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Oral and Dental Health

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Oral Health".

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 131790

Special Issue Editors

Dr. Giuseppe Lo Giudice

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Guest Editor
Department of Oral and Maxillo-Facial Science, “Sapienza”-University of Rome, 00100 Rome, Italy
Interests: dentistry; oral pathology; restorative dentistry; oral rehabilitation; epidemiology; minimally invasive surgery
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Giuseppe Colella

E-Mail Website
Guest Editor
Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
Interests: oral oncology; head and neck surgery; oral carcinogenesis; salivary glands surgery; parotid gland surgery; oral potentially malignant disorders
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Oral and dental health plays a very important role in the organism’s general balance: caries, periodontal pathology, TMJ disorders, mucosa lesions, and maxillofacial pathologies may lead to systemic diseases. Prevention, early diagnosis, accurate treatment planning, and dental material biocompatibility represent the key points in the management of the pathologies of the dental, oral, and facial system.

The prevalence of dental and oral pathologies in the world population is very high, and WHO (resolution WHA 53.17) highlights the importance of prevention and control.

Research on oral and maxillofacial diseases allows improving individual and public health increases average life expectancy.

The aim of this Special Issue is the analysis of risk factors linked to lifestyle, minimal invasive therapies, and the use of biocompatible, green materials and techniques.

It would be good to create a platform for researchers and university groups to share their experiences and original, clinical, and review studies in these fields.

Dr. Giuseppe Lo Giudice
Dr. Giuseppe Colella
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • restorative dentistry
  • oral rehabilitation
  • epidemiology
  • minimally invasive surgery
  • temporomandibular disorders
  • oral pathology
  • prevention
  • green dental materials

Published Papers (35 papers)

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13 pages, 1623 KiB  
Article
How Dentists Face the COVID-19 in Mexico: A Nationwide Cross-Sectional Study
by Miguel Ángel Casillas Santana, Alan Martínez Zumarán, Nuria Patiño Marín, Brenda Eréndida Castillo Silva, Carolina Sámano Valencia and Marco Felipe Salas Orozco
Int. J. Environ. Res. Public Health 2021, 18(4), 1750; https://doi.org/10.3390/ijerph18041750 - 11 Feb 2021
Cited by 9 | Viewed by 4456
Abstract
Background: on 7 January 2020, a new type of coronavirus was isolated, the Severe Acute Respiratory Syndrome Coronavirus2 (SARS-CoV-2), the organism causing the outbreak that has affected the lives of all humans and has modified the rules of coexistence around the world. [...] Read more.
Background: on 7 January 2020, a new type of coronavirus was isolated, the Severe Acute Respiratory Syndrome Coronavirus2 (SARS-CoV-2), the organism causing the outbreak that has affected the lives of all humans and has modified the rules of coexistence around the world. In Mexico, from 3 January 2020 to 9 January 2021, there have been 1439, 569 confirmed cases of COVID-19 with 131,031 deaths. The World Health Organization reported that Mexico was ranked twelfth, in terms of confirmed cases of COVID-19 by country. Aim: the objective of this study was to determine what modifications dentists from the Mexican Republic have made to their dental practice during theCOVID-19 pandemic. Methods: the study was conducted based on a questionnaire to evaluate the dentists’ response and knowledge on the modifications in their dental practice to combat the new coronavirus’s cross-transmission. The questionnaire was piloted before it was distributed. The questionnaire was disseminated through the social network Facebook. The questionnaire was distributed to groups of dentists on Facebook, in each of the Mexican Republic states. The survey was carried out during June 2020. Results and Conclusions: from the 32 states of the Mexican Republic, 29 participated with at least one respondent. The results of the applied survey suggest that dentists, at least the population of surveyed ones, have proper knowledge of detection methods of patients suspected of COVID-19, preventive measures that must be applied in the dental office to decrease the risk of infection, and the appropriate procedures and solutions for dental office disinfection. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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14 pages, 3199 KiB  
Article
Investigation of Changes in Saliva in Radiotherapy-Induced Head Neck Cancer Patients
by Christina Winter, Roman Keimel, Markus Gugatschka, Dagmar Kolb, Gerd Leitinger and Eva Roblegg
Int. J. Environ. Res. Public Health 2021, 18(4), 1629; https://doi.org/10.3390/ijerph18041629 - 9 Feb 2021
Cited by 16 | Viewed by 3155
Abstract
The intact function of the salivary glands is of utmost importance for oral health. During radiotherapy in patients with head and neck tumors, the salivary glands can be damaged, causing the composition of saliva to change. This leads to xerostomia, which is a [...] Read more.
The intact function of the salivary glands is of utmost importance for oral health. During radiotherapy in patients with head and neck tumors, the salivary glands can be damaged, causing the composition of saliva to change. This leads to xerostomia, which is a primary contributor to oral mucositis. Medications used for protective or palliative treatment often show poor efficacy as radiation-induced changes in the physico-chemical properties of saliva are not well understood. To improve treatment options, this study aimed to carefully examine unstimulated whole saliva of patients receiving radiation therapy and compare it with healthy unstimulated whole saliva. To this end, the pH, osmolality, electrical conductivity, buffer capacity, the whole protein and mucin concentrations, and the viscoelastic and adhesive properties were investigated. Moreover, hyaluronic acid was examined as a potential candidate for a saliva replacement fluid. The results showed that the pH of radiation-induced saliva shifted from neutral to acidic, the osmolality increased and the viscoelastic properties changed due to a disruption of the mucin network and a change in water secretion from the salivary glands. By adopting an aqueous 0.25% hyaluronic acid formulation regarding the lost properties, similar adhesion characteristics as in healthy, unstimulated saliva could be achieved. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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13 pages, 1932 KiB  
Article
Salivary Metalloproteinase-8 and Metalloproteinase-9 Evaluation in Patients Undergoing Fixed Orthodontic Treatment before and after Periodontal Therapy
by Ioana-Andreea Sioustis, Maria-Alexandra Martu, Liana Aminov, Mariana Pavel, Petru Cianga, Diana Cristala Kappenberg-Nitescu, Ionut Luchian, Sorina Mihaela Solomon and Silvia Martu
Int. J. Environ. Res. Public Health 2021, 18(4), 1583; https://doi.org/10.3390/ijerph18041583 - 8 Feb 2021
Cited by 15 | Viewed by 2720
Abstract
(1) Background: Metalloproteinase-8 (MMP-8) and metalloproteinase-9 (MMP-9) are members of a family of proteases of major importance during orthodontic tooth movement. Their levels increase during orthodontic therapy and in periodontally affected tissues. Orthodontic fixed appliances retain dental plaque and can cause gingival inflammation. [...] Read more.
(1) Background: Metalloproteinase-8 (MMP-8) and metalloproteinase-9 (MMP-9) are members of a family of proteases of major importance during orthodontic tooth movement. Their levels increase during orthodontic therapy and in periodontally affected tissues. Orthodontic fixed appliances retain dental plaque and can cause gingival inflammation. When gingival inflammation is present, the forces produced during orthodontic tooth movement can aggravate tissue reaction and cause the destruction of supportive periodontal tissue. This study aimed to identify biomarkers that facilitate the assessment of periodontal status during orthodontic treatment. (2) Methods: Our study was conducted on 111 patients who were about to receive fixed orthodontic treatment. We determined the salivary levels of MMP-8 and MMP-9 and bleeding on probing (BOP) before applying the orthodontic fixed appliance (T1), one week after appliance placement (T2), and during orthodontic treatment, one month after non-surgical periodontal treatment (T3). (3) Results: Patients undergoing orthodontic treatment show a significant increase in BOP, MMP-8, and MMP-9 levels one week after orthodontic appliance placement (T2) and a decrease in these parameters one month after periodontal treatment (T3). Statistically significant correlations were found between MMP-8 levels and BOP values at T1, T2, and T3. (4) Conclusion: In our study patients undergoing orthodontic treatment show a significant increase in BOP, MMP-8, and MMP-9 levels one week after orthodontic appliance placement and a decrease in these parameters one month after periodontal treatment. Strong positive statistically significant correlations were found between MMP-8 levels and BOP and medium positive statistically significant correlations between MMP-9 and BOP values before and after orthodontic treatment and periodontal treatment. MMP-8, MMP-9, and BOP could be used to assess the periodontal status of orthodontic patients. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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10 pages, 473 KiB  
Article
Effects of Oral Probiotics on Subjective Halitosis, Oral Health, and Psychosocial Health of College Students: A Randomized, Double-Blind, Placebo-Controlled Study
by Dong-Suk Lee, Myoungsuk Kim, Seoul-Hee Nam, Mi-Sun Kang and Seung-Ah Lee
Int. J. Environ. Res. Public Health 2021, 18(3), 1143; https://doi.org/10.3390/ijerph18031143 - 28 Jan 2021
Cited by 15 | Viewed by 3906
Abstract
Altogether, 81% of Korean college students experience halitosis and concomitant psychosocial problems such as depression and lowered self-esteem, as well as poor oral-health-related quality of life. Although halitosis causes many social and psychological problems among college students, there have been no reports of [...] Read more.
Altogether, 81% of Korean college students experience halitosis and concomitant psychosocial problems such as depression and lowered self-esteem, as well as poor oral-health-related quality of life. Although halitosis causes many social and psychological problems among college students, there have been no reports of improvement interventions. This study aimed to identify the effects of ingesting tablets of the oral probiotic Weissella cibaria CMU (Chonnam Medical University, Gwangju, Korea) on halitosis and examine its effects on psychosocial indicators. This was a randomized, double-blind, placebo-controlled trial. The participants were randomly assigned to the experimental group or the control group. They ingested W. cibaria CMU or the placebo, depending on which group they belonged to, before going to bed daily for eight weeks. The measured indicators were subjective halitosis, subjective oral-health status, depression, self-esteem, and oral-health-related quality of life. Measurements were at baseline and eight weeks later. The participants showed statistically significant differences in subjective halitosis and oral-health-related quality of life. For college students with halitosis, intake of the oral probiotic for eight weeks could be a useful nursing intervention for reducing halitosis and improving oral-health-related quality of life. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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14 pages, 635 KiB  
Article
Toothpastes with Enzymes Support Gum Health and Reduce Plaque Formation
by Pune N. Paqué, Patrick R. Schmidlin, Daniel B. Wiedemeier, Florian J. Wegehaupt, Phoebe D. Burrer, Philipp Körner, Shengjile Deari, Michel-Angelo Sciotti and Thomas Attin
Int. J. Environ. Res. Public Health 2021, 18(2), 835; https://doi.org/10.3390/ijerph18020835 - 19 Jan 2021
Cited by 3 | Viewed by 3634
Abstract
Enzymes in toothpastes can support host immune responses, and thus maintain oral health. This study aimed to investigate gingival health and the plaque-reducing effects of enzyme-containing toothpastes. A laboratory study tested the antimicrobial potential of different enzyme-containing toothpaste formulations. Two promising formulations (enzyme-containing [...] Read more.
Enzymes in toothpastes can support host immune responses, and thus maintain oral health. This study aimed to investigate gingival health and the plaque-reducing effects of enzyme-containing toothpastes. A laboratory study tested the antimicrobial potential of different enzyme-containing toothpaste formulations. Two promising formulations (enzyme-containing toothpastes with glucose oxidase and D-glucose with (C+) and without Citrox (C−) Citrox) were investigated in a clinical crossover trial (two slurries: sodium lauryl sulfate-containing (SLS), a toothpaste without SLS (reference), and water). Subjects (n = 20) abstained from toothbrushing for four days and rinsed with a toothpaste slurry. Bleeding on probing (BOP) and plaque indices (PI) were measured. A mixed linear model was used to statistically compare the slurries with respect to BOP and PI change. The in vitro bacterial growth-inhibiting evaluation showed the best results for SLS, followed by C+ and C−. The change in BOP and PI exhibited statistically significant differences to water rinsing (BOP; PI changes in % points (difference of the baseline and post-rinse values: water = 8.8%; 90.0%; C+ = −1.4%; 80.4%; SLS = 1.5%; 72.1%; reference = 0.8%; 77.5%; C− = −1.8%; 75.1%). All slurries exhibited anti-gingivitis and anti-plaque effects, resulting in a prophylactic benefit for limited-access regions during brushing. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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11 pages, 353 KiB  
Article
Associations between Pharmacotherapy for Cardiovascular Diseases and Periodontitis
by Ewa Pająk-Łysek, Maciej Polak, Grzegorz Kopeć, Mateusz Podolec, Moïse Desvarieux, Andrzej Pająk and Joanna Zarzecka
Int. J. Environ. Res. Public Health 2021, 18(2), 770; https://doi.org/10.3390/ijerph18020770 - 18 Jan 2021
Cited by 4 | Viewed by 2637
Abstract
The goal of the study was to assess the relationship between cardioprotective medications, i.e., beta-blockers, angiotensin-converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), angiotensin II receptor blockers (ARBs), statins, acetylsalicylic acid (ASA), and periodontitis (PD). Background: Xerostomia increases the risk of PD and [...] Read more.
The goal of the study was to assess the relationship between cardioprotective medications, i.e., beta-blockers, angiotensin-converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), angiotensin II receptor blockers (ARBs), statins, acetylsalicylic acid (ASA), and periodontitis (PD). Background: Xerostomia increases the risk of PD and is a side effect of some pharmacotherapies. Information about the effect of cardioprotective treatment of periodontal status is scarce. Methods: We studied 562 dentate residents of Krakow at the age of 50 to 70 years. Information about treatment was collected using a standardized questionnaire. The pocket depth and clinical attachment level (CAL) were used to ascertain PD. Multivariate logistic regression was applied to assess the relation between cardioprotective medications and PD. Results: PD was found in 74% of participants. The range of cardioprotective drug use among participants was 7% (ARBs) to 32% (beta-blockers). After adjusting for age, sex, number of teeth, smoking, and education, ASA’s use was related to a lower prevalence of PD in all dentate participants (odds ratio (OR) = 0.63, 95% confidence interval (CI): 0.40–0.99). The use of ARBs and statins was found to be associated with a higher prevalence of PD in persons having ≥6 teeth (odds ratio (OR) = 3.57, 95% CI: 1.06–11.99 and OR = 1.81, 95% CI: 1.03–3.16, respectively). Further adjustment for CVD risk factors, history of coronary heart disease, and other chronic diseases did not attenuate the results. There was no significant relation between PD and the use of other cardioprotective drugs. Full article
(This article belongs to the Special Issue Oral and Dental Health)
13 pages, 1841 KiB  
Article
The Impact of Using Kinesio Tape on Non-Infectious Complications after Impacted Mandibular Third Molar Surgery
by Aleksandra Jaroń, Olga Preuss, Elżbieta Grzywacz and Grzegorz Trybek
Int. J. Environ. Res. Public Health 2021, 18(2), 399; https://doi.org/10.3390/ijerph18020399 - 6 Jan 2021
Cited by 20 | Viewed by 4202
Abstract
Non-infectious complications such as post-extraction pain, trismus, and swelling are extremely common after impacted wisdom tooth removal. The aim of the study was to assess the impact of using kinesio tape on the level of the postoperative swelling of soft tissues, trismus, and [...] Read more.
Non-infectious complications such as post-extraction pain, trismus, and swelling are extremely common after impacted wisdom tooth removal. The aim of the study was to assess the impact of using kinesio tape on the level of the postoperative swelling of soft tissues, trismus, and pain in patients undergoing the surgical extraction of an impacted mandibular third molar. One hundred patients undergoing the surgical extraction of a lower wisdom tooth were randomly divided into two groups: a study group with kinesio taping (KT) (n = 50) and a control group without kinesio taping (NKT) (n = 50). The surgical procedure was performed according to the same repeatable scheme. Kinesio tape was applied immediately after surgery in the KT group. In both groups, measurements of swelling, trismus, and pain were performed before the surgery and on the third and seventh postprocedural days. Kinesio tape had a significant effect on the decrease in facial swelling on the third day after surgery and a decrease in trismus and pain severity levels on the third and seventh days after surgery. The kinesio tape method is non-invasive, continuously active throughout the entire application period, and requires no additional patient appointments. KT application is an effective method for reducing postoperative edema, pain, and trismus after impacted mandibular wisdom teeth surgery. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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9 pages, 822 KiB  
Article
The Effect of Regime Oral-Hygiene Intervention on the Incidence of New White Spot Lesions in Teenagers Treated with Fixed Orthodontic Appliances
by Urszula Kozak, Anna Sękowska and Renata Chałas
Int. J. Environ. Res. Public Health 2020, 17(24), 9460; https://doi.org/10.3390/ijerph17249460 - 17 Dec 2020
Cited by 12 | Viewed by 2175
Abstract
The present study aimed to evaluate the effect of the oral-hygiene regime on the incidence of enamel demineralization in young patients treated with fixed appliances. Research was conducted in a group of 144 patients aged 12–18 years, divided into 2 groups: orthodontically treated [...] Read more.
The present study aimed to evaluate the effect of the oral-hygiene regime on the incidence of enamel demineralization in young patients treated with fixed appliances. Research was conducted in a group of 144 patients aged 12–18 years, divided into 2 groups: orthodontically treated and control. The study was divided into three stages: before treatment (I), at 1 month (II), and at 6 months (III) for their follow-up. The International Caries Detection and Assessment System (ICDAS) was used for the visual assessment of white spot lesions (WSL). After 1 month, no new white spot lesions were observed. After 6 months of the treatment, new lesions were observed in 5% of the orthodontically treated patients and in 6% of the patients in the control group. New decalcifications were located on the proximal surfaces of the central incisors, first premolars, and first molars in the orthodontically treated group; and on the lateral incisors, first premolars, and first molars in the control group. We also observed new enamel demineralization on the vestibular surfaces of the canine and first premolar in the study group. The placement of a fixed appliance did not significantly affect teeth with the presence of new white spot lesions compared to the control group during 6 months of observation. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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20 pages, 5132 KiB  
Article
Assessment of Peri-Implant Soft Tissues Conditions around Short and Ultra-Short Implant-Supported Single Crowns: A 3-Year Retrospective Study on Periodontally Healthy Patients and Patients with a History of Periodontal Disease
by Giorgio Lombardo, Annarita Signoriello, Mauro Marincola and Pier Francesco Nocini
Int. J. Environ. Res. Public Health 2020, 17(24), 9354; https://doi.org/10.3390/ijerph17249354 - 14 Dec 2020
Cited by 10 | Viewed by 2956
Abstract
The aim of this retrospective study was to evaluate implant survival, marginal bone loss and peri-implant complications in 326 short and ultra-short implants. Implants were placed in the maxillary and mandibular posterior regions of 140 patients with (PP) and without (NPP) a history [...] Read more.
The aim of this retrospective study was to evaluate implant survival, marginal bone loss and peri-implant complications in 326 short and ultra-short implants. Implants were placed in the maxillary and mandibular posterior regions of 140 patients with (PP) and without (NPP) a history of periodontal disease. Clinical and radiographic examinations were performed at 3-year recall appointments. The 8.0, 6.0 and 5.0 mm-length implants placed in PP and NPP were respectively 43.75% and 38.46%, 35.10% and 34.19%, 21.15% and 27.35%; 325 implants (one early failure) were rehabilitated with single crowns in 139 patients. Overall implant survival after 3 years of follow-up was 97.55%, 98.08% and 96.61% for PP and NPP (p = 0.46). Crestal bone level variations were not statistically different among PP and NPP; 15.41% of implants presented signs of mucositis, 14.71% and 16.67% in PP and NPP (p = 0.64). Setting the threshold for bone loss at 2 mm after 36 months, peri-implantitis prevalence was 2.2%, 1.96% and 2.63% in PP and NPP (p = 0.7). Overall implant success was 82.39%, 83.33% and 80.7% for PP and NPP (p = 0.55). Short-term outcomes suggest that short and ultra-short locking-taper implants can successfully be restored with single crowns in the posterior jaws both in PP and NPP. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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20 pages, 863 KiB  
Article
Factorial Validity and Variance of the Maslach Burnout Inventory between Demographic and Workload Groups among Dentists of Lithuania
by Eglė Slabšinskienė, Andrej Gorelik, Ingrida Vasiliauskienė, Aistė Kavaliauskienė and Apolinaras Zaborskis
Int. J. Environ. Res. Public Health 2020, 17(24), 9154; https://doi.org/10.3390/ijerph17249154 - 8 Dec 2020
Cited by 9 | Viewed by 2429
Abstract
There is a lack of evidence about burnout syndrome among Lithuanian dentists; as a reliable instrument to examine the syndrome in this professional group has not yet been tested. The study aimed to investigate the performance of the items and the subscales of [...] Read more.
There is a lack of evidence about burnout syndrome among Lithuanian dentists; as a reliable instrument to examine the syndrome in this professional group has not yet been tested. The study aimed to investigate the performance of the items and the subscales of the Maslach burnout inventory (MBI) by validating its factorial structure and analyzing its variance between demographic and workload groups of dental professionals in Lithuania. The survey was conducted among practicing dentists online or during the scientific conferences for dentists using an anonymous questionnaire. To evaluate the level of burnout the MBI was chosen. Reports of a total of 380 respondents were examined. Three-factor structure of the MBI with cross-loading of two items suggested a good fit to data (χ2/df = 1.67; CFI = 0.93; TLI = 0.93; IFI = 0.93; and RMSEA = 0.059) and was invariant across demographic and workload groups of dentists. Multigroup factorial analysis revealed that females as compared to males had higher average emotional exhaustion; and the respondents up to 30 years as compared to respondents over 30 years of age had higher averages of the emotional exhaustion and depersonalization components. Highly specialized dentists (oral surgeons, prosthodontists, orthodontists, endodontists and poedodontists) were particularly less prone to burnout syndrome than dentists of general practice. It was concluded that the MBI offers factorial validity and demonstrates its invariant structure and variance of burnout dimensions across demographic and workload groups. These findings are informative for burnout prevention and intervention programs among dentists in Lithuania. Such information may contribute to lessen professional burnout among dentists in Lithuania. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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9 pages, 436 KiB  
Article
Can Desensitizing Toothpastes Also Have an Effect on Gingival Inflammation? A Double-Blind, Three-Treatment Crossover Clinical Trial
by Riccardo Monterubbianesi, Scilla Sparabombe, Vincenzo Tosco, Fabia Profili, Marco Mascitti, Andrell Hosein, Angelo Putignano and Giovanna Orsini
Int. J. Environ. Res. Public Health 2020, 17(23), 8927; https://doi.org/10.3390/ijerph17238927 - 1 Dec 2020
Cited by 7 | Viewed by 2136
Abstract
Background: Many desensitizing toothpastes exist commercially; however, few clinical trials have investigated their anti-inflammatory effects. This study aimed to evaluate the anti-inflammatory effect and patient appreciation of two toothpastes containing desensitizing agents: (1) a zinc-carbonate-hydroxyapatite nanoparticle (CHA) and (2) a calcium sodium phosphosilicate [...] Read more.
Background: Many desensitizing toothpastes exist commercially; however, few clinical trials have investigated their anti-inflammatory effects. This study aimed to evaluate the anti-inflammatory effect and patient appreciation of two toothpastes containing desensitizing agents: (1) a zinc-carbonate-hydroxyapatite nanoparticle (CHA) and (2) a calcium sodium phosphosilicate bioactive glass (CSPS). Methods: CHA and CSPS were compared with an anti-inflammatory and antibacterial herbal based toothpaste (HB). The aims were accomplished by comparing the following outcomes: (1) the reduction in plaque and bleeding score (Full Mouth Plaque Score (FMPS) and Full Mouth Bleeding Score (FMBS), respectively); (2) the antibacterial activity (AbA) of the toothpaste by saliva samples; (3) the patient appreciation score (Visual Analogue Scale; VAS). Clinical parameters were assessed at baseline and 14 days post-treatment. Results: The final sample consisted of 25 subjects, aged between 20 and 58 years. Although no differences in FMPS were reported (p > 0.05), both desensitizing toothpastes showed an improvement in FMBS. CSPS and HB recorded more AbA compared to CHA (p < 0.05). Moreover, HB resulted in a higher VAS score than both desensitizing toothpastes (p < 0.05). Conclusion: In conclusion, only CSPS displayed a similar anti-inflammatory effect compared to HB. Despite the low VAS score, CSPS could be considered as a valid and effective toothpaste in subjects with both dentin hypersensitivity and inflamed gums, highlighting its utility in clinical practice. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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9 pages, 1181 KiB  
Article
Effect of Bioactive Glass-Based Root Canal Sealer on the Incidence of Postoperative Pain after Root Canal Obturation
by Ayako Washio, Hiroki Miura, Takahiko Morotomi, Miki Ichimaru-Suematsu, Hirotake Miyahara, Kaori Hanada-Miyahara, Shinji Yoshii, Kazumasa Murata, Nana Takakura, Eiichi Akao, Masataka Fujimoto, Atsushi Matsuyama and Chiaki Kitamura
Int. J. Environ. Res. Public Health 2020, 17(23), 8857; https://doi.org/10.3390/ijerph17238857 - 28 Nov 2020
Cited by 7 | Viewed by 2811
Abstract
The purpose of this study is to evaluate the effect of a bioactive glass-based root canal sealer, Nishika Canal Sealer BG (CS-BG), on the incidence of postoperative pain (PP) after root canal obturation (RCO). Eleven dentists performed pulpectomy or infected root canal treatments [...] Read more.
The purpose of this study is to evaluate the effect of a bioactive glass-based root canal sealer, Nishika Canal Sealer BG (CS-BG), on the incidence of postoperative pain (PP) after root canal obturation (RCO). Eleven dentists performed pulpectomy or infected root canal treatments for 555 teeth. During RCO, CS-BG was used. After RCO, the rate of PP and the factors affecting PP (pain during RCO and pain immediately after RCO) were analyzed. PP was observed in eight teeth (1.5%), and within 7 days after RCO, there were no teeth with pain. In these teeth with PP, there was a significant difference in the occurrence of pain during RCO, but not in the occurrence of pain immediately after RCO, when compared with pulpectomy and infected root canal treatment. These clinical results show that CS-BG has an excellent biocompatibility, and can suppress the distress of patients during RCO. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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13 pages, 1182 KiB  
Article
Analysis of Labial and Lingual Strength among Healthy Chinese Adults in Taiwan
by Shang-Jung Wu, Chun-Chieh Wang, Feng-Yu Lin, Kai-Yu Tseng and Yueh-Juen Hwu
Int. J. Environ. Res. Public Health 2020, 17(21), 7904; https://doi.org/10.3390/ijerph17217904 - 28 Oct 2020
Cited by 11 | Viewed by 1872
Abstract
This study collected 11 parameters regarding the labial and lingual strength for maximum isometric and swallowing tasks among 150 healthy Chinese adults in Taiwan. Measurements were performed using the Iowa Oral Performance Instrument (IOPI). All of the labial and lingual strength parameters were [...] Read more.
This study collected 11 parameters regarding the labial and lingual strength for maximum isometric and swallowing tasks among 150 healthy Chinese adults in Taiwan. Measurements were performed using the Iowa Oral Performance Instrument (IOPI). All of the labial and lingual strength parameters were measured three times. The maximal value of three trials represents the pressure of every parameter. The overall mean (±standard deviation) and maximum isometric pressures of the lips, anterior tongue, and posterior tongue were 24.81 ± 5.64, 55.95 ± 14.13, and 53.23 ± 12.24 kPa, respectively. The mean value of posterior tongue strength was less than that of the anterior tongue by approximately 5%. The percentages of maximum isometric tongue pressure during the swallowing of saliva and water were 85% and 80% for the anterior tongue and 90% and 81% for the posterior tongue, respectively. The average endurances for the anterior tongue and posterior tongue were 13.86 ± 7.08 and 10.06 ± 5.40 s, respectively. The maximum isometric pressures were greater than both the saliva and water swallowing pressures, and the saliva swallowing pressures were greater than the water swallowing pressures. A value of 33 kPa in maximum isometric pressure could serve as a demarcation of weak tongue strength for healthy Chinese adults. As for the repeated trials of labial and lingual strength, there were no statistically significant differences for any of the pressures obtained from the 11 labial and lingual strength parameters. The normative data can be used for the objective assessment of labial and lingual strength in healthy Chinese adults. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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9 pages, 442 KiB  
Article
Association of Insufficient or Excess Sleep with Type 2 Diabetes Mellitus in the Presence of Periodontitis
by Se-Yeon Kim, Ji-Soo Kim, Min-Ji Byon, Hyun Kyung Kang and Jin-Bom Kim
Int. J. Environ. Res. Public Health 2020, 17(20), 7670; https://doi.org/10.3390/ijerph17207670 - 21 Oct 2020
Cited by 1 | Viewed by 1746
Abstract
We aimed to investigate the effects of sleep duration on impaired fasting glucose and diabetes in Korean adults with periodontal disease. This cross-sectional study was performed using data for 10,465 subjects aged >19 years who completed the periodontal examination and questionnaires in the [...] Read more.
We aimed to investigate the effects of sleep duration on impaired fasting glucose and diabetes in Korean adults with periodontal disease. This cross-sectional study was performed using data for 10,465 subjects aged >19 years who completed the periodontal examination and questionnaires in the Sixth Korea National Health and Nutrition Examination Survey (2013–2015). The effect of sleep was confirmed by a complex-sample multinomial logistic regression analysis. Confounding variables were age, sex, household income, education level, smoking status, and sleep duration. Of all participants, 25.7% had periodontitis, of which 28.6% had fasting serum glucose disorder and 14.2% had diabetes. Among participants with periodontitis, the prevalence of diabetes was 1.49 times higher in participants with an average sleep duration of ≥8 h than those with an average sleep duration of 6–7 h. The prevalence of diabetes among participants without periodontitis was 1.49 times and 1.57 times higher in participants with an average sleep duration of ≤5 and ≥8 h, respectively, than those with an average sleep duration of 6–7 h. We found that altered sleep duration may be a risk factor for diabetes and that proper sleep duration is important to control diabetes incidence. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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14 pages, 304 KiB  
Article
German Dentists’ Preferences for the Treatment of Apical Periodontitis: A Cross-Sectional Survey
by Jonas Conrad, Jan Retelsdorf, Sameh Attia, Christof Dörfer and Mohamed Mekhemar
Int. J. Environ. Res. Public Health 2020, 17(20), 7447; https://doi.org/10.3390/ijerph17207447 - 13 Oct 2020
Cited by 8 | Viewed by 2372
Abstract
Currently, there is no standard treatment protocol for apical periodontitis (AP). Thus, restorable teeth might get extracted and replaced prosthetically. This study evaluated German dentists’ preferred AP treatment decisions and the influencing factors for selecting tooth retention by initial/repeated surgical/non-surgical root-canal treatment (RCT) [...] Read more.
Currently, there is no standard treatment protocol for apical periodontitis (AP). Thus, restorable teeth might get extracted and replaced prosthetically. This study evaluated German dentists’ preferred AP treatment decisions and the influencing factors for selecting tooth retention by initial/repeated surgical/non-surgical root-canal treatment (RCT) or extraction with/without prosthetic replacement. Through an online-survey, participants (n = 260) rated different treatment options for four case scenarios with AP in anterior/posterior teeth without/with previous RCT. Statistical analysis included the Friedman test for intra-case comparisons and Chi-squared test for factor-associations (p ≤ 0.05). Tooth retention using initial/repeated RCT was ranked first in all scenarios and rated as (very) appropriate by most participants, while implant-supported crowns (ISC) and apicoectomy had the second ratings. ISC were preferred more on posterior teeth or previous root-canal-treated teeth. Rating levels of treatment options displayed significant differences for all case scenarios. Posterior tooth retention by RCT demonstrated a significant association with work experience. Tooth retention with previous RCT displayed a significant correlation with dentists’ privately insured patients. Most dentists preferred tooth preserving with initial/repeated RCT, while others selected non-evidence-based choices. This reflects a lack of consensus of AP treatment decisions in Germany. Fixed treatment guidelines and further evaluation of treatment–decision-correlated factors are recommended for correct treatment planning. Full article
(This article belongs to the Special Issue Oral and Dental Health)
9 pages, 578 KiB  
Article
Does the Clinical Form of Oral Lichen Planus (OLP) Influence the Oral Health–Related Quality of Life (OHRQoL)?
by Linda Daume, Constance Kreis, Lauren Bohner, Johannes Kleinheinz and Susanne Jung
Int. J. Environ. Res. Public Health 2020, 17(18), 6633; https://doi.org/10.3390/ijerph17186633 - 11 Sep 2020
Cited by 14 | Viewed by 5744
Abstract
(1) Background: The aim of the study was to investigate the oral health–related quality of life (OHRQoL) of patients with oral lichen planus (OLP) and to evaluate differences between the various clinical forms of OLP. Specifically, the differences in OHRQoL, physical pain levels [...] Read more.
(1) Background: The aim of the study was to investigate the oral health–related quality of life (OHRQoL) of patients with oral lichen planus (OLP) and to evaluate differences between the various clinical forms of OLP. Specifically, the differences in OHRQoL, physical pain levels and eating restriction were assessed; (2) Methods: One hundred and twelve patients with clinical and histological features of OLP from the Department of Cranio-Maxillofacial Surgery of the Münster University Hospital participated in this prospective study. OHRQoL was analysed by using the German short version of the Oral Health Impact Profile (OHIP-14). Physical pain levels and restriction in eating were rated on visual analogue scales (VAS). The statistical analysis was performed using the Mann–Whitney U-Test and the chi-squared test with a significance level at p = 0.05; (3) Results: Group 1 consisted of patients with reticular OLP (n = 50) and group 2 of patients with atrophic, erosive-ulcerative or bullous OLP (n = 62). The average OHIP-14 score was 13.54 points and differed significantly between the two groups. There were significant differences in the domains “physical pain”, “psychological discomfort”, “physical disability” and “social disability”. The VAS “physical pain” score and “restriction in eating” score varied significantly between the clinical forms. Positive correlations were found between the OHIP-14 total scores and the VAS scores; (4) Conclusion: The OHRQoL is significantly limited in patients with OLP; especially, patients with erosive-ulcerative OLP are affected. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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11 pages, 1636 KiB  
Article
Improvement of Periodontal Parameters with the Sole Use of Free Gingival Grafts in Orthodontic Patients: Correlation with Periodontal Indices. A 15-Month Clinical Study
by Marco Orsini, Dunia Benlloch, Juan José Aranda Macera, Karina Flores, José-Vicente Ríos-Santos, Francisco Javier Pedruelo, Blanca Ríos-Carrasco and Massimo di Cesare
Int. J. Environ. Res. Public Health 2020, 17(18), 6578; https://doi.org/10.3390/ijerph17186578 - 9 Sep 2020
Cited by 3 | Viewed by 2773
Abstract
The aim of this study was to evaluate the changes in periodontal parameters solely using free gingival grafts during orthodontic treatment without any oral hygiene re-enforcement. Methods: A total of 19 patients underwent periodontal examination before orthodontic treatment. Patients received oral hygiene instruction [...] Read more.
The aim of this study was to evaluate the changes in periodontal parameters solely using free gingival grafts during orthodontic treatment without any oral hygiene re-enforcement. Methods: A total of 19 patients underwent periodontal examination before orthodontic treatment. Patients received oral hygiene instruction and professional hygiene therapy. Where needed; full periodontal treatment was completed. Only periodontally stable patients were included in the study. Periodontal indices and keratinized tissue were recorded at time 0 (T0) (delivery of orthodontic appliances), and at three months (T1) during orthodontic therapy; when surgery was performed. At T1; orthodontically treated sites with minimum keratinized tissue (≤1 mm) received a free gingival graft to enhance the band of keratinized tissue. At three months after surgery (T2), new measurements were recorded. The orthodontics-treated sites after three months (T1) were used as control. The same sites were used as a test three months after mucogingival correction (T2). Between T1 and T2; orthodontics was suspended; no professional oral hygiene was performed; and no additional oral hygiene instructions were given to the patient. No oral hygiene procedures were administered for 15 months (T3), when the final recordings were taken. Results: The results showed that there was a worsening of gingival index (GI) and plaque index (PI) of the treated sites between T0 and T1 during initial orthodontics treatment; whereas there was an improvement of the gingival inflammation at T2 when compared with T1. At T2; there was also a statistically significant improvement in GI and PI compared with T0. A T3 improvement in periodontal parameters was sustained. A non-parametric test (Wilcoxon signed-rank test) was used for statistical analysis. Conclusions: Augmentation of the width of keratinized gingiva; as the sole treatment; favors the improvement of GI and PI during orthodontic therapy. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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11 pages, 459 KiB  
Article
Risk Factors for Tooth Loss in Patients Undergoing Mid-Long-Term Maintenance: A Retrospective Study
by Hiroo Kawahara, Miho Inoue, Kazuo Okura, Masamitsu Oshima and Yoshizo Matsuka
Int. J. Environ. Res. Public Health 2020, 17(17), 6258; https://doi.org/10.3390/ijerph17176258 - 27 Aug 2020
Cited by 9 | Viewed by 3546
Abstract
In this retrospective study, we identified risk factors for tooth loss in patients undergoing mid–long-term maintenance therapy. We surveyed 674 maintenance patients for ≥5 years after active treatment who visited a dental clinic between January 2015 and December 2016. Of these, 265 were [...] Read more.
In this retrospective study, we identified risk factors for tooth loss in patients undergoing mid–long-term maintenance therapy. We surveyed 674 maintenance patients for ≥5 years after active treatment who visited a dental clinic between January 2015 and December 2016. Of these, 265 were men (mean age 54.6 ± 8.0 years old) and 409 were women (mean age 54.0 ± 7.9 years old). Study variables included patient compliance, sex, number of teeth lost, cause of tooth loss (dental caries, periodontal disease, root fracture, others, vital or non-vital teeth), age at start of maintenance, number of remaining teeth at start of maintenance, smoking, use of salivary secretion inhibitors, presence of diabetes mellitus, condition of periodontal bone loss, and use of a removable denture. Most lost teeth were non-vital teeth (91.7% of all cases) and the most common cause of tooth loss was tooth fracture (62.1% of all cases). A statistically significant risk factors for tooth loss was number of remaining teeth at the start of maintenance (p = 0.003). Full article
(This article belongs to the Special Issue Oral and Dental Health)
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10 pages, 1481 KiB  
Article
Relationship between Unilateral Posterior Crossbite and Human Static Body Posture
by Jorge Zurita-Hernandez, Raul Ayuso-Montero, Meritxell Cuartero-Balana, Eva Willaert and Jordi Martinez-Gomis
Int. J. Environ. Res. Public Health 2020, 17(15), 5303; https://doi.org/10.3390/ijerph17155303 - 23 Jul 2020
Cited by 11 | Viewed by 3212
Abstract
Background: We compared photogrammetry-assessed body posture between young adults with and without unilateral posterior crossbite (UPCB). Assessments were controlled by vision, mandibular position and sitting/standing position. In addition, we aimed to determine the relationship between UPCB laterality and the direction of body posture [...] Read more.
Background: We compared photogrammetry-assessed body posture between young adults with and without unilateral posterior crossbite (UPCB). Assessments were controlled by vision, mandibular position and sitting/standing position. In addition, we aimed to determine the relationship between UPCB laterality and the direction of body posture using photogrammetry and a static postural platform. Methods: Adults with natural dentition, with and without UPCB, were enrolled. Static body posture was assessed by photogrammetry based on horizontal acromial alignment and horizontal anterior-superior iliac spine (ASIS) alignment. Frontal photographs were taken with participants asked to open or close their eyes and hold their jaws at rest, at an intercuspal position, and at left or right lateral positions. Distribution of foot pressure was recorded using a static postural platform at different visual input and mandibular positions. General linear models with repeated measures were used to assess the effect of the various within- and between-subject factors. Results: In total, 36 adults (left UPCB = 12; Right UPCB = 6; controls = 18) participated. There were significant differences between the control and UPCB groups in horizontal alignment at the acromion (p = 0.035) and ASIS (p = 0.026) levels when controlled by visual input and mandibular position. No significant differences in horizontal alignment or foot pressure distribution were observed by laterality in the UPCB group. Conclusion: The presence of UPCB affects static body posture, but the side of crossbite is not related to the direction of effect on static body posture. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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13 pages, 330 KiB  
Article
Evaluation of an Oral Hygiene Education Program for Staff Providing Long-Term Care Services: A Mixed Methods Study
by Shang-Jung Wu, Chun-Chieh Wang, Shu-Chen Kuo, Shwn-Huey Shieh and Yueh-Juen Hwu
Int. J. Environ. Res. Public Health 2020, 17(12), 4429; https://doi.org/10.3390/ijerph17124429 - 19 Jun 2020
Cited by 7 | Viewed by 3550
Abstract
Background: Oral hygiene is often neglected in clients receiving long-term care, suggesting that long-term care workers require formal oral hygiene education. Thus, the aim of this study was to investigate the effects of oral hygiene education on long-term care workers. Methods: This study [...] Read more.
Background: Oral hygiene is often neglected in clients receiving long-term care, suggesting that long-term care workers require formal oral hygiene education. Thus, the aim of this study was to investigate the effects of oral hygiene education on long-term care workers. Methods: This study utilized a mixed methods design. Eighty long-term care workers were recruited for participation in the oral hygiene education program, which employed three teaching methods: narration with multimedia presentation, demonstration, and teach-back. The effect of the education program on the participants’ level of oral hygiene knowledge, attitudes, and skills was measured using a structured questionnaire that was administered both pre- and post-delivery of the education program. Three months later, all participants submitted a self-report of their oral hygiene skills, and six participants completed a telephone interview. Quantitative data were analyzed using paired t-tests, and qualitative data were manually analyzed and coded. Results: Scores of oral hygiene knowledge (p < 0.001), attitudes (p = 0.001), and oral cleaning daily frequency for clients (p < 0.001), were significantly higher three months after undertaking the educational program. Conclusions: This preliminary study suggests that oral hygiene education may be effective in improving oral hygiene knowledge, attitudes, and skills among long-term care staff. Full article
(This article belongs to the Special Issue Oral and Dental Health)
8 pages, 629 KiB  
Article
Large Gender Gap in Oral Hygiene Behavior and Its Impact on Gingival Health in Late Adolescence
by Masanobu Abe, Akihisa Mitani, Kazuto Hoshi and Shintaro Yanagimoto
Int. J. Environ. Res. Public Health 2020, 17(12), 4394; https://doi.org/10.3390/ijerph17124394 - 18 Jun 2020
Cited by 18 | Viewed by 2405
Abstract
Background: Epidemiologic studies provide broad-based evidence that males are at greater risk of severe periodontal diseases than females. Our recent findings further revealed that male gender was an independent risk factor for gingival bleeding in late adolescents in Japan. Gingival health status [...] Read more.
Background: Epidemiologic studies provide broad-based evidence that males are at greater risk of severe periodontal diseases than females. Our recent findings further revealed that male gender was an independent risk factor for gingival bleeding in late adolescents in Japan. Gingival health status has been reported to be affected by oral hygiene behavior. However, gender difference in this regard has not yet been clarified. Methods: We conducted a retrospective review of mandatory medical questionnaires administered as part of a legally required freshman medical checkup between April 2017 and 2019 at the University of Tokyo. Results: Among a total of 9376 sets of responses, chosen subjects were 9098 students aged 17–19. For frequency of daily brushing, males brushed less frequently than females (p < 0.001): 1 time or less (male: 22.9%, female: 11.2%), twice (65.0%, 69.2%), 3 times or more (12.1%, 19.6%). For the duration of brushing each time, males brushed for a shorter period of time than females (p = 0.005): 1 min or less (male: 17.2%, female: 14.1%), 2–3 min (46.9%, 49.2%), 4 min or more (35.9%, 36.7%). (1) Male gender, (2) lower frequency of daily brushing and (3) shorter duration of brushing each time, were significantly associated with the presence of gingival bleeding (p < 0.001 for all). Multivariate regression analysis showed that: (1) male gender (odds ratio 1.29, 95% confidence interval 1.15–1.44); (2) frequency of daily brushing: 1 time or less (2.36, 2.02–2.76), twice (1.45, 1.27–1.67); and (3) brushing duration each time: 1 min or less (1.57, 1.39–1.78), 2–3 min (1.26, 1.14–1.39), were independent risk factors for gingival bleeding (p < 0.001 for all). Conclusions: Males showed poorer oral hygiene behavior than females in late adolescents in Japan. Male gender was an independent risk factor for gingival bleeding, as well as poor oral hygiene behavior. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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9 pages, 317 KiB  
Article
Close Associations of Gum Bleeding with Systemic Diseases in Late Adolescence
by Masanobu Abe, Akihisa Mitani, Atsushi Yao, Hideyuki Takeshima, Liang Zong, Kazuto Hoshi and Shintaro Yanagimoto
Int. J. Environ. Res. Public Health 2020, 17(12), 4290; https://doi.org/10.3390/ijerph17124290 - 16 Jun 2020
Cited by 15 | Viewed by 2425
Abstract
Background: Though it is well known that periodontal diseases are associated with various systemic diseases in adults, the associations in late adolescents have not been adequately elucidated. We investigated the association between gum bleeding (a major symptom of periodontal diseases) and common systemic [...] Read more.
Background: Though it is well known that periodontal diseases are associated with various systemic diseases in adults, the associations in late adolescents have not been adequately elucidated. We investigated the association between gum bleeding (a major symptom of periodontal diseases) and common systemic diseases in late adolescents: allergic, respiratory, and otorhinolaryngologic diseases. Methods: We conducted a retrospective review of the mandatory medical questionnaires administered as a part of legally required freshman medical checkup between April 2017 and April 2019 at the University of Tokyo. Among the total of 9376 sets of responses, 9098 sets from students aged less than 20 were analyzed. An χ2 test and univariate and multivariate binomial logistic regression analyses were performed using SAS ver. 9.4. A value of p < 0.05 was accepted as significant. Results: According to the questionnaire data, 3321 students (36.5%; 2780 males and 541 females) responded that they experienced gum bleeding whenever they brushed their teeth. These students had significantly higher incidence rates of otitis media/externa and asthma/cough-variant asthma (p = 0.001 and p = 0.006, respectively). The results of the multivariate analysis showed significant rates of the following complications among these students: (1) otitis media/externa (odds ratio (OR) 1.691; 95% confidence interval (CI): 1.193–2.396; p = 0.003), (2) asthma/cough-variant asthma (OR 1.303; 95% CI: 1.091–1.556; p = 0.003), and (3) male gender (OR 1.536; 95% CI: 1.337–1.765; p < 0.001). Conclusions: Gum bleeding was closely associated with otitis media/externa and asthma in late adolescents. Our study reinforces new evidence about the association between periodontal diseases and asthma, and it reveals a novel and close association between gum bleeding and otitis media/externa. Full article
(This article belongs to the Special Issue Oral and Dental Health)
11 pages, 314 KiB  
Article
Oral Health Attitudes among Preclinical and Clinical Dental Students in Germany
by Mohamed Mekhemar, Jonas Conrad, Sameh Attia and Christof Dörfer
Int. J. Environ. Res. Public Health 2020, 17(12), 4253; https://doi.org/10.3390/ijerph17124253 - 15 Jun 2020
Cited by 16 | Viewed by 3739
Abstract
Oral health care providers are expected to show good examples of oral health behaviours and attitudes to their community. Previous studies displayed the constructive effect of dental education on oral hygiene manners of undergraduate students. The aim of this survey was to assess [...] Read more.
Oral health care providers are expected to show good examples of oral health behaviours and attitudes to their community. Previous studies displayed the constructive effect of dental education on oral hygiene manners of undergraduate students. The aim of this survey was to assess and compare aspects of oral health attitudes and behaviours between preclinical and clinical dental students in German universities. The German-language version of the HU-DBI was distributed to preclinical and clinical students from different German universities. Dichotomized (agree/disagree) responses to 20 HU-DBI items were provided in this study, with a maximum possible score of 19. A quantitative estimate of oral health attitudes and behaviours was provided by the total of appropriate answers given to every statement by each group. Data were analysed statistically. The overall mean score of answers favouring good oral hygiene was marginally higher in preclinical (14.62) than clinical students (14.31) but showed no statistical significance. Similarly, the analysis of each item individually displayed no statistically significant differences between preclinical and clinical participants, except in a single item of the survey. This study showed no effective differences in oral hygiene attitudes and behaviour between preclinical and clinical students in German universities. This reveals a weak effect of dental education on improving students’ oral health attitudes in Germany and might demand the introduction of more courses emphasizing the importance of correct oral health behaviour of health care providers. Full article
(This article belongs to the Special Issue Oral and Dental Health)
15 pages, 2057 KiB  
Article
A WHO Pathfinder Survey of Dental Caries in 6 and 12-Year Old Transylvanian Children and the Possible Correlation with Their Family Background, Oral-Health Behavior, and the Intake of Sweets
by Patricia Ondine Lucaciu, Alexandru Mester, Ioana Constantin, Nora Orban, Lavinia Cosma, Sebastian Candrea, Ruxandra Sava-Rosianu and Anca Stefania Mesaros
Int. J. Environ. Res. Public Health 2020, 17(11), 4180; https://doi.org/10.3390/ijerph17114180 - 11 Jun 2020
Cited by 12 | Viewed by 4492
Abstract
To our knowledge, recent oral health data in Romania is poor, as no comprehensive oral health surveys have been carried out in the last five years. The present cross-sectional oral health survey aimed to assess the dental health status in 6 and 12-year [...] Read more.
To our knowledge, recent oral health data in Romania is poor, as no comprehensive oral health surveys have been carried out in the last five years. The present cross-sectional oral health survey aimed to assess the dental health status in 6 and 12-year old children from Transylvania, in correlation with their family background, oral-health behavior, and the intake of sweets. The study was conducted on 290 children from nine schools in the Transylvanian region of Romania. The study consisted of the clinical examination of children, recording of data in an International Cavity Detection and Assessment System (ICDAS) chart, and a questionnaire referring to the child’s parental education, frequency, and motivation of visits to the dentist, dental care habits, and the intake of sweets. Our results indicated that the most prevalent ICDAS scores recorded in 6-year-old children were “0A” (p = 0.001464), “03” (p = 0.00366), “05” (p = 0.005563), “06” for rural areas. Restorations were statistically more prevalent in the urban population (p = 0.000076). The ICDAS score for 12-year old children was “03” (p = 0.003614) and prevalent in the urban area. The ICDAS score for the rural area was “04” (p = 0.0056). Comparing dental health status with family background demonstrated a strong correlation for the group of 6-year-old children, and a lack of correlation for the 12-year-old children. The number of dental visits corelated with the parents’ backgrounds, and was higher in the urban population. Frequent hygiene habits (toothbrushing) were statistically correlated with lower ICDAS scores: “04” (p = 0.016482), “05” (p = 0.039127), “06” (p = 0.010785). Eating habits in both age groups were associated with statistically significant differences of “03”, “04”, “05”, “06”, “0A” in the ICDAS score. The obtained results provided clarification on the dental health situation in Romania and the potential risk factors of caries among the population, and therefore it could be used as a starter point for future studies to investigate, in depth, the effects of various variables on cavities found in Transylvanian schoolchildren. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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15 pages, 654 KiB  
Article
Relationships of Dental Caries and Malocclusion with Oral Health-Related Quality of Life in Lithuanian Adolescents Aged 15 to 18 Years: A Cross-Sectional Study
by Aistė Kavaliauskienė, Antanas Šidlauskas, Miglė Žemaitienė, Eglė Slabšinskienė and Apolinaras Zaborskis
Int. J. Environ. Res. Public Health 2020, 17(11), 4072; https://doi.org/10.3390/ijerph17114072 - 8 Jun 2020
Cited by 7 | Viewed by 3035
Abstract
There is a lack of evidence of the moderating effects of caries lesions and malocclusions on oral health-related quality of life (OHRQoL) among older adolescents. This study aimed to evaluate the relationship of dental caries and malocclusion with OHRQoL among Lithuanian adolescents aged [...] Read more.
There is a lack of evidence of the moderating effects of caries lesions and malocclusions on oral health-related quality of life (OHRQoL) among older adolescents. This study aimed to evaluate the relationship of dental caries and malocclusion with OHRQoL among Lithuanian adolescents aged 15 to 18 years. A survey in a representative sample of adolescents included a clinical examination to assess dental health status using the DMFT (Decayed, Missing, and Filled Permanent Teeth) index, and malocclusion using the Index of Complexity, Outcome, and Need (ICON). The Child Perceptions Questionnaire (CPQ) was used to evaluate respondents’ OHRQoL. Negative binomial regression was fitted to associate the clinical variables with the CPQ scores. A total of 600 adolescents were examined. The overall mean DMFT score was 2.7. A need for orthodontic treatment was detected among 27.7% of adolescents. Subjects with caries lesions (DMFT > 3) had higher CPQ scores in the domains of functional limitations and social wellbeing (relative risks were 1.35 (95% confidence interval: 1.09–1.67) and 1.30 (1.03–1.64), respectively), while subjects with a need for orthodontic treatment (ICON > 43) had higher CPQ scores in the domains of emotional wellbeing and social wellbeing (relative risks were 1.81 (1.40–2.22), and 1.69 (1.34–2.14), respectively). It was concluded that both dental caries and malocclusion have negative relationships with OHRQoL in adolescents above 15 years, but their effects occur differently in each OHRQoL domain. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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12 pages, 2851 KiB  
Article
The Influence of Custom-Milled Framework Design for an Implant-Supported Full-Arch Fixed Dental Prosthesis: 3D-FEA Study
by João Paulo Mendes Tribst, Amanda Maria de Oliveira Dal Piva, Roberto Lo Giudice, Alexandre Luiz Souto Borges, Marco Antonio Bottino, Ettore Epifania and Pietro Ausiello
Int. J. Environ. Res. Public Health 2020, 17(11), 4040; https://doi.org/10.3390/ijerph17114040 - 5 Jun 2020
Cited by 40 | Viewed by 3772
Abstract
The current study aimed to evaluate the mechanical behavior of two different maxillary prosthetic rehabilitations according to the framework design using the Finite Element Analysis. An implant-supported full-arch fixed dental prosthesis was developed using a modeling software. Two conditions were modeled: a conventional [...] Read more.
The current study aimed to evaluate the mechanical behavior of two different maxillary prosthetic rehabilitations according to the framework design using the Finite Element Analysis. An implant-supported full-arch fixed dental prosthesis was developed using a modeling software. Two conditions were modeled: a conventional casted framework and an experimental prosthesis with customized milled framework. The geometries of bone, prostheses, implants and abutments were modeled. The mechanical properties and friction coefficient for each isotropic and homogeneous material were simulated. A load of 100 N load was applied on the external surface of the prosthesis at 30° and the results were analyzed in terms of von Mises stress, microstrains and displacements. In the experimental design, a decrease of prosthesis displacement, bone strain and stresses in the metallic structures was observed, except for the abutment screw that showed a stress increase of 19.01%. The conventional design exhibited the highest stress values located on the prosthesis framework (29.65 MPa) between the anterior implants, in comparison with the experimental design (13.27 MPa in the same region). An alternative design of a stronger framework with lower stress concentration was reported. The current study represents an important step in the design and analysis of implant-supported full-arch fixed dental prosthesis with limited occlusal vertical dimension. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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7 pages, 278 KiB  
Article
COVID-19 Outbreak Perception in Italian Dentists
by Alberto De Stefani, Giovanni Bruno, Sabrina Mutinelli and Antonio Gracco
Int. J. Environ. Res. Public Health 2020, 17(11), 3867; https://doi.org/10.3390/ijerph17113867 - 29 May 2020
Cited by 48 | Viewed by 4355
Abstract
The aim of this study is an evaluation of the Italian dentists’ knowledge regarding COVID-19 and their perception of the risks associated with COVID-19, their attitude in resuming their activities, and how they judge the institutional intervention on a health and economic basis. [...] Read more.
The aim of this study is an evaluation of the Italian dentists’ knowledge regarding COVID-19 and their perception of the risks associated with COVID-19, their attitude in resuming their activities, and how they judge the institutional intervention on a health and economic basis. Methods: This research evaluated Italian dentists from 11 to 18 April 2020, using a questionnaire submitted via Google Forms (Alphabet, Mountain View, CA, USA). It consisted of different investigations about sociodemographic aspects, profession-related characteristics, knowledge about COVID-19 infection transmission modalities, symptoms, and attitude in treating potentially infected patients. Statistical analysis was performed using the Pearson chi2 test and Student t-test. The α-level was fixed at p = 0.05. All data were analyzed with STATA 16 (StataCorp LP, College Station, TX, USA). Results: 1500 dentists (664 men and 836 women) completed the questionnaire. The majority of respondents declared having been trained in infection prevention procedures (64.3%) but not specifically to prevent the spread of COVID-19 (48.7%). A total of 57.2% declared that they were not trained sufficiently to restart working after lockdown, with a significantly higher prevalence (Pearson chi2 test, p < 0.001) among women (62.3%) than men (50.9%). Conclusion: Italian dentists were informed correctly on the mode of transmission but partially missed COVID-19 symptoms. Dentists considered the virus infection highly dangerous, and they were not confident in being able to work safely. The lack of precise operating guidelines creates uncertainties on infection control measures and appropriate personal protective equipment (PPE) use. The participants revealed apprehension for their health and the current and future economic situation of their practices. Full article
(This article belongs to the Special Issue Oral and Dental Health)
10 pages, 1522 KiB  
Article
Evaluation of the Stomatognathic System before and after Osteopathic Manipulative Treatment in 120 Healthy People by Using Surface Electromyography
by Andrea Manzotti, Chiara Viganoni, Dorina Lauritano, Silvia Bernasconi, Alice Paparo, Rachele Risso and Alessandro Nanussi
Int. J. Environ. Res. Public Health 2020, 17(9), 3250; https://doi.org/10.3390/ijerph17093250 - 7 May 2020
Cited by 23 | Viewed by 6226
Abstract
Objective: To investigate the action of osteopathic manipulative treatment on the muscular activity of the stomatognathic apparatus by using surface electromyography (sEMG). Material and Methods: Surface electromyography (sEMG) was performed on the masseter and anterior temporalis muscles of 120 subjects (73 F; 47 [...] Read more.
Objective: To investigate the action of osteopathic manipulative treatment on the muscular activity of the stomatognathic apparatus by using surface electromyography (sEMG). Material and Methods: Surface electromyography (sEMG) was performed on the masseter and anterior temporalis muscles of 120 subjects (73 F; 47 M), both at time T0 and T2. The sample was divided into three randomized groups of 40 subjects each: control, placebo, and osteopathic manipulative treatment (OMT). In the T1 interval between the two evaluations, the control group was not treated, the placebo group underwent a placebo treatment, and the OMT group underwent manipulative treatment. The mean value of each measurement and its coefficient of variation, between time T0 and T2, were calculated for both the intragroup (OMT, placebo, control) and the intergroup (OMT-placebo, OMT-control). Outcomes: In 40% of the subjects, statistically significant improvements were highlighted in the OMT. Whereas, the statistically significant results of the placebo and control groups were 7.5% and 17.5%, respectively, of which more than 75% moved away from the physiological range, showing a worsening of the muscular activity. This analysis showed statistically significant variations (p ≤ 0.05) in the OMT group compared to the placebo and the control groups. Conclusions: OMT determines variations of the activity of masticatory muscles. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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11 pages, 1196 KiB  
Article
Vitamin D Receptor Gene Polymorphisms and Cigarette Smoking Impact on Oral Health: A Case-Control Study
by Aleksandra Suchanecka, Krzysztof Chmielowiec, Jolanta Chmielowiec, Grzegorz Trybek, Jolanta Masiak, Monika Michałowska-Sawczyn, Renata Nowicka, Katarzyna Grocholewicz and Anna Grzywacz
Int. J. Environ. Res. Public Health 2020, 17(9), 3192; https://doi.org/10.3390/ijerph17093192 - 4 May 2020
Cited by 6 | Viewed by 2821
Abstract
Periodontal diseases are multiperspective problems resulting from numerous and diverse exposures that influence the process of initiation or progression of disease. The negative influence of tobacco smoking on oral health is well documented. The aim of the study was to analyze three SNPs [...] Read more.
Periodontal diseases are multiperspective problems resulting from numerous and diverse exposures that influence the process of initiation or progression of disease. The negative influence of tobacco smoking on oral health is well documented. The aim of the study was to analyze three SNPs in vitamin D receptor gene—rs7975232 (ApaI), rs2228570 (FokI) and rs1544410 (BsmI)—combined with oral health assessment—pH, gingival index, dry mouth, periodontitis, dry socket, redness of oral cavity mucosa, leukoplakia—in a group of cigarette smokers and in non-smokers. Moreover, the possibility of interactions between these polymorphisms and smoking was examined. When comparing the smokers and non-smokers groups, we noticed that rs1544410 heterozygotes were significantly more frequent in the first group, and for the second, both homozygotes were more frequent. Additionally, we observed the impact of interaction between the rs7975232 genotype and smoking status on gingival index. Current smoking was also associated with all analyzed oral health measures except for leucoplakia. Correlation between pH and age in both smokers and non-smokers was also present. Results of our analysis indicate that in our study group lifestyle and aging were leading factors associated with worse oral health status. However, the impact of genetic variants, and also the impact of their interaction with smoking on analyzed parameters was also visible. These results show great possibilities for all levels of prevention of oral diseases by means of education based on evidence-based medicine, but also for incorporating genetic testing and early interventions into this process for predisposed individuals. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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12 pages, 2887 KiB  
Article
The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS CoV-2) in Dentistry. Management of Biological Risk in Dental Practice
by Roberto Lo Giudice
Int. J. Environ. Res. Public Health 2020, 17(9), 3067; https://doi.org/10.3390/ijerph17093067 - 28 Apr 2020
Cited by 83 | Viewed by 12636
Abstract
The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a novel coronavirus first identified in Wuhan, China, and the etiological agent of Coronavirus Disease-2019 (COVID-19). This infection spreads mainly through direct contact with Flügge micro droplets or core droplets that remain suspended as [...] Read more.
The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a novel coronavirus first identified in Wuhan, China, and the etiological agent of Coronavirus Disease-2019 (COVID-19). This infection spreads mainly through direct contact with Flügge micro droplets or core droplets that remain suspended as aerosol. Moreover, it has been reported that infected subjects, both with and without clinical signs of COVID-19, can transmit the virus. Since the infection typically enters through mouth, nose, and eyes, dentistry is one of the medical practices at highest risk of infection due to the frequent production of aerosol and the constant presence of saliva. The World Health Organization (WHO) has suggested that only emergency/urgent procedures should be performed during the coronavirus outbreak. Considering the virus’ route of transmission, a specific protocol should be applied to reduce the risk of infection in addition to measures that prevent the spread of infection from a patient to another person or medical tools and equipment (cross-infection). This protocol should be implemented by modifying both patient management and clinical practice, introducing particular devices and organizational practices. This paper aims to discuss and suggest the most appropriate procedures in every aspect of dental practice to reduce infection risk. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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9 pages, 747 KiB  
Article
Association between Sleep Quality and Duration and Periodontal Disease among University Students: A Cross-Sectional Study
by Md Monirul Islam, Daisuke Ekuni, Naoki Toyama, Ayano Taniguchi-Tabata, Kota Kataoka, Yoko Uchida-Fukuhara, Daiki Fukuhara, Hikari Saho, Nanami Sawada, Yukiho Nakashima, Yoshiaki Iwasaki and Manabu Morita
Int. J. Environ. Res. Public Health 2020, 17(9), 3034; https://doi.org/10.3390/ijerph17093034 - 27 Apr 2020
Cited by 12 | Viewed by 4047
Abstract
The purpose of this cross-sectional study was to investigate the association between sleep quality and duration, and periodontal disease among a group of young Japanese university students. First-year students (n = 1934) at Okayama University who voluntarily underwent oral health examinations were [...] Read more.
The purpose of this cross-sectional study was to investigate the association between sleep quality and duration, and periodontal disease among a group of young Japanese university students. First-year students (n = 1934) at Okayama University who voluntarily underwent oral health examinations were included in the analysis. Sleep quality and duration were assessed by the Japanese version of the Pittsburgh Sleep Quality Index. Dentists examined Oral Hygiene Index-Simplified (OHI-S), probing pocket depth (PPD), and percentage of sites with bleeding on probing (BOP). Periodontal disease was defined as presence of PPD ≥ 4 mm and BOP ≥ 30%. Overall, 283 (14.6%) students had periodontal disease. Poor sleep quality was observed among 372 (19.2%) students. Mean (± standard deviation) sleep duration was 7.1 ± 1.1 (hours/night). In the logistic regression analysis, periodontal disease was significantly associated with OHI-S (odds ratio [OR]: 2.30, 95% confident interval [CI]: 1.83–2.90; p < 0.001), but not sleep quality (OR: 1.09, 95% CI: 0.79–1.53; p = 0.577) or sleep duration (OR: 0.98, CI: 0.87–1.10; p = 0.717). In conclusion, sleep quality and duration were not associated with periodontal disease among this group of young Japanese university students. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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11 pages, 331 KiB  
Article
Correlation between Caries, Body Mass Index and Occlusion in an Italian Pediatric Patients Sample: A Transverse Observational Study
by Angela Militi, Riccardo Nucera, Ludovica Ciraolo, Angela Alibrandi, Rosamaria Fastuca, Roberto Lo Giudice and Marco Portelli
Int. J. Environ. Res. Public Health 2020, 17(9), 2994; https://doi.org/10.3390/ijerph17092994 - 26 Apr 2020
Cited by 4 | Viewed by 2142
Abstract
Background: The aim of this study was to evaluate the correlation between caries, body mass index (BMI) and occlusion in a sample of pediatric patients. Methods: The study group included 127 patients (72 female, 55 male) aged between 6 and 16 years (mean [...] Read more.
Background: The aim of this study was to evaluate the correlation between caries, body mass index (BMI) and occlusion in a sample of pediatric patients. Methods: The study group included 127 patients (72 female, 55 male) aged between 6 and 16 years (mean age 10.2) and selected between January and June 2019 at the Department of Pediatric Dentistry, University of Messina. Caries incidence was evaluated using the decayed, missing and filled teeth (DMFT) index. On the basis of BMI values, using a table adjusted for age and gender, patients were grouped into four categories (underweight, normal weight, risk of overweight, overweight). Results: There was no significant correlation between BMI and DMFT in the whole sample. The study of the correlation between BMI and DMFT in patients with different types of malocclusion showed a significant inverse correlation for patients affected by II class and deepbite malocclusion. Conclusions: The incidence of caries does not seem to be significantly related to BMI and occlusal patterns, but it decreases with increasing age. Full article
(This article belongs to the Special Issue Oral and Dental Health)

Review

Jump to: Research, Other

13 pages, 489 KiB  
Review
Risk Factors related to Late Failure of Dental Implant—A Systematic Review of Recent Studies
by Thanh An Do, Hoang Son Le, Yen-Wen Shen, Heng-Li Huang and Lih-Jyh Fuh
Int. J. Environ. Res. Public Health 2020, 17(11), 3931; https://doi.org/10.3390/ijerph17113931 - 2 Jun 2020
Cited by 57 | Viewed by 8541
Abstract
Resolving late failure of dental implant is difficult and costly; however, only few reviews have addressed the risk factors associated with late failure of dental implant. The aim of this literature review was to summarize the influences of different potential risk factors on [...] Read more.
Resolving late failure of dental implant is difficult and costly; however, only few reviews have addressed the risk factors associated with late failure of dental implant. The aim of this literature review was to summarize the influences of different potential risk factors on the incidence of late dental implant failure. The protocol of this systematic review was prepared and implemented based on the PRISMA (Preferred reporting items for systematic reviews and meta-analyses) guideline. In December 2018, studies published within the previous 10 years on late dental implant failure were selected by fulfilling the eligibility criteria and the risk factors identified in qualified studies were extracted by using a predefined extraction template. Fourteen eligible studies were assessed. The common risk factors for late failure were divided into three groups according to whether they were related to (1) the patient history (radiation therapy, periodontitis, bruxism and early implant failure), (2) clinical parameters (posterior implant location and bone grade 4) or (3) decisions made by the clinician (low initial stability, more than one implant placed during surgery, inflammation at the surgical site during the first year or using an overdenture with conus-type connection). Clinicians should be cautions throughout the treatment process of dental implant—from the initial examination to the treatment planning, surgical operation and prosthesis selection—in order to minimize the risk of late failure of dental implant. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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Other

Jump to: Research, Review

17 pages, 829 KiB  
Systematic Review
Regenerative Endodontic Procedures: An Umbrella Review
by Luísa Bandeira Lopes, João Albernaz Neves, João Botelho, Vanessa Machado and José João Mendes
Int. J. Environ. Res. Public Health 2021, 18(2), 754; https://doi.org/10.3390/ijerph18020754 - 17 Jan 2021
Cited by 7 | Viewed by 4198
Abstract
The Regenerative Endodontic Procedure (REP) is a biologically based method in which a damaged pulp–dentin complex is replaced by a new vital tissue. This umbrella review aimed to critically assess the available systematic reviews (SRs) on REP. An electronic database search was conducted [...] Read more.
The Regenerative Endodontic Procedure (REP) is a biologically based method in which a damaged pulp–dentin complex is replaced by a new vital tissue. This umbrella review aimed to critically assess the available systematic reviews (SRs) on REP. An electronic database search was conducted (PubMed-Medline, CENTRAL, Scielo, Web of Science, and LILACS) until December 2020. Studies were included if they were an SR on REP. The Risk of Bias (RoB) of SRs was analyzed using the Measurement Tool to Assess SRs criteria 2 (AMSTAR2). The primary outcome was the methodological quality in each specific section of REP protocols and outcomes. From 403 entries, 29 SRs were included. Regarding the methodological quality, ten studies were of critically low, three of low, fourteen of moderate, and two were rated as high quality. The quality of evidence produced by the available SRs was not favorable. Future high standard SRs and well-designed clinical trials are warranted to better elucidate the clinical protocols and outcomes of REP. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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10 pages, 2469 KiB  
Case Report
Is Biofeedback through an Intra-Aural Device an Effective Method to Treat Bruxism? Case Series and Initial Experience
by Kira Pfeiffer, Thaqif El Khassawna, Deeksha Malhan, Christine Langer, Barbara Sommer, Mohamed Mekhemar, Hans-Peter Howaldt and Sameh Attia
Int. J. Environ. Res. Public Health 2021, 18(1), 51; https://doi.org/10.3390/ijerph18010051 - 23 Dec 2020
Cited by 2 | Viewed by 3030
Abstract
Biofeedback was reported as an effective concept for bruxism treatment, through increasing patient’s awareness of the habit. During bruxing both ear canals become tighter, therefore, an in-ear device can provide biofeedback. The in-ear device is fitted to the ear canal in physiological status, [...] Read more.
Biofeedback was reported as an effective concept for bruxism treatment, through increasing patient’s awareness of the habit. During bruxing both ear canals become tighter, therefore, an in-ear device can provide biofeedback. The in-ear device is fitted to the ear canal in physiological status, during bruxing the ear-canal tightens resulting in stress on the canal walls and unpleasant feeling. Subsequently, patients stop their bruxing habit. The aim of this study is to provide first clinical evidence that in-ear devices have a positive impact on relieving bruxism in patients. Despite the low number of patients, this early study was designed as a controlled prospective study. The trial included seven female patients with a median age of 47.3 years (23–64 years). Only two patients implemented their devices for eight and seven months, respectively. One patient reported a relief in her symptoms, like headaches and pain intensity during the night, by 50% after three month and 80% after six months. Despite the limited number of participants, the study reflects a potential of Intra-aural devices as effective biofeedback devices in treating bruxism. Full article
(This article belongs to the Special Issue Oral and Dental Health)
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