored based on pellicle cleaning ratio. Biofilm regrowth was measured by counting colonies on the agar plates. All studies were conducted using bovine teeth specimens. The efficacy of Toothpaste C (CloSYS anticavity toothpaste) was compared with United States Pharmacopoeia Reference Dentifrice, Toothpaste B (discontinued CloSYS anticavity toothpaste formulation) and leading commercial toothpastes. The enamel fluoride uptake and remineralization by Toothpaste C was 96.1% to 303.3% and 38.0% to 102.4% higher than the tested toothpastes, respectively. The mean pellicle cleaning ratio of Toothpaste C was similar to American Dental Association Reference Material. Toothpaste C had a significant reduction in regrowth of the oral polymicrobial biofilm compared to the control. All tested toothpastes contained 0.24% sodium fluoride. Toothpaste C exhibited significantly superior performance towards fluoride uptake and remineralization compared to the tested toothpastes. Therefore, toothpaste ingredients other than sodium fluoride accounted for the enhanced fluoride uptake and remineralization. Full article
(This article belongs to the Section Oral Hygiene, Periodontology and Peri-implant Diseases)
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Open AccessArticle
Association between Vitamin D and Candida-Associated Denture Stomatitis
Dent. J. 2020, 8(4), 121; https://doi.org/10.3390/dj8040121 - 21 Oct 2020
Viewed by 448
Abstract
Candida-associated denture stomatitis (CADS) is a fungal infection affecting 60–65% of denture wearers. Its etiology is complex and multifactorial and often associated with host immunodeficiency. Evidence exists that vitamin D has potential immunomodulatory and anti-inflammatory effects. The aim of this case–control study [...] Read more.
Candida-associated denture stomatitis (CADS) is a fungal infection affecting 60–65% of denture wearers. Its etiology is complex and multifactorial and often associated with host immunodeficiency. Evidence exists that vitamin D has potential immunomodulatory and anti-inflammatory effects. The aim of this case–control study was to assess the association between vitamin D levels and CADS. The study included 32 complete denture wearers with CADS and 32 sex- and age-matched complete denture wearers without CADS. The patients were clinically examined, and the severity of denture stomatitis was assessed according to Newton’s classification scale. The serum vitamin D level was determined via the use of an electrochemiluminescence assay. The vitamin D level in the CADS group and control group was 54.68 ± 17.07 and 56.82 ± 17.75 nmol/L, respectively. There was no significant difference between the groups (p = 0.622). Univariate logistic regression analysis showed that the presence of CADS was not associated with hypovitaminosis D (odds ratio (OR) = 1.44; 95% confidence interval (CI) = 0.37–5.54). It can be concluded that vitamin D is not associated with CADS and does not play a significant role in host susceptibility to CADS. This finding suggests that vitamin D screening is not indicated routinely in patients with Candida-associated denture stomatitis. Full article
(This article belongs to the Special Issue Oral Medicine)
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Open AccessArticle
Reliability and Validity of the Arabic Version of a Questionnaire Assessing Pain, Discomfort and Related Jaw Function Impairment after Extraction of Primary Teeth in Children
Dent. J. 2020, 8(4), 120; https://doi.org/10.3390/dj8040120 - 19 Oct 2020
Viewed by 326
Abstract
This study aims to translate a previously published English language questionnaire that assessed pain and discomfort after the extraction of primary teeth in children into Arabic, and evaluate its validity and reliability. All participating children (n = 120), aged 9 to 12-years-old, [...] Read more.
This study aims to translate a previously published English language questionnaire that assessed pain and discomfort after the extraction of primary teeth in children into Arabic, and evaluate its validity and reliability. All participating children (n = 120), aged 9 to 12-years-old, completed the 33-item Arabic version questionnaire after the extraction procedure had taken place. The questionnaire included three parts that were completed at three different times, namely, immediately, the first evening, and one week after the extraction procedure. Internal consistency, content validity, criterion validity, and factor analysis were performed. The results showed a good internal consistency (Cronbach’s alpha = 0.83), acceptable criterion validity with a significantly strong correlation with the Visual Analog Scale (VAS), and satisfactory content validity (average content validity index (CVI = 0.90). The final factor model was comprised of four factors with an eigenvalue greater than 1, explaining 70% of the common variance. The identified factors were labeled as follows: Factor 1—analgesic consumption; Factor 2—expression of discomfort from the extraction site; Factor 3—perception of masticatory capability; and Factor 4—pain/discomfort from the dental extraction procedure. Based on the results, a shorter form of the questionnaire had satisfactory psychometric characteristics and can be used with children within the selected age group. Full article
(This article belongs to the Section Dental Education)
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Open AccessArticle
Assessment of Screening for Nasal Obstruction among Sleep Dentistry Outpatients with Obstructive Sleep Apnea
Dent. J. 2020, 8(4), 119; https://doi.org/10.3390/dj8040119 - 14 Oct 2020
Viewed by 417
Abstract
Oral appliances (OA), a common treatment modality for obstructive sleep apnea (OSA), are not suitable for patients with nasal obstruction. Rhinomanometry, the gold standard technique to assess nasal airway resistance, is not readily available in sleep dentistry clinics. We demonstrate the use of [...] Read more.
Oral appliances (OA), a common treatment modality for obstructive sleep apnea (OSA), are not suitable for patients with nasal obstruction. Rhinomanometry, the gold standard technique to assess nasal airway resistance, is not readily available in sleep dentistry clinics. We demonstrate the use of a portable lightweight peak nasal inspiratory flow (PNIF) rate meter to objectively assess nasal airflow and utilized the Nasal Obstruction Symptom Evaluation (NOSE) scale to subjectively assess nasal obstruction in 97 patients with OSA and 105 healthy controls. We examined the correlations between the following variables between the groups: demographics, body mass index, PNIF, NOSE scale scores, apnea–hypopnea index (AHI), minimum SpO2 (SpO2min), Mallampati classification, and Epworth Sleepiness Scale (ESS) scores. Patients with OSA had significantly lower PNIF values and higher NOSE scores than controls. In the patient group, PNIF was not significantly correlated with AHI, SpO2min, Mallampati classification, or NOSE or ESS scores. Lower PNIF values and higher NOSE scores suggested impaired nasal airflow in the OSA group. As daytime PNIF measurement bears no relationship to AHI, this cannot be used alone in predicting the suitability of treatment for OSA with OA but can be used as an adjunct for making clinical decisions. Full article
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Open AccessArticle
Communication, Trust and Dental Anxiety: A Person-Centred Approach for Dental Attendance Behaviours
Dent. J. 2020, 8(4), 118; https://doi.org/10.3390/dj8040118 - 13 Oct 2020
Viewed by 642
Abstract
Effective communication forges the dentist-patient treatment alliance and is thus essential for providing person-centred care. Social rank theory suggests that shame, trust, communication and anxiety are linked together, they are moderated by socio-economic position. The study is aimed to propose and test an [...] Read more.
Effective communication forges the dentist-patient treatment alliance and is thus essential for providing person-centred care. Social rank theory suggests that shame, trust, communication and anxiety are linked together, they are moderated by socio-economic position. The study is aimed to propose and test an explanatory model to predict dental attendance behaviours using person-centred and socio-economic position factors. A secondary data analysis was conducted on a cross-sectional representative survey of a two-stage cluster sample of adults including England, Wales and Northern Ireland. Data were drawn from structured interview. Path analysis of proposed model was calculated following measurement development and confirmation of reliable constructs. The findings show model fit was good. Dental anxiety was predicted negatively by patient’s trust and positively by reported dentist communication. Patient’s shame was positively associated with dental anxiety, whereas self-reported dental attendance was negatively associated with dental anxiety. Both patient’s trust and dentist’s communication effects were moderated by social class. Manual classes were most sensitive to the reported dentist’s communications. Some evidence for the proposed model was found. The relationships reflected in the model were illuminated further when social class was introduced as moderator and indicated dentists should attend to communication processes carefully across different categories of patients. Full article
(This article belongs to the Special Issue Person-Centred Dentistry)
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Open AccessCase Report
Superficial Temporal Artery Perforator Flap: Indications, Surgical Outcomes, and Donor Site Morbidity
Dent. J. 2020, 8(4), 117; https://doi.org/10.3390/dj8040117 - 12 Oct 2020
Viewed by 392
Abstract
The aim of this retrospective case series was to discuss indications, surgical outcomes, and donor site morbidity in the use of superficial temporal artery perforator (STAP) flaps in intra-oral or extra-oral facial reconstruction. This study involved 9 patients treated with a STAP flap [...] Read more.
The aim of this retrospective case series was to discuss indications, surgical outcomes, and donor site morbidity in the use of superficial temporal artery perforator (STAP) flaps in intra-oral or extra-oral facial reconstruction. This study involved 9 patients treated with a STAP flap at the Maxillo-Facial Surgery Unit of the University of Campania “Luigi Vanvitelli”, Naples. A STAP flap was used alone or in combination with other local flaps, for the coverage of facial soft tissue defects, after the resection of craniofacial malignant tumors (n = 7) or as a salvage flap, in partial or total microvascular flap loss (n = 2). The STAP flap was proven to be a valuable surgical option despite it not being frequently used in facial soft tissue reconstruction nor was it chosen as the first surgical option in patients under 70 year’s old. Donor site morbidity is one of the major reasons why this flap is uncommon. Appropriate patient selection, surgical plan, and post-surgical touch-ups should be performed in order to reduce donor site scar morbidity. Full article
(This article belongs to the Special Issue Oral Cancer: Diagnosis and Treatment)
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Open AccessArticle
Comparison in Four Different Implant Systems of Mechanical Resistance to Maximal Stress in Prosthetic Screws—An In Vitro Study
Dent. J. 2020, 8(4), 116; https://doi.org/10.3390/dj8040116 - 09 Oct 2020
Viewed by 478
Abstract
Micromovements of the implant–abutment connection influence peri-implant bone preservation. This study evaluates and quantifies the maximal torque after a cycle of implant prosthetic screws tightening using original components. A total of 40 samples were tested: Megagen®—Daegu, South Korea; Dentium®—Gangnam-Gu, [...] Read more.
Micromovements of the implant–abutment connection influence peri-implant bone preservation. This study evaluates and quantifies the maximal torque after a cycle of implant prosthetic screws tightening using original components. A total of 40 samples were tested: Megagen®—Daegu, South Korea; Dentium®—Gangnam-Gu, Seoul, Korea; BIOMET 3i®—West Palm Beach, FL, USA and BTI®—Álava, Spain. Screws from each manufacturer were subjected to maximal stress force until they fractured. The fracture points were recorded and compared among all samples. To compare the mean values of fracture torques, the reference values associated with each brand and the sample results were used in t-tests. ANOVA (analysis of variance) was used to compare the maximal resistance limit between brands, complemented with Tukey’s multiple-comparison test. The maximal considered level of significance was 5%. The average fracture force for the brands was 40.07 Ncm for Megagen®, 53.39 Ncm for Dentium®, 39.74 Ncm for Biomet 3i®, and 68.84 Ncm for BTI®. BTI® screws showed the most resistance to fracture. According to the protocol that was applied, the implant–abutment connection demonstrated good resistance and a precise fit between these interfaces; therefore, in some cases, the presented values showed a lack of quality control and low fracture resistance. Full article
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Open AccessArticle
Three-Dimensional Assessment of Mandibular Condylar Volume and Position Subsequent to Twin Block Functional Therapy of Skeletal Class II Malocclusion Accompanied by Low-Level Laser Therapy
Dent. J. 2020, 8(4), 115; https://doi.org/10.3390/dj8040115 - 09 Oct 2020
Viewed by 497
Abstract
This study aimed to evaluate and compare the effect of low-level laser therapy (LLLT) on mandibular condylar volume and position following treatment of a Class II malocclusion with a twin block (TB) appliance employing cone beam computed tomography (CBCT). Twenty-four growing patients, aged [...] Read more.
This study aimed to evaluate and compare the effect of low-level laser therapy (LLLT) on mandibular condylar volume and position following treatment of a Class II malocclusion with a twin block (TB) appliance employing cone beam computed tomography (CBCT). Twenty-four growing patients, aged 9–12 years, were randomly allocated into control and laser groups. All patients were treated with a TB appliance. The patients in the laser group were treated weekly with a gallium–aluminum–arsenide (GaAlAs) diode laser around the temporomandibular joint (TMJ) region for three months. CBCT images were obtained before and after TB therapy and the changes in TMJ and skeletal variables were evaluated and compared among and between the groups. In the laser group, the condylar volume of the right and left sides significantly increased by 213.3 mm3 and 231.2 mm3, respectively (p < 0.05), whereas in the control group it significantly increased by 225.2 mm3, and 244.2 mm3, respectively (p < 0.05), with forward and lateral positioning of both sides. Furthermore, effective mandibular, ramus, and corpus lengths were increased, which were not significant between the groups. Low-Level Laser therapy accomplished no considerable effect on mandibular condylar volume and position following the functional orthopedic treatment of skeletal Class II malocclusions using a TB appliance. Full article
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Open AccessReview
Photobiomodulation Dose Parameters in Dentistry: A Systematic Review and Meta-Analysis
Dent. J. 2020, 8(4), 114; https://doi.org/10.3390/dj8040114 - 06 Oct 2020
Viewed by 533
Abstract
Objective: This systematic review and meta-analysis of published randomized controlled trials examines a possible relationship between optical spot size at surface tissue, irradiance, radiant exposure, total energy delivered, operator technique and reported clinical outcomes. Background: Clinical photobiomodulation (PBM) therapy has achieved [...] Read more.
Objective: This systematic review and meta-analysis of published randomized controlled trials examines a possible relationship between optical spot size at surface tissue, irradiance, radiant exposure, total energy delivered, operator technique and reported clinical outcomes. Background: Clinical photobiomodulation (PBM) therapy has achieved a high level of evidence-based acceptance in the mitigation of oral mucositis associated with cancer radiotherapy and chemotherapy, and supportive clinical research in relation to orthodontic tooth movement, oral medical conditions, including burning mouth syndrome, xerostomia and lichen planus. Inconsistent outcomes have been reported not withstanding a substantial body of primary supportive research from clinical, in vitro and animal studies. Materials and Methods: PubMed, Cochrane Database of Reviews and Google Scholar search engines were applied to identify human clinical trials of PBM therapy in clinical dentistry. A total of 766 articles between February 2009 and June 2020 were identified and following a full text evaluation, 38 papers with sufficient data to permit analyses are included in this investigation. Results: Following a detailed assessment of potential factors that may have an influence in clinical outcome, a clear trend is apparent associating optical spot size to a positive or negative effect. Furthermore, there is a clear difference in the reported results in relation to total energy applied, delivery techniques and optical parameters, which merits further investigation. Factorial statistical analyses identified an association between smaller optical surface applications and an overall lower level of reported clinical success in treating superficial and deeper targets, and correspondingly sub-surface larger target tissues were found to be more responsive to therapy by use of a larger optical surface spot size. Moreover, use of multiple small diameter probe applications was found to provide inconsistent results. Conclusions: Many factors can confound clinical success including variations in anatomy, site location, clinical condition and subject individuality. To achieve higher levels of predictable outcome, a mature appreciation of these factors, plus an expanded understanding of laser parametry, tissue volume and target depth to deliver an adequate dose within current recommended guidelines, is essential. Full article
(This article belongs to the Special Issue Lasers in Dentistry: Hard and Soft Tissues)
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Open AccessArticle
Association between Clinical Signs of Oral Lichen Planus and Oral Health-Related Quality of Life: A Preliminary Study
Dent. J. 2020, 8(4), 113; https://doi.org/10.3390/dj8040113 - 04 Oct 2020
Viewed by 353
Abstract
Subjective patient’s symptoms and Oral Health-Related Quality of Life (OHRQoL) are recommended to be involved in oral lichen planus (OLP) studies. This study aims to assess the OHRQoL of OLP patients, and their associations with pain and OLP in Thai patients. Sixty-nine patients [...] Read more.
Subjective patient’s symptoms and Oral Health-Related Quality of Life (OHRQoL) are recommended to be involved in oral lichen planus (OLP) studies. This study aims to assess the OHRQoL of OLP patients, and their associations with pain and OLP in Thai patients. Sixty-nine patients were interviewed using the Numeric Rating Scale (NRS) for pain perception and Oral Impacts on Daily Performance (OIDP) index. OLP signs examined included localization, types, number of affected sides and clinical severity using the Thongprasom sign scoring system. There were significant associations (rs = 0.490, p < 0.001) between clinical severity and the intensity of oral impacts as well as pain (rs = 0.298, p = 0.013). The intensity of oral impacts and pain increased according to the increasing OLP clinical severity, except for the white striae lesions (Thongprasom sign score 1). The erosive/ulcerative OLP lesions (Thongprasom sign scores 4 and 5) were the most painful symptom and had the highest degree of oral impacts (p < 0.001). No significant associations were found between the number of affected lesion sides and OHRQoL (p = 0.316) and pain (p = 0.284). OHRQoL was associated with OLP type and clinical severity but not with the number of affected sides. Full article
(This article belongs to the Special Issue Oral Medicine)
Open AccessFeature PaperArticle
Associations among Primary Stability, Histomorphometric Findings, and Bone Density: A Prospective Randomized Study after Alveolar Ridge Preservation with a Collagen Cone
Dent. J. 2020, 8(4), 112; https://doi.org/10.3390/dj8040112 - 02 Oct 2020
Viewed by 451
Abstract
Background: The objective of this investigation was to examine whether determination of bone density (BD) with a cone beam computed tomography (CBCT) scan could help predict the primary stability (PS) of the implants and to investigate whether associations between the histomorphometric findings and [...] Read more.
Background: The objective of this investigation was to examine whether determination of bone density (BD) with a cone beam computed tomography (CBCT) scan could help predict the primary stability (PS) of the implants and to investigate whether associations between the histomorphometric findings and the CBCT scan could be observed. Materials and methods: In this randomized clinical study, the efficacy of alveolar ridge preservation (ARP) with a combination of a collagen cone and a collagen membrane procedure after tooth extraction was investigated. CBCT scans were obtained after a healing period of 8 (±1) weeks. Subsequently, the CBCT scans were evaluated in terms of BD at different heights of the former socket. Eleven (±1) weeks after tooth extraction, implant placement was performed and PS was measured with resonance frequency analysis. Potential associations among the radiologically measured BD, the histomorphometric results, and the PS were analyzed. Results: No direct association was observed between the radiologically determined BD and the histomorphometric findings. No significant associations could be found between the BD and the PS. Conclusion: No significant associations were observed among the BD determined by the CBCT, the histomorphometric findings, and the PS. Full article
(This article belongs to the Section Restorative Dentistry and Traumatology)
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Open AccessArticle
Salivary Hormones and Quality of Life in Female Postmenopausal Burning Mouth Patients—A Pilot Case-Control Study
Dent. J. 2020, 8(4), 111; https://doi.org/10.3390/dj8040111 - 01 Oct 2020
Viewed by 411
Abstract
The objective of our study was to investigate salivary levels of estradiol, progesterone and dehydroepiandrosterone (DHEA), and quality of life, in female postmenopausal women with burning mouth syndrome. The study included new patients diagnosed with burning mouth syndrome and excluded local and systemic [...] Read more.
The objective of our study was to investigate salivary levels of estradiol, progesterone and dehydroepiandrosterone (DHEA), and quality of life, in female postmenopausal women with burning mouth syndrome. The study included new patients diagnosed with burning mouth syndrome and excluded local and systemic causes. Unstimulated saliva samples were taken in the morning from 9 AM and 11 AM and immediately frozen for hormone analysis. The patients filled out a self-perceived quality of life questionnaire Oral Health Impact Profile-14 and determined the intensity of mucosal symptoms according to the visual-analog scale grading 0 to 10. A total of 40 patients were included. The study group had significantly lower levels of salivary estradiol. No difference was observed in levels of progesterone and DHEA between the groups. The levels of salivary hormones did not exhibit a significant correlation according to the Spearman correlation test with a self-perceived quality of life questionnaire (OHIP-14) in the study group or in the control group. Further research on a larger number of patients is needed to verify these results. This information might help to enable more precise and efficient treatment. Full article
(This article belongs to the Special Issue Oral Medicine)
Open AccessCase Report
The Effect of High-Frequency Vibration on Tooth Movement and Alveolar Bone in Non-Growing Skeletal Class II High Angle Orthodontic Patients: Case Series
Dent. J. 2020, 8(4), 110; https://doi.org/10.3390/dj8040110 - 01 Oct 2020
Viewed by 448
Abstract
This study presents a novel technique utilizing high-frequency vibration to shorten treatment time and preserve alveolar bone in challenging orthodontic cases that have been treated with Invisalign® clear aligners. Four non-growing orthodontic patients (age range 14–47 years old) with Class II skeletal [...] Read more.
This study presents a novel technique utilizing high-frequency vibration to shorten treatment time and preserve alveolar bone in challenging orthodontic cases that have been treated with Invisalign® clear aligners. Four non-growing orthodontic patients (age range 14–47 years old) with Class II skeletal patterns (convex profiles with retrognathic mandibles) who sought correction of their crowded teeth and non-surgical correction of their convex profiles were included in this study. These patients were treated using Invisalign clear aligners together with high-frequency vibration (HFV) devices (120 Hz) (VPro5™) that were used by all patients for five minutes per day during active orthodontic treatment. Vertical control and forward rotation of the mandible for each patient was achieved through pre-programming the Invisalign to produce posterior teeth intrusion. Successful forward rotation of the mandibles achieved in all patients led to improvement of their facial convex profiles (apical base relationship (ANB) improved 2.1 ± 0.5 degrees; FMA (Frankfurt mandibular plane angle) improved 1.2 + 1.1 degrees). Dental decompensation was achieved by lingual tipping of the lower incisors and palatal root torque of upper incisors. The use of HFV together with Invisalign facilitated achieving these results within a 12 ± 6 months period. In addition, more bone labial to the lower incisors after their lingual movement was noted. In conclusion, the use of HFV concurrent with SmartTrack Invisalign aligners allowed complex tooth movement and forward mandibular projection without surgery in non-growing patients with skeletal Class II relationships. The clinical impact and implications of this case series are: (1) the use of HFV facilitates complex orthodontic tooth movement including posterior teeth intrusion and incisor decompensation; (2) forward mandibular projection of the mandible and increased bone formation labial to lower incisors can be achieved in non-growing patients that may minimize the need for surgical intervention in similar cases or gum recession due to lower incisors labial inclination. Full article
(This article belongs to the Special Issue New Frontiers in Orthodontics)
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Open AccessArticle
Effect of an Er,Cr:YSGG Laser on the Surface of Implants: A Descriptive Comparative Study of 3 Different Tips and Pulse Energies
Dent. J. 2020, 8(4), 109; https://doi.org/10.3390/dj8040109 - 30 Sep 2020
Viewed by 477
Abstract
Peri-implant diseases are one of the main complications of dental implants. There are no well-established guidelines regarding laser parameters for implant decontamination. The aim was to compare two different settings of irradiation of the Er,Cr:YSGG laser on dental implants regarding surface alterations and [...] Read more.
Peri-implant diseases are one of the main complications of dental implants. There are no well-established guidelines regarding laser parameters for implant decontamination. The aim was to compare two different settings of irradiation of the Er,Cr:YSGG laser on dental implants regarding surface alterations and determine the best settings for less damage on the surface. An in vitro study was performed and 30 areas of dental implants were irradiated with two different regimes of energy per pulse 50 and 84 mJ (1.5 W/30 Hz and 2.5 W/30 Hz). A total of 30 sites of implants were irradiated with three different tips (10 surfaces per tip): conical (RTF3-17 mm), side firing (SFT8-18 mm) and cylindrical (MGG6-6 mm). The following descriptive classification on surface damage was employed: no damage (class A), minimal effects (class B), metal fall with melting (class C), and destruction with carbonization (class D). The assessment was made through a descriptive scanning electron microscope (SEM) analysis. Side firing and conical tips at 50 mJ were classified as class A. Side firing at 84 mJ and cylindrical tips 50 mJ and 84 mJ were classified as class B. Finally, class C defects were found in the areas where the conical tip was used at 84 mJ. Side firing and conical tips at 50 mJ do not seem to damage the implant surface. Full article
(This article belongs to the Special Issue Laser in Implantology)
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Open AccessArticle
In Vitro Shear Bond Strength of Orthodontic Brackets after Enamel Conditioning with Acid Etching and Hydroabrasion
Dent. J. 2020, 8(4), 108; https://doi.org/10.3390/dj8040108 - 30 Sep 2020
Viewed by 456
Abstract
The purpose of this study was to evaluate the shear bond strength and adhesive remnant index ARI) of orthodontic brackets following enamel conditioning with acid etching, hydroabrasion, and with both procedures. Thirty extracted human premolars were divided into three groups and received either [...] Read more.
The purpose of this study was to evaluate the shear bond strength and adhesive remnant index ARI) of orthodontic brackets following enamel conditioning with acid etching, hydroabrasion, and with both procedures. Thirty extracted human premolars were divided into three groups and received either acid etching, hydroabrasion or both procedures. Orthodontic brackets were bonded with composite resin. Shear bond strength was tested with a tensile machine, then the teeth were observed under a stereomicroscope to evaluate ARI scores. The enamel morphology after each conditioning method was evaluated with scanning electron microscope imaging. A one-way ANOVA and a Kruskal−Wallis H test were used to compare the bond strength and the ARI scores among the three groups. Hydroabrasion alone produced shear bond strength values below clinical acceptability, while the combination of acid etching and hydroabrasion produced the highest values. The ARI scores in the hydroabrasion group were significantly different from the other groups. Hydroabrasion followed by acid etching was effective in increasing the shear bond strength of orthodontic brackets. Further in vivo studies are needed to confirm the cost and benefits of this technique. Full article
(This article belongs to the Special Issue Oral Hygiene and Biofilms in Orthodontics)
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