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Dentistry Journal — Open Access Journal

Dentistry Journal (ISSN 2304-6767) is an international peer-reviewed open access journal published quarterly online by MDPI.

Open Access free for readers, with article processing charges (APC) paid by authors or their institutions.
High visibility: Citations available in PubMed , full-text archived in PubMed Central. Indexed in Scopus from Vol. 6 (2018).
Rapid publication: manuscripts are peer-reviewed and a first decision provided to authors approximately 18.8 days after submission; acceptance to publication is undertaken in 8.2 days (median values for papers published in this journal in the second half of 2018).
Recognition of reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.

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Latest Articles

Open AccessArticle

Bone Density and Implant Primary Stability. A Study on Equine Bone Blocks

by Francesco Orlando, Federico Arosio, Paolo Arosio and Danilo Alessio Di Stefano

Dent. J. 2019, 7(3), 73; https://doi.org/10.3390/dj7030073 - 1 July 2019

Abstract

Previous results on synthetic blocks mimicking bone indicate that bone density can be measured by the friction encountered by a rotating probe while it descends into bone, and that primary implant stability may be measured through the integral (I) of the torque–depth curve at implant insertion. This study aims to repeat those tests on collagen-preserving equine bone blocks as they better reproduce the mechanical properties of natural bone. Fifteen cancellous equine blocks had their density measured using a measuring probe. This was compared to their known physical density through linear regression analysis. Implant placement was carried out into six cancellous equine blocks and primary stability was measured using (I), as well as the insertion torque (IT), the implant stability quotient (ISQ), and the reverse torque (RT). The relation between (I), (IT), (ISQ), and (RT) was investigated by correlation analysis. Bone density measured using the probe correlated significantly with actual density, both with (r = 0.764) and without irrigation (r = 0.977). (I) correlated significantly with IT and RT under all irrigation conditions, and with ISQ only without irrigation (r = 0.886). The results suggest that the probe provides actual bone density measurements. They also indicate that (I) measures primary implant stability and is more sensitive to density variations than IT, RT, and ISQ. Results are consistent with those obtained on synthetic blocks but suggest that equine bone blocks may better reproduce the mechanical properties of human cancellous alveolar bone. This should be the subject of additional studies. Full article

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Open AccessFeature PaperReview

Antibacterial Additives in Epoxy Resin-Based Root Canal Sealers: A Focused Review

by Alexander Brezhnev, Prasanna Neelakantan, Ray Tanaka, Sergey Brezhnev, George Fokas and Jukka P. Matinlinna

Dent. J. 2019, 7(3), 72; https://doi.org/10.3390/dj7030072 - 1 July 2019

Abstract

Dental materials used in root canal treatment have undergone substantial improvements over the past decade. However, one area that still remains to be addressed is the ability of root canal fillings to effectively entomb, kill bacteria, and prevent the formation of a biofilm, all of which will prevent reinfection of the root canal system. Thus far, no published review has analysed the literature on antimicrobial additives to root canal sealers and their influence on physicochemical properties. The aim of this paper was to systematically review the current literature on antimicrobial additives in root canal sealers, their anti-fouling effects, and influence on physicochemical properties. A systematic search was performed in two databases (PubMed and Scopus) to identify studies that investigated the effect of antimicrobial additives in epoxy resin-based root canal sealers. The nature of additives, their antimicrobial effects, methods of antimicrobial testing are critically discussed. The effects on sealer properties have also been reviewed. A total of 31 research papers were reviewed in this work. A variety of antimicrobial agents have been evaluated as additives to epoxy resin-based sealers, including quaternary ammonium compounds, chlorhexidine, calcium hydroxide, iodoform, natural extracts, antibiotics, antifungal drugs, and antimicrobial agent-functionalised nanoparticles. Antimicrobial additives generally improved the antimicrobial effect of epoxy resin-based sealers mainly without deteriorating the physicochemical properties, which mostly remained in accordance with ISO and ANSI/ADA specifications. Full article

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Open AccessReview

Adhesive Systems Used in Indirect Restorations Cementation: Review of the Literature

by Cristian Abad-Coronel, Belén Naranjo and Pamela Valdiviezo

Dent. J. 2019, 7(3), 71; https://doi.org/10.3390/dj7030071 - 1 July 2019

Abstract

New technologies are changing the therapeutical options to do indirect restorations and new adhesive systems are continuously introduced to be used by clinicians. Different interactions between restorations, adhesive systems components, enamel and dentin require having criteria based on the selection of the adhesive system, ensuring the longevity of the restorations and the preservation of the biological remnant. The adhesion force to the dental tissue is one of the indicatives of the behavior of the adhesive systems and influences the behavior of the treatments with direct and indirect restorations. The objective of this search was to find the adhesive systems with the best results in terms of the adhesion strength of indirect restorations on the dental tissues. The search was conducted in two MEDLINE digital databases (PubMed), and the Cochrane Library with a search strategy based on the combination of MeSH (Medical Subject Headings) keywords. This systematic review used the PRISMA guide (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). According to this review, the 3-step adhesive systems were the best performing and still are the gold standard for the cementing of indirect restorations. In addition, it can be concluded that self-etched adhesive systems reduce the time spent in clinical practice, however at the interface level they behave as permeable membranes more susceptible to degradation. Full article

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Open AccessArticle

Chemical, Clinical and Histomorphometric Comparison between Equine Bone Manufactured through Enzymatic Antigen-Elimination and Bovine Bone Made Non-Antigenic Using a High-Temperature Process in Post-Extractive Socket Grafting. A Comparative Retrospective Clinical Study

by Danilo Alessio Di Stefano, Terry Zaniol, Lorenzo Cinci and Laura Pieri

Dent. J. 2019, 7(3), 70; https://doi.org/10.3390/dj7030070 - 1 July 2019

Abstract

Enzyme-deantigenic equine bone (EDEB) and anorganic bovine bone (ABB) are two xenografts made non-antigenic through different processing methods. This study aimed to characterize them for the presence of native bone collagen and other proteins and to compare their histomorphometric outcome when they were used to graft post-extractive sockets. The records of 46 patients treated with EDEB (n = 22) or ABB (n = 24) and followed-up for at least four months after delayed implant placement, were retrospectively collected. Samples of EDEB and ABB were analyzed using Attenuated Total Reflection Fourier Transform Infrared and Sodium Dodecyl Sulfate-Polyacrylamide Gel Electrophoresis for the presence of collagen and other proteins. For histomorphometric analysis on bone specimens, newly formed bone and residual biomaterial percentages were calculated. Results of the present study show that EDEB contains type I bone collagen in its native conformation, while no proteins were detected in ABB. Grafting EDEB resulted in a significantly greater quantity of newly formed bone and less residual biomaterial. Our findings suggest that the manufacturing process can greatly affect the graft behavior and a process preserving collagen in its native form may favor bone tissue regeneration. Full article

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Open AccessArticle

‘Message to Dentist’: Facilitating Communication with Dentally Anxious Children

by Helen Rodd, Laura Timms, Fiona Noble, Sarah Bux, Jenny Porritt and Zoe Marshman

Dent. J. 2019, 7(3), 69; https://doi.org/10.3390/dj7030069 - 1 July 2019

Abstract

Dental anxiety affects children worldwide and can have negative consequences on oral health. This study aimed to evaluate a novel communication aid ‘message to dentist’ (MTD), as part of a wider cognitive behavioural therapy approach to reduce dental anxiety in young patients. Dentally anxious children, aged 9–16 years, were invited to complete the MTD proforma, before and following their course of treatment. They scored how worried they were and their anticipated pain levels on a scale of 1–10 (10 being the worst outcome). They also wrote down their coping plans and post-treatment reflections. One hundred and five children, from a UK general dental practice and a hospital clinic, were included. They had a mean age of 11.6 years, and 65% were female. There was a significant reduction in self-report worry (from 4.9 to 2.1) and anticipated pain (from 5.1 to 2.0) scores (p < 0.05, paired t-test). Many children (30%) used listening to music/audiobook as a coping strategy. Thematic analysis revealed concerns around pain, uncertainty, errors and specific procedures. The MTD proforma proved an effective means of facilitating communication between anxious children and the dental team, allowing them to identify their worries and make personalised coping plans. Full article

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Open AccessArticle

Factors Associated with Dental Fear and Anxiety in Children Aged 7 to 9 Years

by Andreas Dahlander, Fernanda Soares, Margaret Grindefjord and Göran Dahllöf

Dent. J. 2019, 7(3), 68; https://doi.org/10.3390/dj7030068 - 1 July 2019

Abstract

The aim was to investigate changes in dental fear and anxiety (DFA) and verify factors associated with DFA in children. A longitudinal cohort study that included 160 children aged 7 years was carried out. A questionnaire was completed by parents at two time points and evaluated the immigrant background, maternal education, whether the child had ever had toothache, and whether the parents had dental fear. The oral clinical examination evaluated decayed, extracted, and filled primary teeth (deft). The children’s fear survey schedule dental subscale (CFSS-DS) was used to assess the dental fear of the children. Multilevel mixed-effects logistic regressions analyses were used. The CFSS-DS found that 7% of the children had dental fear at age 7 and mean CFSS-DS was 22.9. At 9 years of age, 8% reported dental fear and the mean increased to 25.4. Parental dental fear, experience of toothache, and report of painful dental treatment and caries development between 7 and 9 years of age were factors that were significantly related to development of DFA. There was a change in DFA between 7 and 9 years of age. Dental fear and anxiety is a dynamic process in growing individuals and is significantly related to painful symptoms and experiences of dental care as well as parental dental fear. Full article

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Open AccessArticle

The Relationship between Caries-Specific Quality of Life and Generic Wellbeing in a Dutch Pediatric Population

by Helen J. Rogers, Jan H. Vermaire, Fiona Gilchrist and Annemarie A. Schuller

Dent. J. 2019, 7(3), 67; https://doi.org/10.3390/dj7030067 - 1 July 2019

Abstract

Dental caries has significant negative impacts on the lives of children and young people. Whilst the impacts on children’s oral health-related quality of life (OHRQoL) have been increasingly investigated, the effect on children’s overall wellbeing remains largely unknown. Data were obtained from a survey conducted across four cities in the Netherlands. Children and their parents completed a series of questionnaires, which included Dutch versions of a caries-specific pediatric measure of OHRQoL (CARIES-QC-NL) and a generic pediatric health utility measure (CHU9D-NL). The participating children underwent dental examinations to determine their caries status. A total of 486 11-year-old children participated in the study, of which 184 had caries experience (38%). The mean number of decayed, missing and filled teeth (DMFT) was 0.71. The CARIES-QC-NL was found to have statistically significant correlations with the DMFT and CHU9D-NL. There were no statistically significant correlations between the CHU9D and the clinical variables. The CARIES-QC-NL had acceptable internal consistency and construct validity in this population despite the low prevalence of active caries. A relationship was demonstrated between OHRQoL and generic wellbeing in this population. Despite this, the CHU9D did not show any correlation with the clinical data, which may limit its application in studies of the impact of dental caries. Full article

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Open AccessArticle

Investigating Eating Behaviors and Symptoms of Oral Frailty Using Questionnaires

by Tsukasa Hihara, Takaharu Goto and Tetsuo Ichikawa

Dent. J. 2019, 7(3), 66; https://doi.org/10.3390/dj7030066 - 29 June 2019

Abstract

A questionnaire survey was conducted to investigate eating behavior and the subjective symptoms of oral frailty, and to examine the relationship between them. A total of 744 subjects with ages over 65 years were included. The questionnaire comprised 18 question items indicating eating behavior and seven question items indicating oral frailty. All items were assessed according to 4 grades on a scale of 1 (not applicable) to 4 (applicable). The total score of oral frailty gradually increased with age. Regarding the scores for “eating recognition” and “eating habits”, no changes were observed, however the scores for “eating action” demonstrated a decreasing tendency with age and the scores of ≥ 85 years age group was significantly lower than the 65–69, 70–74, and 75–79 years age groups. As a result of multiple regression analysis, among the significant independent variable, the scores of “I do not chew foods well” under the category of “eating action” showed the highest standard partial regression coefficients for dependent variable of symptoms of oral frailty. The significant association was found between the eating behavior and subjective symptoms of oral frailty, and this study suggests that the good chewing habit might be an important criterion for the prevention of oral frailty. Full article

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Open AccessCase Report

Dental Rehabilitation for Free Fibula Flap-Reconstructed Mandible with Scar Contracture: A Technical Note

by Masaya Akashi, Kousuke Matsumoto, Daisuke Takeda, Junya Yamashita, Nanae Yatagai, Kazunobu Hashikawa and Takahide Komori

Dent. J. 2019, 7(3), 65; https://doi.org/10.3390/dj7030065 - 29 June 2019

Abstract

Dental rehabilitation with osseointegrated implants in reconstructed mandibles is a common procedure, but the technique still requires improvement, especially in its reliability and technical simplification. We herein report dental rehabilitation of a free fibula-reconstructed mandible with scar contracture. A vestibuloplasty technique with application of a polyglycolic acid (PGA) sheet is described. The implants were inserted into a viable fibula flap with severe scar contracture of the overlying epithelium resulting from vascular instability in skin paddle. Only the fibula periosteum was sutured after implant insertion; exposed surfaces were covered with a combination of PGA sheet and fibrin sealant. The area with PGA sheet coverage gradually healed with moderate contracture. The epithelium around the almost implants became immobilized. The implant-supported removable partial denture with custom titanium bar was acceptable. Dental rehabilitation is possible for reconstructed mandibles with severe scar contracture. Application of a PGA sheet may be useful for vestibuloplasty in patients with reconstructed mandibles. Full article

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Open AccessArticle

Impact of Different Irrigant Agitation Methods on Bacterial Elimination from Infected Root Canals

by Wajih Hage, Roeland J. G. De Moor, Désirée Hajj, Germain Sfeir, Dolla K. Sarkis and Carla Zogheib

Dent. J. 2019, 7(3), 64; https://doi.org/10.3390/dj7030064 - 27 June 2019

Abstract

Activation techniques are essential for root canal disinfection but may result in incomplete removal of bacteria. The aim of our study was to assess the antibacterial action of sonically, ultrasonically and laser-activated irrigation and 5.25% sodium hypochlorite (NaOCl) on Enterococcus faecalis in an infected tooth. Forty-four extracted mandibular premolars were mechanically prepared, sterilized, and inoculated with E. faecalis for 1 week. Bacterial counts after inoculation were evaluated in 4 randomly chosen teeth, remaining root canals were divided into 4 groups. Group A: laser-activated irrigation by photon-induced photoacoustic streaming, Group B: the sonic irrigation by EDDY, Group C: ultrasonic irrigation by EndoUltra, and Group D: 5.25% NaOCl. Colony forming unit (CFU) counts were measured and Kolmogorov–Smirnov, Wilcoxon, Kruskal–Wallis and Mann–Whitney tests were used to determine differences. The mean of CFU was found to significantly decrease in group D, 2110 ± 1015.93 (p < 0.001). Changes in measurement levels followed the same trend over time in groups A 27.40 ± 30.15, B 81.3 ± 85.68 and C 44.40 ± 67.12 (p = 0.141). The average CFU after irrigation in all groups was significantly greater than 0. Within the limitations of this study, all activation techniques were superior to NaOCl 5.25% in reducing E. faecalis from the infected tooth model. Full article

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Open AccessCase Report

Uprighting an Impacted Permanent Mandibular First Molar Associated with a Dentigerous Cyst and a Missing Second Mandibular Molar—A Case Report

by Konstantina Tsironi, Emmanouil Inglezos, Emmanouil Vardas and Anastasia Mitsea

Dent. J. 2019, 7(3), 63; https://doi.org/10.3390/dj7030063 - 27 June 2019

Abstract

The purpose of this paper is to present a case of an impacted mandibular first molar associated with a dentigerous cyst and a missing mandibular second molar in an 11-year-old girl that was treated with combined surgical and orthodontic procedures. After clinical and radiographic evaluation, marsupialization of the cyst was decided, and a molar attachment was bonded on the buccal side of the impacted molar as a part of a full orthodontic treatment with fixed appliances. After 18 months of orthodontic traction, the molar was moved to a more advantageous position, and new bone apposition was observed on the site of the cystic lesion. Histological examination confirmed a dentigerous cyst. The molar was left to erupt spontaneously for 14 more months. A functional occlusion was finally achieved. An interdisciplinary approach proved to be an effective modality in treating a large dentigerous cyst associated with a deeply impacted first mandibular molar, presenting many advantages, such as new bone apposition and patient comfort. Full article

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Open AccessCommentary

Delivering Mobile Dentistry to the Geriatric Population—The Future of Dentistry

by Jim Chung

Dent. J. 2019, 7(2), 62; https://doi.org/10.3390/dj7020062 - 4 June 2019

Abstract

The human population throughout the world is aging rapidly, and will require the adoption of new modes of dental practice to address the special needs of this demographic. These are some of the reflections of my decade of providing mobile dentistry to geriatric [...] Read more.

Open AccessArticle

Spectrophotometric Determination of the Aggregation Activity of Platelets in Platelet-Rich Plasma for Better Quality Control

by Tetsuhiro Tsujino, Kazushige Isobe, Hideo Kawabata, Hachidai Aizawa, Sadahiro Yamaguchi, Yutaka Kitamura, Hideo Masuki, Taisuke Watanabe, Hajime Okudera, Koh Nakata and Tomoyuki Kawase

Dent. J. 2019, 7(2), 61; https://doi.org/10.3390/dj7020061 - 3 June 2019

Abstract

Although platelet-rich plasma (PRP) is now widely used in regenerative medicine and dentistry, contradictory clinical outcomes have often been obtained. To minimize such differences and to obtain high quality evidence from clinical studies, the PRP preparation protocol needs to be standardized. In addition, emphasis must be placed on quality control. Following our previous spectrophotometric method of platelet counting, in this study, another simple and convenient spectrophotometric method to determine platelet aggregation activity has been developed. Citrated blood samples were collected from healthy donors and used. After centrifugation twice, platelets were suspended in phosphate buffered saline (PBS) and adenosine diphosphate (ADP)-induced aggregation was determined using a spectrophotometer at 615 nm. For validation, platelets pretreated with aspirin, an antiplatelet agent, or hydrogen peroxide (H₂O₂), an oxidative stress-inducing agent, were also analyzed. Optimal platelet concentration, assay buffer solution, and representative time point for determination of aggregation were found to be 50–100 × 10⁴/μL, PBS, and 3 min after stimulation, respectively. Suppressed or injured platelets showed a significantly lower aggregation response to ADP. Therefore, it suggests that this spectrophotometric method may be useful in quick chair-side evaluation of individual PRP quality. Full article

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Open AccessArticle

Anorexia, Oral Health and Antioxidant Salivary System: A Clinical Study on Adult Female Subjects

by Marco Mascitti, Erminia Coccia, Arianna Vignini, Luca Aquilanti, Andrea Santarelli, Eleonora Salvolini, Jacopo Sabbatinelli, Laura Mazzanti, Maurizio Procaccini and Giorgio Rappelli

Dent. J. 2019, 7(2), 60; https://doi.org/10.3390/dj7020060 - 1 June 2019

Abstract

The aim of this study was to compare the oral health status and salivary antioxidant system between patients diagnosed with anorexia nervosa (AN) and healthy controls. A total of 25 female AN patients and 25 matched healthy controls were enrolled. Clinical parameters and saliva samples were collected for each patient. Two questionnaires to investigate oral health and hygiene were administered. Superoxide Dismutase (SOD) activity and High Reactive Oxygen Species (hROS) were evaluated. Salivary concentration of SOD was significantly higher in subjects with AN compared with control group (1.010 ± 0.462 vs. 0.579 ± 0.296 U/mL; p = 0.0003). No significant differences between groups were identified for hROS (233.72 ± 88.27 vs. 199.49 ± 74.72; p = 0.15). Data from questionnaires indicated that, although most of the patients recognized the oral hygiene importance in maintaining a good oral health, more than half of them had poor oral hygiene. Altered biochemical composition of saliva in patients with AN could be interpreted as an effective defence mechanism against oxidative stress. Moreover, despite the discrepancy between clinical findings and perception of the oral health in AN population arose, the quality of life of these patients appears not to be significantly affected by their dental condition. Full article

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Open AccessCommunication

Salivary Cortisol Levels in Patients with Oral Lichen Planus—A Pilot Case-Control Study

by Ivana Skrinjar, Valentina Vidranski, Bozana Loncar Brzak, Danica Vidovic Juras, Ana Andabak Rogulj, Vlaho Brailo and Vanja Vucicevic Boras

Dent. J. 2019, 7(2), 59; https://doi.org/10.3390/dj7020059 - 1 June 2019

Abstract

It is known that cortisol level increases in stress situations. The aim of the study was to measure the levels of salivary cortisol in patients with oral lichen planus (OLP) and healthy controls. This was a case-control pilot study which included seven patients with reticular (non-symptomatic) OLP, eight patients with atrophic/erosive (symptomatic) OLP, and nine healthy controls. We hypothesized that patients with an atrophic/erosive type of OLP have higher levels of cortisol compared to patients with the reticular type of OLP and healthy controls. In each participant, unstimulated saliva was collected in order to determine cortisol levels by using commercially available ELISA kit. Our results have shown no differences between levels of salivary cortisol in OLP patients and healthy controls. We can conclude that further research with a larger number of OLP patients is needed to determine the correlation between OLP and stress. Full article

Open AccessArticle

Effect of Dietary Fiber on the Composition of the Murine Dental Microbiome

by Lea Sedghi, Craig Byron, Ryan Jennings, George E. Chlipala, Stefan J. Green and Laura Silo-Suh

Dent. J. 2019, 7(2), 58; https://doi.org/10.3390/dj7020058 - 1 June 2019

Abstract

The oral cavity houses a diverse consortium of microorganisms, heavily influenced by host diet, that can mediate dental health and disease. While the impact of dietary carbohydrates to the dental microbiome has been well-documented, the effect of fiber as a mechanical influence on the dental microbiome is unexplored. We performed 16S rRNA gene analysis to investigate the response of the dental microbiome to the presence of increased fiber in terms of microbial taxonomic abundance and diversity. Dental microbial community structure was significantly different in mice fed a diet supplemented with increased fiber and/or sugar. Fiber significantly affected measures of beta diversity at the phylum and genus levels, and a strong interactive effect on alpha diversity was observed between sugar and fiber at the phylum level. The addition of fiber also induced significant variation in relative taxonomic abundance. This study demonstrates that fiber can promote significant variations in the mouse dental microbiome. Full article

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Open AccessReview

Role of Cone-Beam Computed Tomography in the Management of Periodontal Disease

by V. Thomas Eshraghi, Kyle A. Malloy and Mehrnaz Tahmasbi

Dent. J. 2019, 7(2), 57; https://doi.org/10.3390/dj7020057 - 1 June 2019

Abstract

The goal of this paper was to review the current literature surrounding the use of cone beam computed tomography (CBCT) related to the diagnosis, prognostic determination, and treatment of periodontal diseases. A literature review was completed to identify peer-reviewed articles related to CBCT and periodontics. The results were filtered to pool only articles specific to CBCT and periodontal diagnosis, prognosis, and treatment/outcomes. The articles were reviewed and findings summarized. Author’s commentary on technological advances and additional potential uses of CBCT in the field of periodontics were included. There is evidence to suggest that CBCT imaging can be more accurate in diagnosing specific periodontal defects (intrabony and furcation defects), and therefore be helpful in the prognostic determination and treatment planning. However, at this time, CBCT cannot be recommended as the standard of care. It is up to the individual clinician to use one’s own judgment as to when the additional information provided by CBCT may be beneficial, while applying the As Low As Reasonably Achievable (ALARA) principle. With continued technological advances in CBCT imaging (higher resolution, reduced imaging artifacts, lower exposure, etc.) the author’s believe that CBCT usage will become more prominent in diagnosis and treatment of periodontal diseases. Full article

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Open AccessReview

An Overview of Different Interdental Cleaning Aids and Their Effectiveness

by Ethan Ng and Lum Peng Lim

Dent. J. 2019, 7(2), 56; https://doi.org/10.3390/dj7020056 - 1 June 2019

Abstract

Optimisation of plaque control is essential for the success of non-surgical and surgical periodontal therapy. This cannot be achieved with brushing alone; hence, there is a need for adjunctive interdental cleaning aids. The aim of this paper is to provide an overview of different interdental cleaning aids and review the literature for consensus on their effectiveness. A literature search of articles in English, up to December 2018, was conducted in Pubmed. High-quality flossing is difficult to achieve, and ineffective routine use of floss may not confer significant benefits over brushing alone. Interdental brushes are more effective than brushing as a monotherapy. They are at least as good if not superior to floss in reducing plaque and gingivitis. Although they are effective for patients regardless of their periodontal status (healthy or active), they are especially indicated in periodontal patients where widened embrasures are common. Added benefits include ease of use, patient acceptance, and recontouring of interdental tissues. Rubberpiks do not demonstrate inferiority to conventional interdental brushes. Wooden interdental aids appear to offer no significant advantage over brushing with respect to plaque removal; they may, however, reduce gingival bleeding. Oral irrigators are a promising tool for reducing gingival inflammation, despite minimal changes to plaque levels. For cleaning around dental implants, oral irrigators and interdental brushes are preferred over floss. Full article

Open AccessCase Report

Idiopathic Exposed Bone Lesions of the Jaw

by Božana Lončar Brzak, Vanja Vučičević Boras, Ana Kotarac Knežević, Mato Sušić, Sven Seiwerth and Dragana Gabrić

Dent. J. 2019, 7(2), 55; https://doi.org/10.3390/dj7020055 - 1 June 2019

Abstract

Introduction: Osteonecrosis of the jaw is defined as exposed bone in the oral cavity that does not heal longer than eight weeks after identification. The two most common predisposing factors for osteonecrosis of the jaw are medication-related and radiotherapy. Rarely, exposed bone in the maxillofacial region can occur due to other causes and represents a clinical and therapeutic challenge for the dentist because there is no universally accepted treatment protocol. Case presentation: We report a case of a patient with two idiopathic lesions of exposed bone which have healed after systemic antibiotic therapy, seven weeks after the first examination. Conclusion: Exposed bone lesions of the jaw are a rare entity and are poorly documented in the literature. It is necessary to exclude possible local or systemic contributing factors. Surgical and conservative therapy (antibiotics) are the treatment of choice. Full article

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