Search Results (94)

Background: This study aimed to analyze and compare the translucency and marginal adaptation of five resin-based materials used as occlusal sealants, both before and after simultaneous fatigue and thermocycling. Two null hypotheses were tested: (1) All tested materials allow the transillumination of sealed occlusal carious lesions. (2) There are no differences in marginal adaptation before and after simultaneous fatigue and thermocycling. Methods: Forty extracted human molars with early occlusal caries lesions were randomly divided into five equal groups. Near-infrared transillumination images of cleaned occlusal surfaces were captured before and after applying the following sealants: (I) OptiBond FL (adhesive alone), (II) OptiBond FL (primer and adhesive) (Kerr Corp., Brea, CA, USA), (III) Scotchbond Universal (3M, St. Paul, MN, USA) combined with OptiBond FL adhesive, (IV) Fissurit (VOCO GmbH, Cuxhaven, Germany), (V) Helioseal Clear (Ivoclar Vivadent AG, Schaan, Liechtenstein). A scanning electron microscope was used to assess marginal adaptation before and after simultaneous fatigue and thermocycling. The percentages of continuous margins (CMs) were quantified before and after the fatigue test and statistically compared (Shapiro–Wilk Normality test, two-way ANOVA with Fisher’s post hoc test). Results: Helioseal Clear and Fissurit were fully transparent under near-infrared transillumination. The percentage of closed margins significantly decreased after loading in one group: OptiBond FL primer application before adhesive application significantly reduced marginal adaptation. Conclusion: OptiBond FL (adhesive), Scotchbond Universal with OptiBond FL (adhesive), Fissurit, and Helioseal Clear provided excellent marginal adaptation. However, using OptiBond FL primer on enamel negatively impacted adaptation. Helioseal Clear and Fissurit, as transparent sealants, may allow lesion monitoring using an 850 nm transillumination camera. Full article

Background: The treatment of head and neck cancer primarily involves surgical tumor removal combined with radiotherapy and/or chemotherapy. It often leads to significant side effects, impacting the anatomical structures of the oral cavity and resulting in major functional, esthetic, and socio-relational alterations. Case presentation: This clinical report aims to demonstrate the effectiveness of a hospital-based approach incorporating general anesthesia (GA) and computer-aided design and manufacturing (CAD/CAM) technology in the oral rehabilitation of a 58-year-old woman in remission from intraoral squamous cell carcinoma of the mandibular symphysis. The patient presented with oral pain, radiation-induced caries, reduced occlusal vertical dimension, and severely compromised teeth. Treatment Approach: The treatment plan included the removal of two non-restorable teeth, root canal treatment for the remaining teeth, and the placement of ceramic crowns and a partial removable prosthesis. Due to the complexity of the case and the patient’s limitations, the treatment was performed under GA, allowing for a staged approach. Digital technologies, including intraoral scanning and CAD-CAM, enhanced precision and patient comfort. This approach facilitated tooth preservation and minimized the number of extractions while achieving satisfactory functional and esthetic outcomes. Conclusion: The case highlights the value of GA and digital techniques in managing special-needs patients with a history of irradiated head and neck cancer. Full article

Background/Objectives: The aim of this in vitro study was to determine the optimal combinations of wavelengths for short wavelength infrared (SWIR) multispectral transillumination and reflectance imaging of caries lesions on proximal and occlusal surfaces. Methods: The contrasts of (n = 76) caries lesions on the occlusal and proximal surfaces of extracted teeth were measured at 1050, 1300, and 1550 nm for occlusal transillumination and 1058, 1300, 1450, and 1675 nm for occlusal reflectance. All teeth were also imaged using radiography and microcomputed tomography (μCT) to verify lesion presence. A custom-fabricated handheld imaging probe suitable for clinical use and for the simultaneous acquisition of SWIR occlusal transillumination and reflectance (SWIR-OTR) images was used. Three high-power superluminescent diode lasers were used for transillumination, and a fiber-optic switch was used to switch between the transillumination wavelengths. Optical bandpass filters coupled with a tungsten halogen lamp were used for reflectance. All images were acquired at the same position and with the same field of view for comparison. Results: The highest contrasts in reflection were at 1450 and 1675 nm for occlusal and interproximal lesions, and the highest contrasts for transillumination were at 1050 and 1300 nm. Conclusions: This study suggests that the best wavelengths for SWIR-OTR are between 1000 and 1300 nm for transillumination and greater than 1400 nm for reflectance. Wavelengths beyond 1400 nm are advantageous for reflectance and yield significantly higher contrast. Wavelengths beyond 1300 nm are not promising for occlusal transillumination since internal water absorption leads to contrast inversion. Full article

Objectives: This study examines the association between a predominantly soft-textured diet and clinical signs of maxillary bone hypoplasia, such as maxillary constriction and related malocclusions like crossbite. A secondary aim is to assess whether this diet correlates with dental caries and higher plaque index in children with early mixed dentition. Methods: A total of 106 pediatric patients (4–12 years) were enrolled during routine visits (June 2022–February 2024), divided into 53 “cases” (maxillary hypoplasia and malocclusions) and 53 “controls” (normal maxillary development, no malocclusions). Patients with congenital craniofacial malformations were excluded. Dietary habits were assessed using a food questionnaire categorizing foods into four consistencies (“Semi-Liquid”, “Creamy”, “Soft”, and “Solid”). The DMFT index was calculated, considering only missing teeth due to caries. The plaque index (PI) was recorded at the first visit to evaluate the relationship between food texture and plaque accumulation. Statistical analyses included Student’s t-test, Z-test, Chi-square test, and Fisher’s exact test. Results: Mixed breastfeeding was common in both groups with no significant difference. However, natural breastfeeding was significantly more frequent in the non-crossbite group. A high-arched palate was more prevalent in the crossbite group (p = 0.042 *). Soft food consumption was significantly higher in the crossbite group compared to controls (p = 0.032 *). A statistically significant association was found between caries prevalence (DMFT > 0) and posterior crossbite (p = 0.04). Furthermore, the relationship between the dental plaque index and food consistency demonstrated a statistically significant result. In particular, there was a correlation between soft food and semi-solid foods and the plaque index (χ² = 3.55, p = 0.04). Conclusions: Posterior crossbite is associated with increased consumption of soft foods, potentially reducing the mechanical stimulation essential for maxillary growth. Conversely, non-crossbite subjects consume more hard foods and are more frequently breastfed naturally, reinforcing their role in craniofacial development. Additionally, posterior crossbite is associated with higher caries prevalence, indicating a potential connection between occlusion and oral health. Dietary texture also influences oral hygiene, with soft and semi-solid foods correlating with increased plaque accumulation, while no association was found with solid or hard foods. Full article

Background/Objectives: Artificial intelligence (AI)-based software is increasingly used for radiographic analysis in dentistry. This study aimed to evaluate the diagnostic accuracy of an AI-powered radiographic analysis system, using Diagnocat (DGNCT LLC, Miami, FL, USA) as an example, compared with clinical evaluations performed by three experienced dentists. The assessment focused on primary caries detection and the total number of primary and secondary caries based on panoramic radiographs (OPGs). Methods: Three dentists with similar expertise independently classified teeth for treatment using only panoramic radiographs and their clinical knowledge. The study was conducted under single-blind conditions, where clinicians were unaware that their diagnoses would be compared to the AI system’s analysis. Results: The AI system’s agreement with human evaluations varied depending on tooth location, patient age, and gender. The lowest agreement was observed for premolars, likely due to limitations of 2D imaging, while higher accuracy was found for molars and incisors, particularly in younger patients. The system showed limitations in detecting occlusal, labial, and lingual caries. Conclusions: AI-assisted radiographic analysis has the potential to enhance diagnostic efficiency and automation in dentistry. However, its accuracy is influenced by tooth location and imaging modality. Further research is needed to explore the benefits of integrating AI with 3D imaging techniques to improve diagnostic reliability. Full article

Background/Objectives: Smith–Lemli–Opitz syndrome is a metabolic autosomal recessive disease, characterized by congenital defects, with concomitant psychomotor developmental delay. The symptoms are variable and depend on the clinical form of the disease. The aim of this study was to assess the prevalence and types of oral abnormalities in children and adolescents with Smith–Lemli–Opitz syndrome. Methods: The study enrolled 30 patients, including 15 subjects with Smith–Lemli–Opitz syndrome, confirmed by a genetic examination. We performed an extra- and intraoral examination, paying attention to the presence of dysmorphic features, including the shape and symmetry of the face; the condition of the skin and lips; the gingival and hygienic status; dental caries; lesions of non-carious origin; abnormalities of size, shape, and number; and alignment of teeth in the dental arch. Results: Patients in the study group presented with micrognathia, a short neck, ptosis, and an upturned nose. More frequently than in the control group, we observed occlusal abnormalities and dental crowding, anatomical abnormalities or gingivitis. The prevalence of dental caries in both groups was similar; however, the study group recorded higher dmft and DMFT values. Conclusions: The phenotypic features of patients with Smith–Lemli–Opitz syndrome increase their risk of developing dental caries and gingivitis. Full article

This article reviews the topic of stannous fluoride as an anti-caries additive in toothpastes. It is based on a literature survey carried out using Science Direct, supplemented by information from PubMed. The keywords used were stannous fluoride, toothpaste, clinical effects, caries, hypersensitivity, gingival health, structure and aqueous solutions. The initial searches covered the period 2015–2024 and identified 57 references. Older references cited in these papers, and also papers already known to the author, were also included. The information thus obtained shows that stannous fluoride has three main effects, namely, reduction in the viability of the oral biofilm, increase in remineralisation of the hydroxyapatite tooth mineral and occlusion of dentinal tubules leading to reduced hypersensitivity. Stannous fluoride was shown to be the most effective of all the fluoride additives used in toothpastes. In much of the dental literature, this is attributed to the effects of Sn²⁺ ions. However, as has been shown extensively in the wider scientific literature, free Sn²⁺ ions do not occur in aqueous systems. Rather, the initial products of the dissolution of SnF₂ is undissociated, hydrated SnF₂ and SnF⁺ ions. These gradually exchange fluoride to form Sn(OH)₂ and Sn(OH)⁺. Their likely mechanism of action based on their toxicity towards oral micro-organisms and their interaction with hydroxyapatite is discussed. Full article

Background: Dental caries remains one of the most widespread chronic diseases that also affects first permanent molars (FPMs). In this study, we analyzed the prevalence of carious lesions using a standardized evaluation system, while following the analysis of the influence of favoring factors represented by the type and frequency of snacks and the frequency of tooth brushing. Method: A clinical–statistical study was carried out on a group of 311 children from both urban and rural environments, aged between 6 and 19 years old. As a diagnostic system and assessment of the depth of carious processes, we used the ICDAS system. The following parameters were recorded: odontal status of the 4 FPMs, age, gender, residence, frequency of dental brushing, and frequency of between-meal snacks and their type. The ICDAS system was used as a diagnostic system and assessment of the depth of carious processes. The data were statistically analyzed with SPSS, using the Kruskal–Wallis H and Chi-Square tests. Results: The occlusal surface was the most interesting in the presence of odontal lesions. Sweet snacks were the most frequent snacks consumed by the subjects. The age group of 13–19 years presented fewer healthy FPMs, compared to the age group of 6–12 years. The higher involvement of older subjects was found for all four molars, both in the case of identified carious lesions and the presence of root debris and edentations. Brushing twice a day was more frequent in the 6–12 age group. In analyzing the status of the first molars in relation to the gender of the subjects, in the present study, no statistically significant differences were recorded between the status of the molars relative to gender, except for molar 1.6 (p > 0.05). Regarding the other types of snacks, children from rural areas consume more fruits than those from urban areas. Conclusions: The frequency of tooth brushing and the type and frequency of snacks between meals influence the prevalence of carious lesions at the level of the first permanent molars. Full article

Background/Objectives: Dental agenesis is the congenital absence of at least one tooth and has been associated with several other developmental dental conditions, such as morphological dental alterations and Carabelli trait. This study sought to investigate whether third molar agenesis is associated with Carabelli traits in permanent molars. Methods: This was a cross-sectional study that used a convenience sample obtained from the orthodontic records of German patients. Patients with syndromes, oral clefts, congenital alterations including dental agenesis (except agenesis of third molars), and severe cases of bruxism with a loss of tooth tissue were excluded. Teeth with cavitated lesions of dental caries, occlusal wear, restorations, and evident dental deformities were not included in the evaluation. The Carabelli trait was evaluated in the permanent maxillary molars. The Carabelli trait was classified according to its expression for each tooth as either absent, negative, and positive expressions. Third molar agenesis was evaluated only in patients older than 10 years old (based on when initial tooth formation should be visible in the panoramic radiographs). The two-sided Chi-squared test was used to investigate the association between the conditions, using an alpha of 5% (p < 0.05). Results: A total of 155 patients (74 females and 81 males) were investigated; 39 had third molar agenesis and 75 had the Carabelli trait. There was no statistical significance difference between patients with third molar agenesis and those with Carabelli traits in relation to sex (p > 0.05). The Carabelli trait was more common in first molars than in second molars. There was no statistical significant association between third molar agenesis and Carabelli traits (p > 0.05). Conclusions: Third molar agenesis was not associated with the Carabelli trait in the permanent molars in this population. Full article

Background/Objectives: Many older adults living in long-term care (LTC) environments have varying numbers of retained natural teeth. The objective of this study was to assess the disease findings based on tooth type and estimate the role of tooth types in occlusion. Methods: We conducted clinical oral examinations of 276 LTC residents. The disease findings were analyzed for each tooth type and to determine their associations with dementia. Results: In total, 67.8% of the participants had molar teeth. Premolars/canines were often present as residual roots and had caries. Deepened periodontal pockets and higher plaque index (PI) values for molars had odds ratios of 2.5 (95% confidence interval [CI] of 1.59–3.91) and 1.61 (95% CI of 1.29–2.02), respectively. Participants with dementia were more likely to have incisors and premolars/canines in the form of root remnants and higher PI scores for all tooth types (p ≤ 0.01), as well as more deepened periodontal pockets in all teeth (p = 0.029), than those without dementia. The median number of remaining molars per participant was 3 out of a maximum of 12 (95% CI 3.4–4.0); thus, they often lacked occlusal contact. Conclusions: The LTC residents’ molars were more prone to periodontal problems, whereas their premolars/canines often had caries or were present in the form of root remnants, especially in the participants with dementia. People’s teeth should be treated in an easy-to-maintain way before they move into LTC to enable daily oral hygiene measures and maintain oral health. Full article

Prosthodontic treatment of developmental age patients presents a significant challenge to the dentist. The growth and development of the stomatognathic system must be considered in treatment planning. Temporary prosthetic restorations must be regularly inspected and recemented, and final prosthetic restoration should not be delivered until the growth of the body is complete. In addition, due to the complex nature of morphological and functional disorders during the developmental period, simultaneous prosthetic and orthodontic treatment may be required. The case presented in this article is a 16-year-old boy with severe tooth destruction caused by untreated caries disease and poor oral hygiene. The patient required conservative, endodontic, and surgical treatment to restore the occlusion and aesthetics to allow the proper development of the masticatory organ. This article also presents the treatment case of a young patient with damaged crowns in the upper arch, which were restored with standard root–crown posts and cores and temporary 3D-printed composite crowns. Full article

Background: Obstructive sleep apnea (OSA) is a prevalent sleep disorder characterized by repeated episodes of partial or complete obstruction of the upper airway during sleep. While the systemic implications of OSA are well documented, the dental consequences are less frequently discussed yet equally significant. This review aims to elucidate the oral health impacts of OSA, emphasizing the importance of interdisciplinary care. Methods: A comprehensive literature search was conducted across several databases to identify studies examining the relationship between OSA and various oral health parameters. The review included observational studies, clinical trials, and systematic reviews published in English up to January 2024. Results: OSA was significantly associated with heightened risks of bruxism, dry mouth, periodontal disease, temporomandibular joint disorders, palatal and dental changes, and alterations in taste sensation. Mouth breathing associated with OSA was a critical factor in exacerbating xerostomia and dental caries. Furthermore, the systemic inflammation induced by OSA appeared to correlate with the severity of periodontal disease. Patients using oral appliance therapy for OSA also showed notable changes in dental occlusion and required ongoing dental monitoring. Conclusions: The findings underscore the bidirectional relationship between OSA and oral health, highlighting the need for dental professionals to be integral participants in the management of OSA. Early dental evaluation and intervention can contribute to the overall health and quality of life of individuals with OSA. The review advocates for the development of clinical guidelines to facilitate the early identification and management of OSA-related oral health issues within dental practice and encourages a collaborative approach to patient care. Full article

In pediatric and operative dentistry, caries treatment benefits from a therapeutic option based on the use of silver fluoride (AgF) associated with potassium iodide (KI) to avoid dark colorations on dental tissues. The objective of this in vitro study is to evaluate the retention of glass ionomer cement (GIC) on a dentin when treated with AgF and KI. Twenty-two healthy human permanent molars and eight human primary teeth, all free of any decay, were cut to obtain occlusal flat dentinal surfaces and were then treated with AgF for a duration of 60 s. For half of the teeth, a drop of KI was applied for a duration of 30 s. All samples were covered with a plot of GIC and their resistance to shear bond strength was measured. The fracture resistance in both permanent and primary teeth does not show any statistically significant differences whether KI was applied or not. For permanent teeth, the resistance is slightly higher in the group treated with KI than in the group treated with AgF alone. To our knowledge, these data are the first to describe the possible application of KI both on primary and permanent teeth. In any case, further studies are needed to investigate the bond strength between dentin and GIC on a wider range of samples. Full article

Background and Objective: Sealant application is a proven method to prevent occlusal caries; however, long-term studies on this topic are scarce. This study aimed to assess the survival rate and clinical effectiveness of glass ionomer cement (GIC) and resin-based sealants (RBSs) on second permanent molars over a long-term follow-up period. Materials and methods: Sixteen patients aged 11–13 years with all four completely erupted permanent second molars were enrolled in the study. All patients attended 1-year and 3-year follow-ups; however, one participant did not respond after 10 years and was excluded from the final analyses. The oral health status evaluation was based on WHO criteria. A total of 32 teeth received an RBS (Clinpro), and a further 32 teeth were sealed with GIC (Fuji IX). The sealant retention was determined according to the Kilpatrick criteria after 1 year, 3 years, and 10 years, respectively. Statistical analysis included a chi-square test, the Kaplan–Meier method, and the Cox proportional hazard model. Results: At baseline, seven boys and eight girls participated in the study, with a mean age of 12.3 ± 0.9 years. The 1-year follow-up results revealed that 90% of the RBSs and 43.3% of the GIC sealants were completely retained, and no caries lesions were recorded (p = 0.01). The 3-year follow-up results showed that 23.3% of the RBSs and 0% of the GIC sealants demonstrated complete retention (p = 0.034). Moreover, 10.0% of the occlusal surfaces in the RBS group and 13.3% of the occlusal surfaces in the GIC group were filled (p > 0.05). A total of 6.7% of the RBSs showed complete retention. One-third of the sealed teeth (30.0% of the teeth sealed with RBSs and 36.7% of teeth applied with GIC) were filled after 10 years. The Kaplan–Meier analysis demonstrated a higher survival rate in the RBS group when compared with the GIC over the entire follow-up period (p = 0.001). Conclusions: Although the survival rate of RBSs was higher than GIC sealants, their effectiveness in preventing fissure caries in permanent second molars did not differ significantly over a 10-year follow-up. Full article

The possibility of dental pulp damage during dental procedures is well known. According to studies, during finishing and polishing without cooling, temperatures of up to 140 °C or more can be generated. There are many studies that have analysed the influence of the finishing and polishing of fillings on the mechanical parameters, but the analysis of thermal parameters has led to uncertain results due to the difficulty of performing this in vivo. Background: We set out to conduct a study, using the finite element method, to determine the extent to which the type of class II cavity and the volume of the composite filling influence the duration of heat transfer to the pulp during finishing and polishing without cooling. Materials and Methods: A virtual model of an upper primary molar was used, with a caries process located on the distal aspect, in which four types of cavities were digitally prepared: direct access, horizontal slot, vertical slot and occlusal–proximal. All four cavity types were filled using a Filtek Supreme XT nanocomposite. Results: The study showed that the filling volume almost inversely proportionally influences the time at which the dental pulp reaches the critical temperature of irreversible damage. The lowest duration occurred in occlusal–distal restorations and the highest in direct access restorations. Conclusions: based on the results of the study, a working protocol can be issued so that finishing and polishing restorations without cooling are safe for pulpal health. Full article