Showing papers in "European Journal of Dentistry in 2021"

COVID-19: The Dentists' Perceived Impact on the Dental Practice.

Abstract: Objectives The present study aimed to investigate the dentists’ knowledge of the risks from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and how it will impact their practice. Materials and Methods An ad hoc self-administered anonymous questionnaire was submitted to Italian dentists. Statistical Analysis Differences in rates were calculated using the chi-square test. The level of significance was set at p Results A total of 849 dentists fully completed the survey. Eighty-eight per cent of Italian dentists are worried about the health of their families, with no difference in high-risk (red zone) and low-risk (orange zone) regions. About 86% of professionals report some income loss and 94% fear a drop in patients after the quarantine phase, with the dentists working the red zone claiming a greater economic loss and fearing a reduced practice after the end of the lockdown. Discussion A large majority of the Italian dentists appears to be aware of the need for changes in their dental practices by planning specific sterilization processes between appointments, testing patients for SARS-CoV-2 serology, asking patients not to be accompanied, and reducing the number of visits per day. Conclusion The survey expresses the serious concern of the dentists for the pandemic’s effects on their profession.

Clinical Performance of Bulk-Fill Resin Composite Restorations Using the United States Public Health Service and Federation Dentaire Internationale Criteria: A 12-Month Randomized Clinical Trial.

Abstract: Objective This study was aimed to compare the 12-month clinical performance of two full-body bulk-fill resin composites Filtek bulk fill/3M ESPE (FBF) and Tetric EvoCeram bulk fill/Ivoclar Vivadent (TBF) and a conventional microhybrid resin composite Filtek Z250/3M ESPE (Z250) using the modified the United States Public Health Service (USPHS) and Federation Dentaire Internationale (FDI) criteria. Also, the agreement between the two evaluation criteria was evaluated at baseline and after 12 months of follow-up. Materials and Methods A total of 138 class I and II restorations were placed in posterior teeth (split-mouth design) of 46 volunteers following manufacturer’s instructions and bonded with a self-etching bonding agent (Clear fill SE Bond/Kuraray). The restorations were evaluated at baseline and after 12 months of follow-up by three previously calibrated dentists (Cohen’s K = 0.84). Statistical Analysis Fisher’s exact test and Pearson’s Chi-squared test were used to evaluating the homogeneity of distribution of the clinical characteristics. Friedman’s test was applied to evaluate differences among the resin composites. The results obtained for the USPHS and FDI criteria at the different observation times were compared using the Wilcoxon test. A level of significance of 0.05 was adopted for all tests. Results After 12 months (recall rate, 78.3%, n = 36 patients), the overall success rate was 99.07% for both criteria. Only one failed restoration (0.93%) was detected for each system during follow-up in the TBF group. Conclusion The bulk-fill resin composites showed satisfactory clinical performance compared with conventional resin composite after 12 months. The percentage of the acceptable scores was significantly higher for the USPHS criteria, due to discrepancies in the score description for each criterion.

Effectiveness of Virtual Reality and Interactive Simulators on Dental Education Outcomes: Systematic Review

Abstract: In recent years, virtual reality and interactive digital simulations have been used in dental education to train dental students before interacting with real patients. Scientific evidence presented the application of virtual technology in dental education and some recent publications suggested that virtual and haptic technologies may have positive effects on dental education outcomes. The aim of this systematic review was to determine whether virtual technologies have positive effects on dental education outcomes and to explore the attitudes of dental students and educators toward these technologies. A thorough search was conducted in PubMed, Scopus, MEDLINE (via EBSCO), The Cochrane Library (via Wiley), Web of Science Core Collection (via Thomson Reuters), and Dentistry and Oral Science source (via EBSCO) using the keywords (student, dental) AND (education, dental) AND (virtual reality) OR (augmented reality) OR (haptics) OR (simulation) AND (dentistry) OR (dental medicine). The quality of the reported information was assessed following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement for systematic reviews. A total of 73 publications were considered for this review. Fifty-two of the selected studies showed significant improvement in educational outcomes and virtual technologies were positively perceived by all the participants. Within the limitations of this review, virtual technology appears to improve education outcomes in dental students. Further studies with larger samples and longer term clinical trials are needed to substantiate this potential positive impact of various virtual technologies on dental education outcomes.

COVID-19: The Patients' Perceived Impact on Dental Care.

Abstract: Objectives The present study aims to investigate the effect of the COVID-19 pandemic on people’s mental and physical balance, oral hygiene habits, type of diet, perceived safety of returning to the dentist, and aesthetics with the use of masks. Materials and Methods An online questionnaire was submitted to the Italian population between December 2020 and January 2021. It was sent via online platforms and included 21 questions. Statistical Analysis Differences in rates were calculated by using the Chi-square test. The level of significance was set at p Results A total of 1,008 individuals completed the questionnaire. About 72% of participants were not concerned about returning to the dentist. Approximately 45% of the individuals intensified their oral hygiene and preventive rules. About 38% of participants increased their carbohydrate intake, while 28% increased their fat consumption. Furthermore, 75% of the participants felt that the mask did not diminish the beauty of their smile. Conclusions Most participants felt comfortable returning to the dentist but only for more urgent treatment. However, most people reported that they had not stepped up their home oral hygiene measures. The biggest changes in the population’s eating habits involved increased carbohydrate and fat consumption. Finally, most participants responded that mask use did not compromise their aesthetics.

Mechanical Response of PEKK and PEEK As Frameworks for Implant-Supported Full-Arch Fixed Dental Prosthesis: 3D Finite Element Analysis

Abstract: Objective Polymeric framework represent an innovative approach for implant-supported dental prostheses. However, the mechanical response of ultra-high performance polymers as frameworks for full-arch prostheses under the “all-on-four concept” remains unclear. The present study applied finite element analysis to examine the behavior of polyetherketoneketone (PEKK) and polyetheretherketone (PEEK) prosthetic frameworks. Materials and Methods A three-dimensional maxillary model received four axially positioned morse-taper implants, over which a polymeric bar was simulated. The full-arch prosthesis was created from a previously reported database model, and the imported geometries were divided into a mesh composed of nodes and tetrahedral elements in the analysis software. The materials were assumed as isotropic, elastic, and homogeneous, and all contacts were considered bonded. A normal load (500 N magnitude) was applied at the occlusal surface of the first left molar after the model was fixed at the base of the cortical bone. The microstrain and von-Mises stress were selected as criteria for analysis. Results Similarities in the mechanical response were observed in both framework for the peri-implant tissue, as well as for stress generated in the implants (263–264 MPa) and abutments (274–273 MPa). The prosthetic screw and prosthetic base concentrated more stress with PEEK (211 and 58 MPa, respectively) than with PEKK (192 and 49 MPa), while the prosthetic framework showed the opposite behavior (59 MPa for PEEK and 67 MPa for PEKK). Conclusion The main differences related to the mechanical behavior of PEKK and PEEK frameworks for full-arch prostheses under the “all-on-four concept” were reflected in the prosthetic screw and the acrylic base. The superior shock absorbance of PEKK resulted in a lower stress concentration on the prosthetic screw and prosthetic base. This would clinically represent a lower fracture risk on the acrylic base and screw loosening. Conversely, lower stress concentration was observed on PEEK frameworks.

Periodontal Diseases and COVID-19: A Scoping Review.

Abstract: The aim of this scoping review was to present the existing literature regarding the relationship between periodontal diseases and coronavirus disease 2019 (COVID-19). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping review guidelines was followed. Articles were retrieved from PubMed/MEDLINE and Scopus databases and screened to include studies relating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 to periodontal cells and/or tissues and/or diseases. Twenty-five papers were included; consisting of six reviews, seven original articles, six short reports, four letters to the editor, one commentary, and one case report. The articles were allocated to three different topics: (i) hypotheses on the relationship between periodontal diseases and COVID-19; (ii) risk factors and comorbidities common to periodontitis and COVID-19; (iii) periodontal manifestations of COVID-19. Certain molecules (angiotensin-converting enzyme-2, furin, cathepsin, TMPRSS2...) that are found at a high level in periodontal tissues, particularly in patients with periodontitis, are involved in the mechanism of entry of SARS-CoV-2 into cells. Periodontopathic bacteria could also play a direct role in the mechanism of entry of SARS-CoV-2 by cleaving the S-protein, and the cytokines produced during periodontitis could add to the cytokine storm found in the severe forms of COVID-19. It thus appears that the treatment of periodontitis, which allows a reduction in periodontopathic bacteria and of the local and systemic inflammation state, could be part of a strategy to prevent the development of severe forms of COVID-19.

Current Concepts on the Pathogenesis of Peri-implantitis: A Narrative Review.

Abstract: As implant treatment has been integrated in contemporary dental practice, complications with the forms of peri-implant mucositis and peri-implantitis have also increased in prevalence. Peri-implantitis is the more severe biological complication and is defined as an inflammatory disease affecting peri-implant tissues resulting in bone and eventually implant loss. In addition, the treatment of peri-implantitis has currently become a substantial global economic burden. In the current study, a search was conducted in several electronic databases using specific keywords relevant to the article’s main topic. An increasing number of scientific reports have investigated the etiopathology of peri-implant diseases, focusing mainly on peri-implantitis. Microbial biofilm consists an important etiological factor of peri-implant pathology analogous to periodontal diseases. Although several data confirm that peri-implant infections are dominated by gram-negative bacteria, similar to periodontal infections, there is evidence that some cases may harbor a distinct microbiota, including opportunistic microorganisms and/or uncultivable species. Additionally, data support that several parameters, such as genetic predisposition of individual patients, occlusal overload, and local factors such as titanium particles and excess cement, may be implicated in peri-implantitis pathogenesis. Simultaneously, the release of titanium metal particles and their biological consequences or the presence of excess cement in the adjacent peri-implant tissues have also been suggested as factors that contribute to peri-implant pathology. A specific line of research also indicates the role of foreign body response to implant installation. This narrative review aims to discuss the current concepts of etiopathogenetic factors implicated in peri-implantitis.

Effect of Modeling Resins on Microhardness of Resin Composites.

Abstract: Objectives This study was aimed to determine the effects of modeling resins on the surface microhardness of composites. Materials and Methods Six resin-based composites (Charisma Smart, Estellite Asteria, CeramX-One SphereTEC, Admira Fusion, Filtek Ultimate, and Clearfil Majesty Es-2) and three wetting agents (Modeling Liquid, Composite Primer, and Modeling Resin) were investigated. In all, 240 specimens were prepared, and wetting agents were applied prior to light curing in the experimental groups. After 24 hours, specimens were polished and Vickers microhardness (VHN) values were measured. Statistical Analysis Shapiro–Wilk and two-way analysis of variance (ANOVA) were used for analyses (p Results Both modeling resin and composites were determined to be effective factors (p Conclusion All tested modeling resins decreased VHN value, and the amount of reduction varied among composites and wetting agents. It might be safer not to use wetting agents unless they are necessary.

Micro-osteoperforations and Its Effect on the Rate of Tooth Movement: A Systematic Review

Abstract: Prolonged orthodontic treatments have inconvenienced patients and clinicians alike Surgically assisted techniques for accelerating orthodontic tooth movement have shown promising results in the literature over the years The minimally invasive nature of micro-osteoperforations (MOPs), however, for enhanced orthodontic tooth movement has recently gained momentum, with many clinical trials conducted on both animals and humans An electronic search was performed to extract papers using PubMed, Google Scholar, Scopus, and Web of Science The keywords that were used included “MOP,” “accelerating tooth movement,” “orthodontic tooth movement,” and “regional acceleratory phenomenon” The studies that met our inclusion criteria were extracted and evaluated in this review MOPs have been proven time and again, in animal and human studies alike, to increase the rate of orthodontic tooth movement The application of perforations to cortical bone present in the pathway of teeth, which are specifically to be moved creates transient osteopenia This reduces the density of the cortical bone, hence speeding up the rate of orthodontic tooth movement Many techniques have been implemented and perfected to enhance orthodontic tooth movement and shorten the treatment time in the literature MOPs have proven to be a universally applied, nontechnical, repeatable, and minimally invasive method of accelerating tooth movement, with extremely minimal consequences

Does Growth Stunting Correlate with Oral Health in Children?: A Systematic Review.

Abstract: Growth stunting is when children tend to be shorter than their peers through the World Health Organization child growth standard measurement. The condition may affect the development of the brain and other parts of the body, including the oral cavity, which manifests in oral hygiene and overall oral health. This systematic approach literature study aimed to evaluate the correlation between growth stunting and oral health in children. This study was conducted by using a literature review method with a systematic approach by searching for articles related to research topics on PubMed and Google Scholar. The search was adjusted to the inclusion category, which is research that discusses malnutrition and oral health published between 2010 and 2020—research conducted on boys and girls—from birth to 18 years. The exclusion categories used were articles that did not discuss growth stunting and oral health, and grey literature was excluded. The selection of articles was carried out by using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach and resulted in 10 selected articles with details as follows: the correlation between growth stunting and oral health in three articles. A high plaque index in growth stunting children was found in two articles, and a decrease in saliva composition in growth stunting children was also found in two articles. Four articles showed a relationship between growth stunting and salivary flow rate. Lastly, one article showed the relationship between growth stunting and the incidence of dental caries. Despite the limitation of the review, the correlation between growth stunting and overall oral health in children can be seen through the oral hygiene index as moderate to low, high plaque index, decreased salivary flow rate, salivary composition, and dental caries in children with growth stunting.

Role of Hydroxyapatite and Ellagic Acid in the Osteogenesis.

Abstract: Objective Ellagic acid (EA), a phenolic antioxidant, has benefits in bone health and wound healing. The combination of EA and hydroxyapatite (HA) (EA-HA) is expected to increase osteogenesis. The aim of this study was to analyze osteogenesis after application of EA-HA according to the number of osteoblasts and osteoclasts in the bone and the expression of the receptor activator of nuclear factor kappa-β ligand (RANKL), osteoprotegerin (OPG), and osteocalcin (OCN) protein. Materials and Methods Thirty Wistar rats were assessed with bone defects created in the left femur. The defects were filled with EA-HA and then sutured. Control groups were filled with polyethylene glycol (PEG) or HA. Each group was sacrificed either 7 or 14 days after treatment. Results The defects filled with EA-HA exhibited the highest number of osteoblasts and the greatest expression of OPG and OCN at both day 7 and day 14 (p = 0.000). Conversely, treatment with EA-HA resulted in lower numbers of osteoclasts and reduced RANKL staining at both time points (p = 0.000). Conclusions EA-HA can increase osteogenesis in bone defects by increasing the number of osteoblasts and the expression of OPG and OCN.

Survival Rates for Porcelain Laminate Veneers: A Systematic Review

Abstract: The aim of this systematic review was to analyze and compare the most up-to-date information available on long-term, medium-term, and short-term survival rates of porcelain laminate veneers (PLVs) and investigate the homogeneity in current studies or lack of it. An electronic search was performed using PubMed, Ovid MEDLINE, Cochrane Library, Web of Science, EBSCO, Science Direct, Wiley, and Scopus databases. Based on the PRISMA guidelines, the main inclusion criteria consisted of research articles published after the year 2000, in vivo studies with a follow-up period of at least 1 year and reporting of the Kaplan–Meier estimated cumulative survival rates. Quality assessment of the included studies was performed using the modified systematic assessment list consisting of 24 items. Thirty full-text articles were reviewed in detail. A total of 30 articles met the inclusion criteria and were selected for qualitative synthesis. The remaining 27 publications were retained to discuss the heterogeneity in the current literature and reported longevity of veneer restorations. A conclusive estimation of the longevity of PLVS beyond 20 years is lacking. The availability of evidence in the current literature is limited in terms of sample size and duration of follow-up. However, the majority of studies have concluded that PLVs have high-success rates and predictable patient outcomes. The present literature indicates an increased heterogeneity among research study designs. Researchers should aim for homogeneous study designs that can be included in systematic reviews and meta-analyses.

Effect of Different Polishing Systems on the Surface Roughness and Gloss of Novel Nanohybrid Resin Composites

Abstract: Objectives To evaluate the surface roughness and gloss of three nanohybrid resin composites after polishing with three different polishing systems. Materials and Methods A total number of 112 disc specimens (10 × 3 mm) were prepared from nanohybrid—Empress Direct (ID), Grandio (GR), Filtek Z350 (Z350) and a microhybrid resin composite restorative materials—Filtek Z250 (Z250). Following 24-hour storage in 37°C distilled water, each composite group (n = 28) was assigned into four groups (n = 7) according to finishing/polishing (F/P) system: Mylar strip, Optrapol, Politip, and Sof-Lex (SL). The surface roughness (Ra, mm) was measured by a novel three-dimensional method using an image analysis software attached to an environmental scanning electron microscope. A glossometer was used to measure the surface gloss. Results Statistical analysis used was ANOVA test. Two-way Anova test revealed that the “type of composite” and “F/P techniques” had a significant effect on both surface roughness and gloss of the tested resin composite materials (p Conclusion The tested F/P systems provided comparable surface roughness and gloss for nanohybrid composites. The Sof-Lex system provided the best surface roughness and gloss for nanohybrid composites.

Curcumin Promotes Collagen Type I, Keratinocyte Growth Factor-1, and Epidermal Growth Factor Receptor Expressions in the In Vitro Wound Healing Model of Human Gingival Fibroblasts.

Abstract: Objective Curcumin promotes oral wound healing; however, the underlying mechanism remains unknown. We hypothesized that curcumin may regulate gene expression in human gingival fibroblasts (hGFs). This study investigated the effect of curcumin on the expression of wound healing–related genes, collagen type I (COL1), keratinocyte growth factor (KGF)-1, and epidermal growth factor receptor (EGFR), in the in vitro wound healing model of hGFs, as well as the signaling pathway involved in the regulation of these genes by curcumin. Materials and Methods The hGFs were treated with curcumin in the unwounded condition and in the in vitro wound healing model (scratch assay). Gene expression was determined by quantitative polymerase chain reaction. PD98059 was used to elucidate whether extracellular signal regulated kinase (ERK) signaling is involved in the curcumin-regulated gene expression in hGFs. Cell migration was also analyzed by the scratch assay. Statistical Analysis Data were analyzed by independent t-test or one-way analysis of variance (ANOVA) followed by Tukey’s Honestly Significant Difference ( HSD) test. Results In unwounded hGFs, curcumin significantly increased KGF-1 and EGFR expressions but not COL1 mRNA expression. Interestingly, curcumin significantly upregulated COL1, KGF-1, and EGFR expressions in the in vitro wound healing model. Furthermore, PD98059 significantly decreased the curcumin-induced COL1 and EGFR expressions, but did not significantly affect KGF-1 upregulation by curcumin. However, hGF migration was not affected by curcumin treatment. Conclusion Curcumin induced KGF-1 and EGFR expressions in unwounded hGFs. In the in vitro wound healing model, curcumin upregulated COL1 and EGFR expression via the ERK pathway and increased KGF-1 expression, possibly by an ERK-independent mechanism.

Systematic Review on White Spot Lesions Treatments.

Abstract: The difference in refractive index between the healthy enamel and the demineralized area generates a lesion with a milky white opaque appearance, clearly distinguishable from the surrounding healthy enamel. The aim of this systematic review is to evaluate if the infiltration technique is the most efficient treatment to resolve a white spot lesion when compared with remineralization and microabrasion techniques. The Population/Intervention/Comparison/Outcome question investigated: “in enamel WS lesion, the infiltration treatment compared to remineralization or microabrasion treatments is more or less effective in the camouflage effect?” The research was performed on electronic databases, including Ovid MEDLINE, PubMed, and web of science. The search was conducted up to April 1, 2020. The scientific search engines produced 324 results. Only 14 were screened after screening. Based on the articles analyzed in this systematic review, the resin infiltration technique seems to be the most effective and predictable treatment for the aesthetic resolution of WSLs.

Effect of Tricalcium Silicate on Direct Pulp Capping: Experimental Study in Rats.

Abstract: Objectives Conduct a histological comparison of the pulp response to different materials, with a focus on the continuity and morphology of the mineralized barrier after direct pulp capping. Materials and Methods One hundred and eight maxillary first molars of 54 Wistar rats were subject to direct pulp capping and divided into three groups according to the materials used: calcium hydroxide (CH), mineral trioxide aggregate (MTA), and Biodentine. All cavities were sealed, and the animals were euthanized at 7, 14, and 21 days. Descriptive histological evaluation of the inflammation and formation of the mineralized barrier was performed. Statistical Analysis Statistical analyses were performed using the Kruskal–Wallis test, which was complemented by the Dunn test; differences with p Results The results showed that MTA and Biodentine elicited less intense inflammatory reactions than CH. With respect to the formation and quality of the dentin barrier formed, differences were observed at 21 days between the analyzed groups; the best results being obtained following treatment with MTA and Biodentine. Conclusion MTA and Biodentine induced formation of a more continuous and uniform mineralized barrier with less intense pulp response than CH.

Periodontal Disease as a Predictor of Undiagnosed Diabetes or Prediabetes in Dental Patients.

Abstract: Objectives The study investigates whether periodontal parameters can identify subjects with undiagnosed diabetes mellitus (DM) or pre-DM in patients seeking dental treatment at a university dental hospital. Materials and Methods Adults older than 35 years, not being diagnosed with DM before and have at least one of the risk factors of DM were included in the study. All subjects received a complete periodontal examination, filled a medical history survey, and a fasting blood glucose measurement was obtained. A multiple logistic regression test using a backward elimination method to assess factors that predict if the participant is healthy, prediabetic or diabetic was done. A p-value of Results A total of 61 subjects were enrolled with an average age of 42.9 ± 9.4 years. Having a family member diagnosed with DM was reported by 64.5% of the subjects; 59% were diagnosed with advanced periodontal disease. The final logistic regression model included smoking, hypertension, family history of DM, and percentage of clinical attachment loss >3 mm was statistically significant (P Conclusion Dental patients presenting with severe clinical attachment loss and family history of DM have increased likelihood of undiagnosed DM or pre-DM and would benefit from screening at the dental office.

FEM Analysis Applied to OT Bridge Abutment with Seeger Retention System

Abstract: Objective The purpose of this investigation is to highlight the technical components of a new kind of screw-retained dental implant prosthesis. The hypothesis is whether the OT Bridge (Rhein 83 S.R.L.; Bologna, Italy) system could be applied without secondary screw in the “all-on-four” retention system, thanks to the presence of an internal seeger. Materials and Methods By using engineering device such as finite element method (FEM) and von Mises investigation, it has been studied how the fixed prosthodontics for full-arch retention can be influenced by the presence of the screw for stabilizing it. Results In a dental implant, one model with four different configurations of the full-arch prosthesis retainer and the seeger has been investigated and then examined in contrast with or without the passant screw for locking the system. The experiments of this virtual study highlighted different features and mechanical behaviors of prosthodontic attachments. Conclusion The first two configurations, respectively those in which there are four and three connection screws, are safe and predictable. Therefore, the presence of the seeger significantly improves the stability and the retention of the whole prosthesis.

Dental Implants Surface in vitro Decontamination Protocols.

Abstract: Objective The number of patients rehabilitated with dental implants has contributed to increased incidence of peri-implant diseases. Due to complex and difficult treatment, peri-implantitis is a challenge and an efficient clinical protocol is not yet established. Aim of this study was to evaluate the efficacy of two protocols for in vitro decontamination of dental implants surface. Material and Methods Twenty titanium implants (BioHE-Bioconect) were used. Implants were divided into five groups (n = 4). NC group (negative control): sterile implants; PC group (positive control): biofilm contaminated implants; S group: biofilm contaminated implants, brushed with sterile saline; SB group: biofilm contaminated implants, brushed with sterile saline and treated with air-powder abrasive system with sodium bicarbonate (1 minute); and antimicrobial photodynamic therapy (aPDT) group: biofilm contaminated implants, brushed with sterile saline and treated with antimicrobial photodynamic therapy (red laser + toluidine blue O). The implants were contaminated in vitro with subgingival biofilm and distributed in groups PC, S, SB, and aPDT. Each group received the respective decontamination treatment, except groups NC and PC. Then, all implants were placed in tubes containing culture medium for later sowing and counting of colony-forming units (CFUs). Statistical Analysis One-way analysis of variance and Tukey tests were performed, at 5% significance level. Results Significantly fewer CFUs were observed in the aPDT group (19.38 × 105) when compared with groups SB (26.88 × 105), S (47.75 × 105), and PC (59.88 × 105) (p Conclusion Proposed protocols, using air-powder abrasive system with sodium bicarbonate and aPDT, showed to be efficacious in the decontamination of dental implants surface in vitro.

1-Year Evaluation of OT Bridge Abutments for Immediately Loaded Maxillary Fixed Restorations: A Multicenter Study.

Abstract: Objective Preliminary data on survival and success rates of immediately loaded, maxillary, screw-retained, implant-supported, fixed restorations delivered on narrow and low-profile OT Equator abutments (OT Bridge, Rhein’83) were evaluated. Materials and Methods This retrospective study evaluated data collected from patients rehabilitated with OT Bridge prosthetic concept between November 2017 and February 2019 in six different centers. Outcome measures were implant and prosthetic survival rates, biological and technical complications, marginal bone loss (MBL), oral health impact profile (OHIP), bleeding on probing, and plaque index. Results A total of 76 implants were inserted in 14 patients. Patients were followed for a mean period of 15.8 months (range = 12–24). All the patients receive OT Equator (Rhein'83) as intermediate abutments. One year after loading, one implant failed (1.3%). None of the prosthesis failed. One prosthetic complication was experienced in one patient. Three out of 76 implants were connected to the prosthetic framework using only the Seeger system, without screw. Difference in OHIP values was statistically significant (71.9 ± 8.5; p = 0.000). One year after loading, MBL was 0.21 ± 0.11 mm and p-value was 0.000. One year after loading, 8.7% of the examined implant sites present positive bleeding on probing, while 6.4% of the implant sites presented plaque. Conclusion The OT Equator abutments (Rhein'83) showed successful results when used to support maxillary fixed dental prosthesis delivered on four to six implants. High implant and prosthetic survival rates, very low complications, high patient satisfaction, and good biological parameters, including only 0.2 mm of bone remodeling were experienced one year after function. Further studies are needed to confirm these preliminary results.

Traumatic Dental Injuries, Treatment, and Complications in Children and Adolescents: A Register-Based Study

Abstract: Objective Traumatic dental injury (TDI) is a common dental concern among children worldwide We performed a retrospective patient register study among children under 18 years to investigate TDIs with respect to causes, treatment, and complications Materials and Methods We collected information on TDIs from the original patient records of 407 child patients visiting dental clinic of Lithuanian University of Health Sciences, Kaunas, Lithuania We analyzed all child patients’ (n = 407) background, cause, type of TDI, treatment, complications, and time elapsed from injury to visit to the dentist Statistical Analysis The χ 2-test, analysis of variance (ANOVA), and Kruskal–Wallis and Mann–Whitney tests served in the statistical analyses Results A total of 579 TDI cases occurred during 2010 to 2016 Lateral luxation (198%) and intrusion (148%) occurred more often in the primary than the permanent dentition (p Conclusion The most frequent TDIs included lateral luxation in primary teeth and enamel-dentine fractures in permanent teeth We observed a delay in patients obtaining emergency dental care

Biomimetic Mechanism of Action of Fluoridated Toothpaste Containing Proprietary REFIX Technology on the Remineralization and Repair of Demineralized Dental Tissues: An In Vitro Study.

Abstract: Objectives This in vitro study aimed to characterize the mineral content and surface and cross-sectional morphology of enamel and dentin tissues treated with a 1450 ppm fluoride-containing toothpaste with REFIX technology. Materials and Methods Bovine enamel blocks (n = 5) were obtained (4 × 4 × 6 mm), demineralized (artificial caries lesion), and treated (pH cycling and brushing with the toothpaste). During the pH cycling, which lasted for 7 days (demineralization and remineralization took 6 and 18 hours, respectively), the enamel was brushed for 5 minutes using an electric toothbrush before being immersed in a remineralizing solution. The dentin blocks were acid-etched for 2 minutes (0.05 M citric acid, pH 1.8) to expose the dentinal tubules (n = 5). Morphological analysis of the dentin was performed immediately and after 7 days of brushing with the dentifrice, and compared with the control group. The specimens were then cross-sectioned. The surface and cross-sectional micromorphology were assessed using scanning electron microscopy (SEM). The elemental analyses (weight%) were determined with an energy-dispersive X-ray spectroscopy (EDS). Results The toothpaste with REFIX technology remineralized and repaired the surface enamel effectively. The elemental analysis also demonstrated that treating the enamel with the toothpaste formed a silicon-enriched mineral layer on the enamel surface. Elemental analysis of the enamel cross-sections showed that the toothpaste induced a mineral change. The results were also consistent in the dentin, where the dentinal tubules were progressively occluded until there was complete occlusion after 7 days. Conclusions We prove the biomimetic mechanism of action of fluoridated toothpaste containing proprietary REFIX technology for obtaining silicon-enriched, remineralized and repaired dental tissues.

Microleakage of Direct Restorations. Comparisonbetween Bulk-Fill and Traditional Composite Resins:Systematic Review and Meta-Analysis

Abstract: Since the bulk-fill composites were produced, there was a progressive diffusion of their use for direct conservative treatment in posterior teeth. Their chemical structure increases the depth of cure and decreases the polymerization contraction; in this manner, bulk-fill composites can be placed in 4 mm single layers and the treatment times are considerably reduced. However, aesthetic and mechanical properties and impact on microleakage of bulk-fill resins are still unclear. This systematic review and meta-analysis aimed to assess the risk of microleakage of direct posterior restorations made of bulk-fill versus conventional composite resins. Researches were performed on PubMed and Scopus databases. Eligible in vivo studies, published since 2006, were reviewed. Outcomes of marginal discoloration, marginal adaptation, and recurrent caries were considered to conduct the systematic review and meta-analysis. Secondary data were examined to implement additional analysis and assess the risk of bias. Eight randomized clinical trials were analyzed, involving 778 direct restorations. The summary of RCTs led to significant but inconsistent results; the marginal discoloration and recurrent caries were found to be improved respectively by 5.1 and 1.4%, whereas the marginal adaptation was reduced of 6.5%. Secondary analyses revealed that follow-up periods, the adhesive system used and the class of carious lesions evaluated are confounding factors, and they result in a risk of bias across studies. Bulk-fill composites are innovative materials for conservative dentistry and they can be used to reduce treatment steps and duration of operative times. There are insufficient data to explore the relationship between bulk-fill composites and microleakage and further investigations are needed.

The NF-kB and Collagen Type 1 Expression in Dental Pulp after Treated Calcium Hydroxide Combined with Propolis.

Abstract: Objective To analyze the expression of nuclear factor kappa B (NF-kB) and collagen type 1 on dental pulp after a treated combination of calcium hydroxide and propolis. Materials and Methods The first maxillary molars of 30 rats were mechanically perforated. Teeth were divided into three groups of 10 for two separate extraction time frames, giving a total of 60 rats. The control groups were treated with Cention, the second treatment groups were treated with calcium hydroxide, and the third treatment groups were treated with a combination of calcium hydroxide and propolis. Final restoration was done with Cention. The teeth were extracted on days 7 and 14, and the expression of NF-kB and collagen type I was analyzed using immunohistochemistry. Results There is lowest NF-kB expression and highest collagen type 1 expression on dental pulp after treated with a combination of calcium hydroxide and propolis on days 7 and 14 (p Conclusion The combination of calcium hydroxide and propolis inhibits pulp inflammation and stimulates regeneration through decreasing the NF-kB expression and increasing collagen type 1.

Role of New Hydrophilic Surfaces on Early Success Rate and Implant Stability: 1-Year Post-loading Results of a Multicenter, Split-Mouth, Randomized Controlled Trial.

Abstract: Objective To compare early implant failure and implant stability of one-stage Hiossen ET III implants with its new hydrophilic (NH) surface, compared with Hiossen ET III implants with the sandblasted and acid-etched (SA) surface at 1-year follow-up. Materials and Methods This study was designed as a split-mouth, multicenter randomized controlled trial aimed to compare SA surface implants (SA group) and NH surface, (NH group). Outcomes were implant and prosthetic survival rates, complications, the insertion torque at implant placement, and implant stability quotient (ISQ) values. Results Twenty-nine patients (mean age 59.9 ± 11.3 years) were treated and followed up to 1 year after loading. No patient dropped out. Fifty-eight implants (29 SA group and 29 NH group) were placed. No implants or prostheses failed and no complications were experienced during follow-up. The mean insertion torque was 40.5 ± 3.23 (38.17–41.83) Ncm in the SA group and 40.48 ± 3.49 (38.02–41.98) Ncm in the NH group (p = 0.981). There was a statistically significant difference at the second week (T2) with higher values in the NH group (p = 0.041). Similar results were found in the maxilla (p = 0.045), but not in the mandible (p = 0.362). A positive correlation was found between initial insertion torque and ISQ with higher value in the NH group (0.73 vs. 0.66). Conclusions NH implants are a viable alternative to SA surface, as they seem to avoid the ISQ drop during the bone remodeling phase.

Fracture Strength of Monolithic Zirconia Crowns with Modified Vertical Preparation: A Comparative In Vitro Study.

Abstract: OBJECTIVE The aim of this study was to evaluate the influence of different marginal designs (deep chamfer, vertical, and modified vertical with reverse shoulder) on the fracture strength and failure modes of monolithic zirconia crowns. MATERIALS AND METHODS Thirty sound human maxillary first premolar teeth with comparable size were used in this study. The teeth were divided randomly into three groups according to the preparation design (n = 10): (1) group A: teeth prepared with a deep chamfer finish line; (2) group B: teeth prepared with vertical preparation; and (3) group C: teeth prepared with modified vertical preparation, where a reverse shoulder of 1 mm was placed on the buccal surface at the junction of middle and occlusal thirds. All samples were scanned by using an intraoral scanner (CEREC Omnicam, Sirona, Germany), and then the crowns were designed by using Sirona InLab 20.0 software and milled with a 5-axis machine. Each crown was then cemented on its respective tooth with self-adhesive resin cement by using a custom-made cementation device. A single load to failure test was used to assess the fracture load of each crown by using a computerized universal testing machine that automatically recorded the fracture load of each sample in Newton (N). STATISTICAL ANALYSIS The data were analyzed statistically by using one-way analysis of variance test and Bonferroni test at a level of significance of 0.05. RESULTS The highest mean of fracture load was recorded by chamfer (2,969.8 N), which followed by modified vertical (2,899.3 N) and the lowest mean of fracture load was recorded by vertical (2,717.9 N). One-way ANOVA test revealed a significant difference among the three groups. Bonferroni test showed a significant difference between group A and group B, while a nonsignificant difference was revealed between group C with group A and group B. CONCLUSION Within the limitations of this in vitro study, the mean values of fracture strength of monolithic zirconia crowns of all groups were higher than the maximum occlusal forces in the premolar region. The modification of the vertical preparation with a reverse shoulder placed at the buccal surface improved the fracture strength up to the point that it was statistically nonsignificant with the chamfer group.

Effect of Different Host-Related Factors on Postoperative Endodontic Pain in Necrotic Teeth Dressed with Interappointment Intracanal Medicaments: A Multicomparison Study.

Abstract: Objectives The current study aimed to assess the impact of factors such as age, gender, and the tooth type on postoperative endodontic pain in necrotic teeth with symptomatic periapical periodontitis and radiolucency dressed randomly with either calcium hydroxide or propolis paste. Materials and Methods The standard chemomechanical root canal preparation of 80 teeth was performed by the primary investigator. The intracanal medicaments were inserted by the secondary operator. Patients self-recorded their postoperative endodontic pain intensity with the help of visual analog scale at 4, 12, 24 (day 2), 48 (day 3), and 72 (day 4) hours. During analysis, patients (68/80) were grouped according to gender, age, and the tooth type. Statistical Analysis Mann–Whitney’s U test was applied for mean pain score comparison between genders and between tooth type. Kruskal–Wallis’ test was applied for mean pain score comparison between the age groups. Results No significant difference (p > 0.05) in pain scores was found between the age groups and between the tooth types. Males had significantly higher pain scores as compared with females at days 2 (p = 0.035), 3 (p = 0.023), and 4 (p = 0.020). Conclusion The results suggested that there was no impact of age and tooth types on postoperative endodontic pain.

Quality of Root Canal Filling Using a Bioceramic Sealer in Oval Canals: A Three-Dimensional Analysis.

Abstract: Objectives The oval canals may be associated with inadequate debridement, which can affect the quality of the root canal filling, thus the treatment outcome The aim of the present work was to compare the quality of oval canals fillings using EndoSequence BC sealer with the single-cone technique or cold lateral compaction Materials and Methods Thirty-eight human single-rooted premolars with oval canals were instrumented to 1 mm from the apical foramen with hand nickel–titanium files, followed by circumferential filing with Hedstrom files Teeth were paired into two groups based on their micro-computed tomography (CT) morphological parameters Both groups were filled using EndoSequence BC sealer The first used a single cone and the other with the cold lateral compaction technique The voids volume was evaluated by micro-CT and the percentage was calculated for the total length and for the apical 5 mm of each canal The Mann–Whitney U test was used to assess whether the surface area and obturation length differed significantly between the groups and to compare the percentage of voids for each technique Results Both techniques resulted in less than 16% voids, with no statistically significant difference between them for the total canal length and for the apical 5 mm (p > 005) Conclusions The quality of the obturation performed with the single-cone technique was similar to that achieved with lateral compaction using EndoSequence BC sealer in oval canals

Perception of Dentofacial Aesthetics in School Children and Their Parents

Abstract: Objective The aim of this research was to examine the attitudes and perceptions of dentofacial aesthetics among different age groups. Materials and Methods The sample consisted of elementary-school students from the city of Sarajevo, Bosnia and Herzegovina, and their parents. This study included 314 subjects: 157 children and 157 parents. The children’s group consisted of 85 (54.14%) males and 72 (45.85%) females, aged 9 to 15 years. Statistical Analysis Descriptive statistics were used to determine frequency distribution and percentages for all variables. A chi-squared (x 2) test was used to determine the association between variables and a p-value Results For the dentofacial appearance with no teeth irregularity or with severe teeth irregularity, an analysis of variance (ANOVA) (post-hoc tests—Tukey’s HSD) indicated that the difference is not statistically significant (p = 0.06) relative to rank matching between all three subject groups. For dentofacial appearance with mild teeth irregularity, an ANOVA (post-hoc tests—Tukey’s HSD) showed statistical difference (p = 0.07) between the teenage group of subjects relative to pre-teenage group of subjects and adult group of subjects. Conclusion Attitudes about desirable and acceptable dental aesthetics differ in younger children compared with older children and parents. Ten years old children find good function with poor aesthetics more pleasing, while 14 years old children find aesthetics with bad function as more pleasing.

Developing an Instrument to Measure Maternal Knowledge and Attitude of Oral Health on Children Under 3 Years.

Abstract: Objective Parental knowledge, belief, and attitude about oral health affect children’s dental cleaning behavior. Further research on maternal knowledge and attitude about early-age children’s oral health has been suggested to identify factors related to pediatric dental and oral health. For that purpose, a measurement instrument is needed. The research aimed to develop an instrument to measure maternal knowledge and attitude about under 3-year-old children’s oral health. Materials and Methods Using a validity-based approach, we held a series of basic consultation (workshops and interviews) to identify the conceptually different domains. Instrument items were derived from relevant theories. Cognitive interviews were conducted to ensure that the items were properly understood. The items were first tested among the population calibration samples (n = 150). All instrument items were analyzed for reliability and validity. Results In total, 15 items were derived from Bloom’s theory of learning and were developed for the knowledge instrument, while 10 others were developed for the attitude instrument. The reliability analysis yielded Cronbach’s α scores of 0.620 for the knowledge instrument and 0.565 for the attitude instrument. All items were considered valid based on Pearson’s correlation test results. Conclusion The instruments on maternal knowledge and attitude about under 3-year-old children’s oral health consisted of three dimensions, respectively. Both instruments have been tested and analyzed and therefore are applicable for use.