Orthodontic treatment demand for fixed treatment and aligners among young adults in middle Europe and South America - a questionnaire study

BACKGROUND

Patients experiencing any malocclusion, may desire for treatment. However, there is no scientific information orthodontic treatment demand and the knowledge of young adults about orthodontic treatment. The aim of the study was to assess orthodontic treatment demand in young adults from Poland and Chile, their previous orthodontic experience and their knowledge on fixed and aligner orthodontic treatment.

METHODS

The target group comprised people aged 18-30. The sample size was estimated as above 400 for each country. The survey was carried out in Polish and Spanish within 3 months and consisted of 25 questions delivered via social media. Comparisons were made between countries, age subgroups and gender.

RESULTS

The response rate was 1,99%, what stands for 1092 responses, 670 from Chile and 422 from Poland, respectively. The percentage of young adults who were already treated was 42,9% in Poland and 25,0% in Chile. The ones planning to have orthodontic treatment within a year counted for 11,8% in Poland and 5,3% in Chile. Most young adults who want to be treated (20,6%) rely on doctor's recommendation on type of appliance while 14,7% of all respondents are interested solely in aligners. Most respondents have heard about aligners (58%). Direct provider-to-customer service without a doctor is not acceptable, neither in Poland (85,1%) nor in Chile (64,8%). Most young adults provided incorrect answers referring various aspects of aligner treatment.

CONCLUSIONS

In both countries, patients demand to be treated and monitored by the orthodontist. A high percentage of patients want to be treated exclusively with aligners. Direct-to-consumer orthodontics does not seem attractive to patients. Young adults do not have adequate knowledge referring to aligner treatment. Many people want to be treated despite a previous orthodontic treatment.

Three-dimensional microanalysis of tooth movement during the first 6 months of orthodontic double retention

INTRODUCTION

This study performed a 3-dimensional analysis of tooth movement during orthodontic retention to assess the effectiveness of double retention (fixed and removable) in preventing undesired tooth movement.

METHODS

One hundred randomly selected patients were included at the initiation of double orthodontic retention with fixed retainers and vacuum-formed splints (recommended to be worn 22 h/d) in both arches. Intraoral scans were performed directly (T0), 1 month (n = 88), 3 months (T2) (n = 78), and 6 months (T3) (n = 66) after retainer bonding. Nine reference points were marked on each tooth in every patient. Subsequent scans were superimposed, and point displacement was calculated. Statistical analysis was performed using the R statistical software (version 4.2.2; R Core Team, Vienna, Austria).

RESULTS

Sample size calculation determined at least 55 patients were needed. The total dropout between T0 and T3 was 34 patients (did not show up for appointment). The median absolute displacement value of a single point between T0 and T3 was 0.015 mm. The most stable teeth were mandibular central incisors, whereas the least stable were mandibular molars. Most tooth displacements occurred between T0 and T2, then slowed down significantly.

CONCLUSIONS

Double orthodontic retention prevents major tooth displacements in most patients during the first 6 months of retention; however, larger, unpredictable single-tooth displacement may occur in individual patients.

Association of Three Genetic Loci with Molar Incisor Hypomineralization in Polish Children

BACKGROUND

Molar incisor hypomineralization (MIH) is a qualitative, demarcated enamel defect of hypomineralization affecting one to four first permanent molars, often with incisor involvement. Its etiology is complex. However, evidence suggests the influence of genetic factors, potentially including the single nucleotide polymorphisms (SNPs) rs2889956, rs4811117 and rs13058467, which were previously linked to MIH in a genome-wide association study of German children. The aim was to replicate analyses of possible associations between the SNPs and molar incisor hypomineralization in Polish children.

METHODS

The final study group consisted of 778 children aged 126-168 months old. Saliva samples were taken, and genomic DNA was extracted and genotyped using beadchip microarrays.

RESULTS

Among the 778 subjects, there were 68 (8.7%) subjects with MIH and 710 (91.3%) subjects without MIH. There were no significant differences in distributions in age, sex, or the frequency of caries in permanent dentition between the MIH and non-MIH groups. The rs2889956, rs4811117, and rs13058467 genotype distributions in the studied group conformed to the expected Hardy-Weinberg equilibria, and there were no significant differences in the distributions of their alleles or genotypes between the MIH and non-MIH groups.

CONCLUSION

Our replication study did not confirm highly significant associations between the single nucleotide polymorphisms rs2889956, rs4811117, and rs13058467 with molar incisor hypomineralization in Polish children.

Morphological Variations and Anomalies of the Sella Turcica on Lateral Cephalograms of Cleft-Palate-Only (CPO) Patients

Sella turcica abnormalities were reported in malocclusions and clefts. No studies were found on sella turcica abnormalities in CPO patients. This study aimed to compare the prevalence of sella turcica abnormalities on cephalometric radiographs in CPO versus non-cleft orthodontic patients. Cephalograms of CPO patients (n = 89) and controls (n = 89) were analyzed for normal sella turcicae and sella turcica abnormalities. Then, cephalometric analysis was performed using specialized software. Statistical analysis was performed using the Rv.4.1.1 package. No variation in or anomaly of the sella turcica was more frequent in CPO compared to non-cleft individuals. Patients with hypertrophic posterior clinoid process had higher interincisal and 1+:Nasion-A angles. Subjects with hypertrophic posterior clinoid process and double contour of the floor had higher Sella-Nasion-A, Sella-Nasion-B and Sella-Nasion-Pogonion and lower ANB. A pyramidal shape of the dorsum sellae was more prevalent in males, as was double contour of the floor in females. Subjects with an oblique anterior wall had lower SNB, GntgoAr and NLA. Subjects with a normal sella had higher SNPg, ML-NSL and 1+:NAmm. A normal sella was more prevalent in younger patients. CPO is not associated with sella turcica abnormalities compared to non-cleft orthodontic patients.

Craniofacial Cephalometric Morphology in Caucasian Adult Patients with Cleft Palate Only (CPO)

Orofacial clefts are common birth defects that affect the morphology of the skull. Cleft palate only (CPO) has a different etiology than other types of clefts, and craniofacial morphology in CPO differs from that of UCLP and BCLP. The long-term effect of the cleft and its surgery is visible after growth cessation. However, few studies exist describing cephalometric craniofacial morphology in adults with CPO. The aim of the present study was to describe the cephalometric craniofacial morphology of adult patients with CPO compared to healthy patients. The study included analysis of cephalometric lateral headfilms of 28 adults with CPO and 28 healthy subjects. It was found that the angles of SNA, ANB, 1-:NB angle (°) and Wits appraisal were significantly smaller in CPO, whereas NL-NSL (°), 1+:NA angle (°) and 1+:NA (mm) had significantly higher values in CPO compared to the control group. It has been concluded that CPO in adult patients is characterized by a sagittal jaw discrepancy due to maxillary deficiency, with a tendency for compensatory inclination of the upper and lower incisors.

IRF6 and FGF1 polymorphisms in non-syndromic cleft lip with or without cleft palate in the Polish population

Non-syndromic cleft lip with or without cleft palate (NSCL/P) is the most common developmental defect that significantly affects the morphology and function of the stomatognathic system in children. The etiology of these birth defects is multifactorial, and single nucleotide polymorphisms (SNPs) in IRF6 and FGF1 have been associated with NSCL/P. This study aimed to evaluate whether SNPs in IRF6, namely rs2013162, rs642961, rs2235373, and rs34010 in FGF1, are associated with NSCL/P occurrence in the Polish population. The study included 627 participants: 209 children with NSCL/P and 418 healthy controls. DNA was isolated from saliva in the study group and from umbilical cord blood in controls. Genotyping of polymorphisms was performed using quantitative PCR. There was no statistically significant association of IRF6 gene variants with NSCL/P occurrence, although for rs2013162, AA genotype, odds ratio (OR) = 1.16 and for AC genotype, OR = 0.83; for rs642961, AA genotype, OR = 0.84 and for AG genotype, OR = 1.41; and for rs2235373, AA genotype, OR = 0.79 and for AG, OR = 0.85. In the instance of rs34010 polymorphism in FGF1, the presence of the AA genotype was statistically significant in reducing the risk of NSCL/P (OR = 0.31, p = 0.001). Genetic variation in FGF1 is an important risk marker of NSCL/P in the Polish population, which cannot be stated for the polymorphisms in the IRF6 gene.

Attachments for the Orthodontic Aligner Treatment-State of the Art-A Comprehensive Systematic Review

BACKGROUND

In recent years the burden of aligner treatment has been growing. However, the sole use of aligners is characterized by limitations; thus attachments are bonded to the teeth to improve aligner retention and tooth movement. Nevertheless, it is often still a challenge to clinically achieve the planned movement. Thus, the aim of this study is to discuss the evidence of the shape, placement and bonding of composite attachments.

METHODS

A query was carried out in six databases on 10 December 2022 using the search string ("orthodontics" OR "malocclusion" OR "Tooth movement techniques AND ("aligner*" OR "thermoformed splints" OR "invisible splint*" AND ("attachment*" OR "accessor*" OR "auxill*" AND "position*").

RESULTS

There were 209 potential articles identified. Finally, twenty-six articles were included. Four referred to attachment bonding, and twenty-two comprised the influence of composite attachment on movement efficacy. Quality assessment tools were used according to the study type.

CONCLUSIONS

The use of attachments significantly improves the expression of orthodontic movement and aligner retention. It is possible to indicate sites on the teeth where attachments have a better effect on tooth movement and to assess which attachments facilitate movement. The research received no external funding. The PROSPERO database number is CRD42022383276.

Carotid Artery Calcifications on Panoramic Radiographs

OBJECTIVE

The objective of this study was to evaluate the prevalence of carotid artery calcifications (CACs) on panoramic radiographs of Polish dental patients.

METHODS

Panoramic radiographs made between 2005 and 2012 in 4000 patients born between 1922 and 1958 were accessed from the server of the Department of Radiology and analyzed for the presence or absence of CACs by a group of trained dentists.

RESULTS

The anatomical area covered by the analysis was visible in 2189 images (54.73%). Calcifications in the carotid arteries were found in 468 (21.68%) patients, including 327 (14.94%) unilaterally and 141 (6.44%) bilaterally. CACs were found in 284 (60.68%) women and 184 (39.32%) men.

CONCLUSIONS

The prevalence rate of CACs detected on panoramic radiographs in patients aged 54 and older was 21.68%, which makes it an important clinical problem.

Influence of Primary Palatal Surgery on Craniofacial Morphology in Patients with Cleft Palate Only (CPO)-Systematic Review with Meta-Analysis

BACKGROUND

Cleft palate only (CPO) is the second most prevalent cleft type. Both the cleft and palatal scarring may affect craniofacial growth. The aim of this systematic review was to summarize scientific evidence on effect of palatal surgery on craniofacial morphology in CPO.

METHODS

A search was conducted in PubMed, PMC, WoS, Scopus, Embase, using the keywords: "cleft palate" AND ("craniofacial morphology" OR "cephalometric analysis") NOT "lip" with inclusion and exclusion criteria ensuring confident, direct comparison between study groups. The quality assessment was performed with Arrive's scale for radiologic examinations.

RESULTS

Of 713 potential articles, 19 were subjected to qualitative analysis and 17 to meta-analysis, which confirmed reduced SNA in unoperated CPO versus non-cleft individuals. No scientific evidence was found directly assessing the effect of surgery on craniofacial morphology. The negative effect of palatal surgery was seen indirectly: in treated CPO versus non-cleft, the size effect of SNA is bigger than in untreated CPO versus non-cleft. A high heterogeneity came from a few non-European publications.

CONCLUSIONS

CPO is associated with sagittal maxillary deficiency resulting both from the cleft and from primary surgery, disregarding cleft severity in operated CPO patients. Ethnic differences influence craniofacial morphology in CPO. This research received no external funding. Study protocol number in PROSPERO database: CRD42021268957.

Pandemic COVID-19 Influence on Adult's Oral Hygiene, Dietary Habits and Caries Disease-Literature Review

Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2. The pandemic over the past two years has completely changed people's daily habits with an impact on oral hygiene, eating habits, and oral health.

MATERIALS AND METHODS

The available literature was reviewed on the PubMed platform and from other sources MEDLINE and Cochrane Reviews. The analysis included comparative and clinical trials as well as pragmatic clinical/randomized controlled trials, and observational studies which focused on the effects of COVID-19 on the dietary habits of the population, oral hygiene, and caries incidence.

RESULTS

The analysis shows that the COVID-19 pandemic had a significant negative impact on dietary habits and an ambiguous impact on oral health habits of the population. The researchers showed that patients' visits were limited only to those necessary, because of fear of infecting with the SARS-CoV-2.

CONCLUSIONS

The literature review shows that the COVID-19 pandemic, by affecting many aspects of everyday life, including eating habits, caring for oral hygiene, and avoiding regular visits to the dentist, may generate an increase in oral diseases. Due to the differences in knowledge results, further research observations in this field are necessary.

How Does Orthodontic Mini-Implant Thread Minidesign Influence the Stability?—Systematic Review with Meta-Analysis

Background: Clinical guidelines are lacking for the use of orthodontic mini-implants (OMIs) in terms of scientific evidence referring to the choice of proper mini-design. Thus, the present study aimed to investigate to what extent orthodontic mini-implant thread design influences its stability. Methods: Search was conducted in five search engines on 10 May. Quality assessment was performed using study type specific scales. Whenever possible, meta-analysis was performed. Results: The search strategy identified 118 potential articles. Twenty papers were subjected to qualitative analysis and data from 8 papers—to meta-analysis. Studies included were characterized by high or medium quality. Four studies were considered as low quality. No clinical studies considering the number of threads, threads depth, or TSF have been found in the literature. Conclusions: Minidesign of OMIs seems to influence their stability in the bone. Thread pitch seems to be of special importance for OMIs retention—the more dense thread—the better stability. Thread depth seems to be of low importance for OMIs stability. There is no clear scientific evidence for optimal thread shape factor. Studies present in the literature vary greatly in study design and results reporting. Research received no external funding. Study protocol number in PROSPERO database: CRD42022340970.

Cytotoxic Potential of Denture Adhesives on Human Fibroblasts—In Vitro Study

(1) In recent years, there has been a significant increase in the availability of denture adhesives for stabilizing removable dentures. The aim of the present study was to assess the cytotoxicity of three denture adhesives on human fibroblasts. (2) Methods: Three denture adhesives were analyzed. Fibroblast cultures were established for the study and control groups in order to assess the incidence of necrosis and to evaluate the microscopic intracellular alterations induced. Following incubation with (study groups) or without adhesives (control group), trypan blue dye exclusion assay was used to determine the number of viable and/or dead cells. Microscopic specimens were stained with haematoxylin and eosin, scanned, digitally processed and then analyzed by a histopathologist. (3) Results: All three denture adhesives analyzed demonstrated various toxic effects in vitro on human fibroblast: quantitative evaluation—45.87–61.13% reduction of cell viability (p = 0.0001) and slight to moderate cytotoxicity in qualitative evaluation. (4) Conclusions: Denture adhesive creams demonstrated a toxic effect on human fibroblasts in vitro in quantitative and qualitative evaluation. In vivo observations are needed to find out if denture adhesives present a cytotoxic effect in patients.

Sella Turcica Abnormalities, Dental Age and Dental Abnormalities in Polish Children

The frequency of some sella turcica abnormalities on cephalometric radiographs is age related. Chronological age might not overlap with growth; however, no studies could be found on the association between sellar morphology and dental age. Although an association exists between sella turcica bridging and dental abnormalities, no studies have been found correlating sellar abnormalities other than bridging with dental abnormalities. The aim of this study was to find any correlations between sella turcica abnormalities and dental age or dental abnormalities. Methods: Lateral cephalograms and panoramic radiographs of 206 children aged 6–15 years were analyzed for sela turcica abnormalities, Demirijan dental age, and dental abnormalities. Results: The prevalence of dental abnormalities in patients with sela turcica abnormalities was 16.98%, while in those with normal sella, it was 3%. The differences between dental and chronological age were higher in patients with sella turcica abnormalities (p = 0.002). Dental abnormalities were more prevalent (p = 0.001) in patients with sellar abnormalities other than sellar bridging than in those with sellar bridging or normal sella. Conclusions: Sella turcica abnormalities are correlated with delayed dental age. Dental abnormalities are more frequent in patients with sellar abnormalities. Dental abnormalities are less frequent in subjects with sellar bridges compared to those with other sellar abnormalities.

What causes failure of fixed orthodontic retention? - systematic review and meta-analysis of clinical studies

BACKGROUND

Orthodontic retention aims to maintain optimal teeth positions after active treatment. The stability is affected by numerous factors, including patients' individual features, thus retention should be adjusted in the most optimal way. Bonding a retainer makes retention less dependent on patient's compliance.

QUESTIONS ARISE

What wire or fiber splint type provides the best treatment stability? What materials should be used to bond the wire or fiber splint? Should be the bonding procedure be direct or indirect? The aim of the study is to assess and synthesize available controlled trials investigating failures of fixed retainers.

METHODS

Literature searches of free text and MeSH terms were performed in Scopus, Web of Science, Embase and PubMed Central in order to find studies, referring to failures of fixed retention (12th February 2021). The keywords were: ("orthodontic retainers AND failure AND wire"). The framework of this systematic review according to PICO was: Population: orthodontic patients; Intervention: fixed orthodontic retainer bonding; Comparison: Different protocols of fixed orthodontic retention applied; Outcomes: failure rate, survival rate. Three different specific scales from the Cochrane Collaboration Handbook were used, according to each study type. Additionally, a meta-analysis was conducted to compare the effectiveness of retention using fiber reinforced composite and multistranded steel wire.

RESULTS

The search identified 177 potential articles: 114 from PubMed, 41 from Scopus, 20 from Web of Science and 2 from Embase. After excluding studies inconsistent with selection criteria, 21 studies were included and subjected to qualitative analysis. The main outcome investigated was failure rate. This systematic review has some potential limitations due to the heterogeneity of design between included studies.

CONCLUSIONS

No retainer is proved to guarantee a perfect stability of dental alignment. The retainer should be bonded to all adherent teeth, preferably with additional use of bonding resin. No wire or fiber splint present superior characteristics concerning failure rate. Fiber reinforced composite retention is more sensitive to operator skills, and with imperfect bonding technique, failure rate is much higher. During the first 6 months after bonding retainer the patient should be under frequent control. The study protocol was registered in PROSPERO database with the number CRD42021233406.

Electromyographic activity analysis of temporal and masseter muscles in psychoactive substance addicts

OBJECTIVES

As part of this study, a comparative analysis of the temporal and masseter muscle electrical activity at rest and during mandible excursion positions (protrusion, laterotrusion and maximal occlusion) was performed among patients aged 21 to 68 years.

METHODS

Each of three groups: opioid addicts, alcohol addicts and the control group - consisted of 30 individuals (90 individuals in total, including 37 females and 53 males). Electrodes were placed on the masseter venters and mandibular movements were executed: right/left lateral, protrusion, intercuspation, rest and MVC. Then the same routine was applied to the anterior parts of temporal muscles.

RESULTS

Based on EMG data in alcohol addicts, higher electrical activity of masseters and temporal muscles was observed during the mandible excursions, compared to the control group. In comparison of opiate addicts to healthy controls, no statistical significance was observed in electrical activity of masseter and temporal muscles.

CONCLUSIONS

On the basis of the conducted research, a conclusion can be drawn that alcohol addiction significantly affects the function of the largest muscles of the stomatognathic system.

Effect of injectable equine collagen type I on metabolic activity and apoptosis of gingival fibroblasts

Collagen as a biomaterial is widely used for tissue regeneration due to various advantages including its biodegradation, biocompatibility, and low allergenicity. Along with aesthetic medicine development, collagen is also used in the injectable form as a tissue biostimulator. The area of our study was collagen's impact on fibroblast activity and apoptosis. The research showed that atelocollagen decreases metabolic activity of fibroblasts, but also showed an increasing number of living cells after 48 h and 72 h incubation under the influence of collagen.

Sella Turcica Morphology on Cephalometric Radiographs and Dental Abnormalities-Is There Any Association?-Systematic Review

Background: The sella turcica is a saddle-like structure in the middle cranial fossa on the intracranial surface of the sphenoid bone, visible on lateral cephalograms routinely conducted for orthodontic diagnosis. The development of facial structures follows similar traits to the sella turcica: glandular anomalies may be associated with functional disorders, e.g., altered hormonal levels, thus influencing dental development. The aim of this study is to find out if there is any association between the morphology of the sella turcica on cephalometric radiographs and the presence of dental abnormalities. (2) Methods: The search was conducted on 27 January 2021 in four search engines: Medline (PubMed Central), Scopus, Web of Science, Embase. The keywords used in the search strategy were as follows: “sella turcica” AND (“dental abnormalities” OR “dental anomalies” OR “malocclusion”). Since all the studies finally included were retrospective case–control studies, the Newcastle–Ottawa Quality Assessment Form for Case–Control Studies was applied. (3) Results: The search strategy identified 465 articles: 289 from PubMed, 121 from Scopus, 32 from Web of Science and 23 from Embase. Finally, 10 full-text papers were included into qualitative analysis. (4) Conclusions: Sella turcica bridging is very frequent among orthodontic patients. A clear association exists between dental abnormalities and sella turcica bridging.

Methods of Analysis of the Nasal Profile: A Systematic Review with Meta-analysis

The nose is the most prominent structure of the face, influencing facial appearance and profile. Orthodontists have an awareness of facial structures, including nasal morphology, when diagnosing and treatment planning. Maxillofacial surgeons influence facial profile by bimaxillary surgery, improving facial aesthetics and harmony. The aim of this review was to summarize the available methods of analysing nasal morphology and profile, and to assess their complexity. A literature search was conducted in PubMed, Scopus, Web of Science, and Embase using the following search terms: "nasal profile analysis", "nasolabial angle", and "nasal profile cephalometric" in order to select studies providing knowledge on correlations between occlusion and nasal development, differences between skeletal classes, ethnic variability, and differences between the sexes. Studies concerning genetic disorders were excluded. Finally, 17 full-text papers were analysed, which pertained to nasolabial angle, or facial profile including the nose. Data concerning methods, ethnic group, reference landmarks used, and measurements made were extracted and placed in tables. Numerous methods of nasal profile analysis can be found in the literature. These methods describe various numbers of parameters, which have influence on facial aesthetic. Nasal parameters are correlated to skeletal class and nasolabial angle, positions of upper incisors, and maxillary inclination.

Analysis of Instagram® Posts Referring to Cleft Lip

Background: Social media has become a source of medical information. Cleft lip and palate is a visible congenital anomaly. The aim of the study was to analyze Instagram^® posts on the topic of cleft lip. Methods: Instagram^® posts with “#cleftlip” from March 2014–March 2017 were accessed. Separate lists of expressions (hashtags, meaningful words, words with emojis or emojis alone) were prepared for primary posts and for replies. Thirty expressions statistically most frequent in primary versus secondary posts and 30 in secondary versus primary posts were identified (Group 1) as well as 30 English words or hashtags (Group 2), non-English words or hashtags (Group 3) and emojis (Group 4). The frequencies of expressions were compared (Z-test for the difference of two population proportions). Results: There were 34,129 posts, (5427 primary posts and 28,702 replies), containing 62,163 expressions, (35,004 in primary posts). The occurrence of all expressions was 454,162, (225,418 in primary posts and 228,744 in replies). Posts with positive expressions such as “beautiful”, “love”, “cute”, “great”, “awesome” occurred more often than these with negative ones. In replies all emojis were positive. Conclusions: Numerous Instagram^® posts referring to cleft lip are published and do provoke discussion. People express their solidarity and sympathize with persons affected by cleft.

Effect of nano-hydroxyapatite and ozone on approximal initial caries: a randomized clinical trial

The aim of the study was to assess the efficacy of three methods of enamel remineralization on initial approximal caries: (1) a nano-hydroxyapatite gel, (2) gaseous ozone therapy, (3) combination of a nano-hydroxyapatite gel and ozone. Patients (n = 92, age 20-30 years) with initial approximal enamel lesions on premolar and molar teeth (n = 546) were randomly allocated to three groups subjected to a 6-months treatment: Group I: domestic nano-hydroxyapatite remineralizing gel, group II: in-office ozone therapy, group III: both domestic remineralizing gel and ozone therapy. Caries lesions were assessed on bitewing radiographs at baseline, after 1 year and after 2 years. At one-year follow-up, the smallest rate of lesions with remineralisation (36.5%) was found in group I, and the highest (69.3%)-in group III. In group III a significant remineralisation was noticed in after 1 year and then a demineralisation after 2 years. Thus nano-hydroxyapatite gel and ozone therapy exert some capacities to remineralize approximal enamel and dentine subsurface lesions of premolar and molar teeth. Moreover, the combination of both methods produces the best effect compared to nano-hydroxyapatite or ozone therapy applied alone. However, the treatment should be continued for a long time in order to achieve nonrestorative recovery of caries.

Influence of Herbal Medicines on HMGB1 Release, SARS-CoV-2 Viral Attachment, Acute Respiratory Failure, and Sepsis. A Literature Review

By attaching to the angiotensin converting enzyme 2 (ACE2) protein on lung and intestinal cells, Sudden Acute Respiratory Syndrome (SARS-CoV-2) can cause respiratory and homeostatic difficulties leading to sepsis. The progression from acute respiratory failure to sepsis has been correlated with the release of high-mobility group box 1 protein (HMGB1). Lack of effective conventional treatment of this septic state has spiked an interest in alternative medicine. This review of herbal extracts has identified multiple candidates which can target the release of HMGB1 and potentially reduce mortality by preventing progression from respiratory distress to sepsis. Some of the identified mixtures have also been shown to interfere with viral attachment. Due to the wide variability in chemical superstructure of the components of assorted herbal extracts, common motifs have been identified. Looking at the most active compounds in each extract it becomes evident that as a group, phenolic compounds have a broad enzyme inhibiting function. They have been shown to act against the priming of SARS-CoV-2 attachment proteins by host and viral enzymes, and the release of HMGB1 by host immune cells. An argument for the value in a nonspecific inhibitory action has been drawn. Hopefully these findings can drive future drug development and clinical procedures.

Effect of air-polishing on surface roughness of composite dental restorative material - comparison of three different air-polishing powders

Background

Increased composite roughness enhances bacterial adhesion and discoloration, thus increasing the risk of gingival inflammation and secondary caries. Concerns about detrimental effects of sodium bicarbonate on surface roughness influenced the development of less abrasive powders: a glycine-based powder and an erythritol-based powder, additionally - sodium bicarbonate-based powder of reduced grain size. However, there is limited evidence on effects of these materials on the surface of dental fillings. The aim of the present study was to compare the effects of three air-polishing powders (of a reduced abrasiveness) on surface roughness of microhybrid restorative composite material.

Material and methods

Microhybrid light-cure resin composite samples were placed on 64 plaster cubes and light-cured through polyester strips. Surface roughness was measured using laser confocal microscope (magnification 2160x). The specimens were randomly divided into three groups (n = 20, 20 and 24) and air-polished with: sodium bicarbonate (40 μm), glycine (25 μm) and erythritol (14 μm), respectively. Then surface roughness was remeasured, keeping the same field of observation. Specialized 3D analysis software was used for data processing. Parameters according to ISO 25178: Sa, Sq, Sku, Sp, Sv, Sz, Ssk were used to describe surface roughness.

Results

Sa, Sq, Sp, Sv, Sz increased significantly following air polishing. Ssk was significantly higher, whereas Sku was significantly lower in sodium bicarbonate and erythritol groups than before air polishing. Comparison between the three powders revealed that Sa was significantly higher in sodium bicarbonate group than in glycine group. Sku was significantly higher in glycine and erythritol groups than in sodium bicarbonate group.

Conclusions

Sodium bicarbonate has a stronger detrimental effect on composite surface than glycine or erythritol. No advantage of erythritol comparing to glycine could be found.

Panoramic radiographs and quantitative ultrasound of the radius and phalanx III to assess bone mineral status in postmenopausal women

Background

Various mandibular indices have been developed to detect osteoporosis on panoramic radiographs. Quantitative ultrasound (QUS) is a low-cost, radiation-free method to assess bone status. The aim of this study was to compare mandibular morphometric analysis and QUS at the radius and proximal phalanx III finger.

Methods

The study involved 97 postmenopausal women, aged 48.5–71.5y (mean: 55.4). Mandibular morphometric analysis comprised: distance between upper and lower mandibular borders just behind the mental foramen (H), distance: mental foramen - inferior mandibular cortex (IM) and mandibular cortical width at the mental region (MCW). Then, ratios were calculated: MCW/IM = PMI (panoramic mandibular index), H/IM = MR (mandibular ratio). Mandibular cortical index (MCI) was used to classify the morphology of the mandibular cortex.

Bone mineral status assessed using QUS at the radius and proximal phalanx III finger was compared to population mean apical bone mass (T-score).

Linear regression analysis was used for correlations between continuous variables, Pearson’s correlation coefficient r - for variables of normal distribution. Student’s t-test was used to compare variables of normal distribution and for the latter - Mann-Whitney U-test. The level of significance was p < 0.05.

Results

Mandibular height was 13.42–34.42 mm. The mean mandibular cortical width was 3.31 mm. Mean values of PMI and MR were 0.33 and 2.57, respectively. Higher mean value of Ad-SoS was found in the radius than in the III finger. Phalanx T-score values ​​were lower than those of the radius. T-score of the radius was < − 1.0 in 22 patients, indicating osteopenia. Basing on phalanx T-score, osteopenia was found in 39 patients. Category C1 of Mandibular Cortical Index was found in 48 women, C2 - in 37 women and C3 - in 12 women. Higher scores of Mandibular Cortical Index were recorded in older women. MCI significantly correlated with the skeletal status (p = 0.01) as well as with H, MCW and MR. Phalanx T-score was not correlated to PMI, MR or MCW.

Conclusions

1. Mandibular Cortical Index can be used as a screening tool for detecting osteoporosis.

2. Quantitative ultrasound at the phalanx III constitutes a reliable way of assessing bone status.

Electronic supplementary material

The online version of this article (10.1186/s12903-018-0593-4) contains supplementary material, which is available to authorized users.

Factors affecting the outcomes of direct pulp capping using Biodentine

Introduction

This study aimed to evaluate the prognostic value of factors with regard to the treatment outcome of direct pulp capping using Biodentine (Septodont, Saint-Maur-des-Fossés, France), in permanent teeth in which the pulps were exposed during caries removal.

Methods

Between 2010 and 2014, 112 teeth with deep carious lesions underwent direct pulp capping. The patients were followed up at 2–3 months and 1–1.5 years with a routine examination on both recall visits. Periapical radiographs were taken at 1–1.5 years. Lack of patient complaints, positive reactions to cold and electric testing, no sensitivity to percussion, and no widening of the periapical ligament indicated success. The Fisher exact test was used for statistical analysis. The significance level was P = .05.

Results

Eighty-six teeth were available for 1–1.5 years follow-up. The overall success rate was 82.6%. Only age had a significant effect on the pulpal survival rate: the success rate was 90.9% in patients younger than 40 years and 73.8% in patients 40 years or older (P = .0480). Sex, initial or secondary caries treatment, occlusal or cervical/proximal caries, delayed placement of permanent filling, tooth position, and arch type did not influence the outcome.

Conclusions

A patient’s age influenced the outcome of direct pulp capping using this new calcium silicate cement.

Clinical relevance

Asymptomatic vital permanent teeth with cariously exposed pulp can be treated successfully by direct pulp capping using Biodentine.

Effect of orthodontic debonding and residual adhesive removal on 3D enamel microroughness

Background

Termination of fixed orthodontic treatment is associated with bracket debonding and residual adhesive removal. These procedures increase enamel roughness to a degree that should depend on the tool used. Enamel roughening may be associated with bacterial retention and staining. However, a very limited data exists on the alteration of 3D enamel roughness resulting from the use of different tools for orthodontic clean-up.

Aims

1. To perform a precise assessment of 3D enamel surface roughness resulting from residual adhesive removal following orthodontic debonding molar tubes.

2. To compare enamel surfaces resulting from the use of tungsten carbide bur, a one-step polisher and finisher and Adhesive Residue Remover.

Material and Methods

Buccal surfaces of forty-five extracted human third molars were analysed using a confocal laser microscope at the magnification of 1080× and 3D roughness parameters were calculated. After 20 s etching, molar tubes were bonded, the teeth were stored in 0.9% saline solution for 24 hours and debonded. Residual adhesive was removed using in fifteen specimen each: a twelve-fluted tungsten carbide bur, a one-step finisher and polisher and Adhesive Residue Remover. Then, surface roughness analysis was repeated. Data normality was assessed using Shapiro–Wilk test. Analysis of variance (ANOVA) was used to compare between variables of normal distribution and for the latter—Kruskal-Wallis test.

Results

Sa (arithmetical mean height) was significantly different between the groups (p = 0, 01326); the smoothest and most repeatable surfaces were achieved using Adhesive Residue Remover. Similarly, Sq (root mean square height of the scale-limited surface) had the lowest and most homogenous values for Adhesive Residue Remover (p = 0, 01108). Sz (maximum height of the scale-limited surface) was statistically different between the groups (p = 0, 0327), however no statistically significant differences were found concerning Ssk (skewness of the scale-limited surface).

Discussion

Confocal laser microscopy allowed 3D surface analysis of enamel surface, avoiding the limitations of contact profilometry. Tungsten carbide burs are the most popular adhesive removing tools, however, the results of the present study indicate, that a one step polisher and finisher as well as Adhesive Residue Remover are less detrimental to the enamel. This is in agreement with a recent study based on direct 3D scanning enamel surface. It proved, that a one-step finisher and polisher as well as Adhesive Residue Remover are characterized by a similar effectiveness in removing residual remnants as tungsten carbide bur, but they remove significantly less enamel.

Conclusion

Orthodontic debonding and removal of adhesive remnants increases enamel roughness. The smoothest surfaces were achieved using Adhesive Residue Remover, and the roughest using tungsten carbide bur.

Interdisciplinary index of prosthodontic/substitution orthodontic treatment need for patients with missing teeth

The need for treatment in cases of missing teeth may result from aesthetic demands or functional impairment, although tooth loss itself does not necessarily constitute a need for prosthetic replacement. In selected cases, restorative treatment can be replaced by tooth autotransplantation or substitution orthodontic treatment. The authors have tried to make an index based not on missing particular teeth, but on the presence of spacing requiring restoration. An attempt has been made to categorize the restorative treatment need. Orthodontic treatment was considered, when it could completely eliminate the need for prosthetic treatment. The proposed classification could be used for assessing eligibility for public refund of restorative or substitution orthodontic treatment, as well as to motivate the patients to have restorations. It should be an individual approach-based decision, which treatment: orthodontic substitution tooth movement or prosthodontic is more cost-effective for the rest of the patient's life.

Effect of orthodontic debonding and adhesive removal on the enamel - current knowledge and future perspectives - a systematic review

After orthodontic treatment, brackets are debonded and residual adhesive is removed, causing iatrogenic enamel damage. The aim of this study was to review the methods of orthodontic adhesive removal, find clear evidence, and provide a rationale for this procedure.

A literature search was performed in PubMed, Dentistry and Oral Sciences, Scopus, Cochrane, Google, and Google Scholar using keywords: orthodontic adhesive removal, orthodontic debonding, orthodontic clean-up. Studies concerning human enamel roughness or loss from debonding and adhesive removal were considered. Forty-four full-text articles were analyzed and 3 were rejected after detailed reading; finally 41 papers were included.

Fifteen qualitative studies, 13 studies based on indices of enamel surface, and 13 quantitative studies were found. No meta-analysis could be performed due to a lack of homogenous quantitative evidence. The most popular tools were tungsten carbide burs, which were faster and more effective than Sof-Lex discs, ultrasonic tools, hand instruments, rubbers, or composite burs. They remove a substantial layer of enamel and roughen its surface, but are less destructive than Arkansas stones, green stones, diamond burs, steel burs, and lasers. Multi-step Sof-Lex discs and pumice slurry are the most predictable enamel polishing tools.

Arkansas stones, green stones, diamond burs, steel burs, and lasers should not be used for adhesive removal. The use of tungsten carbide bur requires multistep polishing. Further efforts should be made to find tools and methods for complete removal of adhesive remnants, minimizing enamel loss and achieving a smooth surface.

Three-dimensional quantitative analysis of adhesive remnants and enamel loss resulting from debonding orthodontic molar tubes

AIMS

Presenting a new method for direct, quantitative analysis of enamel surface. Measurement of adhesive remnants and enamel loss resulting from debonding molar tubes.

MATERIAL AND METHODS

Buccal surfaces of fifteen extracted human molars were directly scanned with an optic blue-light 3D scanner to the nearest 2 μm. After 20 s etching molar tubes were bonded and after 24 h storing in 0.9% saline - debonded. Then 3D scanning was repeated. Superimposition and comparison were proceeded and shape alterations of the entire objects were analyzed using specialized computer software. Residual adhesive heights as well as enamel loss depths have been obtained for the entire buccal surfaces. Residual adhesive volume and enamel loss volume have been calculated for every tooth.

RESULTS

The maximum height of adhesive remaining on enamel surface was 0.76 mm and the volume on particular teeth ranged from 0.047 mm3 to 4.16 mm3. The median adhesive remnant volume was 0.988 mm3. Mean depths of enamel loss for particular teeth ranged from 0.0076 mm to 0.0416 mm. Highest maximum depth of enamel loss was 0.207 mm. Median volume of enamel loss was 0.104 mm3 and maximum volume was 1.484 mm3.

CONCLUSIONS

Blue-light 3D scanning is able to provide direct precise scans of the enamel surface, which can be superimposed in order to calculate shape alterations. Debonding molar tubes leaves a certain amount of adhesive remnants on the enamel, however the interface fracture pattern varies for particular teeth and areas of enamel loss are present as well.

Sella turcica anomalies on lateral cephalometric radiographs of Polish children

OBJECTIVES

To assess the prevalence of sella turcica anomalies on lateral cephalograms of children with malocclusion. To describe the craniofacial morphology in patients with sella turcica anomalies.

METHODS

Lateral cephalograms obtained at ages 8-16 years (n = 431) were assessed for good visibility of cephalometric structures, including the sella turcica, and the absence of craniofacial congenital deformities; finally, 322 cephalograms were included and analysed. Subsequently, anomalies of sella turcica have been identified. Hypertrophic posterior clinoid process, hypotrophic posterior clinoid process and oblique contour of the floor were the abnormalities found that could not be classified based on literature. The study group consisted of 151 cephalograms with abnormal sella turcica, while the control group consisted of 171 cephalograms without any sellar pathology. Data normality has been tested using Shapiro-Wilk test. Correlations with age were made using Spearman correlation coefficient and those with sex were made using independence test with Yate's correction for continuity. Mann-Whitney test was used to compare between groups and subgroups. The level of significance has been established as p < 0.05.

RESULTS

Sellar anomalies were found in 151 individuals (46.9%). Statistically significant differences between patients with normal and abnormal sellar morphology were found concerning: Pg:NB (p = 0.0009), 1+:NA (p = 0.0004) and 1-:NB (p = 0.012), indicating a more distal position of jaw structures in subjects with abnormal sella.

CONCLUSIONS

The finding that almost 50% of children with malocclusion have sellar abnormalities confirms a general aetiology of malocclusion. Sella turcica assessment should be carried out during cephalometric analysis.

Odontogenous sinus tract to the chin--case report

This report describes the diagnosis, treatment and follow-up of a rare case of an odontogenic sinus tract to the chin. Despite the absence of caries, fillings, or crown damage, both lower central incisors were involved in a bony lesion. No history of any traumatic facial or dental injury was reported, and no orthodontic treatment with fixed appliances was performed. The findings on panoramic radiograph were incidental--the patient applied to the dental clinic due to a toothache in a lower first molar. The patient's history comprised seven-year-long unsuccessful dermatologic therapy. This included intraoral antibiotic and antihistamine intake, as well as topical antibiotic and steroid application. Endodontic treatment was proceeded, followed by recovery of the skin lesion. In the case of a single chronic suppurative or nodulocystic facial lesion, a dental clinical examination as well as a radiological assessment of the maxillary and mandibular dentition should be performed to exclude any odontogenic cause.

Oral health and bone mineral density in postmenopausal women

OBJECTIVE

The objective of the study was to assess dental and periodontal status in relation to bone mineral density (BMD), and to study cytological changes in oral epithelium.

METHODS

Thirty-seven postmenopausal women aged 50-70 were given a dental examination and a BMD assessment.

RESULTS

There was a relationship between the femoral neck BMD and teeth state, a negative correlation between the lumbar BMD and the periodontal disease index (PDI) and between the radius BMD and the papillary bleeding index (PBI). PDI correlated positively with the number of superficial cells in the marginal gingiva smears. Correlation between PDI and parabasal cells and the number of teeth was negative.

CONCLUSIONS

In observed postmenopausal women, there is a negative association between bone mineral density and teeth state and periodontal indices. Oral epithelium revealed atrophic changes resulting in low keratinization. The study suggests an association between decreasing in bone mineral density, alveolar bone loss and the numbers of various cell types in epithelial smears.

Endodontic and prosthetic treatment of teeth with C-shaped root canals

INTRODUCTION

The aim of this study was to describe and discuss the unusual anatomy that can be detected during routine endodontic and prosthetic treatment of mandibular second molars.

MATERIAL AND METHODS

We studied 2 mandibular second molars with C-shaped canals in two patients who underwent endodontic and prosthetic treatment. In one patient, the preoperative radiograph of mandibular right second molar indicated radicular fusion with single apex and two canals. However, four separate canals were disclosed during endodontic treatment. There were no complications during cleaning, shaping, and obturation of the canals. In the second patient, prosthetic restoration of the mandibular left second molar after root canal treatment was necessary. The radiograph showed radicular fusion with one wide central canal correctly obturated. The tooth was prepared without difficulty or complications for the cast post and crown.

RESULTS

Endodontic treatment in the first patient was successful as confirmed with the postoperative radiograph showing precisely obturated canals. The cast post performed in the second patient enabled effective tooth reconstruction with a prosthetic crown.

CONCLUSIONS

C-shaped canals may be precisely debrided and obturated on condition that they have been disclosed on preoperative radiographs. Prosthetic reconstruction of these teeth with a post-crown is possible but only with the use of the distal canal.

[Some salivary proteins as a biomarkers of local and general diseases. Literature review]

The article is a review of literature concerning proteins present in saliva, which matter in diagnostics. Much consideration has been given to osteonectin, a not well known glycoprotein. Osteonectin is a normal matrix bone component, which might serve as a marker of bone resorption and could be a potential marker for periodontal disease activity. The authors also mentioned oxidative stress and associations between the state of the oral cavity and general diseases.

[The influence of hygiene and health habits on the concentration of some ions in saliva of postmenopausal women]

PURPOSE

The study was designed to evaluate the influence of tooth-brushing, milk consumption, hormone therapy, allergy, and cigarette smoking on the content of fluoride, calcium, magnesium and phosphorus in saliva.

MATERIAL AND METHODS

Unstimulated saliva samples were collected from 100 women aged 48-70 years. Biochemical analysis was done to measure ion content. A questionnaire was used to determine hygiene and health habits. Correlation analysis was done to determine the relationships between parameters.

CONCLUSIONS

A significant correlation was observed between ion content in saliva and frequency of tooth-brushing, smoking, and use of oral contraceptives. More frequent tooth-brushing was associated with reduced salivary content of calcium and phosphorus. Significantly higher salivary calcium levels were observed in smokers than non-smokers. Oral contraceptives produced significantly higher concentrations of fluoride ions in saliva. No correlation was noted between ion content in saliva and milk consumption, hormone replacement therapy (HRT), or allergy.

[Mineral content of enamel, depth of biopsy, and dentition status in postmenopausal women]

PURPOSE

The study was designed to evaluate the relationship between the content of fluoride, magnesium and phosphorus in enamel, depth of biopsy, and dentition status in postmenopausal women.

MATERIAL AND METHODS

Dentition status in 81 postmenopausal women aged 48-70 years (mean 54.98 years) was determined using the Decayed, Missing and Filled Surfaces (DMFS) index. Double-layer superimposed acid biopsies were used for sampling labial enamel of upper permanent central incisor. Biochemical analysis was performed to determine the content of fluoride, magnesium, and phosphorus. Assuming that enamel contains 37% calcium, enamel mass, layer thickness, biopsy depth and concentrations of ions in the surface and subsurface layer were calculated. Correlation analysis was done to disclose relationships between the parameters studied.

CONCLUSIONS

It was observed that the concentration of ions decreased with growing depth of biopsy. Decreasing depth of biopsy correlated with increasing concentration of fluorides and magnesium in surface and subsurface layer of enamel. The total depth of biopsy correlated more exactly with the concentration of fluorides and magnesium in subsurface layer than in surface layer. Increasing concentration of fluoride was associated with increasing concentration of magnesium. No correlation was observed between DMFS and the depth of enamel biopsy.

[Effect of 10-15% carbamide peroxide on enamel fluoride concentration in vital bleached teeth]

The objective of the study was to evaluate the concentration of fluoride in human enamel before and after bleaching using 10-15% carbamide peroxide and after application of the fluoride varnish. Microsamples of enamel were collected using acid biopsy and the concentration of fluoride in the superficial and underlying layer was assayed. No significant differences were observed in the concentration of fluoride in both layers of enamel before and after bleaching as well as after varnish application. Bleaching with 10-15% carbamide peroxide has no influence on the concentration of fluoride in enamel.

[The effect of selected prophylactic-educational programs on oral hygiene, periodontium and caries in school children during a 4-year observation]

The aim of the work was the continuation of the evaluation of the efficacy of three prophylactic-educational programs in the field of oral cavity hygiene, status of periodontium and dental caries, and their influence on the forming of pro-health awareness and correct hygiene habits among school children. The work under discussion is the second stage of observations of the above-mentioned programs as well as the complete evaluation of 4-years examinations. The clinical and questionnaire studies were carried out in two elementary schools in Szczecin. Two hundred and twenty-three pupils were randomly allocated to three test groups: I (45 children), II (71 children), III (60 children) and control group K (47 children). In both schools mentioned above the examinations started when children were 7-8 years old and all of them were receiving planned stomatological treatment and contact fluoridation. All programs of the second stage of studies were the same as those of the first stage [49], only with the modified frequency of meetings with children. Program I, carried out in group I, was based on individual, motivating instructions of oral cavity hygiene (total 10 meetings during second stage of research). Programs II and III (group II and III accordingly) were expanded by educational activity among children and their parents. Additionally program III was enriched by professional mechanical tooth-cleaning, the use of fissure sealants, intensive dental care and proximal surface cleaning with dental floss (Tab. 1). The above-mentioned programs were carried out in co-operation with school dentists, teachers, fifth year dentistry students and students from Medical College--Oral Hygienist Faculty. After 4-years-long studies the evaluation of the three above-mentioned programs in oral cavity hygiene was achieved by using OHI-S and PI(QH). The status of periodontium was evaluated by GI and the intensity of dental caries by DMFT and DMFS. The increase of caries during the second stage of examinations was additionally evaluated and analysed thoroughly. The questionnaire studies made it possible to estimate the changes in the pro-health awareness among examined children. Reduction of OHI-S after 4 years was about 23% to 26% (Fig. 1). The status of gums shows the state of oral cavity hygiene in a better way. In control group the state remained unchanged, but in groups I, II and III it improved considerably (reduction of GI about 46% to 79%--Fig. 2). The reduction of caries in examined groups obtained after 4 years of studies was about 25% to 77% (Fig. 3) however during the second stage of research if figured out from 17% up to 72% (Fig. 4). Extreme increase of DS observed in the second stage of studies was 2.0 in control group K, a little less--1.51 in group I and 0.38 in group III (Fig. 5). The DS in group III reached the value -0.27 which proved that program III was the most efficient. The results of questionnaire studies showed a distinct improvement of health awareness among examined children. However the value of GI indicated some discrepancy between children's health knowledge and pro-health behaviour. Also it was noticed that the level of parents' education and their socioeconomic status had influence on building up good hygiene habits and on the state of caries among the examined children. The studies proved that the implementation of the above-mentioned prophylactic-educational programs or similar ones in elementary school conditions is possible with the use of hygienist under the dentist's supervision.