Search Results (28)

Background/Objectives: Tooth bleaching is a widely requested aesthetic procedure in modern dentistry. However, the structural effects of high-concentration peroxide-based bleaching agents on enamel remain insufficiently understood. This study aims to evaluate and compare the effects of three in-office bleaching agents—Opalescence Boost (40% hydrogen peroxide [HP]), Opalescence Quick (45% carbamide peroxide [CP]), and BlancOne Ultra + (35% hydrogen peroxide [HP])—on enamel surface characteristics and color change using confocal laser scanning microscopy (CLSM) and spectrophotometric analysis. Methods: Forty-two extracted human teeth were sectioned and divided into experimental and control halves. Each experimental specimen underwent bleaching according to the manufacturer’s protocol. Color measurements were conducted at baseline, immediately post-treatment, at 3 days, 7 days, and 6 months following treatment using the Vita Easyshade^® spectrophotometer. Color differences were calculated using the CIEDE2000 (ΔE₀₀) formula. Enamel surface morphology was assessed by CLSM. Data were analyzed using Wilcoxon and Kruskal–Wallis tests (p < 0.05), performed with SPSS v23. Results: All bleaching agents produced clinically perceptible color changes (ΔE₀₀ > 3.3). Opalescence Boost achieved the highest and most consistent whitening effect (mean ΔE₀₀ > 11), while Opalescence Quick showed moderate efficacy (ΔE₀₀ ~6–8), and BlancOne Ultra+ induced milder changes (ΔE₀₀ ~4–5). CLSM imaging revealed surface alterations in all bleached samples, with more pronounced changes observed in specimens treated with higher peroxide concentrations. Conclusions: All three bleaching systems were effective in improving enamel color, with Opalescence Boost delivering the most substantial and durable effect. CLSM analysis confirmed morphological changes in enamel without evidence of severe damage. These results underscore the importance of selecting bleaching protocols that balance efficacy with enamel safety. Further in vivo studies are recommended to validate long-term structural effects and support clinical decision-making. Full article

In-office teeth bleaching is an esthetic dental procedure performed to whiten teeth. A desensitizing procedure often requires prior in-office bleaching to relieve tooth hypersensitivity. The objective of this study was to evaluate the bleaching efficiency of teeth specimens pre-treated with different desensitizing agents by analyzing the color parameters. A total of 25 bovine specimens were stained and divided into five groups (n = 5). The specimens were pre-treated with GLUMA, ICON, bonding, or fluoride varnish according to the manufacturer’s instructions. Subsequently, the samples underwent three consecutive 20 min bleaching sessions using an in-office bleaching product. Color values in the CIE L*, a*, and b* color space were initially recorded, both before any treatment and after each bleaching session. The color difference (ΔE) was then computed. The data were analyzed using SPSS 24.0 software. The color alteration after pre-treatment was analyzed using a one-way ANOVA test, and the color alteration in each bleaching session was compared using a repeated-measure ANOVA test. A one-way ANOVA analysis showed a statistically significant difference in the bleaching efficiency of teeth specimens pre-treated with different desensitizers (p < 0.001). The repeated-measure ANOVA analysis showed no statistically significant difference in additional bleaching sessions (p = 0.133). The ICON and bonding pre-treatment showed the color alteration of teeth specimens before the bleaching procedure. Although the different desensitizer pre-treatments showed significant differences in bleaching efficiency, the differences in color parameters of the teeth specimens at the end of three bleaching sessions were statistically insignificant. Desensitizer pre-treatment influenced the degree of color change during multiple bleaching sessions; however, the outcome of bleaching was not affected by desensitizer pre-treatment. Full article

Aim: To evaluate patient satisfaction outcomes with respect to pain, discomfort, and quality of life with hematology/oncology referrals undergoing CT-guided bone marrow biopsy and compare these scores with those of patients undergoing in-office biopsy. Methods: A retrospective chart review was performed over 2 years with all patients who underwent CT-guided bone marrow biopsy at our university set-up. Age, gender, BMI, radiation dose (CTDI/DLP), number of in-office biopsies, number of CT-guided biopsies, type/amount of moderate sedation used, technical and pathologic success rates, and complication rates were recorded. All patients who underwent both in-office and CT-guided biopsy were contacted by telephone to answer a brief survey regarding pain, discomfort, quality of life, and future preference with respect to each biopsy. Results: A total of 32 patients underwent CT-guided bone marrow biopsy. Moderate sedation was utilized for all CT patients, and 19 patients underwent both in-office and CT-guided biopsies. Upon surveying the 19 patients who underwent both kinds of biopsies, on a scale of 1–10 (10 = highest discomfort and highest pain), the patients on an average reported 7.8 for in-office vs. 2.1 for CT for the discomfort level (p < 0.001) and 7.9 vs. 1.7 for the pain (p < 0.001). The patients reported an average quality-of-life score of 82 (out of a scale of 100) after CT procedures and 53 for in-office (p < 0.001). All patients reported that they would prefer CT-guided procedures with sedation versus in-office procedures in the future. Conclusion: CT-guided bone marrow biopsy is the preferred and more comfortable procedure, especially in low-pain-tolerant patients, although it involves more cost, conscious sedation, and radiation exposure. Full article

The primary objective of this pilot study was to identify which aspects of in-office rhinologic procedures (IORPs) warrant further attention and investigation in the future. The secondary objectives were to survey which IORPs are most common and to identify needs for education and training. A cross-sectional study was carried out following the Consensus-Based Checklist for Reporting of Survey Studies (CROSS). The survey collected demographic, organizational, quality, and safety aspects of IORPs and was electronically distributed to YO-IFOS members across five continents. A total of 194 surgeons completed the survey, and 172 respondents (88%) performed IORPs. Ninety-nine responders (51.5%) worked in an academic setting. Common procedures included powered polypectomy (48, 28.4%) and turbinate reduction (93, 54.1%). The main concerns were about patients’ tolerance (116, 76.3%) and about the safety of the procedure (102, 67.1%). The most important barriers to the diffusion of IORPs are concerns about the tolerance and safety of these procedures. It would be convenient to establish protocols for this type of procedure to ensure the greatest patient comfort based on evidence. Full article

(1) Background: Orthopedic surgery has been transformed by 3D-printed personalized instruments (3DP-PSIs), which enhance precision and reduce complications. Hospitals are adopting in-house 3D printing facilities, using cost-effective methods like Fused Deposition Modeling (FDM) with materials like Polylactic acid (PLA) to create 3DP-PSI. PLA’s temperature limitations can be overcome by annealing High-Temperature PLA (ann-HTPLA), enabling steam sterilization without compromising properties. Our study examines the in vivo efficacy of ann-HTPLA 3DP-PSI in pediatric orthopedic surgery. (2) Methods: we investigated safety and efficacy using ann-HTPLA 3DP-PSI produced at an “in-office” 3D-printing Point-of-Care (3DP-PoC) aimed at correcting limb deformities in pediatric patients. Data on 3DP-PSI dimensions and printing parameters were collected, along with usability and complications. (3) Results: Eighty-three ann-HTPLA 3DP-PSIs were utilized in 33 patients (47 bone segments). The smallest guide used measured 3.8 cm³, and the largest measured 58.8 cm³. Seventy-nine PSIs (95.2%; 95% C.I.: 88.1–98.7%) demonstrated effective use without issues. Out of 47 procedures, 11 had complications, including 2 infections (4.3%; 95% CI: 0.5–14.5%). Intraoperative use of 3DP-PSIs did not significantly increase infection rates or other complications. (4) Conclusions: ann-HTPLA has proven satisfactory usability and safety as a suitable material for producing 3DP-PSI in an “in-office” 3DP-PoC. Full article

The aim of this investigation was to conduct a systematic review and meta-analysis to determine the necessity of a white diet during or following a bleaching procedure. This systematic review and meta-analysis followed the PRISMA guidelines meticulously. The research question was: Is a white diet necessary during and/or after a bleaching treatment? In vitro studies or clinical trials reporting the color change in bleached enamel after the use of a free-staining diet were considered for full-text review. For the analyses, a random-effects model was employed. Statistical significance was defined as a p-value < 0.05. A total of 17 documents were eligible for qualitative analysis: 5 clinical trials and 12 in vitro studies. Only data from the clinical trials were included in the meta-analysis. For at-home bleaching, differences in the color among the subjects were not statistically significant during the first (p = 0.64), second (p = 0.26) or third (p = 0.43) weeks of treatment. Also, the color difference one month after finishing the bleaching treatment were not statistically significant (p = 0.27). The color difference one month after finishing an in-office treatment showed that the restrictions on diet did not significantly improve the bleaching outcomes (p = 0.90). According to the findings of this review, dietary restrictions are not necessary during or after bleaching procedures. Full article

Study Design: The study was a retrospective cross-sectional database analysis. Objective: Deoxycholic acid (DOC) injections are a novel, in-office procedural alternative to submental liposuction or submentoplasty to address excess submental fat. Post-market safety data regarding this treatment is currently limited. The objective of this study is to analyze adverse events reported in the Manufacturer and User Facility Device Experience (MAUDE) database. Methods: The MAUDE database was queried for all reports related to adverse events involving deoxycholic acid using the search terms “KYBELLA” and “deoxycholic acid.” Reports were individually reviewed by 2 reviewers and categorized with special attention to adverse events. Results: A total of 34 medical device reports were identified from the database query. Thirteen of these reports (21 total events) were included in the analysis after excluding duplicates, unrelated adverse events, or events associated with the offlabel use of DOC. Reported adverse events include excessive swelling (n = 5, 24%), marginal mandibular nerve weakness (n = 4, 19%), unsatisfactory aesthetic outcome (n = 4, 19%), numbness (n = 3, 14%), dysphagia (n = 1, 5%), infection (n = 1, 5%), and skin necrosis (n = 3, 14%). Two patients required hospitalization for skin necrosis management; both had underlying systemic diseases. Conclusions: Adverse events following DOC injections included excessive swelling, dysphagia, numbness, infection, unsatisfactory aesthetic outcome, facial nerve weakness, and skin necrosis requiring hospitalization and/or surgery. Patient counseling regarding these adverse events should be discussed when offering DOC injections for submental convexity. Full article

(1) Background: Virtual reality and 3D printing are transforming orthopedic surgery by enabling personalized three-dimensional (3D) models for surgical planning and Patient-Specific Instruments (PSIs). Hospitals are establishing in-house 3D printing centers to reduce costs and improve patient care. Pediatric orthopedic surgery also benefits from these technologies, enhancing the precision and personalization of treatments. This study presents preliminary results of an In-Office 3D Printing Point of Care (PoC), outlining considerations and challenges in using this program for treating lower limb deformities in pediatric patients through Virtual Surgical Planning (VSP) and 3D-printed Patient-Specific Instruments (PSIs). (2) Materials and Methods: Pediatric patients with congenital or acquired lower limb deformities undergoing surgical correction based on VSP, incorporating 3D-printed PSIs when required, were included in this study. The entire process of VSP and 3D printing at the In-Office PoC was illustrated. Data about deformity characteristics, surgical procedures, and outcomes, including the accuracy of angular correction, surgical times, and complications, were reported. (3) Results: In total, 39 bone correction procedures in 29 patients with a mean age of 11.6 ± 4.7 years (range 3.1–18.5 years) were performed according to VSP. Among them, 23 procedures were accomplished with PSIs. Surgeries with PSIs were 45 min shorter, with fewer fluoroscopy shots. Optimal correction was achieved in 37% of procedures, while the remaining cases showed under-corrections (41%) or over-corrections (22%). Major complications were observed in four patients (13.8%). (4) Conclusions: The In-Office 3D Printing Point of Care is becoming an essential tool for planning and executing complex corrections of lower limb deformities, but additional research is needed for optimizing the prediction and accuracy of the achieved corrections. Full article

The long-term color stability and surface properties of anterior laminate veneers are among the crucial factors affecting the clinical longevity of aesthetic restorations. Novel 3D-printed materials are being introduced as definitive restorative treatment. In light of the existing variety of indirect yet minimally invasive composite resin veneers, research on their surface properties is warranted. This in vitro study evaluated the effect of artificial aging by immersion in different staining solutions on the color changes, gloss, and surface roughness (Ra) of 3D-printed veneers compared to the prefabricated resin composite veneer systems (PRCVs) manufactured by Componeer and Edelweiss. Moreover, this study compared the effects of two methods for stain removal: repolishing with Sof-Lex disks and in-office bleaching with 40% hydrogen peroxide. The veneers (n = 24) were randomly divided according to the immersion solutions used, i.e., tea and coffee. Colorimetric measurements, surface roughness, and surface gloss were determined before and after staining and surface treatment with either in-office bleaching or surface polishing. The data were statistically analyzed using two-way ANOVA followed by the Tukey’s post hoc test (α = 0.05). Artificial aging with immersion in staining solutions led to significant color changes, increased surface roughness, and gloss reduction in all materials (p  <  0.05). The 3D-printed veneers showed higher ΔE values (coffee = 10.112 ± 0.141) and (tea = 10.689 ± 0.771) compared to baseline after 7 days of aging. The 3D-printed veneers had a statistically significant surface roughness Ra (0.574 µm ± 0.073). The gloss was >70% in all groups at baseline; these values dropped in all groups after 7 days of artificial aging. After the stain-removing procedures, the ΔE values decreased in all tested veneers. That being said, they failed to return to the baseline values, and both stain-removing methods were found to have an adverse effect on surface roughness and gloss retention in all tested veneers. Full article

The aim of this laboratory study was to investigate and compare the impact of five desensitizing techniques as a treatment fortooth sensitivity on the exposed dentin after an in-office tooth bleaching procedure. Thirty intact human molars were collected for this investigation. The specimens were obtained by transversely cutting 2.5 mm of the crowns, leading to exposure of the dentin. The specimens were cleaned in an ultrasonic bath and treated initially with EDTA gel 15% for 4 min and then with Opalescence Boost bleaching gel (40% H₂O₂) for two sets of 20 min. Then, the samples were randomly divided into six groups (n = 5) and received one of the following treatments: Group 1 (no treatment—control group), Group 2 (Emofluor gel—0.4% SnF₂), Group 3 (MI Paste—CPP-ACPF), Group 4 (BioMinF paste—calcium phospho-fluoro-silicate), Group 5 (air-abrasion with ProSylc—Bioglass 45S5), and Group 6 (Er,Cr:YSGG laser). Subsequently, each sample was observed utilizing scanning electron microscopy (SEM) in order to detect the rate of occlusion of dentin tubules. SEM-EDS analysis revealed no occlusion of the dentin tubules in the control group, while Groups 2, 4, and 5 presented high effectiveness (>95% percentage of occluded tubules), and Groups 3 and 6 presented lower values (21.6 and 26.8%, respectively). It was concluded that althoughall the tested groups presented higher percentages of occlusion of the dentinal tubules compared to the control group, there were differences in effectiveness among them. The most effective treatments were the daily use of BioMinF paste and SnF₂-containing gel, as well as air-abrasion with ProSylc powder. Full article

Introduction: Laser surgery of the larynx is currently the standard of clinical practice in a multitude of procedures. Lasers with photoangiolytic properties have a wide application in endolaryngeal lesions. One of their most prominent features is the ability to coagulate blood vessels, reducing unwanted tissue damage. Our objective is to expose the uses of the blue laser (445 nm) in the larynx. Material and methods: A retrospective study was carried out including 47 patients treated with blue photoangiolytic laser from October 2021 to January 2023 at a university hospital. Demographic data, type of lesion presented, date of intervention and scope of the procedure, as well as the parameters of the laser used, were recorded. The number of sessions received per patient, the result and complications were also collected. Results: A total of 47 patients with laryngeal lesions were treated, including vascular angiomas, laryngeal sulcus vocali, vocal cord polyps, Reinke’s edemas, laryngeal papillomatoses, subglottic stenosis, laryngeal synechiae, subglottic granulomas, glottic scars, vocal fold leukoplakias, laryngeal dysplasias and tracheostomal granulomas. The mean age was 52.5 years, and 64.3% of the patients were women. The range of power used in the resective surgeries was 2–10 Watts with a 20-millisecond window. The average number of sessions received was 2.1 (range 1–4). A satisfactory situation was obtained in 45 of the 47 patients treated (95.75%), and an evident decrease in lesions was seen in the remaining two. There was no evidence of any complications directly derived from the use of the blue laser. Twenty-seven cases (54%) were treated exclusively in-office. Conclusions: The blue laser is safe and effective in the treatment of a wide range of laryngeal pathologies. Its advantages include its portability, its photoangiolytic qualities as well as its ability to vaporize tissue in contact mode, which can treat subepithelial vessels or resect lesions. Full article

This study aims to analyze the effect of desensitizing agents on the shear bond strength (SBS) of ceramic brackets after in-office bleaching procedures. Twenty-seven extracted premolars were equally divided into three groups (n = 9). Group 1 served as the control; bleaching was performed with 37% hydrogen peroxide. In group 2, bleaching and the application of a fluoride-containing desensitizing agent (CPP-ACFP) were performed. In group 3, bleaching and the application of a non-fluoride-containing desensitizing agent (CPP-ACP) were performed. Ceramic brackets were bonded with composite resin. SBS was tested using a universal testing machine. The site of bonding failure was measured using the adhesive remnant index (ARI) score. There was a statistically significant difference in mean SBS values (p < 0.05). Group 1 showed the lowest SBS value (6.32 ± 4.83 MPa), which differed significantly with groups 2 and 3 (p < 0.05). There was no significant difference between group 2 (15.36 ± 4.67 MPa) and group 3 (12.19 ± 6.81 MPa) (p > 0.05). The ARI score did not show a significant difference. The conclusion is that the application of fluoride-containing and non-fluoride desensitizing agents increases the shear bond strength of ceramic brackets on bleached teeth with composite resin cementation. The application of both desensitizing agents had no impact on the results of the ARI score, with the highest ARI score in each group being 4, indicating that less than 10% of the adhesive substance remains on the enamel. Full article

Introduction: The present study aimed to investigate the effectiveness of low-level laser therapy (LLLT) use before in-office bleaching to prevent an increase in the risk and intensity of tooth sensitivity. Methods: Thirty patients were selected. Before bleaching with 38% hydrogen peroxide, the participants were randomly divided into two groups of 15 subjects. Test group: the patients’ teeth were subjected to a preliminary LLLT procedure by an 810 nm diode laser with 0.5 W for 30 s for an energy density of 15 J/cm² and a group placebo. All patients were instructed to report their cold sensitivity experiences immediately, 1 h, 24 h, and 48 h after the end of bleaching via a VAS score. Results: The results obtained show an increase in VAS values for both groups (290 and 490 vs. 224 and 234 of baseline time of test and placebo group, respectively); afterward, the VAS value seemingly decreases at 1 h after the end of bleaching, approaching the baseline VAS for the test group (274) in comparison to the placebo group. Conclusions: The use of preliminary diode LLLT could represent a valid possibility to reduce the occurrence of tooth sensitivity post-whitening and shorten recovery time in cases where tooth sensitivity occurs. Full article

The aim of this study was to explore and assess office-based ultrasound-guided intraosseous and intra-articular infiltrations of plasma rich in growth factors (PRGF) in patients with moderate and severe knee osteoarthritis (KOA). Seventy-nine patients (30 women and 49 men) with grade 3–4 KOA according to the Kellgren–Lawrence classification participated in the study. All patients were treated with a minimally invasive technique using local anesthesia WALANT (wide-awake local anesthesia no tourniquet) in the ambulatory setting. A PRGF intra-articular infiltration and two intraosseous infiltrations in the tibial plateau and femoral condyle were performed weekly for a total of three sessions. The evaluation of the results was carried out using knee injury and osteoarthritis outcome score (KOOS) at baseline and post-treatment. After a follow-up period of 11 months (median) [interquartile range, 7–14], all the KOOS domains showed statistically significant improvement (p < 0.001). Moreover, 88% of the patients showed a pain reduction of at least 10 points (minimally clinically important improvement) from pre- to post-treatment. Our retrospective study using the in-office procedure of ultrasound-guided combination of intra-articular and intraosseous infiltrations of PRGF is a safe and efficacious approach for the treatment of grade 3–4 knee osteoarthritis. Full article

Abnormal uterine bleeding is a common benign gynecological complaint and is also the most common symptom of endometrial cancer (EC). Although many microRNAs have been reported in endometrial carcinoma, most of them were identified from tumor tissues obtained at surgery or from cell lines cultured in laboratories. The objective of this study was to develop a method to detect EC-specific microRNA biomarkers from liquid biopsy samples to improve the early diagnosis of EC in women. Endometrial fluid samples were collected during patient-scheduled in-office visits or in the operating room prior to surgery using the same technique performed for saline infusion sonohysterography (SIS). The total RNA was extracted from the endometrial fluid specimens, followed by quantification, reverse transcription, and real-time PCR arrays. The study was conducted in two phases: exploratory phase I and validation phase II. In total, endometrial fluid samples from 82 patients were collected and processed, with 60 matched non-cancer versus endometrial carcinoma patients used in phase I and 22 in phase II. The 14 microRNA biomarkers, out of 84 miRNA candidates, with the greatest variation in expression from phase I, were selected to enter phase II validation and statistical analysis. Among them, three microRNAs had a consistent and substantial fold-change in upregulation (miR-429, miR-183-5p, and miR-146a-5p). Furthermore, four miRNAs (miR-378c, miR-4705, miR-1321, and miR-362-3p) were uniquely detected. This research elucidated the feasibility of the collection, quantification, and detection of miRNA from endometrial fluid with a minimally invasive procedure performed during a patient in-office visit. The screening of a larger set of clinical samples was necessary to validate these early detection biomarkers for endometrial cancer. Full article