Dentine disorders and adhesive treatments: A systematic review

Dental Management of Genetic Dental Disorders: A Critical Review

Genetic dental disorders (GDDs) can occur either isolated or as part of syndromes. Clinically, deviations in tooth shape, size, or structure, as well as the absence of multiple teeth, lead to severe dysfunction and a reduced quality of life, requiring lifelong preventive, conservative, and prosthodontic dental care. The dental management of prevalent dental diseases, such as caries or periodontitis, has been based on decades of research, whereas scientific data on the dental management of GDDs are scarce. This lack of data is challenging for dental practitioners, who must primarily rely on empirical knowledge only. Therefore, a systematic literature search and review were conducted on the dental management of common GDDs, such as ectodermal dysplasia, amelogenesis imperfecta, dentinogenesis imperfecta, periodontitis as a manifestation of rare systemic diseases, and X-linked hypophosphatemia and hypophosphatasia. The review revealed that 468 of the 9,115 retrieved publications met the inclusion criteria, with most being case reports or case series, highlighting a lack of robust clinical trials. This critical review provides a brief summary of the genetic background, key clinical signs, and treatment options for these conditions. The dominance of case reports emphasizes the need for improved reporting standards and long-term follow-up to support comprehensive data synthesis and meta-analyses. In addition, the uneven global distribution of publications suggests disparities in access to advanced dental care for GDDs. Efforts to standardize reporting and improve treatment documentation globally are crucial to addressing these challenges. In this way, information on GDD management can be improved, and statistical analyses of the data can be performed.

Air Particle Abrasion in Dentistry: An Overview of Effects on Dentin Adhesion and Bond Strength

Background/Objectives: Air particle abrasion (APA) is a common surface preparation method in dentistry, particularly for improving bond strength to dentin. This review evaluates the influence of APA on dentin adhesion. Methods: A systematic literature search from 2018 to 2023 was conducted according to PRISMA-ScR guidelines. Articles investigating the effects of APA on dentin adhesion using different particle types, sizes and adhesive systems were included. Data extraction included particle size, air pressure, outcomes tested and failure modes. Results: Fourteen primary studies met the criteria. Bioactive glass showed higher bond strength and more cohesive failures than alumina. Alumina particles (50 μm) bonded effectively in etch-and-rinse adhesive systems but failed more often in self-etch systems. Silica-modified alumina and mixed abrasive systems showed improvements in bonding performance. Optimal APA parameters were identified as 50 μm particle size, 60 psi (4 bar) air pressure and 5 s exposure time. Longer exposure times provided no additional benefit. Self-etch systems showed reduced bond strength compared to etch-and-rinse systems. Conclusions: This review looks at how particle type, size and air pressure affect dentin adhesion. Bioactive glass is a superior material due to its bond strength and reduced cytotoxicity. The optimal APA parameters are 50 μm particle size, 60 psi and 5 s. Etch-and-rinse systems are recommended for optimal adhesion. Further research is required on APA protocols and long-term durability.

Pretreatments to bonding on enamel and dentin disorders: a systematic review

INTRODUCTION

This systematic review focuses on structural anomalies of enamel and dentin such as fluorosis (F), molar-incisor hypomineralization (MIH), amelogenesis imperfecta (AI), dentinogenesis imperfecta (DI), osteogenesis imperfecta (OI), and X-linked hypophosphatemia (XLH). These pathologies affect up to 31% of the population, posing challenges in the adhesion of direct restorations. The primary objective of this analysis is to examine the survival rate and/or bonding resistance of direct restorations on tissues affected by enamel and dentin disorders in humans. We aim to provide precise clinical recommendations for dentists to choose the appropriate bonding pretreatment for various enamel and dentin disorders.

METHODS

We systematically searched the medical literature to identify abstracts of interest indexed between 1993 and May 2024, from 4 databases (PubMed, PMC-PubMed, Web of Science and Cochrane Library). The results are reported following the PRISMA statement. The GRADE approach was used to assess the risk of bias.

RESULTS

The two authors included 27 studies out of the 600 identified. The data extracted from these studies are highly heterogeneous, and the mentioned bonding protocols are all different. 15 articles pertain to F, 7 to MIH, 5 to AI, and none focus on HSPM, dentin disorders and XLH. We identified 12 pretreatments of enamel or dentin (7 for F, 2 for MIH, and 3 for AI), including 3 strong recommendations. Additional studies are necessary to confirm the effectiveness of certain pretreatments. In developmental enamel defects, the main recommendation we collected is to bond on enamel with an etch-and-rinse technique on F and MIH. Considerations with lower strength of evidence include a deproteinization step on enamel on F, MIH and AI and modifications of the etching parameters on F and AI. The research strategy was registered on the Prospero platform (CRD42023447502).

Dentinogenesis imperfecta in a 6-year-old male neutered Labrador retriever: Case report with atypical clinical presentation and treatment review

This case report details the diagnosis and treatment of dentinogenesis imperfecta in a 6-year-old neutered male Labrador, presenting without concurrent osteogenesis imperfecta. Diagnostic modalities, including radiographs, CT imaging, and histopathological examination, are reviewed in conjunction with the latest literature on canine dentinogenesis imperfecta. This patient presented at a more advanced age than typically reported cases. The clinical history, as provided by referring veterinarians, documented fractured deciduous teeth with delayed exfoliation. By 10 months of age, the patient's permanent dentition exhibited a translucent appearance and structural anomalies. Upon presentation to Eastcott Referrals the patient was experiencing significant oral pain and exhibited generalised coronal wear with yellow/brown intrinsic discolouration. CT imaging revealed that all teeth had endodontic disease and associated apical periodontitis, with varied root canal widths indicating that teeth succumbed to endodontic disease at different time points. The treatment protocol involved staged full-mouth extractions, resulting in the complete resolution of clinical symptoms. This case underscores the importance of early diagnosis and intervention in managing dentinogenesis imperfecta in dogs.

Bioactive ceramic-based materials: beneficial properties and potential applications in dental repair and regeneration

Bioactive ceramics, primarily consisting of bioactive glasses, glass-ceramics, calcium orthophosphate ceramics, calcium silicate ceramics and calcium carbonate ceramics, have received great attention in the past decades given their biocompatible nature and excellent bioactivity in stimulating cell proliferation, differentiation and tissue regeneration. Recent studies have tried to combine bioactive ceramics with bioactive ions, polymers, bioactive proteins and other chemicals to improve their mechanical and biological properties, thus rendering them more valid in tissue engineering scaffolds. This review presents the beneficial properties and potential applications of bioactive ceramic-based materials in dentistry, particularly in the repair and regeneration of dental hard tissue, pulp-dentin complex, periodontal tissue and bone tissue. Moreover, greater insights into the mechanisms of bioactive ceramics and the development of ceramic-based materials are provided.

Accuracy of the preparation depth in mixed targeted restorative space type veneers assisted by different guides: An in vitro study

PURPOSE

Most veneers are mixed targeted restorative space (MTRS)-type restorations that are partially within the original tooth and require inconsistent preparation depths. This study aimed to evaluate the accuracy of the preparation depth for MTRS veneer preparation.

METHODS

MTRS veneer preparation models were developed using the twisted maxillary central incisor (MCI) as the original tooth and the standard MCI as the waxing. Veneer preparations were performed using freehand (MF), silicone (MS), thermoplastic (MT), 3D-printed uniform (MD), and auto-stop (MA) guides. The prepared and original MCI were scanned and superimposed using a custom-made base. The mean absolute differences (MADs) were measured to evaluate the accuracy of the preparation depth. Statistical analysis was performed using the multivariate analysis of variance (MANOVA) test (α=0.05).

RESULTS

The accuracy of the preparation depth was 0.237±0.090, 0.191±0.099, 0.149±0.078, 0.093±0.050, and 0.059±0.040 mm in MF, MS, MT, MD, and MA, respectively. The MADs between the groups were significant (P<0.05). The accuracy of the trial restoration was 0.140±0.081 mm in the MS, and the accuracy of the guiding tube was 0.055±0.033, 0.036±0.011, and 0.033±0.010 mm in the MT, MD, and MA, respectively.

CONCLUSIONS

In MTRS veneer preparation for MCI, tooth preparation guides improved the accuracy of the preparation depth by visualizing the TRS profile and providing clear measurement points. The accuracy of the guide is influenced by its flexibility, and the accuracy of the preparation depth is affected by the accuracy of the measurement points.

Type I Dentin Dysplasia: The Literature Review and Case Report of a Family Affected by Misrecognition and Late Diagnosis

Background and Objectives: Type I dentin dysplasia (DD-I) is a rare genetic disorder with autosomal dominant or recessive inheritance at risk of late or long-misunderstood diagnosis because the teeth, compared to other degenerative dentin diseases, do not have coronal defects and/or alterations but only at the root level (absent, conical, pointed roots, and obliterated pulp canals). The first radiographic suspicion often occurs only in case of sudden mobility and/or abscesses of the permanent teeth. Genetic tests confirm the diagnosis. Case Presentation: This case report describes the oral and radiographic characteristics of two siblings, 12 and 10 years old, a male and a female, at an early age affected by DD-I, whose diagnosis was made for a first orthodontic visit. The father and the older child had already undergone dental and orthodontic treatments, respectively, without the disease being suspected by the dentist. Results: Genetic tests support the diagnosis of DD-I. Following the diagnosis, the patients began a process of close periodic checks every 3-4 months to monitor their situation. The male child lost upper lateral incisors, which were then replaced with a light nylon removable prosthesis. Conclusions: The ability to recognize the radiographic features characteristic of DD-I is very important to avoid prejudicial diagnostic delays and to be able to plan the long-term treatment of these patients better, especially when the pathology was primarily misrecognized in the family.

The roles of 10-methacryloyloxydecyl dihydrogen phosphate and its calcium salt in preserving the adhesive-dentin hybrid layer

OBJECTIVES

10-Methacryloyloxydecyl dihydrogen phosphate (MDP) has been regarded as the most effective dentin-bonding monomer for more than 20 years. Although the dentin-bonding promoting effect of MDP has been well demonstrated, the mechanisms by which it benefits the stably of collagen within the adhesive-dentin hybrid layer are not currently fully understood. The objective of this study was to investigate the roles of MDP and its calcium salt in preserving the adhesive-dentin hybrid layer.

METHODS

MDP-conditioned collagen was investigated by Fourier-transform infrared spectroscopy, Ultraviolet-visible spectroscopy, and molecular docking. The structural changes to the dentin surface upon acid-etching and MDP-conditioning were observed by SEM. X-ray diffraction and nuclear magnetic resonance were used to investigate the chemical interactions between MDP and HAp. The collagen-protecting effects of MDP and its Ca salt were investigated using in-situ zymography, rhMMP-9 colorimetric assay, hydroxyproline assay, and molecular docking.

RESULTS

MDP forms a stable collagen-phosphate complex through hydrogen bonding with the collagen in dentin. Furthermore, it generates MDP-Ca salts that are deposited on the dentin collagen scaffold, protecting it from degradation. Moreover, both free MDP and the MDP-Ca salt inhibit matrix metallopeptidase and exogenous proteases, with the inhibitory effect of the calcium salt being significantly stronger than that of the free form.

SIGNIFICANCE

MDP-based adhesives preserve the collagen within the hybrid layer by simultaneously improving collagen's resistance to exogenous enzymes and inhibiting MMP activity, both of which contribute to the longevity of dentin-resin bonding.

Full-mouth rehabilitation choices depending on amelogenesis imperfecta's type: A familial case report

Amelogenesis imperfecta, a rare disease, represents inherited, congenital defects that primarily affect enamel with esthetic and functional impairment affecting everyday life. We present oral rehabilitation of a mother and her son, respectively, suffering from an hypoplastic and an hypocalcified form of AI.