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Néma V, Kunsági-Máté S, Őri Z, Kiss T, Szabó P, Szalma J, Fráter M, Lempel E. Relation between internal adaptation and degree of conversion of short-fiber reinforced resin composites applied in bulk or layered technique in deep MOD cavities. Dent Mater 2024; 40:581-592. [PMID: 38368136 DOI: 10.1016/j.dental.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 01/08/2024] [Accepted: 02/12/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE The purpose was to evaluate the degree of conversion (DC), internal adaptation (IA) and closed porosity (CP) of short-fiber reinforced resin composites (SFRC) associated with layered or bulk restorative procedures in deep MOD cavities. METHODS Eighty third molars with standardized MOD cavities (5-mm-depth, 2.5-mm-width) were randomly divided into four groups and restored as follows: 1) bulk SFRC; 2) layered SFRC; 3) flowable bulk-fill resin-based composites (RBC); 4) layered conventional RBC. After one-month wet storage the samples were subjected to micro-computed tomography measurements and scanning electron microscopy to assess the IA and CP. Micro-Raman spectroscopy was used to determine the DC in different depths. Data were subjected to ANOVA and Tukey's post-hoc test, multivariate analysis and partial eta-squared statistics (p < 0.05). Pearson correlation coefficient was determined to assess the relationship among the parameters of interest. RESULTS Gap/total interface volume ratio ranged between 0.22-0.47%. RBCs applied in bulk revealed significantly lower gap volume (p < 0.001) and CP (p < 0.05). Each group showed complete detachment on the pulpal and partial on the lateral walls, except for group3. While the highest DC% was achieved by the conventional RBC (87.2%), followed by the flowable bulk-fill (81.2%), SFRC provided the best bottom to top DC ratio (bulk: 96.4%, layered: 98.7%). The effect of factors studied (RBC type, filling technique) on IA and DC was significant (p < 0.001). SIGNIFICANCE Bulk placement of RBCs exhibited lower interfacial gap volume and achieved satisfactory DC without significant correlation between these parameters. Incremental insertion of SFRC had no advantage over bulk placement in terms of IA and DC.
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Affiliation(s)
- Viktória Néma
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, Tisza Lajos Blvd 64-66, 6720 Szeged, Hungary
| | - Sándor Kunsági-Máté
- Department of Organic and Pharmacological Chemistry, University of Pécs Medical School, Faculty of Pharmacy, Honvéd street 1, 7624 Pécs, Hungary; János Szentágothai Research Center, University of Pécs, Ifjúság Street 12, 7624 Pécs, Hungary
| | - Zsuzsanna Őri
- Department of Nutritional Sciences and Dietetics, University of Pécs, Faculty of Health Sciences, Vörösmarty Street 4, 7621 Pécs, Hungary; Department of Physical Chemistry and Materials Science, University of Pécs, Faculty of Sciences, Ifjúság Street 6, 7624 Pécs, Hungary
| | - Tamás Kiss
- Department of Pharmacology and Pharmacotherapy, University of Pécs Medical School, Szigeti Street 12, 7624 Pécs, Hungary
| | - Péter Szabó
- János Szentágothai Research Center, University of Pécs, Ifjúság Street 12, 7624 Pécs, Hungary
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, University of Pécs Medical School, Tüzér Street 1, 7623 Pécs, Hungary
| | - Márk Fráter
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, Tisza Lajos Blvd 64-66, 6720 Szeged, Hungary
| | - Edina Lempel
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Tüzér Street 1, 7623 Pécs, Hungary.
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Dunavári EK, Kőházy A, Vecsernyés M, Szalma J, Lovász BV, Berta G, Lempel E. Does Preheating Influence the Cytotoxic Potential of Dental Resin Composites? Polymers (Basel) 2024; 16:174. [PMID: 38256973 PMCID: PMC10820920 DOI: 10.3390/polym16020174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/01/2024] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
Resin-based dental composites (RBC) release cytotoxic components, however the extent of the elution from preheated RBCs is barely investigated. The aim was therefore to determine the cytotoxic effect of preheated conventional, bulk, and thermoviscous RBCs of clinically relevant sizes using different cell viability methods in a contact-free model. Samples (6 × 4 mm) were prepared from conventional [Estelite Sigma Quick (ESQ), Filtek Z250 (FZ)] and bulk-filled [Filtek One BulkFill Restorative (FOB), SDR Plus Bulk Flow (SDR), VisCalor Bulk (VCB)] RBCs. The pre-polymerization temperature was set to room temperature (RT) and 55/65 °C. Pulp cells were cultured, followed by a 2-day exposure to monomers released from solid RBC specimens suspended in the culture medium. Cytotoxicity was assessed using a WST-1, MTT, and LDH colorimetric viability assays. Data were analyzed using one-way ANOVA, Tukey's post hoc test, multivariate analysis, and independent t-test. The effect size (ƞp2) of material and temperature factors was also assessed. All the RBCs demonstrated cytotoxic effect upon exposure to pulp cells, but to a varying extent (ESQ >> VCB > FZ = FOB = SDR). The effect of pre-polymerization temperature was insignificant (ƞp2 < 0.03), except for the thermoviscous RBC, which showed inconsistent findings when subjected to distinct viability tests. Cell viability was predominantly dependent on the type of material used (p < 0.001) which showed a large effect size (ƞp2 > 0.90). Irrespective of the pre-polymerization temperature, RBC samples in a clinically relevant size can release monomers to such an extent, which can substantially decrease the cytocompatibility.
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Affiliation(s)
- Erika Katalin Dunavári
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Tüzér Street 1, 7624 Pécs, Hungary; (E.K.D.); (A.K.)
| | - Anna Kőházy
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Tüzér Street 1, 7624 Pécs, Hungary; (E.K.D.); (A.K.)
| | - Mónika Vecsernyés
- Department of Medical Biology and Central Electron Microscope Laboratory, University of Pécs Medical School, Szigeti Street 12, 7624 Pécs, Hungary; (M.V.); (G.B.)
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, University of Pécs Medical School, Tüzér Street 1, 7624 Pécs, Hungary;
| | - Bálint Viktor Lovász
- Oral and Maxillofacial Department, Manchester University Foundation Trust, Manchester Royal Infirmary Hospital, Oxford Rd, Manchester M13 9WL, UK;
| | - Gergely Berta
- Department of Medical Biology and Central Electron Microscope Laboratory, University of Pécs Medical School, Szigeti Street 12, 7624 Pécs, Hungary; (M.V.); (G.B.)
| | - Edina Lempel
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Tüzér Street 1, 7624 Pécs, Hungary; (E.K.D.); (A.K.)
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Lempel E, Gyulai S, Lovász BV, Jeges S, Szalma J. Clinical evaluation of lithium disilicate versus indirect resin composite partial posterior restorations - A 7.8-year retrospective study. Dent Mater 2023; 39:1095-1104. [PMID: 37821330 DOI: 10.1016/j.dental.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 09/26/2023] [Accepted: 10/07/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE To evaluate retrospectively the longevity of lithium disilicate ceramic (LidiSi) vs. laboratory-processed resin-based composite (RBC) inlay/onlay/overlay restorations and risk factors associated with restoration deficiencies and failures. METHODS Patients (n = 91) receiving LidiSi (73.1%) and RBC (36.9%) inlays/onlays/overlays between 2007 and 2017 were selected. The restorations were evaluated using the modified U.S. Public Health Service criteria. The survival of the restorations was analyzed using the Kaplan-Meier method and log rank test. Factors affecting the occurrence of deficiencies were examined by logistic regression analysis. This was performed with the use of the Generalized Estimating Equation model including Repeated measurements (GEER), with the consideration that the same patient had several teeth in the sample. Risk estimation was conducted for each evaluated criterion (p < 0.05). RESULTS The survival of LidiSi and RBC restorations were 96.8% and 84.9%, respectively after a mean observation period of 7.8 ± 3.3 years. The annual failure rate was 0.2% for LidiSi and 1.0% for RBC. The probability of survival was above 98% for both restorations in the first 6 years, however, it dropped to 60% for RBC by the end of the 15th year. For both materials the reasons for failure included secondary caries, restoration fracture, and endodontic complication. In addition, LidiSi also failed due to tooth fracture, while RBC due to marginal gap formation and loss of retention. Among the evaluated risk factors, material of restoration (OR=6.8, CI95%:3.1-14.9), oral hygiene (OR=8.0, CI95%: 2.9-22.1], and bruxism (OR=1.9, CI95%: 1.1-3.3) showed a significant impact on the evaluated criteria. SIGNIFICANCE LidiSi and RBC restorations showed similarly excellent 6-year survival, however, in the long term significantly more failures should be expected for RBCs.
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Affiliation(s)
- Edina Lempel
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Tüzér Street 1, Pécs 7623, Hungary.
| | - Sarolta Gyulai
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Tüzér Street 1, Pécs 7623, Hungary; Department of Oral and Maxillofacial Surgery, University of Pécs Medical School, Tüzér Street 1, Pécs 7623, Hungary
| | - Bálint Viktor Lovász
- Oral and Maxillofacial Department, Manchester University Foundation Trust, Manchester Royal Infirmary Hospital, Oxford Rd, Manchester M13 9WL, United Kingdom
| | - Sára Jeges
- Faculty of Health Sciences, University of Pécs, Vörösmarty M. Street 4, Pécs 7621, Hungary
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, University of Pécs Medical School, Tüzér Street 1, Pécs 7623, Hungary
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Pacheco A, Soós B, Lempel E, Simon I, Maróti P, Möhlhenrich SC, Szalma J. The effect of individual drilling sleeves on the precision of coronectomy tooth sections. An in vitro 3D-printed jaw model experiment. Clin Oral Investig 2023; 27:6769-6780. [PMID: 37783802 PMCID: PMC10630220 DOI: 10.1007/s00784-023-05289-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 09/27/2023] [Indexed: 10/04/2023]
Abstract
OBJECTIVES The aim of this in vitro study was to evaluate the effect of a 3D-printed drill sleeve (DS) on the precision and duration of coronectomy sections. MATERIALS AND METHODS Thirty-six trainees and oral surgeons performed 72 coronectomy cuts in a 3D-printed, entirely symmetric mandible model. Coronectomy was performed freehand (FH) on one side and with a DS on the other side. The occurrence of "too superficial" (≥ 4 mm unprepared lingual tooth tissue) and "too deep" (drilling ≥ 1 mm deeper as tooth contour) cuts and sectioning times were registered. RESULTS In 7 cases, the sections were "too deep" with FH, while none with DS (OR: 18.56; 95%CI: 1.02-338.5; p = 0.048). The deviation between virtually planned and real cut depths was significantly greater in the FH group (1.91 ± 1.62 mm) than in DS group (1.21 ± 0.72 mm) (p < 0.001). A total of 18 "too superficial" buccolingual sections occurred with FH, while 8 cases with DS (OR: 3.50; 95%CI: 1.26-9.72; p = 0.016). Suboptimal sections did not correlate with experience (p = 0.983; p = 0.697). Shortest, suboptimal drillings were most frequently seen distolingually (OR: 6.76; 95% CI: 1.57-29.07; p = 0.01). In the inexperienced group, sectioning time was significantly longer with FH (158.95 ± 125.61 s vs. 106.92 ± 100.79 s; p = 0.038). CONCLUSIONS The DS effectively reduced tooth sectioning times by less experienced colleagues. Independently from the level of experience, the use of DS obviated the need for any preparation outside the lingual tooth contour and significantly decreased the occurrence of "too superficial" cuts, leaving thinner unprepared residual tooth tissue lingually. CLINICAL RELEVANCE Coronectomy sections may result in lingual hard and soft tissue injury with the possibility of damaging the lingual nerve. The precision of the buccolingual depth-control can be improved, while surgical time can be reduced when applying a drilling sleeve.
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Affiliation(s)
- Ana Pacheco
- Department Oral and Maxillofacial Surgery, Medical School, University of Pécs, 1. Tüzér St, 7623, Pécs, Hungary
| | - Balázs Soós
- Department Oral and Maxillofacial Surgery, Medical School, University of Pécs, 1. Tüzér St, 7623, Pécs, Hungary
| | - Edina Lempel
- Department of Conservative Dentistry and Periodontology, Medical School, University of Pécs, 1. Tüzér St, 7623, Pécs, Hungary
| | - Imre Simon
- 3D Printing and Visualization Centre, University of Pécs, 2. Boszorkany St, 7624, Pécs, Hungary
| | - Péter Maróti
- 3D Printing and Visualization Centre, University of Pécs, 2. Boszorkany St, 7624, Pécs, Hungary
- Medical Skills Education and Innovation Centre, Medical School, University of Pecs, 12. Szigeti St, 7624, Pécs, Hungary
| | | | - József Szalma
- Department Oral and Maxillofacial Surgery, Medical School, University of Pécs, 1. Tüzér St, 7623, Pécs, Hungary.
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Starch-Jensen T, Gacic B, Konstantinovic VS, Valls Ontañón A, Sapundzhiev A, Pavlov N, Pechalova P, Szalma J, Mottl R, Tamme T, Tiigimäe-Saar J, Ivask O, Božič V, Jovanovski T, Dovšak T, Țenț PA, Brucoli M, Rocchetti V, Boffano P. Patient's perception of recovery following surgical removal of mandibular third molars. A prospective european multi-center study. J Craniomaxillofac Surg 2023; 51:635-643. [PMID: 37858483 DOI: 10.1016/j.jcms.2023.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/25/2023] [Accepted: 09/30/2023] [Indexed: 10/21/2023] Open
Abstract
This study evaluated patient's perception of recovery following surgical removal of mandibular third molars (SRM3s) including analyze of potential risk factors associated with impaired convalescent. Patient related parameters combined with preoperative questionnaires including Modified Dental Anxiety Scale, Oral Health Impact Profile-14, and Decayed, Missing, Filled Teeth index were correlated with questionnaires assessing pain, swelling, trismus, sick leave, social and working isolation, physical appearance, eating and speaking ability, diet variations, sleep impairment, impaired sensation of the lip, chin, and tongue, one month following SRM3s. Totally, 412 patients (223 females, 189 males) with mean age of 29.4 years were included. Treatment satisfaction and willingness to undergo similar surgery were reported by 92% and 95%, although 21% reported that the surgery and postoperative period had been worse than expected. Mean days with pain, sick leave, and swelling were 3.6, 2.1, and 3.6, respectively. Preoperative symptoms, dental anxiety level, and prolonged surgical time were associated with increased pain and swelling (P < 0.05). Pell and Gregory classification (I-IIIC) were associated with impaired sensation of the lower lip and chin (P < 0.05). Consequently, results from this study improve the surgeon's ability to predict parameters that predisposed to impaired recovery and neurosensory disturbances following SRM3s.
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Affiliation(s)
- Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark.
| | - Bojan Gacic
- School of Dental Medicine, University of Belgrade, Serbia
| | | | | | - Angel Sapundzhiev
- Department of Oral Surgery, Faculty of Dental Medicine, Medical University of Plovdiv, Bulgaria
| | - Nikolay Pavlov
- University Hospital "St. Georgi", Clinic of Maxillofacial Surgery, Plovdiv, Bulgaria
| | - Petia Pechalova
- Department of Oral Surgery, Faculty of Dental Medicine, Medical University of Plovdiv, Bulgaria
| | - József Szalma
- Department of Oral Maxillofacial Surgery, Medical School, University of Pécs, Pécs, Hungary
| | - Radovan Mottl
- Department of Dentistry, Faculty of Medicine in Hradec Kralove, Charles University and University Hospital, Hradec Kralove, 500 05, Hradec Kralove, Czech Republic
| | - Tiia Tamme
- Department of Maxillofacial Surgery, Institute of Dentistry, University of Tartu, L. Puusepa 8, Tartu, 51014, Estonia
| | - Janne Tiigimäe-Saar
- Department of Maxillofacial Surgery, Institute of Dentistry, University of Tartu, L. Puusepa 8, Tartu, 51014, Estonia
| | - Oksana Ivask
- Department of Maxillofacial Surgery, Institute of Dentistry, University of Tartu, L. Puusepa 8, Tartu, 51014, Estonia
| | - Veronika Božič
- Clinical Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Trajche Jovanovski
- Clinical Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Tadej Dovšak
- Clinical Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Paul Andrei Țenț
- Department of Oral and Maxillo-Facial Surgery, University of Oradea, Oradea, Romania
| | - Matteo Brucoli
- Division of Oral and Maxillo-Facial Surgery, Novara University Hospital, Novara, Italy
| | | | - Paolo Boffano
- Division of Dentistry, Vercelli Hospital, Vercelli, Italy
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Gurdán Z, Balázs D, Pásti D, Fathi M, Maróti P, Kardos K, Pacheco A, Szalma J. Pre-eruptive intracoronal resorption in orthodontic patients: A retrospective analysis of 3,143 patients. Heliyon 2023; 9:e18699. [PMID: 37560674 PMCID: PMC10407135 DOI: 10.1016/j.heliyon.2023.e18699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 07/18/2023] [Accepted: 07/25/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVES The aim of this retrospective study was to analyze the occurrence and characteristics of pre-eruptive intracoronal resorptions in a clinical orthodontic patient population. MATERIALS AND METHODS Patients treated in an orthodontic department (University of Pécs, Pécs, Hungary) were included. Unerupted teeth on panoramic radiographs were analyzed for intracoronal radiolucent lesions. For each patient, the demographic data, jaw localization, number of unerupted teeth with pre-eruptive intracoronal resorption lesions, number of lesions per tooth, size and localization of pre-eruptive intracoronal resorption defects, affected tooth's surface, pulp involvement and ectopic position of the tooth with defects were recorded. RESULTS In the 3,143 patients investigated, 55 teeth in 49 patients showed pre-eruptive intracoronal resorption lesions (subject incidence: 1.56%). The incidence on unerupted teeth was 0.25%. Pre-eruptive intracoronal resorption was significantly more common in mandibles (43 mandibular vs. 12 maxillary lesions) with an odds ratio of 12.84 (95% Confidence Interval: 5.19-31.74) and no gender differences were found (p = 0.746). The occurrence of pre-eruptive intracoronal resorption was highest in the youngest (7-10 years) mixed dentition status group (p < 0.001). Most of the lesions (44 of 55, or 80.0%) were localized in the dentin, occupying two-third or less of the dentin thickness. Only 12.73% (7/55) of the lesions were not localized on the occlusal surface. Of the lesions, 89.1% (49/55) showed no obvious size increase over an average follow-up of 36.4 ± 8.1 months. CONCLUSIONS Pre-eruptive intracoronal resorption may occur mainly in the mixed dentition stage in orthodontic patients. Careful and attentive radiographic evaluations may facilitate early detection and follow-up of the lesions' possible dimensional changes, especially when resorption influences orthodontic extraction therapy.
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Affiliation(s)
- Zsuzsanna Gurdán
- Department of Orthodontics, Medical School, University of Pécs, 1. Tüzér st., Pécs, 7623, Hungary
| | - Dorottya Balázs
- Department of Orthodontics, Medical School, University of Pécs, 1. Tüzér st., Pécs, 7623, Hungary
| | - Dóra Pásti
- Department of Orthodontics, Medical School, University of Pécs, 1. Tüzér st., Pécs, 7623, Hungary
| | - Meetra Fathi
- Department of Orthodontics, Medical School, University of Pécs, 1. Tüzér st., Pécs, 7623, Hungary
| | - Péter Maróti
- 3D Printing and Visualisation Centre, University of Pécs, 2. Boszorkány st., Pécs, 7624, Hungary
| | - Kinga Kardos
- 3D Printing and Visualisation Centre, University of Pécs, 2. Boszorkány st., Pécs, 7624, Hungary
| | - Ana Pacheco
- Department of Oral and Maxillofacial Surgery, Medical School, University of Pécs, 1. Tüzér st., Pécs, 7623, Hungary
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, Medical School, University of Pécs, 1. Tüzér st., Pécs, 7623, Hungary
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Németh KD, Told R, Szabó P, Maróti P, Szénai R, Pintér ZB, Lovász BV, Szalma J, Lempel E. Comparative Evaluation of the Repair Bond Strength of Dental Resin Composite after Sodium Bicarbonate or Aluminum Oxide Air-Abrasion. Int J Mol Sci 2023; 24:11568. [PMID: 37511327 PMCID: PMC10380324 DOI: 10.3390/ijms241411568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/19/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
The dental prophylactic cleaning of a damaged resin-based composite (RBC) restoration with sodium bicarbonate can change the surface characteristics and influence the repair bond strength. The purpose of this study was to compare the effect of sodium bicarbonate (SB) and aluminum oxide (AO) surface treatments on the microtensile bond strength (µTBS) of repaired, aged RBC. Bar specimens were prepared from microhybrid RBC and aged in deionized water for 8 weeks. Different surface treatments (AO air-abrasion; SB air-polishing), as well as cleaning (phosphoric acid, PA; ethylene-diamine-tetraacetic-acid, EDTA) and adhesive applications (single bottle etch-and-rinse, ER; universal adhesive, UA), were used prior to the application of the repair RBC. Not aged and aged but not surface treated RBCs were used as positive and negative controls, respectively. The repaired blocks were cut into sticks using a precision grinding machine. The specimens were tested for tensile fracture and the µTBS values were calculated. Surface characteristics were assessed using scanning electron microscopy. AO-PA-UA (62.6 MPa) showed a 20% increase in µTBS compared to the NC (50.2 MPa), which proved to be the most significant. This was followed by SB-EDTA-UA (58.9 MPa) with an increase of 15%. In addition to AO-PA-UA, SB-EDTA-UA could also be a viable alternative in the RBC repair protocol.
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Affiliation(s)
- Kinga Dorottya Németh
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Tüzér Street 1, 7623 Pécs, Hungary
| | - Roland Told
- 3D Printing and Visualization Centre, University of Pécs, Boszorkány Street 2, 7624 Pécs, Hungary
| | - Péter Szabó
- János Szentágothai Research Center, Ifjúság Street 12, 7624 Pécs, Hungary
| | - Péter Maróti
- 3D Printing and Visualization Centre, University of Pécs, Boszorkány Street 2, 7624 Pécs, Hungary
| | - Réka Szénai
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Tüzér Street 1, 7623 Pécs, Hungary
| | - Zsolt Balázs Pintér
- Department of Oto-Rhino-Laryngology, Maxillo-Facial and Oral Surgery, St. John's Hospital and North Buda Unified Hospitals, Diós Árok Street 1-3, 1112 Budapest, Hungary
| | - Bálint Viktor Lovász
- Oral and Maxillofacial Department, Manchester Royal Infirmary Hospital, Manchester University Foundation Trust, Oxford Rd., Manchester M13 9WL, UK
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, University of Pécs Medical School, Tüzér Street 1, 7623 Pécs, Hungary
| | - Edina Lempel
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Tüzér Street 1, 7623 Pécs, Hungary
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Kincses D, Jordáki D, Szebeni D, Kunsági-Máté S, Szalma J, Lempel E. Effect of Ceramic and Dentin Thicknesses and Type of Resin-Based Luting Agents on Intrapulpal Temperature Changes during Luting of Ceramic Inlays. Int J Mol Sci 2023; 24:ijms24065466. [PMID: 36982546 PMCID: PMC10057599 DOI: 10.3390/ijms24065466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 03/16/2023] Open
Abstract
The adhesive cementation of ceramic inlays may increase pulpal temperature (PT) and induce pulpal damage due to heat generated by the curing unit and the exothermic reaction of the luting agent (LA). The aim was to measure the PT rise during ceramic inlay cementation by testing different combinations of dentin and ceramic thicknesses and LAs. The PT changes were detected using a thermocouple sensor positioned in the pulp chamber of a mandibular molar. Gradual occlusal reduction obtained dentin thicknesses of 2.5, 2.0, 1.5, and 1.0 mm. Light-cured (LC) and dual-cured (DC) adhesive cements and preheated restorative resin-based composite (RBC) were applied to luting of 2.0, 2.5, 3.0, and 3.5 mm lithium disilicate ceramic blocks. Differential scanning calorimetry was used to compare the thermal conductivity of dentin and ceramic slices. Although ceramic reduced heat delivered by the curing unit, the exothermic reaction of the LAs significantly increased it in each investigated combination (5.4–7.9 °C). Temperature changes were predominantly influenced by dentin thickness followed by LA and ceramic thickness. Thermal conductivity of dentin was 24% lower than that of ceramic, and its thermal capacity was 86% higher. Regardless of the ceramic thickness, adhesive inlay cementation can significantly increase the PT, especially when the remaining dentin thickness is <2 mm.
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Affiliation(s)
- Dóra Kincses
- Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, University of Pécs Medical School, PTüzér Street 1, 7623 Pécs, Hungary
| | - Dóra Jordáki
- Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, University of Pécs Medical School, PTüzér Street 1, 7623 Pécs, Hungary
| | - Donát Szebeni
- Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, University of Pécs Medical School, PTüzér Street 1, 7623 Pécs, Hungary
| | - Sándor Kunsági-Máté
- Department of Organic and Medicinal Chemistry, Faculty of Pharmacy, University of Pécs, Honvéd Street 1, 7624 Pécs, Hungary
- János Szentágothai Research Center, Ifjúság Street 20, 7624 Pécs, Hungary
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Pécs Medical School, Tüzér Street 1, 7623 Pécs, Hungary
| | - Edina Lempel
- Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, University of Pécs Medical School, PTüzér Street 1, 7623 Pécs, Hungary
- Correspondence: ; Tel.: +36-(72)-536402
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Lempel E, Szebeni D, Őri Z, Kiss T, Szalma J, Lovász BV, Kunsági-Máté S, Böddi K. The effect of high-irradiance rapid polymerization on degree of conversion, monomer elution, polymerization shrinkage and porosity of bulk-fill resin composites. Dent Mater 2023; 39:442-453. [PMID: 36918332 DOI: 10.1016/j.dental.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 02/17/2023] [Accepted: 03/03/2023] [Indexed: 03/13/2023]
Abstract
OBJECTIVE The purpose was to compare the degree of conversion (DC), monomer elution (ME), polymerization shrinkage (PS) and porosity of two addition-fragmentation chain transfer (AFCT) modified resin-based composites (RBC) light-cured with rapid- (RP), turbo- (TP) or conventional polymerization (CP) settings. METHODS Cylindrical samples (6-mm wide, 4-mm thick) were prepared from Tetric PowerFill (TPF) and Filtek One Bulk (FOB). Four groups were established according to the polymerization settings: 3s-RP, 5s-TP, 10s-CP and 20s-CP. Samples in 1 mm thickness with 20s-CP settings served as controls. The DC at the top and bottom surfaces was measured with micro-Raman spectroscopy. ME was detected with high-performance liquid chromatography. PS and porosity were analyzed by micro-computed tomography. ANOVA and Tukey's post-hoc test, multivariate analysis and partial eta-squared statistics were used to analyze the data (p < 0.05). RESULTS FOB showed higher DC values (61.5-77.5 %) at the top compared to TPF (43.5-67.8 %). At the bottom TPF samples achieved higher DCs (39.9-58.5 %) than FOB (18.21-66.18 %). Extending the curing time increased DC (except the top of FOB) and decreased ME. BisGMA release was the highest among the detected monomers from both RBCs. The amount was three-fold more from TPF. The factor Material and Exposure significantly influenced DC and ME. PS (1.8-2.5 %) did not differ among the groups and RBCs except for the lowest value of TPF cured with the 3s_RP setting (p = 0.03). FOB showed 4.5-fold lower porosity (p < 0.001). Significantly higher pore volume was detected after polymerization in 3s_RP (p < 0.001). SIGNIFICANCE High-irradiance rapid 3-s curing of AFCT modified RBCs resulted in inferior results for some important material properties. A longer exposure time is recommended in a clinical situation.
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Affiliation(s)
- Edina Lempel
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Tüzér Street 1, Pécs 7623, Hungary.
| | - Donát Szebeni
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Tüzér Street 1, Pécs 7623, Hungary
| | - Zsuzsanna Őri
- János Szentágothai Research Center, Ifjúság Street 12, Pécs 7624, Hungary; Department of General and Physical Chemistry, University of Pécs, Ifjúság Street 6, Pécs 7624, Hungary
| | - Tamás Kiss
- János Szentágothai Research Center, Ifjúság Street 12, Pécs 7624, Hungary
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, University of Pécs Medical School, Tüzér Street 1, Pécs 7623, Hungary
| | - Bálint Viktor Lovász
- Department of Oral and Maxillofacial Surgery, University of Pécs Medical School, Tüzér Street 1, Pécs 7623, Hungary
| | - Sándor Kunsági-Máté
- János Szentágothai Research Center, Ifjúság Street 12, Pécs 7624, Hungary; Department of Organic and Medicinal Chemistry, University of Pécs, Faculty of Pharmacy, Honvéd Street 1, Pécs 7624, Hungary
| | - Katalin Böddi
- Department of Biochemistry and Medical Chemistry, University of Pécs Medical School, Szigeti Street 12, Pécs 7624, Hungary
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Dunavári E, Berta G, Kiss T, Szalma J, Fráter M, Böddi K, Lempel E. Effect of Pre-Heating on the Monomer Elution and Porosity of Conventional and Bulk-Fill Resin-Based Dental Composites. Int J Mol Sci 2022; 23:ijms232416188. [PMID: 36555828 PMCID: PMC9782750 DOI: 10.3390/ijms232416188] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/06/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022] Open
Abstract
The pre-heating of dental resin-based composites (RBCs) improves adaptability to cavity walls, reducing microleakages. However, the rapid cooling of the pre-heated RBC may change the polymerization kinetics, and thus the final network configuration of the RBC. It is well known that unreacted monomers remaining in the set RBC can leach into the oral cavity. However, it is still not clear how the pre-heating and cooling of RBCs alter monomer elution (ME). Thus, the purpose was to determine the ME from room-temperature and pre-heated RBCs, in addition to determining the closed porosity (CP) volume. Bulk-filled RBCs and layered conventional RBC samples were prepared. The pre-polymerization temperature was set at 24 °C and 55/65 °C. The ME from RBC samples was assessed with high-performance liquid chromatography using standard monomers. CP was measured with micro-computed tomography. ME decreased significantly from bulk fills and increased from layered samples as a result of pre-heating. Pre-heating was unfavorable in terms of CP in most RBCs. Based on the effect size analysis, ME and CP were greatly influenced by both material composition, pre-polymerization temperature, and their interaction. While the pre-heating of high-viscosity bulk-fill RBCs is advantageous from a clinical aspect regarding biocompatibility, it increases CP, which is undesirable from a mechanical point of view.
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Affiliation(s)
- Erika Dunavári
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Tüzér Street 1, 7624 Pécs, Hungary
| | - Gergely Berta
- Department of Medical Biology and Central Electron Microscope Laboratory, University of Pécs Medical School, Szigeti Street 12, 7624 Pécs, Hungary
- Szentágothai Research Centre, University of Pécs, Ifjúság Street 20, 7624 Pécs, Hungary
| | - Tamás Kiss
- Szentágothai Research Centre, University of Pécs, Ifjúság Street 20, 7624 Pécs, Hungary
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, University of Pécs Medical School, Tüzér Street 1, 7624 Pécs, Hungary
| | - Márk Fráter
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, Tisza Lajos Street 64, 6720 Szeged, Hungary
| | - Katalin Böddi
- Department of Biochemistry and Medical Chemistry, University of Pécs Medical School, Szigeti Street 12, 7624 Pécs, Hungary
| | - Edina Lempel
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Tüzér Street 1, 7624 Pécs, Hungary
- Correspondence: ; Tel.: +36-7253-9402
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11
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Szalma J, Janovics K, Pacheco A, Kaszás B, Lempel E. Pre-eruptive intracoronal resorption in "high-risk" impacted third molars: A report of four cases. J Craniomaxillofac Surg 2022; 50:S1010-5182(22)00131-7. [PMID: 36224052 DOI: 10.1016/j.jcms.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 09/04/2022] [Accepted: 09/18/2022] [Indexed: 10/14/2022] Open
Abstract
Pre-eruptive intracoronal resorption (PEIR) is usually an incidental finding as a radiolucent lesion within the coronal dentin of unerupted teeth. Through the four cases reported here, authors would demonstrate deeply impacted "high-risk" third molars with PEIR defects, showing an increased risk of inferior alveolar nerve (IAN) injury. However, follow-up or coronectomy may eliminate or reduce the risk of neurosensory disturbances, in case of PEIR lesions this can be contradictory due to the unpredictable reactions of the third molar's pulp. Cases show the important role of preoperative imaging in the diagnostics and management of deeply impacted PEIR third molars and highlight the need for investigations regarding coronectomy in such cases.
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Affiliation(s)
- József Szalma
- Department of Oral and Maxillofacial Surgery, Medical School, University of Pécs, 5. Dischka St., 7621, Pécs, Hungary.
| | - Kata Janovics
- Department of Conservative Dentistry and Periodontology, Medical School, University of Pécs, 5. Dischka St., 7621, Pécs, Hungary
| | - Ana Pacheco
- Department of Oral and Maxillofacial Surgery, Medical School, University of Pécs, 5. Dischka St., 7621, Pécs, Hungary
| | - Bálint Kaszás
- Department of Pathology, Medical School, University of Pécs, 12. Szigeti St., 7624 Pécs, Hungary
| | - Edina Lempel
- Department of Conservative Dentistry and Periodontology, Medical School, University of Pécs, 5. Dischka St., 7621, Pécs, Hungary
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12
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Kovács AL, Kárteszi J, Prohászka Z, Kalmár T, Késmárky G, Koltai K, Nagy Z, Sebők J, Vas T, Molnár K, Berki T, Böröcz K, Gyömörei C, Szalma J, Egyed M, Horváth S, Oláh P, Csuka D, Németh V, Gyulai R. Hemizygous nonsense variant in the moesin gene (MSN) leads to a new autoimmune phenotype of Immunodeficiency 50. Front Immunol 2022; 13:919411. [PMID: 36119109 PMCID: PMC9477008 DOI: 10.3389/fimmu.2022.919411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Here, we present the findings of an investigation involving two male siblings with juvenile total tooth loss, early-onset chronic leg ulcers, and autoimmune thyroiditis, as well as focal segmental glomerulosclerosis with associated pulmonary emphysema in one and diabetes mellitus in the other. The clinical picture and lupus anticoagulant, cryoglobulin, and cold agglutinin positivity suggested the diagnosis of antiphospholipid syndrome. Flow cytometry analysis showed immunophenotypes consistent with immune dysregulation: a low number of naive T cells, elevated CD4+ T cell counts, and decreased CD8+ T-cell counts were detected, and more than half of the T-helper population was activated. Considering the siblings' almost identical clinical phenotype, the genetic alteration was suspected in the background of the immunodeficiency. Whole exome sequencing identified a previously not described hemizygous nonsense variant (c.650G>A, p.W217X) within exon 6 of the moesin (MSN) gene localized on chromosome X, resulting in significantly decreased MSN mRNA expression compared to healthy controls. We present a putative new autoimmune phenotype of Immunodeficiency 50 (MIM300988) characterized by antiphospholipid syndrome, Hashimoto's thyroiditis, leg ulcers, and juvenile tooth loss, associated with W217X mutation of the MSN gene.
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Affiliation(s)
- András L. Kovács
- Department of Dermatology, Venereology and Oncodermatology, Medical School, Clinical Centre, University of Pécs, Pécs, Hungary
| | - Judit Kárteszi
- Genetic Counseling, Saint Rafael Hospital of Zala County, Zalaegerszeg, Hungary
| | - Zoltán Prohászka
- Research Group for Immunology and Haematology, Eötvös Loránd Research Network (Office for Supported Research Groups), Semmelweis University, Budapest, Hungary
| | - Tibor Kalmár
- Genetic Diagnostic Laboratory, Department of Pediatrics and Pedriatic Health Center, Albert Szent-Györgyi Health Centre, University of Szeged, Szeged, Hungary
| | - Gábor Késmárky
- Division of Angiology, 1st Department of Internal Medicine, Medical School, Clinical Centre, University of Pécs, Pécs, Hungary
| | - Katalin Koltai
- Division of Angiology, 1st Department of Internal Medicine, Medical School, Clinical Centre, University of Pécs, Pécs, Hungary
| | - Zsuzsanna Nagy
- Nephrological and Diabetological Center, 2nd Department of Internal Medicine, Medical School, Clinical Centre, University of Pécs, Pécs, Hungary
| | - Judit Sebők
- Nephrological and Diabetological Center, 2nd Department of Internal Medicine, Medical School, Clinical Centre, University of Pécs, Pécs, Hungary
| | - Tibor Vas
- Nephrological and Diabetological Center, 2nd Department of Internal Medicine, Medical School, Clinical Centre, University of Pécs, Pécs, Hungary
| | - Krisztián Molnár
- Department of Medical Imaging, Medical School, Clinical Centre, University of Pécs, Pécs, Hungary
| | - Tímea Berki
- Department of Immunology and Biotechnology, Medical School, Clinical Centre, University of Pécs, Pécs, Hungary
| | - Katalin Böröcz
- Department of Immunology and Biotechnology, Medical School, Clinical Centre, University of Pécs, Pécs, Hungary
| | - Csaba Gyömörei
- Department of Pathology, Medical School, Clinical Centre, University of Pécs, Pécs, Hungary
| | - József Szalma
- Oral and Maxillofacial Surgery, Department of Dentistry, Medical School, Clinical Centre, University of Pécs, Pécs, Hungary
| | - Miklós Egyed
- Department of Hematology, Somogy County Mór Kaposi General Hospital, Kaposvár, Hungary
| | - Szabina Horváth
- Department of Dermatology, Venereology and Oncodermatology, Medical School, Clinical Centre, University of Pécs, Pécs, Hungary
| | - Péter Oláh
- Department of Dermatology, Venereology and Oncodermatology, Medical School, Clinical Centre, University of Pécs, Pécs, Hungary
- Department of Dermatology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Dorottya Csuka
- Research Group for Immunology and Haematology, Eötvös Loránd Research Network (Office for Supported Research Groups), Semmelweis University, Budapest, Hungary
| | - Viktória Németh
- Department of Dermatology, Venereology and Oncodermatology, Medical School, Clinical Centre, University of Pécs, Pécs, Hungary
| | - Rolland Gyulai
- Department of Dermatology, Venereology and Oncodermatology, Medical School, Clinical Centre, University of Pécs, Pécs, Hungary
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Németh KD, Haluszka D, Seress L, Lovász BV, Szalma J, Lempel E. Effect of Air-Polishing and Different Post-Polishing Methods on Surface Roughness of Nanofill and Microhybrid Resin Composites. Polymers (Basel) 2022; 14:polym14091643. [PMID: 35566812 PMCID: PMC9100913 DOI: 10.3390/polym14091643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 11/27/2022] Open
Abstract
Air-abrasion is a popular prophylactic procedure to maintain oral hygiene. However, depending on the applied air-abrasive powder, it can damage the surface of the tooth and restorations, making it susceptible to plaque accumulation. The purpose of this study was to investigate the effect of 5 s and 10 s air-abrasion of calcium carbonate on surface roughness (Ra) of enamel, nanofill, and microhybrid resin-composites and the effect of post-polishing with two-step rubber- (RP) or one-step brush polisher (BP) to re-establish the surface smoothness. Surface topography was visualized by scanning-electron-microscopy. The quantitative measurement of the Ra was carried out with atomic-force-microscopy. Air-abrasion for 10 s decreased the Ra of enamel as a result of abrasion of the natural surface texture. Post-polishing with RP after 10 s air-abrasion did not change the Ra or BP; however, Ra was increased significantly by scratching the surface. Air-abrasion increased the Ra of resin composites significantly, irrespective of the application time. While RP provided a similarly smooth surface to the control in the case of microhybrid resin composite, BP increased the Ra significantly. The Ra for the control group of the nanofill-resin composite was initially high, which was further increased by air-abrasion. RP and BP re-established the initial Ra with deeper and shallower scratches after BP. Both the material and treatment type showed a large effect on Ra.
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Affiliation(s)
- Kinga Dorottya Németh
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Dischka Gy. Street 5, 7621 Pécs, Hungary;
| | - Dóra Haluszka
- Department of Biophysics and Radiation Biology, Semmelweis University, Tűzoltó Street 37–47, 1094 Budapest, Hungary;
| | - László Seress
- Central Electron Microscope Laboratory, University of Pécs Medical School, Szigeti Street 12, 7624 Pécs, Hungary;
| | - Bálint Viktor Lovász
- Department of Oral and Maxillofacial Surgery, University of Pécs Medical School, Dischka Gy. Street 5, 7621 Pécs, Hungary; (B.V.L.); (J.S.)
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, University of Pécs Medical School, Dischka Gy. Street 5, 7621 Pécs, Hungary; (B.V.L.); (J.S.)
| | - Edina Lempel
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Dischka Gy. Street 5, 7621 Pécs, Hungary;
- Correspondence: ; Tel.: +36-72-535926
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Lempel E, Németh KG, Lovász BV, Szalma J. Adhesive Management of Anterior Tooth Wear in Combination with the Dahl Concept-A 27-Month Observational Case Series. Oper Dent 2021; 46:594-608. [PMID: 35507908 DOI: 10.2341/20-190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2021] [Indexed: 11/23/2022]
Abstract
Localized anterior maxillary tooth wear caused by erosion and attrition with loss of interocclusal space is difficult to manage. This observational case-series study reports six cases with worn anterior dentition treated with labial ceramic and palatal direct resin composite veneers at an increased vertical dimension of occlusion without restoration of unaffected posterior teeth. Thirty-six palatal direct veneers were made in six patients from a nanohybrid resin composite with the help of a wax-up-based template at an increased vertical dimension. After the complete re-establishment of posterior occlusion, 40 labial lithium-disilicate ceramic veneers were fabricated with a mock-up-guided method. The sandwich veneers were evaluated according to the United States Public Health Service (USPHS) criteria after a mean service time of 22.7 months. Re-establishment of posterior contacts as well as subjective patient satisfaction and function were evaluated. The overall success of the labial ceramic veneers was excellent. The quality of the palatal resin composite restorations was found to be good with predominantly "Alpha" scores. The marginal quality (11.1% and 33.3% of integrity and discoloration, respectively) and surface roughness (16.7%) showed small deteriorations indicated by "Beta" scores. The resin composite showed, in general, signs of wear facets which resulted in "Beta" scores in 44.4% of the cases. Posterior contacts re-established firmly within 4 weeks in all cases. Patient satisfaction with esthetics and function was high. The short-term outcome of this non-invasive treatment option is favorable and promising.
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Affiliation(s)
- E Lempel
- *Edina Lempel, DMD, PhD, Habil, assistant professor, Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Hungary
| | - K G Németh
- Kinga Dorottya Németh, DMD, Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Pécs, Hungary
| | - B V Lovász
- Bálint Viktor Lovász, DMD, PhD student, University of Pécs Medical School, Pécs, Hungary
| | - J Szalma
- József Szalma, DMD, PhD, Habil, Department of Oral and Maxillofacial Surgery, University of Pécs Medical School, Pécs, Hungary
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Kincses D, Böddi K, Őri Z, Lovász BV, Jeges S, Szalma J, Kunsági-Máté S, Lempel E. Pre-Heating Effect on Monomer Elution and Degree of Conversion of Contemporary and Thermoviscous Bulk-Fill Resin-Based Dental Composites. Polymers (Basel) 2021; 13:polym13203599. [PMID: 34685358 PMCID: PMC8538921 DOI: 10.3390/polym13203599] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 11/16/2022] Open
Abstract
Detection of unreacted monomers from pre-heated resin-based dental composites (RBC) is not a well-investigated topic so far. The objectives were to determine the temperature changes during the application and polymerization, the degree of conversion (DC) and unreacted monomer elution of room temperature (RT), and pre-heated thermoviscous [VisCalor Bulk(VCB)] and high-viscosity full-body contemporary [Filtek One Bulk(FOB)] bulk-fill RBCs. The RBCs' temperatures during the sample preparation were recorded with a K-type thermocouple. The DC at the top and bottom was measured with micro-Raman spectroscopy and the amounts of eluted BisGMA, UDMA, DDMA, and TEGDMA were assessed with High-Performance Liquid Chromatography. The temperatures of the pre-heated RBCs decreased rapidly during the manipulation phase. The temperature rise during photopolymerization reflects the bottom DCs. The differences in DC% between the top and the bottom were significant. RT VCB had a lower DC% compared to FOB. Pre-heating did not influence the DC, except on the bottom surface of FOB where a significant decrease was measured. Pre-heating significantly decreased the elution of BisGMA, UDMA, DDMA in the case of FOB, meanwhile, it had no effect on monomer release from VCB, except TEGDMA, which elution was decreased. In comparison, RBC composition had a stronger influence on DC and monomer elution, than pre-cure temperature.
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Affiliation(s)
- Dóra Kincses
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Dischka Gy. Street 5, 7621 Pécs, Hungary;
| | - Katalin Böddi
- Department of Biochemistry and Medical Chemistry, University of Pécs Medical School, Szigeti Street 12, 7624 Pécs, Hungary;
| | - Zsuzsanna Őri
- Department of Physical Chemistry and Materials Science, University of Pécs, Ifjúság Street 6, 7624 Pécs, Hungary;
- János Szentágothai Research Center, Ifjúság Street 20, 7624 Pécs, Hungary;
| | - Bálint Viktor Lovász
- Department of Oral and Maxillofacial Surgery, University of Pécs Medical School, Dischka Gy. Street 5, 7621 Pécs, Hungary; (B.V.L.); (J.S.)
| | - Sára Jeges
- Faculty of Sciences, University of Pécs, Ifjúság Street 12, 7624 Pécs, Hungary;
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, University of Pécs Medical School, Dischka Gy. Street 5, 7621 Pécs, Hungary; (B.V.L.); (J.S.)
| | - Sándor Kunsági-Máté
- János Szentágothai Research Center, Ifjúság Street 20, 7624 Pécs, Hungary;
- Institute of Organic and Medicinal Chemistry, Faculty of Pharmacy, University of Pécs Medical School, Szigeti Street 12, 7624 Pécs, Hungary
| | - Edina Lempel
- Department of Restorative Dentistry and Periodontology, University of Pécs Medical School, Dischka Gy. Street 5, 7621 Pécs, Hungary;
- Correspondence: ; Tel.: +36-72-535-926
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Lempel E, Szalma J. Effect of spray air settings of speed-increasing contra-angle handpieces on intrapulpal temperatures, drilling times, and coolant spray pattern. Clin Oral Investig 2021; 26:523-533. [PMID: 34145477 PMCID: PMC8212794 DOI: 10.1007/s00784-021-04030-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 06/07/2021] [Indexed: 11/07/2022]
Abstract
Objectives Decreasing aerosol leaks are of great interest, especially in the recent era of COVID-19. The aim was to investigate intrapulpal heat development, coolant spray patterns, and the preparation efficiency of speed-increasing contra-angle handpieces with the spray air on (mist) or off (water jet) settings during restorative cavity preparations. Methods Standard-sized cavities were prepared in 80 extracted intact human molar teeth using diamond cylindrical drills with a 1:5 speed-increasing contra-angle handpiece. A custom-made device maintained the standardized lateral drilling force (3 N) and predetermined depth. Temperatures were measured using intrapulpal thermocouple probes. The four experimental groups were as follows: mist cooling mode at 15 mL/min (AIR15), water jet cooling mode at 15 mL/min (JET15), mist cooling mode at 30 mL/min (AIR30), and water jet cooling mode at 30 mL/min (JET30). The coolant spray pattern was captured using macro-photo imaging. Results The JET15 group had the highest increase in temperature (ΔT = 6.02 °C), while JET30 (ΔT = 2.24 °C; p < 0.001), AIR15 (ΔT = 3.34 °C; p = 0.042), and AIR30 (ΔT = 2.95 °C; p = 0.003) had significantly lower increases in temperature. Fine mist aerosol was formed in the AIR15 and AIR30 preparations but not in the JET15 and JET30 preparations (p < 0.001). The irrigation mode had no influence on the preparation time (p = 0.672). Conclusions Water jet irrigation using coolant at 30 mL/min appeared to be the optimal mode. Considering the safe intrapulpal temperatures and the absence of fine mist aerosols, this mode can be recommended for restorative cavity preparations. Clinical significance To increase infection control in dental practices, the water jet irrigation mode of speed-increasing handpieces with coolant flow rates of 30 mL/min should be considered for restorative cavity preparations. Supplementary Information The online version contains supplementary material available at 10.1007/s00784-021-04030-3.
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Affiliation(s)
- Edina Lempel
- Department of Conservative Dentistry and Periodontology, Medical School, University of Pécs, 5. Dischka St, 7621, Pécs, Hungary
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, Medical School, University of Pécs, 5. Dischka Gy St, Pécs, 7621, Hungary.
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Gurdán Z, Szalma J, Benedek P. Achondroplasia from the viewpoint of orthodontics. Orv Hetil 2021; 162:683-688. [PMID: 33838027 DOI: 10.1556/650.2021.32074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 11/05/2020] [Indexed: 11/19/2022]
Abstract
Összefoglaló. Az achondroplasia kialakulásáért az FGFR3-gén mutációja tehető felelőssé, mely a porc növekedési lemezében található chondrocyták érésében okoz zavart. Az esetbemutatásban szereplő lánygyermeknél a születést követő első hónapban a klinikai, laboratóriumi és röntgenvizsgálatok alapján achondroplasia igazolódott. A klinikai tünetek közé tartoznak a rövid végtagok - különösen a proximalis szegmensben -, a macrocephalia, a hypotonia és a horkolás. Szembetűnő a középarc hypoplasiája. A középfül diszfunkciója tovább súlyosbítja a kórképet, sok esetben megfigyelhető a hallás nagyfokú csökkenése, illetve kezelés hiányában akár a hallás elvesztése. A közlemény részletesen bemutatja az obstruktív alvási apnoe szindróma diagnózisrendszerét és kezelési alternatíváit, hangsúlyozva az orthodontiai szempontokat. A fül-orr-gégészeti és a fogszabályozó terápiának köszönhetően, a diagnózistól számított harmadik évre, az alvási apnoe szindróma megszüntetésével a folyamatos pozitív nyomású lélegeztetést el lehetett hagyni. A horkolás és az alvási apnoe szindróma kezelése napjainkban egyre nagyobb hangsúlyt kap, melynek komplex kezelésében a fogszabályozás is jelentős lehet. A harmonikus együttműködés és teamkezelés betegünknél jelentős életminőség-javulást eredményezett. Orv Hetil. 2021; 162(17): 683-688. Summary. Development of achondroplasia is due to the mutation of FGFR3 gene, which disrupts the maturation of chondrocytes found in the growth plate. The diagnosis of the girl in the present case study was established based on clinical symptoms, laboratory tests and X-ray imaging in the first month following childbirth. Clinical symptoms include shorter limbs especially in the proximal segments, macrocephaly, hypotonia and snoring. Hypoplasia of the midface is apparent. Dysfunction of the middle ear further worsens the condition, in many cases severe hearing loss and, without treatment, even deafness can be observed. The publication describes the diagnostic criteria and therapeutic options of obstructive sleep apnea syndrome in detail, with an emphasis on the orthodontic aspects. A comprehensive combined three-year oto-laryngological and orthodontic treatment finally succeeded in controlling the sleep apnea syndrome and it was possible to discontinue the continuous positive airway pressure therapy by the end of the orthodontic therapy. Nowadays, even more alternative therapeutic approaches are available to treat snoring and sleep apnea syndromes, in which the role of orthodontics must not be neglected. Harmonic collaboration and team work treatment resulted in a significant improvement in the quality of life of our patient. Orv Hetil. 2021; 162(17): 683-688.
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Affiliation(s)
- Zsuzsanna Gurdán
- 1 Pécsi Tudományegyetem, Klinikai Központ, Fogorvostudományi Szak, Gyermek- és Ifjúsági Fogászati Tanszék, Pécs, Dischka Győző u. 5., 7621
| | - József Szalma
- 2 Pécsi Tudományegyetem, Klinikai Központ, Fogorvostudományi Szak, Arc-, Állcsont- és Szájsebészeti Tanszék, Pécs
| | - Pálma Benedek
- 3 Heim Pál Országos Gyermekgyógyászati Intézet, Alvásdiagnosztikai és Terápiás Labor, Budapest
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Lovász BV, Berta G, Lempel E, Sétáló G, Vecsernyés M, Szalma J. TEGDMA (Triethylene Glycol Dimethacrylate) Induces Both Caspase-Dependent and Caspase-Independent Apoptotic Pathways in Pulp Cells. Polymers (Basel) 2021; 13:polym13050699. [PMID: 33669057 PMCID: PMC7956203 DOI: 10.3390/polym13050699] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/18/2021] [Accepted: 02/20/2021] [Indexed: 12/13/2022] Open
Abstract
Monomers leached from resin-based composites (RBCs) may reach intrapulpal concentrations of the millimolar (mM) range, which could contribute to inflammation. The aim of this investigation was to assess the cytotoxicity of triethylene glycol dimethacrylate (TEGDMA) monomers on pulp cells as well as to identify molecular mechanisms leading to apoptosis. Pulp cells were harvested from molars extracted for orthodontic reasons and cultured through an explant method. To assess cytotoxicity, cells underwent a 5-day exposure to 0.75, 1.5, and 3 mM TEGDMA and were subject to cell counting and WST-1 staining. Based on the findings, cells were subsequently exposed to 0.1, 0.2, 0.75, 1.5, and 3 mM TEGDMA for 24 h to uncover the details of apoptosis. Changes in the production or cleavage of the apoptosis-specific proteins caspase-8, caspase-9, caspase-3, caspase-12, and Apoptosis-Inducing Factor (AIF) were measured by Western blot. The 5-day study showed concentration- and time-dependent cytotoxicity. Significant cell death was detected after 24 h with TEGDMA concentrations of 1.5 and 3 mM. One-day exposure to TEGDMA led to the activation of caspase-8, -9, -3, and -12 and an increased AIF production. Results suggest that relevant concentrations of TEGDMA monomers, leached from RBCs, induce apoptosis in pulp cells through both caspase-dependent as well as caspase-independent mechanisms. Endoplasmic reticulum stress and the activation of caspase-independent apoptotic pathways may be further mechanisms by which monomers induce apoptosis in pulp cells.
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Affiliation(s)
- Bálint Viktor Lovász
- Department of Oral and Maxillofacial Surgery, University of Pécs, Medical School, 5. Dischka St., 7621 Pécs, Hungary;
- Correspondence: ; Tel.: +4-479-8860-0193
| | - Gergely Berta
- Department of Medical Biology and Central Electron Microscope Laboratory, University of Pécs Medical School, 12. Szigeti St., 7624 Pécs, Hungary; (G.B.); (G.S.J.); (M.V.)
- Szentágothai Research Centre, University of Pécs, Ifjúság Street 20, 7624 Pécs, Hungary
| | - Edina Lempel
- Department of Restorative Dentistry, University of Pécs, Medical School, 5. Dischka St., 7621 Pécs, Hungary;
| | - György Sétáló
- Department of Medical Biology and Central Electron Microscope Laboratory, University of Pécs Medical School, 12. Szigeti St., 7624 Pécs, Hungary; (G.B.); (G.S.J.); (M.V.)
- Szentágothai Research Centre, University of Pécs, Ifjúság Street 20, 7624 Pécs, Hungary
| | - Mónika Vecsernyés
- Department of Medical Biology and Central Electron Microscope Laboratory, University of Pécs Medical School, 12. Szigeti St., 7624 Pécs, Hungary; (G.B.); (G.S.J.); (M.V.)
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, University of Pécs, Medical School, 5. Dischka St., 7621 Pécs, Hungary;
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Lovász BV, Lempel E, Szalma J, Sétáló G, Vecsernyés M, Berta G. Influence of TEGDMA monomer on MMP-2, MMP-8, and MMP-9 production and collagenase activity in pulp cells. Clin Oral Investig 2020; 25:2269-2279. [PMID: 32845470 PMCID: PMC7966645 DOI: 10.1007/s00784-020-03545-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 08/20/2020] [Indexed: 01/06/2023]
Abstract
Objectives Resin-based composites may leach monomers such as triethylene-glycol dimethacrylate (TEGDMA), which could contribute to intrapulpal inflammation. The aim of this investigation was to examine whether various concentrations of TEGDMA are able to influence dentally relevant Matrix metalloproteinase (MMP)-2, MMP-8, and MMP-9 production, total collagenase/gelatinase activity in pulp cells, and suggest possible signaling mechanisms. Materials and methods Pulp cells were cultured, followed by a 1-day exposure to sublethal TEGDMA concentrations (0.1, 0.2, and 0.75 mM). Total MMP activity was measured by an EnzCheck total collagenase/gelatinase assay, while the production of specific MMPs and the relative changes of phosphorylated, i.e., activated signaling protein levels of extracellular signal-regulated kinase (ERK)1/2, p38, c-Jun N-terminal kinase (JNK) were identified by western blot. Immunocytochemistry image data was also plotted and analyzed to see whether TEGDMA could possibly alter MMP production. Results An increase in activated MMP-2, MMP-8, and MMP-9 production as well as total collagenase activity was seen after a 24-h exposure to the abovementioned TEGDMA concentrations. Increase was most substantial at 0.1 (P = 0.002) and 0.2 mM (P = 0.0381). Concurrent p-ERK, p-p38, and p-JNK elevations were also detected. Conclusions Results suggest that monomers such as TEGDMA, leached from resin-based restorative materials, activate and induce the production of dentally relevant MMPs in pulp cells. Activation of ERK1/2, p38, or JNK and MMP increase may play a role in and/or can be part of a broader stress response. Clinical relevance Induction of MMP production and activity may further be components in the mechanisms of intrapulpal monomer toxicity.
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Affiliation(s)
- Bálint Viktor Lovász
- Department of Oral and Maxillofacial Surgery, University of Pécs Medical School, 5 Dischka Gy. St, Pécs, 7621, Hungary.
| | - Edina Lempel
- Department of Conservative Dentistry and Periodontology, University of Pécs Medical School, 5 Dischka Gy. St, Pécs, 7621, Hungary
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, University of Pécs Medical School, 5 Dischka Gy. St, Pécs, 7621, Hungary
| | - György Sétáló
- Department of Medical Biology and Central Electron Microscope Laboratory, University of Pécs Medical School, 12 Szigeti St, Pécs, 7624, Hungary
| | - Mónika Vecsernyés
- Department of Medical Biology and Central Electron Microscope Laboratory, University of Pécs Medical School, 12 Szigeti St, Pécs, 7624, Hungary
| | - Gergely Berta
- Department of Medical Biology and Central Electron Microscope Laboratory, University of Pécs Medical School, 12 Szigeti St, Pécs, 7624, Hungary
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20
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Möhlhenrich SC, Heussen N, Modabber A, Bock A, Hölzle F, Wilmes B, Danesh G, Szalma J. Influence of bone density, screw size and surgical procedure on orthodontic mini-implant placement - part B: implant stability. Int J Oral Maxillofac Surg 2020; 50:565-572. [PMID: 32713778 DOI: 10.1016/j.ijom.2020.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 04/17/2020] [Accepted: 07/02/2020] [Indexed: 11/19/2022]
Abstract
This in vitro study aimed to investigate the influence of bone density, implant size, and surgical procedure on the primary stability (PS) of orthodontic mini-implants (OMIs). In total, 640 OMIs of various sizes (2.0 × 7, 2.3 × 7, 2.0 × 11 and 2.3 × 11 mm) were inserted in the artificial bone of different densities (D1-D4). Placement was performed with an insertion angle of 90° or 60° to the bone surface and in 320 cases without predrilling, which resulted in 64 groups. PS was measured on the basis of implant stability quotient (ISQ) and insertion torque (IT). With regard to all possible influencing parameters, the mean PS differed between 39.20 and 60.00 (ISQ), and 10.00 and 39.00 Ncm (IT). The effect of OMI size and surgical procedure was dependent on bone quality. For example, implant size had less effect in high-density bone and was stronger with decreasing density. Overall, implant length had a greater influence than the diameter, and a high correlation was found among both PS measurement techniques. Therefore, a suitable choice of implant size and surgical protocol with regard to bone density can positively influence PS. In principle, ISQ and IT are suitable for measuring OMI stability.
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Affiliation(s)
- S C Möhlhenrich
- Department of Orthodontics, University of Witten/Herdecke, Witten, Germany; Department of Oral and Maxillofacial Surgery, University Hospital of the RWTH Aachen, Aachen, Germany.
| | - N Heussen
- Department of Medical Statistics, University Hospital of the RWTH Aachen, Aachen, Germany; Center of Biostatistics and Epidemiology, Medical School, Sigmund Freud University, Vienna, Austria
| | - A Modabber
- Department of Oral and Maxillofacial Surgery, University Hospital of the RWTH Aachen, Aachen, Germany
| | - A Bock
- Department of Oral and Maxillofacial Surgery, University Hospital of the RWTH Aachen, Aachen, Germany
| | - F Hölzle
- Department of Oral and Maxillofacial Surgery, University Hospital of the RWTH Aachen, Aachen, Germany
| | - B Wilmes
- Department of Orthodontics, University Hospital of Düsseldorf, Düsseldorf, Germany
| | - G Danesh
- Department of Orthodontics, University of Witten/Herdecke, Witten, Germany
| | - J Szalma
- Department of Oral and Maxillofacial Surgery, University of Pecs, Pecs, Hungary
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Möhlhenrich SC, Heussen N, Modabber A, Kniha K, Hölzle F, Wilmes B, Danesh G, Szalma J. Influence of bone density, screw size and surgical procedure on orthodontic mini-implant placement - part A: temperature development. Int J Oral Maxillofac Surg 2020; 50:555-564. [PMID: 32694036 DOI: 10.1016/j.ijom.2020.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 04/17/2020] [Accepted: 07/02/2020] [Indexed: 10/23/2022]
Abstract
The aim of this in vitro study was to determine the influence of bone density, orthodontic mini-implant (OMI) size, and the surgical procedure on temperature increase during implant site osteotomy and placement. OMIs of different sizes (2.0×7, 2.3×7, 2.0×11, and 2.3×11mm) were placed in artificial bone blocks of different densities (D1-D4). Optionally, the drilling and insertion angle was 90° or 60° to the bone surface. A total of 640 OMIs were inserted, and predrilling was performed in 320 cases. All insertions were done without irrigation with an axial load of 20N, which resulted in 64 groups. Temperature measurements were performed during implant site preparation and placement using Type-K-thermocouples. Mean temperature increase differed for OMI osteotomy between 1.38°C and 8.75°C and placement between 3.8°C and 18.74°C, respectively. Critical thermal increase was especially reached during placement using long implants. Increasing bone density and implant size (diameter <length) correlated with thermal increase. Predrilling and angulated implant placement resulted in less heat development. Critical temperature behaviour in high-density bone could be partially responsible for the high failure rates of OMI placement in the lower jaw. The influence of the implant size on temperature development should be considered when selecting an OMI.
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Affiliation(s)
- S C Möhlhenrich
- Department of Orthodontics, University of Witten/Herdecke, Witten, Germany; Department of Oral and Maxillofacial Surgery, University Hospital of the RWTH Aachen, Aachen, Germany.
| | - N Heussen
- Department of Medical Statistics, University Hospital of the RWTH Aachen, Aachen, Germany; Center of Biostatistics and Epidemiology, Medical School, Sigmund Freud University, Vienna, Austria
| | - A Modabber
- Department of Oral and Maxillofacial Surgery, University Hospital of the RWTH Aachen, Aachen, Germany
| | - K Kniha
- Department of Oral and Maxillofacial Surgery, University Hospital of the RWTH Aachen, Aachen, Germany
| | - F Hölzle
- Department of Oral and Maxillofacial Surgery, University Hospital of the RWTH Aachen, Aachen, Germany
| | - B Wilmes
- Department of Orthodontics, University Hospital of Düsseldorf, Düsseldorf, Germany
| | - G Danesh
- Department of Orthodontics, University of Witten/Herdecke, Witten, Germany
| | - J Szalma
- Department of Oral and Maxillofacial Surgery, University of Pecs, Pecs, Hungary
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Soós B, Janovics K, Tóth Á, Szalma J. A bölcsességfog és az occlusio szerepének vizsgálata a mandibulaangulus és -condylus töréseiben. Orv Hetil 2020; 161:1166-1174. [DOI: 10.1556/650.2020.31791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 03/31/2020] [Indexed: 11/19/2022]
Abstract
Absztrakt:
Bevezetés és célkitűzés: Retrospektív keresztmetszeti
vizsgálatunk célja az occlusiós megtámasztás és az alsó bölcsességfog szerepének
vizsgálata volt az angulus- és condylustöréseknél. Módszer és
eredmények: Egyoldali, izolált angulus- vagy condylustörött
betegeket vizsgáltunk. Az adatgyűjtés betegkartonok és
panoráma-röntgenfelvételek segítségével történt. Vizsgálatunkban az elsődleges
prediktor változó az occlusiós megtámasztás minősége, a másodlagos prediktor a
bölcsességfog jelenléte vagy hiánya volt. A kimeneti változó a törés típusa,
illetve az egyéb prediktorok a demográfiai adatok voltak. A prediktorok és a
kimeneti változók közti összefüggéseket khi-négyzet-teszttel és logisztikus
regressziós analízissel vizsgáltuk. Az angulustörött csoportot 43 (átlagéletkor:
29,9 ± 12,8 év; 98,4% férfi), míg a condylustörött csoportot 37 beteg
(átlagéletkor: 46,8 ± 20,2 év; 62,2% férfi) alkotta. Angulustörés esetén
81,4%-ban, míg condylustörés esetén 51,3%-ban láttunk kétoldali occlusiós
megtámasztást (p<0,001). Kétoldali occlusiós megtámasztás esetén az
angulustörés esélyhányadosa 4,2 volt (p<0,006). Az angulustörések 86%-ában, a
condylustörések 43,2%-ában volt jelen bölcsességfog a törés oldalán
(p<0,001). Azonos oldali bölcsességfog jelenléte esetén az angulustörés
esélye a 8,1-szeresére emelkedett (p<0,001). Amennyiben kétoldali occlusiós
megtámasztás és törésoldali bölcsességfog is jelen volt, az angulustörés esélye
a 15,9-szeresére nőtt (p<0,001). Következtetés: Az occlusiós
megtámasztás és a bölcsességfog együttes és külön-külön való jelenléte is
egyértelműen fokozta az angulustörés, és csökkentette a condylustörés rizikóját,
míg hiányuk a condylustörés rizikóját fokozta, és az angulustörés esélyét
csökkentette. Orv Hetil. 2020; 161(28): 1166–1174.
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Affiliation(s)
- Balázs Soós
- 1 Általános Orvostudományi Kar, Klinikai Központ, Fogászati és Szájsebészeti Klinika, Pécsi Tudományegyetem, Pécs, Dischka u. 5., 7621
| | - Kata Janovics
- 1 Általános Orvostudományi Kar, Klinikai Központ, Fogászati és Szájsebészeti Klinika, Pécsi Tudományegyetem, Pécs, Dischka u. 5., 7621
| | - Ákos Tóth
- 2 Természettudományi Kar, Sporttudományi és Testnevelési Intézet, Pécsi Tudományegyetem, Pécs
| | - József Szalma
- 1 Általános Orvostudományi Kar, Klinikai Központ, Fogászati és Szájsebészeti Klinika, Pécsi Tudományegyetem, Pécs, Dischka u. 5., 7621
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Szalma J, Vajta L, Lovász BV, Kiss C, Soós B, Lempel E. Identification of Specific Panoramic High-Risk Signs in Impacted Third Molar Cases in Which Cone Beam Computed Tomography Changes the Treatment Decision. J Oral Maxillofac Surg 2020; 78:1061-1070. [PMID: 32304662 DOI: 10.1016/j.joms.2020.03.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 03/12/2020] [Accepted: 03/13/2020] [Indexed: 01/25/2023]
Abstract
PURPOSE The aim of this study was to investigate the treatment decisions of oral-maxillofacial surgeons in the management of impacted lower third molars (M3s) according to panoramic radiography (PR) and cone beam computed tomography (CBCT) risk analysis. PATIENTS AND METHODS Ten surgeons analyzed 40 deliberately selected M3 cases showing 1 or more panoramic high-risk signs: 1) darkening of the root, 2) interruption of the white line, 3) diversion of the inferior alveolar canal (IAC), 4) narrowing of the IAC, and 5) 2 or more signs occurring simultaneously (including darkening and/or interruption of the IAC). After evaluating the PR images, the observers analyzed the patients' CBCT images. The treatment decision (extraction vs coronectomy) and surgical technique (number of planned tooth sections) were recorded. RESULTS On the CBCT coronal slices, direct contact between the M3 and IAC, together with narrowing and/or fenestration of the IAC, was observed most frequently when 2 or more panoramic signs were seen simultaneously on the PR images (odds ratio [OR], 7.2; P = .021). CBCT findings led to a significant decrease in the number of coronectomy decisions (23% vs 14.5%, P = .002), which was most prominent in the groups showing panoramic signs of darkening (approximately 50%, P = .007) and narrowing (approximately 66%, P = .044). A significant number of extraction decisions were modified to coronectomy when 2 or more panoramic signs occurred together (OR, 7.9; P < .001). However, there were no significant differences regarding the number of planned hypothetical tooth sections. CONCLUSIONS The results showed that the surgeons' confidence in the treatment decision increased after CBCT imaging, resulting in fewer coronectomy decisions. CBCT information that changed a previous coronectomy decision to extraction was most frequently observed in cases showing darkening and narrowing PR signs. The chance of changing an extraction decision to a coronectomy decision after evaluating the patient's CBCT images was the highest when 2 or more PR signs were observed simultaneously.
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Affiliation(s)
- József Szalma
- Associate Professor and Head of the Department, Department of Oral and Maxillofacial Surgery, University of Pécs, Pécs, Hungary.
| | - László Vajta
- Assistant Lecturer, Department of Oral and Maxillofacial Surgery, University of Pécs, Pécs, Hungary
| | - Bálint Viktor Lovász
- Resident and PhD Student, Department of Oral and Maxillofacial Surgery, University of Pécs, Pécs, Hungary
| | - Csanád Kiss
- Resident, Department of Oral and Maxillofacial Surgery, University of Pécs, Pécs, Hungary
| | - Balázs Soós
- PhD Student and Assistant Lecturer, Department of Oral and Maxillofacial Surgery, University of Pécs, Pécs, Hungary
| | - Edina Lempel
- Associate Professor, Department of Conservative Dentistry and Periodontology, University of Pécs, Pécs, Hungary
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Soós B, Janovics K, Tóth Á, Di Nardo MD, Szalma J. Association Between Third Molar Impaction Status and Angle or Condylar Fractures of the Mandible: A Retrospective Analysis. J Oral Maxillofac Surg 2020; 78:1162.e1-1162.e8. [PMID: 32151652 DOI: 10.1016/j.joms.2020.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/05/2020] [Accepted: 02/05/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of our study was to evaluate the correlations between mandibular third molar impaction status and mandibular angle and condylar fractures. MATERIALS AND METHODS This retrospective cross-sectional study included patients with unilateral and isolated angle or condylar fractures. Patient records and panoramic radiographs were evaluated. The predictor variables included the presence, impaction status (Pell and Gregory [P&G] classification), and angulation (Winter classification) of the third molar. The outcome variable was the type of fracture, whereas other predictor variables included demographic factors such as age, gender, and fracture etiology. Bivariate (χ2 test) and logistic regression analyses were conducted to estimate the associations between variables and the outcome. RESULTS The sample was composed of 164 angle fracture (mean age, 31.6 ± 12.3 years; 83.5% male) and 115 condylar fracture (mean age, 41.9 ± 16.8 years; 76.5% male) patients. A third molar was present in 72.6% of the angle fracture group and 54.8% of the condylar fracture group (P = .002). Deep impactions (classes IC, IIC, IIIB, and IIIC) exhibited an odds ratio (OR) of 3.60 for angle fractures (P < .001). No association was found between tooth angulations and the type of fracture. According to logistic regression analysis, older age (adjusted OR, 1.05; 95% confidence interval [CI], 1.03 to 1.07), P&G class I impaction (OR, 1.86; 95% CI, 1.09 to 3.20), and P&G class A impaction (OR, 1.91; 95% CI, 1.12 to 3.24) were significantly associated with condylar fractures whereas the presence of a third molar (OR, 0.46; 95% CI, 0.28 to 0.76) or P&G class B impaction (OR, 0.287; 95% CI, 0.12 to 0.69) was associated with angular fractures. CONCLUSIONS P&G class II or III and class B impaction status was significantly associated with angle fractures, whereas missing or fully erupted (class IA) third molars significantly correlated with condylar fractures.
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Affiliation(s)
- Balázs Soós
- PhD Student and Assistant Lecturer, Department of Oral and Maxillofacial Surgery, Medical School, University of Pécs, Pécs, Hungary
| | - Kata Janovics
- Assistant Lecturer, Department of Conservative Dentistry and Periodontology, University of Pécs, Pécs, Hungary
| | - Ákos Tóth
- Assistant Professor, Institute of Sport Sciences and Physical Education, Faculty of Sciences, University of Pécs, Pécs, Hungary
| | | | - József Szalma
- Associate Professor and Department Head, Department of Oral and Maxillofacial Surgery, Medical School, University of Pécs, Pécs, Hungary.
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Gurdán Z, Gelencsér G, Lengyel Z, Szalma J. [The complex dental and oral surgical management with 8-year follow up of a Gorlin‒Goltz syndrome patient]. Orv Hetil 2020; 161:67-74. [PMID: 31902234 DOI: 10.1556/650.2020.31566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Gorlin-Goltz syndrome is an autosomal dominant hereditary disease. Its leading symptoms include keratocysts of the jaws, multiple basal cell carcinomas, skeletal abnormalities, intracranial calcifications and dyskeratosis of the soles and palms. One of the most common and often firstly discovered symptoms is the single or multiplex keratocysts of the jaws. The authors present a case of a child, diagnosed in their orthodontic department. Despite the rare occurrence of the disease, an early detection is important, especially in young patients. Regular follow-up and timely care for patients may avoid life-threatening malformations and radical surgical treatments. Orv Hetil. 2020; 161(2): 67-74.
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Affiliation(s)
- Zsuzsanna Gurdán
- Fogorvostudományi Kar, Gyermek- és Ifjúsági Fogászati Tanszék,Pécsi Tudományegyetem, Klinikai KözpontPécs, Dischka Győző u. 5., 7621
| | - Gábor Gelencsér
- Fogorvostudományi Kar, Arc-, Állcsont- és Szájsebészeti Tanszék,Pécsi Tudományegyetem, Klinikai KözpontPécs
| | - Zsuzsanna Lengyel
- Általános Orvostudományi Kar, Bőr-, Nemikórtani és Onkodermatológiai Klinika,Pécsi Tudományegyetem, Klinikai KözpontPécs
| | - József Szalma
- Fogorvostudományi Kar, Arc-, Állcsont- és Szájsebészeti Tanszék,Pécsi Tudományegyetem, Klinikai KözpontPécs
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Szalma J, Soós B. Coronectomy of third molars: concerns when the roots of teeth surround the inferior alveolar neurovascular bundle. Br J Oral Maxillofac Surg 2019; 57:1165-1166. [DOI: 10.1016/j.bjoms.2019.08.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 08/19/2019] [Indexed: 11/24/2022]
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Lempel E, Lovász BV, Bihari E, Krajczár K, Jeges S, Tóth Á, Szalma J. Long-term clinical evaluation of direct resin composite restorations in vital vs. endodontically treated posterior teeth — Retrospective study up to 13 years. Dent Mater 2019; 35:1308-1318. [DOI: 10.1016/j.dental.2019.06.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/17/2019] [Accepted: 06/17/2019] [Indexed: 01/11/2023]
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Szalma J, Lovász BV, Lempel E, Maróti P. Three-Dimensionally Printed Individual Drill Sleeve for Depth-Controlled Sections in Third Molar Surgery. J Oral Maxillofac Surg 2019; 77:704.e1-704.e7. [PMID: 30610836 DOI: 10.1016/j.joms.2018.11.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/09/2018] [Accepted: 11/28/2018] [Indexed: 10/27/2022]
Abstract
During surgical third molar removal and coronectomy procedures, tooth sectioning is an important and, in some cases, an inferior alveolar nerve-endangering step. This article introduces a drilling sleeve that was printed according to the individual tooth-sectioning situation preoperatively, using diagnostic cone-beam computed tomography data. Not only did the sleeve function in our case as a mark on the drill; it was also a reliable physical limiter, serving as a determinant of the required depth during tooth sectioning. This fast and cost-effectively produced drilling sleeve may help younger colleagues when the depth of tooth sections should be precisely controlled.
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Affiliation(s)
- József Szalma
- Associate Professor and Head of Department, Department of Oral and Maxillofacial Surgery, University of Pécs, Pécs, Hungary.
| | - Bálint Viktor Lovász
- PhD Student, Department of Oral and Maxillofacial Surgery, University of Pécs, Pécs, Hungary
| | - Edina Lempel
- Associate Professor, Department of Restorative Dentistry and Periodontology, University of Pécs, Pécs, Hungary
| | - Péter Maróti
- PhD Student, Department of Biophysics, University of Pécs, Pécs, Hungary
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Lempel E, Őri Z, Szalma J, Lovász BV, Kiss A, Tóth Á, Kunsági-Máté S. Effect of exposure time and pre-heating on the conversion degree of conventional, bulk-fill, fiber reinforced and polyacid-modified resin composites. Dent Mater 2018; 35:217-228. [PMID: 30503020 DOI: 10.1016/j.dental.2018.11.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 10/03/2018] [Accepted: 11/14/2018] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To determine the degree of conversion (DC) of different type of resin-based composites (RBC) in eight-millimeter-deep clinically relevant molds, and investigate the influence of exposure time and pre-heating on DC. METHODS Two-millimeter-thick samples of conventional sculptable [FiltekZ250 (FZ)], flowable [Filtek Ultimate Flow (FUF)] and polyacid-modified [Twinky Star Flow (TS)] RBCs, and four-millimeter-thick samples of flowable bulk-fill [Filtek Bulk Fill Flow (FBF), Surefil SDR (SDR)] and sculptable fibre-reinforced [EverX Posterior (EX)] RBCs were prepared in an eight-millimeter-deep mold. The RBCs temperature was pre-set to 25, 35 and 55°C. The RBCs were photopolymerized with the recommended and its double exposure time. The DC at the top and bottom was measured with micro-Raman spectroscopy. Data were analyzed with ANOVA and Scheffe post-hoc test (p<0.05). RESULTS The differences in DC% between the top/bottom and the recommended/extended exposure time were significant for the materials, except SDR (64.5/63.0% and 67.4/63.0%). FUF (69.0% and 53.4%) and TS (64.9% and 60.9%) in 2mm provided higher DC% at the top and bottom with the recommended curing time, compared to the other materials, except SDR. Pre-heating had negative effect on DC at the bottom in flowable RBCs (FUF: 48.9%, FBF: 36.7%, SDR: 43%, TS: 54.7%). Pre-heating to 55 °C significantly increased the DC% in fibre-reinforced RBC (75.0% at the top, 64.7% at the bottom). SIGNIFICANCE Increased exposure time improves the DC for each material. Among bulk-fills, only SDR performed similarly, compared to the two-millimeter-thick flowable RBCs. Pre-heating of low-viscosity RBCs decreased the DC% at the bottom. Pre-heating of fibre-reinforced RBC to 55°C increased the DC% at a higher rate than the extended curing time.
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Affiliation(s)
- Edina Lempel
- Department of Restorative Dentistry and Periodontology, University of Pécs, Pécs, Hungary.
| | - Zsuzsanna Őri
- Department of General and Physical Chemistry, University of Pécs, 6 Ifjúság Street, Pécs, H-7624, Hungary; János Szentágothai Research Center, 20 Ifjúság Street, Pécs, H-7624, Hungary
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, University of Pécs, Pécs, Hungary
| | - Bálint Viktor Lovász
- Department of Restorative Dentistry and Periodontology, University of Pécs, Pécs, Hungary
| | - Adél Kiss
- Department of Restorative Dentistry and Periodontology, University of Pécs, Pécs, Hungary
| | - Ákos Tóth
- Faculty of Sciences, University of Pécs Pécs, Hungary
| | - Sándor Kunsági-Máté
- Department of General and Physical Chemistry, University of Pécs, 6 Ifjúság Street, Pécs, H-7624, Hungary; János Szentágothai Research Center, 20 Ifjúság Street, Pécs, H-7624, Hungary
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Szalma J, Soós B, Krajczár K, Lempel E. Piezosurgical management of sealer extrusion-associated mental nerve anaesthesia: A case report. AUST ENDOD J 2018; 45:274-280. [PMID: 30338599 DOI: 10.1111/aej.12316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2018] [Indexed: 01/13/2023]
Abstract
The present report describes a case where sealer extrusion (Sealapex) occurred during root canal obturation of a left lower second premolar tooth, and the patient experienced sudden pain and followed by complete anaesthesia of the lower lip. After 3 weeks of conservative therapy and an unaltered anaesthesia period, piezosurgical removal of the extruded sealer and root-end resection was performed despite the direct contact with the mental neurovascular bundle. At suture removal, 1 week after surgery, there was no improvement in sensation. Two weeks after the operation, the patient reported some changes, including a short paraesthesia period alternating with anaesthesia. At the fourth post-operative week, neurosensory function recovered completely. This case represents successful use of the piezoelectric technique for mental nerve decompression and periapical surgery of a lower second premolar with close contact of the mental nerve.
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Affiliation(s)
- József Szalma
- Department of Oral and Maxillofacial Surgery, University of Pécs, Pécs, Hungary
| | - Balázs Soós
- Department of Oral and Maxillofacial Surgery, University of Pécs, Pécs, Hungary
| | - Károly Krajczár
- Department of Conservative Dentistry and Periodontology, University of Pécs, Pécs, Hungary
| | - Edina Lempel
- Department of Conservative Dentistry and Periodontology, University of Pécs, Pécs, Hungary
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Möhlhenrich SC, Kniha K, Szalma J, Ayoub N, Hölzle F, Wolf M, Modabber A, Raith S. Stress distribution in mandibular donor site after harvesting bone grafts of various sizes from the ascending ramus of a dentate mandible by finite element analysis. Clin Oral Investig 2018; 23:2265-2271. [PMID: 30288605 DOI: 10.1007/s00784-018-2671-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 09/26/2018] [Indexed: 12/01/2022]
Abstract
PURPOSE Harvesting bone from the ascending ramus of the mandible is a common procedure. However, mandibular fracture may occur after grafting bone blocks. This study aimed to investigate the resulting force distribution of stress and strain in the mandibular donor site after harvesting bone grafts of different sizes and various loadings. METHODS Finite element analysis was performed for virtual harvesting of bone blocks of nine different sizes between 15 × 20 and 25 × 30 mm and three different chewing loads (incisal, ipsilateral and contralateral). von Mises stress and first principal stress distributions were measured. RESULTS von Mises stress was distributed between 35.01 (10 × 15 mm graft, incisal load) and 333.25 MPa (30 × 20 mm graft ipsilateral load), whereas first principal stress distributions were between 48.27 (10 × 15 mm graft, incisal load) and 414.69 MPa (30 × 20 mm graft ipsilateral load). In general, the least stress was observed with incisal load followed by ipsilateral load and finally contralateral load. The critical value of 133 MPa was found after removing almost all grafts with a width of 20 or 30 mm. CONCLUSIONS Incisal loading led to less stress compared with contralateral and ipsilateral loads. Increasing graft size led to increasing weakness of the donor site. Graft width exerted a greater influence on stress development than its height. CLINICAL RELEVANCE Ipsilateral chewing and increasing width of the bone graft result in maximum stress in the mandibular donor side, and critical values regarding to the possibility of fractures are already to expect from a graft size of 20 × 15 mm.
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Affiliation(s)
- Stephan Christian Möhlhenrich
- Department of Orthodontics and Dentofacial Orthopedics, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany. .,Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Kristian Kniha
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, University of Pecs, Dischka Győző str. 5, Pecs, 7621, Hungary
| | - Nassim Ayoub
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Michael Wolf
- Department of Orthodontics and Dentofacial Orthopedics, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Ali Modabber
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Stefan Raith
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
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Abstract
Aims Orthodontic mini-implants are important devices for successful anchorage management in orthodontics; however, the survival of these devices depends on several clinical factors. The aim of our study was to calculate the success and complication rates of orthodontic mini-implants. Materials and Methods In this retrospective study, patients of our orthodontic department were enrolled, getting overall 59 orthodontic mini-implants during their orthodontic treatment in a 2-year period. Every patient had one or more of the 1.6 mm × 8 mm in size self-drilling mini-implants (Jeil Dual Top Anchor System, Jeil Medical Corp., Seoul, Korea). Screw loading was performed immediately after insertions, keeping tension forces under 150 g. Soft tissue and bone infections, implant mobility and screw loss, implant fracture, and neighboring tooth injury were registered. Relationships between variables were tested using the Chi-square test for statistical significance. Results The success rate of the orthodontic mini-implants was 89.8% in this study while the average loading period was 8.1 months. Soft-tissue infections varied between 6.3% and 33.3% of the cases while screw mobility varied between 3.1% and 20.8% of the cases regarding the anatomic localization. Screw mobility was significantly more frequent in the buccal fold than in the palate (P = 0.034). Screw mobility was significantly more frequent in the buccal fold than in the palate (P = 0.034) and screw mobility was found more frequently in case of intrusions than by extrusions (P = 0.036). Conclusions The overall success rate of mini-implants was found acceptable in this study, however, screw mobility in the buccal fold showed a high incidence, suggesting the thorough consideration of the immediate loading by buccal mini-implants.
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Affiliation(s)
- Z Gurdan
- Department of Paediatric and Adolescent Dentistry, University of Pécs, H-7621 Pécs, Hungary
| | - J Szalma
- Department of Paediatric and Adolescent Dentistry, University of Pécs, H-7621 Pécs, Hungary
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Abstract
OBJECTIVES The aim of this study was to determine the increase in heat production, preparation time, and cutting surface quality of conventional, high-speed rotating instruments and piezoelectric preparation for coronectomy procedures. MATERIALS AND METHODS One hundred intact extracted molars were sectioned horizontally, sub-totally, 1 mm under the cemento-enamel line with five methods: (1) tungsten carbide torpedo (TcT), (2) round (TcR) drills using a conventional speed surgical straight handpiece (< 40,000 min-1), (3) tungsten carbide fissure (TcF), (4) diamond torpedo (DT) drills using a surgical high-speed, contra-angle handpiece (~ 120,000 min-1), or (5) a saw-like piezoelectric tip (PT). Temperatures, preparation times, and cutting surface irregularities were registered and the differences were analyzed with ANOVA, Tukey's HSD post hoc test (temperature, time) and with chi-square test (irregular surface). RESULTS Rotating instruments produced a maximal temperature increase of less than 1 °C. TcF produced the least heat (ΔT = - 3.92 °C to the baseline), while PT produced significantly the highest temperature increases (ΔT = 12.38 °C, p < 0.001). Tungsten carbide drills were the fastest for coronectomy (from 55.9 to 64.3 s), while DT (169.7 s) while PT (146.8 s) were significantly slower. TcT and TcR drills produced an irregular root surface more frequently. CONCLUSIONS During coronectomy, rotating instruments produced entirely acceptable heat, while PT produced unacceptable temperatures. Tungsten carbide drills performed coronectomies effectively, but the diamond torpedo and PT seemed clinically questionable. Considering heat, speed, and the cutting surface quality simultaneously, TcF in a surgical high-speed handpiece seems to be the best choice for coronectomy. CLINICAL RELEVANCE The correct insert can significantly reduce excessive heat and operation time during coronectomy procedures.
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Affiliation(s)
- József Szalma
- Department of Oral and Maxillofacial Surgery, University of Pécs, 5 Dischka Gy Street, Pécs, 7621, Hungary.
| | - László Vajta
- Department of Oral and Maxillofacial Surgery, University of Pécs, 5 Dischka Gy Street, Pécs, 7621, Hungary
| | - Lajos Olasz
- Department of Oral and Maxillofacial Surgery, University of Pécs, 5 Dischka Gy Street, Pécs, 7621, Hungary
| | - Edina Lempel
- Department of Restorative Dentistry and Periodontology, University of Pécs, 5 Dischka Gy Street, Pécs, 7621, Hungary
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Abstract
Abstract: Coronectomy of lower impacted wisdom teeth is the partial removal of third molars, aiming to avoid inferior alveolar nerve injuries. The coronectomy procedure has several crucial points, such as the pulpal, periapical preoperative conditions of the tooth, the way of crown sectioning and decoronation, the wound closure and the length of patients’ follow up. In addition it is important to identify and manage possible intraoperative or postoperative complications correctly. According to the literature, the complication rate of coronectomy is usually lower, than that of total teeth removal, furthermore considering inferior alveolar nerve injuries, coronectomy is significantly the safer procedure. The aim of the authors was to review the relevant literature, defining the indications, contraindications and the correct implementation of the coronectomy and to demonstrate the causes and incidences of failures and complications. Further aim was to promote the domestic acceptance of this procedure. Orv Hetil. 2017; 158(45): 1787–1793.
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Affiliation(s)
- József Szalma
- Arc-, Állcsont- és Szájsebészeti Tanszék, Pécsi Tudományegyetem, Klinikai Központ, Fogorvostudományi Kar Pécs, Dischka Győző u. 5., 7621
| | - Edina Lempel
- Konzerváló Fogászati és Parodontológiai Tanszék, Pécsi Tudományegyetem, Klinikai Központ, Fogorvostudományi Kar Pécs
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Szalma J, Vajta L, Lempel E, Tóth Á, Jeges S, Olasz L. Intracanal temperature changes during bone preparations close to and penetrating the inferior alveolar canal: Drills versus piezosurgery. J Craniomaxillofac Surg 2017; 45:1622-1631. [DOI: 10.1016/j.jcms.2017.07.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 06/26/2017] [Accepted: 07/19/2017] [Indexed: 12/11/2022] Open
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Lempel E, Lovász BV, Meszarics R, Jeges S, Tóth Á, Szalma J. Direct resin composite restorations for fractured maxillary teeth and diastema closure: A 7 years retrospective evaluation of survival and influencing factors. Dent Mater 2017; 33:467-476. [PMID: 28256273 DOI: 10.1016/j.dental.2017.02.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 02/12/2017] [Accepted: 02/13/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVES This retrospective study evaluated the survival rate of anterior direct resin based composite (RBC) build-ups in vital teeth made of microhybrid and nanofill RBC materials and the influence of bruxism, beverage consumption and smoking on the long-term performance of restorations. METHODS Patients receiving anterior restoration between 2006 and 2011, with the diagnosis of fracture or diastema, were selected. A total of 65 adult patients (mean age: 25.2) with 163 restorations (78 Filtek Supreme XT and 85 Enamel Plus HFO) were evaluated using the USPHS criteria. Data were analyzed with Fisher's Exact Test, Extended Cox-regression analysis and Kaplan-Meier method. RESULTS Mean observation period was 7.2 (±1.4) years and the mean annual failure rate for this period was 1.43%. The reasons of failures included restoration fracture and color mismatch. Nanofill restorations had significantly higher rate of color mismatch (p=0.002), microhybrids more frequently failed in fracture of restoration (p=0.034). The overall difference in potential hazard of using Enamel Plus HFO or Filtek Supreme XT was not significant (p=0.704). Chipping or fracture of the restoration was more frequent in the first year after placement (p=0.036), while beverage consumption was significantly correlated with discoloration of the restorations (p=0.005). SIGNIFICANCE The application of direct RBC restorations provides an excellent treatment option for fractured teeth and for closing diastemas. The overall survival rate was 88.34% up to 10 years. Microhybrid and nanofill RBC restorations showed similar survival rates, however nanofills discolored at a higher rate, meanwhile chipping of the restoration occurred frequently with microhybrids.
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Affiliation(s)
- Edina Lempel
- Department of Restorative Dentistry and Periodontology, University of Pécs, Pécs, Hungary.
| | - Bálint Viktor Lovász
- Department of Restorative Dentistry and Periodontology, University of Pécs, Pécs, Hungary
| | - Réka Meszarics
- Department of Restorative Dentistry and Periodontology, University of Pécs, Pécs, Hungary
| | - Sára Jeges
- Faculty of Sciences, University of Pécs, Pécs, Hungary
| | - Ákos Tóth
- Faculty of Sciences, University of Pécs, Pécs, Hungary
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, University of Pécs, Pécs, Hungary
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Gurdán Z, Vajta L, Tóth Á, Lempel E, Joób-Fancsaly Á, Szalma J. Effect of pre-drilling on intraosseous temperature during self-drilling mini-implant placement in a porcine mandible model. J Oral Sci 2017; 59:47-53. [DOI: 10.2334/josnusd.16-0316] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Zsuzsanna Gurdán
- Department of Paediatric and Adolescent Dentistry, University of Pécs
| | - László Vajta
- Department of Oral and Maxillofacial Surgery, University of Pécs
| | - Ákos Tóth
- Faculty of Sciences, University of Pécs
| | - Edina Lempel
- Department of Restorative Dentistry and Periodontology, University of Pécs
| | | | - József Szalma
- Department of Oral and Maxillofacial Surgery, University of Pécs
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Tordai B, Stáczer N, Vajta L, Szalma J. [Giant sialolithiasis: Diagnosis and management. Case reports]. Orv Hetil 2016; 157:1967-1972. [PMID: 27917674 DOI: 10.1556/650.2016.30617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Sialolithiasis is one of the most frequent form of calcifications in the maxillofacial area. 0.45% of the population is affected by symptoms caused by salivary calculi, though the estimated frequency including asymptomatic form may exceed 1% in adult population. Radiographs presenting a large portion of the maxillofacial region (panoramic radiography, computed tomography) could detect salivary calculi with high accuracy. The size of the sialoliths is usually less than 10 mm in diameter. Salivary calculi larger than 15 mm (considering the largest diameter) are classified as giant sialoliths and most of them are located in the submandibular gland or in its duct. Two unusually large submandibular salivary calculi cases are represented (diameters of 27 and 34 mm), whereas in one of the cases development and dimensional changes of the calculus are described via a seven years period. This case report represents diagnostic and therapeutic consequences in giant sialolithiasis and demonstrates possible differential diagnostic difficulties. Orv. Hetil., 2016, 157(49), 1967-1972.
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Affiliation(s)
- Bálint Tordai
- Arc-, Állcsont- és Szájsebészeti Tanszék, Pécsi Tudományegyetem, Klinikai Központ Pécs, Dischka Győző u. 5., 7621
| | - Nóra Stáczer
- Arc-, Állcsont- és Szájsebészeti Tanszék, Pécsi Tudományegyetem, Klinikai Központ Pécs, Dischka Győző u. 5., 7621
| | - László Vajta
- Arc-, Állcsont- és Szájsebészeti Tanszék, Pécsi Tudományegyetem, Klinikai Központ Pécs, Dischka Győző u. 5., 7621
| | - József Szalma
- Arc-, Állcsont- és Szájsebészeti Tanszék, Pécsi Tudományegyetem, Klinikai Központ Pécs, Dischka Győző u. 5., 7621
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Lukács D, Stáczer N, Vajta L, Olasz L, Joób-Fancsaly Á, Szalma J. [Dental and oral surgical treatment of medication-induced bleeding patients: Audit of the national guideline in Hungary]. Orv Hetil 2016; 157:1722-1728. [PMID: 27774803 DOI: 10.1556/650.2016.30568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION In 2015 a new Hungarian guideline was published regarding dental treatment and management of anticoagulated patients in agreement of the Hungarian Association of Oral and Maxillofacial Surgeons and the Dental Implantology Association of Hungarian Dentists. AIM The aim of the authors was to evaluate the efficiency and safety of local hemostatic measures recommended by the guideline in anticoagulated patients. METHOD In these patients, postoperative bleeding episodes were examined after dental and oral surgical treatments, retrospectively. RESULTS Overall 263 bleeding risk cases were treated; 138 patients with vitamin K antagonists, 97 patients with antiplatelet therapy and 6 patients with novel oral anticoagulants. Six patients (2.3%) had minor postoperative bleeding after the "one hour control", while one patient needed a night duty support (0.5%). In contrast, 86 patients who were treated in rural practices neglecting the guideline attended the night duty with postoperative bleeding (3 patients treated with vitamin K antagonists, 24 patients taking low molecular weight heparin, 30 patients receiving antiplatelet therapy and one patient on novel oral anticoagulant therapy. CONCLUSIONS The Hungarian guideline can be applied safely, without increasing the risk of postoperative bleeding, however, rural dental practices are frequently unprepared for these treatments. Orv. hetil., 2016, 157(43), 1722-1728.
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Affiliation(s)
- Dénes Lukács
- Fogorvostudományi Kar, Klinikai Központ, Arc-, Állcsont- és Szájsebészeti Tanszék, Pécsi Tudományegyetem Pécs, Dischka Győző u. 5., 7621
| | - Nóra Stáczer
- Fogorvostudományi Kar, Klinikai Központ, Arc-, Állcsont- és Szájsebészeti Tanszék, Pécsi Tudományegyetem Pécs, Dischka Győző u. 5., 7621
| | - László Vajta
- Fogorvostudományi Kar, Klinikai Központ, Arc-, Állcsont- és Szájsebészeti Tanszék, Pécsi Tudományegyetem Pécs, Dischka Győző u. 5., 7621
| | - Lajos Olasz
- Fogorvostudományi Kar, Klinikai Központ, Arc-, Állcsont- és Szájsebészeti Tanszék, Pécsi Tudományegyetem Pécs, Dischka Győző u. 5., 7621
| | - Árpád Joób-Fancsaly
- Fogorvostudományi Kar, Arc-, Állcsont-, Szájsebészeti és Fogászati Klinika, Semmelweis Egyetem Budapest
| | - József Szalma
- Fogorvostudományi Kar, Klinikai Központ, Arc-, Állcsont- és Szájsebészeti Tanszék, Pécsi Tudományegyetem Pécs, Dischka Győző u. 5., 7621
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Cziriak NB, Szalma J, Vag J, Bogdan S. In vitro comparison of the effect of piezosurgery and conventional bone preparation technique on intraosseous heat generation. Fogorv Sz 2016; 109:88-93. [PMID: 29693954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The aim of this in vitro study was to compare the effect of sagittal saw handpiece with a piezoelectric device on the rise in intraosseous temperature and on the preparation time. 100 native pieces of pork ribs were cut either with S-8 S handpiece connected to Elcomed surgical motor (W&H) (n = 30) or with B6 insert connected to Piezomed (W&H) using continuous movement (n = 30) or with B6 using short breaks to perform intermittent cutting (n = 30). The rest were cut either by S-8 S (n = 5) or by B6 (n = 5) both applied by permanent pressure. The intraosseous temperature was measured by K-type thermocouple connected to digital thermometer placed in the bone 1 mm away of the cutting line. The heat generated and the time of the complete cutting were recorded. In S-8 S group the temperature never rose above 47⁰C. Using the B6 with permanent movement the critical temperature was reached in 16.2 ± 3.53% of the cases while taking breaks decreased the results to 2.6 ? 0.96% (p <0.001). In no cases the temperature elevation above 4700 lasted more than 60 sec. Applying the B6 by permanent pressure resulted in heat up to 90.3⁰C. Our results suggest that piezoelectric device could use safely according to the factory instructions, however further reduce of heat load could be achieved if the intermittent cutting motion combined with short-time cooling periods.
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Abstract
The tendency for bisphosphonate and non-bisphosphonate (eg.: antiresorptive or anti-angiogenesis drugs) induced osteonecrosis is increasing. Treatment of these patients is a challenge both for dentists and for oral and maxillofacial surgeons. Cooperation with the drug prescribing general medicine colleagues to prevent osteonecrosis is extremely important. Furthermore, prevention should include dental focus elimination, oral hygienic instructions and education, dental follow-up and, in case of manifest necrosis, referral to maxillofacial departments. Authors outline the difficulties of conservative and surgical treatment of a patient with sunitinib and zoledronic acid induced osteonecrosis. The patient became symptomless and the operated area healed entirely six and twelve months postoperatively. A long term success further follow-up is necessary to verify long-term success.
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Affiliation(s)
- Balázs Soós
- Arc-, Állcsont- és Szájsebészeti Tanszék, Pécsi Tudományegyetem, Fogorvos-tudományi Kar Pécs, Dischka Győző u. 5., 7621
| | - László Vajta
- Arc-, Állcsont- és Szájsebészeti Tanszék, Pécsi Tudományegyetem, Fogorvos-tudományi Kar Pécs, Dischka Győző u. 5., 7621
| | - József Szalma
- Arc-, Állcsont- és Szájsebészeti Tanszék, Pécsi Tudományegyetem, Fogorvos-tudományi Kar Pécs, Dischka Győző u. 5., 7621
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Szalma J, Joób-Fancsaly Á. [Dental management of hemorrhage-prone patients]. Fogorv Sz 2015; 108:57-60. [PMID: 26434209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The authors present a proposal of dental treatment and management of anticoagulated patients and of patients on antiplatelet therapy, with the approval by the Hungarian Association of Oral and Maxillofacial Surgeons and by the Dental Implantology Association of Hungarian Dentists. This current guide was based on recent Hungarian and on several foreign national guidelines and considers significant publications from international literature.
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Vajta L, Nagy Á, Kálovics J, Szalma J. [Dental and oral surgical treatment of a B haemophilic patient with high inhibitor level. Case report]. Fogorv Sz 2015; 108:61-64. [PMID: 26434210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
More than 1000 hemophilic male patients are registered in Hungary, from which only a trace number suffers from factor IX inhibitory hemophilia. For correct dental and oral surgical treatment of these patients mandatory cooperation is required among medical specialties, exerting multi-staged haemostatic principles. Authors represent in this case report the dental and oral surgical treatment of a B hemophilic patient with high inhibitor level and describe possible local haemostatic measures.
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Lempel E, Tóth Á, Fábián T, Krajczár K, Szalma J. Retrospective evaluation of posterior direct composite restorations: 10-year findings. Dent Mater 2014; 31:115-22. [PMID: 25480695 DOI: 10.1016/j.dental.2014.11.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Revised: 04/16/2014] [Accepted: 11/03/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This 10-year retrospective study investigated the differences in the changes and the longevity of Class II restorations using 4 similar microhybrid resin composites (Filtek Z250, Herculite XR, Gradia Direct Posterior, Renew). METHODS Data were collected from patient records. Those patients who received posterior restoration between 2001 and 2003, and who still visited the clinical practice for regular check-up visits were selected. A total of 225 adult patients (86 males, 139 females) with 701 restorations were evaluated by 2 operators using the USPHS criteria. Data were analyzed with Fisher's Exact Test, Pearson's Chi-Square Test and Kaplan-Meier analysis (p<0.05). RESULTS A failure rate of 2.1% was detected. The reasons of failures included restoration fracture, secondary caries and endodontic treatment. Similar survival rates for Gradia Direct Posterior (91.25%) and Renew (92.19%) were observed; better performance was observed with the Filtek Z250 (99.1%) and Herculite XR (98.64%). There was a higher probability of failure in 3 surface (n=10) than in 2 surface (n=5) restorations (p<0.001), and this rate was similar when molars (n=8) and premolars (n=7) were compared. The most frequent but clinically acceptable deficiency was the marginal discoloration. SIGNIFICANCE All four microhybrid resin composites showed acceptable clinical durability in Class II restorations during the 10-year follow-up period, with an overall survival rate of >97.8%. Higher rates of failures and deficiencies were observed with the Renew (fracture) and Gradia Direct Posterior (color match), respectively.
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Affiliation(s)
- Edina Lempel
- Department of Restorative Dentistry and Periodontology, University of Pécs, Pécs, Hungary.
| | - Ákos Tóth
- Faculty of Sciences, University of Pécs, Pécs, Hungary
| | - Tamás Fábián
- Department of Restorative Dentistry and Periodontology, University of Pécs, Pécs, Hungary
| | - Károly Krajczár
- Department of Restorative Dentistry and Periodontology, University of Pécs, Pécs, Hungary
| | - József Szalma
- Department of Oral and Maxillofacial Surgery, University of Pécs, Pécs, Hungary
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Lempel E, Czibulya Z, Kunsági-Máté S, Szalma J, Sümegi B, Böddi K. Quantification of Conversion Degree and Monomer Elution from Dental Composite Using HPLC and Micro-Raman Spectroscopy. Chromatographia 2014. [DOI: 10.1007/s10337-014-2647-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Szalma J, Bata Z, Lempel E, Jeges S, Olasz L. Quantitative pixel grey measurement of the "high-risk" sign, darkening of third molar roots: a pilot study. Dentomaxillofac Radiol 2013; 42:20130160. [PMID: 23775927 DOI: 10.1259/dmfr.20130160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Our aim was to examine the panoramic darkening of the root, which is a "high-risk" sign, using quantitative measurements of pixel grey values to determine different aetiological backgrounds, namely inferior alveolar nerve (IAN) exposure with or without groove formation of the third molar roots or thinning/fenestration of the lingual cortex (LCTF). METHODS 38 impacted third molars that had been surgically removed and had darkened roots on panoramic radiographs were included in this retrospective case-control study. 15 IAN exposure cases were selected for the case group, and 23 cases with proven lingual cortical thinning or fenestration were chosen for the control group. The mean pixel grey values of selected areas in the dark band (D) and control areas within the same roots (R) were determined with the ImageTool (University of Texas Health Science Center, San Antonio, TX) software. The differences in pixel values (R-D) of the IAN and LCTF groups were analysed using the Mann-Whitney U-test and Pearson's χ(2) test. RESULTS The medians of the R-D pixel values were 45.7 in the IAN group and 34.3 in the LCTF group, whereas the interquartile ranges were 12.0 (IAN) and 18.3 (LCTF) (p < 0.001). The R-D critical value at which the outcomes differed significantly was 38. If the differences in pixel grey values (R-D) were higher than 38, the chance of IAN exposure was approximately 32 times higher than the chance of LCTF (χ(2) test, p < 0.001; odds ratio, 32.0; 95% confidence interval, 3.5-293.1). CONCLUSIONS The pre-operative prediction of IAN exposure or lingual cortical thinning in cases with "darkening" is possible based on pixel grey measurements of digital panoramic radiographs.
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Affiliation(s)
- J Szalma
- Department of Oral and Maxillofacial Surgery, University of Pécs, Pécs, Hungary.
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Szalma J. Is early extraction really the silver bullet to avoid nerve injury in lower third molar removal? Int J Oral Maxillofac Surg 2012; 41:1587-8; author reply 1589. [PMID: 23036606 DOI: 10.1016/j.ijom.2012.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 09/05/2012] [Indexed: 11/24/2022]
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Lempel E, Szalma J, Jeges S, Kende D, Krajczár K, Nagy A, Tóth V. [Retrospective study of direct composite restorations according to the USPHS criteria]. Fogorv Sz 2012; 105:47-52. [PMID: 22826906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The purpose of this retrospective study was to evaluate and describe the occurrence of different deficiencies of composite restorations in molar and premolar teeth. Further aim was to investigate possible correlations between occurring malformations and the localization or size of the restorations. 240 class II composite restorations (in 85 patients) were involved in the study. Control examinations were carried out five years after restorations, according to the United States Public Health Services' criteria. Namely, anatomic form, marginal integrity, marginal stain, color stability, surface smoothness, and the presence of secondary caries or fractures of the restorations. The associations between variables were calculated by bivariate analyses using either Pearson chi-square or Fisher tests. P < 0.05 was considered significant. In 0.8% of the fillings, secondary caries and in 0.4% of the cases, fracture was found as a failure. The frequency of adjacent deficiencies were found as follows: color instability, 12.5%; marginal stain, 20.8%; anatomic deformity, 15.0%; failure of marginal integrity, 8.8%; and surface roughness, 2.5%. Color instability was significantly more frequent in premolar teeth, than in molars (P = 0.031). Color instability (P = 0.015), marginal stain (P < 0.001) and anatomic form malformation (P = 0.002) occurred more frequently in MOD restorations than in MO/OD fillings. Our results suggest that class II restorations are correct both functionally and esthetically in 98.8% of the cases, even after a 5-year-period.
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Affiliation(s)
- Edina Lempel
- Pécsi Tudományegyetem Klinikai Központ Fogászati és Szájsebészeti Klinikája, Konzerváló Fogászati és Parodontológiai Tanszék
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Szalma J, Lempel E, Jeges S, Olasz L. Darkening of Third Molar Roots: Panoramic Radiographic Associations With Inferior Alveolar Nerve Exposure. J Oral Maxillofac Surg 2011; 69:1544-9. [DOI: 10.1016/j.joms.2010.09.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Revised: 07/26/2010] [Accepted: 09/22/2010] [Indexed: 01/27/2023]
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Szalma J, Lempel E, Csuta T, Vajta L, Jeges S, Olasz L. [The specific panoramic radiographic signs and their relation with inferior alveolar nerve injuries after mandibular third molar surgery]. Fogorv Sz 2011; 104:27-32. [PMID: 21789933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The aim of the authors was to describe the classic specific panoramic signs (indicating a close spatial relationship between dental canal and third molar's root) on panoramic radiographic images and determine their role in the risk assessment, predicting inferior alveolar nerve (IAN) paresthesia after lower third molar removal. The authors represented an informative case, where the IAN was visible during the surgery. The exact knowledge of classic panoramic radiographic signs should help the determination of "high risk" cases predicting IAN paresthesia after mandibular third molar removal. The authors keep panoramic radiography rather a routine than the most superior diagnostic tool in third molar surgery.
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Affiliation(s)
- József Szalma
- Pécs Tudományegyetem Altalános Orvostudományi es Egészségtudományi Centrum Altalános Orvostudományi Kar Fogászati es Szájsebészeti Klinikája, Arc-, AlIcsont- es Szájsebészeti Tanszék
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