Dentistry Journal

16 pages, 406 KiB

Open AccessReview

Updates on Caries Risk Assessment—A Literature Review

by Toby Cheuk-Hang Ng, Bella Weijia Luo, Walter Yu-Hang Lam, Aylin Baysan, Chun-Hung Chu and Ollie Yiru Yu

Dent. J. 2024, 12(10), 312; https://doi.org/10.3390/dj12100312 (registering DOI) - 29 Sep 2024

Abstract

This narrative review aims to provide an update on caries risk assessment (CRA) and the available CRA tools. CRA can be used to monitor the status of oral care, as well as for documentation and research purposes. Caries risk is determined by the [...] Read more.

This narrative review aims to provide an update on caries risk assessment (CRA) and the available CRA tools. CRA can be used to monitor the status of oral care, as well as for documentation and research purposes. Caries risk is determined by the interplay of risk and protective factors. Common risk factors include suboptimal oral hygiene practices, previous caries experience, low plaque acidity, frequent snacking, cariogenic diet, enamel defects, reduced salivary flow, polypharmacy, and radiotherapy experience. Caries risk can be reduced through some preventive measures, such as the use of fluoride, gum chewing, dental sealants. The CRA process can be categorized as single or multifactor tools. Single-factor CRA tools include diet analysis questionnaires, cariogenic bacteria testing and saliva testing kits, whereas multifactor CRA tools encompass Caries Management by Risk Assessment (CAMBRA), Cariogram, and PreViser. Some CRA tools may quantify risk and protective factors to compute caries risk. Additionally, they can generate visual and educational presentations that foster success in oral care. Clinicians consider CRA beneficial for developing personalized care plans. However, the literature fails to reflect this and reveals limited studies supporting its use as evidence-based practice for caries management. Full article

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

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15 pages, 974 KiB

Open AccessSystematic Review

The Effects of Smoking on Dental Implant Failure: A Current Literature Update

by Hanna L. Stiller, Josephine Ionfrida, Peer W. Kämmerer and Christian Walter

Dent. J. 2024, 12(10), 311; https://doi.org/10.3390/dj12100311 (registering DOI) - 29 Sep 2024

Abstract

Background: This systematic review assesses the current literature (2020–2024) evaluating the impact of smoking on dental implant failure rates. Methods: A non-funded Pubmed database review was conducted according to PRISMA guidelines, and the results were tabulated to extract the study design, patient characteristics, [...] Read more.

Background: This systematic review assesses the current literature (2020–2024) evaluating the impact of smoking on dental implant failure rates. Methods: A non-funded Pubmed database review was conducted according to PRISMA guidelines, and the results were tabulated to extract the study design, patient characteristics, follow-up time, comparison, outcome, and strengths and weaknesses, including risk of bias. This review included 33 studies with 29,519 implants placed in over 18,301 patients. We included prospective and retrospective clinical studies, randomized and non-randomized controlled trials, cohort studies, and observational studies that examined smoking’s effects on implant failure rates. Studies had to classify individuals into two groups, smokers and non-smokers, with at least ten implants. Exclusions included reviews, case reports, experimental studies, guidelines, non-English publications, studies lacking comparative data on failure rates, those excluding smokers, and studies focusing on head and neck cancer patients or specialized implants. Results: Our findings indicate a significant correlation in 25 out of 33 studies between smoking and increased implant failure rates, affecting both early and late stages of implant integration and survival as well as revealing a dose–response relationship, with higher daily cigarette consumption significantly increasing the risk of implant failure. Conclusions: This review highlights the importance of smoking cessation efforts, patient education, and tailored patient care in dental implantology. Future research should explore the effects of smoking frequency and alternative tobacco products, such as e-cigarettes, aiming to improve success rates among smokers. Full article

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

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11 pages, 1733 KiB

Open AccessArticle

Traumatic Dental Injuries: Prevalence, First Aid, and Mouthguard Use in a Sample of Italian Kickboxing Athletes

by Roberto Biagi, Cristina Mirelli, Rebecca Ventimiglia and Saverio Ceraulo

Dent. J. 2024, 12(10), 310; https://doi.org/10.3390/dj12100310 (registering DOI) - 29 Sep 2024

Abstract

Background: Traumatic dental injuries (TDIs) are a common complication in sports, with an overall prevalence ranging from 0.71% to 60%. Kickboxing is a high-risk combat sport for trauma to the facial region. Methods: A total of 142 5-to-65-year-old amateur athletes participated in the [...] Read more.

Background: Traumatic dental injuries (TDIs) are a common complication in sports, with an overall prevalence ranging from 0.71% to 60%. Kickboxing is a high-risk combat sport for trauma to the facial region. Methods: A total of 142 5-to-65-year-old amateur athletes participated in the survey with a questionnaire that was released during their regular practice days. The questionnaire was structured into three parts: (1) questions about age, gender, type, and time of sports practice; (2) questions about dental injuries, personal experience, and awareness of emergency management, particularly about tooth avulsion; (3) questions about wearing a mouthguard for TDI prevention. Results: A total of 13 percent of athletes suffered a TDI while training or fighting. Regarding first aid, 61% of the participants in this survey are aware of the possibility of replanting a tooth after its avulsion; 10% believe that the tooth should be replanted within 15 min, and 37% of athletes believe that it should be kept wet. The mouthguard is known to the majority of athletes (94%), and 66% were informed by the coach; 68% of the athletes use it. Seventy-four percent of the mouthguards were purchased in a sports shop. Conclusions: A relatively low prevalence of TDIs was observed in players in the sample. A lack of information about the emergency management of tooth avulsion and about the type of mouthguard to wear emphasizes the importance of educational training by dentists to athletes and coaches. Full article

(This article belongs to the Special Issue Feature Papers in Restorative Dentistry, Endodontology and Traumatology)

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16 pages, 3351 KiB

Open AccessArticle

The Accuracy of Custom-Made Milled Metal Posts as Compared to Conventional Cast Metal Posts

by Tabarak M. AL-Rubaye and Emad S. Elsubeihi

Dent. J. 2024, 12(10), 309; https://doi.org/10.3390/dj12100309 (registering DOI) - 28 Sep 2024

Abstract

Aim: The aim of this study was to compare the fitting accuracy of custom-made metal posts and cores fabricated by half-digital and milling technique to that of conventional cast posts fabricated by direct technique. Methods: Sixteen extracted single-rooted teeth were endodontically treated followed [...] Read more.

Aim: The aim of this study was to compare the fitting accuracy of custom-made metal posts and cores fabricated by half-digital and milling technique to that of conventional cast posts fabricated by direct technique. Methods: Sixteen extracted single-rooted teeth were endodontically treated followed by post space preparation. A direct resin post and core pattern was made for each tooth and used for the fabrication of two posts (n = 16). Each post resin pattern was digitized with a laboratory scanner and used for the fabrication of a milled cobalt–chrome (Co–Cr) alloy post, while the direct resin pattern, after scanning, was cast in a Co–Cr alloy to produce a cast post. Each post was seated on its respective tooth and evaluated using microcomputed tomography. The following variables were evaluated: total space volume between the post and root canal, the volume and distance of the apical gap between each post and the remaining apical root canal filling, as well as the distance and surface area of the space between the post and lateral root canal wall at four determined points along the length of each post. Results: The results revealed that half-digital and milled posts had a statistically significantly higher total space volume (p < 0.05), apical gap volume (p < 0.02) and distance (p < 0.02), as well as a higher surface area of space between the post and root canal wall at the cervical area as compared to the cast post (p < 0.05). Conclusions: This study demonstrated that the fitting accuracy of cast posts was more accurate than posts fabricated with half-digital and milling technique. Full article

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10 pages, 1440 KiB

Open AccessArticle

Photothermal Effect of 970 nm Diode Laser Irradiation on Enterococcus faecalis Biofilms in Single-Rooted Teeth Ex Vivo

by Soraya Tanner, Anna Thibault, Julian Grégoire Leprince and Serge Bouillaguet

Dent. J. 2024, 12(10), 308; https://doi.org/10.3390/dj12100308 - 27 Sep 2024

Abstract

Objective: The aim of this study was to evaluate the photothermal effect of a 970 nm diode laser on Enterococcus faecalis biofilms. Methods: 72 extracted human single-rooted teeth were prepared, sterilized, and inoculated with Enterococcus faecalis to establish a two-week-old biofilm. [...] Read more.

Objective: The aim of this study was to evaluate the photothermal effect of a 970 nm diode laser on Enterococcus faecalis biofilms. Methods: 72 extracted human single-rooted teeth were prepared, sterilized, and inoculated with Enterococcus faecalis to establish a two-week-old biofilm. The specimens were divided into six groups (n = 12): Group 1 (G1)—negative control (PBS—no laser), Group 2 (G2)—positive control (1% NaOCl rinse—no laser), Group 3 (G3)—a 970 nm laser in 1.5 W pulse mode, Group 4 (G4)—a 970 nm laser in 2 W pulse mode, Group 5 (G5)—a 970 nm laser in 1.5 W continuous mode, Group 6 (G6)—a 970 nm laser in 2 W continuous mode. Bacterial viability was evaluated using the LIVE/DEAD BacLight kit and analyzed by flow cytometry (FCM). Temperature changes on the root surface during irradiation were analyzed using a K-type thermocouple. Data were statistically analyzed using one-way ANOVA and Tukey’s multiple comparison test (α = 0.05). Results: Bacterial viability was significantly reduced after laser irradiation in continuous mode using 1.5 W (21% of live bacteria) and 2 W (14% of live bacteria). When the pulsed mode was applied, the reduction in bacterial viability was less, with a mean survival of 53% (1.5 PF, whereas 29% of bacteria survived after 2 W irradiation). Conclusions: The 970 nm diode laser at 2 W continuous mode effectively reduced the viability of E. faecalis biofilms in root canals without causing unacceptable temperature rises at the root surface. Full article

(This article belongs to the Special Issue Endodontics and Restorative Sciences: 2nd Edition)

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9 pages, 1516 KiB

Open AccessArticle

Synergistic Effect of Metronidazole and Chlorhexidine against Porphyromonas gingivalis Growth: An In Vitro Study

by Claudia Lorenzi, Fabrizio Lio, Vincenzo Mazzetti, Paolo Carosi, Stefano Lamelza, Enrico Salvatore Pistoia, Francesca Pica and Roberta Gaziano

Dent. J. 2024, 12(10), 307; https://doi.org/10.3390/dj12100307 - 27 Sep 2024

Abstract

Aim: To evaluate the potential synergistic activity of metronidazole (MTZ) and chlorhexidine (CHX) against Porphyromonas. gingivalis (P. gingivalis) growth. Methods: Antimicrobial susceptibility tests of P. gingivalis to MTZ and CHX were performed on in vitro serial 2-fold dilutions of MTZ (from 1 mg/mL to [...] Read more.

Aim: To evaluate the potential synergistic activity of metronidazole (MTZ) and chlorhexidine (CHX) against Porphyromonas. gingivalis (P. gingivalis) growth. Methods: Antimicrobial susceptibility tests of P. gingivalis to MTZ and CHX were performed on in vitro serial 2-fold dilutions of MTZ (from 1 mg/mL to 0.015 mg/mL) and CHX (from 1 mg/mL to 0.03 mg/mL) in thioglycollate medium broth in a 96-well plate. The turbidity of each sample was analyzed by absorbance spectrophotometry at 450 nm wavelengths by using an enzyme-linked immunosorbent assay (ELISA) reader. The MIC50 (minimum inhibitory concentration) and MBC (minimum bactericidal concentration) were assessed. To investigate the potential synergism between MTZ and CHX, bacterial cells were treated with MTZ or CHX, as described above, either alone or in combination. Results: The MIC₅₀ of MTZ was 0.03 mg/mL while that of CHX ranged from 0.12 to 0.06 mg/mL. MTZ and CHX exerted a significant inhibitory effect on P. gingivalis growth in a dose-dependent manner. MTZ at a low and ineffective concentration of 0.015 mg/mL, associated with a suboptimal concentration of CHX (0.03 mg/mL), exhibited a significant synergistic inhibitory effect on bacterial growth (50% inhibition vs. control) (p < 0.001), and the effect was more remarkable with 0.06 mg/mL CHX (75% inhibition vs. control). Conclusions: CHX and MTZ showed a significant synergistic effect against P. gingivalis growth. A non-effective concentration of MTZ (0.015 mg/mL) combined with suboptimal concentrations of CHX (0.03 mg/mL and 0.06 mg/mL) were related to a 50% growth in the inhibition and 99.99% death of P. gingivalis, respectively. The applicability of the clinical use of these concentrations should be tested in randomized controlled trials. Full article

(This article belongs to the Special Issue Editorial Board Members’ Collection Series: Inflammation Prophylaxis, Aesthetic and Functional Treatment in Periodontitis Patients - A Special Challenge?)

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13 pages, 553 KiB

Open AccessReview

Wind Instruments and Oral Health: Challenges Faced by Professional Wind Musicians

by Nils P. Czech and Kurt W. Alt

Dent. J. 2024, 12(10), 306; https://doi.org/10.3390/dj12100306 - 26 Sep 2024

Abstract

Background: Recent studies have shown an association between playing wind instruments and their impact on the orofacial system. However, they have not fully evaluated all aspects of the topic, leaving a gap in the overall understanding. Methods: A thorough search of the National [...] Read more.

Background: Recent studies have shown an association between playing wind instruments and their impact on the orofacial system. However, they have not fully evaluated all aspects of the topic, leaving a gap in the overall understanding. Methods: A thorough search of the National Library of Medicine database was conducted using our research strategy, resulting in the identification of relevant studies. An expert perspective was obtained by conducting two in-depth expert interviews with a professor of horn-playing and a specialised dentist. Results: Thirty-seven relevant publications were included in the traditional literature review. The most common diseases among professional wind instrumentalists include the lip area, temporomandibular joint, oral mucosa, respiratory system, oral allergic reactions, and orofacial trauma. Special measures, preventive measures, and expert opinions were utilised to address and overcome the associated orofacial problems. Conclusions: Wind instruments affect the oral health and tooth movement of professional instrumentalists, and dentists should consider the impact of dental changes on embouchure and performance. Dental impressions and three-dimensional intra-oral scans are important for reconstruction. This research highlights the need for specialised dental care for professional wind instrumentalists, and further studies are necessary to fully explore this topic. Full article

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12 pages, 2188 KiB

Open AccessArticle

Head and Neck Cancer in Pan-American Notable People: An International Survey

by Josefina Martínez-Ramírez, Cristina Saldivia-Siracusa, Maria Eduarda Pérez-de-Oliveira, Ana Gabriela Costa Normando, Luiz Paulo Kowalski, Maria Paula Curado, Lady Paola Aristizabal Arboleda, Ana Carolina Prado-Ribeiro, Leonor-Victoria González-Pérez, Gisele Aparecida Fernandes, Florence Juana Maria Cuadra-Zelaya, Pablo Agustin Vargas, Marcio Ajudarte Lopes, Marco A. O. Magalhaes, Vidya Sankar, Alessandro Villa and Alan Roger Santos-Silva

Dent. J. 2024, 12(10), 305; https://doi.org/10.3390/dj12100305 - 26 Sep 2024

Abstract

Background: The study of notable people as advocates for raising cancer awareness began in the latter decades of the 20th century. This research aimed to identify Pan-American notable people with head and neck cancer (HNC) and to explore senior health professionals’ perspectives on [...] Read more.

Background: The study of notable people as advocates for raising cancer awareness began in the latter decades of the 20th century. This research aimed to identify Pan-American notable people with head and neck cancer (HNC) and to explore senior health professionals’ perspectives on communicating stories of notable patients with HNC to promote prevention. Method: A cross-sectional survey was conducted using an online questionnaire designed in REDCap and administered to 32 senior health professionals with long-standing academic and clinical backgrounds in HNC. In addition, a structured literature review was performed on PubMed, Scopus, EMBASE, Web of Science, LILACS, and gray literature. Results: 18 notable figures were successfully identified from the survey, and 24 from the literature review. These individuals came from the United States, Brazil, Argentina, Mexico, El Salvador, Chile, Colombia, and Peru, and were recognized primarily for their performances as actors, artists, musicians, and athletes. The professionals’ outlooks were positive, with 31 (96.9%) agreeing that disseminating these stories can contribute to reducing risk behaviors. Furthermore, all participants (100%) agreed that such stories can promote early detection of HNC, primarily through social media, followed by the internet, and television. Conclusions: The study identified notable individuals and gathered positive perspectives from professionals. Our results suggest that notable people could serve as potential advocates for HNC prevention. Further research is warranted to explore the potential of this prevention strategy. Full article

(This article belongs to the Special Issue Dental Oncology)

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24 pages, 2803 KiB

Open AccessReview

Dental Applications of Ion-Substituted Hydroxyapatite: A Review of the Literature

by Eisha Imran, May L. Mei, Kai Chun Li, Jithendra Ratnayake, Manikandan Ekambaram and Paul R. Cooper

Dent. J. 2024, 12(10), 304; https://doi.org/10.3390/dj12100304 - 25 Sep 2024

Abstract

Hydroxyapatite (HA) forms an essential constituent of human teeth and bone. Its distinctive characteristic features, such as bioactivity and osteoconductivity, make it an ideal candidate to be used as an implant coating in restorative dentistry and maxillofacial surgery for bone regeneration. However, low [...] Read more.

Hydroxyapatite (HA) forms an essential constituent of human teeth and bone. Its distinctive characteristic features, such as bioactivity and osteoconductivity, make it an ideal candidate to be used as an implant coating in restorative dentistry and maxillofacial surgery for bone regeneration. However, low fracture toughness and brittleness are a few of the inherent features of HA, which limit its application in load-bearing areas. The potential of HA to engage its lattice structure with either partial or complete substitution with external ions has become an increasing area of research as this phenomenon has the potential to enhance the biological and functional properties of the material. Consequently, this review aimed to highlight the role of various substituted ions in dental applications. Data indicate that the newly formed HA-substituted biomaterials demonstrate enhanced remineralization and antimicrobial activity along with improved hardness. Ion-substituted HA offers a promising strategy for future clinical research as these materials may be incorporated into various dental products for therapeutic treatments. Full article

(This article belongs to the Special Issue Dental Materials Design and Innovative Treatment Approach)

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52 pages, 1438 KiB

Open AccessReview

Customized 3D-Printed Mesh, Membrane, Bone Substitute, and Dental Implant Applied to Guided Bone Regeneration in Oral Implantology: A Narrative Review

by Federica Di Spirito, Francesco Giordano, Maria Pia Di Palo, Cosimo Ferraro, Luigi Cecere, Eugenio Frucci, Mario Caggiano and Roberto Lo Giudice

Dent. J. 2024, 12(10), 303; https://doi.org/10.3390/dj12100303 - 25 Sep 2024

Abstract

Background: The new frontiers of computer-based surgery, technology, and material advances, have allowed for customized 3D printed manufacturing to become widespread in guided bone regeneration (GBR) in oral implantology. The shape, structural, mechanical, and biological manufacturing characteristics achieved through 3D printing technologies allow [...] Read more.

Background: The new frontiers of computer-based surgery, technology, and material advances, have allowed for customized 3D printed manufacturing to become widespread in guided bone regeneration (GBR) in oral implantology. The shape, structural, mechanical, and biological manufacturing characteristics achieved through 3D printing technologies allow for the customization of implant-prosthetic rehabilitations and GBR procedures according to patient-specific needs, reducing complications and surgery time. Therefore, the present narrative review aims to elucidate the 3D-printing digital radiographic process, materials, indications, 3D printed manufacturing-controlled characteristics, histological findings, complications, patient-reported outcomes, and short- and long-term clinical considerations of customized 3D printed mesh, membranes, bone substitutes, and dental implants applied to GBR in oral implantology. Methods: An electronic search was performed through MEDLINE/PubMed, Scopus, BioMed Central, and Web of Science until 30 June 2024. Results: Three-dimensionally printed titanium meshes and bone substitutes registered successful outcomes in vertical/horizontal bone defect regeneration. Three-dimensionally printed polymeric membranes could link the advantages of conventional resorbable and non-resorbable membranes. Few data on customized 3D printed dental implants and abutments are available, but in vitro and animal studies have shown new promising designs that could improve their mechanical properties and tribocorrosion-associated complications. Conclusions: While 3D printing technology has demonstrated potential in GBR, additional human studies are needed to evaluate the short- and long-term follow-up of peri-implant bone levels and volumes following prosthetic functional loading. Full article

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

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Graphical abstract

14 pages, 1560 KiB

Open AccessReview

Computer-Assisted Porcelain Laminate Veneer Preparation: A Scoping Review of Stereolithographic Template Design and Fabrication Workflows

by Xin Guan, Yew Hin Beh and In Meei Tew

Dent. J. 2024, 12(10), 302; https://doi.org/10.3390/dj12100302 - 25 Sep 2024

Abstract

Computer-assisted preparation of porcelain laminate veneers (PLVs) using stereolithographic templates has been developed to enhance the accuracy of tooth preparation. However, the digital workflows involved in guided PLV preparation remain inconsistently defined across various practices. Therefore, this scoping review aimed to examine publications [...] Read more.

Computer-assisted preparation of porcelain laminate veneers (PLVs) using stereolithographic templates has been developed to enhance the accuracy of tooth preparation. However, the digital workflows involved in guided PLV preparation remain inconsistently defined across various practices. Therefore, this scoping review aimed to examine publications on computer-assisted PLV preparation to identify the key stage of digital workflows involved in designing and fabricating stereolithographic templates, as well as to highlight the limitations of various template designs. This scoping review aimed to identify publications on digital workflows for designing and fabricating stereolithographic templates in computer-assisted porcelain laminate veneer preparation. A systematic search on MEDLINE/PubMed, Web of Science and Scopus identified English-language articles published from 2014 to March 2024. Eligible articles focused on digitally designed and fabricated tooth reduction templates for porcelain laminate veneers, excluding conventional tooth preparation procedures for tooth reduction assessment. Seven clinical reports were included, demonstrating various 3D data acquisition techniques for virtual patient generation. All articles described virtual diagnostic wax-ups on digital casts, with two using a virtual articulator. Only five articles documented chair-side mock-ups with resin trial restorations to evaluate planned dental esthetics. Additionally, virtual tooth preparation prior to templates design was included in only four articles. The templates were designed using different software and ranged from simple designs with access windows to complex stacked templates with rotary instrument sleeved windows. Each template design had limitations affecting tooth reduction accuracy. All articles reported printing templates in clear acrylic resin using different technologies. In conclusion, the review highlights a lack of standardization in the digital workflow for designing stereolithographic templates for PLVs. Establishing a sound protocol for designing the tooth reduction templates is essential to ensure the accuracy and consistency of veneer preparation. Full article

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14 pages, 3544 KiB

Open AccessArticle

Comparative Assessment of Pharyngeal Airway Dimensions in Skeletal Class I, II, and III Emirati Subjects: A Cone Beam Computed Tomography Study

by Sara AlAskar, Mohamed Jamal, Amar Hassan Khamis and Ahmed Ghoneima

Dent. J. 2024, 12(10), 301; https://doi.org/10.3390/dj12100301 - 25 Sep 2024

Abstract

The aim of the current study was to evaluate the pharyngeal airway dimensions of individuals with different skeletal patterns in a cohort of the Emirati population. The specific aim was to assess the relationship between pharyngeal airway dimensions and anterior facial height in [...] Read more.

The aim of the current study was to evaluate the pharyngeal airway dimensions of individuals with different skeletal patterns in a cohort of the Emirati population. The specific aim was to assess the relationship between pharyngeal airway dimensions and anterior facial height in relation to different skeletal patterns. This retrospective study was conducted on a sample of 103 CBCT scans of adult Emirati subjects categorized into three groups according to their skeletal classification as indicated by the ANB angle: Class I (n = 35), Class II (n = 46), and Class III (n = 22). All CBCT scans were taken using an i-CAT CBCT imaging machine (Imaging Sciences, Hatfield, PA, USA). The age range of the patients was 19 to 68 years (62 women and 41 men). ANOVA, t-tests, Kruskal–Wallis, and Mann–Whitney tests were employed for comparing means among groups. The correlation coefficient was used to evaluate the association between variables. A p-value of less than 0.05 was considered statistically significant. This study revealed significant associations between various airway parameters and cephalometric measurements. Positive correlations were observed between nasal cavity volume and nasopharynx volume, as well as anterior facial height. Oropharynx volume exhibited positive correlations with hypopharynx volume and total airway volume, and negative correlations with overjet, ANB angle, and patient age. Hypopharynx volume correlated positively with total airway volume and the most constricted area of the airway (MCA). Total airway volume showed positive correlations with MCA and anterior facial height. MCA had negative correlations with ANB angle and patient age. Nasopharynx volume was significantly larger in the skeletal Class I group than in the Class II or Class III groups, while the other airway parameters showed no significant differences among the groups (p > 0.05). Several airway parameters showed a correlation with anterior facial height among the different skeletal patterns. Nasopharyngeal airway volume was significantly larger in the skeletal Class I group than in Class II and III groups in the studied sample. Full article

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10 pages, 1991 KiB

Open AccessArticle

by Olivier Quinty, Gregory S. Antonarakis, Stavros Kiliaridis and Anestis Mavropoulos

Dent. J. 2024, 12(10), 300; https://doi.org/10.3390/dj12100300 - 24 Sep 2024

Abstract

This study aimed to investigate the influence of various patient-specific and bracket location-specific factors on bracket survival rates during comprehensive fixed appliance orthodontic treatment. A total of 197 patients (116 females, 81 males; mean age 16.3 years) having completed orthodontic treatment were included [...] Read more.

This study aimed to investigate the influence of various patient-specific and bracket location-specific factors on bracket survival rates during comprehensive fixed appliance orthodontic treatment. A total of 197 patients (116 females, 81 males; mean age 16.3 years) having completed orthodontic treatment were included in this retrospective cohort study. Patients were treated using stainless steel non-self-ligating brackets, and the treatment duration was 23.7 months on average. The primary outcome was bracket bond failure. Potential predictors for bracket bond failure recorded included age, sex, oral hygiene, treatment duration, and several pre-treatment cephalometric characteristics such as overjet, overbite, and sagittal and vertical skeletal relationships. Factors associated with bracket failure were analysed with Cox regression, and proportional hazard assumptions were assessed using Kaplan–Meier tests. The overall failure rate was 4.4%. Bracket bond failure rates varied among tooth types and seemed to occur more on posterior teeth and on the right side of the arch. Bracket failure was more common in male patients and those with poor oral hygiene. Concerning dentofacial characteristics, bracket failure of anterior teeth was more common in those with an increased overjet and overbite. Full article

(This article belongs to the Topic Assessment of Craniofacial Morphology: Traditional Methods and Innovative Approaches)

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21 pages, 908 KiB

Open AccessFeature PaperReview

The Oral Microbiome of Peri-Implant Health and Disease: A Narrative Review

by Natalia de Campos Kajimoto, Yvonne de Paiva Buischi, Mansour Mohamadzadeh and Peter Loomer

Dent. J. 2024, 12(10), 299; https://doi.org/10.3390/dj12100299 - 24 Sep 2024

Abstract

Peri-implantitis disease has increased significantly over the last years, resulting in increased failure of implants. Many factors may play a role in implant complications and failure, including ones related to the oral microbiota. This literature review aims to summarize the current knowledge of [...] Read more.

Peri-implantitis disease has increased significantly over the last years, resulting in increased failure of implants. Many factors may play a role in implant complications and failure, including ones related to the oral microbiota. This literature review aims to summarize the current knowledge of microbiome of implants in health and disease, focusing not only on the presence/absence of specific microbiota or on their relative abundance, but also on their phenotypic expression and their complex relationships with the host. The authors examined the MEDLINE database and identified key topics about peri-implant oral microbiome in health and disease. The peri-implant microbiome differs from that of the tooth, both in health and disease, as they are structurally and chemically different. The adhesion and formation of the peri-implant biofilm can be affected by the surface energy, topography, wettability, and electrochemical charges of the implant surface. In addition, the morphogenesis of the tissues surrounding the dental implant also differs from the tooth, making the dental implant more susceptible to bacterial infection. This interplay between the microbiome and the host immune system in peri-implant infections still needs to be elucidated. Full article

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

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17 pages, 1394 KiB

Open AccessArticle

Assessing the Impact of IOS Scanning Accuracy on Additively Manufactured Occlusal Splints

by Eduardo Anitua, Asier Lazcano, Asier Eguia and Mohammad Hamdan Alkhraisat

Dent. J. 2024, 12(10), 298; https://doi.org/10.3390/dj12100298 - 24 Sep 2024

Abstract

Introduction: Digital workflow and intraoral scanners (IOSs) are used to clinically obtain data for a wide range of applications in restorative dentistry. The study aimed to compare two different IOSs with inexperienced users in the digital workflow of oral split manufacturing. Material and [...] Read more.

Introduction: Digital workflow and intraoral scanners (IOSs) are used to clinically obtain data for a wide range of applications in restorative dentistry. The study aimed to compare two different IOSs with inexperienced users in the digital workflow of oral split manufacturing. Material and Methods: Anonymous stone models of upper and lower dentate patients were used. Both models were scanned with a desktop 3D scanner 3Shape D2000 to obtain the reference models (STL_R). Ten inexperienced operators scanned each model three times with each IOS system (3Shape TRIOS 3 and Carestream CS 3800). Finally, 20 intraoral scanners were randomly chosen from the obtained dataset (10 per IOS system) to design and manufacture 20 nightguards. All the nightguards were scanned. Trueness and precision were calculated and compared between the two IOS systems. Results: All the mean errors both for trueness and precision were below 40 µm, more than acceptable for the design and manufacturing of intraoral devices such as nightguards. All the mean errors (except one) for trueness between the inner part of the nightguards and the upper control model were below 100 µm, less than a printed layer height. For inexperienced operators, both IOSs are suitable for a digital workflow of manufacturing occlusal splints. Full article

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

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13 pages, 712 KiB

Open AccessSystematic Review

Asymmetric Dimethylarginine as a Potential Mediator in the Association between Periodontitis and Cardiovascular Disease: A Systematic Review of Current Evidence

by Biagio Rapone, Francesco Inchingolo, Giulia Margherita Tartaglia, Jr., Maurizio De Francesco and Elisabetta Ferrara

Dent. J. 2024, 12(9), 297; https://doi.org/10.3390/dj12090297 - 21 Sep 2024

Abstract

Background: Periodontitis, a chronic inflammatory disease, has been associated with an elevated risk of cardiovascular disease (CVD). Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, has emerged as a potential biomarker linking periodontitis, endothelial dysfunction, and CVD. This systematic review aimed [...] Read more.

Background: Periodontitis, a chronic inflammatory disease, has been associated with an elevated risk of cardiovascular disease (CVD). Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, has emerged as a potential biomarker linking periodontitis, endothelial dysfunction, and CVD. This systematic review aimed to synthesize the existing evidence on the relationship between ADMA, periodontitis, and CVD, and to evaluate ADMA’s potential as a biomarker for periodontal disease progression and its correlation with endothelial dysfunction. Methods: A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science databases from their inception to March 2023. Observational and interventional studies assessing ADMA levels in patients with periodontitis and/or CVD were included. The methodological quality of the included studies was evaluated using the NIH Quality Assessment Tools. Due to the heterogeneity of the included studies, a qualitative synthesis was performed. Results: Cross-sectional studies consistently demonstrated significantly elevated ADMA levels in patients with periodontitis and CVD compared to healthy controls. The prospective cohort study indicated that successful periodontal treatment was associated with a significant reduction in ADMA levels and concomitant improvement in endothelial function. The pilot cohort study reported a significant decrease in ADMA levels following periodontal therapy in patients with chronic kidney disease. However, the randomized controlled trials did not demonstrate significant alterations in ADMA levels or endothelial function subsequent to periodontal treatment in patients with periodontitis alone. Conclusions: Periodontal treatment may effectively reduce ADMA levels and improve endothelial function, particularly in patients with comorbidities. These findings suggest that ADMA is a promising biomarker linking periodontitis, endothelial dysfunction, and CVD. However, the limitations of this study include the small number of studies, heterogeneity in the study designs, and a lack of long-term follow-up data. Further high-quality, longitudinal studies are required to confirm its clinical utility and elucidate the underlying mechanisms of these relationships. The integration of periodontal care into CVD prevention and management strategies warrants consideration, as it may contribute to mitigating the cardiovascular risk associated with periodontitis. Full article

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

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11 pages, 634 KiB

Open AccessArticle

Effect of a Novel Ergonomic Sheath on Dental Device-Related Muscle Work, Fatigue and Comfort—A Pilot Clinical Study

by Steven Dang, Cherie Wink, Susan Meishan Yang, Kairong Lin, Thair Takesh, Ali A. Habib and Petra Wilder-Smith

Dent. J. 2024, 12(9), 296; https://doi.org/10.3390/dj12090296 - 21 Sep 2024

Abstract

Background: Dental instrumentation with hand-held devices is associated with discomfort, fatigue and musculoskeletal diseases or repetitive stress injuries. The goal of this in vivo study was to determine the effect of an ergonomic handle sheath on muscle work, comfort and fatigue associated with [...] Read more.

Background: Dental instrumentation with hand-held devices is associated with discomfort, fatigue and musculoskeletal diseases or repetitive stress injuries. The goal of this in vivo study was to determine the effect of an ergonomic handle sheath on muscle work, comfort and fatigue associated with (a) piezoelectric scaling by hygienists with and without musculoskeletal disorders (MSDs), and (b) dental cavity preparation by healthy dentists using a dental micromotor. Materials and Methods: Two groups of ten hygienists each tested the piezoelectric scaler. Hygienists in Group 1 had no MSDs, while those in Group 2 had been diagnosed with MSDs. Additionally, ten dentists with no MSDs used a dental micromotor to prepare four standardized cavities. Time-based work in four muscles, comfort and fatigue were recorded in the presence and absence of an add-on soft, insulating handle sheath. Data were analyzed using a repeated measures analysis of variance model with Tukey’s post-hoc test. Results: Comfort, fatigue and muscle work were significantly better for both devices when the sheath was used. While hygienists with MSDs used more muscle work to complete the set scaling task, and the sheath-related reduction in work was somewhat greater, these MSD-related differences did not quite reach significance. Conclusions: The results of this pilot study show that the ergonomic performance of an ultrasonic scaler and a dental micromotor may be improved by the use of an ergonomic handle sheath. Full article

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

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11 pages, 234 KiB

Open AccessReview

Evaluating Treatment Modalities for Reducing Recurrence in Central Giant Cell Granuloma: A Narrative Review

by Flamur Aliu, Donika Bajrami Shabani, Iliriana Aliu, Etleva Droboniku Qeli, Gerta Kaçani, Luca Fiorillo and Aida Meto

Dent. J. 2024, 12(9), 295; https://doi.org/10.3390/dj12090295 - 19 Sep 2024

Abstract

Treating central giant cell granuloma (CGCG) is challenging due to high recurrence rates and variable therapy responses. This study examines the efficacy of various treatments in reducing CGCG recurrence. A literature review explored outcomes of surgical excision, curettage, intralesional corticosteroid injection, and adjuvant [...] Read more.

Treating central giant cell granuloma (CGCG) is challenging due to high recurrence rates and variable therapy responses. This study examines the efficacy of various treatments in reducing CGCG recurrence. A literature review explored outcomes of surgical excision, curettage, intralesional corticosteroid injection, and adjuvant therapy, considering factors like lesion location, size, and histological features. Aggressive surgical techniques such as en bloc resection were found to potentially lower recurrence rates compared to conservative approaches. However, treatment should be tailored to individual patient needs. Further research is needed to confirm these findings and improve treatment strategies. A concise literature review was conducted using PubMed, MEDLINE, and Google Scholar, focusing on papers published from 1986 to 2024. Search terms included “central giant cell granuloma”, “recurrence”, “treatment modalities”, and “surgical excision”. Studies reporting recurrence rates and treatment outcomes for CGCG were analyzed. Twenty-nine studies were reviewed, including six studies on surgical excision and curettage, eight studies on intralesional corticosteroid injections, six studies on calcitonin therapy, five studies on interferon-alpha therapy, and four studies on the therapy with denosumab. Analysis indicated that aggressive surgical treatments like en bloc resection were associated with lower recurrence rates compared to conservative methods. Predictors of recurrence included lesion size (>3 cm), location (mandible), and aggressive histopathological features. Aggressive surgical excision combined with nonsurgical methods may lower recurrence rates, while conservative techniques remain viable in some cases. Further prospective research is needed to validate these findings and enhance CGCG treatment options. Full article

(This article belongs to the Special Issue Endodontics and Restorative Sciences: 2nd Edition)

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13 pages, 2944 KiB

Open AccessArticle

Influence of Direct Coronal Restoration Materials on the Fracture Resistance of Endodontically Treated Premolars: An In Vitro Study

by Georgiana Florentina Gheorghe, Ana Maria Cristina Țâncu, Oana Elena Amza, Ioana Suciu, Laura Iosif, Stanca Cuc, Ioan Petean, Marioara Moldovan and Bogdan Dimitriu

Dent. J. 2024, 12(9), 294; https://doi.org/10.3390/dj12090294 - 19 Sep 2024

Abstract

(1) Background: The long-term survival of an endodontically treated tooth depends on a successful root canal treatment as well as an adequate definitive coronal restoration. This study aimed to evaluate the strength of endodontically treated premolars with mesial–occlusal–distal (MOD) cavity preparation restored with [...] Read more.

(1) Background: The long-term survival of an endodontically treated tooth depends on a successful root canal treatment as well as an adequate definitive coronal restoration. This study aimed to evaluate the strength of endodontically treated premolars with mesial–occlusal–distal (MOD) cavity preparation restored with different direct coronal restoration materials but from the same manufacturer against fracture. (2) Methods: sixty intact premolars were selected and placed into five groups (n = 12): G1—intact teeth, G2—endodontic treatment and unrestored MOD cavities, G3—endodontic treatment and MOD cavities restored with Tetric PowerFlow and Tetric EvoCeram, G4—endodontic treatment and MOD cavities restored with Multicore Flow and Tetric EvoCeram, and G5—endodontic treatment and MOD cavities restored with Multicore Flow. The specimens were subjected to an axial compression load at a speed of 1.6 mm/min and optically inspected before and after with a stereomicroscope. For each premolars group, the following data were recorded: the compression resistance, the compressive strength, and the maximum force supported. The microstructure of the samples after the compression test was analyzed using scanning electron microscopy (SEM). (3) Results: statistical analysis (ANOVA and Tukey test) showed that there was a statistically significant difference between G1 and the other groups. Even though there was no statistically significant difference between the restored groups, a better mechanical behavior was registered within the G3. (4) Conclusions: this in vitro study indicated that none of the materials used can lead to a higher or at least similar fracture resistance as the intact teeth. The coronal restoration only with nano-hybrid composites may lead to a higher therapeutic benefit for the fracture-susceptible premolars. Full article

(This article belongs to the Section Restorative Dentistry and Traumatology)

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