Dentistry Journal

25 pages, 1899 KiB

Open AccessReview

Conspiracy of Silence in Head and Neck Cancer Diagnosis: A Scoping Review

by Cristina Saldivia-Siracusa, Erison Santana Dos Santos, Wilfredo Alejandro González-Arriagada, Ana Carolina Prado-Ribeiro, Thaís Bianca Brandão, Adepitan Owosho, Marcio Ajudarte Lopes, Joel B. Epstein and Alan Roger Santos-Silva

Dent. J. 2024, 12(7), 214; https://doi.org/10.3390/dj12070214 - 11 Jul 2024

Abstract

Cancer disclosure represents a complex healthcare dynamic. Physicians or caregivers may be prompted to withhold diagnosis information from patients. This study aims to comprehensively map and synthesize available evidence about diagnosis nondisclosure regarding head and neck cancer (HNC) patients. Following the Joanna Briggs [...] Read more.

Cancer disclosure represents a complex healthcare dynamic. Physicians or caregivers may be prompted to withhold diagnosis information from patients. This study aims to comprehensively map and synthesize available evidence about diagnosis nondisclosure regarding head and neck cancer (HNC) patients. Following the Joanna Briggs Institute guidelines, a scoping review was conducted across major databases without period restriction, yielding 9238 publications. After screening and selection, a descriptive synthesis was conducted. Sixteen studies were included, primarily conducted in academic settings (75%) from Europe and Asia, with a total population of 662 patients predominantly diagnosed with brain, oral, pharyngeal, or laryngeal tumors. Remarkably, 22.51% of patients were unaware of their diagnosis. Although physicians were the main source of diagnostic information (35%), they reported to often use vague terms to convey malignancy. Additionally, 13.29% of patients were aware of their diagnosis from sources other than doctors or caregivers. Caregivers (55%) supported diagnosis concealment, and physicians tended to respect family wishes. A high diagnosis-to-death interval, education, and age significantly influenced diagnosis disclosure. HNC patients expressed a desire for personalized open communication. Multiple factors influenced the decision on diagnosis disclosure. Current evidence on this topic varies significantly, and there is limited research on the consequences of nondisclosure. These findings reflect the underestimation of the patients’ outlook in the diagnosis process and highlight the need for further research, aiming to establish open communication and patient autonomy during the oncological journey. Full article

(This article belongs to the Special Issue Feature Review Papers in Dentistry)

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11 pages, 259 KiB

Open AccessArticle

The Role of Malocclusion and Oral Parafunctions in Predicting Signs and Symptoms of Temporomandibular Disorders—A Cross-Sectional Study

by Luka Šimunović, Marina Lapter Varga, Dubravka Negovetić Vranić, Ivana Čuković-Bagić, Lana Bergman and Senka Meštrović

Dent. J. 2024, 12(7), 213; https://doi.org/10.3390/dj12070213 - 10 Jul 2024

Abstract

Background: The aim of this study was to examine to what extent malocclusion and parafunctional habits contribute to the development of signs and symptoms associated with temporomandibular disorders (TMD) in schoolchildren with mixed dentition in Croatia in a sample of 338 children, aged [...] Read more.

Background: The aim of this study was to examine to what extent malocclusion and parafunctional habits contribute to the development of signs and symptoms associated with temporomandibular disorders (TMD) in schoolchildren with mixed dentition in Croatia in a sample of 338 children, aged 9 to 15 years. Methods: TMD signs and symptoms assessed by the clinician were joint function and pain, masticatory muscles tenderness, range of mandibular motion, and joint sounds. To evaluate subjective symptoms and parafunctions, children and parents were asked about the presence of headaches, jaw locking, temporomandibular joint (TMJ) sounds, pain during mouth opening, or bruxism, as well as parafunctions like biting pencils or nails, chewing hard candies or ice, daily gum chewing, opening bottles with teeth, engaging in jaw play, thumb-sucking, and clenching/grinding teeth. Results: At least one symptom of a TMD was pronounced in 142 participants (42.0%). The most commonly reported parafunction was pencil or nail biting, present in 25.1% of participants. Class II malocclusion increased the likelihood by 2.6 times, pencil or nail biting by 2.34 times, and clenching/grinding teeth by 8.9 times that the subject would exhibit at least one TMD symptom. Conclusions: Every child with mixed dentition should undergo a brief examination of the TMJ, especially in cases of Class II malocclusion, pencil or nail biting, and teeth clenching or grinding, as these have all been identified as significant risk factors that increase the likelihood of experiencing TMD symptoms. This highlights the need for proactive screening and assessment by healthcare providers to reduce the risk and prevalence of TMDs in affected children and ensure timely diagnosis and treatment. Full article

(This article belongs to the Special Issue Feature Papers to Celebrate the First Impact Factor of Dentistry Journal)

11 pages, 1223 KiB

Open AccessArticle

Prevalence and Classification of C-Shaped Canal and Radix in Mandibular Molars Using Cone-Beam Computed Tomography on Mexican Population

by Hugo Bojorquez Armenta, Angel Gustavo Romo Mireles, Javier Solis Martinez, Jesus Pescador Alvarez, Yarely Ramos Herrera, Omar Tremillo Maldonado, Oscar Almeda Ojeda, Jose Salas Pacheco, Gamaliel Ortiz Sarabia, Francisco Xavier Castellanos-Juarez and Sergio Salas Pacheco

Dent. J. 2024, 12(7), 212; https://doi.org/10.3390/dj12070212 - 10 Jul 2024

Abstract

The diverse morphological configurations in teeth present clinical challenges in root canal treatment, complicating instrumentation and irrigation processes, which can lead to treatment failure. Understanding anatomical variations, such as C-shaped canals and radix entomolaris, enhances clinical skills and improves long-term endodontic treatment success [...] Read more.

The diverse morphological configurations in teeth present clinical challenges in root canal treatment, complicating instrumentation and irrigation processes, which can lead to treatment failure. Understanding anatomical variations, such as C-shaped canals and radix entomolaris, enhances clinical skills and improves long-term endodontic treatment success rates. Cone-beam computed tomography (CBCT) offers superior diagnostic capabilities over conventional radiography, enabling the pre-operative detection of root configurations and canal numbers, facilitating personalized endodontic treatments. A total of 2173 teeth of a Mexican population, including 1057 first mandibular molars and 1116 s mandibular molars, were studied using only CBCT to identify C-shaped canals and radix configurations of patients who were treated from 2018 to 2023 at the Department of Radiology at the Faculty of Dentistry, Juarez University of the State of Durango, Mexico. C-shaped canals were identified in 160 teeth, with a prevalence of 0.2% in first mandibular molars and 14.1% in second mandibular molars. The highest frequency was in the left second mandibular molar (3.7) at 14.8%. Gender differences were significant, with higher prevalence in females (27.3%) compared to males (13.3%). The most common C-shaped canal configuration was type C2 (39.3%). Radix entomolaris was found in 52 teeth, with a prevalence of 3.4% in first mandibular molars and 1.4% in second mandibular molars. This research on a Mexican population using cone-beam computed tomography (CBCT) highlights significant findings in the prevalence and types of C-shaped canals and radix entomolaris in mandibular molars for this population. The left second mandibular molar (3.7) showed the highest prevalence at 14.8%, followed closely by the right second mandibular molar (4.7) at 13.5%, with a significant difference (p < 0.001). We found a significant difference in the prevalence of C-shaped canals between genders (p = 0.004, OR 1.78). Additionally, radix entomolaris (p < 0.001) was more frequently identified in first mandibular molars to a significant degree. These insights underscore the importance of CBCT in diagnosing complex root anatomies, which can greatly enhance the success rates of endodontic procedures by allowing for more tailored and precise treatments for this population. Full article

(This article belongs to the Special Issue Endodontics: From Technique to Regeneration)

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15 pages, 1319 KiB

Open AccessArticle

Investigation of Oral Health in Children from Urban Slums of Nairobi, Kenya

by Gianni Di Giorgio, Simona De Pasquale, Enrico Battaglia, Giulia Zumbo, Cristina Mollica, Rita D’Ecclesia, Antonella Polimeni and Maurizio Bossù

Dent. J. 2024, 12(7), 211; https://doi.org/10.3390/dj12070211 - 10 Jul 2024

Abstract

For children living in the urban slums of Nairobi (Kenya), primary health conditions are not guaranteed, and oral diseases add further concern at social and institutional levels beyond the general poverty conditions. This study aims at determining the factors that influence the oral [...] Read more.

For children living in the urban slums of Nairobi (Kenya), primary health conditions are not guaranteed, and oral diseases add further concern at social and institutional levels beyond the general poverty conditions. This study aims at determining the factors that influence the oral health status of children living in Nairobi slums. A cross-sectional study on school-aged subjects was conducted in June 2022 in three urban slum areas of Nairobi through a pediatric dental screening. The PI (Plaque Index), CPITN (Community Periodontal Index of Treatment Needs), and dmft (decayed, missing, and filled teeth index—deciduous) were considered as primary outcomes of dental health. Multivariate statistical analysis, based on ordinal and zero-inflated negative binomial regression models, was conducted to identify determinants of the oral outcomes in a wide set of potential predictors. A sample of 359 children aged 2–17 was examined. The PI was significantly associated with age, the type of bite, and the use of a toothbrush. The CPITN is influenced by different types of malocclusions, abnormal frenulum, dental trauma, and fluorosis. Dietary habits were found to significantly impact the susceptibility to dental caries. Fluorosis and a dental visit in the last year were highlighted as risk and protective factors, respectively, against higher rates of caries. The oral health features of children living in Nairobi slums are differently affected by socio-demographic conditions, dietary habits, dental characteristics, and oral care practices. Full article

(This article belongs to the Special Issue Preventive Dentistry and Dental Public Health)

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9 pages, 214 KiB

Open AccessArticle

Demographic and Radiographic Characteristics Associated with the Occurrence of Impacted Third Molars in Indonesian Patients: A Retrospective Study

by Indra Hadikrishna, Melita Sylvyana, Madhuri Pattamatta, Folli Mulyawati and Tantry Maulina

Dent. J. 2024, 12(7), 210; https://doi.org/10.3390/dj12070210 (registering DOI) - 9 Jul 2024

Abstract

An impacted third molar is one of the most common abnormalities of the tooth position, impacting patients and their quality of life. Based on the impact and the invasive removal procedure, this study aimed to evaluate the characteristics of impacted third molars based [...] Read more.

An impacted third molar is one of the most common abnormalities of the tooth position, impacting patients and their quality of life. Based on the impact and the invasive removal procedure, this study aimed to evaluate the characteristics of impacted third molars based on their radiographic features as well as their association with demographic characteristics. Outpatient dental records of the oral and maxillofacial surgery department of Hasan Sadikin Hospital, Bandung, Indonesia, from 1 January 2018 to 31 December 2019, were sorted, and relevant clinical and demographic data and panoramic radiographic examination results were extracted from these records. All data were then tabulated and analyzed by using SPSS version 29. As many as 3019 impacted third molars were identified. Our findings suggested the association between age to the occurrence of impacted third molars where patients aged between 17 and 29 years old showed high occurrences of impacted third molars. Male patients with impacted third molars are more likely to have multiple impacted third molars, while this risk decreases in females. Radiographic examination showed that the mesioangular position is the most common position for mandibular third molars. The variation in high occurrences of the impacted third molar is associated with several demographic factors. Full article

(This article belongs to the Topic Diagnosis and Treatment of Dental Diseases and Tempromandibular Joints)

18 pages, 1666 KiB

Open AccessArticle

Evaluation of Biomarkers of Bone Metabolism on Salivary Matrix in the Remodeling of Periodontal Tissue during Orthodontic Treatment

by Angela Pia Cazzolla, Vincenzo Brescia, Roberto Lovero, Antonietta Fontana, Arcangela Giustino, Mario Dioguardi, Maria Severa Di Comite, Francesca Di Serio, Domenico Ciavarella and Vito Crincoli

Dent. J. 2024, 12(7), 209; https://doi.org/10.3390/dj12070209 - 9 Jul 2024

Abstract

The aim of this study was to evaluate changes in the concentration of N-terminal type I collagen extension pro-peptide (PINP), tartrate-resistant acid phosphatase (TRAcP), and parathyroid hormone-related protein (PTHrP) in saliva during orthodontic treatment in order to evaluate whether changes in bone turnover [...] Read more.

The aim of this study was to evaluate changes in the concentration of N-terminal type I collagen extension pro-peptide (PINP), tartrate-resistant acid phosphatase (TRAcP), and parathyroid hormone-related protein (PTHrP) in saliva during orthodontic treatment in order to evaluate whether changes in bone turnover marker (BTM) concentration can help highlight the effects of orthodontic mechanical loading in the absence of clinical evidence of tooth movement in terms of tooth movement. Saliva samples from 25 apparently healthy young subjects (10 females and 15 males) were collected using Salivette^® (Sarstedt) with cotton swabs and the concentrations of PTHrP, TRAcP 5b, and PINP were analyzed at time 0 (T1), 25 days (T2), and at 45 days (T3). Differences in the median value of biomarker levels between baseline T1 and follow-up of the different groups (T2 and T3) were assessed using the non-parametric Mann–Whitney U test. Trough concentrations of P1NP, PTHrP, and TRAcP were 0.80 µg/L, 0.21 ng/mL, and 0.90 U/L above the method LOD. The non-parametric Mann–Whitney U test confirmed a statistically significant difference in T1 versus concentrations of T2 and T3. All subjects evaluated had a statistically significant difference between T1 vs. T3. when compared with the specific critical difference (RCV) for the analyte The results obtained demonstrate that the evaluation of BTM changes in saliva can help the evaluation of orthodontic procedures and the monitoring of biomechanical therapy. Full article

(This article belongs to the Special Issue Tradition and Innovation in Orthodontics)

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14 pages, 2946 KiB

Open AccessArticle

Gingival Enlargement Associated with Orthodontics Appliance Increases Protein Carbonylation and Alters Phosphorylation of Salivary Proteome

by Zulieth Lopez Arrieta, Erika Rodríguez-Cavallo and Darío Méndez-Cuadro

Dent. J. 2024, 12(7), 208; https://doi.org/10.3390/dj12070208 - 8 Jul 2024

Abstract

Gingival enlargement is a common clinical sign in the gingival diseases associated with orthodontic treatment. Its biological mechanisms are not completely understood; nevertheless, the biochemical changes associated with these inflammatory and overgrowth processes could alter the post-translational protein modifications occurring in various locations [...] Read more.

Gingival enlargement is a common clinical sign in the gingival diseases associated with orthodontic treatment. Its biological mechanisms are not completely understood; nevertheless, the biochemical changes associated with these inflammatory and overgrowth processes could alter the post-translational protein modifications occurring in various locations within the mouth. Here, changes in the profiles of the carbonylated and phosphorylated proteins in saliva were examined in donors with gingival enlargement (seven men and seven women) and healthy donors (six men and eight women). The sociodemographic characteristics of both groups did not present significant differences. Carbonylation was measured by a quantitative immunoassay (Dot Blot), whereas the profiles of the phosphorylated proteins were visualized by SDS-PAGE with quercetin staining. Some phosphopeptides were also identified using a typical LC-MS-MS approach. Our results showed that gingival enlargement induced a significant increase in oxidative damage in salivary proteins. While a significant reduction in phosphorylation was observed at the stain level in SDS-PAGE, there was a slight increase in the number of phosphorylated proteins identified by MS in samples with gingival enlargement. Full article

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11 pages, 235 KiB

Open AccessArticle

Clinical Management of Facemasks for Early Treatment of Class III Malocclusion: A Survey among SIDO Members

by Lorenzo Franchi, Michele Nieri, Patrizia Marti, Annamaria Recupero, Alessandra Volpe, Alessandro Vichi and Cecilia Goracci

Dent. J. 2024, 12(7), 207; https://doi.org/10.3390/dj12070207 - 5 Jul 2024

Abstract

To evaluate whether there are differences among orthodontists in the clinical management of facemask treatment for early treatment of Class III malocclusion, a survey consisting of 16 questions was conducted among members of the Italian Society of Orthodontics (SIDO). Sixty percent of the [...] Read more.

To evaluate whether there are differences among orthodontists in the clinical management of facemask treatment for early treatment of Class III malocclusion, a survey consisting of 16 questions was conducted among members of the Italian Society of Orthodontics (SIDO). Sixty percent of the respondents were Specialists in Orthodontics (S) whereas 40% were General Dentists practicing Orthodontics (GD). Descriptive statistics were calculated to summarize the collected data. Differences in answers between S and GD were assessed with the Fisher’s exact test for dichotomous variables, chi-square test for qualitative variables, and Mann–Whitney test for ordinal variables. A total of 151 clinicians participated in this survey. As for treatment timing, about 80% of the participants reported treating Class III patients with RPE and facemask between 5 and 8 years of age. Most of the participants requested the patients to wear the facemask in the afternoon and at night for a period of 9 or 12 months with recommended forces of 500 g per side. Comparisons between S and GD showed that S preferred the Petit facemask whereas GD favored the Delaire’s type facemask (Fisher’s Exact test, p = 0.0005). S and GD also differed significantly in their judgment of the most critical time of treatment, which for the majority of GD was the initial period but for the S was the final period (Chi-square test p = 0.0188). This survey showed that the facemask is not well received by the patients who, along with their parents, express concerns regarding its tolerability. Full article

(This article belongs to the Special Issue Current Research Topics in Orthodontics)

12 pages, 1048 KiB

Open AccessArticle

Adhesive Performance of Pit and Fissure Sealants on Deproteinized Enamel with Different Proteolytic Agents: In Vitro Study

by Luis Francisco García-Mota, Miguel-Ángel Fernández-Barrera, Rene Garcia-Contreras, Guillermo Grazioli, Juan Eliezer Zamarripa-Calderón, José Alejandro Rivera-Gonzaga and Carlos Enrique Cuevas-Suárez

Dent. J. 2024, 12(7), 206; https://doi.org/10.3390/dj12070206 - 4 Jul 2024

Abstract

The objective of this work was to assess the efficacy of different proteolytic agents on the bond strength of pit and fissure sealants to bovine enamel. Eighty-four bovine enamel specimens were randomly assigned in groups according to the pit and fissure sealant applied [...] Read more.

The objective of this work was to assess the efficacy of different proteolytic agents on the bond strength of pit and fissure sealants to bovine enamel. Eighty-four bovine enamel specimens were randomly assigned in groups according to the pit and fissure sealant applied (HelioSeal F or Dyad Flow). Then, the specimens were subdivided according to the proteolytic agent used (n = 7): Group 1, distilled water (control); Group 2, 10 wt.% Tergazyme^®; Group 3, 10 wt.% ZYME^®; Group 4, 10% papain gel; Group 5, 10% bromelain gel; and Group 6, 5.25 wt.% sodium hypochlorite. The cell viability of the proteolytic solutions was assessed through the MTT assay. The proteolytic agents were applied on the enamel surface prior to the acid-etching procedure; then, the pit and fissure sealants were placed. The micro-shear bond strength was evaluated after 24 h or 6 months of water storing at 37 °C. Representative SEM images were taken for each experimental group. The bond strength data were statistically analyzed by a three-way ANOVA test using a significance level of α = 0.05. Bromelain and papain proteolytic solutions did not exert any cytotoxic effect on the human dental pulp cells. After 24 h and 6 months of aging, for both pit and fissure sealants, sodium hypochlorite, papain, bromelain, and Tergazyme^® achieved statistically significant higher bond strength values (p < 0.05). Irrespective of the deproteinizing agent used, Dyad Flow resulted in a better bond strength after 6 months of aging. The type 1 etching pattern was identified for sodium hypochlorite, papain, and bromelain. Tergazyme^®, papain, and bromelain demonstrated efficacy in deproteinizing enamel surfaces prior to acid etching, leading to the improved bond strength of pit and fissure sealants. Clinically, this suggests that these proteolytic agents can be considered viable alternatives to traditional methods for enhancing sealant retention and longevity. Utilizing these agents in dental practice could potentially reduce sealant failures. Full article

(This article belongs to the Special Issue Prevention of Dental Caries and Erosive Tooth Wear)

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11 pages, 698 KiB

Open AccessArticle

Rehabilitation Using Implants with Sloped Platform Edge vs. Standard Platform with Guided Bone Regeneration: A Randomized Control Clinical Trial

by Igor Ashurko, Andrey Samsonov, Anna Galyas, Marina Petukhova, Svetlana Tarasenko and Alexey Unkovskiy

Dent. J. 2024, 12(7), 205; https://doi.org/10.3390/dj12070205 - 4 Jul 2024

Abstract

The purpose of this study was to evaluate the vertical bone loss after using different techniques: sloped implants or standard implants with guided bone regeneration. Patients with tooth gap and horizontal bone deficiency were randomly allocated to the test group (implants with sloped [...] Read more.

The purpose of this study was to evaluate the vertical bone loss after using different techniques: sloped implants or standard implants with guided bone regeneration. Patients with tooth gap and horizontal bone deficiency were randomly allocated to the test group (implants with sloped platform—SLP) and control group (standard design implants with guided bone regeneration—GBR). The primary outcome was bone loss (6 months after finishing the prosthetic treatment). Secondary outcomes included the following: patient-reported outcome measures (PROMs), post-operative edema, keratinized mucosa width, and pink aesthetic score (PES). The average bone loss at 6 months was 0.23 ± 0.15 mm and 1.03 ± 0.37 mm in the SLP and GBR groups, respectively. The SLP group was characterized by lower pain intensity the first 7 days (p < 0.001), lower post-operative edema (p < 0.001), lower consumption of NSAIDs on days 1, 3, 5, and 7 (p = 0.002, <0.001, <0.001, and 0.008), and lower total OHIP-14 (p = 0.047) on day 7. The keratinized mucosa width was 3.7 (3.4–4.0) mm and 2 (1.4–2.0) mm in the SLP and GBR groups, respectively. The preservation of the mesial, distal papillae, and the level of soft tissue correspondence were significantly higher in the SLP group (p = 0.003, 0.038, <0.001). In the SLP group, more natural color and better texture of soft tissues were found (p = 0.048, p = 0.041). The use of implants with a sloped platform resulted in superior outcomes compared to the standard-design implants with GBR. Full article

(This article belongs to the Section Dental Implantology)

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Graphical abstract

15 pages, 2163 KiB

Open AccessFeature PaperArticle

Computerized Axiographic Findings in a Cohort of Migraine Patients: A Cross-Sectional Study

by Nikolaos Zokaris, Marcus Greven, Michail Tzakis and Vasileios Psarras

Dent. J. 2024, 12(7), 204; https://doi.org/10.3390/dj12070204 - 30 Jun 2024

Abstract

Background: The objective of this work was to investigate the association between the function of the stomatognathic system and migraine presence through an instrumental functional analysis in a group of diagnosed migraine patients and a control group. Methods: This study included 50 individuals [...] Read more.

Background: The objective of this work was to investigate the association between the function of the stomatognathic system and migraine presence through an instrumental functional analysis in a group of diagnosed migraine patients and a control group. Methods: This study included 50 individuals in each group. A jaw-tracking analysis was performed using Cadiax 4. Tracings of the following movements were recorded: open/close, protrusion/retrusion, mediotrusion, speech, bruxing, and mastication. The tracings were evaluated for their quantity, quality, transversal characteristics, speed, curvature pattern, and condylar stability. Results: Statistically significant differences between the groups were established for several aspects of the evaluation. Migraineurs presented with (a) higher values of mandibular lateral translation in protrusion/retrusion (p = 0.001), open/close (p = 0.031), and mastication (p = 0.016); (b) transient velocity losses in open/close (p = 0.001) and protrusive movements (p = 0.018); (c) a compromised condylar stability for protrusion/retrusion (p = 0.001) and mediotrusion (p = 0.003); (d) a compromised quality for protrusion/retrusion (p < 0.001) and mediotrusion (p = 0.003); and (e) a more frequent “figure-eight” curvature in open/close (p = 0.012). Conclusions: The importance of the stomatognathic function in migraine pathogenesis and treatment should be considered by using a patient-centered and interdisciplinary approach. Full article

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Graphical abstract

9 pages, 15648 KiB

Open AccessCase Report

Gingivectomy–Gingivoplasty for Oral Physiological Melanosis Depigmentation: A Case Report Involving Human Papillomavirus

by Leslie Villa-Martínez, Blanca Itzel Mendoza-Espinosa, Luis Fernando Jacinto-Alemán, Adriana Molotla-Fragoso, Claudia Patricia Mejía-Velázquez, Alejandro Alonso-Moctezuma, Carla Monserrat Ramírez-Martínez, David Alonso Trejo-Remigio and Elsa Mónica Toriz-Pichardo

Dent. J. 2024, 12(7), 203; https://doi.org/10.3390/dj12070203 - 30 Jun 2024

Abstract

Gingiva hyperpigmentation resulting from physiological melanosis causes aesthetic discomfort and is usually perceived as a disease by patients because healthy attached gingiva is typically characterized by coral pink coloring with stippling and scalloped contours. When physiological melanosis compromises the aesthetics of smiling, it [...] Read more.

Gingiva hyperpigmentation resulting from physiological melanosis causes aesthetic discomfort and is usually perceived as a disease by patients because healthy attached gingiva is typically characterized by coral pink coloring with stippling and scalloped contours. When physiological melanosis compromises the aesthetics of smiling, it may induce insecurity in patients, who usually seek out alternatives for reducing or eliminating hyperpigmentation. We present a case report of a surgical procedure combining gingivectomy with gingivoplasty for the management of physiological melanosis. The surgical procedure was performed on a 40-year-old female patient with bilateral pigmentation in both arches. The results of the histological analysis confirm the diagnoses of melanotic macula, with papillary hyperplasia and cytopathic changes being suggestive of HPV infection, which was verified using an immunohistochemistry analysis based on the detection of a major capsid protein of HPV. Acceptable functional and aesthetic results were obtained for the patient without major discomfort during the postoperative period. In cases when HPV infection is present, long-term follow-up becomes necessary. Full article

(This article belongs to the Special Issue Advances in Periodontal and Peri-Implant Tissues Health Management)

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15 pages, 2316 KiB

Open AccessArticle

A Novel Device for the Evaluation of In Vitro Bacterial Colonization in Membranes for Guided Tissue and Bone Regeneration

by Ana Clara Kuerten Gil, Eugenio A. D. Merino, Diogo Pontes Costa, César Nunes Giracca, Ricardo Mazzon, Gabriel Leonardo Magrin, Josiane de Almeida and Cesar Augusto Magalhães Benfatti

Dent. J. 2024, 12(7), 202; https://doi.org/10.3390/dj12070202 - 29 Jun 2024

Abstract

Purpose: To evaluate, in vitro, the efficiency of a novel apparatus to test the adherence and penetration of bacteria on different membranes for guided regeneration. Methodology: To create the 3D device, Computer Aided Design/Computer Aided Manufacturing (CAD/CAM) systems were used. Three types of [...] Read more.

Purpose: To evaluate, in vitro, the efficiency of a novel apparatus to test the adherence and penetration of bacteria on different membranes for guided regeneration. Methodology: To create the 3D device, Computer Aided Design/Computer Aided Manufacturing (CAD/CAM) systems were used. Three types of biomaterials were tested (n = 6): (DT) a collagen membrane; (DS) a polymer membrane; and (LP) a dense polytetrafluoroethylene barrier. The biomaterials were adapted to the apparatuses and challenged with two different monospecies bacterial culture of A. actinomycetemcomitans b and S. mutans. After 2 h, bacterial adherence and penetration were quantified by counting the number of colony-forming units (CFUs). Two specimens from each group were used for image analysis using Confocal Laser Scanning Microscopy. Statistical analysis was performed. Findings: The DS group had a higher adherence of S. mutans compared to A. actinomycetemcomitans b (p = 0.05). There was less adherence of A. actinomycetemcomitans b in the DS group, compared to the LP (p = 0.011) and DT (p < 0.001) groups. Only the membranes allowed penetration, which was blocked by barriers. The DT group allowed a greater penetration of S. mutans to occur compared to A. actinomycetemcomitans b (p = 0.009), which showed a higher penetration into the DS membranes compared to S. mutans (p = 0.016). The penetration of A. actinomycetemcomitans b through DS was higher compared to its penetration through DT and LP (p < 0.01 for both). DT and DS allowed a greater penetration of S. mutans to occur compared to LP, which prevented both bacterial species from penetrating. Conclusion: The apparatus allowed for the settlement and complete sealing of the biomaterials, enabling standardization. Full article

(This article belongs to the Special Issue Rising Stars: Oral Infections and Microbes)

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11 pages, 2048 KiB

Open AccessArticle

Root Canal Dentin Microhardness after Contact with Antibiotic Medications: An In Vitro Study

by Amanda Palmeira Arruda Nogueira, Renata Grazziotin-Soares, Adriana Marques Mesquita Leal, Sérgio Alves Guida Freitas Júnior, Bruna Laís Lins Gonçalves, José Bauer, Meire Coelho Ferreira and Ceci Nunes Carvalho

Dent. J. 2024, 12(7), 201; https://doi.org/10.3390/dj12070201 - 29 Jun 2024

Abstract

Background: Antibiotic pastes used as intracanal medication in cases of revascularization therapy might cause negative effects on tooth properties, such as a reduction in dentin microhardness. This in vitro study investigated dentin microhardness in three different locations distancing from the canal lumen after [...] Read more.

Background: Antibiotic pastes used as intracanal medication in cases of revascularization therapy might cause negative effects on tooth properties, such as a reduction in dentin microhardness. This in vitro study investigated dentin microhardness in three different locations distancing from the canal lumen after 20 days of treatment with a tri-antibiotic paste (ciprofloxacin, metronidazole, and minocycline), and with a double-antibiotic paste (ciprofloxacin and metronidazole), with calcium hydroxide [Ca(OH)₂] Ultracal^TM XS-treated dentin as comparison. Material and Methods: Human mandibular premolars (n = 48) had the root canals cleaned and shaped and were used to produce dentin slices. Dentin slices remained immersed in the medications for 20 days. The Knoop microhardness (KHN) test was performed before (baseline/Day-0) and after treatment (Day-20) with the medications. Indentations were made at 25 µm, 50 µm, and 100 µm distances from the root canal lumen. The KHN was compared intra-group using Wilcoxon’s test. Independent groups were compared using Mann–Whitney’s and Kruskal–Wallis’ tests, at α = 5%. Results: The microhardness in all the tested groups was reduced at Day-20 in comparison with Day-0 (p < 0.001) (intra-group comparison/same distances). The Day-0 values were similar, and the Day-20 values were higher for the Ca(OH)₂ group (p < 0.05) (comparison between groups/same distances). Conclusions: Calcium hydroxide for 20 days would be preferred rather than antibiotic pastes to minimize the expected reduction in dentin microhardness during regenerative procedures. Full article

(This article belongs to the Topic Oral Health Management for Children, Adolescents, and Adults, 2nd Volume)

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18 pages, 707 KiB

Open AccessSystematic Review

Clinical Factors on Dental Implant Fractures: A Systematic Review

by Mattia Manfredini, Pier Paolo Poli, Luca Giboli, Mario Beretta, Carlo Maiorana and Matteo Pellegrini

Dent. J. 2024, 12(7), 200; https://doi.org/10.3390/dj12070200 - 28 Jun 2024

Abstract

Dental implant fractures pose a significant challenge to long-term treatment success. This systematic review aims to comprehensively examine the clinical factors influencing dental implant fractures (IFs). Furthermore, strategies to choose the right type of implant and prevent this complication are addressed. A systematic [...] Read more.

Dental implant fractures pose a significant challenge to long-term treatment success. This systematic review aims to comprehensively examine the clinical factors influencing dental implant fractures (IFs). Furthermore, strategies to choose the right type of implant and prevent this complication are addressed. A systematic search was conducted across PubMed, Scopus, and Web of Science databases. Eligible studies included retrospective case–control, prospective cohort studies, and clinical trials. The initial search yielded 361 articles, of which 312 were excluded being these reviews, case reports, irrelevant, or written in languages other than English. This left 49 articles, with only 6 meeting the eligibility criteria for an in-depth review. These studies, all retrospective case–control, examine implant characteristics, patient demographics, surgical and prosthetic variables, biomechanical and functional factors, clinical and procedural variables, complications and maintenance issues. The risk of bias was assessed as low using the ROBINS-I tool. Key findings suggest a correlation between implant diameter and structural resistance, with wider implants demonstrating reduced fracture risk. Additionally, posterior regions, especially molars and premolars, exhibit higher susceptibility to IFs due to increased masticatory forces. Implant design and material may considerably influence fracture risk, with conical implants and screw-retained prostheses showing higher vulnerability. Biomechanical overload, particularly in patients with bruxism, emerges as a primary contributing factor to IFs. Prosthesis type significantly influences fracture incidence, with cantilever prostheses posing a higher risk due to increased stress. Peri-implant bone loss is strongly associated with IFs, emphasizing the need for meticulous preoperative assessments and individualized management strategies. Future research should prioritize larger and heterogeneous populations with long-term follow-up and standardized methodologies to enhance the generalizability and comparability of findings. Randomized controlled trials and biomechanical studies under controlled conditions are also essential to elucidate the complex interactions contributing to IFs and developing effective prevention strategies. Additionally, integrating patient-reported outcomes may offer a comprehensive understanding of the impact of IFs on quality of life. Full article

(This article belongs to the Special Issue Risk Factors in Implantology)

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10 pages, 2875 KiB

Open AccessArticle

Implementation of Patient-Individualized 3D-Printed Models in Undergraduate Students’ Education for Various Prosthetic Treatments: A Cross-Sectional Survey Study

by Andrea Klink, Fabian Engelskirchen, Pablo Kaucher-Fernandez, Fabian Huettig and Ariadne Roehler

Dent. J. 2024, 12(7), 199; https://doi.org/10.3390/dj12070199 - 27 Jun 2024

Abstract

Background: Due to rapid changes in dental practice, digital technologies have become prominent in undergraduate dental education at German universities in recent years. This shift has prompted a re-evaluation of content as well as teaching methods, particularly in courses where students are prepared [...] Read more.

Background: Due to rapid changes in dental practice, digital technologies have become prominent in undergraduate dental education at German universities in recent years. This shift has prompted a re-evaluation of content as well as teaching methods, particularly in courses where students are prepared for patient treatment. Traditional training on standardized models with resin teeth cannot cover the complexity of individual dental arch configuration encountered in patient situations. This study explores the use of 3D printing technology to create individualized models for prosthetic treatment simulations, aiming to evaluate students’ feedback towards their experience with this training setting. Methods: First, the study describes the design and fabrication of individualized models with exchangeable teeth based on intraoral scans, mounted on connected plates with distance holders that can be fixed to standard phantom heads. Second, students provided feedback through a questionnaire, assessing various aspects such as the effectiveness of the 3D-printed models compared to traditional frasaco models for preparation exercises. Results: The results indicated that the design of the realized models was feasible for preparation training (question no. 4: 93% positive rating) and showed positive perceptions of the 3D-printed models, with students finding them effective for preparation exercises and beneficial in bridging the gap between simulation and real patient situations (question no. 6: 69% positive rating). Conclusions: The study suggests that 3D printing technology offers a valuable tool in dental education, providing realistic and patient-specific scenarios for students to enhance their skills and readiness for clinical practice. Further improvements in material properties in hand with cost-effective approaches are essential for widespread implementation. Full article

(This article belongs to the Special Issue Feature Papers in Digital Dentistry)

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12 pages, 1462 KiB

Open AccessFeature PaperArticle

Effect of Different Graft Material Consistencies in the Treatment of Minimal Bone Dehiscence: A Retrospective Pilot Study

by Maria Menini, Luigi Canullo, Roberta Iacono, Alessio Triestino, Vito Carlo Alberto Caponio, Paolo Savadori, Paolo Pesce, Andrea Pedetta and Fabrizio Guerra

Dent. J. 2024, 12(7), 198; https://doi.org/10.3390/dj12070198 - 27 Jun 2024

Abstract

Among different therapeutic strategies proposed in the case of bone volume deficit, guided bone regeneration (GBR) is a consolidated surgical procedure. The objective of this study is to retrospectively evaluate the behavior of two bone grafts with different consistencies in the GBR procedure [...] Read more.

Among different therapeutic strategies proposed in the case of bone volume deficit, guided bone regeneration (GBR) is a consolidated surgical procedure. The objective of this study is to retrospectively evaluate the behavior of two bone grafts with different consistencies in the GBR procedure by measuring the volumetric tissue changes 1 year after surgery. For this retrospective analysis, 25 cases of GBR with simultaneous implant insertion were selected. A total of 13 were grafted with a porcine cortico-cancellous bone mix (CCBM group), and 12 were grafted with a pre-hydrated granulated cortico-cancellous bone mix of porcine origin blended with 20% TSV gel (Collagenated-CCBM). A collagen membrane was fixed to cover the bone defect. A total of 42 implants were placed with computer-guided surgery. Preoperative and 12-month postoperative digital impressions were used to evaluate dimensional changes. Student’s t-test used for independent samples showed no statistically significant differences between the integrated distance (p = 0.995) and mean distance (p = 0.734). The mean integrated distance in the CCBM group was 41.80 (SD. 101.18) compared to a mean of 42.04 (SD. 66.71) in the Collagenated-CCBM group. Given the limitations of this study, in patients with peri-implant bone dehiscence, simple heterologous and collagenated heterologous cortico-cancellous bone grafts are suitable for filling the bone defect to promote bone regeneration, although further studies are needed. Full article

(This article belongs to the Special Issue Oral Implantology and Bone Regeneration)

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11 pages, 1745 KiB

Open AccessArticle

Safety and Effectiveness of a Novel Color Corrector Serum for Causing Temporary Changes to Tooth Shade: A Randomized Controlled Clinical Study

by Mauro Pascolutti, Alex Tomic, Kimberly R. Milleman, Jeffery L. Milleman and Laurence J. Walsh

Dent. J. 2024, 12(7), 197; https://doi.org/10.3390/dj12070197 - 27 Jun 2024

Abstract

Tooth color is a major driver of facial esthetics. While permanent changes in tooth shade can be achieved by bleaching and restorations, there is a need for cosmetic products that can cause reversible color changes. This randomized controlled clinical study assessed the effectiveness [...] Read more.

Tooth color is a major driver of facial esthetics. While permanent changes in tooth shade can be achieved by bleaching and restorations, there is a need for cosmetic products that can cause reversible color changes. This randomized controlled clinical study assessed the effectiveness and safety of a novel color-correcting product (Hismile™ V34 Color Corrector Serum™) versus a placebo (vehicle control lacking the color-change dyes). A single-center, randomized, controlled, examiner-blind, two-group, parallel design, single-use study design was followed. The test products were applied on a cotton bud for 30 s, and then, rinsed off. Tooth shade for maxillary central incisors was measured at baseline, immediately, and at 30 and 60 min, using the Vita Bleachedguide 3D-Master^® Shade Guide and the EasyShade Advanced 4.0 spectrophotometer (for determining values of L*a*b*). The subjects (N = 60) had a baseline shade of 1M2 (rank 9) or darker. A single application of the test product resulted in an immediate and significant (p < 0.001) three shade improvement (26.2%) according to the shade guide, and the same significant benefits extended to 30 and 60 min. The placebo product did not alter tooth shade (p = 0.326). These changes were accompanied by significant improvements in the L value (whiteness) up to 30 min, and a reduction in b* (yellowness) for up to 60 min. Two-thirds of subjects using the test product stated in a survey that their teeth appeared both whiter and brighter. No safety issues arose from the use of the test product or vehicle control. These results indicate that using a color corrector can achieve worthwhile changes to tooth shade for up to 60 min. Full article

(This article belongs to the Topic Advances in Dental Health)

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14 pages, 592 KiB

Open AccessArticle

CBCT in Dental Implantology: A Key Tool for Preventing Peri-Implantitis and Enhancing Patient Outcomes

by Souheil Hussaini, Michael Glogauer, Zeeshan Sheikh and Haider Al-Waeli

Dent. J. 2024, 12(7), 196; https://doi.org/10.3390/dj12070196 - 26 Jun 2024

Abstract

(1) Introduction: Trust is a cornerstone of the patient–physician relationships. Unforeseen complications in the health care system could jeopardize patients’ trust in their physicians. (2) Aim: This article presents a quantitative figure regarding foreseeing the necessity of a three-dimensional quantitative visualization of bone [...] Read more.

(1) Introduction: Trust is a cornerstone of the patient–physician relationships. Unforeseen complications in the health care system could jeopardize patients’ trust in their physicians. (2) Aim: This article presents a quantitative figure regarding foreseeing the necessity of a three-dimensional quantitative visualization of bone structure and concurrently preparing for an ancillary procedure by a dentist to successfully perform the surgery that could minimize unforeseen complications; (3) Materials and method: This retrospective study has been derived based on an analysis of 1134 patients who had received 4800 dental implants from January 2001 to August 2020, out of which 200 cases were randomly selected for this study. Each procedure during implant treatment was categorized as OPG (Orthopantomography) or OPG with CBCT as per all the procedures which included and were coded as follows, 1: Surgery & Restoration, 2: GBR (Guided Bone Regeneration), 3: GTR (Guided Tissue Regeneration), 4: Block Bone Graft, 5: Spreading, 6: Splitting, 7: Internal Sinus, 8: External Sinus, 9: PRF (Platelet Rich Fibrin). Any of the 200 cases in which implant placement could not have been performed for reasons related to a lack of CBCT were selected for this study. The surgery was aborted halfway through without implant placement in these cases due to a lack of bone quantity and/or lack of primary stability. These cases were registered for re-evaluation and statistical analysis; (4) Results: 7% of the cases that used OPG alone led the surgeon to unexpectedly abort in the middle of the surgery without implant placement. All (100%) of the patients who had CBCT during treatment planning were able to receive implants during the surgery. None of the patients left the surgery without receiving implants if CBCT was used (0%); (5) Discussion: Radiographic image quality is defined as the amount of information within the image that allows the radiologist to make a diagnostic decision with a particular level of certainty (Martin et al., 1999) and hence the importance of CBCT. The unexpected 7% of devastating situations for patients who started surgery but did not have implant placement led to [A] aborting the surgery, [B] procedural difficulties requiring an alternative treatment plan, [C] a negative impact on the patient’s behavior, and [D] wanting to change doctor due to a lack of trust; (6) Conclusion: This study indicates that in implant dentistry patients’ mistrust could be avoided by 7% if CBCT is obtained. It also shows the significance of cone-beam computed tomography as an adjunct to panoramic radiography during the diagnosis and treatment planning phase. The use of panoramic radiography alone can lead to a 7% likelihood of misdiagnosis. A lack of CBCT during treatment planning negatively affects the outcome of surgical procedures. Full article

(This article belongs to the Special Issue Latest Advances in Peri-Implantitis)

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