Search Results (74)

Jaw fracture management significantly advanced with the introduction of Erich Arch Bars (EABs) during World War II, becoming the gold standard for maxillomandibular fixation (MMF). EABs, however, are time-consuming, pose risks of sharps injuries, and hinder oral hygiene and patient comfort. This study tested the Minne Ties Hybrid Arch Bar System (MTHAB), a novel MMF technology. This cadaveric study used specimens with near-complete dentition to compare MTHAB and EABs. The technologies were applied by trained surgeons to measure occlusal forces, increasing elastic loads, and application and removal times. Surgeons completed structured usability surveys. The results indicated that MTHAB significantly reduced application time (19.8 ± 4.1 min versus 35.2 ± 5.7 min, p = 0.0027) and removal time (1.6 ± 0.4 min versus 5.1 ± 2.1 min, p = 0.0465) compared to EABs, while also being rated higher for ease of use and safety. Both technologies achieved acceptable occlusion forces, although MTHAB needed more elastics to achieve comparable forces to EABs. While MTHAB appears promising, future clinical trials are needed to evaluate long-term outcomes, fixation stability, and patient selection. MTHAB represents a potential advancement in MMF technology, balancing surgical efficiency, safety, and fixation strength. Full article

Background/Objectives: Cervical cancer is a leading cause of cancer-related mortality among women, primarily driven by persistent infections with high-risk human papillomavirus (HPV), particularly HPV-16. Vaccines based on plasmid DNA encoding the viral oncogenes E6 and E7 represent a promising immunotherapeutic strategy, but their efficacy remains limited due to poor cellular uptake. Cell-penetrating peptides such as RALA improve intracellular delivery, and functionalization with octa-arginine peptide conjugated to mannose (R8M) further enhances targeting of antigen-presenting cells (APCs). This study aimed to obtain the minicircle DNA (mcDNA) encoding mutant HPV-16 E6 and/or E7 antigens, and optimize its complexation with mannosylated RALA-based nanoparticles to improve vector delivery and consequently antigen presentation. Methods: Nanoparticles were formulated at different concentrations of RALA, with and without R8M functionalization. Their characterization included hydrodynamic diameter, polydispersity index, zeta potential, complexation efficiency (CE), stability, morphology, and Fourier-Transform Infrared Spectroscopy. In vitro assays in JAWS II dendritic cells (DCs) assessed biocompatibility, transfection efficiency and target gene expression. Results: Optimal conditions were obtained at 72.5 µg/mL of RALA, producing nanoparticles smaller than 150 nm with high CE (>97%) and uniform size distribution. Functionalization with R8M at 58 µg/mL preserved these characteristics when complexed with all mcDNA vectors. The formulations were biocompatible and effectively transfected DCs. Mannosylated formulations enhanced antigenic expression compared to non-mannosylated counterparts, evidencing a mannose-receptor-mediated uptake, while increasing the production of pro-inflammatory cytokines. Conclusions: Nanoparticles based on the RALA peptide and functionalized with R8M significantly improved mcDNA transfection and gene expression in APCs. These findings support further investigation of this system as a targeted DNA vector delivery platform against HPV-16. Full article

Background: Posturography is a diagnostic method used to evaluate postural stability by recording body sway and the distribution of pressure on the ground. Temporomandibular disorders (TMDs) involve musculoskeletal and neuromuscular dysfunctions affecting the temporomandibular joint, masticatory muscles, and associated structures. Given the anatomical and functional connections between the stomatognathic system and postural control mechanisms, this study aimed to assess whether TMDs influence body posture and balance as measured by posturographic parameters. Methods: 75 volunteers, aged 19–48, were included. The TMD group (n = 45) was diagnosed based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), and the control group (n = 30) showed no signs of TMD. All participants underwent posturographic assessment and jaw opening range measurement. Posturography was performed using a pressure platform that recorded the center of pressure (COP) in static conditions. Postural stability was assessed using the Romberg test with eyes open and closed. Results: No statistically significant differences were found between the TMD and control groups in COP parameters, including ellipse area (EA) and total load distribution. Within both groups, COP sway increased significantly in the eyes-closed (EC) condition, as reflected by a greater unsteadiness length (UL). In contrast, EA was larger in the eyes-open (EO) condition in both groups, indicating a wider but more controlled spatial dispersion of COP. Intra-group analysis further revealed a significantly higher load on the left side in the control group only. Conclusions: The results do not support a significant postural imbalance in individuals with TMD compared to healthy controls. However, increased sway with eyes closed suggests that visual input plays a key role in postural control, regardless of TMD status. Full article

Ceramic dental implants, particularly one-piece zirconia, offer a biocompatible and aesthetic alternative to titanium, with high strength and improved oral hygiene. By eliminating the implant–abutment micro-gap, they reduce bacterial accumulation because of their low plaque affinity and enhance stability. However, challenges remain, including alignment precision, limited retrievability, and sensitivity to mechanical stress. Misalignment can affect occlusal and functional outcomes, and zirconia’s rigidity complicates crown removal and modification. This case report explores the use of PEEK (polyether ether ketone) primary telescopic crowns to overcome these limitations, improving force distribution, enabling minor adjustments, and enhancing prosthetic retrievability in full-mouth zirconia restorations. A 62-year-old male patient seeking a fixed solution to replace removable dentures received 16 one-piece zirconia implants (eight per jaw). PEEK telescopic crowns were used over implant abutment copings, finalized with aesthetic zirconia bridges. The report details surgical and prosthetic procedures, along with a brief literature review on zirconia implants and PEEK applications. PEEK integration in telescopic prosthetic designs marks a notable advancement in prosthodontics. Its shock-absorbing, biocompatible, and stress-modulating properties make it valuable for implant-supported and hybrid restorations. As digital workflows advance, PEEK-based telescopic restorations may increasingly replace traditional metal-based solutions, improving long-term clinical outcomes. Further clinical research on a larger sample is needed. Full article

Background/Objective: Postural stability and motor coordination require precise regulation of agonist and antagonist muscle activities. Jaw clenching modulates neuromuscular control during static and reactive postural tasks. However, its effects on dynamic voluntary movement remain unclear. This pilot study aimed to investigate the effects of jaw clenching on muscle activity and kinematics during repetitive single-leg sit-to-stand task performance. Methods: Eleven healthy adults (age: 21.2 ± 0.4 years; 6 males and 5 females; height: 167.9 ± 9.6 cm; body weight: 59.7 ± 8.1 kg) performed repetitive single-leg sit-to-stand tasks for 30 s under jaw-clenching and control conditions. Electromyography (EMG) signals from eight muscles and kinematic data from 16 inertial measurement unit sensors were analyzed, focusing on the seat-off phase. Results: Jaw clenching resulted in a significantly lower success rate than the control condition (success rate: 0.96 ± 0.13 vs. 0.78 ± 0.29, p = 0.047). Under the jaw clenching condition, failed trials exhibited higher medial gastrocnemius and masseter EMG activity (p < 0.001), lower erector spinae longus EMG activity (p < 0.001), and altered kinematics, including increased trunk yaw and roll angles (p < 0.001). Jaw clenching increased the coactivation of the gastrocnemius and tibialis anterior muscles (p < 0.001), disrupting the reciprocal muscle patterns critical for task performance. Conclusions: These findings suggest that jaw clenching may reduce task performance by altering neuromuscular coordination during dynamic postural tasks. Full article

(1) Introduction: The clinical success of dental implants depends on rapid osseointegration, which can be impaired by hydrocarbon contamination and biological aging of titanium surfaces. Chairside plasma surface treatment has emerged as a practical method to restore surface hydrophilicity and enhance early bone–implant integration. (2) Materials and Methods: This retrospective cohort study evaluated 73 plasma-treated implants placed in 47 patients from June 2023 to October 2024. Non-thermal atmospheric pressure plasma was applied immediately before placement using the ACTILINK™ Reborn system. Implant stability was assessed baseline, weekly for the first four weeks, and again at week 8 using resonance frequency analysis (ISQ). Subgroup analyses were conducted according to initial ISQ, jaw location, implant length/diameter, and final insertion torque. (3) Results: All implants healed uneventfully without a stability dip. Mean ISQ increased from 78.97 ± 5.52 at placement to 83.74 ± 4.36 at week 8 (p < 0.001). Implants with lower initial stability demonstrated the greatest relative gains, while those with very high initial stability showed minimal changes. Mandibular and shorter implants demonstrated higher stability gains compared to maxillary and longer fixtures. (4) Conclusions: Chairside plasma surface treatment was associated with progressive ISQ increases during the 8-week healing period. The greatest gains occurred in implants with lower initial stability, while very stable implants showed little change. Stability improvements were also greater in mandibular sites, shorter fixtures, and those with higher insertion torque. These findings are limited to short-term ISQ outcomes and require validation in prospective controlled trials with standardized protocols. Full article

Implant treatment in the aesthetic regions of the jaw often requires hard and soft tissue augmentation to ensure optimal prosthetic outcomes. Radiological evaluation with cone-beam computed tomography (CBCT) and visual inspection of intraoral photographs are effective for assessing hard tissues but are limited in evaluating soft tissues. This study aimed to objectively evaluate volumetric and dimensional changes of the alveolar ridge, including both hard and soft tissues, following simultaneous horizontal bone augmentation and implant placement using intraoral digital scanning. Intraoral digital scans were obtained at baseline (T0) and at 2 (T1), 6 (T2), and 12 weeks (T3) post-surgery. Scans were superimposed using dedicated imaging software to measure volumetric and cross-sectional changes. Volumetric gain was significant at T1 but decreased significantly from T1 to T2 (p = 0.0006) and from T1 to T3 (p = 0.0002). Cross-sectional analysis showed significant increases in ridge width at T1 at all measured levels, accompanied by a significant vertical decrease at the alveolar crest from T1 to T2 (p = 0.0056) and T3 (p = 0.0106).These findings indicate that horizontal augmentation provides initial volumetric gain but is followed by substantial reduction at the crest, suggesting that rigid fixation may enhance stability; however, controlled clinical trials are required. Full article

Background/Objectives: McCune–Albright syndrome (MAS) is a rare disease characterized by the triad of fibrous dysplasia (FD), café au lait skin macules, and hyperfunctioning endocrinopathies. Although there are many case reports of MAS, few have discussed long-term oral management. We describe the long-term follow-up of an MAS patient over 15 years. Case Presentation: A male patient aged 13 years and 7 months was referred to our department with a chief complaint of difficulty with toothbrushing. He was diagnosed with MAS at 9 years, and bisphosphonate therapy was started. We continued to review the patient periodically and extracted several primary teeth with no adverse effects such as the medication-related osteonecrosis of the jaw (MRONJ). We evaluated the changes in FD using facial photographs, and facial asymmetry worsened over time until the age of 19, when surgery was performed. Although improvement was observed after surgery, there was a tendency for recurrence up to the age of 25 years. Conclusions: Continuous dental support over 15 years has prevented oral disease and minimized the need for surgical procedures such as tooth extractions, which are factors in MRONJ. The worsening of FD on the left side caused facial asymmetry until the age of 25 years; however, the asymmetry may have stabilized with the development of FD on the right side and with age-related changes. It is important for dental professionals to provide MAS patients with appropriate oral health instruction and oral management, taking changes in FD into consideration. Full article

Temporomandibular joint disorders (TMDs), particularly disc displacement with reduction (DDwR), are prevalent musculoskeletal conditions characterized by symptoms such as joint clicking, pain, and sometimes limited jaw movements. Accurate diagnosis requires a multidisciplinary approach, including clinical examination, imaging (MRI), and functional analysis. Among conservative treatment modalities, anterior repositioning splints (ARSs) are widely used to recapture the displaced discs and reposition the mandibular condyles. Determining the optimal therapeutic position (Th.P) for anterior repositioning splint fabrication remains challenging due to individual anatomical variability and a lack of standardized guidelines. This study introduces the controlled mandibular repositioning (CMR) method, which integrates clinical examination, imaging (MRI), computerized cephalometry, computerized condylography, neuromuscular palpation, and the Condylar Position Variator (CPV) to define an individualized Th.P. After treatment with CMR stabilizers (splints), the control MRI confirmed that in 36 out of 37 joints, the discs were repositioned to their normal position. There was a reduction in pain, as shown by VAS scores at the 6-month follow-up. This study demonstrated the effectiveness of the CMR method to find a precise therapeutic position, resulting in a 97.3% joint luxation reduction in DDwR. This study underscores the importance of precise, individualized Th.P determination for effective anterior repositioning. Full article

Background/Objectives: The aim of this systematic review was to identify the role of orthodontics in patients undergoing tumor-ablative surgery, in collaboration with maxillofacial prosthodontic rehabilitation in a multidisciplinary fashion. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42024582050). The focused question was constructed using the PICO (participant, intervention, comparison, and outcome) approach. A three-stage search was performed in PubMed, Scopus, and Web of Science using Medical Subject Heading (MeSH) terms. To assess the risk of bias, the National Institute of Health (NIH) “Quality Assessment Tool for case series/reports” was used. All data was synthesized qualitatively, according to the Synthesis Without Meta-analysis (SWiM) reporting guideline. Results: The initial search yielded 624 articles, of which 22 met the inclusion criteria after screening and eligibility assessment, with most being single-patient case reports and one case series involving 12 patients. The included studies primarily involved tumors in the mandible (64.5%) and maxilla (32.3%). Orthodontic treatment was initiated at various time points, ranging from one month pre-surgery to 19 years post-surgery, primarily utilizing fixed appliances (77.8%). In some studies, orthodontic appliances were used to enhance the stability of maxillofacial prostheses. The results of this study indicate that orthodontic treatment may facilitate prosthetic rehabilitation by improving conditions prior to prosthetic intervention and increasing the retention of the obturator prosthesis. Conclusions: Orthodontic treatment can enhance maxillofacial prosthetic rehabilitation after tumor-ablative surgery by optimizing jaw growth, improving occlusion, and facilitating prosthetic retention or space creation. Further research is needed to establish treatment guidelines. Orthodontic miniscrews may improve temporary prosthesis retention before final implant placement, when indicated. Full article

Background: In modern dentistry, alveolar socket preservation after tooth extraction plays a critical role in maintaining the alveolar ridge for future dental implants. This retrospective clinical study evaluated bone-level changes 15 years after immediate implant placement, coupled with alveolar ridge preservation. Methods: Fifty non-smoking patients aged 25 to 75 (30 males and 20 females) who underwent single-implant rehabilitation in both anterior and posterior regions of the upper and lower jaws were included. The study examined bone levels and implant survival over time, using standardized intraoral radiographs at 1, 5, and 15 years post-loading. Implants were placed immediately after atraumatic extraction, and the residual gap was grafted with bovine hydroxyapatite and covered with a collagen membrane. The primary outcome was bone-level stability, while secondary outcomes included implant failure. No temporary crowns or removable dentures were provided during healing. Radiographs were digitized for detailed analysis. Results: The results for 50 patients with immediate implant placement showed that bone-resorption levels were significantly higher in the upper jaw than in the lower jaw. Conclusions: Posterior implants exhibited greater bone loss than anterior implants, particularly at 1 year and 15 years, while no implant failures occurred. Full article

Background/Objectives: This study aimed to explore the functional implications of occlusal changes during clear aligner treatment (CAT) to (a) analyze occlusal changes throughout CAT and the extent of post-treatment occlusal recovery; (b) assess the relationship between post-treatment occlusion and masticatory performance; (c) investigate whether case complexity, facial biotype, and type of malocclusion influence occlusal adaptation and functional outcomes; and (d) evaluate the presence and progression of signs or symptoms of TMDs in patients undergoing CAT. Methods: This longitudinal cohort pilot study included 42 individuals who underwent CAT. Occlusion was evaluated at three timepoints: before treatment (T0), at treatment completion (T1), and three months after with night-only aligner use (T2). Masticatory performance was assessed using a two-colored chewing gum test analyzed through colorimetric software. TMD signs/symptoms were assessed using the Diagnostic Criteria for TMD [DC/TMD]. Statistical analysis used non-parametric tests. Results: A significant decrease in occlusal contact area was observed during active CAT [p = 0.016], which partially recovered at follow-up. Individuals with normal facial proportions (normodivergent) showed more anterior contacts at T1 compared to hyperdivergent individuals [p = 0.013]. Masticatory performance remained stable between T1 and T2 [p = 0.528]. A weak negative correlation was found between posterior contact number and performance score at T1 [r = −0.378, p < 0.05], suggesting that more contacts may be linked to better chewing. No TMD signs or symptoms were detected at any timepoint. Conclusions: Although CAT temporarily reduces occlusal contact area, it does not negatively impact chewing efficiency or trigger TMD symptoms. These findings support the functional safety of CAT when treatment is properly planned and monitored. Full article

Background: Many studies analyse the effectiveness of the Herbst device in the treatment of dentoskeletal Class II malocclusion due to mandibular retrusion. This fixed device was devised by Emil Herbst for Class II treatment using a bite jumping, i.e., a device that holds the jaw in a forced anterior position. Comparison of the results obtained in numerous studies is difficult because they are often not comparable and not congruent due to a number of variables that prevent standardization. Methods: The purpose of the present study is to report some clinical-level considerations that may be important in order to obtain more predictable therapeutic outcomes. The simplified design of the Herbst device offers better patient comfort and easier cleanability but may show some disadvantages, such as less anchorage. Results: The device was evaluated in conjunction with the multi-bracket phase that preceded Herbst therapy and concluded after the device was removed. The therapy was performed in the absence of skeletal anchorage. Conclusions: In our opinion, standardization of therapy according to precise protocols may positively affect the therapeutic outcomes by achieving faster occlusal stabilization, more proper neuro-muscular balance, less stress on anchor units, and shorter treatment time. Full article

Background/Objectives: The objective of this study was to analyze the profiles of sphingosine (Sph), sphinganine (SPA), sphingosine-1-phosphate (S1P), and ceramides (C14 Cer, C16 Cer, C18:1 Cer, C18 Cer, C20 Cer, C22 Cer, C24:1 Cer, and C24 Cer), along with caspases (CAS-3, CAS-6, and CAS-9), in serum and in the periosteum of the maxilla and mandible in patients with dentofacial deformities undergoing treatment with titanium fixations (miniplates and miniscrews). Methods: The study group comprised 20 patients who underwent bilateral jaw osteotomy due to dentofacial deformities. The osteotomy segments were stabilized with titanium alloy miniplates and screws. The control group consisted of 20 patients who had not yet received surgical treatment for maxillofacial defects. Results: Sphinganine (SPA) and ceramide C22 (C22 Cer) were the only compounds found to be significantly elevated in the serum of the study group compared to the control group. The concentrations of Sph, SPA, C14 Cer, C16 Cer, C18 1 Cer, C18 Cer, C22 Cer, C24 1 Cer, C24 Cer, and S1P were significantly lower in the maxillary periosteum of patients in the study group compared to those in the control group. The concentration of C20 Cer was significantly higher in the maxillary periosteum of patients in the study group compared to the control group. In contrast, the concentrations of Sph, SPA, C14 Cer, C16 Cer, C18 1 Cer, C22 Cer, C24 1 Cer, and C24 Cer were significantly lower in the mandibular periosteum of the study group compared to the control group. The concentrations of C20 Cer and S1P were significantly elevated in the mandibular periosteum of patients in the study group compared with the control group. The activity of CAS-3 was significantly higher in the mandibular periosteum of patients in the study group compared to those in the control group. Conclusions: Titanium fixations induce local changes in the sphingolipid profile within the periosteum of the maxilla and mandible, while no systemic impact on this metabolism was observed. Full article

Background/Objectives: Transurethral resection of bladder tumor (TURBT) is commonly performed in elderly patients and often requires repeated procedures. A high proportion of non-procedural time in TURBT affects operating room utilization, highlighting the need for a safe and efficient anesthesia method. This study aimed to compare remimazolam-based monitored anesthesia care (MAC) guided by analgesia nociception index (ANI) monitoring to inhalation-based general anesthesia (GA) for TURBT, focusing on induction and emergence time (IAET). Methods: Forty-six patients who underwent TURBT were randomly assigned into either the MAC group or GA group. The primary outcome was the IAET. The secondary outcomes included hospital and anesthesia charges, safety (intraoperative hypotension and desaturation), and feasibility (surgeon and patient satisfaction) of both anesthetic methods. Results: The MAC group demonstrated a significantly shorter IAET (14 vs. 25 min, p < 0.001) and lower anesthesia cost (USD 152 vs. USD 195, p < 0.001). The MAC group showed better hemodynamic stability with a lower incidence of hypotension (29% vs. 73%, p = 0.004). Seven patients (33%) in the MAC group experienced intraoperative desaturation; all patients recovered without complications through the jaw-thrust maneuver. Patient satisfaction was equally high in both groups, and surgeon satisfaction, though slightly lower with MAC (71% vs. 100% rating “excellent”, p = 0.009), remained acceptable. Conclusions: Remimazolam-based MAC, guided by ANI monitoring, offers significant advantages including shorter IAET, reduced costs, and improved safety for TURBT, particularly in patients with small tumors. These findings support MAC as a promising alternative to GA for TURBT, as it enhances perioperative outcomes and operating room efficiency. Full article