Clinical Trial to Assess Physiology and Activity of Masticatory Muscles of Complete Denture Wearer Following Vitamin D Intervention

Management of Oro-Antral Communication: A Systemic Review of Diagnostic and Therapeutic Strategies

Aim: This study aims to evaluate the management of oro-antral communications (OAC) and fistulas (OAF), focusing on treatment strategies based on defect size, epithelialization, and the presence of sinus infections, while exploring both traditional and emerging techniques. Materials and Methods: The systematic review was conducted following the PRISMA guidelines and registered on PROSPERO (CDR ID 623251). Using targeted keywords, articles in English published within the last 10 years were analyzed from databases such as PubMed, WoS and Scopus, selecting only clinical studies on human patients. After thorough screening, 20 publications were included in the qualitative analysis, among 734 initially identified. Results: Small OACs (<5 mm) were managed conservatively with hemostatic materials, while larger defects (>5 mm) required surgical closure, with the Bichat flap proving highly effective for large defects. Innovative treatments using autologous bone grafts and PRF showed promise in supporting tissue regeneration. In cases with sinusitis, the combination of FESS and intra-oral closure techniques resulted in high success rates for infection resolution and defect closure. Conclusions: Treatment outcomes for OAC and OAF are highly dependent on the size of the defect and the presence of sinusitis. Multidisciplinary collaboration, along with timely surgical intervention and adherence to medical therapies, is essential for successful management. Emerging techniques and minimally invasive procedures continue to improve patient outcomes, offering hope for more effective and sustainable solutions in complex cases.

Vitamin D serum levels and temporomandibular disorders: A systematic review and meta-analysis

OBJECTIVE

This systematic review evaluates the connection between vitamin D serum levels, deficiency, and temporomandibular disorders (TMD), offering a meta-analysis of the existing evidence in this domain.

DESIGN

The Scopus, ISI Web of Science, and Pubmed databases were searched for human studies concerning the connection between vitamin D and TMD comprising a control group. A random-effect model with forest plots was used for vitamin D serum levels mean difference (MD), vitamin D deficiency odds ratio (OR), and risk difference (RD) between subjects with and without TMD. Subgroup analysis was conducted based on ethnicity, overall risk of bias, TMD diagnosis method, and study designs. A p-value lower than 0.05 was considered significant. The certainty of the meta-evidence was evaluated according to the GRADE approach.

RESULTS

Of the 2621 identified unique records, 15 studies were included in the study, eight of which were considered for the meta-analysis. The meta-analysis revealed a significant vitamin D deficiency OR (3.85; 95 % CI: 2.35 - 5.43; Certainty: Low) and RD (22 %; 95 % CI: 11 % - 32 %; Certainty: Very low), and vitamin D serum levels MD (-5.03 ng/mL; 95 % CI: -9.92 - -0.13; Certainty: Very low) between subjects with and without TMD. Among subgroup analyses, only the difference in vitamin D MD between Middle Eastern and European patients was significant (P < 0.01).

CONCLUSION

Considering the low to very low certainty of the evidence, vitamin D serum levels are significantly lower, and vitamin D deficiency is significantly more prevalent in TMD patients.

Orthopedic Devices for Skeletal Class III Malocclusion Treatment in Growing Patients: A Comparative Effectiveness Systematic Review

Background/Objectives: Skeletal Class III malocclusion (Cl III) presents a significant orthodontic challenge, particularly in growing patients, requiring interceptive treatment to achieve effective functional and aesthetic correction. This review aims to compare various orthopedic devices and therapeutic protocols used in Cl III correction, identifying the most effective options in an interceptive context. Methods: We searched the PubMed, Scopus, and Web of Science databases for studies published between 1 January 2003, and 19 July 2023. Inclusion criteria included English language, human studies, open access, and studies addressing Cl III correction with interceptive orthopedic devices. Results: Exclusions included in vitro, animal, off-topic studies, reviews, meta-analyses, and articles in languages other than English. After removing duplicates, 30 articles were selected from a total of 1193 results. Conclusions: The application of orthopedic devices in growing patients can lead to rapid improvement of Cl III malocclusion, although each device has specific effects on the surrounding skeletal structure.

Advancing Postoperative Pain Management in Oral Cancer Patients: A Systematic Review

The goal of this review is to shed light on the management of orofacial discomfort after a cancer diagnosis in the head and neck region. A search was conducted on PubMed, Scopus, and Web of Science to identify studies on postoperative pain control in oral cancer. The review included open-access research, investigations into pain management, randomized clinical trials, retrospective studies, case-control studies, prospective studies, English-written studies, and full-text publications. Exclusion criteria included animal studies; in vitro studies; off-topic studies; reviews, case reports, letters, or comments; and non-English language. Three reviewers independently accessed databases and assigned a quality rating to the chosen articles. The review explores postoperative pain management in oral cancer patients; highlighting persistent opioid use; the efficacy of adjuvant drugs, such as gabapentin; and a multimodal approach. It emphasizes the need for personalized pain management, recognizing individual pain perception and tailoring interventions. Integrating pharmacological and non-pharmacological strategies is crucial for comprehensive pain management. The review also serves as a guide for future research, emphasizing the need for standardized methodologies and diverse participant populations.

Cigarette smoke and tobacco heating aerosol on the aging of clear aligners

BACKGROUND

The treatments with clear aligners (CA) showed an exponential higher percentage in the last years being almost invisible with major patient acceptability and a resulting improvement in quality of life. CA are composed of thermoplastic polyurethane not inert but subjected to changes due to heating and humidity, chewing forces, and prolonged exposure to enzymes in saliva in the oral cavity and external factors. Cigarette smoke (CS) and the aerosol produced by tobacco products with reduced health risks may be considered among the external factors affecting CA. The purpose of this study was the assessment of optical properties (absorbance and transmittance) and roughness of CA after in vitro aging due to exposition to CS and THS2.2, compared to controls. The secondary objective will be the investigation of CS and THS2.2 effects on resin composite inside aligners used for attachments during treatment with CA.

METHODS

A total number of 60 CA units will be used and equally divided in three different groups (20 in each): CS group exposed to reference cigarettes smoking, THS2.2 group exposed to aerosol from 20 heat-not-burn sticks, and control group, CG to pure air only. The aligners will present ten introflection for the attachments on the anterior part. In accordance with ISO standard 3402, 3R4F cigarettes and THS2.2 tobacco sticks must undergo conditioning for a minimum of 48 hours and a maximum of 21 days at a temperature of 22±1 °C and a relative humidity of 60±3%.

RESULTS

Using spectrophotometry, the optical characteristics (absorbance and transmittance) of each aligner will be evaluated after aging (Jasco UV-vis V630PC, Tokyo, Japan). Each aligner will be cut with a rotating saw from canine to canine prior to the measurements in order to lop off the lingual region and displaying the labial barrier. The absorbance and transmittance measurements will be collected and statistically analyzed with a significance of P<0.05.

CONCLUSIONS

Surface roughness of the aligners and attachments inside them will be assessed by 3D scanning microscopy (Infinite Focus G4h). Color of resin composite will be assessed using the (CIE Lab) Commission Internationale de l'Eclairage L*a*b* color space by means of Olympus CrystalEyef dental spectrophotometer. Clinicians should advise patients to refrain from smoking and drinking coffee or tea while wearing aligners for two reasons: first, the color change is unacceptably noticeable when wearing aligners, and second, the material's chemical composition may be slightly altered, which could affect the intended dental movements.

Arthroscopy for the Treatment of Temporomandibular Disorders

How to cite this article: Mosaddad SA. Arthroscopy for the Treatment of Temporomandibular Disorders. J Contemp Dent Pract 2024;25(3):197-198. Keywords: Arthroscopy, Facial pain, Temporomandibular joint, Temporomandibular joint disorders.

Prevalence of temporomandibular disorders in clear aligner patients using orthodontic intermaxillary elastics assessed with diagnostic criteria for temporomandibular disorders (DC/TMD) axis II evaluation: A cross-sectional study

BACKGROUND

The objective of this investigation is to assess the relationship between the utilisation of orthodontic intermaxillary elastics and temporomandibular disorder (TMD) symptoms in clear aligner patients and to examine the correlation between the elastic usage time with the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)-Axis II Evaluation Forms.

METHODS

This study was carried out on a total of 40 clear aligner patients using intermaxillary elastics in the experimental group and 30 clear aligner patients who did not use any intermaxillary elastics in the control group. The data were evaluated using the Mann-Whitney U, chi-square, Fisher's exact chi-square, and Fisher Freeman Halton exact chi-square tests.

RESULTS

The characteristic pain intensity, mastication, mobility, communication, global and PHQ-9 scores of the experimental group were significantly higher than those of the control group (p < .05). The characteristic pain intensity score, interference score and chronic pain grade score of patients using Class III elastics were statistically significantly higher than those of patients using Class II elastics (p < .05). Patients who used elastics for less than 6 months had statistically significantly higher PHQ-9 scores than those who used elastics for more than 6 months (p < .05).

CONCLUSIONS

Orthodontic treatment may affect occlusion, bite force and jaw movement, which may cause or worsen TMD symptoms, and the DC/TMD questionnaires can determine if orthodontic patients acquire TMD by assessing their psychosocial state and pain-related problems.

Celiac Disease-Related Enamel Defects: A Systematic Review

INTRODUCTION

This systematic review aims to elucidate the intricate correlation between celiac disease (CD) and dental enamel defects (DED), exploring pathophysiological mechanisms, oral health implications, and a dentist's role in early diagnosis.

MATERIALS AND METHODS

Following PRISMA guidelines, a comprehensive search from 1 January 2013 to 1 January 2024 across PubMed, Cochrane Library, Scopus, and Web of Science identified 153 publications. After exclusions, 18 studies met the inclusion criteria for qualitative analysis. Inclusion criteria involved study types (RCTs, RCCTs, case series), human participants, English language, and full-text available.

RESULTS

The search yielded 153 publications, with 18 studies meeting the inclusion criteria for qualitative analysis. Notable findings include a high prevalence of DED in CD patients, ranging from 50 to 94.1%. Symmetrical and chronological defects, according to Aine's classification, were predominant, and significant associations were observed between CD severity and enamel defect extent.

CONCLUSIONS

The early recognition of oral lesions, particularly through Aine's classification, may signal potential CD even in the absence of gastrointestinal symptoms. Correlations between CD and dental health conditions like molar incisor hypomineralization (MIH) emphasize the dentist's crucial role in early diagnosis. Collaboration between dentists and gastroenterologists is essential for effective monitoring and management. This review consolidates current knowledge, laying the groundwork for future research and promoting interdisciplinary collaboration for improved CD-related oral health outcomes. Further large-scale prospective research is recommended to deepen our understanding of these issues.

Surface Electromyography in Dentistry-Past, Present and Future

Surface electromyography (sEMG) is a technique for measuring and analyzing the electrical signals of muscle activity using electrodes placed on the skin's surface. The aim of this paper was to outline the history of the development and use of surface electromyography in dentistry, to show where research and technical solutions relating to surface electromyography currently lie, and to make recommendations for further research. sEMG is a diagnostic technique that has found significant application in dentistry. The historical section discusses the evolution of sEMG methods and equipment, highlighting how technological advances have influenced the accuracy and applicability of this method in dentistry. The need for standardization of musculoskeletal testing methodology is highlighted and the needed increased technical capabilities of sEMG equipment and the ability to specify parameters (e.g., sampling rates, bandwidth). A higher sampling rate (the recommended may be 2000 Hz or higher in masticatory muscles) allows more accurate recording of changes in the signal, which is essential for accurate analysis of muscle function. Bandwidth is one of the key parameters in sEMG research. Bandwidth determines the range of frequencies effectively recorded by the sEMG system (the recommended frequency limits are usually between 20 Hz and 500 Hz in masticatory muscles). In addition, the increased technical capabilities of sEMG equipment and the ability to specify electromyographic parameters demonstrate the need for a detailed description of selected parameters in the methodological section. This is necessary to maintain the reproducibility of sEMG testing. More high-quality clinical trials are needed in the future.

Up regulation of serum L fucose glycoprotein as a diagnostic biomarker for dysplasia in oral sub mucous fibrosis patients

Glycoproteins, essential for cellular functions, contain monosaccharides like Levo-fucose, crucial for cell communication. Recent research highlights serum L-fucose as a potential biomarker for early detection of malignancies. Typically, serum L-fucose levels are low but rise with malignancy. This study evaluates serum L-fucose as an early biomarker in oral submucous fibrosis (OSMF) patients.

Aim

Assess serum L-fucose's diagnostic potential for dysplasia in OSMF patients.

Objectives

Determine the Association between Serum L Fucose Glycoprotein Levels and Dysplasia in OSF Patients.Evaluate the Diagnostic Accuracy of Serum L Fucose Glycoprotein as a Biomarker for OSF-Related Dysplasia.

Methodology

Over a span of two years, this study encompassed 80 subjects, aged between 18 and 60 years, who were clinically and histopathologically identified as OSMF patients, with or without dysplastic alterations. From each participant, 5 ml of blood was collected. Following centrifugation to separate the serum, the samples were analyzed to determine the levels of Levo-fucose.

Statistical analysis

Using SPSS (version 17.0), serum L-Fucose levels of the case group were compared to the control group using ANOVA. Frequencies were analyzed with the chi-square test, and Tukey's Test was used for multiple comparisons. Significance was set at p < 0.01.

Results

The analysis revealed a statistically significant disparity in the mean serum L-Fucose levels between the two groups (p < 0.01). Notably, Group II patients (those with OSMF and dysplasia) exhibited markedly elevated mean serum L-fucose levels.

Conclusion

Elevated serum L-Fucose levels were observed in OSMF patients with dysplasia. Harmful habits, especially gutkha chewing, were linked to Oral Squamous Cell Carcinoma onset. Serum L-fucose can be a reliable marker for evaluating precancerous conditions.

Diagnosis and Orthodontic Treatment of Obstructive Sleep Apnea Syndrome Children-A Systematic Review

Obstructive sleep apnea syndrome (OSAS) is a respiratory illness that is associated with recurrent episodes of either partial or full obstruction of the upper airways, or apnea, among other sleep disorders. This study aims to analyze, through a literature review, whether orthodontic treatment can be a good treatment strategy for this type of disorder. We performed a database search on Scopus, Web of Science, and Pubmed with the keywords OSA(S) and orthodontics to select the papers under evaluation. The criteria for inclusion were articles related to OSA(S) children undergoing an orthodontic treatment and clinical studies or case series, excluding systematic reviews, narrative reviews, meta-analyses, adult studies, animal models, and in vitro studies. The screening phase ended with the selection of 16 publications for this work. RME, or rapid maxillary expansion, turned out to be the preferred orthodontic treatment in cases of pediatric OSAS. The goal of this orthodontic procedure is to increase the hard palate's transverse diameter by reopening the mid-palatal suture. Children with maxillary contraction and dental malocclusion typically undergo such a procedure and have excellent results. However, OSAS is a multifactorial disorder; it does not seem related to the morphology of the oral cavity, and therefore, it is not always possible to cope with this problem exclusively through orthodontic treatment.

Prevalence of temporomandibular disorders diagnosis in patients treated with Herbst appliance: a systematic review and meta-analysis

BACKGROUND

The Herbst appliance is an excellent therapy for treating class II malocclusions with increased overjet. Its mechanics involve propelling the mandibular bone using two pistons the patient cannot remove. The so-called bite-jumping keeps the mandible in a more anterior position for a variable period, usually at least 6 months. This appliance does not inhibit joint functions and movements, although there are scientific papers in the literature investigating whether this appliance can lead to temporomandibular disorders. This systematic review aims to evaluate whether Herbst's device can cause temporomandibular diseases by assessing the presence of TMD in patients before and after treatment.

METHODS

A literature search up to 3 May 2023 was carried out on three online databases: PubMed, Scopus and Web of Science. Only studies that evaluated patients with Helkimo scores and Manual functional analysis were considered, as studies that assessed the difference in TMD before and after Herbst therapy. Review Manager version 5.2.8 (Cochrane Collaboration) was used for the pooled analysis. We measured the odds ratio (OR) between the two groups (pre and post-Herbst).

RESULTS

The included papers in this review were 60. Fifty-seven were excluded. In addition, a manual search was performed. After the search phase, four articles were considered in the study, one of which was found through a manual search. The overall effect showed that there was no difference in TMD prevalence between pre-Herbst and post-Herbst therapy (OR 0.74; 95% CI: 0.33-1.68).

CONCLUSION

Herbst appliance seems not to lead to an increase in the incidence of TMD in treated patients; on the contrary, it appears to decrease it. Further studies are needed to assess the possible influence of Herbst on TMDs.

Effect of non-surgical periodontal therapy on CD14 + CD16+ monocyte counts in peripheral blood samples: a clinical interventional study

Monocytes and their macrophage progeny are thought to be involved in tissue and alveolar bone destruction in periodontal disease. It has been documented that the proportion of (CD14 + CD16+) non-classical monocytes in the blood are elevated in chronic periodontitis;A total of 20 chronic generalized periodontitis patients who were otherwise healthy, were recruited for this study. At baseline and 3 weeks after non-surgical periodontal treatment, peripheral blood was obtained to assess the levels of C-reactive protein (CRP) and the proportion of monocyte subsets. Monocyte subsets were assessed using flow cytometry;The mean percentage of CD14 + CD16+ non-classical monocytes in the peripheral blood sample at baseline was 13.95 + 2.09, that reduced to 8.94 + 1.23 3 weeks after non-surgical treatment. A distinct significant reduction in the percentage of non-classical monocytes and a concomitant increase in classical monocytes were observed following periodontal treatment compared to baseline. There was a significant reduction in the all the periodontal parameters and CRP levels 3 weeks post non-surgical periodontal treatment. A positive correlation between CRP and percentage of non-classical monocytes was also observed; Periodontal treatment potentially modulates the host response effectively.

Correlating estrogen replacement therapy and temporomandibular disorders: a comprehensive review following PRISMA principles and cochrane handbook for systematic reviews of interventions

BACKGROUND

Estrogen replacement therapy (ERT) is a common hormonal treatment for postmenopausal women, aimed at alleviating menopausal symptoms and reducing the health risks associated with estrogen deficiency. However, the impact of ERT on temporomandibular disorders (TMDs) remains unclear. This systematic review aims to evaluate the relationship between ERT and TMDs, including TMD occurence, pain, and associated symptoms.

METHODS

A comprehensive search of seven electronic databases was conducted using predefined search terms and Boolean operators. Inclusion criteria encompassed studies examining the association between ERT and TMDs. Two independent reviewers screened the identified articles, extracted data, and assessed the risk of bias using the RoB -2 tool.

RESULTS

Search strategy identified a total of 3 articles which met the inclusion criteria. The included studies investigated the impact of ERT on TMD occurrence and its related symptoms. The analysis revealed no significant association between ERT and TMD occurrence. A significant dose relationship was noted in one of the studies while another mentioned the possible relationship of TMD with educational status. Risk of bias among the studies was low, and the overall quality of evidence was deemed to be high.

CONCLUSION

This systematic review suggests that there is no conclusive evidence supporting an increased risk of TMDs among women receiving ERT. The findings indicate that ERT is unlikely to have a noticeable impact on TMDs. However, due to the limited number of studies available, further research is warranted to strengthen these conclusions and explore potential factors that may influence the relationship between ERT and TMDs.

The Impact of Cesarean Section Delivery on Intestinal Microbiota: Mechanisms, Consequences, and Perspectives-A Systematic Review

The relationship between cesarean section (CS) delivery and intestinal microbiota is increasingly studied. CS-born infants display distinct gut microbial compositions due to the absence of maternal birth canal microorganisms. These alterations potentially link to long-term health implications like immune-related disorders and allergies. This correlation underscores the intricate connection between birth mode and the establishment of diverse intestinal microbiota. A systematic literature review was conducted on the PubMed, Scopus, and Web of Science databases by analyzing the articles and examining the intricate interactions between CS delivery and the infant's intestinal microbiota. The analysis, based on a wide-ranging selection of studies, elucidates the multifaceted dynamics involved in CS-associated shifts in the establishment of fetal microbiota. We also explore the potential ramifications of these microbial changes on neonatal health and development, providing a comprehensive overview for clinicians and researchers. By synthesizing current findings, this review contributes to a deeper understanding of the interplay between delivery mode and early microbial colonization, paving the way for informed clinical decisions and future investigations in the field of perinatal medicine.

Pharmacological therapy in the management of temporomandibular disorders and orofacial pain: a systematic review and meta-analysis

BACKGROUND

Temporomandibular disorders (TMD) are manifested by soreness in the jaw joint area and jaw muscles, clicks or creaks when opening or closing the mouth. All these symptoms can be disabling and occur during chewing and when the patient yawns or speaks. Several classes of drugs are used to treat symptoms. This review aims to assess which drug suits the different signs.

METHODS

Pubmed, Web of Science and Lilacs were systematically searched until 01/02/2023. Clinical trials were selected that dealt with drugs used in temporomandibular dysfunction RESULTS: Out of 830 papers, eight studies were included. The Meta-Analysis with Continuous Outcomes with Pre-Calculated Effect Sizes resulted in the rejection that there is intergroup variability (p.0.74).

CONCLUSIONS

Treatment of orofacial pain is still a significant challenge for dentistry. We can conclude that there is no drug of first choice in the treatment of temporomandibular pain. However, the clinician must distinguish the type of pain and the aetioloic cause of the pain so that the patient can be treated and managed pharmacologically.

The effectiveness of chitosan as a hemostatic in dentistry in patients with antiplatelet/anticoagulant therapy: systematic review with meta-analysis

Hemorrhage control is a crucial aspect of dental procedures, and achieving efficient hemostasis remains a key challenge. The advent of hemostatic dressings has revolutionized the field of dentistry by providing effective and convenient solutions for managing bleeding in vari-ous dental scenarios. This article aims to provide an overview of hemostatic dressings, their mechanisms of action, and their diverse applications in dentistry. We applied the following Pop-ulation, Exposure, Comparator, and Outcomes (PICO) model to assess the document eligibility. A literature search was performed on major search engines, using keywords. At the end of the search, 3 articles were selected that matched the PICO. Three items were selected after the screen-ing process, and bleeding times were analyzed between the control group and the study group. The overall effect showed a substantial and statistically significant difference with bleeding time in favour of HDD-treated patients, showing that this garrison is very useful in controlling bleed-ing for patients taking anticoagulants and antiplatelets (Mean difference - 5.61; C.I. -5.70, - 5.52); Overall, hemostatic dressings have revolutionized the management of bleeding in dentistry, offering a promising solution to achieve optimal hemostasis, improve treatment outcomes, and enhance patient care, particularly Hemcon.

A comparative evaluation of physical properties of CAD/CAM complete denture resins- an in vitro study

BACKGROUND

In dentistry, there is a growing preference for computer-aided design and computer-aided manufacturing (CAD/CAM) systems over traditional laboratory procedures. However, there is not much literature comparing various CAD/CAM materials. Thus, this study aimed to assess and compare the color stability and hardness of gingival and tooth colored milled and 3D-printed acrylic resins.

MATERIALS AND METHODS

Four types of CAD/CAM materials were prepared: 3D-printed pink shade (PP), milled polymenthymethacrylate (PMMA) pink shade (MP), 3D-printed tooth shade (PT) and milled PMMA tooth shade (MT) (n = 6). For hardness, disc shaped samples of 15 mm × 2 mm and for color stability, bar shaped samples of 65mmx10mmx2.5 mm were prepared and polished. Vickers hardness test was performed in a microhardness tester. Color stability test was done by immersing in coffee solution and coca cola for 7 days. Day 0 and day 7 measurements were recorded using a digital spectrophotometer and the change in color was calculated. For statistical analysis, one-way ANOVA and Tukey's post hoc tests were done.

RESULTS

For color stability, milled PMMA was superior to 3D-printed resin samples. Milled pink and tooth shade samples had similar color stability, whereas 3D-printed tooth shade samples were more color stable as compared to pink shade 3D-printed samples. For hardness, milled tooth shade PMMA was the most superior one, followed by 3D-printed tooth shade, whereas pink shade milled PMMA and 3D-printed resin samples had similar hardness values and were inferior to the tooth shade CAD/CAM materials.

CONCLUSION

Color stability of milled PMMA is superior to that of 3D-printed resins. Hardness of tooth shade milled and 3D-printed resins is more than that of pink shade milled and 3D-printed resins.

Attenuation of orthodontically induced inflammatory root resorption by using low-intensity pulsed ultrasound as a therapeutic modality- a systematic review

Ultrasound is an effective tool for both diagnostic and therapeutic applications. As an imaging tool, ultrasound has mostly been used for real-time noninvasive diagnostic imaging. As ultrasound propagates through a material, a reflected radio-frequency (RF) signal is generated when encountering a mismatch in acoustic impedance. While traditionally recognized for its diagnostic imaging capabilities, the application of ultrasound has broadened to encompass therapeutic interventions, most notably in the form of Low-Intensity Pulsed Ultrasound (LIPUS). Low-Intensity Pulsed Ultrasound (LIPUS) is a form of mechanical energy transmitted transcutaneously by high-frequency acoustic pressure waves. The intensity of LIPUS (30 mW/cm2) is within the range of ultrasound intensities used for diagnostic purposes (1-50 mW/cm2) and is regarded as non-thermal, non-destructive, permeating living tissues and triggering a cascade of biochemical responses at the cellular level. The LIPUS device produces a 200 µs burst of 1.5 MHz acoustic sine waves, that repeats at a modulation frequency of 1 kHz and provides a peak pressure of 30 mW/cm2. Low-intensity pulsed ultrasound (LIPUS) forms one of the currently available non-invasive healing-enhancing devices besides electro-stimulation (pulsed electro-magnetic field, PEMF). This modality has been leveraged to enhance drug delivery, expedite injury recovery, improve muscle mobility, alleviate joint stiffness and muscle pain, and enhance bone fracture healing. Although LIPUS has been embraced within various medical disciplines, its integration into standard dental practices is still in its nascent stages, signifying an unexplored frontier with potentially transformative implications. Low-intensity pulsed ultrasound (LIPUS) has emerged as an attractive adjuvant therapy in various dental procedures, such as orthodontic treatment and maxillary sinus augmentation. Its appeal lies in its simplicity and non-invasive nature, positioning LIPUS as a promising avenue for clinical innovation. One particular area of interest is orthodontically induced inflammatory root resorption (OIIRR), an oftenunavoidable outcome of the orthodontic intervention, resulting in the permanent loss of root structure. Notably, OIIRR is the second most common form of root resorption (RR), surpassed only by root resorption related to pulpal infection. Given the high prevalence and potential long-term consequences of OIIRR, this literature review seeks to evaluate the efficacy of LIPUS as a therapeutic approach, with an emphasis on assessing its capacity to reduce the severity of OIIRR to a level of clinical significance. To conduct this systematic review, a comprehensive automated literature search was executed across multiple databases, including MEDLINE, Embase, PsycINFO, Web of Knowledge, Scopus, CINAHL, LILACS, SciELO, Cochrane, PubMed, trials registries, 3ie, and Google Scholar. Both forward and backward citation tracking was employed, encompassing studies published from database inception through January 2009 to April 2023. The review focused on randomized controlled trials (RCTs) that specifically evaluated the effects of low-intensity pulsed ultrasound therapy on orthodontically induced inflammatory root resorption (OIIRR), without restrictions of publication date. A stringent selection criterion was applied, and only studies demonstrating high levels of statistical significance were included. Ultimately, fourteen studies met the inclusion criteria and were subjected to further analysis. The overall quality of the included randomized controlled trials (RCTs) was rigorously assessed utilizing the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. This analysis revealed certain methodological limitations that posed challenges in drawing definitive conclusions from the available evidence. Despite these constraints, the review offers invaluable insights that can inform and guide future research. Specifically, it delineates recommendations for targeted populations, necessary interventions, appropriate outcome measures, suitable study designs, and essential infrastructure to facilitate further investigations. The synthesis of these insights aims to enhance the development and application of low-intensity pulsed ultrasound therapy within the field of dentistry, thereby contributing to improved patient outcomes.

Biomimetic approach to strengthen the incisal fracture composite build-up: an in vitro study

OBJECTIVE

Incisal composite build-up shows a high failure susceptibility. The incorporation of fiber-reinforced composite (FRC) during composite restoration could improve its strength. Hence the study was planned to compare the effect of various positions of FRC on the strength of composite resin incisal build-ups.

METHODS

In maxillary incisors (n = 90), 3 mm of the incisal edge was cut and teeth were categorized into three groups based on the location and number of fibers used during incisal composite build-up - Group I: composite resin; Group II: composite resin and a single fiber palatally and Group III: composite resin along with two fibers palatally.

RESULTS

The data showed that group II had the maximum load-bearing values followed by group I and group III.

CONCLUSION

Within the confines of our study, it can be concluded that the addition of FRC to the conventional incisal composite build-up increased the overall strength restoration. Such composite restoration reinforced with a single fiber on the palatal side showed the highest load-bearing capacity compared to two fibers reinforced and unreinforced composites. The common mode of failure in group I was in composite resin, in two fibers reinforced at fibers-composite junction, and in one fiber reinforced composite was in the remaining part of the tooth.

Importance of periodontal phenotype in periodontics and restorative dentistry: a systematic review

BACKGROUND

Periodontal phenotype is regarded to be one of the key factors influencing the efficacy of restorative therapies in dental practice. The objective of the systematic review was to explore the importance of thin and thick periodontal phenotypes and how they affect the outcome of periodontal and restorative therapies by looking at a number of academic publications from various online databases.

METHODS

Following the PRISMA guidelines (Preferred Reporting Items for Systematic Review standards), relevant data will be searched and retrieved from three significant scientific databases, including PubMed, EBSCO, and Scopus. The articles with full texts that matched the keywords and published in English between 2018 and 2023 were taken into consideration.

RESULTS

The majorities of these articles were based on the type of periodontal phenotype and their impact on periodontal and restorative treatment outcomes were selected. The initial search yielded a total of 530 articles. Only 273 were relevant to the review's objectives, and these were considered for determining eligibility. Only 20 publications were eligible for analysis.

CONCLUSION

Understanding these anatomical aspects of periodontal phenotype is crucial to both periodontology and restorative dentistry. The clinical outcome of restorative, prosthetic, orthodontic, surgical, and periodontal therapies is determined in large part by the periodontal phenotype, which also plays a significant role in clinical failure or success in dental treatments.

TRIAL REGISTRATION

This study protocol registered with the International Prospective Register of Systematic Reviews (PROSPERO) dated 16th June 2023 with the registration ID CRD42023432568.

Modified Technique to Rehabilitate American Society of Anesthesiology-III Patient, Through Flapless Procedure With Computed Tomography-Guided Surgery

PURPOSE

The aim was to evaluate the safety and effectiveness of a computed tomography-guided surgery implant placement with a flapless technique and immediate functional loading in an American Society of Anesthesiology-III patient.

METHODS

This technical note involved a 64-year-old American Society of Anesthesiology-III patient. Her hopeless teeth were extracted and a restorative evaluation was provided as a prosthetic reference. The surgical procedure was based on the flapless technique that let us to use local anesthesia. The authors used an All-on-4 concept restoration for maxilla and conventional fixed prosthesis procedures for jaw rehabilitation. The authors placed 4 tilted implants in the upper maxilla and 6 right implants in the jaw. Implants were loaded with a provisional prosthesis on the same day of surgery. Five months later, provisional restoration was removed; the authors placed into the ceramic crowns 2 Procera Implant Bridge (Nobel Biocare) frameworks, developed through computer-aided design/computer-aided manufacturing technology.

CONCLUSIONS

Computed tomography-guided surgery is a minimally invasive technique that allows, through a flapless approach, safer and more predictable procedures. In this technical note, the authors achieved accurate implant placement and precise fit of restoration with natural looking appearance; this patient-oriented-treatment led to a reduced healing time with better compliance.

Clinical application of a positioning annular gingival cutter in minimally invasive stage II implant surgery

BACKGROUND

Dental implant restoration is an effective therapy for missing teeth and is widely used in clinical practice to provide more treatment options for patients.

OBJECTIVE

To explore the application of a positioning annular gingival cutter in minimally invasive stage II implant surgery and to evaluate its clinical effects.

METHOD

Stage II implant surgery using a positioning annular gingival cutter was performed on 15 selected patients at 15 implant sites with sufficient keratinized gingival width in the posterior region. The patient underwent crown restoration 2 weeks after surgery and returned for follow-up 3 months later. The surgical effects were recorded for each patient, including the duration of surgery, postoperative pain and swelling, keratinized gingiva width, probing depth (PD) measurements, and the percentage of bleeding on probing (BOP) before surgery, during crown restoration, and 3 months after crown restoration. The data were subjected to a paired sample t-test using Statistical Product and Service Solutions (SPSS) 25.0.

RESULTS

The duration of stage II implant surgery using a positioning annular gingival cutter was 9.23 ± 1.63 min, and the duration of postoperative pain and swelling was 0.73 ± 0.35 and 0.81 ± 0.35 d, respectively. The keratinized gingiva width was 2.93 ± 0.41 mm before surgery and 2.91 ± 0.46 mm after crown restoration, demonstrating no significant reduction (P> 0.05). The keratinized gingiva width remained stable 3 months after crown restoration, with an average of 2.85 ± 0.49 mm, without significant reduction (P> 0.05). No obvious inflammation is observed. PD was 2.60 ± 0.52 mm and BOP was 10%.

CONCLUSION

The use of a positioning annular gingival cutter in stage II implant surgery achieves a positive and stable clinical effect within a short time.

Repair of pressure ulcers in the elderly using autologous microskin implantation and negative pressure wound therapy: A retrospective study

BACKGROUND

Pressure ulcers remain a worldwide problem.

OBJECTIVE

To introduce an intermittent and feasible wound treatment method for the treatment of pressure ulcers in elderly patients.

METHODS

This surgical procedure was performed on eight elderly patients suffering from pressure ulcers. Microskin measuring 0.1 × 0.1 centimeters was cut from a small amount of thin skin and then grafted onto the wound surface in conjunction with closed negative pressure therapy.

RESULTS

Seven patients had their wounds closed after a single surgery, while one patient required two surgeries to close the wound.

CONCLUSION

Autologous microskin implantation for the treatment of pressure ulcers in the elderly is an effective method to close the wound, which can prevent the elderly from living with wounds in their later years and is a viable treatment option.

Estimation of age implementing pulp tooth volume ratio in maxillary canines of an Indian population by means of CBCT scans

BACKGROUND

Forensic odontology is a subfield of forensics that can assist in determining age, gender, and other demographic factors.

OBJECTIVE

The focus of this research is to ascertain age by tooth volume ratio of permanent maxillary canines using a CBCT scan.

METHODS

In this retrospective investigation, 1000 CBCT images were gathered and focused on only fully developed maxillary canines. For each of the maxillary canines, the researchers measured and calculated the volume of the pulp chamber, root canal, and entire tooth using the ITK Snap programme. The pulp volume to tooth volume ratio was computed. The equation AGE = 59.208 - (583.652 x pulp volume/tooth volume) was then used to compute age. The samples were divided into 5 age groups; 13-20, 21-30, 31-40, 41-50, and 51-60. The age was calculated for samples in each group and it was compared to the actual age.

RESULTS

Between individuals' actual age and computed age, the study discovered a statistically significant positive association. While groups 3, 4, and 5 demonstrated positive but weaker correlations (r= 0.854, r= 0.658, and r= 0.612, respectively), groups 1 and 2 displayed statistically significant strong positive correlations (r= 0.987 and r= 0.923, respectively). The average total discrepancy between the age that was computed and the actual age was 2.45 1.344.

CONCLUSION

The study found a statistically significant positive correlation between computed age and actual age, with the younger age groups 1 (13-20) and 2 (21-30) showing the strongest relationships. This underlines its potential success in court, particularly when dealing with young criminals.

Therapeutic evaluation of titanium dioxide nanoparticles based herbal dental varnish derived from rosemary and ginger extracts:A comprehensive investigation into anti-inflammatory and antioxidant properties

BACKGROUND

Titanium nanoparticles (NPs) offer promising applications in the treatment and prevention of inflammatory disorders due to their unique physicochemical characteristics. However, additional research is necessary to attain a thorough comprehension and validate the efficacy of this approach in dental practice.

OBJECTIVE

This study scrutinizes the anti-inflammatory properties of a dental varnish infused with ginger and rosemary extracts mediated by titanium dioxide (TiO2) nanoparticles.

METHODS

A herbal dental varnish was formulated by integrating ginger and rosemary extracts with titanium dioxide nanoparticles at concentrations of 10, 20, 30, 40, and 50 μL. Anti-inflammatory properties were assessed through Bovine Serum Albumin denaturation and membrane stabilization assays, comparing results with a control group.

RESULTS

The results reveal concentration-dependent antioxidant and anti-inflammatory properties in the test group when compared to the control group. The BSA assay corroborates increased percent inhibition with rising titanium dioxide nanoparticle concentrations. In line with existing literature, titanium dioxide nanoparticles enhance dental material properties.

CONCLUSION

The bioactive compounds in ginger and rosemary, such as phenolic compounds and terpenes, contribute to anti-inflammatory and antioxidant effects of the varnish. Additionally, the therapeutic potential of titanium dioxide nanoparticles in addressing inflammatory diseases underscores their significance in this formulation.

Technical assessment of shear bond strength at ceramo-alloy interface after various surface treatment combinations and application of metal bonding agent

BACKGROUND

Bonding between metal and ceramic is one of the most important aspects of a successful prosthesis. Various methods have been recommended for preparing the metal surface to enhance the bond between metal and ceramic including the use of a metal bonding agent.

OBJECTIVE

This study aims to evaluate and compare the shear bond strength of the metal-ceramic (M-C) interface after combinations of various surface treatments including the application of a metal bonding agent.

METHOD

40 Ni-Cr alloy specimens were made and divided into 4 groups of 10 each based on the combination of surface treatments. Sandblasting, surface grinding, and Oxidation heat treatment (OHT) were performed on specimens from Group 1 (Control). In addition, Group 2 specimens received ultrasonic cleaning, Group 3 steam cleaning, and Group 4 metal bonding agent application. Following surface treatments on all specimens, porcelain build-up was performed, and shear bond strength was tested in a Digital Universal testing machine. The statistical tests used were independent t-test and ANOVA.

RESULTS

Results revealed that Group 4 specimens had the highest mean value of shear bond strength of 39.087 MPa while Group 3 specimens showed the least mean shear bond strength of 18.154 MPa with highly statistically significant results (p< 0.001).

CONCLUSION

The surface treatments and application of bonding agent to metal prior to porcelain application resulted in increased shear bond strength of the metal-ceramic interface.

Micronuclei as an indicator of genotoxic change in epithelial cells of buccal mucosa after panoramic radiographs

BACKGROUND

The radiation released at the time of dental panoramic radiographs causes genotoxic and cytotoxic effects on epithelial cells.

OBJECTIVE

This research aimed to evaluate the changes in the frequencies of micronucleated cells in patients' buccal epithelial cells following dental panoramic radiography.

METHODS

74 patients were recruited for the study who were advised for panoramic radiographs. Using a wooden spatula, the buccal epithelial cells were scraped from both cheeks before to panoramic radiation exposure and ten days after the panoramic radiation exposure. Giemsa stain was used to stain the cells, and 500 cells were scored on a slide to determine the frequency of micronuclei. To determine the difference between the frequency of micronuclei before and after radiation exposure, a paired t-test was used in the statistical analysis.

RESULTS

The proportion of micronuclei cells was 0.11% before radiation exposure and 0.57% following radiation exposure after 10 days. A statistically significant increase in the frequencies of micronuclei was noted after radiation exposure values.

CONCLUSION

This study revealed the genotoxicity of epithelial cells with dental panoramic radiation exposure. It is advised to reduce the use of such radiographs and to use only when there is no other diagnostic tool that is helpful or when absolutely essential.

Analysis of modified palatal surface for better speech in edentulous patients: A clinico-analytical study

BACKGROUND

Phonetics with mechanics and aesthetics are considered cardinal factors contributing to the success of complete dentures.

OBJECTIVE

The aim of the current study was to evaluate the changes in speech in complete denture patients with and without palatal surface changes.

METHODS

The data collected for the study involved completely edentulous Patients (n= 80). Patients were divided into two groups. Group A: Up to 50 years (n= 40); Group B: Above 50 years (n= 40) (including male and female). Each group was further divided into four subgroups for speech analysis-without dentures (A1/B1); with conventional dentures (A2/B2); dentures with a palatogram (A3/B3) and dentures with palate sandblasted (A4/B4). The speech sounds of all patients were evaluated for pitch and intensity using a spectrophotogram (Praat software) and Likert scale. The data so obtained from the quantitative and qualitative analysis were statistically analysed through one-way ANOVA, unpaired student's t-test, and Pearson correlation coefficient. Qualitative analysis was done with the Mann-Whitney U test.

RESULTS

The maximum mean value of the pitch and intensity in Groups A and B was subgroup A3 (Palatogram) 190.37 ± 21.50 and 77.07 ± 7.58, B3 (Palatogram) 190.87 ± 24.36 and 75.33 ± 8.12. When comparing Groups A [A1, A2, A3, A4] and B [B1, B2, B3, B4] on the basis of pitch and intensity, a statistically insignificant value was found. No changes in speech sounds (pitch and intensity) were observed in terms of age. Both quantitative and qualitative analysis results showed that speech sounds in the patients with palatogram, had the highest pitch and intensity and were most clear to the listener and there were statistically significant differences from other groups.

CONCLUSION

Speech was better in palatogram-based dentures in comparison to a sandblasted denture, conventional denture and without denture in terms of qualitative and quantitative analysis. The physiologic nature of the palatogram fabrication technique produces the palatal part of the denture more compatible with the tongue, thus producing better speech.

The commercially available oral rinse vs. curcumin photosensitizers in an artificial mouth model mimicking their use after meals on early colonizers single species biofilm: An in vitro study

BACKGROUND

Commercially available oral rinses contain active ingredients with concentration that is claimed by manufacturers to be effective as antiplaque agent. To date there has been no mention of the effect of oral rinse on the adherence of early plaque colonizers in plaque formation and the concentration to be used before/after meals.

OBJECTIVE

The chief aim of the study was to evaluate microbial retention on the salivary pellicle on treatment with oral rinses (CHX & EO)/PS (mimicking after meals use of mouth wash/PS).

METHODS

Noordini's Artifical Mouth model was used for developing the single species biofilm with early microbial colonizers of oral biofilm (A. viscosus, Strep. mitis and Strep. sanguinis respectively). The microbial retention on use of oral rinses comprising of CHX and EO as an active ingredients respectively was compared with Curcumin PS. For evaluating the microbial retention, the pellicle with microbial inoculation was developed on the glass beads in the mouth model. Subsequently the respective single specie biofilm was exposed to the mouth wash and PS after inoculation. It mimicked as use of mouth wash/PS after meals. The bacterial count in the dental biofilm was evaluated on serial dilution (CFU/ml). Sterile deionized water was used as a negative control. For qualitative analysis, Scanning electron microscope (SEM) was used to evaluate the microbial count.

RESULTS

From the data it was observed that for the treatment of single species experimental biofilm with commercially available mouth rinses (CHX & EO) and PS (curcumin), there was significant retention for S.mitis, S.sanguinis and A.viscosus. There was no significant difference observed between PS and CHX treated single species biofilm. Whereas a significant difference was observed between EO treated biofilms and CHX/PS treated biofilms (p⩽ 0.05).

CONCLUSION

It can be concluded from the results that curcumin PS and CHX should not be used after meals whereas EO containing mouth rinse can be used to maintain the oral mocroflora.

Implant-supported prosthetic rehabilitation after Ameloblastomas treatment: a systematic review

BACKGROUND

Ameloblastoma (AM), the benign counterpart of ameloblastic carcinoma, is a benign odontogenic tumor of epithelial origin, naturally aggressive, with unlimited growth potential and a high tendency to relapse if not adequately removed. Patients with AM treated surgically can benefit from dental implant therapy, promoting oral rehabilitation and improving their quality of life. The present study aimed to determine the survival rate of dental implants placed after surgical treatment of patients affected by AM. In addition, there were two secondary objectives: 1) To evaluate which dental implant loading protocols are most frequently used and 2) To determine the type of prosthetic restoration most commonly used in these patients.

METHODS

The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed during the study. Searches were performed in three databases (PubMed/MEDLINE, Scopus, and Google Scholar) until November 2023. Additionally, the electronic search was enriched by an iterative hand search of journals related to oral pathology and medicine, maxillofacial surgery, and oral prosthodontics and implantology. Only reports and case series in English from January 2003 to date were included. The Joanna Briggs Institute tool (JBI-Case Reports/Case Series) was used for the study quality assessment.

RESULTS

The total number of patients and implants studied were 64 and 271, respectively, all with surgically treated AM. The patient's ages ranged from 8 to 79 years, with a mean (SD) age of 37.3 ± 16.4. Fifty-three percent were male and 47% were female. The range of follow-up duration was 1 to 22 years. An implant survival/success rate of 98.1% was reported. In addition, most of them were conventionally loaded (38.3%). Hybrid implant-supported fixed dentures were the most commonly used by prosthodontists (53%).

CONCLUSIONS

Oral rehabilitation with dental implants inserted in free flaps for orofacial reconstruction in surgically treated patients with AM can be considered a safe and successful treatment modality.

Artificial Intelligence and Its Clinical Applications in Orthodontics: A Systematic Review

This review aims to analyze different strategies that make use of artificial intelligence to enhance diagnosis, treatment planning, and monitoring in orthodontics. Orthodontics has seen significant technological advancements with the introduction of digital equipment, including cone beam computed tomography, intraoral scanners, and software coupled to these devices. The use of deep learning in software has sped up image processing processes. Deep learning is an artificial intelligence technology that trains computers to analyze data like the human brain does. Deep learning models are capable of recognizing complex patterns in photos, text, audio, and other data to generate accurate information and predictions.

MATERIALS AND METHODS

Pubmed, Scopus, and Web of Science were used to discover publications from 1 January 2013 to 18 October 2023 that matched our topic. A comparison of various artificial intelligence applications in orthodontics was generated.

RESULTS

A final number of 33 studies were included in the review for qualitative analysis.

CONCLUSIONS

These studies demonstrate the effectiveness of AI in enhancing orthodontic diagnosis, treatment planning, and assessment. A lot of articles emphasize the integration of artificial intelligence into orthodontics and its potential to revolutionize treatment monitoring, evaluation, and patient outcomes.

The Effects of Periodontal Treatment on Rheumatoid Arthritis and of Anti-Rheumatic Drugs on Periodontitis: A Systematic Review

Rheumatoid arthritis (RA) and periodontitis are chronic inflammatory diseases that widely spread and share the same patterns of pro-inflammatory cytokines. This systematic review aims to evaluate the effects of non-surgical periodontal treatment (NSPT) on RA and, conversely, the impact of disease-modifying anti-rheumatic drugs (DMARDs) on periodontitis. PubMed, Embase, and Web of Science were searched using the MESH terms "periodontitis" and "rheumatoid arthritis" from January 2012 to September 2023. A total of 49 articles was included in the final analysis, 10 of which were randomized controlled trials. A total of 31 records concerns the effect of NSPT on parameters of RA disease activity, including a 28-joint disease activity score, anti-citrullinated protein antibodies, rheumatoid factor, C reactive protein, erythrocyte sedimentation rate, pro-inflammatory cytokines and acute phase proteins in serum, saliva, gingival crevicular fluid, and synovial fluid. A total of 18 articles investigated the effect of DMARDs on periodontal indexes and on specific cytokine levels. A quality assessment and risk-of-bias of the studies were also performed. Despite some conflicting results, there is evidence that RA patients and periodontitis patients benefit from NSPT and DMARDs, respectively. The limitations of the studies examined are the small samples and the short follow-up (usually 6 months). Further research is mandatory to evaluate if screening and treatment of periodontitis should be performed systematically in RA patients, and if the administration of DMARDs is useful in reducing the production of cytokines in the periodontium.

Predictability of Dental Distalization with Clear Aligners: A Systematic Review

The current review aims to evaluate the scientific evidence relating to the effectiveness of treatment with clear aligners (CAs) in controlling distalization orthodontic tooth movement. "Orthodontics, aligners" and "distalization" were the search terms used on the Scopus, Web of Science and Pubmed databases with the Boolean operator "AND". The results of the last ten years of research were 146 studies; of these, 19 publications were included for this review. The distalization movement is possible with invisible masks alone, but the risk of losing anchorage in the anterior sectors is very probable. The stability of the results and the reduction of unwanted effects can be guaranteed by the use of skeletal anchoring devices and interproximal enamel reduction (IPR), with which compensations are obtained to reduce the initial overjet. Temporary anchorage devices (TADs) can be used to manage posterior anchorage after distalization of maxillary molars with aligners. This hybrid approach has demonstrated the greatest orthodontic success. TADs are useful aids to provide direct and indirect skeletal anchorage. The opposite effect must be considered when planning dental distalization, especially of the molars, in patients with large overjet, and corrective measures or the use of auxiliaries may be necessary to prevent midcourse corrections. This systematic review provides a critical evidence-based assessment of the predictability of dental distalization with CAs, an ever-evolving orthodontic technique.

Treatment Approaches to Molar Incisor Hypomineralization: A Systematic Review

AIM

This systematic review aimed to comprehensively evaluate the available literature on treating molar incisor hypomineralization (MIH) or enamel hypomineralization published between 2013 and 2023, focusing on identifying relevant studies and their characteristics.

MATERIALS AND METHODS

The search process encompassed reputable academic databases, including PubMed, Scopus, Cochrane Library, and Web of Science, using a precise keyword strategy ("((molar incisor hypomineralization) OR (enamel hypomineralization)) AND (treatment)"). A total of 637 articles were initially retrieved, followed by a strict selection process adhering to PRISMA guidelines. The inclusion criteria encompassed Randomized Control Trials (RCTs), case series with more than five clinical cases (CSs), studies involving human participants, availability as free full-text or accessible with university credentials, and English-language publications. Exclusion criteria included systematic or literature reviews, editorials, single-case reports, studies conducted in vitro, those involving animals, paid articles, and non-English-language publications.

RESULTS

The search yielded 864 articles, of which 23 met the stringent inclusion criteria after a meticulous selection process. These studies will serve as the basis for a comprehensive analysis of MIH treatment approaches. The systematic review ensures the quality and relevance of the chosen studies for a detailed assessment of MIH treatment strategies.

CONCLUSIONS

This systematic review will provide valuable insights into the characteristics of selected studies, patient profiles, and available treatment options for molar incisor hypomineralization, contributing to a better understanding of this dental condition's management.

Comparative evaluation of antimicrobial efficacy of different combinations of calcium hydroxide against Enterococcus faecalis

BACKGROUND

The study aims to compare the synergistic antibacterial efficacy of different combinations of calcium hydroxide as an intracanal medicament against E. faecalis.

MATERIAL AND METHODS

The current study included four hundred extracted human permanent mandibular premolar teeth. After complete chemo-mechanical preparation, the middle third of the root was sectioned using a rotary diamond disc and a total of 400 samples were obtained. The specimens were inoculated with E. faecalis for 21 days. After that, specimens were divided into five groups (n = 80) based on materials used for the disinfection of samples: Group I, calcium hydroxide alone; Group II, calcium hydroxide + 2% chlorhexidine gel; Group III, calcium hydroxide + 2% chitosan gel; Group IV, calcium hydroxide + 0.02% silver nanoparticle gel; Group V, calcium hydroxide + Bioactive glass S53P4. Dentin shavings from the apical third were obtained from the inner third of dentin were obtained using gates glidden no.1 to the apical depth, followed by no.2, 3, 4 and 5 analyzed for E. faecalis using the culture method. One-way analysis of variance (ANOVA) was used for data analysis, followed by post-hoc Tukey's test for multiple comparisons of means to check the difference in bacterial inhibition between the groups.

RESULTS

ANOVA results revealed a significant reduction of bacterial counts in all the groups compared (p < 0.001). Intergroup comparison showed maximum bacterial reduction (p < 0.001) with calcium hydroxide + bioactive glass S53P4 compared with other groups.

CONCLUSION

Synergistic effect of calcium hydroxide showed better bacterial reduction compared to calcium hydroxide alone. Among the combinations evaluated, calcium hydroxide with bioactive glass, found to be most effective compared to other groups.

Primary Failure Eruption: Genetic Investigation, Diagnosis and Treatment: A Systematic Review

AIM

The aim of this systematic review is to explore the pathology, diagnosis, treatment, and genetic basis of Primary Failure of Eruption (PFE) in the field of pediatric dentistry and orthodontics.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed for this review. The databases PubMed, Science Direct, Scopus, and Web of Science were searched from 1 July 2013 to 1 July 2023, using keywords "primary failure of tooth eruption" OR "primary failure of eruption" OR "tooth eruption failure" OR "PFE" AND "orthodontics". The study selection process involved screening articles based on the inclusion and exclusion criteria.

RESULTS

A total of 1151 results were obtained from the database search, with 14 papers meeting the inclusion criteria. The review covers various aspects of PFE, including its clinical features, diagnosis, treatment options, and genetic associations with mutations in the PTH1R gene. Differentiation between PFE and Mechanical Failure of Eruption (MFE) is crucial for accurate treatment planning. Orthodontic and surgical interventions, along with multidisciplinary approaches, have been employed to manage PFE cases. Genetic testing for PTH1R mutations plays a significant role in confirming the diagnosis and guiding treatment decisions, although some cases may not be linked to this mutation.

CONCLUSIONS

This systematic review provides valuable insights into the diagnosis, treatment, and genetic basis of PFE. Early diagnosis and personalized treatment planning are crucial for successful management. Genetic testing for PTH1R mutations aids in accurate diagnosis and may influence treatment decisions. However, further research is needed to explore the complex genetic basis of PFE fully and improve treatment outcomes for affected individuals.

Post-traumatic stress, prevalence of temporomandibular disorders in war veterans: Systematic review with meta-analysis

INTRODUCTION

The physical and psychological effects of war are not always easy to detect, but they can be far-reaching and long-lasting. One of the physical effects that may result from war stress is temporomandibular disorder (TMD).

OBJECTIVE

To evaluate the prevalence of TMD sign and symptoms among war veterans diagnosed with PTSD.

METHODS

We systematically searched in Web of Science, PubMed and Lilacs for articles published from the inception until 30 December 2022. All documents were assessed for eligibility based on the following Population, Exposure, Comparator and Outcomes (PECO) model: (P) Participants consisted of human subjects. (E) The Exposure consisted of exposition to war. (C) The Comparison was between war veterans (subjects exposed to war) and subjects not exposed to war. (O) The Outcome consisted of presence of temporomandibular disorders sign or symptoms (we considered pain to muscle palpation in war veterans).

RESULTS

Forty studies were identified at the end of the research. We chose only four study to draw up the present systematic study. The included subjects were 596. Among them, 274 were exposed to war, whereas the remaining 322 were not exposed to war stress. Among those exposed to war, 154 presented sign/symptoms of TMD (56.2%) whereas only 65 of those not exposed to war (20.18%). The overall effect revealed that subjects exposed to war and diagnosed with PTSD had a higher prevalence of TMD signs (pain at muscle palpation) than controls (RR 2.21; 95% CI: 1.13-4.34), showing an association PTSD war-related and TMD.

CONCLUSIONS

War can cause lasting physical and psychological damage that can lead to chronic diseases. Our results clearly demonstrated that war exposure, directly or indirectly, increases the risk of developing TMJ dysfunction and TMD sign/symptoms.

Gaucher: A Systematic Review on Oral and Radiological Aspects

Background and Objectives: Gaucher disease (GD) is a lysosomal storage disorder with the genetic autosomal recessive transmission. Bone involvement is a prevalent finding in Gaucher disease. It causes deformity and limits daily activities and the quality of life. In 75% of patients, there is bone involvement. This review aims to evaluate the principal findings in the jaw by a Cone-beam computed tomography (CBTC) and X-ray orthopantomography; Materials and Methods: PubMed, Web of Science, Lilacs and Scopus were systematically searched until 31 December 2022. In addition, a manual search was performed using the bibliography of selected articles and a Google Scholar search. Clinical studies were selected that considered principal radiographic findings in radiography in a group of patients affected by GD. Results: Out of 5079 papers, four studies were included. The main findings are generalized rarefaction and enlarged narrow space, anodontia. Conclusions: The exact mechanism of bone manifestation is probably due to the infiltration of Gaucher cells in the bone marrow and, consequently, the destruction of bone architecture. All long bones are a potential means of skeletal manifestation. The jaw is more affected than the maxilla, and the principal features are cortical thinning, osteosclerosis, pseudocystic lesions, mental demineralization, flattening in the head of the condyle, effacement of anatomical structures, thickening of maxillary sinus mucosa. The dentist plays a crucial role in diagnosing and treating these patients. Sometimes the diagnosis can be made by a simple panoramic radiograph. All long bones are affected, and the mandible is particularly involved.

Challenges of E-Learning: Behavioral Intention of Academicians to Use E-Learning during COVID-19 Crisis

The COVID-19 crisis demanded that all educational activities should be performed virtually to follow social distancing guidelines. Therefore, there was a need to perform a research study to assess the effects of external factors on the perceived usefulness, ease of use of e-learning, and the further effect of these perceptions on attitude and intent to use e-learning by using the technology acceptance model (TAM) among academicians at higher education institutions in the Kingdom of Saudi Arabia. Methods: A cross-sectional study was conducted, and data were collected from 263 academicians across Saudi Arabia through an online survey questionnaire using a non-probability purposive sampling technique and analyzed and tested using the SPSS and Smart PLS software. Results: This study found that self-efficacy was positively associated with perceived usefulness at β = 0.143 and p < 0.05, but it had no association with perceived ease of use at β = 0.057 at p > 0.05. System accessibility had a significant and positive relationship with perceived usefulness and perceived ease of use at β = 0.283, β = 0.247, and p < 0.01, respectively. Self-efficacy had a positive effect on perceived usefulness, whereas the subjective norm had no relationship with perceived usefulness and perceived ease of use at β = −0.065 and β = −0.012 at p > 0.05, respectively. Perceived ease of use and perceived usefulness were positively related to attitude towards use, which has a significant influence on intention to use e-learning. Conclusion: Perceived ease of application is the most significant factor (β = 0.556) in developing the attitude among academicians to practice e-learning, followed by perceived usefulness (β = 0.262). Moreover, it can be concluded that system accessibility has a stronger influence on developing perception among academicians about the expediency and ease of application of e-learning than self-efficacy.

Prevalence of temporomandibular disorders in children and adolescents evaluated with Diagnostic Criteria for Temporomandibular Disorders: A systematic review with meta-analysis

BACKGROUND

The prevalence of temporomandibular disorders (TMDs) in children and adolescents is not well-known. This is partly because TMD is not often diagnosed in children and partly because there is no agreed-upon definition of TMD. There is a growing body of evidence to suggest that there are gender differences in the prevalence and presentation of TMD in adult. The aim was to assess the prevalence of TMDs in subjects aged 8-19 evaluated with Diagnostic Criteria for TMDs (DC/TMD) and to assess gender differences.

METHODS

PubMed, Web of Science and Lilacs were systematically searched until 30 November 2022, to identify studies presenting children and adolescents patients affected by TMDs.

RESULTS

Out of 40 papers, three studies were included. The included subjects in this review were 1914 (1093 female and 821 male). Seven hundred and thirty-six on 1914 patients (38.4%) presented TMD. Among 1093 female, 489 (44.7%) presented TMD, while 247/821 male (30%) experienced TMD. Meta-analysis revealed that the female had a higher TMD prevalence than male (RR 2.10; 95% CI: 1.21-3.65).

CONCLUSION

TMD prevalence in children and adolescence varies between 20% and 60%. Female had a higher prevalence of TMDs compared to male.

The Association between COVID-19 Related Anxiety, Stress, Depression, Temporomandibular Disorders, and Headaches from Childhood to Adulthood: A Systematic Review

Objective: The coronavirus belongs to the family of Coronaviridae, which are not branched single-stranded RNA viruses. COVID-19 creates respiratory problems and infections ranging from mild to severe. The virus features mechanisms that serve to delay the cellular immune response. The host’s response is responsible for the pathological process that leads to tissue destruction. Temporomandibular disorders are manifested by painful jaw musculature and jaw joint areas, clicks, or creaks when opening or closing the mouth. All these symptoms can be disabling and occur during chewing and when the patient yawns or even speaks. The pandemic situation has exacerbated anxieties and amplified the vulnerability of individuals. Therefore, from this mechanism, how the COVID-19 pandemic may have increased the incidence of temporomandibular disorders is perceived. The purpose of this review is to evaluate whether COVID-19-related anxiety has caused an increase in temporomandibular dysfunction symptoms in adults to children. Methods: PubMed, Web of Science, Lilacs, and Scopus were systematically searched, until 30 July 2022, to identify studies presenting: the connection between COVID-19 with temporomandibular disorders. Results: From 198 papers, 4 studies were included. Literature studies have shown that the state of uncertainty and anxiety has led to an increase in the incidence of this type of disorder, although not all studies agree. Seventy-three studies were identified after viewing all four search engines; at the end of the screening phase, only four were considered that met the PECO, the planned inclusion, and the exclusion criteria. All studies showed a statistically significant correlation between temporomandibular disorders and COVID-19 with a p < 0.05. Conclusions: All studies agreed that there is an association between COVID-19 and increased incidence of temporomandibular disorders.

An Investigation of the Fracture Loads Involved in the Framework of Removable Partial Dentures Using Two Types of All-Ceramic Restorations

Retention and support are needed for removable partial denture stability. The stability can be achieved by clasps, occlusal and cingulum rests on healthy abutment teeth. However, implants or crowns can be used to support the removable partial denture instated on unhealthy abutment teeth. This study was conducted to investigate the fracture strength of two types of all-ceramic restorations used as abutments for the removable partial denture framework. The crowns were manufactured with two types of ceramic materials: zirconia and IPS e.max Press ceramics. The metal alloy (cobalt-chrome) was cast to form the removable partial denture framework. A universal testing machine was used to evaluate the fracture strength of both ceramic crown materials. The results presented no fractures in all-ceramic crowns, but deformation of the partial denture frameworks occurred. With the limitation of this study, it can be concluded that zirconia and IPS e.max Press ceramic can be used as abutments to provide adequate support to the removable partial denture.

Radix molaris is a hidden truth of mandibular first permanent molars: A descriptive- analytic study using cone beam computed tomography

BACKGROUND

Cone-beam computed tomography (CBCT) could be more beneficial in clinical situations that involve the determination of root canal morphology.

AIM

The aim of the study was to ascertain the prevalence of radix molaris (paramolaris-RP and entomolaris-RE) in a subpopulation of Saudi Arabia using CBCT.

METHOD

A total of 700 CBCT scans of mandibular permanent first molars were included in this study. All CBCT scans were interpreted by two trained dentists and an endodontist. Mandibular permanent first molars with fully developed roots and closed apices were only included. Computed Tomography scans were obtained from the dental college record. The anatomic characteristics which were checked included: the prevalence of radix molaris in both RE and RP and the prevalence of radix molaris according to the patient's gender and age. All CBCT images were processed and reconstructed using OnDemand3DTM imaging software.

RESULTS

Of the 700 patients included, 651 (93.0%) did not have radix molaris, 46 (6.6%) had radix entomolaris and 3 (0.4%) had radix paramolaris in the study group. There was no statistically significant difference between the genders and age in the incidence of RE and RP (P-value < 0.05).

CONCLUSION

The study showed that RE prevalence is more compared to RP in the first lower molars in the population studied. It is important to identify extra roots and associated canals to perform successful root canal treatment and avoid failure.