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  • Influence of endodontic sealers with different chemical compositions on bond strength of the resin cement/glass fiber post junction to root dentin
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-24
    Isadora Mello Vilarinho Soares, Bruno Monguilhott Crozeta, Rodrigo Dantas Pereira, Ricardo Gariba Silva, Antonio Miranda da Cruz-Filho

    Abstract Objective This study evaluated the influence of endodontic sealers with different chemical compositions on bond strength of resin cement/glass fiber post junction to root dentin. Materials and methods Seventy-two maxillary canines roots were instrumented with Reciproc (#R50) and distributed in 6 groups (n = 12) according to endodontic sealers: G1—control (no sealer); G2—Endofill; G3—Sealapex; G4—AH Plus; G5—Sealer Plus; G6—EndoSequence BC. The glass fiber post was cemented with Panavia F in 10 of the specimens. Two specimens from each group did not receive post and were analyzed by SEM to verify presence of filling material. Three slices were obtained from each third. The first slice was subjected to push-out test and type of failure. The second slice was imaged using laser confocal microscopy for evaluation of dentin/resin cement adhesive interface. Bond strength (BS) data were analyzed using two-way ANOVA and Tukey’s post hoc tests; for LCM data, we used Kruskal-Wallis and Dunn’s tests. Results Endofill yielded the lowest BS values (p < 0.05). The control and AH Plus groups differed from all others (p < 0.05). In all groups, adhesive to dentin failure predominated. Most specimens of control and AH Plus groups had acceptable interfaces, while those of EndoSequence BC, Sealapex, and Sealer Plus groups ranged between acceptable and poor interfaces. Overall, few filling material remnants were observed on the dentin. Conclusion EndoSequence BC, Sealapex, Sealer Plus, and Endofill negatively interfere with BS of glass fiber post/resin cement junction to root dentin. Clinical relevance In cases whose restoration planning includes a post cemented with resin cement, it is recommended that endodontic sealer be based on epoxy resin.

    更新日期:2020-01-24
  • Staged implant placement after defect regeneration using biphasic calcium phosphate materials with different surface topographies in a minipig model
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-24
    I. Mihatovic, F. Schwarz, K. Obreja, J. Becker, R. Sader, M. Dard, G. John

    Abstract Objective To assess the influence of biphasic calcium phosphate materials with different surface topographies on bone formation and osseointegration of titanium implants in standardized alveolar ridge defects. Materials and methods Standardized alveolar ridge defects (6 × 6 mm) were created in the mandible of 8 minipigs and filled with three biphasic calcium phosphate materials (BCP1–3, 90% tricalcium phosphate/10% hydroxyapatite) with different surface properties (micro- and macroporosities) as well as a bovine-derived natural bone mineral (NBM) as a control. At 12 weeks, implants were placed into the augmented defects. After further 8 weeks of healing, dissected blocks were processed for histological analysis (e.g., mineralized (MT), residual bone graft material (BS), bone-to-implant contact (BIC)). Results All four biomaterials showed well-integrated graft particles and new bone formation within the defect area. MT values were comparable in all groups. BS values were highest in the NBM group (21.25 ± 13.52%) and markedly reduced in the different BCP groups, reaching statistical significance at BCP1-treated sites (9.2 ± 3.28%). All test and control groups investigated revealed comparable and statistically not significant different BIC values, ranging from 73.38 ± 20.5% (BCP2) to 84.11 ± 7.84% (BCP1), respectively. Conclusion All bone graft materials facilitated new bone formation and osseointegration after 12 + 8 weeks of healing.

    更新日期:2020-01-24
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • Anti-inflammatory potential of an essential oil-containing mouthwash in elderly subjects enrolled in supportive periodontal therapy: a 6-week randomised controlled clinical trial
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-08
    Hendrik Jünger, Anna Jaun-Ventrice, Kevin Guldener, Christoph A. Ramseier, Daniel R. Reissmann, Martin Schimmel

    Abstract Objectives Essential oils and other plant extracts have evoked interest as sources of natural medicinal products. They have been proven to exert antibacterial, antifungal, antiviral and antioxidant properties, but the mechanism of action has not been fully elucidated. Aim This study aims to evaluate the potential of a sage-containing mouthwash to alleviate inflammatory signs of intra-oral mucosa and gingiva in comparison with a water/alcohol-based placebo. Material and methods This study was conducted as a randomised, placebo-controlled, double-blind, parallel design clinical study. Forty-eight dentate subjects were randomly assigned to a test (sage-containing mouthwash) or a placebo group (water/alcohol-based solution). Subjects rinsed once daily for 30 s over a period of 6 weeks. Sulcus Bleeding Index (SBI), Plaque Index (PLI), tooth staining, xerostomia and degree of stomatitis were assessed at baseline and after 6 weeks. Results Subjects’ mean age was 77.5 ± 7.3 years. SBI was reduced from 1.3 ± 0.9 to 0.8 ± 0.7 (test, p = 0.0029) and 1.4 ± 0.9 to 1.1 ± 0.7 (placebo, p = 0.0105). Similarly, PLI was reduced from 1.2 ± 0.5 to 1.0 ± 0.3 (test, p = 0.0080) and 1.3 ± 0.4 to 1.1 ± 0.6 (placebo, p = 0.0087); no between-group differences were found (p > 0.05). Stomatitis, xerostomia and tooth staining revealed no change after 6 weeks. Conclusion The irrigation with a sage-containing mouthwash did not result in a superior beneficial effect on inflammatory parameters and plaque indices compared with the placebo. The expected contribution of the plant extracts to their potential impact on oral health may need further investigation. Clinical relevance The proposed mouthwash might be suitable for patients with inflammatory signs of the gingiva who prefer natural remedies.

    更新日期:2020-01-09
  • Formulation of a Jasmine Grandiflorum containing mucoadhesive and evaluation of its healing effect on oral biopsy ulcers
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-08
    Hamed Mortazavi, Fatemeh Mashhadiabbas, Seyed Ali Reza Mortazavi, Kosar Rezaeifar, Mahdieh Farhangi

    The present research aimed to explore the effect of a mucoadhesive containing Jasminum grandiflorum leaves on the process of oral wound healing in animal samples.

    更新日期:2020-01-08
  • Gingival recession behavior with immediate implant placement in the anterior maxilla with buccal dehiscence without additional augmentation—a pilot study
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-08
    Veronika Pohl, Lukas Fürhauser, Robert Haas, Sebastian Pohl

    Abstract Background Immediate implant placement in the presence of intact extraction alveoli has frequently been reported, while hardly any reports on immediate implant placement in missing buccal bone can be found in literature. Objectives This pilot study evaluates esthetic outcome and soft and hard tissue level changes of immediate implant placement with immediate provisionalization in patients with partially/completely missing buccal bone without any further augmentation procedure in the maxillary anterior zone. Material and methods Twelve patients (TG) with partially to completely missing buccal bone designated for extraction and flapless immediate implant insertion in the anterior zone of the maxilla were included. Patients randomly selected out of a larger group of patients with immediate implants with intact alveoli served as controls (CG). Immediate provisionalization was done without any further augmentation of the alveolar ridge. Marginal hard and soft tissue levels, PES, and implant success were evaluated during a 1-year observation period. Results The defect of the buccal alveolar bone was 4.96 mm (min., 2.26 mm; max., 9.68 mm) and the mean mesio-distal extension 4.25 mm (min., 3.2 mm; max., 5.91 mm). Preoperative PES differed significantly between TG (9.68) and CG (12.25) and improved in TG postoperatively with no significant difference to CG after 1 year (TG, 10.91; CG, 11.3). The buccal soft tissue level remained almost unchanged over the observation period (TG preop, 0.86 mm ± 0.90 mm; 1 year, 0.91 mm ± 0.96 mm; CG preop, 0.98 mm ± 0.87 mm; 1 year, 0.98 mm ± 0.87 mm and did not show any correlation with either the mesial/distal bone level or the initial buccal vertical defect at any point of time. Conclusions These clinical results provide evidence that immediate implant placement without additional augmentation, but with immediate provisionalization might be a viable treatment alternative even with missing buccal plate in the esthetic maxillary zone.

    更新日期:2020-01-08
  • Evaluation of a novel dog animal model for peri-implant disease: clinical, radiographic, microbiological and histological assessment
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-08
    Orlando Martins, João Carlos Ramos, Marta Mota, Michel Dard, Carlos Viegas, Francisco Caramelo, Célia Nogueira, Teresa Gonçalves, Isabel Poiares Baptista

    Abstract Objective To assess longitudinal peri-implant tissue evaluation in a plaque compromised ligature free dog model, clinically, radiographically, microbiologically and histologically. Materials and methods Six beagle mandibular premolars and first molars were extracted. Plaque accumulated for 16 weeks. Two implants were placed per hemi-mandible. For 17 weeks, control implants (CI) in one hemi-mandible were brushed daily; test implants (TI) in the other were not. These parameters were then assessed: clinically, probing depth (PD), bleeding-on-probing (BOP), presence of plaque (PP) and clinical attachment level (CAL); radiographically, marginal bone level; microbiologically, counts for Streptococcus spp., Fusobacterium spp., Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella intermedia and total bacterial load. At week 17, histomorphometric analysis was performed (MM-ISH (mucosal margin–implant shoulder); ISH-fBIC (implant shoulder–first bone-to-implant contact); MM-aJE (mucosal margin–apical area junctional epithelium); MM-aINF (mucosal margin–apical limit of the inflammatory infiltrate); %INF (percentage of inflammatory infiltrate)). Results At week 17, TI had significant increased PD, BOP, PP and CAL versus baseline. All clinical variables presented intergroup differences. There was no intergroup difference for radiographic bone loss (p > 0.05). Total bacteria, Fusobacterium spp., A. actinomycetemcomitans and P. gingivalis had intergroup differences. There was no statistically significant intergroup difference for ISH-fBIC. Conclusions Longitudinal microbiology evaluation detected a shift period. Final intergroup microbiological differences were the basis of W17 clinical intergroup differences, with higher values in TI. Microbiological and clinical changes detected in peri-implant tissues were compatible with onset of peri-implant disease. Despite histological inflammatory intergroup difference, no histological or radiographic intergroup bone loss was detected. Clinical relevance This study set-up describes a valuable method for generating “true” early peri-implant defects without mechanical trauma.

    更新日期:2020-01-08
  • Analysis of risk factors for multiple primary oral squamous cell carcinoma: a cohort study
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-06
    Xiaoyu Lin, Xiaoshan Wu, Aly Gomaa, Jie Chen, Limeng Wu, Xiaoyue Xie, Yaqin Hu, Canhua Jiang

    Chewing betel quid (CBQ) is popular in Southeast Asia, resulting in a high incidence of oral squamous cell carcinoma (OSCC). The incidence of multiple primary oral cancer (MPOC) has gradually increased and has become one of the main causes of OSCC treatment failure. However, it is unclear whether the high incidence of MPOC is also correlated with the habit of CBQ.

    更新日期:2020-01-06
  • Triclosan toothpaste as an adjunct therapy to plaque control in children from periodontitis families: a crossover clinical trial
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-06
    Mabelle Freitas Monteiro, Henrique Tonelli, Aurélio Amorim Reis, Marcio Zaffalon Casati, Karina Gonzales Silvério, Francisco Humberto Nociti Junior, Enilson Antônio Sallum, Renato Corrêa Viana Casarin

    Abstract Objectives Studies have demonstrated that children from aggressive periodontitis (AgP) parents presented precocious alterations in their periodontal condition, and the use of chemical agents in association to plaque control could be useful to control these alterations. This study aimed to evaluate the effect of Triclosan toothpaste to modulate the clinical and subgingival condition in children from AgP parents. Methods Fifteen children from AgP parents and 15 from periodontally healthy parents were included in this crossover placebo study. Children were randomly allocated into triclosan or placebo therapy, using selected toothpaste for 45 days. After 15 days of wash-out, groups were crossed, changing the used toothpaste. Clinical examination and saliva, crevicular gingival fluid (GCF), and subgingival biofilm collection were performed at baseline and 45 days of each phase. GCF cytokines’ levels were analyzed by Luminex/MAGpix platform and subgingival and salivary periodontal pathogens’ levels by qPCR. Results At baseline, AgP group presented higher plaque index (PI), gingival index (GI), and bleeding on probing (BoP), higher Aggregatibacter actinomycetemcomitans (Aa) abundance in saliva and subgingival biofilm, and lower levels of INF-ɣ, IL-4, and IL-17 in GCF. Placebo therapy only reduced PI in both groups. Triclosan toothpaste reduced PI and GI in both groups. Triclosan promoted reduction of BoP and probing depth (PD), Aa salivary, and IL-1β levels in AgP group. In health group, triclosan reduced INF-ɣ and IL-4 concentration. Conclusion Triclosan toothpaste demonstrated to be more effective than placebo toothpaste to control the periodontal condition in children from AgP parents, by reducing the BoP, PD, salivary Aa, and IL-1β. Clinical relevance Triclosan toothpaste can improve oral conditions in higher-risk population for AgP. Trial registration This study was registered at ClinicalTrials.gov with the identifier NCT03642353.

    更新日期:2020-01-06
  • The impact of nonsurgical periodontal treatment on oral health-related quality of life: a systematic review and meta-analysis
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-04
    João Botelho, Vanessa Machado, Luís Proença, Danilo Horie Bellini, Leandro Chambrone, Gil Alcoforado, José João Mendes

    To estimate the impact of nonsurgical periodontal treatment (NSPT) on patients’ oral health-related quality of life (OHRQoL). The focused question for this systematic review was: in adults patients with periodontitis, does NSPT improve oral health-related quality of life?

    更新日期:2020-01-04
  • Ceramic laminate veneers: effect of preparation design and ceramic thickness on fracture resistance and marginal quality in vitro
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-04
    Uwe Blunck, Sabine Fischer, Jan Hajtó, Stefan Frei, Roland Frankenberger

    Abstract Objectives The aim of the present study was to investigate the influence of five different preparation designs and two different ceramic thicknesses on margin quality and fracture resistance of ceramic laminate veneers after thermomechanical loading in vitro. Materials and methods Eighty human central incisors were randomly assigned to 10 groups (n = 8) with five different preparation designs: non-prep (NP), minimally invasive (MI) = exclusively enamel-bonded, semi-invasive (SI) = 50% bonded in dentin, invasive (I) = 100% in dentin, and semi-invasive with two additional class III composite resin restorations (SI-C). IPS InLine veneers were fabricated in two thicknesses (L1 = 0.2–0.5 mm; L2 = 0.5–1.2 mm). After adhesive luting (OptiBond FL, Variolink Veneer) with light curing and polishing, specimens were stored in distilled water at 37 °C for 21 days, then thermocycled (2000 cycles between + 5 and + 55 °C), and finally mechanically loaded at the incisal edge at an angle of 45° for 2,000,000 cycles at 50 N und further 1,000,000 cycles at 100 N. Impressions were taken initially, after thermocycling, and after every 250,000 mechanical cycles in order to evaluate cracks and margin quality under a SEM. The veneers were evaluated in a light microscope (× 20) for cracks, chippings, partial, and catastrophic fractures. Results Margin quality after three million cycles revealed medians for continuous margin of 82–95% without significant differences among groups, neither at the ceramic/composite (p = 0.943) nor at the tooth/composite interface (p = 0.571). Visual inspection of veneers exhibited 22 cracks, 11 chippings, 4 partial and 4 catastrophic fractures in 38 of 80 veneers. The statistical ranking regarding fracture risk (p ≤ 0.05) was: IL1 = SIL1 = MIL1 = IL2 = CL1 = CL2, MIL2 = NPL1 = NPL2 = SIL2, IL2 = CL1 = CL2 = MIL2 = NPL1 = NPL2 = SIL2. Conclusions Even after three million cycles with up to 100 N, all groups showed high survival rates. However, the fracture risk increases with thin veneers and preparations with medium to high dentin portions when compared to thicker veneers with preparations in enamel or partially in dentin (p ≤ 0.05). Preexisting resin composite restorations did not show any significant influence on margin quality and facture risk (p > 0.05). Clinical relevance Ceramic laminate veneers are extremely durable with thin veneers and substantial enamel loss being main risk factors for fracture.

    更新日期:2020-01-04
  • Evaluation of efficacy of non-thermal atmospheric pressure plasma in treatment of periodontitis: a randomized controlled clinical trial
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-02
    Diğdem Küçük, Levent Savran, Utku Kürşat Ercan, Ziyşan Buse Yarali, Ozan Karaman, Alpdoğan Kantarci, Mehmet Sağlam, Serhat Köseoğlu

    Abstract Objectives In this clinical study, we aim to evaluate the effectiveness of non-thermal atmospheric pressure plasma (NAPP), which is a novel procedure used in periodontal pocket decontamination adjunctive to non-surgical periodontal treatment (NSPT). Methods The study included 25 systemically healthy periodontitis patients. In the split-mouth design, NAPP application into the pockets, in addition to NSPT, was performed. Clinical periodontal data, gingival crevicular fluid, and subgingival plaque samples of patients were taken before and during the first and third months of treatment. Biochemical assays were conducted using enzyme-linked immunosorbent assay. Analysis of bacteria was performed with polymerase chain reaction method. Results There was more clinical attachment level (CAL) gain in the 3rd month in the test group (deep pockets: 3.90 mm, pockets ≥ 5 mm: 2.72 mm) compared to the control group (deep pockets: 3.40 mm, pockets ≥ 5 mm: 2.58 mm) (p < 0.05), but no significant difference between groups in CAL. Clinical periodontal parameters improved in both study groups (p < 0.05). However, the gingival index (GI) and the bleeding on probing (BOP) rate decreased more in the test group (GI: 0.55, BOP: 9.48%, and GI: 0.38, BOP: 8.46% in the 1st and 3rd months, respectively) compared to the control group (GI: 0.68, BOP: 13.43%, and GI: 0.52, BOP: 14.58%) (p < 0.05). In addition, there was no significant difference in probing depth and biochemical markers between groups (p > 0.05). It was observed that NAPP reduced the number of bacteria more than the control group in the 1st and 3rd months. Conclusions It was seen that the single-time NAPP application concurrent with NSPT provided additional CAL gain, elimination of putative periodontopathogens and reduced their recolonization. Longitudinal studies with larger population and longer time are required. Clinical relevance NSPT is an effective method for the treatment of periodontitis but bacteria recolonization that causes recurrence of the periodontal disease occurs within a short period. NAPP can reduce the recurrence of periodontal disease by providing better bacterial elimination and should, therefore, be used in maintenance of periodontitis.

    更新日期:2020-01-04
  • Effect of high-fluoride dentifrice and bracket bonding composite material on enamel demineralization in situ
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-02
    Robson S. Ferreira, Antonio Pedro Ricomini-Filho, Cínthia P. Tabchoury, Glauber Campos Vale

    Abstract Objective This in situ study evaluated the effect of high-fluoride dentifrice (5000 μg F−/g) and fluoride-containing bonding composite resin on enamel demineralization adjacent to orthodontic brackets. Methods Ten volunteers wore palatal appliances containing bovine enamel blocks with metallic brackets bonded with fluoride-free or fluoride-containing composite resin. During three phases of 14 days each, three dentifrices with different fluoride concentrations (0, 1100, and 5000 μg F−/g) were tested. The cariogenic challenge consisted of 20% sucrose solution dripped 8x/day onto the dental blocks. At the end of each phase, biofilm formed was collected for fluoride analysis. Cross section hardness was performed in enamel blocks, and the lesion area was calculated. Data were analyzed by two-way ANOVA followed by Tukey post hoc test (α = 5%). Results The only signicant factor for all the variables under study was the dentifrice. Smaller lesion area and higher fluoride concentration on biofilm were found in 5000 μg F−/g group, irrespective of bonding composite resin (p < 0.001). Neither bracket-bonding composite resin nor the interaction between the factors was statistically significant (p > 0.05) for all the variables. Conclusion High-fluoride dentifrice is effective in reducing demineralization on enamel adjacent to orthodontic brackets, while the fluoride-containing bonding composite resin does not influence it. Clinical Significance Since high-fluoride dentifrice was able to reduce demineralization adjacent to brackets, it can be an option to caries management in orthodontics patients.

    更新日期:2020-01-04
  • Oral disorders in patients with newly diagnosed haematological diseases
    Clin. Oral Investig. (IF 2.453) Pub Date : 2020-01-02
    Uutela Pauliina, Passweg Jakob, Tim Joda, Roland Weiger, Mauramo Matti, Waltimo Tuomas

    Abstract Objective This study aimed to examine saliva flow rates and prevalence of dental and periodontal diseases of patients with newly diagnosed severe haematological diseases and compare these findings with age-matched controls of normal population. Methods A total of 149 patients diagnosed with haematological diseases aimed to be treated with haematological stem cell transplantation between 2008 and 2018 and 154 controls were included in the study. A dental examination was performed for patients within a maximum of 6 months after diagnosis. Differences were compared in terms of the stimulated salivary flow rate (SSFR); decayed, missing and filled teeth (DMFT) index; number of teeth; caries prevalence; presence of periodontitis and acute infections. Results The mean SSFR of the patient group was significantly lower (1.1 ml/min ± 0.7 ml/min) than the mean SSFR of the controls (1.3 ml/min ± 0.5 ml/min; p = 0.004). The number of caries lesions was significantly higher in the patient group (mean ± SD, 1.1 ± 1.9) than in the control group (mean ± SD, 0.4 ± 1.2; p < 0.001). There were fewer teeth and a higher DMFT index in the patient group compared to the control group, but the differences were not significant. Acute symptomatic infections were observed in eight (5.4%) patients and in none of the controls (p < 0.01). Conclusions and clinical relevance Oral examinations in patients with newly diagnosed severe haematological disease demonstrated a higher prevalence of caries, acute infections and lower mean SSFR compared with the controls. These findings support the recommendations for early dental examination at the time of diagnosis.

    更新日期:2020-01-04
  • Effect of platelet-rich fibrin on cell proliferation, migration, differentiation, inflammation, and osteoclastogenesis: a systematic review of in vitro studies
    Clin. Oral Investig. (IF 2.453) Pub Date : 2019-12-26
    Franz-Josef Strauss, Jila Nasirzade, Zahra Kargarpoor, Alexandra Stähli, Reinhard Gruber

    To systematically assess the effects of platelet-rich fibrin (PRF) on in vitro cellular behavior.

    更新日期:2020-01-04
  • Dental side effects of long-term obstructive sleep apnea therapy: a 10-year follow-up study
    Clin. Oral Investig. (IF 2.453) Pub Date : 2019-12-20
    Julia Anne Margarethe Uniken Venema, Michiel H. J. Doff, Dilyana S. Joffe-Sokolova, Peter J. Wijkstra, Johannes H. van der Hoeven, Boudewijn Stegenga, Aarnoud Hoekema

    Patients with obstructive sleep apnea (OSA) are usually treated with either mandibular advancement device (MAD) or continuous positive airway pressure (CPAP) therapy. The objective of this study is to evaluate changes in dental occlusion associated with long-term MAD and CPAP therapy.

    更新日期:2020-01-04
  • Speech changes in patients with a full rehabilitation for severe tooth wear, a first evaluation study
    Clin. Oral Investig. (IF 2.453) Pub Date : 2019-12-19
    Bernadette A.M.M. Sterenborg, Stanimira I. Kalaykova, Simone Knuijt, Bas A.C. Loomans, Marie-Charlotte D. N. J. M. Huysmans

    The aim of this study was to evaluate changes in speech characteristics and self-perceived quality of speech in tooth wear patients, after occlusal rehabilitation.

    更新日期:2020-01-04
  • Somatosensory changes in Chinese patients after coronectomy vs. total extraction of mandibular third molar: a prospective study
    Clin. Oral Investig. (IF 2.453) Pub Date : 2019-12-18
    Zi-Yu Yan, Xiao-Yan Yan, Chuan-Bin Guo, Qiu-Fei Xie, Guang-Ju Yang, Nian-Hui Cui

    Abstract Objectives This study aimed to quantitatively compare the somatosensory function changes of inferior alveolar nerve (IAN) after mandibular third molar extraction with a surgery protocol of coronectomy, as opposed to the conventional method. Materials and methods Patients with a lower third molar directly contacting IAN were recruited and assigned either to a test group (coronectomy group) or a control group (conventional extraction). A standardized quantitative sensory testing (QST) battery was performed for four times: one week before surgery and the second, seventh, and 28th days after surgery. Z-scores and the loss/gain coding system were applied for each participant. Results A total of 140 molars (test group: n = 91, control group: n = 49) were enrolled. The sensitivity of the mechanical detection threshold (MDT) and pressure pain threshold (PPT) significantly increased after surgery more than before surgery in both groups (P ≤ 0.001). After the surgery, the sensitivities of the cold detection threshold (CDT), cold pain threshold (CPT), and heat pain threshold (HPT) were significantly higher in the test group than in the control group (P ≤ 0.027). The risk of IANI was significantly larger (P = 0.041) in the test group than in the control group. Conclusions QST was a sensitive way to detect somatosensory abnormalities even with no subjective complaint caused by surgery. Coronectomy had less influence on IAN function than conventional total extraction. Clinical relevance The somatosensory function changes after mandibular third molar extraction were quantitatively studied, and coronectomy was proved a reliable alternation to reduce IAN injury rate.

    更新日期:2020-01-04
  • Demineralization detection in orthodontics using an ophthalmic optical coherence tomography device equipped with a multicolor fluorescence module
    Clin. Oral Investig. (IF 2.453) Pub Date : 2019-12-17
    Sinan Şen, Ralf Erber, Nadine Deurer, Gül Orhan, Christopher J. Lux, Sebastian Zingler

    Demineralizations such as white spot lesions are among the most prevalent side effects during orthodontic treatment. Fluorescence devices, including quantitative light-induced fluorescence (QLF), exploiting the intrinsic fluorescence of enamel and teeth and most recently optical coherence tomography (OCT) were introduced for early demineralization detection. In addition to near-infrared OCT scanning, multicolor modules allow for imaging with different laser wavelengths and the detection of reflective- and fluorescent light. The aim of this study was to evaluate a modified multicolor ophthalmic OCT device for the detection of early carious lesions in vitro and in vivo.

    更新日期:2020-01-04
  • In vitro compressive strength and edge stability testing of directly repaired glass-ionomer cements
    Clin. Oral Investig. (IF 2.453) Pub Date : 2019-12-17
    Jing Zhang, Peter Braun, Avijit Banerjee

    Abstract Objective To study the repair potential of seven commercial glass-ionomer cements (GICs) using an in vitro edge compression test model. Materials and methods A total of 448 normal and 192 repaired cylindrical specimens (6 × 4 mm) were produced from 6 GICs and one resin-modified GIC. Repaired samples consisted of a base aged for 1 month before repaired by an overlying layer. All samples were matured for 1 day, 1 week, 1 month or 3 months before compression, and edge tests were performed respectively on the whole surface (compressive strength, CS) or on the edge (edge stability, ES) using a universal testing machine. Results For normal specimens, Ketac Universal (KU) illustrated a significantly higher CS than other groups at all time points (p < 0.001). ES of KU was weaker than EQUIA Forte (EQF), FIX (Fuji IX) and RSC (Riva Self Cure) after 1 day, increasing after 1 week. Repaired specimens showed CS comparable to normal specimens (p > 0.05). Repaired KU significantly improved CS compared to repaired EQF and Fuji II (FII) after 1 day. No statistical difference was found in ES among these groups (p > 0.05). Conclusions KU provided the fastest maturation and greatest CS and ES in both normal and repair models after short-term ageing. Repair of GICs could potentially be achieved directly onto the fractured substrate and the subsequent improved mechanical performance could be maintained for at least 3 months. Clinical relevance This study provides a potential alternative in-vitro method to assess GIC restoration failure as well as provide insight into the mechanisms of GIC restoration repair.

    更新日期:2020-01-04
  • How reliable and accurate is the shade determination of premolars by spectrophotometry?
    Clin. Oral Investig. (IF 2.453) Pub Date : 2019-12-14
    Anna-Luisa Klotz, Yasamin Habibi, Alexander Jochen Hassel, Peter Rammelsberg, Andreas Zenthöfer

    Abstract Objectives To evaluate the reliability and accuracy of spectrophotometric shade determination of premolars and to compare the results with those for incisors. Material and methods Fifty-seven participants with natural maxillary incisors and premolars were recruited to investigate the research question. The colour of test teeth (incisors, n = 210; premolars, n = 192) was measured by use of the Vita Easyshade Advance (ES-A) and Vita Easyshade V (ES-V). Accuracy was evaluated by rating the shade tab matches recommended by the devices (scale, 1 = excellent match to 3 = mismatch). Inter-device reliability between the ES-A and ES-V for measurement of incisors and premolars was evaluated using intra-class correlation coefficients (ICC). The ratings for the accuracy of the devices were analysed using descriptive and bivariate statistics. A linear regression model was used to evaluate possible independent influencing confounders on the shade match. Results Inter-device agreement of the ES-A and ES-V for measurement of incisors and premolars was excellent for all colour components (ICC > 0.9). The accuracy of both devices was acceptable to excellent for incisors and premolars, although the ES-V was more accurate than the ES-A (p < 0.001). No significant difference in accuracy was detected between premolars and incisors (p = 0.182). The linear regression model confirmed the bivariate testing. Conclusions The reliability and accuracy of spectrophotometric shade determination seem comparable for incisors and premolars. The recently introduced ES-V seems more accurate than its predecessor model. Further studies are needed to validate the results of this study.

    更新日期:2020-01-04
  • Reduction of Streptococcus mutans by probiotic milk: a multicenter randomized controlled trial
    Clin. Oral Investig. (IF 2.453) Pub Date : 2019-12-14
    Chanika Manmontri, Areerat Nirunsittirat, Supatcharin Piwat, Onnida Wattanarat, Nuntiya Pahumunto, Anupong Makeudom, Thanapat Sastraruji, Suttichai Krisanaprakornkit, Rawee Teanpaisan

    Abstract Objective To investigate the effects of probiotics, Lactobacillus paracasei SD1, on the quantities of Streptococcus mutans in saliva and plaque samples of preschool children. Design This randomized trial recruited 487 preschool children from eight childcare centers. Participants were assigned to receive a 6-month course of placebo milk daily (group I), probiotic milk either daily (group II) or three days a week (triweekly, group III). The absolute quantities of S. mutans and total lactobacilli in the saliva and plaque samples at baseline (T0), after intervention (T6), and 6 months after discontinuation (T12) were assessed by qPCR. Results Of 487 children, 354 completed all follow-up periods. However, only 268 children (3.2 ± 0.8 years old; groups I = 86, II = 89, and III = 93) provided adequate saliva for qPCR. Whereas the quantities of S. mutans were significantly decreased in groups II and III compared to group I in the saliva and plaque samples at T6 and T12, those of total lactobacilli were significantly increased (p < 0.0167). There was no difference in the quantities of S. mutans or total lactobacilli between groups II and III at any period. Significant changes in the quantities of S. mutans and total lactobacilli lasted until T12 compared to T0 (p < 0.0167). Conclusions Probiotic administration daily or triweekly reduces S. mutans quantities, whereas it increases total lactobacilli quantities that persists at least 6 months after discontinuation in the saliva and plaque samples of preschool children. Clinical relevance Daily or triweekly consumption of L. paracasei SD1 supplemented in milk may help prevent dental caries in preschool children.

    更新日期:2020-01-04
  • Influence of different surface treatments on two-body wear and fracture load of monolithic CAD/CAM ceramics
    Clin. Oral Investig. (IF 2.453) Pub Date : 2019-12-13
    Felicitas Wiedenmann, Denise Böhm, Marlis Eichberger, Daniel Edelhoff, Bogna Stawarczyk

    Abstract Objectives To investigate two-body wear (2BW) and fracture load (FL) of monolithic ceramics after different surface pretreatments. Materials and methods Zirconia (MOZ), lithium-disilicate (LIT), and leucite-reinforced (LEU) specimens (n = 60/group) were manufactured with CAD/CAM-technology and underwent (n = 15/subgroup): 1) grinding + polishing (GrPo), 2) grinding + glazing (GrGz), 3) grinding (Gr), or 4) glazing (Gz). Scanning electron microscope (n = 3/subgroup) and 3D measurements of the ceramic crowns and antagonists (N = 180) were performed to determine 2BW before and after 120,000/1,200,000 masticatory cycles. FL was examined for all specimens (N = 180). Data were analyzed using Kolmogorov-Smirnov, one-way ANOVA, Scheffé post hoc, Kruskal-Wallis, Mann-Whitney-U, and Wilcoxon (p < 0.05). Results MOZ presented the highest FL independent on pretreatment (6960–9250 N), while LEU (1405–2320 N) showed the lowest (p < 0.001). Ceramic and antagonist wear increased between 120,000 and 1,200,000 masticatory cycles (p < 0.001). For pretreatments GrPo, GrGz, and Gz, MOZ showed the lowest wear of the ceramic, while causing the highest antagonist wear (p < 0.001). GrPo resulted in the lowest wear for MOZ (p < 0.001), with Gr leading to the highest antagonist wear (p = 0.008). LIT specimens presented the highest wear of the ceramic and antagonist after Gz (p < 0.001), while GrPo resulted in the lowest antagonist wear (p < 0.001). GrGz led to the highest antagonist wear for LEU (p < 0.001). Conclusions With FL exceeding maximum masticatory forces, the three tested ceramics can be recommended for restorations, even in posterior regions. While glazing resulted in higher wear and impaired FL, polishing improved mechanical properties while largely preserving the antagonist. Clinical relevance While surface pretreatment after grinding is vital to ensure a ceramic’s optimal mechanical properties, glazing and polishing varies with regard to material properties, costs, and time.

    更新日期:2020-01-04
  • Proteomic profile of saliva collected directly from ducts: a systematic review
    Clin. Oral Investig. (IF 2.453) Pub Date : 2019-12-12
    Camilla Vieira Esteves, Wladimir Gushiken de Campos, Juliana Amorim dos Santos, Solange Kobayashi Velasco, Eliete Neves Silva Guerra, Walter L. Siqueira, Celso Augusto Lemos

    Abstract Objective To present a systematic review that provides updated information about proteins found in salivary fluid extracted strictly from ducts. Methods The systematic review probing strategy was based on electronic databases word search (PubMed, EMBASE, LILACS, Web of Science, and Scopus). Risk of bias was assessed based on Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. Results After 2 rounds of scrutiny, 12 articles were included, totaling 231 individuals (125 were healthy, 41 were elder individuals with radicular caries, 56 had primary Sjögren’s syndrome, and 9 were patients who had received radiotherapy for head and neck cancer). The selected studies had no similarities among proteins found, demonstrating the need of standard reference in experimental methodology to obtain a thorough coverage of proteins. Conclusion Further studies are required to better determine the relative amount of proteins described in this study. It is essential to increase the number of samples, to perform similar collection techniques, to include other analyses methods such as mass spectrometry, and to perform the validation of some proteins using immunoassay techniques such as Elisa and Western blot. Clinical relevance Proteomic profile of saliva collected from ducts is essential to better understand the disease process, enabling the identification of biomarkers for specific clinical situations.

    更新日期:2020-01-04
  • Implant survival or implant success? Evaluation of implant-based prosthetic rehabilitation in head and neck cancer patients—a prospective observational study
    Clin. Oral Investig. (IF 2.453) Pub Date : 2019-12-12
    Tobias Ettl, Natalie Junold, Florian Zeman, Matthias Hautmann, Sebastian Hahnel, Carola Kolbeck, Steffen Müller, Christoph Klingelhöffer, Torsten E. Reichert, Johannes K. Meier

    Definition of implant success is unclear in prosthetic implant-based rehabilitation of head neck cancer patients.

    更新日期:2020-01-04
  • Outcomes of endodontically treated cracked teeth: a systematic review and meta-analysis
    Clin. Oral Investig. (IF 2.453) Pub Date : 2019-12-11
    Dephne Jack Xin Leong, Nurun Nisa de Souza, Rehena Sultana, Adrian Ujin Yap

    Abstract Objective Systematic review analyzing the treatment outcomes of cracked teeth that received endodontic treatment is unavailable. The purpose of this study was to examine the treatment outcome of cracked teeth that received root canal treatment and to determine factors that influenced outcome. Materials and methods The specific PIO questions were as follows: Population: patients who were healthy individuals ≥ 18 years old and required root canal treatment due to cracked tooth; Intervention: root canal treatment with at least 1 year in occlusal function; Outcomes: survival rate and pre-operative factors. Ovid, PubMed, and Cochrane databases were searched in conjunction with hand searching. Pooled survival rates were determined from a meta-analysis of the data retrieved from the articles. All statistics were performed by the Comprehensive Meta-Analysis software. Results Four articles met the inclusion criteria. The overall tooth survival at 60 months was 84.1% (95%CI, 72.3–91.5%). Although no pre-operative factors had statistical significance, 4 factors had possible clinical significance. Teeth with single crack and teeth with cracks contained within crowns exhibited lower extraction risk, while teeth with pre-treatment periodontal probing > 3 mm and teeth that were terminal abutments showed a greater risk of extraction. Conclusion This systematic review determined the survival rate of endodontically treated cracked teeth to be moderately high. More studies in this area are, however, warranted before definitive conclusions can be derived. Clinical relevance In view of the relatively high survival rate, endodontic treatment rather than extraction should be considered for cracked teeth.

    更新日期:2020-01-04
  • Osseous ingrowth in allogeneic bone blocks applied for vertical bone augmentation: a preclinical randomised controlled study
    Clin. Oral Investig. (IF 2.453) Pub Date : 2019-12-11
    Tobias Moest, Johanna Frabschka, Marco Rainer Kesting, Christian Martin Schmitt, Gesche Frohwitter, Rainer Lutz, Karl Andreas Schlegel

    Abstract Objectives The aim of the present study was the qualitative and quantitative evaluation of osseous graft consolidation using allogeneic bone blocks for vertical bone augmentation in an animal model. Material and methods Standardised allogeneic and autologous bone blocks were fixed on the frontal skull of 20 adult female pigs and covered with a resorbable collagen membrane. Animals were sacrificed after 2 and 6 months. Specimens were histologically and histomorphometrically analysed focusing on the amount of vital bone, residual bone substitute material and connective tissue. Furthermore, the amount of expression of bone matrix proteins (collagen type I and osteocalcin) and de novo vessel formation (von Willebrand factor) were quantified by immunohistochemistry. Results Significantly more allogeneic bone blocks failed for both evaluation time points (p < 0.05). Allogeneic blocks showed significantly less vital bone with more connective tissue formation compared to autologous bone blocks. Increased vessel formation could be detected for both evaluation time points in the contact area of autologous bone with local bone. The expression of collagen type I and osteocalcin was significantly lower in the allogeneic bone graft. Conclusions Allogeneic cancellous bone blocks showed a significantly higher failure rate compared to autologous bone blocks. Allogeneic bone blocks seemed to negatively affect bone formation or negatively influence the host in the long term, and increased connective tissue formation and block loss should be anticipated. Clinical relevance In order to maintain patient safety and treatment success clinicians should be persuaded to make a conscious choice of the applied biomaterials with regard to their components and structure.

    更新日期:2020-01-04
  • Clustering effects of oral conditions based on clinical and radiographic examinations
    Clin. Oral Investig. (IF 2.453) Pub Date : 2019-12-10
    Leonie Meinhold, Joachim Krois, Rainer Jordan, Norbert Nestler, Falk Schwendicke

    The intra-class correlation coefficient (ICC) is a measure of intra-subject clustering effects. A priori estimates of the ICC and the associated design effect (DE) are required for sample size estimation in clustered studies, and should be considered during their analysis, too. We aimed to determine the clustering effects of carious lesions, apical lesions, periodontal bone loss, and periodontal pocketing, assessed in clinical or radiographic examinations.

    更新日期:2020-01-04
  • Increased risk for tooth extraction in primary hyperparathyroidism and hypercalcemia: a population study.
    Clin. Oral Investig. (IF 2.453) Pub Date : null
    A Koman,P Näsman,A Discacciati,A Ekbom,I-L Nilsson,G Sandborgh-Englund

    The aim of this study was to analyze dental comorbidities in untreated primary hyperparathyroidism (pHPT). Patients with pHPT subjected to parathyroidectomy (PTX) at Karolinska University Hospital, Stockholm, during 2011-2016 (n = 982) were selected from the Scandinavian Quality Register of Thyroid, Parathyroid and Adrenal surgery and compared to a general population cohort (n = 2944), matched for age and gender. Dental data was obtained from the Swedish Dental Health Registry for the 3 years prior to PTX. The incidence rate ratios (IRRs) of tooth loss by extraction, periodontal interventions, and dental visit rate were analyzed by Poisson regression models. In order to analyze the impact of disease severity, the PHPT cohort was sub-grouped based on preoperative serum levels of ionized calcium (S-Ca2+). The total number of tooth extractions, periodontal interventions, and number of visits were similar in the cohorts. PHPT patients belonging to the quartile with the highest S-Ca2+ (≥ 1.51 mmol/L) had increased risk for tooth extraction (IRR 1.85; 95% CI 1.39-2.46). Female gender independently amplified the risk (IRR 1.341, P < 0.027). This study indicates an association between pHPT and oral disorders reflected by increased tooth loss by extraction related to high S-Ca2. Increased awareness of dental comorbidity in primary hyperparathyroidism may benefit a large group of patients with a common disease through earlier detection and prevention.

    更新日期:2019-11-01
  • Expression of gingival crevicular fluid markers during early and late healing of intrabony defects after surgical treatment: a systematic review.
    Clin. Oral Investig. (IF 2.453) Pub Date : 2019-11-07
    V P Koidou,G S Chatzopoulos,I Tomas,L Nibali,N Donos

    BACKGROUND Surgical treatments such as guided tissue regeneration (GTR) and access flap surgery are widely employed for the treatment of intrabony defects. However, little is known regarding the postoperative expression of gingival crevicular fluid (GCF) markers. OBJECTIVE The aim of this systematic review was to compare the expression of GCF markers following treatment of periodontal intrabony defects with guided tissue regeneration or access surgery. The association of the markers' expression with the clinical outcome was also assessed. METHODS An electronic literature search was conducted in MEDLINE, EMBASE, OpenGrey, LILACS and Cochrane Library up to December 2018 complemented by a manual search. Human, prospective clinical studies were identified. The changes from baseline up to 30 days (early healing) and 3 months (late healing) were assessed. RESULTS A total of 164 publications were identified and reviewed for eligibility. Of these, 10 publications fulfilled the inclusion criteria. The included studies evaluated 15 different GCF markers with a follow-up time between 21 and 360 days postoperatively. PDGF, VEGF and TIMP-1 changes were often investigated in the included studies; however, contrasting results were reported. Two studies agreed that both GTR and OFD lead to similar OPG level changes. TGF-β1 is increased early postoperatively, irrespective of the surgical technique employed. CONCLUSION There is limited evidence available on the expression of GCF markers after surgical interventions of intrabony periodontal defects. However, OPG and TGF-β1 tend to increase early post-operatively, irrespective of the surgical technique employed, irrespective of the surgical technique employed. CLINICAL RELEVANCE More well-designed, powered studies with sampling periods reflecting the regenerative process are needed, and future research should focus on employing standardised protocols for collecting, storing and analysing GCF markers.

    更新日期:2019-11-01
  • A novel method for harvesting concentrated platelet-rich fibrin (C-PRF) with a 10-fold increase in platelet and leukocyte yields.
    Clin. Oral Investig. (IF 2.453) Pub Date : null
    Richard J Miron,Jihua Chai,Peng Zhang,Yuqing Li,Yunxiao Wang,Carlos Fernando de Almeida Barros Mourão,Anton Sculean,Masako Fujioka Kobayashi,Yufeng Zhang

    BACKGROUND AND OBJECTIVES Liquid platelet rich fibrin (PRF; often referred to as injectable PRF) has been utilized as an injectable formulation of PRF that is capable of stimulating tissue regeneration. Our research group recently found that following standard L-PRF protocols (2700 RPM for 12 min), a massive increase in platelets and leukocytes was observed directly within the buffy-coat layer directly above the red blood cell layer. The purpose of this study was to develop a novel harvesting technique to isolate liquid PRF directly from this buffy coat layer and to compare this technique to standard i-PRF. MATERIALS AND METHODS Standard high g-force L-PRF and low g-force i-PRF protocols were utilized to separate blood layers. Above the red blood corpuscle layer, sequential 100-μL layers of plasma were harvested (12 layers total; i.e., 1.2 mL, which represents the total i-PRF volume), and 3 layers (3 × 100 μL) were harvested from the red blood cell layer to quantify blood cells. Each layer was then sent for complete blood count (CBC) analysis, and the cell numbers were quantified including red blood cells, leukocytes, neutrophils, lymphocytes, monocytes, and platelets. The liquid PRF that was directly collected from the buffy-coat layer following L-PRF protocols was referred to as concentrated PRF (C-PRF). RESULTS The i-PRF protocol typically yielded a 2- to 3-fold increase in platelets and a l.5-fold increase in leukocyte concentration from the 1- to 1.2-mL plasma layer compared to baseline concentrations in whole blood. While almost no cells were found in the first 4-mL layer of L-PRF, a massive accumulation of platelets and leukocytes was found directly within the buffy coat layer demonstrating extremely high concentrations of cells in this 0.3-0.5-mL layer (~ 20-fold increases). We therefore proposed harvesting this 0.3- to 0.5-mL layer directly above the red blood cell corpuscle layer as liquid C-PRF. In general, i-PRF was able to increase platelet numbers by ~ 250%, whereas a 1200-1700% increase in platelet numbers could easily be achieved by harvesting this 0.3-0.5 mL of C-PRF (total platelet concentrations of > 2000-3000 × 109 cells/L). CONCLUSION While conventional i-PRF protocols increase platelet yield by 2-3-fold and leukocyte yield by 50%, we convincingly demonstrated the ability to concentrate platelets and leukocytes over 10-fold by harvesting the 0.3-0.5 mL of C-PRF within the buffy coat following L-PRF protocols. CLINICAL RELEVANCE Previous studies have demonstrated only a slight increase in platelet and leukocyte concentrations in i-PRF. The present study described a novel harvesting technique with over a 10-fold increase in platelets and leukocytes that can be further utilized for tissue regeneration.

    更新日期:2019-11-01
  • Association between periodontitis and glycosylated haemoglobin before diabetes onset: a cross-sectional study.
    Clin. Oral Investig. (IF 2.453) Pub Date : null
    Gaetano Isola,Giovanni Matarese,Luca Ramaglia,Eugenio Pedullà,Ernesto Rapisarda,Vincenzo Iorio-Siciliano

    OBJECTIVES The aim of the present cross-sectional study was to investigate the association between serum glycosylated haemoglobin (HbA1c) levels and periodontal status in patients with periodontitis (CP) and periodontally healthy controls. Furthermore, the objectives were to determine if the periodontitis influenced the serum HbA1c levels. MATERIALS AND METHODS A total of 93 patients with CP and 95 periodontally healthy subjects were enrolled in the present study using a cross-sectional design. At baseline, patients were examined and characterized on a regular basis for blood serum parameters and non-fasting blood samples levels. In all patients, a full periodontal examination was performed and clinical attachment loss (CAL) was the primary outcome variable chosen. The spearman correlation, a stepwise multivariable linear regression, and Jonckheere-Terpstra tests were applied in order to assess the relationship between HbA1c levels and periodontitis. RESULTS Patients in the CP group presented a significantly higher median serum level of HbA1c [40.9 (31.2; 45.6) mmol/mol)] compared to patients in the healthy control group [35.3 (29.6; 38.6) mmol/mol)] (p < 0.001). HbA1c levels were negatively correlated with the number of teeth and positively correlated with C-reactive protein levels and all periodontal parameters (p < 0.001). Moreover, there was a significant decrease in the number of teeth when HbA1c levels increased (P-trend < 0.001), while there was a significant increase in periodontal parameters (CAL, p = 0.002); PD, p = 0.008; BOP, p < 0.001) when levels of HbA1c increased. CONCLUSIONS Patients with CP and undiagnosed diabetes presented significantly higher serum levels of HbA1c compared to periodontally healthy controls. Moreover, the presence of periodontitis was positively correlated with serum HbA1c levels before diabetes onset. CLINICAL RELEVANCE HbA1c levels were positively correlated with the severity of periodontitis before diabetes onset.

    更新日期:2019-11-01
  • Effect of photobiomodulation therapies on the root resorption associated with orthodontic forces: a pilot study using micro computed tomography.
    Clin. Oral Investig. (IF 2.453) Pub Date : null
    Merve Goymen,Aysegul Gulec

    OBJECTIVES The aim of this study is to investigate the effect of photobiomodulation therapies on root resorption compared with the placebo group. MATERIALS AND METHODS Thirty patients who were admitted to the Gaziantep University Faculty of Dentistry Orthodontics Department for treatment, with an indication of upper right first premolar tooth extraction were included. Before the individuals' orthodontic treatment, 0.022 slot MBT brackets and tubes were placed on the maxillary first premolar and molar. A 150-g buccal tipping force was applied to the first premolar. Cantilever spring with 0.017 × 0.025 Beta Titanium wire was used for force application. Individuals were then randomly divided into three groups. For the first group, laser application was performed with an 810-nm GaAlAs laser device at 0, 3, 7, 14, 21, and 28 days to 8 J/cm2. For the second group, an LED application according to the manufacturer's instructions with an 850-nm wavelength and 20 mW/cm2 output power for 10 min per day during the experiment. For the third group, a placebo therapy was completed whereby a laser device that did not make active pulses was used. At the end of 4 weeks, the amount of root surface resorption was compared using micro-CT imaging after the extraction of the teeth. RESULTS No significant difference was found between the groups in terms of regional and total crater volumes. It was observed that photobiomodulation therapies were not different from the control group in terms of forming root resorption. CONCLUSIONS It is seen that laser and LED photobiomodulation therapies used for accelerate orthodontic tooth movement do not differ from the control group in terms of forming root resorption. CLINICAL RELEVANCE According to the results of this pilot study on this subject, which needs to be clarified with new findings in the future, LED and laser applications may not increase the risk for root resorption.

    更新日期:2019-11-01
  • Selective, stepwise, or nonselective removal of carious tissue: which technique offers lower risk for the treatment of dental caries in permanent teeth? A systematic review and meta-analysis.
    Clin. Oral Investig. (IF 2.453) Pub Date : null
    Myrna Maria Arcanjo Frota Barros,Maria Imaculada De Queiroz Rodrigues,Francisco Wilker Mustafa Gomes Muniz,Lidiany Karla Azevedo Rodrigues

    OBJECTIVES This study aimed to systematically review the literature regarding the risk of selective removal-in comparison with stepwise and nonselective removal-of carious tissue in permanent teeth. MATERIALS AND METHODS Controlled clinical trials and cohort studies involving patients with dental caries in permanent teeth were included. Databases used were PubMed, Embase, and Scopus. The test group should be composed of patients undergoing selective removal of carious tissues, and the control group should comprise patients undergoing nonselective removal and/or stepwise removal of carious tissue. Laboratory tests, studies on primary teeth, and studies that used temporary restorations were excluded, as were literature reviews. The primary outcome was overall success of maintaining pulpal health (both clinically and radiographically). Quality of the restoration, pulp exposure, dentin deposition, and microbiological examination were also assessed. A meta-analysis, using the pooled risk ratio (RR) and its 95% confidence interval (CI), was performed to assess the success of maintaining pulpal health, using the different control treatments as a subgroup analysis. RESULTS A total of 2333 articles were retrieved, of which 10 were included in the systematic review and four in the meta-analysis. In the qualitative evaluation, the control groups presented a higher risk of pulp exposure in relation to the selective removal. In the meta-analysis, the selective carious tissue removal showed significantly higher overall success (RR, 95% CI 1.11, 1.02-1.21). CONCLUSIONS The selective carious tissue removal presented higher success of maintaining pulpal health. CLINICAL RELEVANCE In permanent teeth, selective carious tissue removal should be performed, as this technique results in lower numbers of pulp complications, such as pulp exposure, as compared with nonselective removal.

    更新日期:2019-11-01
  • The association between smoking and periapical periodontitis: a systematic review.
    Clin. Oral Investig. (IF 2.453) Pub Date : null
    A Aminoshariae,J Kulild,J Gutmann

    OBJECTIVES The purpose of this systematic review was to examine if, in adult patients, the absence or presence of smoking influenced the prevalence of periapical periodontitis (PP). MATERIALS AND METHODS Databases were searched, and original research manuscripts up to June 2019 were identified by two reviewers. The Newcastle-Ottawa Scale (NOS) was used for risk of bias. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system was used for certainty in the evidence. A meta-analysis was performed using RevMan 5 software. Risk ratio (RR) was used for the cohort studies, and odds ratio (OR) was used for the case-control studies with 95% confidence interval (CI). RESULTS All the studies had many covariates and confounding variables. Three longitudinal cohort articles discussed radiographic findings as they related to the prevalence of PP in root-filled teeth. The RR of smoking and the prevalence of PP was 2.11 (95% CI 0.88-5.05, p = 0.09). Nine case-control studies focused on the prevalence of PP and smoking. There was a positive association between smoking and the prevalence of PP with an OR of 2.78 and a 95% confidence interval of 2.23-3.48, with p value < 0.05. The quality of the studies was fair per NOS, and the certainty of the literature assessment was moderate per GRADE. CONCLUSIONS The current best available evidence suggests that smoking was associated with the prevalence of PP but more studies are needed to report this association in the longitudinal cohort studies. CLINICAL RELEVANCE Smoking has a positive association with the prevalence of PP.

    更新日期:2019-11-01
  • Barriers and facilitators for provision of oral health care in dependent older people: a systematic review.
    Clin. Oral Investig. (IF 2.453) Pub Date : 2019-02-02
    Gerd Göstemeyer,Sarah R Baker,Falk Schwendicke

    OBJECTIVES Provision of oral health care (OHC), including oral hygiene (OH) or oral/dental treatment, to dependent older people (DOP) is frequently insufficient. We aimed to assess barriers and facilitators perceived by different healthcare professionals towards providing OHC to DOP. MATERIALS AND METHODS A systematic review was performed. Studies reporting on knowledge, attitudes, and beliefs acting as barriers and facilitators for provision of OHC were included. One database (PubMed) was searched and data extraction independently performed by two reviewers. Thematic analysis was used and identified themes translated to the domains and constructs of the theoretical domains framework (TDF) and aligned with the domains of the behavior change wheel (BCW). Analyses were stratified for the two target behaviors (providing oral hygiene and providing oral/dental treatment) and according to different stakeholders' perspective. For quantitative analysis, frequency effect sizes (FES) were calculated. RESULTS In total, 1621 articles were identified and 41 (32 quantitative, 7 qualitative, 2 mixed method) studies included. Within these 41 studies, there were 7333 participants (4367 formal caregivers, 67 informal caregivers, 1100 managers of care, 1322 dentists, 340 DOP). Main barriers for providing OH were "lack of knowledge" (FES 65%, COM-B domain: capability, TDF domain: knowledge) and "patients refusing care" (62%, opportunity, environmental context and resources). Main facilitators were "OHC training/education" (41%, capability, skills) and "presence of a dental professional" (21%, opportunity, environmental context and resources). Main barriers for provision of dental treatment were "lack of suitable facilities for treatment/transportation of patients" (76%) and "patients refusing care" (53%) (both: opportunity, environmental context and resources). Main facilitators were "regular visiting dentist" (35%) and "routine assessment/increased awareness by staff" (35%) (both: opportunity, environmental context and resources). CONCLUSIONS A number of barriers and facilitators for providing different aspects of OHC were identified for different stakeholders. CLINICAL RELEVANCE Our findings help provide the evidence to develop implementation strategies for providing high-quality systematic OHC to DOP. REGISTRATION This review was registered at Prospero (CRD42017056078).

    更新日期:2019-11-01
  • Antimicrobial susceptibilities of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis strains from periodontitis patients in Morocco.
    Clin. Oral Investig. (IF 2.453) Pub Date : 2018-07-04
    M Mínguez,O K Ennibi,P Perdiguero,L Lakhdar,L Abdellaoui,M C Sánchez,M Sanz,David Herrera

    BACKGROUND AND OBJECTIVE Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis have been frequently isolated in periodontitis patients in Morocco. Its persistence after the subgingival debridement of the biofilm has been correlated with worse clinical outcomes. The aim of this study was to evaluate the antimicrobial susceptibilities of A. actinomycetemcomitans and P. gingivalis, to amoxicillin, amoxicillin plus clavulanate, metronidazole, and azithromycin. In addition, microbiological profiles of patients harbouring A. actinomycetemcomitans, P. gingivalis, or both were compared. MATERIAL AND METHODS In 45 consecutive periodontitis Moroccan patients, subgingival samples were taken and processed by culture. Twenty-four A. actinomycetemcomitans and 30 P. gingivalis colonies were isolated (54 strains) and susceptibility tests, using the epsilometric method, were run for amoxicillin, amoxicillin plus clavulanate, metronidazole, and azithromycin. Minimum inhibitory concentrations for 50 (MIC50) and 90% (MIC90) of the organisms were calculated. RESULTS The prevalence of A. actinomycetemcomitans and P. gingivalis was 79.5 and 84.4%, respectively. A. actinomycetemcomitans showed susceptibility to amoxicillin, amoxicillin plus clavulanate, while 28% of the isolated strains were resistant to azithromycin and 61.7% towards metronidazole. No P. gingivalis resistance towards amoxicillin, amoxicillin plus clavulanate, metronidazole, and azithromycin was found. CONCLUSION A. actinomycetemcomitans and P. gingivalis were frequently detected in Moroccan patients with periodontitis, while antimicrobial resistance was only detected for A. actinomycetemcomitans to metronidazole and azithromycin. CLINICAL RELEVANCE A. actinomycetemcomitans resistance against some antimicrobials in periodontitis patients in Morocco can influence the selection of the therapeutic approaches.

    更新日期:2019-11-01
  • Carotid calcifications in panoramic radiographs are associated with future stroke or ischemic heart diseases: a long-term follow-up study.
    Clin. Oral Investig. (IF 2.453) Pub Date : 2018-07-04
    Viveca Wallin Bengtsson,G Rutger Persson,Johan Berglund,Stefan Renvert

    OBJECTIVE To assess if carotid calcifications detected in panoramic radiographs are associated with future events of stroke, and/or ischemic heart diseases over 10-13 years in individuals between 60 and 96 years. MATERIALS AND METHODS Baseline (2001-2004) panoramic radiographs were assessed for evidence of carotid calcifications from individuals with no previous history of stroke and/or ischemic heart diseases. A radiopaque nodular mass adjacent to the cervical vertebrae, at or below the intervertebral space C3-C4, was interpreted as carotid calcification. Annual medical records were searched for ICD 10 codes through 2014. RESULTS Signs of carotid calcification was demonstrated in 238/635 (37.5%) of the study individuals. Signs of carotid calcification was associated with future stroke and/or ischemic heart diseases (χ2 = 9.1, OR 1.6, 95% CI 1.2, 2.2, p < 0.002). In individuals 60-72 years, a significant association between radiographic signs of carotid calcification and stroke and/or ischemic heart diseases (χ2 = 12.4, OR 2.4, 95% CI 1.5, 4.0, p < 0.000) (adjusted for high blood pressure, diabetes type 2, BMI; OR 1.9, 95% CI 1.1, 3.5, p = 0.03). Individuals (60-72 years) with radiographic evidence of carotid calcifications had a mean cumulative stroke and/or ischemic heart diseases survival time of 12.1 years compared to those without such evidence (13.0 years) (log rank Mantel-Cox χ2 = 10.7, p = 0.001). CONCLUSIONS Evidence of carotid calcifications in panoramic radiographs is associated with an event of stroke and/or ischemic heart diseases in 60-96-year-old individuals. CLINICAL RELEVANCE Radiographic evidence of carotid calcifications is associated with stroke and/or ischemic heart diseases. Patients with signs of carotid calcifications should therefore be referred for medical examination.

    更新日期:2019-11-01
  • Analysis of blood supply in the hard palate and maxillary tuberosity-clinical implications for flap design and soft tissue graft harvesting (a human cadaver study).
    Clin. Oral Investig. (IF 2.453) Pub Date : 2018-07-02
    Arvin Shahbazi,András Grimm,Georg Feigl,Gábor Gerber,Andrea Dorottya Székely,Bálint Molnár,Péter Windisch

    OBJECTIVES The aim of the present study is to provide a detailed macroscopic mapping of the palatal and tuberal blood supply applying anatomical methods and studying specific anastomoses to bridge the gap between basic structural and empirical clinical knowledge. MATERIALS AND METHODS Ten cadavers (three dentate, seven edentulous) have been prepared for this study in the Department of Anatomy, Semmelweis University, Budapest, Hungary, and in the Department of Anatomy of the Medical University of Graz. All cadavers were fixed with Thiel's solution. For the macroscopic analysis of the blood vessels supplying the palatal mucosa, corrosion casting in four cadavers and latex milk injection in other six cadavers were performed. RESULTS We recorded major- and secondary branches of the greater palatine artery (GPA) and its relation to the palatine spine, different anastomoses with the nasopalatine artery (NPA), and lesser palatal artery (LPA) as well as with contralateral branches of the GPA. Penetrating intraosseous branches at the premolar-canine area were also detected. In edentulous patients, the GPA developed a curvy pathway in the premolar area. The blood supply around the maxillary tuberosity was also presented. CONCLUSION The combination of different staining methods has shed light to findings with relevance to palatal blood supply, offering a powerful tool for the design and execution of surgical interventions involving the hard palate. CLINICAL RELEVANCE The present study provides clinicians with a good basis to understand the anatomical background of palatal and tuberal blood supply. This might enable clinicians to design optimized incision- and flap designs. As a result, the risk of intraoperative bleeding and postoperative wound healing complications related to impaired blood supply can be minimized.

    更新日期:2019-11-01
  • Iodonium salt incorporation in dental adhesives and its relation with degree of conversion, ultimate tensile strength, cell viability, and oxidative stress.
    Clin. Oral Investig. (IF 2.453) Pub Date : 2018-07-02
    Camila Perelló Ferrúa,Fernanda Barbosa Leal,Marta de Oliveira Gazal,Gabriele Cordenonzi Ghisleni,Rodrigo Varella de Carvalho,Flávio Fernando Demarco,Fabrício Aulo Ogliari,Fernanda Nedel

    OBJECTIVE The aim of this study was to evaluate the degree of conversion, ultimate tensile strength, cell viability, and oxidative stress of two different ternary initiation systems, using two photoinitiation polymerization times. METHODS The groups investigated were camphorquinone (CQ); CQ and diphenyleneiodonium hexafluorophosphate (DPI); CQ and ethyl 4-dimethylamine benzoate (EDAB); and CQ, EDAB, and DPI, with EDAB in high and low concentration. To assess the degree of conversion (DC) and the ultimate tensile strength (UTS), a real-time Fourier transform infrared spectroscopy and a universal test machine Emic DL-500 were used, respectively. Cell viability and oxidative stress were evaluated by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide), superoxide dismutase (SOD), total sulfhydryl (SH) content, and thiobarbituric acid reactive species (TBARS) formation assays. RESULTS Slight lower cell viability was shown when DPI was associated with high concentrations of EDAB; this reduction seemed to be attenuated when lower concentrations of EDAB were used. When EDAB and DPI were associated, no oxidative damage was shown. The degree of conversion was increased in the ternary systems (CQ + EDAB lower concentration + DPI) group, which did not affect the UTS, cytotoxicity, and oxidative stress parameters. The polymerization time did not affect cell viability, total SH, and TBARS; however, a slight increase was shown in SOD levels. CLINICAL RELEVANCE Our study emphasizes the relevance of incorporating the third element-iodonium salt-in a binary adhesive systems composed exclusively of CQ and EDAB.

    更新日期:2019-11-01
  • Effectiveness of adjunctive hyaluronic acid application in coronally advanced flap in Miller class I single gingival recession sites: a randomized controlled clinical trial.
    Clin. Oral Investig. (IF 2.453) Pub Date : 2018-07-02
    Andrea Pilloni,Patrick R Schmidlin,Philipp Sahrmann,Anton Sculean,Mariana A Rojas

    OBJECTIVES The aim of this randomized controlled clinical trial was to evaluate the possible advantages of adjunctive hyaluronic acid (HA) application in the coronally advanced flap (CAF) procedure in single Miller class I/recession type 1 (RT1) gingival recession treatment. MATERIAL AND METHODS Thirty patients with one recession were enrolled; 15 were randomly assigned CAF + HA and 15 to CAF alone. The recession reduction (RecRed), clinical attachment level gain (CAL-gain), changes in probing pocket depth (PPD) and in the width of keratinized tissue (KT), complete root coverage (CRC), and mean root coverage (MRC) were calculated after 18 months. Post-operative morbidity (pain intensity, discomfort, and swelling) was recorded 7 days after treatment using visual analogue scale (VAS). RESULTS After 18 months, RecRed was statistically significantly higher in the test group (2.7 mm [1.0]) than in the control group (1.9 mm [1.0]; p = 0.007). PPD were found to be slightly but statistically significantly increased in both groups. No statistically significant difference was found for KT gain between treatments. CRC was 80% for test and 33.3% for control sites (p < 0.05). A MRC of 93.8 ± 13.0% for test and 73.1 ± 20.8% for control sites was calculated (p < 0.05). The test group reported lower swelling and discomfort values 7-days post-surgery (p < 0.05). Statistically significant difference was not found for pain intensity. CONCLUSIONS The adjunctive use of HA was effective in obtaining CRC for single Miller class I/RT1 gingival recession sites. CLINICAL RELEVANCE Adjunctive application of HA in the coronally advanced flap procedure may improve the reduction of the recessions and increase the probability of CRC in Miller class I recessions.

    更新日期:2019-11-01
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