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  • Effects of disinfection and sterilization on the dimensional changes and mechanical properties of 3D printed surgical guides for implant therapy – pilot study
    BMC Oral Health (IF 2.048) Pub Date : 2020-01-23
    Gréta Török; Péter Gombocz; Eszter Bognár; Péter Nagy; Elek Dinya; Barbara Kispélyi; Péter Hermann

    The purpose of this research was to investigate the effects of disinfection and three different sterilization methods on the dimensional changes and mechanical properties of three-dimensional (3D) printed surgical guide for implant therapy. The objective was to assess the effects of sterilization procedures in 3D printed drill guide templates with destructive and non-destructive material testing. Fifteen identical drill guide templates were produced using a 3D printer. The surgical guides were classified into five groups: three controls, three disinfected (4% Gigasept®, 60 min), three plasma sterilized, three autoclave sterilized (+ 1 bar, 121 °C, 20 min), and three autoclave sterilized (+ 2 bar, 134 °C, 10 min). The templates were digitalized with a Steinbichler SCAN ST 3D scanner. Length was measured under an SZX16 stereomicroscope. A scanning electron microscope was used to study the surface morphology of the drill templates. The hardness, and flexural and compressive strength were measured to assess any changes in the physical characteristics of the material caused by sterilization. The drill guide templates were also examined with a Dage XiDAT 6600 X-ray. During the X-ray examinations, the following parameters were used: 100 kV voltage, 128 AVG averaging, 0.8 W power. One-way analysis of variance (ANOVA) was used to detect the difference between groups. Evaluation of the hardness measurements of the various specimens shows that the hardness of the material was not changed by the plasma sterilization (p = 0.0680), steam sterilization on 121 °C (p = 0.6033) or disinfection process (p = 0.1399). The statistical analysis revealed significant difference in hardness strength of the autoclave sterilized (134 °C) specimens (p = 0.0002). There was no significant difference between the goups regarding the scanning electron microscopic and stereomicroscopic examinations. There was no significant difference regarding the X-ray visibility of the templates to the effect of the disinfection (p = 0.7844), plasma sterilization (p = 0.4091) and steam sterilization on 121 °C (p = 0.9277) and steam sterilization on 131 °C (p = 0.093). The effect of the sterilization was the same in case of both flexural and compressive strength of the material. Our findings indicate that plasma sterilization and steam sterilization at 121 °C were both suitable for sterilizing the tested 3D printed surgical guides.

    更新日期:2020-01-23
  • Technical note on introducing a digital workflow for newborns with craniofacial anomalies based on intraoral scans - part I: 3D printed and milled palatal stimulation plate for trisomy 21
    BMC Oral Health (IF 2.048) Pub Date : 2020-01-23
    Alexander B. Xepapadeas; Christina Weise; K. Frank; S. Spintzyk; C. F. Poets; C. Wiechers; J. Arand; B. Koos

    Advanced digital workflows in orthodontics and dentistry often require a combination of different software solutions to create patient appliances, which may be a complex and time-consuming process. The main objective of this technical note is to discuss treatment of craniofacial anomalies using digital technologies. We present a fully digital, linear workflow for manufacturing palatal plates for infants with craniofacial anomalies based on intraoral scanning. Switching to intraoral scanning in infant care is advantageous as taking conventional impressions carries the risk of impression material aspiration and/or infections caused by material remaining in the oronasal cavity. The fully digital linear workflow presented in this technical note can be used to design and manufacture palatal plates for cleft palate patients as well as infants with functional disorders. We describe the workflow implemented in an infant with trisomy 21. The maxilla was registered using a digital scanner and a stimulation plate was created using dental CAD software and an individual impression tray module on a virtual model. Plates were manufactured using both additive and subtractive methods. Methacrylate based light curing resin and Poly-Ether-Ether-Ketone were the materials used. The palatal area was successfully scanned to create a virtual model. The plates fitted well onto the palatal area. Manual post-processing was necessary to optimize a functional ridge along the vestibular fold and remove support structures from the additively manufactured plate as well as the milled plate produced from a blank. The additively manufactured plate fitted better than the milled one. Implementing a fully digital linear workflow into clinical routine for treatment of neonates and infants with craniofacial disorders is feasible. The software solution presented here is suitable for this purpose and does not require additional software for the design. This is the key advantage of this workflow, which makes digital treatment accessible to all clinicians who want to deal with digital technology. Whether additive or subtractive manufacturing is preferred depends on the appliance material of choice and influences the fit of the appliance.

    更新日期:2020-01-23
  • Lipopolysaccharide inhibits osteogenic differentiation of periodontal ligament stem cells partially through toll-like receptor 4-mediated ephrinB2 downregulation
    Clin. Oral Investig. (IF 2.453) Pub Date : 

    Abstract Objectives This study aimed to investigate the possible crosstalk between LPS/toll-like receptor 4 (TLR4) and ephrinB2 signaling in mediating osteogenic differentiation of PDLSCs. Materials and methods Human periodontal ligament stem cells (hPDLSCs) were harvested and treated with different concentrations of LPS under osteogenic induction. qPCR, alkaline phosphatase (ALP) staining, and Alizarin Red S staining were performed to assess osteogenic gene expression, ALP activity, and mineralized nodule formation. EphrinB2 mRNA and protein expressions after LPS treatment were also determined. To explore the role of ephrinB2 in LPS-impaired osteogenic differentiation of hPDLSCs, hPDLSCs were stimulated with ephrinB2-Fc or transfected with ephrinB2 lentivirus, and then, the osteogenic differentiation capacity was evaluated. Results LPS inhibited osteogenic differentiation of hPDLSCs and downregulated ephrinB2 expression in hPDLSCs during osteogenic differentiation. Blockage of TLR4 partially reversed LPS-induced decrease in ephrinB2 expression. EphrinB2-Fc promoted mineralized nodule formation and increased the expression of ALP, osteocalcin (OCN), and bone morphogenetic protein 2 (BMP2) in hPDLSCs. EphrinB2-overexpressing hPDLSCs treated with LPS expressed higher ALP and BMP2 mRNA and higher ALP activity and showed more mineralized nodule formation, when compared with wide-type hPDLSCs treated with LPS. Conclusions Our data suggested that LPS decreased the osteogenic differentiation capacity of hPDLSCs partially through downregulation of ephrinB2 expression via LPS/TLR4 signaling. Upregulation of ephrinB2 partially reversed the impaired osteogenic potential of hPDLSCs induced by LPS. Clinical relevance Our results provided a new insight of mechanism underling LPS-mediated osteogenic differentiation inhibition of PDLSCs and clarified a potential target for the management of periodontitis.

    更新日期:2020-01-23
  • Effects of non-surgical periodontal therapy on systemic inflammation and metabolic markers in patients undergoing haemodialysis and/or peritoneal dialysis: a systematic review and meta-analysis
    BMC Oral Health (IF 2.048) Pub Date : 2020-01-22
    Hui Yue; Xinxin Xu; Qin Liu; Xiaozhi Li; Yiting Xiao; Bo Hu

    This systematic review aimed to investigate whether non-surgical periodontal therapy (NSPT) can reduce systemic inflammatory levels and improve metabolism in patients undergoing haemodialysis (HD) and/or peritoneal dialysis (PD). Electronic databases (PubMed, EMBASE, CENTRAL, CNKI, and WFPD) were searched for randomized controlled trials (RCTs) performed through July 2019. The risk of bias within studies was assessed with the Cochrane Collaboration’s risk assessment tool. The systemic inflammatory and metabolic outcomes included the highly sensitive C-reactive protein (hs-CRP), interleukin 6 (IL-6), tumour necrosis factor-a (TNF-a), the albumin (Alb), and lipid metabolite levels. Meta-analyses (MAs) were performed to calculate the overall effect size where appropriate. Five RCTs were included in this study. Compared with untreated periodontitis groups, the dialysis patients after NSPT significantly showed decreased hs-CRP levels at less than or equal to 2 months (standardized mean difference: − 1.53, 95% confidence interval − 2.95 to − 0.11). No significant difference was found in IL-6 and Alb levels following NSPT at either the 3- or 6- month follow-ups. No MAs could be performed on the TNF-a level and the lipid metabolic markers. NSPT can moderately reduce serum hs-CRP levels in HD and/or PD patients, but did not significantly change IL-6 or Alb levels. For TNF-a and lipid metabolism markers, no sufficient evidence supports that these levels are changed after NSPT. Additional scientific research is necessary to assess the effects of NSPT on systemic inflammation and metabolic parameters in dialysis patients.

    更新日期:2020-01-23
  • Oral impact on daily performance (OIDP) scale for use in Sri Lankan adolescents: a cross sectional modification and validation study
    BMC Oral Health (IF 2.048) Pub Date : 2020-01-21
    Uttara Amilani; Prasanna Jayasekara; Irosha R. Perera; Hannah E. Carter; Sameera Senanayake; Sanjeewa Kularatna

    Oral Health Related Quality of Life (OHRQoL) measures play an important role in understanding subjective patient experiences in oral health care. The Oral Impact on Daily Performance (OIDP) scale is a validated OHRQoL tool that measures the impact and extent to which an individual’s daily activities may be compromised by their oral health. It is commonly used to facilitate oral health service planning. The aim of this study was to modify and validate a Sinhalese version of the OIDP for use in Sri Lankan adolescents. Stage I involved cultural adaptation of the tool through translation and modification. Stage II involved the exploring factor structure, validation and a reliability assessment. After translation and cultural adaptation, stage II was conducted among 220 secondary school students aged 15–19 in the Gampaha district, Sri Lanka. Participants completed the modified OIDP scale along with questions on self-reported perceived oral health problems and treatment need which were used to assesses the concurrent validity of the modified OIDP scale. Factorability was assessed by inspection of correlation matrix and Kaiser-Meyer-Olkin and Bartlett’s Test of Sphericity tests as a measure of sampling adequacy. An exploratory factor analysis was carried out using Principal Component Analysis method and factors were rotated using the oblimin method. The Kaiser-Meyer-Olkin measure was 0.87 and Bartlett’s test of Sphericity was significant (p < 0.001) Cronbach’s alpha was calculated as 0.88, indicating a high level of internal consistency of the modified OIDP scale. The principal component analysis produced two factors with Eigen values ranging from 1.12 to 4.40, explaining 70.0% of total variance. Concurrent validity was satisfactory as the OIDP score increased when the adolescents’ perceived oral health decreased. The final modified OIDP consists of eight self-reported items which assesses the impact severity of eight daily performances over past three months. Participant scores ranged from 0 to 24 out of a worst possible score of 40, and nearly 48% of the responders reported at least one impact during past three months. The most prevalent oral health impact related to chewing and enjoying foods, reported by 36.8% of respondents. This study suggests that the modified OIDP scale has promising psychometric properties and is appropriate for use among adolescents in Sri Lanka. Further research is required to test the validity of this tool in other cohorts.

    更新日期:2020-01-22
  • In vitro evaluation of a ceramic bracket with a laser-structured base
    BMC Oral Health (IF 2.048) Pub Date : 2020-01-21
    Selma Elekdag-Türk

    The purpose of this study was the assessment of shear bond strength (SBS), adhesive remnant characteristics, integrity of the enamel, integrity of Discovery Pearl as well as the integrity of Fascination 2 ceramic brackets following SBS testing. Sixty maxillary first premolars were randomly assigned into two groups. These groups were bonded with their respective brackets. The samples underwent thermocycling (1000 cycles), SBS testing and assessment of the residual adhesive. The statistical analyses used were the independent samples t-test, the Weibull analysis and the chi-square test. The independent samples t-test for the comparison of the mean SBS resulted in significant differences between Fascination 2 (10.50 ± 2.61 MPa) and Pearl (13.01 ± 2.50 MPa) brackets (p = 0.0003). The results of the chi-square test for ARI demonstrated a significant difference (p = 0.000) between the groups. A higher frequency of ARI scores of 2 and 3 for Pearl brackets existed. Enamel damage and bracket fracturing was not observed. The mean bond strength value, the adhesive remnant characteristics, the integrity of the enamel and the ceramic brackets as well as the Weibull analyses outcomes were highly encouraging during this in vitro screening. The way is paved for an in vivo investigation with the Pearl ceramic bracket.

    更新日期:2020-01-22
  • C-shaped canals in mandibular molars of a Brazilian subpopulation: prevalence and root canal configuration using cone-beam computed tomography
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-21
    Yuri Nejaim, Amanda Farias Gomes, Lucas de Paula Lopes Rosado, Deborah Queiroz Freitas, Jorge N. R. Martins, Emmanuel João Nogueira Leal da Silva

    Abstract Objectives To assess C-shaped root canal configuration by identifying its prevalence and each configuration type proportion, according to tooth (mandibular first or second molar) and demographic characteristics in a Brazilian population, using cone-beam computed tomography (CBCT). Moreover, it was verified if there is a relationship between root canal configuration observed in two-dimensional reconstructions of CBCT and presence of C-shape. Methods Mandibular jaw CBCT scans (184 males and 220 females, aged 15 to 80 years), which presented 1464 mandibular molars (710 first molars and 754 second molars), were assessed. Teeth were evaluated for the presence and type of C-shaped root canals by observing the roots at five levels in CBCT axial reconstructions. Root canal configuration was assessed in panoramic reconstructions. Data were statistically analyzed at a significance level of 5%. Results Of the 1464 mandibular molars, 125 (8.5%) were classified as C-shaped. This variation was more prevalent in females (n = 107, 85.6%) and in second molars (n = 108, 86.4%). C1 (uninterrupted C-shaped canal) was the most prevalent type of C-shaped configuration (41.76%), while C5 (no canal lumen) was the least prevalent type (0.96%). Single root with single canal in panoramic reconstructions was the most predominant configuration for C-shaped teeth (n = 54, 43.2%). Fused roots presented 17.2 higher odds of being associated with C-shaped root canals than non-fused roots. Conclusions C-shaped root canals were more prevalent in mandibular second molars and in females. Additionally, clinicians should bear in mind the greater possibility of C-shaped configuration in mandibular molars with fused roots. Clinical relevance Mandibular molars with C-shaped canals present a clinical challenge. A higher C-shaped proportion was noted in radiographic fused root types, which had 17.2 higher odds of presenting such anatomy when compared to radiographic non-fused roots. Root radiographic features may help in diagnosis of complex C-shaped morphologies.

    更新日期:2020-01-22
  • Evaluation of the presence of microorganisms from root canal of teeth submitted to retreatment due to prosthetic reasons and without evidence of apical periodontitis
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-20
    Eloa C. Bicego-Pereira, Marlos Barbosa-Ribeiro, Adriana de-Jesus-Soares, Alexandre A. Zaia, Caio C. R. Ferraz, José Flavio A. Almeida, Marina A. Marciano, Magda Feres, Brenda P. F. A. Gomes

    Abstract Aim The objective of this study was to evaluate the presence of microorganisms in the root canals (RC) of teeth submitted to endodontic retreatment due to prosthetic reasons and without evidence of apical periodontitis. Material and methods Twenty teeth referred to endodontic retreatment due to prosthetic reasons and without evidence of apical periodontitis were included in this study. Gutta-percha (GP) was collected from each third of the RC. After GP removal, microbial samples were also collected from the full extension of RC using paper points and files. The samples were cultivated in Fastidious Anaerobe Agar and the colony-forming units (CFU/mL) were counted. They were also semi-quantitatively analyzed by checkerboard DNA–DNA hybridization using 40 DNA bacterial probes. Results Microorganisms were found in all samples. The coronal third of GP was more contaminated than the apical third (p ≤ 0.05). There was prevalence of Enterococcus hirae and Enterococcus faecalis in all RC thirds and also in the samples collected from the full extension of RCs. Conclusion Microorganisms were found in all cases referred to endodontic retreatment due to prosthetic reasons and without evidence of apical periodontitis. Enterococcus was the genus most frequently detected. Clinical significance An endodontic retreatment should be considered before replacing a prosthesis.

    更新日期:2020-01-21
  • Retrospective assessment of dental implant-related perforations of relevant anatomical structures and inadequate spacing between implants/teeth using cone-beam computed tomography
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-20
    Hugo Gaêta-Araujo, Nicolly Oliveira-Santos, Arthur Xavier Maseti Mancini, Matheus Lima Oliveira, Christiano Oliveira-Santos

    Abstract Objectives To assess the prevalence of dental implant-related perforations of relevant anatomical structures and inadequate spacing between the implant and the adjacent tooth or implant, and their association with anatomical location, implant dimension, thread exposure, and presence of graft, using cone beam computed tomography (CBCT). Materials and methods CBCT scans of patients with implants were retrospectively assessed regarding the presence of implant-related perforation of adjacent anatomical structures, and inadequate mesial and distal spacing between the implant and the adjacent tooth/implant (i.e., < 1 mm or < 3 mm, respectively). Implants were classified according to anatomical location, dimensions, thread exposure, and the presence of graft (i.e., bone graft or bone substitutes). Prevalence of perforations and inadequate spacing was compared among the different implant classifications (Chi-squared test). Significance level was set at 5%. Results A total of 1109 implants were assessed, out of which 369 (33.3%) presented perforation of adjacent structures. Prevalence of perforations in the maxilla (43.5%) was higher than in the mandible (11.3%). Inadequate spacing was found in 18.2% of the mesial and distal measurements, which was more prevalent in the maxilla (p < 0.001). Implants perforating adjacent structures or placed with inadequate spacing presented higher prevalence of thread exposure (p < 0.001). No significant difference was found between the presence of perforations or inadequate spacing and presence of graft (p > 0.05). Conclusions Implant-related perforations of relevant anatomical structures and inadequate spacing between the implant and the adjacent tooth/implant are relatively prevalent and more common in the maxilla. Both are associated with threads exposure. Clinical relevance Information on dental implant-related perforations and inadequate spacing can assist dental surgeons in pre-surgical planning.

    更新日期:2020-01-21
  • Effect of gamma-ray sterilization on phase transformation behavior and fatigue resistance of contemporary nickel-titanium instruments
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-20
    Ana Arias, José C. Macorra, Sanjay Govindjee, Ove A. Peters

    Abstract Objectives The aim of this study was to compare body temperature cyclic fatigue resistance (CF) of heat-treated NiTi rotary instruments submitted to gamma-irradiation or autoclave sterilization. Materials and methods A total of 176 instruments (88 Hyflex EDM (HEDM) and 88 TRUShape (TS)) were used. Forty-four of each were submitted to gamma-irradiation. Twenty-two in each group were further autoclaved, resulting in a total of eight groups (n = 22 each): TS-γ and HEDM-γ (gamma-irradiated)/TS-γ-ac and HEDM-γ-ac (gamma-irradiated and autoclaved)/TS-non-γ and HEDM-non-γ (non-sterilized controls, non-gamma-irradiated/non-autoclaved)/TS-non-γ-ac and HEDM-non-γ-ac (non-gamma-irradiated and autoclaved). Twenty in each were tested for CF. Weibull parameters were calculated and compared. The remainder was used for differential scanning calorimetry analysis. Results TS instruments lasted significantly longer if not submitted to gamma-irradiation (TS-non-γ mean-life = 101.5 s, 95 CI% 91.7–112.3; TS-γ mean-life = 83.2 s, 95 CI% 76–91.1); further autoclaving did not significantly affect CF. Gamma-irradiation did not affect HEDM (HEDM-γ mean-life = 717.9 s, 95 CI% 636.8–809.3; HEDM-non-γ: mean-life = 678.8 s, 95 CI% 595.1–744.2); further sterilization significantly decreased fatigue resistance (HEDM-γ-ac mean-life = 524.1 s, 95 CI% 476.1–576.8; HEDM-non-γ-ac mean-life = 570.6, 95 CI% 512.3–635.5). Gamma irradiation benefited HEDM conversion to martensite state and its maintenance, while further autoclave sterilization reverted the benefit. Conclusions Gamma-irradiation and autoclaving differentially affected fatigue life span and transformation temperatures of contemporary martensitic rotary instruments manufactured with different methods. Clinical relevance Gamma-ray processing is increasingly utilized by manufacturers for clinician to use fully sterile packaged instruments; however, the sterilization method of choice should vary depending on the effects on the behavior of contemporary martensitic rotary instruments manufactured with different methods.

    更新日期:2020-01-21
  • Evaluation of adhesion of Streptococcus mutans , plaque accumulation on zirconia and stainless steel crowns, and surrounding gingival inflammation in primary molars: randomized controlled trial
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-18
    Mebin George Mathew, S. R. Samuel, Ashu Jagdish Soni, Korishettar Basavaraj Roopa

    Abstract Objective To evaluate the adhesion of Streptococcus mutans to preformed zirconia and stainless steel crowns and compare plaque accumulation and gingival inflammation over a period of 1 year. Materials and methods Thirty children between 6 to 9 years with pulpectomised bilateral mandibular primary second molars were randomly divided into zirconia/stainless steel groups. Plaque was collected from the crowns using swabs at 3, 6, 9, and 12 months. Gingival and plaque index were recorded at all follow-ups. S. mutans was cultured on tryptone-yeast-cysteine-sucrose-bacitracin agar, and organisms were expressed as colony-forming units. Within-group analysis was performed using repeated measures ANOVA and between-groups using the independent T test. Results S. mutans were found in significantly higher numbers on the stainless steel crowns as compared with zirconia crowns at all the follow-ups. Gingival inflammation and plaque index scores were also significantly higher around the stainless steel crowns as compared with zirconia at the end of 12 months follow-up. Conclusion Adhesion of S. mutans to stainless steel crowns was significantly greater when compared with zirconia, and minimal gingival inflammation and plaque accumulation was found in the tooth restored with zirconia crowns as compared with stainless steel crowns. Clinical relevance Preformed zirconia crowns prevents adhesion of S. mutans onto its surface, and reduces plaque accumulation around the crown, inflammation of surrounding gingiva compared to conventional stainless-steel crowns. Pediatric zirconia crowns could help in reducing the overall microbial density and prevalence in the oral cavity, thus reducing the caries risk in the long term.

    更新日期:2020-01-21
  • Development of a template tool for facilitating fibula osteotomy in reconstruction of mandibular defects by digital analysis of the human mandible
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-18
    Christopher-Philipp Nobis, Marco Rainer Kesting, Klaus-Dietrich Wolff, Gesche Frohwitter, Andrea Rau, Jochen Weitz

    Abstract Objectives Mandibular reconstruction after segmental mandibulectomy can be challenging without virtual surgical planning and osteotomy guides. The purpose of this study was to analyze anatomic parameters to facilitate the evaluation of ideal fibula wedge osteotomies to reconstruct the neomandibula in a simple and cost-effective manner without the need for preoperative virtual planning. Materials and methods Computed tomography scans were acquired from randomly selected patients, and all images were obtained from routine clinical diagnostics, e.g., tumor staging, or preoperatively before reconstruction. Data was used to calculate stereolithographic models of the mandible for length and angle measurements. Statistical analysis was performed (p < 0.05). Results CT scans of 100 patients were analyzed: 39 were female and 61 were male patients, mean age was 59.08a. The mandibular arch angle proved to be constant with 241.07 ± 2.39°. The outside B-segment length was 80.05 ± 5.16 mm; the anterior S-segment length was 27.69 ± 3.16 mm. The angle of the mandibular arch showed differences in means (p = 0.004) between age groups, but effect was proved low. No relevant statistical significances were detected. Conclusions The development of a mandible reconstruction template tool would benefit the majority of head and neck patients, which is due to a constant mandibular arch angle and symphysis segment length throughout the general patient population, allowing the mimicking of a harmonic mandibular arch with up to three fibula segments. Clinical relevance The developed mandible reconstruction template tool can facilitate the fibula wedge osteotomies necessary for reconstruction of an ideal neomandibula providing a novel approach which is simple and cost-effective.

    更新日期:2020-01-21
  • Influence of the preparation form on the retention of resin-bonded attachments for removable dental prostheses
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-18
    Joram Brune, Sebastian Wille, Matthias Kern

    Abstract Objectives The study evaluated the influence of the number of retention grooves and the retainer wing thickness on the retention of resin-bonded attachments (RBAs). Methods Overall, 64 extracted human teeth were prepared, whereby the number of retention grooves (4, 2, 1, or no grooves) and the material thickness (0.7 or 0.5 mm) of the RBAs were varied. This resulted in eight groups with eight specimens each. A sample size of eight specimens per group was chosen because the chewing simulator used for dynamic loading can load eight specimens at a time. After the size of the adhesive area was determined, the abutment teeth were provided with RBAs and subjected to a dynamic loading with thermal cycling. Finally, the failure load was examined using a retention test. Results The mean failure loads ranged from 152 ± 50 N to 228 ± 32 N. There had been a significant interaction between the two main factors, i.e., number of retention grooves and material thickness. Neither the number of retention grooves nor the size of the adhesive area had a significant influence on the failure load. Conclusions Using a reduced number of retention grooves seems reasonable. However, clinical considerations suggest using two retention grooves to simplify the preparation and bonding procedures. Clinical relevance The retention of resin-bonded attachments is promising and supports the clinical application of this minimally invasive treatment modality.

    更新日期:2020-01-21
  • Titanium abutment surface modifications and peri-implant tissue behavior: a systematic review and meta-analysis
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-18
    Luigi Canullo, Maria Menini, Gregorio Santori, Mia Rakic, Anton Sculean, Paolo Pesce

    Abstract Objectives To evaluate the effect of various titanium abutment modifications on the behaviour of peri-implant soft tissue healing, inflammation and maintenance. Material and methods An electronic database research until 30 April 2019 was performed. A meta-analysis (MA) for each outcome parameter was performed by using the random-effects models with the DerSimonian-Laird estimator. Results Ten studies were included in the present review. Four studies with a long follow-up (5–6 years) reported the outcomes in a heterogeneous way and were suitable for MA. Six studies (4 RCT, 2 CCT) including 118 patients and 182 implants dealing with a modified healing abutment surface and short follow-up were selected for MA. The MA for PI and BoP as outcome showed no significant differences between surfaces (PI: P = 0.091; BoP: P = 0.099). The MA for PD as outcome showed no significant differences between surfaces (P = 0.488). No statistical significance was found by evaluating each mixed-effects model for potential moderators (type of study, study design, number of implants, follow-up length). The other four studies with a longer follow-up (5–6 years) reported contradictory results depending on the surface treatment investigated. Conclusions Within their limits, the present findings suggest that peri-implant soft tissue may not be affected by the surface treatment of titanium abutments on the short term. Contrasting results are reported in longer follow-up periods depending on the technique used to modify the abutment. Clinical relevance Clinicians should carefully evaluate the use of a modified titanium surface in their practice. Even if no differences in terms of inflammation are present at short term, these findings need to be validated in long-term studies.

    更新日期:2020-01-21
  • Incidence of root resorption after concussion, subluxation, lateral luxation, intrusion, and extrusion: a systematic review
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-18
    Beatriz Dulcineia Mendes de Souza, Kamile Leonardi Dutra, Jessie Reyes-Carmona, Eduardo Antunes Bortoluzzi, Morgane Marion Kuntze, Cleonice Silveira Teixeira, André Luís Porporatti, Graziela De Luca Canto

    Abstract Objective Traumatic dental injuries often affect the dental hard tissues, periodontal tissues, and dental pulp. Root resorption (RR) is a significantly concerning phenomenon that could lead to loss of the traumatized tooth. The purpose of this systematic review was to analyze the incidences of different types of RR after concussion, subluxation, lateral luxation, intrusive luxation, and extrusive luxation. Material and methods Seven databases were electronically and manually searched for the identification of observational studies that evaluated the incidence of RR after luxation injuries. Following study selection, data extraction, and risk of bias assessment through MAStARI checklist, the GRADE quality of available evidence was assessed. Results In total, 14 studies were included in the present systematic review. Ten and four studies presented a moderate and low RoB, respectively, and the overall GRADE quality of evidence was “very low” for all outcomes. The highest incidence rates of RR were observed for teeth with intrusive luxation, followed by those with extrusive luxation, lateral luxation, subluxation, and concussion. In general, the most common type of RR documented for all injuries was inflammatory RR, followed by replacement RR, surface RR, and internal RR. Conclusions Our findings suggest that RR most commonly occurs in association with intrusive luxation and by inflammatory RR. Awareness regarding the incidence of RR after injuries is useful for clinicians to minimize the risk and severity of its occurrence, because a late diagnosis of RR may limit treatment alternatives and result in tooth loss. Clinical relevance Knowledge about the incidence of RR in teeth with concussion and different types of luxation injuries can ensure appropriate follow-up protocols and favorable outcomes.

    更新日期:2020-01-21
  • 更新日期:2020-01-21
  • Disruption and bactericidal indices depicted in polygonal graphs to show multiple outcome effects of root canal irrigant supplements on single- and dual-species biofilms
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-17
    G. Bryce, J. Pratten, D. Ready, Y.-L. Ng, K. Gulabivala

    Abstract Objectives The aims of this study were to (1) investigate the relative time-dependent disruption and bactericidal effects of detergent-type surfactants on single- or dual-species biofilms of root canal isolates and (2) to examine the utility of polygonal graphs for depiction of biofilm disruption and cell killing. Materials and methods Single-species biofilms of Streptococcus sanguinis, Enterococcus faecalis, Fusobacterium nucleatum and Porphyromonas gingivalis were grown on nitro-cellulose membranes for 72 h and immersed in Tween®80, cetyltrimethylammoniumbromide (CTAB), and sodium dodecyl sulphate (SDS) for 1-, 5- or 10-min (n = 3 per test). The number of viable and non-viable bacteria “disrupted” from the biofilm and those “remaining-attached” was determined using a viability stain in conjunction with fluorescence microscopy. The data were analysed using non-parametric Kruskal-Wallis test with 5% significance level. Results Gram-negative obligate anaerobes were more susceptible to cell removal than gram-positive facultative anaerobes. The majority of cells were disrupted after 1-min of exposure; however, the extent varied according to the agent and species. CTAB and SDS were more effective than Tween 80™ at disrupting biofilms and killing cells but all agents failed to achieve 100% disruption/kill. Conclusions Biofilm disruption and cell viability were influenced by the species, the test agent and the duration of exposure. CTAB and SDS were more effective in biofilm disruption than Tween 80™. Graphical depiction of biofilm disruption- and viability-outcomes provides an alternative means of simultaneously visualising and analysing relative efficacy in different domains. Clinical relevance Surfactants were not as effective at biofilm disruption as NaOCl but may be added to other non-disruptive antibacterial agents to enhance this property.

    更新日期:2020-01-17
  • Effects of additional collagen in biphasic calcium phosphates: a study in a rabbit calvaria
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-17
    Benoit Schaller, Masako Fujioka-Kobayashi, Claudio Zihlmann, Viola Christina Schuler, Hiroki Katagiri, Niklaus P. Lang, Nikola Saulacic

    Biphasic calcium phosphates (BCP) are synthetic biomaterials developed as an alternative to the autogenous bone grafts and xenografts. The aim of the present study was to assess the influence of the addition of collagen onto the BCP resorption rate and bone formation.

    更新日期:2020-01-17
  • The OralChroma TM CHM-2: a comparison with the OralChroma TM CHM-1
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-16
    I. Laleman, C. Dekeyser, A. Wylleman, W. Teughels, M. Quirynen

    Abstract Objectives Already decades ago, the diagnosis of halitosis was facilitated with the arrival of chair-side instruments to score the breath odor. These devices are used for a more objective assessment of halitosis compared with organoleptic scoring, but these too have their disadvantages. To overcome some of the drawbacks of the original model of the OralChromaTM (CHM-1), few years ago a second generation of this machine (CHM-2) was introduced. This study compared both devices in a clinical setting. Materials and methods All records of the patients visiting a specialized halitosis consultation over a period of 5 years (2012–2017) were examined. The correlations of the OralChromaTM CHM-1 and CHM-2 with the organoleptic and Halimeter® measurements were analyzed. Additionally the sensitivity, specificity, and negative and positive predicted values were calculated. Results A total of 581 data points were included (CHM-1: 292, CHM-2: 289). The correlations between both models with the organoleptic measurements were not statistically significant different. The CHM-2 seemed superior to the CHM-1 in the quantification of dimethyl sulfide with a detection rate of 95% and 61%, respectively. Additionally, the CHM-2 was significantly more sensitive for dimethyl sulfide than the CHM-1. However the latter showed in turn a better sensitivity for hydrogen sulfide and methyl mercaptan. Conclusion The CHM-2 showed a better sensitivity for dimethyl sulfide than its predecessor. However, its sensitivity for hydrogen sulfide and methyl mercaptan was worse. Clinical relevance Dimethyl sulfide is the main volatile implicated in extra-oral blood-borne halitosis, this makes the OralChromaTM CHM-2 the instrument of choice when this is suspected.

    更新日期:2020-01-17
  • Long-term effects of splint therapy in patients with posttraumatic stress disease (PTSD)
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-16
    A. Wolowski, T. Eger, R. Braas, J. Gohr, N. Weber, K. Witanski, F. Wörner

    Abstract Objectives The aim of a pilot study was to clarify the question of whether mouth opening restrictions in patients with PTSD by means of splint therapy (st) show long-term therapeutic effects in the case of functional disorders. Material and methods In 31 of 36 inpatients (soldiers, average age 37.1 ± 7.3 years, 26.7 ± 2.1 teeth) with confirmed posttraumatic stress disorder, chronic pain intensity > 6 (visual analogue scale 0 to 10), the mouth opening was determined, and the functional status (RDC-TMD) was recorded. All participants received a splint that was worn at night. A control of the therapeutic effect of the splint occurred after 6 weeks, 3, 6, and 12 months. Results The mouth opening initially had an average of 30.9 ± 6.5 mm (median 31 mm). The pain intensity (PI) was reported to be on average VAS 8.3 ± 0.9, the chronic degree of pain according to von Korff was 3.9 ± 03. Six weeks after the st (n = 31), the average mouth opening was 49.5 ± 6.3 mm (median 51.5). PI was given as VAS 2.3 ± 1.1 on average. After 3, 6, and 12 months, 24, 15, and 14 subjects could be interviewed regarding PI. Based on the last examination date of all subjects, the average PI was given as 1.1 ± 0.9 (median 1). Conclusion The presented data show that the therapeutic short-term results achieved by means of a splint remain valid on the long term despite continued PTSD. Clinical relevance The presented study shows that patients will benefit in the long term from a splint and remain symptom-free, even if this mental illness persists.

    更新日期:2020-01-17
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  • ' If you really want something then go for it'
    BDJ Team Pub Date : 2020-01-17
    Kate Quinlan
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  • The world looks different from my ivory tower
    BDJ Team Pub Date : 2020-01-17
    Cary Cray-Webb
    更新日期:2020-01-17
  • ADC and flexible dental careers
    BDJ Team Pub Date : 2020-01-17
    Caroline Holland
    更新日期:2020-01-17
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  • 'You have to love it to do it'
    BDJ Team Pub Date : 2020-01-17
    Kate Quinlan
    更新日期:2020-01-17
  • Are you considering your career options?
    BDJ Team Pub Date : 2020-01-17
    Julie Deverick
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  • Precision is essential
    BDJ Team Pub Date : 2020-01-17
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  • What do you do with waste?
    BDJ Team Pub Date : 2020-01-17
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  • Periodontal care in general practice: 20 important FAQs - Part two
    BDJ Team Pub Date : 2020-01-17
    Reena Wadia; Iain Chapple
    更新日期:2020-01-17
  • Ed's letter
    BDJ Team Pub Date : 2020-01-17
    Kate Quinlan
    更新日期:2020-01-17
  • Complete-arch fixed reconstruction by means of guided surgery and immediate loading: a retrospective clinical study on 12 patients with 1 year of follow-up
    BMC Oral Health (IF 2.048) Pub Date : 2020-01-16
    Henriette Lerner; Uli Hauschild; Robert Sader; Shahram Ghanaati

    Guided implant surgery is considered as a safe and minimally invasive flapless procedure. However, flapless guided surgery, implant placement in post-extraction sockets and immediate loading of complete-arch fixed reconstructions without artificial gum are still not throughly evaluated. The aim of the present retrospective clinical study was to document the survival and success of complete-arch fixed reconstructions without artificial gum, obtained by means of guided surgery and immediate loading of implants placed also in fresh extraction sockets. A total of 12 patients (5 males and 7 females, with a mean age of 50.0 ± 13.8) were enrolled in this study. Implant planning was performed with a guided surgery system (RealGuide®, 3Diemme, Como, Italy), from which 3D-printed surgical templates were fabricated. All implants (Esthetic Line-EL®, C-Tech, Bologna, Italy) were placed through the guides and immediately loaded by means of a temporary fixed full-arch restoration without any artificial gum; the outcome measures were implant stability at placement, implant survival, complications, prosthetic success, soft-tissue stability, and patient satisfaction. One hundred ten implants (65 of them post-extractive) were placed flapless through a guided surgery procedure and then immediately loaded by means of provisional fixed full arches. Successful implant stability at placement was achieved in all cases. After a provisionalization period of 6 months, 72 fixed prosthetic restorations were delivered. Only 2 implants failed to osseointegrate and had to be removed, in one patient, giving a 1-year implant survival rate of 98.2% (108/110 surviving implants); 8/12 prostheses did not undergo any failure or complication during the entire follow-up period. At the 1-year follow-up control, soft-tissue was stable in all patients and showed satesfactory aesthetic results. Within the limits of this study, complete-arch fixed reconstruction by means of guided surgery and immediate loading of implants placed in fresh extraction sockets appears to be a reliable and successful procedure. Further long-term prospective studies on a larger sample of patients are needed to confirm these positive outcomes.

    更新日期:2020-01-16
  • Development of a Greek Oral health literacy measurement instrument: GROHL
    BMC Oral Health (IF 2.048) Pub Date : 2020-01-15
    Konstantina Taoufik; Kimon Divaris; Katerina Kavvadia; Haroula Koletsi-Kounari; Argy Polychronopoulou

    Oral health literacy is an important construct for both clinical and public health outcomes research. The need to quantify and test OHL has led to the development of measurement instruments and has generated a substantial body of recent literature. A commonly used OHL instrument is REALD-30, a word recognition scale that has been adapted for use in several languages. The objective of this study was the development and testing of the Greek language oral health literacy measurement instrument (GROHL). Data from 282 adult patients of two private dental clinics in Athens, Greece were collected via in-person interviews. Forty-four words were initially considered and tested for inclusion. Item response theory analysis (IRT) and 2-parameter logistic models assessing difficulty and discriminatory ability were used to identify an optimal scale composition. Internal consistency was examined using Cronbach’s alpha and test-retest reliability was measured using intraclass correlation coefficient (ICC) in a subset of 20 participants over a two-week period. Convergent validity was tested against functional health literacy screening (HLS) items, dental knowledge (DK), oral health behaviors (OHBs), oral health-related quality of life (OHRQoL; OHIP-14 index), as well as self-reported oral and general health status. From an initial item pool of 44 items that were carried forward to IRT, 12 were excluded due to no or little variance, 10 were excluded due to low item-test correlation, and 2 due to insignificant contribution to the scale, i.e., difficulty parameter estimate with p > 0.05. The twenty remaining items composed the final index which showed favorable internal consistency (alpha = 0.80) and test-retest reliability (ICC = 0.95). The summary score distribution did not depart from normality (p = 0.32; mean = 11.5; median = 12; range = 1–20). GROHL scores were positively correlated with favorable oral hygiene behaviors and dental attendance, as well as HLS, DK and education level. The GROHL demonstrated good psychometric properties and can be used for outcomes research in clinical and public health settings.

    更新日期:2020-01-15
  • Inhibition of bacterial growth on zirconia abutment with a helium cold atmospheric plasma jet treatment
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-15
    Yang Yang, Miao Zheng, Yang Yang, Jing Li, Yong-Fei Su, He-Ping Li, Jian-Guo Tan

    Abstract Objectives This study presents a surface modification method to treat the zirconia implant abutment materials using a helium cold atmospheric plasma (CAP) jet in order to evaluate its efficacy on oral bacteria adhesion and growth. Materials and methods Yttrium-Stabilized Zirconia disks were subjected to helium CAP treatment; after the treatment, zirconia surface was evaluated using scanning electron microscopy, a contact angle measuring device, X-ray photoelectron spectroscopy for surface characteristics. The response of Streptococcus mutans and Porphyromonas gingivalis on treated surface was evaluated by a scanning electron microscopy, MTT assay, and LIVE/DEAD staining. The biofilm formation was analyzed using a crystal violet assay. Results After the helium CAP jet treatment, the zirconia surface chemistry has been changed while the surface topography remains unchanged, the bacterial growth was inhibited, and the biofilm forming decreased. As the treatment time increases, the zirconia abutment showed a better bacterial inhibition efficacy. Conclusions The helium CAP jet surface modification approach can eliminate bacterial growth on zirconia surface with surface chemistry change, while surface topography remained. Clinical relevance Soft tissue seal around dental implant abutment plays a crucial role in maintaining long-term success. However, it is weaker than periodontal barriers and vulnerable to bacterial invasion. CAP has a potential prospect for improving soft tissue seal around the zirconia abutment, therefore providing better esthetics and most of all, prevent peri-implant lesions from happening.

    更新日期:2020-01-15
  • Optimization of a real-time high-throughput assay for assessment of Streptococcus mutans metabolism and screening of antibacterial dental adhesives
    Dent. Mater. (IF 4.440) Pub Date : 2020-01-15
    Fernando Luis Esteban Florez; Rochelle Denise Hiers; Yan Zhao; Justin Merritt; Adam Justin Rondinone; Sharukh Soli Khajotia

    Objective The present work shows the optimization of a high-throughput bioluminescence assay to assess the metabolism of intact Streptococcus mutans biofilms and its utility as a screening method for nanofilled antibacterial dental materials. Methods The assay was optimized by monitoring changes in bioluminescence mediated by variation of the experimental parameters investigated (growth media and sucrose concentration, inoculum:D-Luciferin ratio, dilution factor, inoculum volume, luminescence wavelength, replicate and luciferase metabolic activity). Confocal microscopy was then used to demonstrate the impact of biofilm growth conditions on the 3-D distribution of extracellular polymeric substance (EPS) within Streptococcus mutans biofilms and its implications as confounding factors in high-throughput studies (HTS). Results Relative Luminescence Unit (RLU) values from the HTS optimization were analyzed by multivariate ANOVA (α = 0.05) and coefficients of variation, whereas data from 3-D structural parameters and RLU values of biofilms grown on experimental antibacterial dental adhesive resins were analyzed using General Linear Models and Student–Newman–Keuls post hoc tests (α = 0.05). Confocal microscopy demonstrated that biofilm growth conditions significantly influenced the quantity and distribution of EPS within the 3-D structures of the biofilms. An optimized HTS bioluminescence assay was developed and its applicability as a screening method in dentistry was demonstrated using nanofilled experimental antibacterial dental adhesive resins. Significance The present study is anticipated to positively impact the direction of future biofilm research in dentistry, because it offers fundamental information for the design of metabolic-based assays, increases the current levels of standardization and reproducibility while offering a tool to decrease intra-study variability.

    更新日期:2020-01-15
  • Teledentistry as a novel pathway to improve dental health in school children: a research protocol for a randomised controlled trial
    BMC Oral Health (IF 2.048) Pub Date : 2020-01-14
    Mohamed Estai; Yogesan Kanagasingam; Maryam Mehdizadeh; Janardhan Vignarajan; Richard Norman; Boyen Huang; Heiko Spallek; Michelle Irving; Amit Arora; Estie Kruger; Marc Tennant

    Despite great improvement in child oral health, some children subgroups still suffer from higher levels of dental caries. Geographic and socioeconomic barriers and the lack of access to dental care services are among common reasons for poor oral health in children. Historically in Australia, oral health therapists or dental therapists have been responsible for providing dental care for school children through the School Dental Services (SDS). The current SDS has been unable to provide sustainable dental care to all school children due to a reduction in workforce participation and limited resources. We propose a paradigm shift in the current service through the introduction of user-friendly technology to provide a foundation for sustainable dental care for school children. We describe an ongoing parallel, two-armed, non-inferiority randomised controlled trial that compares routine and teledental pathway of dental care in children aged 4–15 years (n = 250). Participating schools in Western Australia will be randomly assigned to the control or teledental group, approximately three schools in each group with a maximum of 45 children in each school. All participants will first receive a standard dental examination to identify those who require urgent referrals and then their teeth will be photographed using a smartphone camera. At the baseline, children in the control group will receive screening results and advice on the pathway of dental care based on the visual dental screening while children in the teledental group will receive screening results based on the assessment of dental images. At 9 months follow-up, all participants will undergo a final visual dental screening. The primary outcomes include decay experience and proportion of children become caries active. The secondary outcomes include the diagnostic performance of photographic dental assessment and costs comparison of two pathways of dental care. The current project seeks to take advantage of mobile technology to acquire dental images from a child’s mouth at school settings and forwarding images electronically to an offsite dental practitioner to assess and prepare dental recommendations remotely. Such an approach will help to prioritise high-risk children and provide them with a quick treatment pathway and avoid unnecessary referrals or travel. Australian New Zealand Clinical Trials Registry, ACTRN12619001233112. Registered 06 September 2019.

    更新日期:2020-01-15
  • LncRNA CASC 2 is upregulated in aphthous stomatitis and predicts the recurrence
    BMC Oral Health (IF 2.048) Pub Date : 2020-01-14
    Jiaping Lu; Naizheng Zhang; Chen Wu

    Recurrent aphthous stomatitis (RAS) is a common oral disease with unknown molecular pathogenesis. Our preliminary microarray analysis revealed the altered expression of lncRNA Cancer Susceptibility Gene 2 (CASC2) in RAS. We therefore analyzed the role of CASC2 in RAS. In this study, plasma samples were obtained from RAS patients and healthy participants. Plasma levels of CASC2 were measured by RT-qPCR. Plasma levels of IL-6 and IL-18 were measured by enzyme-linked immunosorbent assay (ELISA). A follow-up study was performed to analyze the role of CASC2 in the recurrence of RAS. In the present study, we found that lncRNA Cancer Susceptibility Gene 2 (CASC2), as well as pro-inflammatory factors interleukin 6 (IL-6) and interleukin 18 (IL-18), were upregulated in plasma of RAS patients compared with healthy participants. Plasma levels of lncRNA CASC2 were positively correlated with plasma levels of IL-6 and IL-18 in RAS patients but not in healthy participants. Compared with pre-treatment levels, plasma levels of lncRNA CASC2, IL-6 and IL-18 were reduced after recovery. A follow-up study showed that patients with high levels of lncRNA CASC2 had a significantly higher recurrence rate. LncRNA CASC 2 is upregulated in RAS and predicts the recurrence.

    更新日期:2020-01-15
  • Evaluation of oral care protocols practice by dentists in Rio de Janeiro towards HIV/AIDS individuals
    BMC Oral Health (IF 2.048) Pub Date : 2020-01-14
    Carina Maciel Silva-Boghossian; Brenda Azzariti Berrondo Boscardini; Claudia Maria Pereira; Edson Jorge Lima Moreira

    The aim of this study was to evaluate the dentists’ knowledge and practice regarding HIV positive individuals’ oral care in Rio de Janeiro State. Dentists from Rio de Janeiro State (n = 242) answered an electronic questionnaire on biosafety procedures, oral manifestations of AIDS, and knowledge of HIV infection. Collected information was stratified by gender, and data were analyzed using Chi-square and t tests. From the 14 oral manifestations investigated, oral candidiasis, necrotizing ulcerative gingivitis, and hairy leucoplakia were more associated with HIV, with no differences between the responses from men and women. Above 85% of the participants would be concerned about becoming infected with HIV after a needle/ sharp object injury and more than 80% of them were willing to be tested for HIV. However, significantly more women (98.8%), compared to men (91.3%), said they knew that HIV/ AIDS patients can contaminate dental care professionals, p = 0.007. There was a significant difference in the answers for the questions: “Are there special dental clinics for treatment of HIV/AIDS patients in Brazil?” (p = 0.044), and “Do the negative HIV tests surely indicate that the persons are free of viruses?” (p = 0.005). Significant differences between men and women were also observed regarding use of disposable mask (p = 0.01), and cap (p < 0.0001). Most dentists who participated in the study presented a good knowledge on the care of HIV/ AIDS individuals, including biosafety protocols and in terms of the oral manifestations commonly associated to AIDS.

    更新日期:2020-01-15
  • Gingival recession after scaling and root planing with or without systemic metronidazole and amoxicillin: a re-review
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-15
    Manuela E. Kaufmann, Daniel B. Wiedemeier, Urs Zellweger, Alex Solderer, Thomas Attin, Patrick R. Schmidlin

    Abstract Background Gingival recessions inevitably occur during healing after scaling and root planing, but synoptic data on this topic is still lacking. This review compared the recession formation with and without the administration of systemic antibiotics. Objectives To evaluate the formation of recession with and without the administration of antibiotics during the healing after scaling and root planing. Materials and methods This study re-analyzed publications that reported clinical attachment levels (CAL) and probing pocket depths (PD) up to January 2019, including the pivotal review by Zandbergen and co-workers (2013). Whereas these studies traditionally focused on PD and CAL, the present analysis compared recession formation (ΔREC) after adjunctive systemic administration of amoxicillin (amx) and metronidazole (met) during scaling and root planing (SRP) and SRP alone. The mean increase in ΔREC, if not reported, was calculated from CAL and PD values and statistically analyzed. Recession formation was compared after 3 and 6 months after therapy. Results were separately reported for chronic periodontitis (CP) as well as aggressive periodontitis (AP) cases. Results Recessions increased consistently between baseline and follow-up. In the AP group, median ΔREC was 0.20 mm after 3 months, irrespective of whether antibiotics were administered or not. After 6 months, median ΔREC increased to 0.35 mm after AB and remained stable at 0.20 mm with SRP alone. In the CP group, after 3 months with and without antibiotics, median ΔREC accounted for 0.30 mm and 0.14 mm, respectively. After 6 months, median ΔREC accounted for 0.28 mm (with AB) and 0.20 mm (without AB). The quantitative assessment by meta-analyses also yielded small values (≤ 0.25 mm) for the estimated differences in recession formation between AB and noAB; however, none of them reached statistical significance. Conclusions Although a slight tendency towards higher recession formation after SRP in combination with AB could be observed in many studies, quantitative meta-analyses showed no clinically relevant difference in recession formation due to the administration of AB. In general, the description and discussion of recessions in the literature seems not to be a major focus so far. Clinical relevance Since the preservation of gingival tissues is important by preventive and therapeutic means, e.g., when avoiding postoperative root sensitivity or performing regenerative surgery, these aspects should not be neglected. We thus suggest to report REC measurements along with PD and CAL values for more direct recession formation (ΔREC) assessments in the future.

    更新日期:2020-01-15
  • Three-dimensional position of mandibular third molars and its association with distal caries in mandibular second molars: a cone beam computed tomographic study
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-14
    Yanan Chen, Jianmao Zheng, Danna Li, Zhuwei Huang, Zijing Huang, Xue Wang, Xiaolei Zhang, Xiaoli Hu

    Abstract Objective To analyze the prevalence of distal caries in mandibular second molars (M2Ms) and its correlation with the three-dimensional position of mandibular third molars (M3Ms) by cone beam computed tomography (CBCT) images. Materials and methods CBCT scans involving 421 M3Ms were assessed. The presence of distal caries of M2Ms, patient age and gender, impaction depths and mesial angulation of M3Ms, the cementoenamel junction (CEJ) distances and contact point localization, and the horizontal positions of M3Ms were assessed. Risk factors were identified by multivariate logistic regression analysis. Results The overall prevalence of distal caries in M2Ms was 31.6%. Mesial angulation (16°–75°) of M3Ms, contact point localization at or below the CEJ of M2Ms, and a buccal or lingual position of M3Ms relative to the molar line were identified as risk factors for the prevalence of distal caries in M2Ms (p < 0.05). Distal caries was more severe when the mesial angulation of M3Ms was 16°–75° (p < 0.05). Conclusions Buccal or lingual position of M3Ms may represent a new risk factor for the distal caries in M2Ms. Mesial angulation (16°–75°) of M3Ms is a predictive parameter for both the presence and severity of distal caries in M2Ms. Clinical relevance As the presence of distal caries in M2Ms is significantly associated with the three-dimensional position of M3Ms, watchful monitoring or prophylactic removal of M3Ms should be deliberated when M3Ms are mesially angulated (16°–75°), buccally or lingually positioned, and with the contact point localization at or below the CEJ of M2Ms.

    更新日期:2020-01-14
  • The dimension and morphology of alveolar bone at maxillary anterior teeth in periodontitis: a retrospective analysis—using CBCT
    Int. J. Oral Sci. (IF 2.750) Pub Date : 2020-01-14
    Xue Zhang; Yuchao Li; Ziming Ge; Haijiao Zhao; Lei Miao; Yaping Pan
    更新日期:2020-01-14
  • Primary versus post-treatment apical periodontitis: microbial composition, lipopolysaccharides and lipoteichoic acid levels, signs and symptoms
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-13
    Felipe Paiva Machado, Rayana Duarte Khoury, Cassia Cestari Toia, Esteban Isai Flores Orozco, Felipe Eduardo de Oliveira, Luciane Dias de Oliveira, Flávia Goulart da Rosa Cardoso, Marcia Carneiro Valera

    Abstract Objectives To compare the microbial load and composition and to determine the lipopolysaccharides (LPS) and lipoteichoic acid (LTA) concentrations found in primary apical periodontitis (PAP) and post-treatment apical periodontitis (PTAP), correlating these findings with clinical/tomographic features. Material and methods Sixty patients with PAP (31) and PTAP (29) were submitted to clinical and tomographic assessment. Samples were collected from each root canal using paper points for microbiological assessment (culture technique and Checkerboard DNA-DNA hybridization) and determination of LPS and LTA levels (limulus amebocyte lysate and enzyme-linked immunosorbent assays, respectively). Data were correlated with clinical/tomographic findings and statistically analyzed using the Mann-Whitney and Pearson correlation tests (α = 5%). Results A higher number of cultivable bacteria and LPS were found in PAP (p < 0.05). The median number of species per root canal found in PAP and PTAP was 9 and 22, respectively (p < 0.05). LPS was positively correlated with a larger periapical lesion volume (p < .05). LTA levels were similar in both infections and had no correlation with signs and symptoms. In PAP, gram-positive bacteria were correlated with spontaneous pain (p < .05) and exudate (p < .05). Tenderness to percussion and pain on palpation were correlated to the presence of both gram-positive and negative bacteria. In PTAP, a positive correlation was observed between both gram-positive and gram-negative bacteria with exudate and periapical lesion volume (p < .05). Conclusions PAP had higher contents of microbial load and LPS compared with PTAP. However, PTAP presented a more diverse microbiota compared with PAP. Higher content of LPS was positively correlated with larger periapical bone destruction, whereas signs and symptoms with specific microorganisms. Clinical relevance It was verified that PAP and PTAP are polymicrobial infections with predominance of gram-negative bacteria and a more diverse bacterial population found in PTAP. A wide interaction of specific microbial species resulted in different clinical features in both infections.

    更新日期:2020-01-14
  • The sandwich osteotomy technique to treat vertical alveolar bone defects prior to implant placement: a systematic review
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-11
    Andrea Roccuzzo, Sissi Marchese, Nils Worsaae, Simon Storgård Jensen

    The aim of this systematic review was to investigate the predictability of the sandwich osteotomy technique to provide sufficient alveolar bone height for dental implant therapy in vertically atrophic jaws.

    更新日期:2020-01-13
  • Standardization of antimicrobial testing of dental devices
    Dent. Mater. (IF 4.440) Pub Date : 2020-01-09
    J. Camilleri; T. Arias Moliz; A. Bettencourt; J. Costa; F. Martins; D. Rabadijeva; D. Rodriguez; L. Visai; C. Combes; C. Farrugia; P. Koidis; C. Neves

    Objective Dental device is a very broad term that can be used to include any foreign material or product that is introduced in the host oral cavity to replace missing tissues. These devices are subjected to different environments which include dental hard tissues, tissue fluids, blood and saliva. All dental devices are continuously challenged microbiologically and a number of failures in clinical management are related to microbial colonization. Thus, the assessment of the antimicrobial properties of dental devices are extremely important. In this paper, a classification of dental devices is being proposed. This classification distinguishes the devices based on whether they are implantable or not, and also sub-classified based on their specific application and the substrate receiving the device. Methods and Results A literature search was conducted to identify how dental devices have been tested with relation to the microbial strains used and whether the testing has been performed in isolation or reported with other relevant tests such as material characterization and biological activity. The results of the literature review were analyzed and recommendations for antimicrobial testing of dental devices are proposed. These recommendations include the need for the setting up of pre-testing parameters such as ageing and the details of the pre-testing sterilization procedures, as these may affect the material chemistry and the specification for antimicrobial testing to be done with specific single strains or polymicrobial that are native to the region where the device is located are also suggested. Testing can be undertaken in vitro, ex vivo and in vivo. Since the antimicrobial and biological activities influence/condition one another and the material chemistry may affect both the antimicrobial and biological testing this document also makes recommendations regarding biological assessment which can be carried out in isolation or integrated with the microbiological testing and also material testing methods including chemical and physical characterization of bulk, surface, eluted and degraded materials as well as physical characterization methods. Significance The level of standardization of antimicrobial testing for the dental devices needs to be based on the device location and host interaction in order to increase the clinical applicability of the mentioned tests.

    更新日期:2020-01-11
  • Bone union formation in the rat mandibular symphysis using hydroxyapatite with or without simvastatin: effects on healthy, diabetic, and osteoporotic rats
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-11
    F. Camacho-Alonso, C. Martínez-Ortiz, L. Plazas-Buendía, A. M. Mercado-Díaz, C. Vilaplana-Vivo, J. A. Navarro, A. J. Buendía, J. J. Merino, Y. Martínez-Beneyto

    Abstract Objective The objective is to compare new bone formation in critical defects in healthy, diabetic, and osteoporotic rats filled with hydroxyapatite (HA) alone and HA combined with simvastatin (SV). Materials and methods A total of 48 adult female Sprague-Dawley rats were randomized into three groups (n = 16 per group): Group, 1 healthy; Group 2, diabetics; and Group 3, osteoporotics. Streptozotocin was used to induce type 1 diabetes in Group 2, while bilateral ovariectomy was used to induce osteoporosis in Group 3. The central portion of the rat mandibular symphysis was used as a physiological critical bone defect. In each group, eight defects were filled with HA alone and eight with HA combined with SV. The animals were sacrificed at 4 and 8 weeks, and the mandibles were processed for micro-computed tomography to analyze radiological union and bone mineral density (BMD); histological analysis of the bone union; and immunohistochemical analysis, which included immunoreactivity of vascular endothelial growth factor (VEGF) and bone morphogenetic protein 2 (BMP-2). Results In all groups (healthy, diabetics, and osteoporotics), the defects filled with HA + SV presented greater radiological bone union, BMD, histological bone union, and more VEGF and BMP-2 positivity, in comparison with bone defects treated with HA alone. Conclusions Combined application of HA and SV improves bone regeneration in mandibular critical bone defects compared with application of HA alone in healthy, diabetic, and osteoporotic rats. Clinical relevance This study might help to patients with osteoporosis or uncontrolled diabetes type 1, but future studies should be done.

    更新日期:2020-01-11
  • Dentistry Down Under
    Br. Dent. J. (IF 1.438) Pub Date : 2020-01-10
    Victoria Mellish
    更新日期:2020-01-10
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  • A highly valuable oral health supplement
    Br. Dent. J. (IF 1.438) Pub Date : 2020-01-10
    更新日期:2020-01-10
  • 更新日期:2020-01-10
  • Youngsters and oldsters
    Br. Dent. J. (IF 1.438) Pub Date : 2020-01-10
    Stephen Hancocks
    更新日期:2020-01-10
Contents have been reproduced by permission of the publishers.
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