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Oral, Volume 4, Issue 2 (June 2024) – 9 articles

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12 pages, 581 KiB  
Review
The Public Health Approach to Oral Health: A Literature Review
by Mariel Cabrera, Raman Bedi and Marta Lomazzi
Oral 2024, 4(2), 231-242; https://doi.org/10.3390/oral4020019 - 20 May 2024
Viewed by 238
Abstract
Background: Oral health (OH) has evolved beyond dental concerns to encompass psychosocial dimensions and overall well-being. This study reviews OH strategies within a public health framework to identify key elements for effective OH promotion. Methods: A literature review following PRISMA guidelines identified 42 [...] Read more.
Background: Oral health (OH) has evolved beyond dental concerns to encompass psychosocial dimensions and overall well-being. This study reviews OH strategies within a public health framework to identify key elements for effective OH promotion. Methods: A literature review following PRISMA guidelines identified 42 relevant articles from 62 screened. Five themes emerged: group-level, individual-level, policy-level (emphasizing devising OH policies), healthcare delivery, and communication. Common components included OH education, behaviour change, access to OH services, and policy integration. Results: Thematic analysis identified five overarching themes in oral health (OH) promotion strategies, with a focus on tailored approaches for specific populations and components such as education, access to services, interventions, and policy, emphasizing the multifaceted nature of OH promotion. Conclusion: Effective OH promotion requires a multifaceted approach and tailored strategies with interprofessional collaboration. Future research should focus on cost-effectiveness and user-friendly resources for OH professionals and policymakers. Full article
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14 pages, 7909 KiB  
Article
Variables Associated with Jaw Clicking in a South Australian Population: A Cross-Sectional Study
by Taseef Hasan Farook, Lameesa Ramees and James Dudley
Oral 2024, 4(2), 217-230; https://doi.org/10.3390/oral4020018 - 10 May 2024
Viewed by 352
Abstract
Background: The influence of medical and dental factors on jaw clicking within the South Australian population remains unexplored, and there is a lack of research on the impact of occlusal therapy on dynamic jaw movement parameters in this population. Purpose: This study investigated [...] Read more.
Background: The influence of medical and dental factors on jaw clicking within the South Australian population remains unexplored, and there is a lack of research on the impact of occlusal therapy on dynamic jaw movement parameters in this population. Purpose: This study investigated the potential significant associations between specific aspects of patient histories, occlusal therapy, and self-reported or observed jaw clicking in a population from the state of South Australia. Methods: Seventy individuals aged 18 to 65 participated in a cross-sectional study. Data collection included comprehensive medical, social, and dental histories, followed by evaluations of jaw function. Twenty-six out of the seventy individuals reported jaw clicking. Electrognathography assessed maximum mouth opening, surface electromyography evaluated masticatory muscle function, and joint vibration analysis measured individual joint vibration amplitudes and integrals. Logistic regression models analysed overall variable effects, while sub-models focused on predictors related to occlusal therapy, specifically orthodontic intervention. Independent t-tests and Mann–Whitney U tests compared jaw functions between participants who received occlusal therapy and those who did not. Results: The number of third molars extracted, vitamin D deficiency, and self-reported mental health disorders (R2 = 0.414, p = 0.048) emerged as significant predictors for jaw clicking. Factors associated with occlusal therapy showed no significant association with jaw clicking (R2 = 0.59, p = 0.027). Furthermore, there were no significant differences observed in mouth opening (t-stat = −0.439, p = 0.662), muscle activity, and joint vibration analysis between participants who underwent occlusal therapy and those who did not. Conclusions: Within the selected study population and limited sample size, the number of third molars extracted, vitamin D deficiency, and self-reported mental health disorders were associated with jaw clicking. Full article
(This article belongs to the Special Issue Oral Health in the Global South)
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11 pages, 1948 KiB  
Article
Mechanical Properties of Direct Composite Resins and CAD/CAM Composite Blocks
by João Carlos Ramos, Alfredo Marinho, Ana Messias, Gabriela Almeida, Alexandra Vinagre and Ricardo Dias
Oral 2024, 4(2), 206-216; https://doi.org/10.3390/oral4020017 - 3 May 2024
Viewed by 398
Abstract
The widespread application of CAD/CAM technology in contemporary dentistry led to the development of promising restorative materials, such as resin composite blocks (RCBs). Thus, the present study aims to evaluate the mechanical properties of RCBs, comparing this material to the direct composite resin [...] Read more.
The widespread application of CAD/CAM technology in contemporary dentistry led to the development of promising restorative materials, such as resin composite blocks (RCBs). Thus, the present study aims to evaluate the mechanical properties of RCBs, comparing this material to the direct composite resin from the same manufacturer. Samples retrieved from three CAD/CAM resin composite blocks (Tetric CAD (TC), Ivoclar Vivadent, Grandio blocs (GB), VOCO GmbH and Brilliant Crios (BC), Coltene/Whaledent) and four direct composite resins (Tetric EvoCeram (TEC), Ivoclar Vivadent, GrandioSO (GS), VOCO GmbH, Brilliant EverGlow Translucent (BET) and Universal Shade (BEU), Coltene/Whaledent) were submitted to three-point bending flexural test and Vickers microhardness test. The resulting data of the flexural strength were analyzed using one-way ANOVA considering Bonferroni correction for post hoc tests (α = 0.05). The flexural modulus and Vickers microhardness results were analyzed using Welch’s ANOVA considering Games–Howell correction for post hoc tests (α = 0.05). Regarding results, flexural strength and flexural modulus values ranged from 81.1 MPa (BEU) to 246.5 MPa (GB) and 10.6 GPa (BEU) to 20.3 GPa (GB), respectively. GS (121.2) and GB (136.2) groups were associated with the highest microhardness values. According to the post hoc tests, statistically significant differences in flexure strength were found in RCBs (BC, GB, and TC) compared to all direct composite resins. Flexural modulus and Vickers microhardness of RCBs (BC, GB, TC) were also significantly different from the direct composite resin (BET, BED, and TEC), except when comparing GS and GB for microhardness. In conclusion, differences between RCBs and direct composite resins were observed regarding flexural strength, flexural modulus, and microhardness, revealing that RCBs have enhanced mechanical properties compared to direct composite resins. Full article
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10 pages, 2587 KiB  
Article
Anatomical Bone Characteristics of the Buccal Step Insertion Site for Mini-Screw Placement in Orthodontic Treatment: A CBCT Study
by Nicola Derton, Angela Mirea Bellocchio, Elia Ciancio, Serena Barbera, Andrea Caddia, Niki Arveda and Riccardo Nucera
Oral 2024, 4(2), 196-205; https://doi.org/10.3390/oral4020016 - 1 May 2024
Viewed by 352
Abstract
Background: To analyze the anatomical characteristics of a posterior area in the mandible localized distally to the second molars and extending in the vestibular direction toward the bony step, which we define as “buccal step”, in a patient with different skeletal patterns for [...] Read more.
Background: To analyze the anatomical characteristics of a posterior area in the mandible localized distally to the second molars and extending in the vestibular direction toward the bony step, which we define as “buccal step”, in a patient with different skeletal patterns for mini-screw insertion. Methods: The sample included 85 CBCT (cone beam computed tomography) records selected from the digital archive. Analysis focused on the buccal step area. Sections were obtained in axial view using reference lines, and measurements of cortical and total bone were taken at specific points M0 (starting point, 6 mm apical from CEJc—cementoenamel junction crest), M2 (located 2 mm posterior to M0 in the apical direction), and M4 (positioned 4 mm posterior to M0 in the apical direction) in both directions. Six measurements were recorded for each scan root plane, assessing cortical and total bone depth. Results: The thickness of the bone increases toward the inside of the mouth at all tested sites (M0, M2, M4), which is good for placing mini-screws. Cortical bone thickness decreases toward the inside of the mouth, with no significant differences among the sites except for M0 vs. M4. People with a particular jaw shape (hypo-divergent) have a thicker cortical bone, indicating that facial structure affects bone thickness. Conclusions: The posterior buccal step insertion site has biomechanical advantages and reduces the risk of damaging roots during mini-screw insertions. Full article
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11 pages, 1043 KiB  
Article
Comparative Analysis of Dental Health Outcomes from Two Outreach Camps in Zanzibar, Tanzania: 2019 and 2023
by Nutayla Al Harthy, Mohammed Al Ismaili and Abubaker Qutieshat
Oral 2024, 4(2), 185-195; https://doi.org/10.3390/oral4020015 - 24 Apr 2024
Viewed by 413
Abstract
Background: In low- and middle-income countries, oral health is frequently marginalized due to limited dental care access. This cross-sectional study assesses the outcomes of dental outreach camps in Zanzibar, Tanzania, organized in 2019 and 2023, to understand their impact on addressing local oral [...] Read more.
Background: In low- and middle-income countries, oral health is frequently marginalized due to limited dental care access. This cross-sectional study assesses the outcomes of dental outreach camps in Zanzibar, Tanzania, organized in 2019 and 2023, to understand their impact on addressing local oral health needs over a four-year span. Methods: The study involved a thorough examination and analysis of clinical dental health data from both outreach camps. In 2019, 224 patients were examined, and in 2023, the number increased to 354. The assessment covered various dental health parameters, including dental caries, DMFT/dmft indices, enamel fluorosis, dental trauma, oral mucosa lesions, and non-carious tooth surface loss. Results: The analysis demonstrated a significant reduction in dental caries among adolescents and teens, decreasing from 62.5% in 2019 to 35.59% in 2023 (p < 0.0001). Similarly, the prevalence of teeth missing due to caries showed marked reductions from 40.2% to 9.04% in adolescents and teens (p < 0.0001) and from 25.89% to 11.86% among preschool and school-aged children (p = 0.004). Moreover, a significant change was observed in the Basic Erosive Wear Examination (BEWE) scores, with cases showing no erosive tooth wear (BEWE = 0) decreasing from 49.1% to 33.3% (p = 0.016), and cases with initial loss of enamel surface texture (BEWE = 1) increasing from 47.3% to 61% (p = 0.044). Conclusions: The outreach camps conducted in 2019 and 2023 showed tangible improvements in certain dental health metrics, particularly a reduction in dental caries and missing teeth due to caries among adolescents and teens. However, the uptick in non-carious tooth surface loss points to emerging dental health concerns. These results underline the importance of sustained and targeted dental health interventions to improve oral health outcomes in underserved communities such as Zanzibar. Full article
(This article belongs to the Special Issue Oral Health in the Global South)
12 pages, 2329 KiB  
Systematic Review
The Effectiveness of Aligners in the Treatment of Anterior Open Bite in Adult Patients: A Systematic Review and Critical Appraisal
by Tainá Iunes, Afonso Pinhão-Ferreira and Vanda Urzal
Oral 2024, 4(2), 173-184; https://doi.org/10.3390/oral4020014 - 22 Apr 2024
Viewed by 534
Abstract
An anterior open bite is a dental malocclusion, the diagnosis of which is fundamental for its treatment. With the evolution of artificial intelligence, it is possible to treat it through the Invisalign G4 protocol, depending on the degree of severity. The aim of [...] Read more.
An anterior open bite is a dental malocclusion, the diagnosis of which is fundamental for its treatment. With the evolution of artificial intelligence, it is possible to treat it through the Invisalign G4 protocol, depending on the degree of severity. The aim of this study was to perform a systematic review, based on the PICO strategy, to evaluate the effectiveness of aligners and accessory devices in adult patients with anterior open bites. The search was carried out in the following databases for publications over the last ten years: PubMed, Web of Science, Cochrane Library, and LILACS. The inclusion criteria were clinical studies evaluating adults with anterior open bites (overbites < 0 mm) and orthodontic studies with aligners. The exclusion criteria were studies of cases with dentofacial deformities, previous orthodontic treatment, history of surgery/trauma, or systemic diseases that affect craniofacial growth, as well as animal studies, reviews, and clinical cases. The selection was carried out separately by two researchers. In the four databases, 108 articles were obtained. By reviewing the titles and abstracts and applying the exclusion criteria, 91 articles were eliminated. The seven resulting articles were submitted to the inclusion criteria, two of which were excluded due to their lack of patients presenting an open bite and the absence of aligner treatment. According to the PRISMA method, five studies were selected. The collected data showed an increase in overbites with the use of aligners. The bias assessment was performed with the ROBINS-I tool, indicating a moderate risk of bias. The included studies demonstrated the effectiveness of aligners in the treatment of adults with mild or moderate open bites; however, due to the lack of scientific evidence, it is necessary to carry out randomized studies with the same standardized variables. Full article
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10 pages, 1757 KiB  
Article
Experimental Evaluation of a Novel Device to Quantify Canal Cleanliness: An In Vitro Study
by Lorenzo Arcuri, Gianluca Gambarini, Alessio Zanza, Luca Testarelli, Claudio Arcuri, Randolph Cross and Massimo Galli
Oral 2024, 4(2), 163-172; https://doi.org/10.3390/oral4020013 - 7 Apr 2024
Viewed by 497
Abstract
Endodontic treatments are performed to avoid extractions and maintain the natural dentition. Root canal treatments are undertaken to eliminate or prevent an infection within the root canal system. Chemical and mechanical root canal debridement are the main methods used in endodontics to remove [...] Read more.
Endodontic treatments are performed to avoid extractions and maintain the natural dentition. Root canal treatments are undertaken to eliminate or prevent an infection within the root canal system. Chemical and mechanical root canal debridement are the main methods used in endodontics to remove necrotic tissue, microorganisms, and microbial byproducts from the canal. However, to date there is no objective method to clinically determine the proper root canal disinfection level and thus proceed with the obturation. Clinicians just rely on their experience and habits or can trust in empirical methods such as the insertion of paper cones inside the canal and then check their appearance after the removal. Even in the in vitro and ex vivo scientific studies there is no objective method to analyze and compare the efficacy of different endodontic chemo-mechanical techniques and materials. The most frequently used method is to visually analyze some areas with a scanning electron microscope (SEM), even if the resulting images are hardly quantifiable and could greatly vary according to the analyzed area. A new device to clinically test the cleanliness of a root canal and display the result in an objective score was recently developed. The device analyzes the luminescence generated by an enzyme cycling method that process the adenosine triphosphate (ATP), adenosine diphosphate (ADP) and adenosine monophosphate (AMP) present in organic residues. The aim of the present in vitro study was to test the efficacy and reliability of this novel device (Endocator) in a controlled in vitro environment, before using it in clinical practice. The device sensitivity was tested on 5 single canal resin blocks. Three consecutive sampling were executed by one operator for each block to test the device repeatability. Results were recorded according to Endoscore (ES) and relative light unit (RLU) scales. Descriptive analysis and comparison between the 5 resin blocks and the 3 consecutive sampling were performed. Only the comparison between the first and third measurements both for ES (p = 0.00115999) and RLU (p = 0.00532749) resulted significant. Endocator was able to determine small variations of canal contamination in a controlled laboratory environment, showing high sensitivity and repeatability. Full article
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15 pages, 1602 KiB  
Systematic Review
Use of Biosensors within the Oral Environment for Systemic Health Monitoring—A Systematic Review
by Natalie Archer, Sa’ada Ladan, Henry T. Lancashire and Haralampos Petridis
Oral 2024, 4(2), 148-162; https://doi.org/10.3390/oral4020012 - 30 Mar 2024
Viewed by 883
Abstract
Scientific advances in biosensor technology are leading to the potential of wearable biosensors for salivary biomarker detection. This review aims to identify the current status of intraoral biosensor technology that can be used to monitor systemic diseases. A total of 11 studies were [...] Read more.
Scientific advances in biosensor technology are leading to the potential of wearable biosensors for salivary biomarker detection. This review aims to identify the current status of intraoral biosensor technology that can be used to monitor systemic diseases. A total of 11 studies were identified for inclusion, which included nine different devices, including modified mouthguards, retainers, toothbrushes, and dental floss. Out of the 11 studies, 8 studied continuous biomarker monitoring, and the remaining 3 were point-of-care applications. A total of seven biomarkers were studied, six of which investigated the intraoral detection of salivary glucose levels using glucose oxidase enzyme. All the sensors demonstrated excellent sensitivity (minimum R = 0.9928) and selectivity. The study designs were proof of concept, with five studies including in vivo components. We concluded that while there are established links between salivary biomarkers and systemic health, there is a lack of mature intraoral biosensor research. Refinement of biosensor design and data analysis is required to improve patient acceptability by promoting more discrete, real-time, low-cost, and wireless devices. Further research that utilises the biosensor technology in large controlled clinical trials will be required to confirm clinical applicability before intraoral biosensor technology can be integrated into routine health monitoring. Full article
(This article belongs to the Special Issue Current Issues in Oral Health)
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22 pages, 12221 KiB  
Case Report
Hybrid Orthodontics for Aesthetic Deep Bite Correction—Case Series and General Clinical Considerations
by Akila Aiyar, Giuseppe Scuzzo, Giacomo Scuzzo and Carlalberta Verna
Oral 2024, 4(2), 126-147; https://doi.org/10.3390/oral4020011 - 30 Mar 2024
Viewed by 661
Abstract
Background: A range of psychosocial and aesthetic factors motivate patients to undergo orthodontic treatment. The appliance choice depends not only on the type of malocclusion, but also on the aesthetic and functional demands of the patients themselves. Nowadays, digital planning enables the manufacture [...] Read more.
Background: A range of psychosocial and aesthetic factors motivate patients to undergo orthodontic treatment. The appliance choice depends not only on the type of malocclusion, but also on the aesthetic and functional demands of the patients themselves. Nowadays, digital planning enables the manufacture of individualised and customised orthodontic appliances. However, the predictability of movements with aligner treatment has long been under discussion. This article illustrates, through a series of case reports, how a hybrid approach combining individualised aesthetic orthodontic appliances can improve the predictability of tooth movements, thereby providing additional tools for clinicians charged with choosing the best indicated and biomechanically advantageous technique. To this end, three patients with different malocclusions were treated via a hybrid approach involving clear aligners in the upper arch followed by lingual fixed appliances in the upper and lower arches. All patients were treated using ALIAS lingual PSL 0.018 × 0.018-inch slot brackets and in-house 3D-printed aligners. Findings: The hybrid approach combining aligners and fixed lingual appliances led to the successful resolution of all three complex cases in the series without prolonging treatment time. The superimpositions demonstrate the predictability of even traditionally difficult movements. In particular, the Alias PSL lingual system, used from the beginning, enabled good control of both the torque and inclination of the lower incisors. Conclusions: Combining clear aligners and fixed lingual appliances provides a highly efficient means of treating malocclusions aesthetically. In our cases, the aligners offset the lack of bite-plate effect from the lingual brackets and appliances, providing advantageous biomechanics for rotation correction and control of tip, torque and root movements. Understanding how to exploit the strengths of each appliance enables the clinician to treat adult patients efficaciously, efficiently and aesthetically. Full article
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