Showing papers in "European Journal of Dentistry in 2023"
TL;DR: In this article , the osteoinductive properties of frozen-dried bovine bone scaffolds with runt-related transcription factor-2 (RUNX2) and Osterix (OSX) were compared with decellularized FDBB and dc-FDBB.
Abstract: Abstract Objective Freeze-dried bovine bone scaffold (FDBB) or decellularized FDBB (dc-FDBB) was developed as an ideal scaffold with osteoinductive properties. This research aims to compare the osteoinductive properties marked by the expression of runt-related transcription factor-2 (RUNX2) and Osterix (OSX) and the osteogenic capacity of these scaffolds imbued with human umbilical cord mesenchymal stem cells (hUCMSCs). Materials and Methods This study was performed in five experimental groups: a negative control group (C-) of hUCMSCs with a normal growth medium, a positive control group (C + ) of hUCMSCs with an osteogenic medium, experimental group 1 (E1) with an FDBB conditioned medium (CM), and experimental group 2 (E2) with a dc-FDBB-CM, and a third experimental group (E3) consisting of a DBBM-CM. Alizarin red staining was performed to qualitatively assess osteoinductive capacity. RUNX2 and OSX expression was quantified using real-time quantification polymerase chain reaction with two replications on day six (D6) and day 12 (D12) as fold changes. Results This experiment revealed that hUCMSCs were positively expressed by CD73, CD90, and CD105 but were not expressed by CD34. Alizarin red staining showed that E1 had the most calcium deposition on D6 and D12, followed by E3 and then E2 The RUNX2 and OSX expression was higher in E1 but this difference was not significant. The OSX expression in E1,E2,E3 was lower on D12 and C+ of OSX had the highest expression. There was a significant difference of fold change measured between all groups ( p < 0.05), and there was no significant difference between any of the groups treated with OSX and RUNX2 on D6 and D12. Conclusion FDBB osteoinduction and osteogenic capacity were higher when compared with DBBM and dc-FDBB.
2 citations
TL;DR: In this article , the marginal accuracy of five contemporary all-ceramic crowns indicated for anterior restorations was evaluated by scanning electronic microscope with a magnification of 300 × 300.
Abstract: Abstract Objectives This study aimed to compare marginal accuracy of five contemporary all-ceramic crowns indicated for anterior restorations. Materials and Methods A master die of maxillary central incisor was prepared for all-ceramic crown and duplicated to produce 50 replicas of epoxy resin material. Five ceramic materials were used to mill the crowns ( n = 10). All crowns were manufactured following the same digital workflow; same master die, scanning unit and design software, and the recommended manufacturing protocol. Final seating of crown was secured by a small droplet of temporary cement on its incisal edge. Marginal accuracy was evaluated by scanning electronic microscope with a magnification of 300 × . Vertical marginal gap was measured for each crown at predefined four points. Statistical Analysis One-way analysis of variance was used to test differences between groups and Tukey test was used for multiple comparisons between group combinations. A level of significance at 95% was set for all statistics. Results The highest mean marginal gap and mean maximum gap calculated were for the e.max CAD crowns (49.2 µm, 87.6 µm), while the lowest values were for the Cercon xt crowns (10.2 µm, 21.7 µm). The mean marginal gap and the mean maximum gap of the e.max CAD crowns were statistically significantly greater than those of all other groups ( p < 0.05). However, the differences between all other combinations were insignificant ( p > 0.05). Conclusion Marginal accuracy of lithium disilicate crowns is clinically acceptable. Zirconia and zirconia-reinforced lithium silicate materials can produce a greater level of marginal accuracy compared to lithium disilicate.
2 citations
TL;DR: In this paper , the authors compared different types of 3D-printed denture teeth in terms of wear and fracture resistance in comparison to control prefabricated denture tooth, and found that NextDent showed the greatest volume loss, whereas FormLabs specimens showed the least volume loss.
Abstract: Abstract Objectives With advanced technology for complete denture fabrication, there is a lack of knowledge on the mechanical behavior of three-dimensional (3D) printed teeth despite the development of complete denture fabrication technologies. This study aimed to compare different types of 3D-printed teeth in terms of wear and fracture resistance in comparison to control prefabricated denture teeth. Materials and Methods One prefabricated tooth was selected and fixed in a resin holder and half of the tooth remained in anatomic form, while the other half was flattened for the wear test. One from each type was scanned and then printed with different resins; Asiga (DentaTOOTH, Asiga, Alexandria 2015,NSW, Australia), FormLabs (Denture Base LP, FormLabs, Berlin, Germany), and NextDent (NextDent C&B MFH, NextDent B.V., Soesterberg, the Netherlands) according to manufacturer recommendations. A total of 60 specimens (20/resin, n = 10) were thermo cycled (5,000 cycles) and wear test samples were further subjected to cyclic loading (1,70,000 cycles) in a chewing simulator machine CS-4.2 (SD Mechatronik GmbH, Germany). The fracture strength of anatomic teeth was measured using a universal testing machine (Instron model 5965, Massachusetts, United States), while Geomagic Control X software was used to assess the amount of wear of flattened teeth. Statistical analyses were performed with one-way analysis of variance with Tukey's post hoc test at significance level of α = 0.05. Results NextDent specimens showed the greatest volume loss, whereas FormLabs specimens showed the least volume loss. Comparing NextDent specimens to FromLabs specimens, FromLabs showed statistically significantly less volume loss ( p < 0.001). No other group pairs differed significantly from one another in terms of volume loss ( p > 0.06). Conclusion 3D-printed denture teeth showed comparable strength and wear resistance with the prefabricated denture teeth and were suitable for long-term clinical usage except for NextDent that significantly showed the lowest fracture resistance.
1 citations
TL;DR: In this paper , the effect of finish lines on the penetration ability of polyether and polyvinyl siloxane impression material into the simulated gingival sulcus was investigated using a two-way analysis of variance (ANOVA) and Tukey's multiple comparison tests.
Abstract: Abstract Objective The aim of this study was to determine the effect of finish lines on the penetration ability of polyether and polyvinyl siloxane impression material into the simulated gingival sulcus. Materials and Methods Three types of finish line (chamfer, deep chamfer, and radial shoulder) were impressed with two types of elastomeric impression material (polyether and polyvinyl siloxane) using a two-step impression technique. Ten samples of each finish line were prepared and then separated into two groups of impression material: polyether and polyvinyl siloxane. The model of the simulated gingival sulcus had a width of 0.1 mm and a depth of 3.5 mm with a subgingival finish line of 0.5 mm. The effect of the finish lines on the penetration ability of these impression materials was analyzed using a two-way analysis of variance (ANOVA) and Tukey's multiple comparison tests at a statistically significant level of 0.05. Results A two-way ANOVA revealed a significant difference among finish lines, impression materials, and their interaction. The deep chamfer and radial shoulder finish lines displayed significantly higher penetration ability than the chamfer finish line. Moreover, polyether revealed significantly higher penetration ability than polyvinyl siloxane. Conclusion The finish lines affected the penetration ability of the impression materials. Therefore, the simulated gingival sulcus model demonstrates that it is an effective way of examining impression materials' penetration abilities.
1 citations
TL;DR: In this article , the authors compared the accuracy of intraoral scanners (IOSs) used in the digital impression of full arches to fabricate implant-supported complete prostheses.
Abstract: Abstract This article compares the accuracy of intraoral scanners (IOSs) used in the digital impression of full arches to fabricate implant-supported complete prostheses. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered in the Open Science Framework (DOI 10.17605/OSF.IO/CPM9K). Six electronic databases, gray literature databases, and a manual search were performed in April 2022. Studies that evaluated the accuracy of intraoral scan impressions compared with conventional impressions in full-arch impressions were included for complete implant-supported prostheses. In addition, an adapted checklist for reporting in vitro studies was used to assess the risk of bias. Meta-analysis was conducted using a random-effects Hunter– Schmidt model. Nine studies were included in the analysis. IOS impressions present higher accuracy (137.86 μm) than conventional impressions (182.51 μm) ( p <0.001). The heterogeneity of the study's methodology was I2¼18.34. However, impression accuracy varies significantly with scan body type, IOS type, scanning strategy, and modification technique. For most IOS systems, the acceptable clinical threshold of linear accuracy of 200 μm can be achieved, except for the True Definition Scanner in one of the studies. Based on the results of the included studies, digital impressions using IOS present similar or better linear accuracy than conventional impression techniques.
1 citations
TL;DR: In this paper , the diagnostic potential of interleukin-17 (IL-17) and IL-10 to differentiate periodontal health from smoker and nonsmoker periodontitis, and to differentiate among different stages (severities).
Abstract: Abstract Objectives The gold standard in the field of periodontal research currently is to find a valid biomarker that can reliably be used for diagnosing periodontal diseases. Given the limitations of the current diagnostic tools that stall to predict susceptible individuals and determine whether active tissue destruction is occurring, there is an increased urge to develop alternative diagnostic techniques that would compensate for the problems inherited in these available methods, such as measuring levels of biomarkers present in oral fluids such as saliva; so the aim of this study was to determine the diagnostic potential of interleukin-17 (IL-17) and IL-10 to differentiate periodontal health from smoker and nonsmoker periodontitis, and to differentiate among different stages (severities) of periodontitis. Materials and Methods An observational case–control study was performed on 175 systemically healthy participants grouped into healthy as controls and periodontitis as cases. Periodontitis cases were divided according to the severity into stages I, II, and III, and each of the stages was further subdivided into smokers and nonsmokers patients. Unstimulated saliva samples were collected, clinical parameters were recorded, and salivary levels were assayed using enzyme-linked immunosorbent assay. Results Elevated levels of IL-17 and IL-10 were associated with stage I and II compared with the healthy controls. However, a significant decrease in stage III was observed compared with the control group for both biomarkers. Conclusion Salivary IL-17 and IL-10 might be useful for distinguishing periodontal health from periodontitis; however, further research is needed to substantiate their use as potential biomarkers for the diagnosis of periodontitis
TL;DR: In this article , the authors describe an approach to excessive gingival display management caused by short teeth and hyperactive lips using a digital workflow for crown lengthening, which enables predictable planning and decreases the need for postsurgical modifications, thus shortening the treatment duration.
Abstract: Abstract Aesthetics is a fundamental part of contemporary dental practice. A pleasant smile depends on the gingival tissue architecture and dental characteristics. Excessive gingival display (gummy smile) is considered an unattractive smile and can affect a person's confidence. There are many etiological factors related to a gummy smile. Aesthetic rehabilitation of these cases often requires an interdisciplinary approach and close collaboration between dental specialties. This article describes an approach to excessive gingival display management caused by short teeth and hyperactive lips using a digital workflow for crown lengthening. A digital approach enables predictable planning and decreases the need for postsurgical modifications, thus shortening the treatment duration. Computer software is used for planning and 3D-printed guide for crown lengthening and implant placement. Two months later, lip repositioning was performed to reduce the hyperactive lip. After 4 months, prosthetic treatment and Botox injections were done to restore an aesthetic smile.
TL;DR: In this article , the authors investigated the effects of radiofrequency (RF) energy, applied through a power toothbrush, on the structural morphology of dental plaque and its bacteria components and found that RF treatment significantly reduced the viable cells in plaque and caused a substantial disruption of plaque morphology.
Abstract: Abstract Objectives To investigate the effects of radiofrequency (RF) energy, applied through a power toothbrush, on the structural morphology of dental plaque and its bacteria components. Previous studies showed that a toothbrush powered by RF (ToothWave) effectively reduces extrinsic tooth stains, plaque, and calculus. However, the mechanism by which it reduces dental plaque deposits is not fully established. Materials and Methods Multispecies plaques at sampling time points of 24, 48, and 72 hours were treated with the application of RF using ToothWave with the toothbrush bristles 1 mm above the plaque surface. Groups that underwent the same protocol but without RF treatment served as paired controls. Confocal laser scanning microscope (CLSM) was used to determine cell viability at each time point. Plaque morphology and bacteria ultrastructure were viewed using scanning electron microscope (SEM) and transmission electron microscope (TEM), respectively. Statistical Analysis Data were analyzed statistically using analysis of variance (ANOVA) and Bonferroni post-tests. Results At each time, RF treatment significantly ( p < 0.05) reduced the viable cells in plaque and caused a substantial disruption of plaque morphology, while the untreated plaque had intact morphology. Cells in treated plaques showed disrupted cell walls, cytoplasmic material, huge vacuoles, and heterogeneity in electron density, while these organelles remained intact in untreated plaques. Conclusion The application of RF via a power toothbrush can disrupt plaque morphology and kill bacteria. These effects were enhanced by the combined application of RF and toothpaste.
TL;DR: In this article , the effect of EGCG and α-mangosteen to SHED metabolite from six passages to obtain the optimum stimulation and able to use as periodontitis regeneration treatment was identified.
Abstract: Abstract Objective Stem cells of human exfoliated deciduous teeth (SHED) metabolites are secreted molecules from SHED, namely cytokines, chemokines, and growth factors. The metabolite can be used in various regenerative therapy based on cell-free immunomodulatory potential effects, like interleukin 10 (IL-10) and LL37. This molecule can stimulate with epigallocatechin gallate (EGCG) and α-mangosteen and has been proven to have anti-inflammatory and antibacterial effects. This study aimed to identify the effect of EGCG and α-mangosteen to SHED metabolite, called SHED-IL10 and SHED-LL37, from six passages to obtain the optimum stimulation and able to use as periodontitis regeneration treatment. Materials and Methods The six different passages of SHED were prepared in Dulbecco's modified Eagle medium and added with EGCG 80% (10 μM), EGCG 95% (10 μM), or α-mangosteen (10 μM). After a 24 hours incubation, each passage was measured with the metabolite concentration, SHED-IL10 and SHED-LL37, with human IL-10 and LL37 using enzyme-linked immunosorbent assay. Each different concentration was then analyzed statistically. Results The addition of EGCG 95% is able to stimulate the SHED-IL10 optimum concentration in passage 1 ( p < 0.01). But, in the different conditions, the addition of EGCG 80%, EGCG 95%, and α-mangosteen was able to stimulate the SHED-LL37 optimum concentration in passage 2 ( p < 0.001). Conclusion The addition of EGCG and α-mangosteen can stimulate the SHED-IL10 and SHED-LL37 concentrations. These two metabolites are promising as regenerative therapy through anti-inflammatory and antibacterial properties.
TL;DR: In this article, a micro-Raman spectroscopy of a thermoplastic material based on polyethylene terephthalate glycol (PET-G) used for the manufacture of Lineo aligners (Micerium Lab, Avegno, Italy) subjected to different staining beverages and cleaning agents.
Abstract: Abstract Objectives Orthodontic treatment with clear thermoplastic aligners is in great demand by patients especially for aesthetics. Any alterations in the chemical composition of the thermoplastic material for aligners, subjected to the oral environment and exposure to various commonly used substances, could influence the desired orthodontic movement decreasing the predictability of the treatment. The objective of this study was to determine the chemical–physical characterization by micro-Raman spectroscopy of a thermoplastic material based on polyethylene terephthalate glycol (PET-G) used for the manufacture of Lineo aligners (Micerium Lab, Avegno, Italy) subjected to different staining beverages and cleaning agents. Materials and Methods Twenty-two thermoformed PET-G samples were immersed to various substances of daily use for 10 and 15 days (coffee, tea, Coca-Cola, red wine, colloidal silver disinfectant, nicotine, artificial saliva, cigarette smoke, and different combinations of saliva with some of the previous solutions). Subsequently, the chemical–physical characterization was investigated by micro-Raman spectroscopy. Results The analysis of the spectra acquired for all the specimens showed no difference in the exposure to the different solvents at 10 and 15 days. Furthermore, having ascertained the heterogeneous surface morphology of the PET-G material due to thermoforming, various deposits were present on all the samples whose consistency and concentration depended on the substance used. Conclusion The spectroscopic investigations have provided a precise and detailed analysis of the qualitative and structural data of the PET-G material under examination. No significant structural modifications of the thermoplastic polymer were found after immersion in different solutions in the exposure times adopted.
TL;DR: In this article , a systematic search was used through PubMed and Google Scholar to search for published articles between 2011 and 2021, which analyzed maternal parenting behaviors with early childhood caries (ECC) and molar incisor hypomineralization.
Abstract: Abstract Stunting has gained global attention as one of the most critical problems in public health. As the first and dominant figure in a child's life, the mother is responsible for determining the proper parenting behaviors to apply to maintain the child's physical health. Stunting is often associated with early childhood caries (ECC) and molar incisor hypomineralization, which can be manifested into each other through various mechanisms. Therefore, it is crucial to explore how far maternal parenting behaviors affect stunting and oral health. This study aims to determine which maternal parenting behaviors can affect stunting and oral health. A systematic search was used through PubMed and Google Scholar to search for published articles between 2011 and 2021. The articles analyze maternal parenting behaviors with stunting and poor oral health. Final analysis was used on 21 articles containing 18 cross-sectional studies, 2 cohort studies, and 1 randomized controlled trial. The result implied that the high prevalence of stunting and ECC is the combined result of prolonged breastfeeding practices (7 articles), poor complementary feeding practice (6 articles), high consumption of sugar (5 articles), and poor oral hygiene practices (5 articles). Maternal parenting styles in the aspect of fulfilling nutrition and maintaining oral health affect the occurrence of stunting and ECC in children.
TL;DR: In this paper , the authors explore the transformative potential of AI in dentistry and emphasize the need to embrace change while maintaining ethical frameworks, while ensuring that regulations keep pace with technological advancements to guide the responsible use of AI.
Abstract: Human beings have long exhibited a natural fear of the unknown. We tend to initially ignore novel changes, only to gradually adapt to them as they become familiar. However, the recent emergence of generative artificial intelligence (AI) applications has propelled us into an era of technological advancement comparable to the invention of electricity. The remarkable speed of these developments has caught many off guard, surpassing our expectations. It is not the change itself that instills fear but rather the breathtaking pace at which it unfolds. The challenge lies in ensuring that regulations keep pace with technological advancements to guide the responsible use of AI. In this guest editorial, we explore the transformative potential of AI in dentistry and emphasize the need to embrace change while maintaining ethical frameworks.
TL;DR: In this article , the authors evaluated the efficacy of spiral ganglion neuron regeneration after dental pulp stem cell (DPSC) transplantation in a rat sensorineural hearing loss (HL) model.
Abstract: Abstract Objectives The purpose of the present study was to evaluate the efficacy of spiral ganglion neuron (SGN) regeneration after dental pulp stem cell (DPSC) transplantation in a rat sensorineural hearing loss (HL) model. Materials and Methods Sham or experimental HL was induced in adult Sprague–Dawley rats by cochlear round window surgery. An HL rat model was established with a single 10 mM ouabain intratympanic injection. After 7 days, the rats received DPSCs, stem cells from human exfoliated deciduous teeth (SHED), or culture medium in the sutural area to establish four groups: sham, HL-DPSC, HL-SHED, and HL-medium. Histological analyses were performed at 4, 7, and 10 weeks after transplantation, and the number of SGNs, specific SGN protein expression, and the function of SGNs were evaluated. Statistical Analysis Data were statistically by MS Excel and SPSS v.15.0. Intergroup level of significance was determined via a one-way analysis of variance and Duncan's multiple range test with 95% confidence intervals. Results New SGN formation was observed in the HL-DPSC and HL-SHED rat groups. The number of SGNs was significantly higher in the HL-DPSC and HL-SHED groups than in the HL-medium group over 4 to 10-week survival period. HL-DPSC rats exhibited higher SGN density compared with that in HL-SHED group, which was statistically significant at week 10. The regenerated SGNs expressed cochlear wiring regulator GATA-binding-protein 3. Moreover, the SGNs from the HL-DPSC group also exhibited a higher expression of synaptic vesicle protein and regulated action potential-dependent neurotransmitter release compared with SGNs from the HL-SHED group. Conclusions Our findings suggest that DPSCs and SHED repair and regenerate SGNs in rat HL model. Dental pulp stem cells represent a promising treatment strategy for restoring damage to the sensory circuits associated with deafness.
TL;DR: In this article , the in-silico analysis was performed using the STRING database for functional association and a better understanding of the interactions of OX40 and its ligand with other proteins.
Abstract: Abstract Objectives This research aimed to determine OX40 and OX40L mRNA expression in blood samples of naive oral squamous cell carcinoma (OSCC) patients in different histological grades and clinical stages. The in silico analysis was performed using the STRING database for functional association and a better understanding of the interactions of OX40 and its ligand with other proteins. Materials and Methods In this study, we recruited 141 newly diagnosed patients of OSCC. Levels of OX40 and OX40L mRNA expression were explored using real-time quantitative polymerase chain reaction. An in silico tool was also utilized to evaluate the OX40/OX40L interactome. Results The results showed higher OX40 expressional levels in the late stage (23-fold) compared with the early stage (8.5-fold) ( p = < 0.001). A similar trend was seen in OX40L mRNA expression, revealing a fold change of 5.8 in the early stage in comparison to 9.9-fold change in the late stage ( p = < 0.001). Overexpression of OX40 and OX40L was found in different histological grades ( p = 0.005 and p = < 0.001, respectively). Overexpression of OX40 and OX40L was detected in habits such as smoking and paan intake, whereas statistically significant upregulation was observed in the cheek, lip, and alveolus tumors. However, there was no substantial difference in OX40 and OX40L expression based on age or gender. The functional interactions, that is, interactomes of OX40 and OX40L with other proteins have been determined by in silico analysis. Conclusion Based on current study findings, despite OX40 and OX40L upregulation in newly diagnosed OSCC patients, it is speculated that the physiological function of these molecules is altered due to immune system exhaustion.
TL;DR: In this paper , the effect of intermittent hypobaric hypoxia (IHH) exposure on the expression of HIF-1α mRNA, VEGF mRNA, and angiogenesis after tooth extraction in rats was investigated.
Abstract: The aim of this study was to investigate the effect of intermittent hypobaric hypoxia (IHH) exposure on the expression of hypoxia-induced factor-1α (HIF-1α) messenger RNA (mRNA), vascular endothelial growth factor-a (VEGF-a) mRNA, and angiogenesis after tooth extraction in rats. On 45 male Sprague-Dawley rats were performed the removal of the maxillary left first molar, and then they were randomly divided into 9 groups, namely: 4 groups that were exposed to IHH for 30 minutes every day in the Hypobaric Chamber at an altitude of 18,000 feet, with 1 time hypobaric hypoxia (HH), 3 times HH, 5 times HH, and 7 times HH; 4 normoxia groups that were terminated on days 1, 3, 5, and 7 after tooth extraction; and the 1 control group. Real-time polymerase chain reaction measured the molecular changes in the socket tissue after tooth extraction in rats to evaluate the expression of HIF-1α mRNA and VEGF mRNA. Histological changes with hematoxylin and eosin staining were noted to evaluate the amount of angiogenesis in the socket after tooth extraction. Molecular and histological parameters were calculated at the end of each experiment on days 0, 1, 3, 5, and 7 after tooth extraction, which exhibited the improvement phase of the wound-healing process. Increases in the expression of HIF-1α mRNA, VEGF mRNA, and angiogenesis were found in the IHH group compared with the normoxia group and the control group. The expression of HIF-1α mRNA increased significantly (p < 0.05) in the group after one time HH exposure on day 1, then decreased in the IHH group (three times HH exposure, five times HH exposure, and seven times HH exposure) approaching the control group. The expression of VEGF mRNA and angiogenesis began to increase after one time HH exposure on day 1, and increased again after three times HH exposure on day 3, then increased even more after five times HH exposure on day 5, and increased very significantly (**p < 0.05) after seven times HH exposure on day 7. It showed that repeated or intermittent exposure to HH conditions induced a protective response that made cells adapt under hypoxia conditions. IHH exposure accelerates the socket healing of post-tooth extraction, which is proven by changes in HIF-1α mRNA expression and increase in VEGF mRNA expression as stimuli for angiogenesis in post-tooth extraction sockets under hypobaric hypoxic condition, which also stimulates the formation of new blood vessels, thereby increasing blood supply and accelerating wound healing.
TL;DR: In this paper , a pilot study was conducted to assess the United Arab Emirates dentists' preparedness to manage medical emergencies and found that only 51% of the dentists can handle emergencies such as anaphylactic shock and syncope in the dental office.
Abstract: Abstract Objectives The purpose of this pilot study is to assess the United Arab Emirates dentists' preparedness to manage medical emergencies. Materials and Methods Ninety-seven licensed dentists participated in this study. Dentists responded to self-administrated questionnaires that contained 23 questions divided into five parts. The first part collected data on participants' sex, years of experience, and whether they are general dental practitioner (GDP) or specialists. The second part included seven questions that asked participants to indicate if they took medical history, obtained vital signs, and attended basic life support courses. The third part included six multiple choice questions regarding the availability of emergency drugs in the dental clinic. The fourth part consisted of three multiple-choice questions that assessed the dentists' immediate response to a medical emergency. Finally, the fifth part comprised four questions to evaluate the dentists' knowledge of proper treatment of special emergency cases they may encounter in the dental offices. Results Out of the 97 participants, only 51% ( N = 49) indicated that they can handle emergencies such as anaphylactic shock and syncope in the dental office. The majority of the dentists (80%) indicated that they have emergency kits. Only 46% of the specialists and 42% of the GDPs were able to correctly plan extractions in a patient with a prosthetic heart valve. Less than half of the participants ( N = 35, 36%) were able to correctly answer the question regarding management of a foreign-body aspiration by attempting Heimlich/Triple maneuver. Conclusions Within the limitations of this study, dentists need further hands-on training to improve their skills and knowledge about medical emergencies that could occur in the dental settings. Furthermore, we recommend that guidelines should be available in the clinic to strengthen the dentists' ability to deal with medical emergencies.
TL;DR: In this article , the authors describe an alternative technique executed to ensure bone regeneration after removing a cystic lesion in the upper jaw, which was filled with autologous fibrin-rich clots containing concentrated growth factor (CGF).
Abstract: Abstract This clinical case report's objective was to describe an alternative technique executed to ensure bone regeneration after removing a cystic lesion in the upper jaw. The bone defect after the cystectomy was filled with autologous fibrin-rich clots containing concentrated growth factor (CGF). A 45-year-old female patient was presumed to have a cystic lesion with massive bone destruction on the vestibular and palatal walls between teeth 2.2 and 2.3. CGF was applied to fill the gap to promote the development of the bone. The tooth was asymptomatic and repair was still increasing steadily after a year, according to the results of the clinical and radiological follow-up assessment. This article describes a different way to treat a two-wall defect involving both the palatal and buccal bone, after removing a cystic lesion, with the use of CGF as an equivalent to the traditional use of autologous or heterologous bone. A promising substance for bone repair is CGF fibrin, which may encourage the growth of new bone in jaw deformities and promote bone tissue healing.
TL;DR: In this paper , the role of the mother's parenting style in predicting adolescent oral hygiene behavior was examined with a cross-sectional approach, and the authors found that supportive parenting style predicts 31.2% of adolescents' oral hygiene behaviors while nonsupportive parenting style did not predict adolescents' behaviors.
Abstract: Adolescent oral hygiene behavior plays a crucial role into adulthood and still requires attention from parents, especially mothers. Parenting done by the mother will directly affect the child's life, including the child's oral hygiene behavior. The aim of this study was to determine the role of the mother's parenting style in predicting adolescent oral hygiene behavior. A quantitative study with a cross-sectional approach was used to examine the role of parenting style on their teenage child's oral hygiene behavior. The instruments used were (1) a parenting style measuring instrument to measure supportive and nonsupportive parenting styles of mothers (parent as social context questionnaire) and (2) a self-structured oral hygiene behavior measuring instrument based on the theory of planned behavior. The population of this study were students at SMP PGRI Depok and SMP Negeri 11 Depok, West Java, aged between 12 and 14 years. The sampling technique used total sampling on SMP PGRI students and multistage random sampling on students at SMP Negeri 11 Depok with a total sample of 230 students. Data analysis was done using multiple linear regression test. Statistical regression tests showed that nonsupportive parenting style did not predict adolescent oral hygiene behavior (p = 0.567), while supportive parenting style did predict adolescent oral hygiene behavior (p = 0.000). Supportive parenting style predicts 31.2% of adolescent oral hygiene behavior. Mother's supportive parenting style plays a role in predicting adolescent oral hygiene, and the mother's nonsupportive parenting style does not play a role in predicting adolescent oral hygiene behavior.
TL;DR: In this paper , a 31-year-old female with mandibular prognathism, difficulty in closing her mouth and anterior open bite was treated by orthodontic surgery at Hasan Sadikin General Hospital.
Abstract: Abstract Mandible prognathism or malocclusion skeletal class III is facial deformities. These deformities can affect orofacial function, such as mastication, speech, and function of the temporomandibular joint. Besides the physical effects of these deformities, the psychosocial impact on the individual is often essential, and such deformities can affect the quality of life and self-confidence. Orthognathic surgery is designed to correct these deformities because these deformities could not have been corrected by only orthodontic treatment. Therefore, at Hasan Sadikin General Hospital, orthognathic surgery is the treatment choice for mandibular prognathism or malocclusion skeletal class III. In this case report, we present a 31-year-old female with mandibular prognathism, difficulty in closing her mouth and anterior open bite. Surgery was performed by Le Fort 1 osteotomy for advancing maxilla and bilateral sagittal split osteotomy for setback mandible. Two weeks after surgery, patient came back to the orthodontic department for occlusion treatment.
TL;DR: In this paper , the effects of duration and intensity of smoking on the healing rate of periapical periodontitis were analyzed, and the results showed that an increase in the value of the smoking index significantly increased the risk of apical Periodontitis persistence (odds ratio [OR] =7.66; 95% confidence interval [CI]: 2.51-23.
Abstract: Abstract Objectives The aim of this prospective study was to compare the healing of periapical bone between smokers and nonsmokers after root canal therapy. The effects of duration and intensity of smoking on the healing rate of apical periodontitis were analyzed. Materials and Methods Fifty-five smokers were included in this study. The control group consisted of healthy nonsmokers who matched the smoker group in age and sex. Only teeth with a favorable periodontal prognosis and adequate coronal restoration were included in the study. The periapical status of treated teeth was assessed using the periapical index system at follow-ups after 6 and 12 months. Statistical Analysis The chi-squared test and Mann–Whitney U test were used to assess the changes in periapical index score at baseline and in subsequent time intervals between the two groups examining dichotomized and ordinal data, respectively. Multivariate logistic regression analysis was used to test the association of independent variables age, gender, tooth type, arch type, and smoking index with the outcome variable. The outcome variable was set as the presence versus absence of apical periodontitis. Results The analysis at 12-month follow-up revealed a significantly higher healing rate in control group than in smokers (90.9 vs. 58.2; χ2 = 13.846; p < 0.001). Smokers had significantly higher periapical index scores than the control group ( p = 0.024). The multivariate logistic regression analysis demonstrated that an increase in the value of the smoking index significantly increases the risk of apical periodontitis persistence (odds ratio [OR] =7.66; 95% confidence interval [CI]: 2.51–23.28; p < 0.001) for smoking index < 400 and (OR = 9.65; 95% CI: 1.45–64.14; p = 0.019) for smoking index 400 to 799. Conclusion The results from this study show a lower rate of apical periodontitis healing in a group of smokers at 1-year follow-up. Delayed periapical healing seems to be associated with the cigarette smoking exposure.
TL;DR: In this article , the authors analyzed the increase in enamel hardness post-external bleaching after remineralized with casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACPF) and 5% sodium fluoride (NaF).
Abstract: Abstract Objective The purpose of this study was to analyze the increase in enamel hardness post-external bleaching after remineralized with casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACPF) and 5% sodium fluoride (NaF) and the difference in increased enamel hardness between CPP-ACPF and NaF materials. Materials and Methods The study was true experimental in vitro using 30 samples of mandibular premolars. All samples were bleached using 40% hydrogen peroxide. The samples were divided into three groups of 10 samples each; group I as a control without application of remineralization material, group II was given an application of CPP-ACPF (GC Tooth Mousse Plus: GC Europe, Lot #201130B), and group III was given an application of 5% NaF (Clinpro White Varnish: 3M ESPE, Lot #NA62322) Then the entire samples were stored in artificial saliva. The hardness of the samples was measured using a Vickers hardness tester before bleaching, after bleaching, and after remineralization for 7, 14, and 21 days. Statistical Analysis Analysis of the data used was an analysis of variance test to assess differences in the increase in enamel hardness between groups and paired t -tests and to determine differences in enamel hardness in each group. Results This study showed that there was an increase in the enamel hardness after bleaching which was remineralized with CPP-ACPF and 5% NaF. There was a difference in the increased enamel hardness between teeth remineralized with CPP-ACPF and 5% NaF. The enamel hardness of CPP-ACPF was higher compared with 5% NaF after remineralization of 7, 14, and 21 days. Conclusion There was an increase in the enamel hardness after external bleaching that was remineralized with CPP-ACPF and 5% sodium fluoride (NaF). There was a difference in the increased enamel hardness between teeth remineralized with CPP-ACPF and 5% sodium fluoride (NaF). CPP-ACPF showed a higher enamel hardness value than 5% NaF.
TL;DR: In this article , the platelet-rich plasma (PRP) was used to stimulate the healing process of traumatic ulcers with diabetes mellitus in an animal model by analyzing the expression of transforming growth factor β1 (TGF-β1) and matrix metalloprotein 9 (MMP-9).
Abstract: Abstract Objective Diabetes mellitus is not only characterized by alterations in the wound healing process but also during oral ulcer healing. The platelet-rich plasma (PRP) can be used to stimulate the healing process. This study was performed to analyze the effect of PRP on traumatic ulcers with diabetes mellitus in an animal model by analyzing the expression of transforming growth factor β1 (TGF-β1) and matrix metalloprotein 9 (MMP-9). Materials and Methods The diabetes mellitus model was developed using streptozotocin that was administrated to Rattus novergicus. The traumatic ulcer model was obtained by placing a heated tip of a ball burnisher for 5 seconds on the lower mucosa labial. Then, the traumatic ulcer was treated with PRP for 3, 5, and 7 days. The expression of TGF-β1 and MMP-9 was analyzed with indirect immunohistochemistry, and differences between each marker were analyzed with statistical analysis. Results All animals showed clinical oral ulceration as a yellow base during the experiment. The application of PRP showed a higher level of TGF-β1 expression than the controls for 3, 5, and 7 days ( p < 0.05). In contrast, the MMP-9 expression was lower than the control for 5 and 7 days ( p < 0.05). Conclusion The PRP affected traumatic ulcers with diabetes mellitus by promoting healing through TGF-β1 expression and suppressing the MMP-9 expression. This material can serve to develop a promising topical therapy for traumatic ulcers, especially with an underlying disease such as diabetes mellitus.
TL;DR: In this article , the potential of modified bioactive glasses containing lithium and zinc as pulp capping materials by investigating the odontogenic differentiation and mineralization response in the tooth culture model was evaluated.
Abstract: Abstract Objective To evaluate the potential of modified bioactive glasses containing lithium and zinc as pulp capping materials by investigating the odontogenic differentiation and mineralization response in the tooth culture model. Materials and Methods Lithium- and zinc-containing bioactive glasses (45S5.1Li, 45S5.5Li, 45S5.1Zn, 45S5.5Zn, 45S5.1Zn sol-gel, and 45S5.5Zn sol-gel), fibrinogen-thrombin, and biodentine were prepared to assess Axin2 gene expression at 0, 30 minutes, 1 hour, 12 hours, and 1 day and DSPP gene expression at 0, 3, 7, and 14 days in stem cells from human exfoliated deciduous teeth (SHEDs) using qRT-PCR. The experimental bioactive glasses incorporated with fibrinogen-thrombin and biodentine were placed on the pulpal tissue in the tooth culture model. Histology and immunohistochemistry were analyzed at 2 weeks and 4 weeks. Results Axin2 gene expression for all experimental groups was significantly higher than the control at 12 hours. The DSPP gene expression for all experimental groups was significantly higher than the control at 14 days. The presence of mineralization foci was significantly higher at 4 weeks for the modified bioactive glasses 45S5.5Zn, 45S5.1Zn sol-gel, and 45S5.5Zn sol-gel as well as Biodentine compared with the fibrinogen-thrombin control. Conclusion Lithium - and zinc - containing bioactive glasses increased Axin2 and DSPP gene expression in SHEDs and can potentially enhance pulp mineralization and regeneration. Zinc - containing bioactive glasses are a promising candidate to be used as pulp capping materials.
TL;DR: In this article , the authors analyzed the clinical outcome, angiogenesis, and expression of FGF-2 and VEGFA in the oral ulcer rat model after AdMSCM oral gel application.
Abstract: Abstract Objective Enhancing wound healing capacity is one of the main principles in oral ulcer management. Efficient oral ulcer management will accelerate clinical symptom amelioration and prevent complications. Adipose mesenchymal stem cell metabolites (AdMSCM), a novel biological product, contains a plethora of bioactive mediators that can induce a series of processes in wound healing. This study will analyze the clinical outcome, angiogenesis, and expression of FGF-2 and VEGFA in the oral ulcer rat model after AdMSCM oral gel application. Materials and Methods Twenty healthy male Wistar rats ( Rattus novergicus ) were used to create oral ulcer animal models. AdMSCM oral gel treatment was performed three times daily for 3 and 7 days. Clinical outcome was assessed by measuring the major diameter of the ulcer; the angiogenesis was evaluated through histological assessment; the expression of VEGFA and FGF-2 was assessed using the immunohistochemistry method. Statistical Analysis This study uses parametric comparative analysis using one-way analysis of variance (ANOVA) and post-hoc Tukey's HSD test Results The application of AdMSCM oral gel in an oral ulcer rat model significantly enhanced the clinical outcome ( p < 0.05). In addition, similar results were shown in the histologic assessment of angiogenesis and supported by the significant increase of VEGFA and FGF-2 expression. Conclusions AdMSCM oral gel accelerates oral ulcer healing processes, proven by the enhancement of angiogenesis, pro-angiogenic factors expression, and clinical outcomes.
TL;DR: In this article , the authors evaluated the efficacy of a CBCT in predicting the incidence of OAC after maxillary third molar extraction, and found that CBCT scan prior to cases with high-risk factors for OAC can be a valuable tool in accurately predicting the chances of oro-antral communication (OAC).
Abstract: Abstract Objective Oro-antral communication (OAC) is one of the most frequently encountered complications during third molar extraction. Various radiographic factors, like excessive maxillary sinus pneumatization, long periods of edentulism, periapical lesions, etc., have been considered high-risk factors for OAC. However, a panoramic radiograph has not proven to be accurate in predicting the chances of OAC. Through this retrospective study, we evaluated the efficacy of a CBCT in predicting the incidence of OAC after maxillary third molar extraction. Materials and Methods We conducted a retrospective study in our department, which included the patients who had undergone extraction of a maxillary third molar over five years with the presence of panoramic X-rays and/or CBCT scans prior to extraction. Primary outcomes assessed from the case files were intra-operative complications like OAC, root fracture, tuberosity fracture, pterygoid plate fracture, etc. The incidence of these complications was correlated with the presence or absence of CBCT before extraction. Results Out of 920 extracted maxillary third molar, only 148 teeth (16.1%) had a CBCT record before extraction. The most commonly encountered complication was broken inaccessible root piece/s (4.9%), followed by OAC (3.5%). An inter-group comparison showed that a significantly higher percentage of patients (p < 0.001) with CBCT records had an incidence of OAC (11.5%) as against the group of patients with no CBCT record (1.9%). Conclusion A CBCT scan prior to cases with high-risk factors for OAC can be a valuable tool in accurately predicting the chances of OAC after maxillary third molar extraction.
TL;DR: In this paper , a supervised machine learning approach was undertaken to develop a segmentation model on a U-Net convolutional neural network (CNN) in the Medical Open Network for Artificial Intelligence (MONAI) framework to identify and delineate edentulous alveolar bone on CBCT images before implant placement.
Abstract: Abstract Objective Dental implants are considered the optimum solution to replace missing teeth and restore the mouth's function and aesthetics. Surgical planning of the implant position is critical to avoid damage to vital anatomical structures; however, the manual measurement of the edentulous (toothless) bone on cone beam computed tomography (CBCT) images is time-consuming and is subject to human error. An automated process has the potential to reduce human errors and save time and costs. This study developed an artificial intelligence (AI) solution to identify and delineate edentulous alveolar bone on CBCT images before implant placement. Materials and Methods After obtaining the ethical approval, CBCT images were extracted from the database of the University Dental Hospital Sharjah based on predefined selection criteria. Manual segmentation of the edentulous span was done by three operators using ITK-SNAP software. A supervised machine learning approach was undertaken to develop a segmentation model on a “U-Net” convolutional neural network (CNN) in the Medical Open Network for Artificial Intelligence (MONAI) framework. Out of the 43 labeled cases, 33 were utilized to train the model, and 10 were used for testing the model's performance. Statistical Analysis The degree of 3D spatial overlap between the segmentation made by human investigators and the model's segmentation was measured by the dice similarity coefficient (DSC). Results The sample consisted mainly of lower molars and premolars. DSC yielded an average value of 0.89 for training and 0.78 for testing. Unilateral edentulous areas, comprising 75% of the sample, resulted in a better DSC (0.91) than bilateral cases (0.73). Conclusion Segmentation of the edentulous spans on CBCT images was successfully conducted by machine learning with good accuracy compared to manual segmentation. Unlike traditional AI object detection models that identify objects present in the image, this model identifies missing objects. Finally, challenges in data collection and labeling are discussed, together with an outlook at the prospective stages of a larger project for a complete AI solution for automated implant planning.
TL;DR: In this article , a study was conducted to determine whether periodontitis in Arab populations from Iraq is correlated with NLRP3 gene polymorphisms and measure clinical periodontal parameters and investigate their association with genetic polymorphisms of the NLRP 3.
Abstract: Abstract Objectives The nod-like receptor pyrin domain-containing protein 3 (NLRP3) inflammasome regulates the maturation and release of the cytokines as well as the activation of caspase in response to danger signals derived from pathogenic infection, tissue damage, andmetabolic changes that have a role in the pathogenesis of different diseases as periodontitis. Yet, the susceptibility to this illness could be determined by population-based genetic differences. The aim of this study was to determine whether periodontitis in Arab populations from Iraq is correlated with NLRP3 gene polymorphisms and measure clinical periodontal parameters and investigate their association with genetic polymorphisms of the NLRP3. Materials and Methods The study sample consisted of 94 participants ranging from 30 to 55 years old, both males and females who fulfilled the study's criteria. The selected participants were divided into two groups: the periodontitis group (62 subjects) and the healthy control group (32 subjects). The examination of clinical periodontal parameters of all participants was carried out, followed by a collection of venous blood for NLRP3 genetic analysis using the polymerase chain reaction–sequencing technique. Results The genetic analysis of NLRP3 genotypes at four single nucleotide polymorphisms (SNPs) (rs10925024, rs4612666, rs34777555, and rs10754557), by Hardy–Weinberg equilibrium, identified nonsignificant differences in studied groups. The C-T genotype among periodontitis was significantly different from controls, while the C-C genotype among control was significantly different from periodontitis at NLRP3 rs10925024. Overall, there were 35 SNPs in the periodontitis group and 10 SNPs in the control group for rs10925024 with significant differences versus nonsignificant differences of the other SNPs between the studied groups. Clinical attachment loss and NLRP3 rs10925024 additionally demonstrated a significant positive correlation in the periodontitis subjects. Conclusion The findings suggested that polymorphisms of the NLRP3 gene may have a role and increasing the genetic susceptibility to periodontal disease in Arabs Iraqi patients.
TL;DR: In this article , the authors evaluated whether a toothpaste containing enzymes and salivary proteins could improve oral health and reduce the presence of periodontal pathogens in subjects predisposed to black stain discoloration.
Abstract: Abstract Objective Black stain (BS) is an extrinsic dental discoloration particularly difficult to treat. Although its etiology is not fully clear yet, chromogenic bacteria inside the oral cavity seem to be involved. In this pilot study, we evaluated whether a toothpaste containing enzymes and salivary proteins could improve oral health and reduce the presence of periodontal pathogens in subjects predisposed to BS discoloration. Methods Twenty-six subjects were enrolled in the study: 10 subjects without BS; 16 subjects with BS, randomly assigned in two groups: test ( n = 8) and control ( n = 8). The test group used a toothpaste containing sodium fluoride, enzymes, and salivary proteins. The control group used a toothpaste with amine fluoride. At enrollment and after 14 weeks, participants were subjected to professional oral hygiene, evaluation of BS (through Shourie index) and oral health status, collection of saliva and dental plaque samples. The presence of periodontal pathogens in plaque and saliva of all subjects was investigated by molecular analysis (PCR). Statistical Analysis The prevalence of investigated microbial species in patients with/without BS was performed by Chi-squared test. The variation in the prevalence of the investigated species after treatment in test and control group was analyzed by t -test. Results Clinical evaluation showed that 86% of participants with BS had a reduction in the Shourie index, independently from the toothpaste used. In particular, a greater reduction in the Shourie index was observed in subjects using an electric toothbrush. We did not observe an effect of the fluoride toothpaste containing enzymes and salivary proteins on the composition of the oral microbiota of the test subjects in comparison with controls. When comparing all subjects with BS ( n = 16) and without BS ( n = 10), P. gingivalis detection was significantly higher in saliva samples collected from subjects with BS ( p = 0.0129). Conclusion We verified that the use of an enzyme-containing toothpaste alone is not sufficient to prevent the formation of BS dental pigmentation in subjects predisposed to this discoloration. Mechanical cleaning, especially using electrical toothbrushes, seems to be useful to counteract BS formation. Moreover, our results suggest a possible association between BS and the presence of P. gingivalis at the salivary level.
TL;DR: In this article, the effectiveness of oral health promotion among individuals with intellectual disabilities (IDs) was reviewed using seven electronic databases using keywords like intellectual disability/mental retardation/learning disability AND dental health education/health promotion.
Abstract: Abstract People with disabilities experience inferior health and poor access to good quality health services as compared with the general population. Optimum oral health is associated with improvement in the quality of life in such patients. As oral diseases are largely preventable, good oral health education can have a positive impact on individuals with disabilities. So, the aim of the study was to review the effectiveness of oral health promotion among individuals with intellectual disabilities (IDs). Seven electronic databases were searched using keywords like intellectual disability/mental retardation/learning disability AND dental health education/health promotion. All records that were identified electronically from this search were subjected to a preliminary review to identify eligible papers. Identified studies were grouped into oral health promotion directed at individuals with IDs, and those aimed at caregivers of people with IDs. Interpretation of the outcomes included the effects on oral health knowledge, attitudes, and behaviors (either observed or self-reported). Eventually, 16 studies were included in the review including five studies that were randomized controlled trials, while the remaining 11 studies were pre-post single group oral health promotion studies. Critical appraisal of each study was conducted with the 21-item criteria by Kay and Locker (1997) to provide a numerical quantification and ranking of the evidence. Positive changes in the behaviors and attitudes were observed, while other studies reported a considerable improvement in the knowledge of caregivers for oral healthcare of individuals with IDs. However, such activities need to be done over a long period of time with constant monitoring.
TL;DR: In this article , a study aimed to describe variables of emotions about dental treatment and found that only participants aged 4 responded with one type of emotion (happy), while the other age groups gave various emotional responses.
Abstract: Abstract Objective Emotion is a feeling that someone can feel. Emotions are generally shown through behavior or facial expressions. Emotions are essential for dental treatment because there is a relation between the emotions felt by children and the success of the dental treatment that the dentist will give. This study aimed to describe variables of emotions about dental treatment. Materials and Methods Descriptive analysis using a convenience nonrandom sampling technique was conducted on 58 preschool children aged 3 to 6 years old who came for dental treatment at the Bandung Dental Center in Bandung, Indonesia. The instrument used to ask children how they feel about dental care is a 7-item questionnaire derived from the children's fear survey scale-dental subscale. Meanwhile, the media used by children to respond was a card with facial expressions from the Facial Expression Emotion Scale. Results The results showed that only participants aged 4 responded with one type of emotion (happy), while the other age groups gave various emotional responses. Fear emotion began to appear in the age group of 5 and 6 years and only in girls, while emotions of anger also appeared in girls and only at the age of 5. Conclusion In this study, the emotions that children choose about dental care at the Bandung Dental Center clinic are happy emotions. The emotions of fear and sadness were chosen more by girl participants, while none of the boy participants chose the emotion of fear. This sad and fearful response is associated with invasive dental treatment. Anger was chosen as a child's response dominantly because of the parents' invitation to the dentist.