Search Results (20)

Background/Objectives: Pacifier use is a widespread soothing practice during infancy, but extended use has been linked to adverse dental outcomes, particularly malocclusion. This review aimed to evaluate the association between pacifier use and dental developmental issues in infants and toddlers and to identify key influencing factors. Methods: A scoping review using PubMed, Scopus, Web of Science, and Dentistry and Oral Sciences Source was performed. Peer-reviewed, full-text articles published in English between 2014 and 2024 were screened by two independent reviewers using predefined criteria. Eligible studies were thematically analyzed. Results: From 262 records, 35 studies met the inclusion criteria. Pacifier use was consistently associated with an increased prevalence of malocclusions, including anterior open bite, posterior crossbite, and overjet. The risk and severity of dental issues were strongly influenced by the duration, frequency, and intensity of pacifier use. Prolonged use beyond three years significantly increased the likelihood of structural changes requiring intervention. Conclusion: There is strong evidence linking pacifier use to negative dental developmental outcomes, particularly when use is prolonged or frequent. Early intervention, caregiver education, and timely weaning are critical to minimizing long-term oral health risks. Future research should explore pacifier design, objective measures of use, and how socioeconomic factors may influence pacifier use patterns and oral health outcomes. Understanding these relationships can support the development of more targeted and equitable prevention strategies. Full article

Background: The COVID-19 pandemic led to significant disruptions in healthcare services worldwide, including dental care, resulting in increased reliance on antibiotics as a substitute for in-person dental interventions. Aim: This study aimed to examine the prescription of different classes of antibiotics at the University Dental Clinical Center of Kosovo during the COVID-19 pandemic and compare it with prescription trends from the pre-pandemic period. Methodology: This study analyzed antibiotic prescription patterns at the University Dental Clinical Center of Kosovo (UCDCK) from 2019 to 2022, focusing on dental patients. Data were collected using a standardized form and a review of electronic health records. Descriptive statistics were used to examine trends, which were compared to data from other countries facing similar healthcare disruptions. The data is organized into quartiles, allowing for a comprehensive understanding of the distribution and trends in antibiotic usage over the four-year period. Results: The study revealed a significant increase in the prescription of broad-spectrum antibiotics, including amoxicillin, clavulanic acid, clindamycin, and metronidazole, during the pandemic period. Data collected from the university dentistry center showed that the highest frequency of antibiotic prescriptions occurred in 2021 (27.6%), while the lowest was in 2022 (22.8%). Metronidazole (39.4%) and amoxicillin with clavulanic acid (38.5%) were the most frequently prescribed antibiotics, together accounting for the majority of prescriptions. Amoxicillin alone represented 18.2%, with other antibiotics prescribed at significantly lower rates. These findings highlight the reliance on these antibiotics for dental treatments and underscore the importance of monitoring prescription trends to optimize usage and minimize resistance risks. Conclusions: The study highlights the impact of the COVID-19 pandemic on dental antibiotic prescription practices in Kosovo, revealing a concerning increase in broad-spectrum antibiotic use. This underscores the need for improved antibiotic stewardship in dental settings, particularly during public health crises, to prevent the exacerbation of antimicrobial resistance. Ensuring continued access to routine dental care and developing robust protocols for antibiotic prescription during emergencies are essential to mitigate the long-term public health impacts of increased antibiotic use. Full article

Space maintainers (SMs) are essential for preserving dental arch integrity after premature tooth loss. This study aimed to develop a deep learning model to predict the necessity of SMs and identify specific teeth requiring intervention. A dataset of 400 dental X-rays was preprocessed to standardize image dimensions and convert them into numerical representations for machine learning. The dataset was divided into training (80%) and testing (20%) subsets. A Convolutional Neural Network (CNN) was designed with multiple convolutional and pooling layers, followed by fully connected layers for binary classification. The model was trained using 30 epochs and evaluated with accuracy, precision, recall, F1-score, ROC AUC, and MCC. The CNN achieved 94% accuracy, with a precision of 0.93 for Class 0 (no SM needed) and 0.95 for Class 1 (SM needed). The ROC AUC was 0.94, and the MCC was 0.875, indicating strong reliability. When tested on 86 X-ray images, the model successfully identified specific teeth (showing teeth number) requiring SMs, with minimal errors. These results suggest that the proposed AI model provides high-performance predictions for SM necessity, offering a valuable decision-support tool for pediatric dentistry. Full article

The development of laser technology has revolutionized dentistry, offering complementary and alternative approaches to traditional techniques. Lasers have been successfully integrated into various dental procedures, enhancing treatment outcomes and patient care. Several types of lasers can increase the acid resistance of enamel, thus preventing caries. Laser fluorescence has been utilized for the pre-operative diagnosis of dental caries, enabling early detection and effective treatment planning. The therapeutic application of lasers in caries treatment aligns with the contemporary philosophy of minimally invasive procedures. Clinicians can use laser Doppler flowmetry as a supplementary tool for pulp vitality testing by detecting pulpal blood flow. Lasers are also employed in various pulp-related interventions, such as managing dentine hypersensitivity and performing root canal therapy. These procedures benefit from the precision and reduced invasiveness provided by laser technology. Furthermore, laser fluorescence serves as an additional tool for subgingival calculus detection. High-power and low-power lasers are used in both nonsurgical and surgical therapies to treat periodontal and peri-implant diseases, oral mucosa conditions, and even cancer based on their specific properties. Lasers are also utilized to accelerate bone regeneration, promote adhesive strength, and remove ceramic brackets. In summary, laser technology has significantly impacted contemporary dentistry by facilitating early diagnosis, minimally invasive treatments, and precise operative procedures, ultimately improving patient outcomes and expanding the scope of dental practice. Full article

Background/Objectives: Managing caries lesions that affect the inner third of the dentin is crucial to ensuring pulp vitality; the clinician must make decisions that will affect the vitality of the tooth. Our purpose is to understand the behavior of Spanish dentists in treating deep cavities and to examine whether variations exist based on their academic training and/or years of professional experience. Methods: This study was approved by the ethics committee of the Balearic Islands CEI-IB. A survey was conducted using the SurveyMonkey platform with 11 questions, the first 4 of which focused on defining the characteristics of the respondents. The following six concerned a clinical case of deep caries in tooth number 4.7, and the last regarded the opinion of the actual treatment of the case. The survey was sent by email in April 2022. The results were analyzed with the SPSS 29.0 program using the chi-square test. Results: A total of 347 responses were obtained (93.95%), and those surveyed stated that they apply minimal intervention concepts in their treatments, with 90.49% performing conservative dentistry treatments daily. A total of 56.48% of the respondents had bachelor’s degrees, 12.39% had graduated, 33.14% had a postgraduate degree, 38.90% had a master’s degree, and 17% had a doctorate. Most (40.63%) had been in professional practice for 16–30 years. Conclusions: Significant differences were identified regarding years of professional experience in terms of decision-making in methods of treatment and the choice of materials used for pulp protection. Likewise, significant differences were found regarding the academic training of the respondents, the cavity cleaning method selected, and the use of chemical substances for removing carious dentin. We can conclude that academic training and years of professional practice influence decision-making at some points in treating deep caries lesions. Full article

Odontogenesis, the process of tooth formation, is complex and susceptible to disruptions that can result in dental anomalies such as tooth impaction. The mandibular second premolar, though less commonly impacted than wisdom teeth, presents a unique challenge in pediatric dentistry due to its intricate etiology and the need for timely intervention. This case report aims to highlight the significance of early diagnosis and conservative management strategies in treating mandibular second premolar impaction. The case involves a pediatric patient with impacted mandibular second premolars. Initial treatment included the use of a lower removable appliance with an expansion screw to alleviate crowding, followed by a fixed space maintainer and a Haas rapid palatal expander. These interventions created the necessary space for the premolars to erupt. Self-ligating brackets were later applied, reducing friction and improving periodontal health. The patient underwent two CBCT examinations to monitor progress, which confirmed the successful eruption and alignment of the impacted premolars without the need for surgical exposure. This case underscores the effectiveness of early diagnosis and minimally invasive treatment in managing mandibular second premolar impaction. The tailored approach facilitated the natural eruption of the teeth, highlighting the importance of individualized treatment plans. Future research should focus on optimizing these conservative strategies to enhance patient outcomes in similar cases. Full article

Accurate detection of implant loosening is crucial for early intervention in total hip replacements, but current imaging methods lack sensitivity and specificity. Vibration methods, already successful in dentistry, represent a promising approach. In order to detect loosening of the total hip replacement, excitation and measurement should be performed intracorporeally to minimize the influence of soft tissue on damping of the signals. However, only implants with a single sensor intracorporeally integrated into the implant for detecting vibrations have been presented in the literature. Considering different mode shapes, the sensor’s position on the implant is assumed to influence the signals. In the work at hand, the influence of the position of the sensor on the recording of the vibrations on the implant was investigated. For this purpose, a simplified test setup was created with a titanium rod implanted in a cylinder of artificial cancellous bone. Mechanical stimulation via an exciter attached to the rod was recorded by three accelerometers at varying positions along the titanium rod. Three states of peri-implant loosening within the bone stock were simulated by extracting the bone material around the titanium rod, and different markers were analyzed to distinguish between these states of loosening. In addition, a modal analysis was performed using the finite element method to analyze the mode shapes. Distinct differences in the signals recorded by the acceleration sensors within defects highlight the influence of sensor position on mode detection and natural frequencies. Thus, using multiple sensors could be advantageous in accurately detecting all modes and determining the implant loosening state more precisely. Full article

The treatment of peri-implantitis is challenging in the clinical practice of implant dentistry. With limited therapeutic options and drug resistance, there is a need for alternative methods, such as photodynamic therapy (PDT), which is a minimally invasive procedure used to treat peri-implantitis. This study evaluated whether the type of photosensitizer used influences the results of inflammatory control, reduction in peri-implant pocket depth, bleeding during probing, and reduction in bone loss in the dental implant region. We registered the study in the PROSPERO (International Prospective Register of Systematic Review) database. We searched three main databases and gray literature in English without date restrictions. In vivo randomized clinical studies involving individuals with peri-implantitis, smokers, patients with diabetes, and healthy controls were included. PDT was used as the primary intervention. Comparators considered mechanical debridement with a reduction in pocket depth as the primary outcome and clinical attachment level, bleeding on probing, gingival index, plaque index, and microbiological analysis as secondary outcomes. After reviewing the eligibility criteria, we included seven articles out of 266. A great variety of photosensitizers were observed, and it was concluded that the selection of the most appropriate type of photosensitizer must consider the patient’s characteristics and peri-implantitis conditions. The effectiveness of PDT, its effects on the oral microbiome, and the clinical patterns of peri-implantitis may vary depending on the photosensitizer chosen, which is a crucial factor in personalizing peri-implantitis treatment. Full article

This review aimed to systematically investigate the effect of minimal intervention dentistry on patient-reported and observation-based outcomes of anxiety, pain and patient cooperation in the pediatric population. Microinvasive treatments (MITs) were compared to conventional treatments, home-based and professionally applied non-invasive treatments (NITs), and between MITs. Two reviewers independently screened studies from four electronic databases, extracted data, assessed the risk of bias and certainty of evidence with the GRADE approach. Ultimately, 26 studies were included for qualitative synthesis, with the data from 12 studies being incorporated into the meta-analysis. No statistically significantly differences in terms of anxiety were noted between MITs and conventional treatments, or between MITs from the meta-analyses. The treatment durations of MITs were not necessarily shorter than conventional treatments but varied with the use of local anesthesia, behavioral and clinical approach, and other confounding factors. The certainties of evidence were deemed low due to high risk of bias of the included studies. NITs evoked less anxiety and pain compared to MITs. Minimal intervention dentistry is an alternative treatment to manage dental caries among children and does not arouse different levels of dental anxiety and pain compared to other treatment modalities. However, further well-designed studies are required to draw an evidence-based conclusion. Full article

Background: The philosophy of minimum interventional dentistry (MID) is to integrate prevention, remineralization, and minimal intervention for the placement and replacement of restorations. All branches of dentistry play an important role in practicing MID, and their primary goal is to realize that any restoration is of less biological significance than the healthy original tissue Objectives: The objective of this study was to assess the perception of MID among dental undergraduate students and interns in terms of knowledge, attitude, and practice at the College of Dentistry. Materials and Methods: This cross-sectional study was conducted among undergraduate students and interns at the College of Dentistry, Qassim University, Saudi Arabia. A self-administered questionnaire was distributed, which included basic demographic profiles and questions about the knowledge, attitude, and practices toward MID. The data were tabulated in MS Excel, and all statistical analyses were performed using SPSS version 21. Results: A total of 163 dental students were recruited, with senior students comprising 73% and interns comprising 27%. Male students were slightly more prevalent (50.9%) than female students (49.1%). About 37.6% of participants received training about MID during educational courses, while 10.3% received it during their internship. A statistical test revealed that the prevalence of interns who were trained in performing MID was significantly higher (p < 0.001). Conclusions: The majority of the participants demonstrated proper knowledge, attitude, and practice in different aspects of MID. Interns reported a higher rate of knowledge, attitude, and practice in MID compared to undergraduate students. However, more education and hands-on training about MID concepts during the college curriculum are necessary to attain better knowledge, attitude, and practices that could be useful for more conservative clinical practice. Full article

Restorative dentistry aims to create a favorable environment to arrest caries with minimal operative intervention. The Hall technique (HT) involves the seating and cementation of stainless steel crowns (SSC) on primary molars without any tooth preparation, caries removal, or local anesthesia. In this manner, it entombs bacteria and arrests caries’ progress. We compared bacterial distribution and quantity among primary molars affected with caries and restored with SSC using the HT (n = 10), the conventional technique (CT; n = 10), or not restored at all (control; n = 10). The teeth were contaminated with Enterococcus faecalis to mimic the clinical situation in the oral cavity and then incubated for 21 days. They were then cut mesiodistally and evaluated with confocal laser scanning microscopy. Total bacterial load (live + dead) in the mesial and distal areas of the crown showed no significant difference between the groups (p = 0.711), but there were significantly more dead than live bacteria in the CT and control groups versus the HT group (p = 0.0274 and p = 0.0483, respectively). Inside the pulp chamber and the crown area, the total bacterial load was significantly higher in the HT compared to the CT group (p < 0.001). Significantly more dead than live bacteria were observed in all tooth areas treated with the HT (p = 0.0169). Bacterial penetration depth was significantly correlated with bacterial load (p = 0.0167). In conclusion, although more bacteria were present in teeth that had undergone the HT versus those treated with the CT, they were mainly unviable. Additionally, the CT and the HT showed a similar performance in terms of marginal leakage, indicating that complete caries removal is not essential to achieve good sealing. Full article

Background: The goal of materials should be early caries detection, removal of carious lesions, and reduction of dentin hypersensitivity. Thus, the study aims to determine the efficacy of a bioactive caries detecting dye (BCD) for the diagnosing and mechanical removal of occlusal and proximal dental caries. Methods: Patients with occlusal (A1, A2) and proximal carious lesions (B1, B2) were treated with the rotary technique and BCD solution on 120 teeth (n = 60 for each). Group 1: Excavation was performed using diamond points. Group 2: 0.5 mL of BCD solution was scrubbed for 20 sec and excavation was performed with a sharp spoon excavator. Post-excavation cavity volume analysis was performed using a 3D scanner. The time required, VAS for pain, VAS for facial expression, and sound eye motor scoring were scored during excavation. Post-restoration evaluation was performed at 3, 6, and 12 months (FDI criteria). Results: The chi-square test revealed that the A1 (197.90 30.97 s) and B1 (273.06 69.95 s) had significantly less mean procedural time than the A2 (292.13 44.87 s) and B2 (411.86 88.34 s). BCD (A2, B2) group showed good patient acceptance, less pain during caries excavation VAS (p = 0.001, FACE (p = 0.001), and SEM (p < 0.001) analysis than the rotary group. There was a statistically insignificant difference between groups immediately (p = 0.235), (p = 0.475) and after 24 h (p = 0.561), (p = 0.688). Color score, hardness of excavated surface, and caries removal score for occlusal and proximal groups showed insignificant differences between the groups. BCD group showed significantly less mean caries excavated volume for the occlusal group (p = 0.003) as compared to the proximal group (p = 0.417) evaluated by 3D scanner. Evaluation of restoration after 3-, 6-, and 12 months intervals (Occlusal caries group (p = 0.247), (p = 0.330), and (0.489) and Proximal caries group (p = 0.299), (p = 0.594), and (0.494)) was acceptable for both the groups. Conclusion: BCD helps in identification of dental caries clinically, radiographically, and in effective removal of denatured teeth with less pain or sensitivity. Full article

Tooth extractions, especially of impacted lower third molars, are among the most common procedures performed in dental practices. The continuity of the patient’s oral mucosa, which is interrupted during them, can manifest itself in general discomfort, pain, swelling, and even trismus. In the age of cosmetic dentistry, when lost teeth are restored through implant, prosthetic, and orthodontic treatment, each tooth extraction actually reduces the amount of available alveolar bone. This has prompted researchers to develop extraction sockets treatment procedures that reduce the negative consequences of surgical intervention while also enhancing the rate of alveolar bone and soft tissue regeneration using minimally invasive approaches. This is expected to enable or significantly facilitate further stages of treatment. The aim of this paper is to review the literature on the use of autologous blood preparations, which are considered to aid regenerative processes when applied to extraction sockets. Full article

The resin infiltration (RI) technique was introduced as one of the minimal intervention dentistry strategies in addressing dental caries among the paediatric population. This technique used the low-viscosity resin monomer to infiltrate the non-cavitated carious lesion and other developmental enamel porosities, thus allowing the conservation of the tooth structure. This narrative review aims to explore the value of RI in Paediatric Dentistry. Through our search of the literature, the development of the material, their clinical applications and shortcomings, as well as the innovation that has been carried out to improve the current RI, were discussed. There are number of high-level evidence supporting the use of RI in arresting non-cavitated proximal caries lesions in primary and permanent teeth, but its efficacy in managing anterior white spot lesions is still unclear. Limited penetration depth, not radiopaque and questionable long-term colour and material stability were among the limitation of the material. Various laboratory-based studies have been conducted to improve the current properties of RI. Nevertheless, RI has emerged as one of the important micro-invasive techniques in addressing non-cavitated and anterior white-spot enamel lesions in children and adolescents with great success. Full article

The contemporary approach for operative caries management emphasizes personalized interventions for each patient, dependent upon the individual’s caries susceptibility/risk, the stage of the carious lesion and its activity. The clinician’s challenge is to optimize the extent of cavity preparation and the choice of dental restorative biomaterials, appreciating the benefits offered by ion-releasing restorative materials. There is a growing application of bioactive/bio-interactive materials in minimally invasive operative dentistry, as they may help with tissue recovery by ion release. In case of moderate or extensive occlusal cavitation, the clinical criteria include the individual caries susceptibility and carious lesion activity. In high caries risk cases, ion-releasing biomaterials (IRB) can be used, as well as for active carious lesions. In proximal lesions, the clinical criteria include the individual caries susceptibility, the lesion activity and presence of cavities with little or no enamel at the gingival margin. This article aims to discuss the restorative ion-releasing options, according to different clinical situations, and the caries susceptibility to manage cavitated carious lesions in permanent adult teeth. Full article