Clinics and Practice

Editorial

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4 pages, 210 KiB

Open AccessEditorial

Clinics and Practice: Consolidating Best Practices in Periodontal Management

by Francesco D’Ambrosio

Clin. Pract. 2023, 13(3), 666-669; https://doi.org/10.3390/clinpract13030061 - 2 Jun 2023

Cited by 1 | Viewed by 1378

Abstract

Periodontitis is a multifactorial inflammatory disease [...] Full article

(This article belongs to the Special Issue New Trends, Materials, and Technologies and Consolidating Best Practices in Dentistry)

Research

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13 pages, 1570 KiB

Open AccessArticle

Comparative Strength Study of Indirect Permanent Restorations: 3D-Printed, Milled, and Conventional Dental Composites

by João Paulo Mendes Tribst, Adelheid Veerman, Gabriel Kalil Rocha Pereira, Cornelis Johannes Kleverlaan and Amanda Maria de Oliveira Dal Piva

Clin. Pract. 2024, 14(5), 1940-1952; https://doi.org/10.3390/clinpract14050154 (registering DOI) - 20 Sep 2024

Viewed by 364

Abstract

Background/Objectives: Limited research has been performed to assess the strength of resin-bonded 3D-printed restorations. Based on that, this study investigates the impact of different manufacturing methods on the fracture load of indirect composite restorations (ICRs) following an aging process. Methods: Three [...] Read more.

Background/Objectives: Limited research has been performed to assess the strength of resin-bonded 3D-printed restorations. Based on that, this study investigates the impact of different manufacturing methods on the fracture load of indirect composite restorations (ICRs) following an aging process. Methods: Three manufacturing techniques—conventional (CRC), milled (MRC), and printed (PRC)—were evaluated using 60 specimens, each with a diameter of 10 mm and a thickness of 1.0 mm. Sandblasting with Al₂O₃ particles was employed to optimize the bonding process, significantly influencing surface roughness parameters (Ra, Rz, RSm). All specimens were bonded to the dentin analog using composite resin cement and subjected to either 10,000 thermocycles (TC) or storage (ST) at 37 °C in distilled water. Fracture load assessments were performed using a universal testing machine. A finite element analysis was conducted to assess stress distribution. Results: Two-way ANOVA results indicated that the manufacturing method significantly affected mean fracture load values (p < 0.001), with PRC showing the highest mean fracture load (4185 ± 914 N), followed by MRC (2495 ± 941 N) and CRC (599 ± 292 N). The aging protocol did not have a significant impact on fracture load. Conclusions: This study revealed that 3D-printed resin composite exhibited comparable strength to milled resin composite when adhesively cemented, suggesting it is a promising option for indirect composite restorations based on its mechanical performance. However, further research is needed to evaluate its bond strength and optimal surface treatment methods to prevent early debonding. Full article

(This article belongs to the Special Issue New Trends, Materials, and Technologies and Consolidating Best Practices in Dentistry)

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13 pages, 287 KiB

Open AccessArticle

Musculoskeletal Disorders in the Clinical Practice of Dental Hygienists and Dentists, Prevention and Awareness among Italian Professionals: Focus on Enlarging Systems

by Andrea Butera, Carolina Maiorani, Giulia Fantozzi, Francesca Bergamante, Matteo Castaldi, Roberta Grassi, Cinzia Leuter, Andrea Scribante and Gianna Maria Nardi

Clin. Pract. 2024, 14(5), 1898-1910; https://doi.org/10.3390/clinpract14050150 - 12 Sep 2024

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Abstract

(1) Background: Musculoskeletal disorders of the upper limbs are a common medical condition among dental hygienists and dentists, making them a common occupational risk for dental professionals. The purpose of the work was to collect information about the dental professions and their habits [...] Read more.

(1) Background: Musculoskeletal disorders of the upper limbs are a common medical condition among dental hygienists and dentists, making them a common occupational risk for dental professionals. The purpose of the work was to collect information about the dental professions and their habits to highlight what can be good practices to be carried out to prevent any musculoskeletal disorders. (2) Methods: To identify habits and problems inherent in the professional activity of dental hygienists and dentists, a questionnaire was formulated on the use of enlarging systems. (3) Results: The questionnaire was completed by 241 dental professionals. As for the use of magnifiers, 72.6% of participants use them: among dental hygienists, 67.8% use magnifiers, among dentists, 80.9% use magnifiers; there is a statistically significant difference. There is no statistically significant difference between professions regarding muscle disorders. (4) Conclusions: For a clearer assessment, it would be appropriate to submit the questionnaire to a wider sample of professionals, to define better the correlation between musculoskeletal disorders, work activity and the type of enlarging systems used. Full article

(This article belongs to the Special Issue New Trends, Materials, and Technologies and Consolidating Best Practices in Dentistry)

21 pages, 4127 KiB

Open AccessArticle

Accelerated Orthodontics: A Descriptive Bibliometric Analysis of the Top 50 Cited Articles from 2012 to 2023

by Ahmed A. Alsulaiman and Osama A. Alsulaiman

Clin. Pract. 2024, 14(5), 1716-1736; https://doi.org/10.3390/clinpract14050137 - 29 Aug 2024

Viewed by 836

Abstract

Background and Objectives: Accelerated orthodontics represents a significant shift in dental practice aimed at reducing treatment times while maintaining optimal patient outcomes. This bibliometric analysis evaluated the research landscape of accelerated orthodontics from 2012 to 2023, focusing on publication trends, citation patterns, influential [...] Read more.

Background and Objectives: Accelerated orthodontics represents a significant shift in dental practice aimed at reducing treatment times while maintaining optimal patient outcomes. This bibliometric analysis evaluated the research landscape of accelerated orthodontics from 2012 to 2023, focusing on publication trends, citation patterns, influential journals, leading institutions, and key contributors. Materials and Methods: A comprehensive search in Scopus identified 600 relevant articles, with the top 50 most-cited papers encompassing systematic reviews, randomized controlled trials, and experimental studies. Key techniques, such as corticotomy and piezocision, have been frequently highlighted for their effectiveness in expediting tooth movement. Results: The analysis revealed fluctuating annual scientific outputs, with notable peaks driven by technological advancements and increased patient demand for quicker orthodontic solutions. However, the production of high-impact papers was hindered by delays in citation accumulation and disruptions caused by the COVID-19 pandemic. Keyword analysis identified critical themes, such as orthodontic tooth movement, malocclusion, and demographic factors, while a global collaboration map underscored extensive international research partnerships. Leading journals included the American Journal of Orthodontics and Dentofacial Orthopedics, and prominent institutions such as the University of California at Los Angeles played significant roles in advancing the field. Conclusions: This study provides a comprehensive overview of the current state of accelerated orthodontics, emphasizing the need for continued research, particularly RCTs, to further refine and validate accelerated orthodontic techniques and improve clinical outcomes. Full article

(This article belongs to the Special Issue New Trends, Materials, and Technologies and Consolidating Best Practices in Dentistry)

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9 pages, 250 KiB

Open AccessArticle

Assessment of 2′-Fucosyllactose and Lacto-N-Neotetraose Solution as an Irrigant in E. faecalis-Infected Root Canals: An In Vitro Study

by Francesco Puleio, Rosario Pirri, Vincenzo Tosco, Angelo Sergio Lizio, Paola Tripodi, Isabella La Spina, Vincenza La Fauci and Raffaele Squeri

Clin. Pract. 2024, 14(4), 1348-1356; https://doi.org/10.3390/clinpract14040108 - 10 Jul 2024

Viewed by 1014

Abstract

Background: Given the lack of an ideal endodontic irrigant on the market, this study evaluates the antimicrobial potential of a formulated solution of 2′-fucosyllactose and lacto-N-neotetraose against E. faecalis within infected root canals, and explores any associated impacts related to the duration of [...] Read more.

Background: Given the lack of an ideal endodontic irrigant on the market, this study evaluates the antimicrobial potential of a formulated solution of 2′-fucosyllactose and lacto-N-neotetraose against E. faecalis within infected root canals, and explores any associated impacts related to the duration of irrigation. Methods: 32 single-rooted teeth extracted for periodontal reasons were infected with Enterococcus faecalis, and subsequently subjected to endodontic treatment with two different irrigation systems: sodium hypochlorite or a solution of 2′-fucosyllactose and lacto-N-neotetraose. These samples were then incubated in sterile culture media at 37 °C to observe microbial activity through turbidity. The culture broth of each individual sample was assessed as positive or negative by observing the turbidity or lack of turbidity in the culture at the time of evaluation. Results: the analysis of the results obtained from the comparison of groups irrigated with sodium hypochlorite or a solution of 2′-fucosyllactose and lacto-N-neotetraose demonstrates that the case solution has no bactericidal effect against E. faecalis inoculated in the endodontic system. Conclusions: the HMOs used in this study do not have a bactericidal effect on E. faecalis inoculated in an endodontic system. Full article

(This article belongs to the Special Issue New Trends, Materials, and Technologies and Consolidating Best Practices in Dentistry)

12 pages, 267 KiB

Open AccessArticle

Perceived Orthodontic Needs and Attitudes towards Early Evaluation and Interventions: A Survey-Based Study among Parents of Italian School-Aged Children

by Federica Di Spirito, Davide Cannatà, Valentina Schettino, Marzio Galdi, Rosaria Bucci and Stefano Martina

Clin. Pract. 2024, 14(3), 1159-1170; https://doi.org/10.3390/clinpract14030092 - 18 Jun 2024

Cited by 1 | Viewed by 657

Abstract

(1) Background: Parents’ awareness of malocclusion and their attitude towards early evaluation and interventions influence children’s orthodontic management. This cross-sectional study investigates factors that affect the perceived orthodontic needs and the attitude towards interceptive orthodontics among a sample of one-thousand eight-hundred and six [...] Read more.

(1) Background: Parents’ awareness of malocclusion and their attitude towards early evaluation and interventions influence children’s orthodontic management. This cross-sectional study investigates factors that affect the perceived orthodontic needs and the attitude towards interceptive orthodontics among a sample of one-thousand eight-hundred and six (1806) parents of children aged between 6 and 11 years. (2) Methods: The investigation was carried out thought a 18-items online questionnaire divided as follows: characteristics of respondents; perceived child’s orthodontic needs; attitude toward early orthodontic evaluation and interventions. The associations between responses were assessed with a Chi-square test. (3) Results: Two-thirds of the respondents referred to having consulted an orthodontist for their child, and more than half of them initiated the required orthodontic treatment. In 44% of cases, the orthodontic consultation occurred after the age of 7 years. Parents’ higher education and history of orthodontic treatment were associated with a greater awareness of orthodontic needs. Parents’ perception of the impact of teeth on their child’s personality was significantly associated with the decision to start the orthodontic treatment (p < 0.001). (4) Conclusions: Although the parents’ level of awareness of their child’s orthodontic needs was generally satisfactory, the results of the present study pointed out the need for a better education regarding the importance of an early orthodontic assessment. Full article

(This article belongs to the Special Issue New Trends, Materials, and Technologies and Consolidating Best Practices in Dentistry)

11 pages, 1357 KiB

Open AccessArticle

Efficacy of Non-Surgical Periodontal Therapy with Adjunctive Methylene Blue and Toluidine Blue O Mediated Photodynamic in Treatment of Periodontitis: A Randomized Clinical Trial

by Kashan Kamal Najm, Sarhang Sarwat Gul and Ali Abbas Abdulkareem

Clin. Pract. 2024, 14(3), 954-964; https://doi.org/10.3390/clinpract14030076 - 22 May 2024

Viewed by 1171

Abstract

Background: This study aimed to examine the efficacy of methylene blue (MB) and toluidine blue O (TBO) photodynamic therapy (PDT) as adjuncts to root surface debridement (RSD). Methods: This split-mouth, randomized, controlled clinical trial included eighteen patients, and a total of 332 sites [...] Read more.

Background: This study aimed to examine the efficacy of methylene blue (MB) and toluidine blue O (TBO) photodynamic therapy (PDT) as adjuncts to root surface debridement (RSD). Methods: This split-mouth, randomized, controlled clinical trial included eighteen patients, and a total of 332 sites (control = 102, MB = 124 and TBO = 106) were examined. Two sessions of PDT were completed at baseline and two weeks after RSD. Clinical parameters of bleeding on probing (BOP), plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were measured pre- and post-treatment. Results: PPD and BOP reductions in sites treated by RSD with adjunctive photosensitizers (MB and TBO) were significantly higher than in control sites. RSD with MB showed higher efficacy in improving moderately deep pockets (OR 3.350), while adjunctive TBO showed better results in treating deeper pockets (OR 4.643). Conclusions: Results suggested that adjunctive use of MB and TBO to RSD could significantly improve periodontal pocket closure and reduce signs of inflammation. In addition, TBO seems to be more efficient in treating deep periodontal pockets than MB, which is more effective in resolving shallower pockets. Full article

(This article belongs to the Special Issue New Trends, Materials, and Technologies and Consolidating Best Practices in Dentistry)

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14 pages, 8357 KiB

Open AccessArticle

Case Report of a Dental Implant with Conometric Abutment–Prosthetic Cap Connection: Advanced High-Resolution Imaging and Peri-Implant Connective Tissue Performance

by Nicole Riberti, Emira D’Amico, Tania Vanessa Pierfelice, Michele Furlani, Alessandra Giuliani, Adriano Piattelli, Giovanna Iezzi and Luca Comuzzi

Clin. Pract. 2024, 14(2), 556-569; https://doi.org/10.3390/clinpract14020043 - 27 Mar 2024

Viewed by 1647

Abstract

Background: In recent years, the use of conometric systems to connect dental implant abutments and prosthetic caps has been advocated because they seem to eliminate the side effects reported when using screw- and cement-connected prosthetic restorations. Objectives: The present case study [...] Read more.

Background: In recent years, the use of conometric systems to connect dental implant abutments and prosthetic caps has been advocated because they seem to eliminate the side effects reported when using screw- and cement-connected prosthetic restorations. Objectives: The present case study is focused on conometric connection characterization and its performance in terms of the microarchitecture of peri-implant soft tissues by using a cross-linked approach based on optical microscopy and three-dimensional imaging. Methods: Two dental implants were characterized using micro-CT and another identical one was implanted into a patient; the latter was retrieved 45 days later due to changes in prosthetic needs. Afterward, the peri-implant soft tissues were investigated using synchrotron-based phase contrast imaging, histology, and polarized light microscopy. Results: Micro-CT analysis showed perfect adhesion between the abutment and prosthetic cap; histology and polarized light microscopy showed that connective tissue was richly present around the abutment retrieved from the patient. Moreover, the quantitative evaluation of connective tissues using synchrotron imaging, supported by artificial intelligence, revealed that this tissue was rich in mature collagen, with longitudinal and transverse collagen bundles intertwined. The number and connectivity of transverse bundles were consistently greater than those of the longitudinal bundles. Conclusion: It was found that the peri-implant soft tissue was already mature and well organized after only 45 days of implantation, supporting the hypothesis that conometric connections contribute to the significant stabilization of peri-implant soft tissues. Full article

(This article belongs to the Special Issue New Trends, Materials, and Technologies and Consolidating Best Practices in Dentistry)

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16 pages, 987 KiB

Open AccessArticle

Evaluation of Abfraction Lesions Restored with Three Dental Materials: A Comparative Study

by Bogdan Constantin Costăchel, Anamaria Bechir, Alexandru Burcea, Laurența Lelia Mihai, Tudor Ionescu, Olivia Andreea Marcu and Edwin Sever Bechir

Clin. Pract. 2023, 13(5), 1043-1058; https://doi.org/10.3390/clinpract13050093 - 26 Aug 2023

Viewed by 2311

Abstract

Background: Abfraction lesions are manifested as damage to hard tissues in the cervical area of dental crowns. The study aimed to assess the direct restoration of abfraction lesions according to the modified United States Public Health Service (USPHS) criteria for 24 months. The [...] Read more.

Background: Abfraction lesions are manifested as damage to hard tissues in the cervical area of dental crowns. The study aimed to assess the direct restoration of abfraction lesions according to the modified United States Public Health Service (USPHS) criteria for 24 months. The restorations were accomplished with Fuji Bulk–GC, Omnichroma Flow-Tokuyama, and Beautifil^® II–Shofu dental materials, and the therapy was or was not associated with wearing thermoformed mouthguards. Methods: From the 53 selected and analyzed patients (n = 53), 28 patients (with restorations of abfraction lesions) belonged to the 1st group and 25 patients (with 105 restorations, who also wore mouthguards) belonged to the 2nd group. Blind determination assessments were effectuated at baseline and after 2, 6, 12, 18, and 24 months. Results showed that, regardless of the rating score, there are no significant statistical differences in the evaluation criteria between the two groups of patients Conclusions: For each material, the scores of USPHS criterion presented good clinical performances after 24 months, with no significant statistical differences between the fillings and the applied therapy in the two groups of patients. Full article

(This article belongs to the Special Issue New Trends, Materials, and Technologies and Consolidating Best Practices in Dentistry)

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16 pages, 2237 KiB

Open AccessEditor’s ChoiceArticle

Pulpectomy vs. Pulpotomy as Alternative Emergency Treatments for Symptomatic Irreversible Pulpitis—A Multicenter Comparative Randomised Clinical Trial on Patient Perceptions

by Guillem Esteve-Pardo, Pedro Barreiro-Gabeiras and Lino Esteve-Colomina

Clin. Pract. 2023, 13(4), 898-913; https://doi.org/10.3390/clinpract13040082 - 2 Aug 2023

Viewed by 2580

Abstract

Aim: There needs to be more general agreement on the most effective treatment for the emergency patient with Symptomatic Irreversible Pulpitis (SIP). This equivalence randomised clinical study compared the clinical efficiency, as an urgent treatment, of pulpotomy (POT) and pulpectomy (PEC) in the [...] Read more.

Aim: There needs to be more general agreement on the most effective treatment for the emergency patient with Symptomatic Irreversible Pulpitis (SIP). This equivalence randomised clinical study compared the clinical efficiency, as an urgent treatment, of pulpotomy (POT) and pulpectomy (PEC) in the permanent teeth with SIP. The primary outcome was pain management, and the secondary outcome was the patient’s perception of duration, comfort, and satisfaction. Material & Methods: 80 patients were blindly and randomly allocated into two equal parallel groups, the control group treated by PEC and the test group by POT. Data were collected through numerical rating scales (NRS) during the intervention and 6, 24, and 72 h post-op. Non-parametric tests were used to analyse the data. The Brunner-Longer models were adopted for longitudinal data and the analysis of variance (ANOVA)-type statistical was used. Results: The mean preoperative pain levels for the whole sample scored 5.8 ± 2.8 and significantly decreased to 2.1 ± 2.4 at 6 h, 1.5 ± 2.1 at 24 h, and 1.3 ± 2 at 72 h, without any differences between the groups. No significant differences were found in the patient’s perception of treatment discomfort or duration between the groups. Three days after the intervention, patient satisfaction was high, with 9.2 ± 1.7 and 9.1 ± 2 in the PEC and POT groups, respectively. Self-reported pain was the only variable penalising the patient’s final satisfaction. Conclusions: The current randomised control trial (RCT) showed that both pulpectomy and pulpotomy effectively eliminate pain and achieve high levels of patient satisfaction. Furthermore, the patient’s perceptions of the duration and discomfort of the two treatments were similar. Given that pulpotomy is a faster and more straightforward technique, it may be recommended as a viable and pragmatic option for treating emergency patients with symptomatic irreversible pulpitis. Full article

(This article belongs to the Special Issue New Trends, Materials, and Technologies and Consolidating Best Practices in Dentistry)

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10 pages, 1282 KiB

Open AccessArticle

Relationships between Lip Seal Strength, Tongue Pressure, and Daytime Sleepiness in Japanese Workers: A Cross-Sectional Study

by Akira Minoura, Yoshiaki Ihara, Hirotaka Kato, Kouzou Murakami, Yoshio Watanabe, Kojiro Hirano, Yoshinori Ito and Akatsuki Kokaze

Clin. Pract. 2023, 13(4), 753-762; https://doi.org/10.3390/clinpract13040068 - 4 Jul 2023

Viewed by 1450

Abstract

This cross-sectional study aimed to examine the relationships between lip seal strength, tongue pressure, and daytime sleepiness in Japanese workers. A self-administered questionnaire which comprised the Epworth Sleepiness Scale (ESS) was completed by 496 workers, and excessive daytime sleepiness was defined by an [...] Read more.

This cross-sectional study aimed to examine the relationships between lip seal strength, tongue pressure, and daytime sleepiness in Japanese workers. A self-administered questionnaire which comprised the Epworth Sleepiness Scale (ESS) was completed by 496 workers, and excessive daytime sleepiness was defined by an ESS score of 11 or over. Lip seal strength and tongue pressure were measured in all participants, and multiple regression analyses were performed to examine the effects of lip seal strength and tongue pressure on daytime sleepiness. The median ESS score was 5.0 (25th and 75th percentiles: 2.0 and 8.0), and 42 (8.5%) workers had excessive daytime sleepiness. The median lip seal strength was 13.5 N (11.4, 16.3), and the tongue pressure was 41.7 kPa (35.2, 48.3). Workers with higher ESS scores had significantly lower levels of lip seal strength than those without, following adjustments for age and body mass index (BMI) values (β (95% confidence interval): −0.043 [−0.081, −0.004]). However, tongue pressure was not significantly associated with ESS score after adjustments for age and/or BMI. These results suggest that maintaining moderate lip seal strength may help prevent excessive daytime sleepiness in Japanese workers regardless of age or BMI. Full article

(This article belongs to the Special Issue New Trends, Materials, and Technologies and Consolidating Best Practices in Dentistry)

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Review

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17 pages, 4585 KiB

Open AccessReview

Anterior Hyperfunction Syndrome: Literature Review and Conceptual Model

by Benjamin Aranda-Herrera, Tania Rubi Agudo-de la Cruz, Carlos Alberto Jurado and Rene Garcia-Contreras

Clin. Pract. 2024, 14(4), 1584-1600; https://doi.org/10.3390/clinpract14040128 - 18 Aug 2024

Viewed by 672

Abstract

Combined Kelly syndrome, also known as anterior hyperfunction syndrome, is a complex pathological condition of the stomatognathic system, originally established by five characteristics but primarily triggered by edentulism, specifically, the absence of the upper and posterior mandibular teeth. This condition is characterized by [...] Read more.

Combined Kelly syndrome, also known as anterior hyperfunction syndrome, is a complex pathological condition of the stomatognathic system, originally established by five characteristics but primarily triggered by edentulism, specifically, the absence of the upper and posterior mandibular teeth. This condition is characterized by a series of clinical features, such as bone loss, tuberosity growth, enamel wear, periodontal damage, muscle fatigue, pain, and temporomandibular joint issues. However, these features are not unique and rather reflect an oral hyperfunction state. There is a lack of consensus on the best way to assess and diagnose this condition, which is proposed to be understood as an “oral hyperfunction state” rather than a syndrome. This study aims to conduct a literature review to analyze the available information on anterior hyperfunction syndrome in dentistry, with the goal of proposing a conceptual model of the etiological risk factors that contribute to early diagnosis and the prevention of complications. This approach has important clinical implications, as it would allow for the early identification and management of risk factors, thus improving the quality of life of patients and preventing malpractice that could compromise their oral health. Full article

(This article belongs to the Special Issue New Trends, Materials, and Technologies and Consolidating Best Practices in Dentistry)

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Other

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9 pages, 15974 KiB

Open AccessCase Report

Guided Biofilm Therapy for Management of “Desquamative Gingivitis”—Clinical Cases

by Blagovesta Yaneva, Maria Mutafchieva, Petar Shentov and Georgi Tomov

Clin. Pract. 2024, 14(5), 1931-1939; https://doi.org/10.3390/clinpract14050153 (registering DOI) - 20 Sep 2024

Viewed by 316

Abstract

Background: Desquamative gingivitis is a clinical manifestation often associated with various mucocutaneous disorders, characterized by red, painful, and friable gingiva. It is predominantly seen in middle-aged to elderly females and is typically linked to autoimmune conditions such as lichen planus, pemphigoid, and pemphigus, [...] Read more.

Background: Desquamative gingivitis is a clinical manifestation often associated with various mucocutaneous disorders, characterized by red, painful, and friable gingiva. It is predominantly seen in middle-aged to elderly females and is typically linked to autoimmune conditions such as lichen planus, pemphigoid, and pemphigus, among others. Due to the chronic pain and difficulty in maintaining personal oral hygiene, professional care becomes crucial. Methods: This article explores the application of guided biofilm therapy as a novel, gentle approach for managing desquamative gingivitis, focusing on three clinical cases. This therapy employs erythritol-based powders for biofilm removal, offering a less abrasive and more comfortable alternative to traditional mechanical plaque removal techniques. Results: The cases demonstrate the effectiveness of guided biofilm therapy in reducing discomfort and improving clinical outcomes in desquamative gingivitis patients, particularly those suffering from mucous membrane pemphigoid, pemphigus vulgaris, and oral lichen planus. Conclusions: The guided biofilm approach underscores the importance of tailored periodontal therapy in managing nonplaque-induced gingival lesions, improving patient compliance and oral health outcomes. Full article

(This article belongs to the Special Issue New Trends, Materials, and Technologies and Consolidating Best Practices in Dentistry)

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11 pages, 25706 KiB

Open AccessOpinion

Importance of Early Detection of Wire Syndrome: A Case Series Illustrating the Main Stages of the Clinical Gradient

by Carole Charavet, Nathan Israël, France Vives and Sophie-Myriam Dridi

Clin. Pract. 2023, 13(5), 1100-1110; https://doi.org/10.3390/clinpract13050098 - 11 Sep 2023

Cited by 3 | Viewed by 2087

Abstract

(1) Context and Objective: Wire syndrome (WS) refers to dental displacements which can be qualified as aberrant, unexpected, unexplained, or excessive of teeth still contained by an intact orthodontic retainer wire without detachment or fracture, leading to evolving aesthetic and/or functional consequences, both [...] Read more.

(1) Context and Objective: Wire syndrome (WS) refers to dental displacements which can be qualified as aberrant, unexpected, unexplained, or excessive of teeth still contained by an intact orthodontic retainer wire without detachment or fracture, leading to evolving aesthetic and/or functional consequences, both dental and periodontal. The clinical diagnosis of WS in severe cases is often easy. On the other hand, emerging cases must be detected early to stop this evolutionary process as soon as possible, as well as to effectively manage unwanted dental displacements and associated dento-periodontal tissue repercussions. The aim of this retrospective study was to understand the challenges and importance of early diagnosis, highlight the clinical gradient of WS, and clarify the key elements of diagnosis for many practitioners confronted with this type of problem. (2) Materials and Methods: Three cases of increasing complexity were described: the history of wire syndrome, a description of the key elements of its diagnosis, and the final diagnosis itself. (3) Results: Different types and locations of wire syndrome have been observed, from early form to terminal wire syndrome. The three main stages of the clinical gradient are described as follows. In the first case, wire syndrome starting on tooth 41, called the “X-effect” type, was suspected. X-effect wire syndrome on 21, X-effect wire syndrome on 41, and Twist-effect wire syndrome on 33 were diagnosed in the second case, which can be classified as an intermediate case. In the extreme clinical situation of the last case, severe and terminal wire syndrome on tooth 41, the X-effect type, was observed. (4) Conclusions: This case series presents the main stages of the clinical gradient of WS. Although in the case of early WS it is very difficult to identify and/or differentiate it from movements related to a classical relapse phenomenon, the diagnosis of terminal WS is very easy. The challenge for the practitioner is therefore to detect WS as early as possible to stop the iatrogenic process and propose a personalized treatment depending on the severity of clinical signs. The earlier WS is detected, the less invasive the treatment. Full article

(This article belongs to the Special Issue New Trends, Materials, and Technologies and Consolidating Best Practices in Dentistry)

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