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Dent. J., Volume 11, Issue 11 (November 2023) – 22 articles

Cover Story (view full-size image): Although a significant amount of work on fixed partial dentures (FPD) and connector design has been carried out, one might ask if there is a way to check the influence of the connector design for individual geometries with reasonable effort. A possible solution is to automate the design using parametric CAD-modelling, and in a second step, use finite element analysis (FEA) to calculate the stress distribution for standard load cases in an automated way. The main goal of this study was to develop an approach for automated parametric remodelling of the connectors‘ dimension of FPDs. While full automation is not yet available, the first steps look promising. The approach was used to generate 3D models, which were used to investigate the influence of connector design on the stress distribution within a four-unit FPD. View this paper
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19 pages, 359 KiB  
Review
Emerging Applications of Nanotechnology in Dentistry
Dent. J. 2023, 11(11), 266; https://doi.org/10.3390/dj11110266 - 15 Nov 2023
Viewed by 2094
Abstract
Dentistry is a branch of healthcare where nanobiotechnology is reverberating in multiple ways to produce beneficial outcomes. The purpose of this review is to bring into the awareness of the readers the various practical dimensions of the nano-dental complex (nanodentistry) in healthcare and [...] Read more.
Dentistry is a branch of healthcare where nanobiotechnology is reverberating in multiple ways to produce beneficial outcomes. The purpose of this review is to bring into the awareness of the readers the various practical dimensions of the nano-dental complex (nanodentistry) in healthcare and how novelties linked with the field are revolutionizing dentistry. A methodological approach was adopted to collect the latest data on nanotechnology and dentistry from sources, including PubMed, Google Scholar, Scopus, and official websites like the WHO. Nanodentistry is an emerging field in dentistry that involves the use of nanomaterials, nanorobots, and nanotechnology to diagnose, treat, and prevent dental diseases. The results summarize the descriptive analyses of the uses of nanodentistry within orthodontics, preventive dentistry, prosthodontics, restorative dentistry, periodontics, dental surgeries, dental restoration technologies, and other areas of dentistry. The future directions of nano-industries and nano-healthcare have been included to link them with the oral healthcare sector, treatment plans, and improved medical services which could be explored in the future for advanced healthcare regulation. The major limitations to the use of dental nanoproducts are their cost-effectiveness and accessibility, especially in financially constrained countries. These data will help the readers to experience a detailed analysis and comprehensive covering of the diverse achievements of nanodentistry with past analyses, present scenarios, and future implications. Full article
(This article belongs to the Special Issue Feature Review Papers in Dentistry)
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31 pages, 8205 KiB  
Article
Ranking Technologies of Additive Manufacturing of Removable Complete Dentures by the Results of Their Mechanical Testing
Dent. J. 2023, 11(11), 265; https://doi.org/10.3390/dj11110265 - 13 Nov 2023
Cited by 1 | Viewed by 1400
Abstract
In this study, a methodology was developed for ranking manufacturing technologies of removable complete dentures (RCDs) according to the results of their full-scale mechanical tests. The actuality of the study is motivated by establishing the advantages and drawbacks of 3D-printed RCDs in contrast [...] Read more.
In this study, a methodology was developed for ranking manufacturing technologies of removable complete dentures (RCDs) according to the results of their full-scale mechanical tests. The actuality of the study is motivated by establishing the advantages and drawbacks of 3D-printed RCDs in contrast with ones manufactured via an analog protocol. The RCDs were fabricated via four technological routes that included various combinations of subtractive technologies (hot polymerization/HP and CAD/CAM milling) and additive manufacturing (digital light processing/DLP) ones and the installation of commercially available cosmetic denture teeth (DT). In the mechanical tests, different blocks of teeth (incisors, canines, premolars and molars) were loaded. To solve the ranking problem, it was proposed to interpret the results of the mechanical tests in terms of the reliability, durability and compliance/stiffness criteria. For this purpose, the combined AHP-VIKOR method was applied. In addition, a computer simulation of the mechanical loading conditions and the response of the RCDs was performed based on the finite element method (FEM). As the key conclusion, it was stated that additive manufacturing (AM) methods are competitive and cost-effective techniques for the fabrication of RCDs. Full article
(This article belongs to the Special Issue 3D Printing and Restorative Dentistry)
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10 pages, 1913 KiB  
Article
Lower Incisor—Pg: A New Cephalometric Parameter to Evaluate the Anterior Limit of Dentition
Dent. J. 2023, 11(11), 264; https://doi.org/10.3390/dj11110264 - 10 Nov 2023
Cited by 1 | Viewed by 1195
Abstract
Background: This present retrospective study aimed to introduce Lower Incisor—Pg and to assess how this new parameter varies with the skeletal sagittal and vertical relationships. Methods: A total of 1256 cephalometric analyses were performed using lateral cephalometric radiographs of a sample [...] Read more.
Background: This present retrospective study aimed to introduce Lower Incisor—Pg and to assess how this new parameter varies with the skeletal sagittal and vertical relationships. Methods: A total of 1256 cephalometric analyses were performed using lateral cephalometric radiographs of a sample of subjects divided according to SN^Go-Gn, ANPg^, and IMPA measurements. The differences in Lower Incisor—Pg between the groups were assessed through ANOVA tests and posthoc analyses, while Pearson’s correlation analysis was used to assess the correlations between the measurements. Results: The mesofacial growth pattern (61.0%) was more common than dolichofacial (30.0%) and brachyfacial (8.6%) ones in the sampled population. Regarding skeletal sagittal relationships, Class I was more frequent (70.9%) than Class II (19.3%) and Class III (9.8%). The mean value of the Lower Incisor—Pg was 3.2 ± 4.0 mm. Linear regression showed that the β coefficient was 0.45 and 0.36 for ANPg^ and SnGoGn^, respectively. Conclusions: Lower Incisor—Pg is a linear cephalometric measurement to evaluate the lower incisor sagittal position. For each degree of increase in ANPg^ and SNGoGn^, the Lower Incisor—Pg increased 0.45 mm and 0.36 mm, respectively. Full article
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13 pages, 1095 KiB  
Review
Are Allergy-Induced Implant Failures Actually Hypersensitivity Reactions to Titanium? A Literature Review
Dent. J. 2023, 11(11), 263; https://doi.org/10.3390/dj11110263 - 09 Nov 2023
Viewed by 1304
Abstract
Purpose: This literature review was performed to assess whether implant failures are associated with titanium allergy. Materials and Methods: An electronic search of the MEDLINE/PubMed, Cochrane Library, and Scopus databases up to April 2021 was conducted, and the obtained articles were independently assessed [...] Read more.
Purpose: This literature review was performed to assess whether implant failures are associated with titanium allergy. Materials and Methods: An electronic search of the MEDLINE/PubMed, Cochrane Library, and Scopus databases up to April 2021 was conducted, and the obtained articles were independently assessed by two reviewers. Articles describing cases of implant failure in which the cause of implant failure was only identified as allergy were included. Results: Twelve studies were included. Eight studies identified Ti allergy by clinical examinations, of which four used patch tests, three used the lymphocyte transformation test (LTT)/memory lymphocyte immunostimulation assay (MELISA), and one used both tests. Nine studies reported cases of titanium hypersensitivity in combination with other systemic allergy-related disorders, with eight cases also showing positive results for Ni, Hg, Cr, and Co hypersensitivity. Ten papers reported the improvement of symptoms after the removal of the Ti implants and their replacement with zirconia implants, and two of these papers showed good results. Conclusion: Cases of probable titanium allergy included those with true titanium allergies and those with a potentially different cause. However, the differentiation of these cases is difficult. Since no definitive method has been established for diagnosing titanium allergy, a comprehensive diagnosis based on the clinical course and clinical examination using a patch test/LTT/MELISA is necessary. Implant treatment should be performed with caution in patients with any preoperative allergies. Full article
(This article belongs to the Special Issue Oral Implantology and Rehabilitation)
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13 pages, 1796 KiB  
Review
Prognostic Significance of Histopathological Parameters for Salivary Gland Adenoid Cystic Carcinoma
Dent. J. 2023, 11(11), 262; https://doi.org/10.3390/dj11110262 - 09 Nov 2023
Viewed by 1240
Abstract
Adenoid cystic carcinoma (ACC) is a rare salivary gland tumor that accounts for approximately 1% of all head and neck cancers. Despite its initial indolent behavior, long-term survival is poor due to locoregional recurrence in approximately 40% and distant metastasis in up to [...] Read more.
Adenoid cystic carcinoma (ACC) is a rare salivary gland tumor that accounts for approximately 1% of all head and neck cancers. Despite its initial indolent behavior, long-term survival is poor due to locoregional recurrence in approximately 40% and distant metastasis in up to 60% of patients who undergo radical treatment. The histological parameters of ACC and the combination of these parameters in histopathological grading systems provide valuable prognostic information about the clinical course of the disease. Within this context, this review aims to analyze the impact of histopathological parameters, individual or combined in histopathological grading systems of malignancy, on ACC prognosis. Individual histopathological parameters such as solid pattern, presence of tumor necrosis, high-grade transformation, dominance of the epithelial component, presence of perineural and lymphovascular invasion, and positive surgical margins have negative impacts on the survival of patients with ACC. There are currently four histopathological grading systems for ACC; however, few studies have validated these systems and most of them explored small cohorts with short follow-up. Considering that the application of grading systems has been associated with ACC prognosis, a broader validation will allow not only their use for prognostic prediction but also assist in treatment planning. Full article
(This article belongs to the Special Issue Feature Review Papers in Dentistry)
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20 pages, 15562 KiB  
Article
Biomechanical Effects of Different Load Cases with an Implant-Supported Full Bridge on Four Implants in an Edentulous Mandible: A Three-Dimensional Finite Element Analysis (3D-FEA)
Dent. J. 2023, 11(11), 261; https://doi.org/10.3390/dj11110261 - 07 Nov 2023
Viewed by 1777
Abstract
The long-term success and predictability of implant-supported restorations largely depends on the biomechanical forces (stresses) acting on implants and the surrounding alveolar bone in the mandible. The aim of our study was to investigate the biomechanical behavior of an edentulous mandible with an [...] Read more.
The long-term success and predictability of implant-supported restorations largely depends on the biomechanical forces (stresses) acting on implants and the surrounding alveolar bone in the mandible. The aim of our study was to investigate the biomechanical behavior of an edentulous mandible with an implant-supported full bridge on four implants under simulated masticatory forces, in the context of different loading schemes, using a three-dimensional finite element analysis (3D-FEA). A patient-specific 3D finite element model was constructed using pre- and post-implantation computer tomography (CT) images of a patient undergoing implant treatment. Simplified masticatory forces set at 300 N were exerted vertically on the denture in four different simulated load cases (LC1–LC4). Two sets of simulations for different implants and denture materials (S1: titanium and titanium; S2: titanium and cobalt-chromium, respectively) were made. Stress outputs were taken as maximum (Pmax) and minimum principal stress (Pmin) and equivalent stress (Peqv) values. The highest peak Pmax values were observed for LC2 (where the modelled masticatory force excluded the cantilevers of the denture extending behind the terminal implants), both regarding the cortical bone (S1 Pmax: 89.57 MPa, S2 Pmax: 102.98 MPa) and trabecular bone (S1 Pmax: 3.03 MPa, S2 Pmax: 2.62 MPa). Overall, LC1—where masticatory forces covered the entire mesio−distal surface of the denture, including the cantilever—was the most advantageous. Peak Pmax values in the cortical bone and the trabecular bone were 14.97–15.87% and 87.96–94.54% higher in the case of S2, respectively. To ensure the long-term maintenance and longevity of treatment for implant-supported restorations in the mandible, efforts to establish the stresses of the surrounding bone in the physiological range, with the most even stress distribution possible, have paramount importance. Full article
(This article belongs to the Special Issue Oral Implantology and Rehabilitation)
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10 pages, 674 KiB  
Article
Is Dental Anxiety Associated with Oral Health-Related Quality of Life? Assessment of Statistical Significance and Clinical Meaningfulness in a Sample of Russian Medical and Dental Students
Dent. J. 2023, 11(11), 260; https://doi.org/10.3390/dj11110260 - 07 Nov 2023
Viewed by 1271
Abstract
Information about oral health-related quality of life (OHRQoL) and dental anxiety (DA) in Russian young adults is scarce. We investigated how DA is associated with OHRQoL in a group of medical and dental students in North-West Russia. The study had a cross-sectional design [...] Read more.
Information about oral health-related quality of life (OHRQoL) and dental anxiety (DA) in Russian young adults is scarce. We investigated how DA is associated with OHRQoL in a group of medical and dental students in North-West Russia. The study had a cross-sectional design and included 807 students aged 18–25 years who attended the Northern State Medical University in Arkhangelsk. OHRQoL and DA were measured by the Oral Health Impact Profile (OHIP-14) and Corah’s Dental Anxiety Scale (DAS), respectively. A questionnaire collected information on socio-demographics and self-reported oral health (OH) characteristics. A dental examination was executed to assess dental caries and oral hygiene. We observed differences in the OHIP-14 scores between dentally anxious and non-anxious students: unadjusted incidence rate ratio [IRR] = 1.65, 95% confidence interval [CI]: 1.29–2.12; after adjustment for socio-demographics and clinically assessed OH: IRR = 1.58, 95% CI: 1.23–2.02; after adjustment for socio-demographics, clinically assessed OH, and self-reported OH characteristics: IRR = 1.27, 95% CI: 0.99–1.63. The differences between estimated marginal means for the DAS categories in the models were 2.92, 2.51, and 1.24, respectively. Minimal clinically important differences of OHIP-14 fell between 1.68 and 2.51. We found a negative statistical association between DA and OHRQoL in our study sample, but after adjustment for potential confounders, the association lost its clinical importance. Full article
(This article belongs to the Special Issue Preventive Dentistry and Dental Public Health)
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15 pages, 308 KiB  
Article
Assessment of Pediatricians’ and General Practitioners’ Knowledge and Practice Regarding Oral Health, Dental Caries and Its Prevention in Children: A Cross-Sectional Study
Dent. J. 2023, 11(11), 259; https://doi.org/10.3390/dj11110259 - 06 Nov 2023
Viewed by 1414
Abstract
Objectives: This study aimed to evaluate and compare the knowledge and practices of family physicians (general practitioners) and pediatricians concerning children’s oral health. Materials and Methods: This research involved a cross-sectional survey with 446 respondents, consisting of 77.8% women and 22.1% men, with [...] Read more.
Objectives: This study aimed to evaluate and compare the knowledge and practices of family physicians (general practitioners) and pediatricians concerning children’s oral health. Materials and Methods: This research involved a cross-sectional survey with 446 respondents, consisting of 77.8% women and 22.1% men, with 81.6% being general (family) practitioners and 18.4% pediatricians. The survey comprised five sections, gathering information on participants’ sociodemographic characteristics, routine oral cavity examination in clinical practice, knowledge about dental caries and its prevention, teething symptoms, and alternatives to fluorides for preventing dental caries. Results: The findings revealed an overall poor understanding of dental caries and its prevention, with an average score of 5.1 ± 1.6 out of a possible 10 points. Notably, practitioners with fewer pediatric patients during the workday, no training on oral health, and uncertainty about physicians’ active role in oral health prevention exhibited lower knowledge levels (p ˂ 0.05). Over 90% of participants conducted dental and oral mucosal examinations on their patients. About 25% had received continuing education on children’s oral health, and 70.6% expressed interest in further education on the subject. Conclusions: This study highlights insufficient knowledge among physicians regarding dental caries and its prevention. With most participants eager to learn and actively promote children’s oral health, providing training is essential to boost their knowledge and support children’s oral health. Full article
(This article belongs to the Special Issue Oral Health Care in Paediatric Dentistry Volume 2)
14 pages, 2418 KiB  
Article
Efficiency and Predictability of Coronal Maxillary Expansion Repercussion with the Aligners System: A Retrospective Study
Dent. J. 2023, 11(11), 258; https://doi.org/10.3390/dj11110258 - 06 Nov 2023
Viewed by 1544
Abstract
The Invisalign® system (SmartForce® G8) aims to guarantee aesthetics and provide good orthodontic treatment results. Dentoalveolar expansion is possible with clear aligners and can be used to correct dentoalveolar crossbite, resolve crowding or modify the arch shape. Despite the treatment’s effectiveness, [...] Read more.
The Invisalign® system (SmartForce® G8) aims to guarantee aesthetics and provide good orthodontic treatment results. Dentoalveolar expansion is possible with clear aligners and can be used to correct dentoalveolar crossbite, resolve crowding or modify the arch shape. Despite the treatment’s effectiveness, there is still disagreement among professionals concerning its true clinical potential. This study aimed to analyze the effectiveness and predictability of coronal tooth expansion movement in permanent dentition in patients who had completed the first phase of treatment with Invisalign® orthodontic aligners. Materials and Methods: The tooth movement tables of 75 previously selected cases were analyzed in terms of dental-arch width and expansion efficiency, through the Invisalign® platform, considering the pre-treatment (T0), planned treatment (TP) and post-treatment models (T1) using ClinCheck Pro® 6.0 software. All patients were treated by an orthodontic specialist and Invisalign® Diamond Provider in a private practice (T.P.). Results: Difference between T1 and T0: for each maxillary and mandibular measurement, there was a statistically significant difference between pre- and post-aligner treatment values. The greatest amount of expansion occurred in both the upper and the lower premolars. Difference between TP and T1: for each maxillary measurement, statistically significant differences were verified for the molar and canine. At the mandibular level, statistically significant differences were only verified in the first molar. Conclusions: The Invisalign® clear aligners are effective for simultaneous intra-arch expansion in both jaws. Full article
(This article belongs to the Special Issue Orthodontics and New Technologies)
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7 pages, 590 KiB  
Case Report
Skin Symptoms That Appeared after Fixation with a Titanium Plate in a Jaw Deformity Patient Suffering from Palmoplantar Pustulosis: A Case Report
Dent. J. 2023, 11(11), 257; https://doi.org/10.3390/dj11110257 - 01 Nov 2023
Viewed by 1510
Abstract
Palmoplantar pustulosis (PPP) is a stubborn skin disease involving repeated aseptic small pustules on the palms and soles of the feet, which is triggered and exacerbated by metals and dental focal infections. There are few reports of an exacerbation of PPP symptoms after [...] Read more.
Palmoplantar pustulosis (PPP) is a stubborn skin disease involving repeated aseptic small pustules on the palms and soles of the feet, which is triggered and exacerbated by metals and dental focal infections. There are few reports of an exacerbation of PPP symptoms after orthognathic surgery. The patient is a 40-year-old female who consulted an orthodontist at our hospital, complaining of a protruding maxilla and malocclusion. Under the diagnosis of skeletal prognathism, she underwent surgery for jaw deformity. Although no allergic symptoms were observed during the orthodontic treatment prior to surgery, postoperative scaling on the palms and soles of her feet worsened, and itching was observed on the skin, especially on the titanium plate used to secure the bone fragments. Under the diagnosis of metal allergy, treatment with steroids and vitamin D ointment failed to improve the condition, so surgery was performed to replace the metal plate with a non-metallic absorbable plate in the third postoperative month. Afterwards, the pruritus resolved, and erythema and scale on the palms and soles nearly disappeared. In the present case, though, oral bacterial infection, a past history of smoking, and stress from surgery were also considered to be possible causes of PPP exacerbation, and we concluded that one of the causes of PPP exacerbation was metal allergy from the plates or screws used to fix the bone fragments. Full article
(This article belongs to the Special Issue Risk Management in Oral Surgery II)
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11 pages, 7274 KiB  
Technical Note
Computer Aided Full Arch Restoration by Means of One-Piece Implants and Stackable Guide: A Technical Note
Dent. J. 2023, 11(11), 256; https://doi.org/10.3390/dj11110256 - 01 Nov 2023
Viewed by 1770
Abstract
This technical note aims to present a recently developed computer-guided protocol characterized by titanium-reinforced stackable surgical guides during post-extractive implant placement and subsequent immediate loading. A full maxillary edentulism was rehabilitated with one-piece implants, starting from a pre-existing removable denture. 3D digital scans [...] Read more.
This technical note aims to present a recently developed computer-guided protocol characterized by titanium-reinforced stackable surgical guides during post-extractive implant placement and subsequent immediate loading. A full maxillary edentulism was rehabilitated with one-piece implants, starting from a pre-existing removable denture. 3D digital scans of the removable denture and upper and lower arches were performed. On this basis, a prototype with ideal esthetic and functional outcomes was realized and replicated into a custom-made radiological stent with markers. The superimposition of STL and DICOM files allowed virtual planning of one-piece implants in the ideal prosthetically driven position. The stackable guides, composed of a fixed base template and additional removable components, were then realized. The fixed template, initially secured with anchor pins to the bone, was no longer removed. The removable components, which were screwed to the base template, were used to perform implant surgery and immediate prosthetic loading. No surgical complications occurred, the implants achieved a minimum insertion torque of 35 Ncm, and immediate prosthetic loading was performed. The base template allowed for the maintenance of a fixed reference during the entire workflow, improving the transition between the digital project, the surgical procedure, and the prosthetic rehabilitation. Full article
(This article belongs to the Special Issue Oral Implantology and Rehabilitation)
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17 pages, 1271 KiB  
Review
Longevity of Anterior Composite Restorations for Localized Tooth Wear: A Scoping Review
Dent. J. 2023, 11(11), 255; https://doi.org/10.3390/dj11110255 - 31 Oct 2023
Viewed by 1446
Abstract
(1) Objective: This scoping review evaluates composite restorations as a treatment modality for anterior tooth surface loss and investigates the longevity of the direct and indirect composites used herein. (2) Method: The search encompassed Medline, Embase, Web of Science, the Cochrane Library, and [...] Read more.
(1) Objective: This scoping review evaluates composite restorations as a treatment modality for anterior tooth surface loss and investigates the longevity of the direct and indirect composites used herein. (2) Method: The search encompassed Medline, Embase, Web of Science, the Cochrane Library, and hand search utilizing the PICO framework. (3) Results: Eight studies were included in this review, comprising one randomized controlled trial, one retrospective, and six prospective studies. Some studies reported favorable outcomes for composite restorations in anterior teeth. Although not statistically significant, evidence supported the anterior composite as a viable short- to medium-term solution for managing tooth wear. Direct resin composites were deemed clinically and cost-effective when managing localized anterior tooth wear. However, limitations and inconsistencies in this scoping review limited definitive clinical recommendations. (4) Conclusions: Further research, including well-managed randomized controlled trials using standardized protocols and longer follow-up periods, is essential to reconfirm the long-term efficacies of anterior composite restorations when managing tooth wear. A robust research design and exacting protocols could facilitate more meaningful clinical conclusions. Full article
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12 pages, 1239 KiB  
Article
Mechanical Behavior of Repaired Monolithic Crowns: A 3D Finite Element Analysis
Dent. J. 2023, 11(11), 254; https://doi.org/10.3390/dj11110254 - 31 Oct 2023
Cited by 2 | Viewed by 1685
Abstract
This study evaluated the mechanical behavior and risk of failure of three CAD-CAM crowns repaired with different resin composites through a three-dimensional (3D) finite element analysis. Three-dimensional models of different cusp-repaired (conventional nanohybrid, bulk-fill, and flowable resin composites) crowns made of zirconia, lithium [...] Read more.
This study evaluated the mechanical behavior and risk of failure of three CAD-CAM crowns repaired with different resin composites through a three-dimensional (3D) finite element analysis. Three-dimensional models of different cusp-repaired (conventional nanohybrid, bulk-fill, and flowable resin composites) crowns made of zirconia, lithium disilicate, and CAD-CAM resin composite were designed, fixed at the cervical level, and loaded in 100 N at the working cusps, including the repaired one. The models were analyzed to determine the Maximum Principal and Maximum Shear stresses (MPa). Complementary, an in vitro shear bond strength test (n = 10) was performed to calculate the risk of failure for each experimental group. The stress distribution among the models was similar when considering the same restorative material. The crown material affected the stress concentration, which was higher for the ceramic models (±9 MPa for shear stress; ±3 MPa for tensile stress) than for the CAD-CAM composite (±7 MPa for shear stress; ±2 MPa for tensile stress). The shear bond strength was higher for the repaired CAD-CAM resin composite (±17 MPa) when compared to the ceramics (below 12 MPa for all groups), while the repair materials showed similar behavior for each substrate. The stress distribution is more homogenous for repaired resin composite crowns, and a flowable direct resin composite seems suitable to repair ceramic crowns with less risk of failure. Full article
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12 pages, 2516 KiB  
Article
Clinicoradiopathologic Analysis of Odontomas: A Retrospective Study of 242 Cases
Dent. J. 2023, 11(11), 253; https://doi.org/10.3390/dj11110253 - 30 Oct 2023
Viewed by 1249
Abstract
Odontomas are considered hamartomatous lesions and are one of the two most common odontogenic tumors of the jaw. Odontomas are classified as compound or complex. Recently, ameloblastic fibro-odontoma (AFO) and ameloblastic fibro-dentinoma were reclassified as developing odontomas. Though clinically odontomas are usually asymptomatic, [...] Read more.
Odontomas are considered hamartomatous lesions and are one of the two most common odontogenic tumors of the jaw. Odontomas are classified as compound or complex. Recently, ameloblastic fibro-odontoma (AFO) and ameloblastic fibro-dentinoma were reclassified as developing odontomas. Though clinically odontomas are usually asymptomatic, they have adverse effects on adjacent teeth such as tooth impaction, delayed eruption, displacement of teeth, over-retention of teeth, and can give rise to odontogenic cysts within the jaw. We sought to evaluate the clinicoradiopathologic presentations of odontomas by collecting and analyzing the clinical, radiographic, and pathologic data of odontomas diagnosed in our institution from 2013 to 2022. Over this 10-year period, there were 242 patients with a histopathological and/or radiographic diagnosis of odontoma. There was no gender predilection and ages ranged from 3 to 101 years (median, 14 years). The second decade of life was the most prevalent (57.4%). There was no jaw predilection; however, the anterior jaw was the most common location. Ninety-four (38.8%) cases presented with clinical findings. The most common finding was tooth impaction (n = 83). Nine (3.7%) cases were histopathologically confirmed to be associated with other lesions such as dentigerous cysts (n = 8) and nasopalatine duct cyst (n = 1). The median age (25 years) of patients diagnosed with odontomas associated with cysts was older than patients with odontomas (14 years) without associated cysts. Compound odontomas were the most common type of odontoma compared to complex and AFOs with 71.4%, 26.6%, and 2%, respectively. The majority of compound odontomas involved the anterior jaw (69.3%) and mandible (54.9%) while the majority of complex odontomas involved the posterior jaw (59.6%) and maxilla (54.7%). The four AFOs were in the posterior jaw and 75% involved the maxilla. The median age (12 years) of patients diagnosed with AFO was the youngest compared to patients diagnosed with compound (13 years) and complex (16 years). In conclusion, we analyzed the clinical, radiographic, and pathologic features of 242 new cases of odontomas. Our study reaffirms that odontomas frequently affect the pediatric population and can disrupt their dentition. Based on the result of this study, our clinical recommendation to prevent problems to adjacent teeth from odontomas is for dentists to be apt in the diagnose of odontomas to ensure that they are surgically removed in a timely manner. Full article
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13 pages, 2635 KiB  
Article
Automated Remodelling of Connectors in Fixed Partial Dentures
Dent. J. 2023, 11(11), 252; https://doi.org/10.3390/dj11110252 - 27 Oct 2023
Viewed by 1337
Abstract
In this study, an approach for automated parametric remodelling of the connector cross-sectional area in a CAD model of a given fixed partial denture (FPD) geometry was developed and then applied to a 4-unit FPD. The remodelling algorithm was implemented using Rhinoceros and [...] Read more.
In this study, an approach for automated parametric remodelling of the connector cross-sectional area in a CAD model of a given fixed partial denture (FPD) geometry was developed and then applied to a 4-unit FPD. The remodelling algorithm was implemented using Rhinoceros and the Grasshopper plugin. The generated CAD models were used to perform a finite element analysis with Ansys to analyse the stress distribution in an implant-supported 4-unit FPD for different connector designs. The results showed that the type of connector adjustment matters and that the resulting stress can be significantly different even for connectors with the same cross-sectional area. For tensile stresses, a reduction in the connector cross-sectional area from the gingival side showed the highest influence on each connector type. It can be concluded that the developed algorithm is suitable for automatic connector detection and adjustment. Full article
(This article belongs to the Special Issue Feature Papers in Digital Dentistry)
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10 pages, 813 KiB  
Article
Impact of the Tobacco Heating System and Cigarette Smoking on the Oral Cavity: A Pilot Study
Dent. J. 2023, 11(11), 251; https://doi.org/10.3390/dj11110251 - 27 Oct 2023
Cited by 2 | Viewed by 1412
Abstract
Cigarette smoking and the harmful chemicals released during smoking have negative effects on oral health. As a measure of harm reduction, a new alternative tobacco heating system (THS) has been developed. The aim of the study was to analyze and compare the effects [...] Read more.
Cigarette smoking and the harmful chemicals released during smoking have negative effects on oral health. As a measure of harm reduction, a new alternative tobacco heating system (THS) has been developed. The aim of the study was to analyze and compare the effects of conventional cigarettes and THS on the oral mucosa, the salivary flow rate (SFR), halitosis, and the load of Candida spp. The study included 20 tobacco heating smokers, 20 conventional cigarette smokers, and 20 nonsmokers. The subjects completed questionnaires on medical information, smoking habits, oral lesions, and symptoms. A clinical examination and SFR test were performed on each subject, followed by an organoleptic assessment of halitosis. Mucosal swabs were collected and cult ured to identify Candida spp. Significant differences were found between the smoking groups in relation to halitosis (p < 0.001; ε2 = 0.624), intraoral findings (p < 0.001; ε2 = 0.507), SFR (p < 0.001; ε2 = 0.0331) and dry mouth for subjective complaints (p = 0.021; ε2 = 0.363). The SFR was significantly lower; however, halitosis, the prevalence of intraoral findings, and dry mouth were significantly higher among smokers, but there were no significant differences between THS and conventional smokers. The present study suggests that THS smoking has similar effects on oral tissues, especially the SFR and halitosis, as conventional cigarette smoking. Full article
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22 pages, 639 KiB  
Systematic Review
Digital Shade Matching in Dentistry: A Systematic Review
Dent. J. 2023, 11(11), 250; https://doi.org/10.3390/dj11110250 - 27 Oct 2023
Cited by 1 | Viewed by 2025
Abstract
The pursuit of aesthetic excellence in dentistry, shaped by societal trends and digital advancements, highlights the critical role of precise shade matching in restorative procedures. Although conventional methods are prevalent, challenges such as shade guide variability and subjective interpretation necessitate a re-evaluation in [...] Read more.
The pursuit of aesthetic excellence in dentistry, shaped by societal trends and digital advancements, highlights the critical role of precise shade matching in restorative procedures. Although conventional methods are prevalent, challenges such as shade guide variability and subjective interpretation necessitate a re-evaluation in the face of emerging non-proximity digital instruments. This systematic review employs PRISMA protocols and keyword-based search strategies spanning the Scopus®, PubMed.gov, and Web of ScienceTM databases, with the last updated search carried out in October 2023. The study aimed to synthesise literature that identified digital non-proximity recording instruments and associated colour spaces in dentistry and compare the clinical outcomes of digital systems with spectrophotometers and conventional visual methods. Utilising predefined criteria and resolving disagreements between two reviewers through Cohen’s kappa calculator, the review assessed 85 articles, with 33 included in a PICO model for clinical comparisons. The results reveal that 42% of studies employed the CIELAB colour space. Despite the challenges in study quality, non-proximity digital instruments demonstrated more consistent clinical outcomes than visual methods, akin to spectrophotometers, emphasising their efficacy in controlled conditions. The review underscores the evolving landscape of dental shade matching, recognising technological advancements and advocating for methodological rigor in dental research. Full article
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15 pages, 3155 KiB  
Article
Comparative Analysis of the Structural Weights of Fixed Prostheses of Zirconium Dioxide, Metal Ceramic, PMMA and 3DPP Printing Resin—Mechanical Implications
Dent. J. 2023, 11(11), 249; https://doi.org/10.3390/dj11110249 - 26 Oct 2023
Cited by 1 | Viewed by 1836
Abstract
The aim of this study was to determine the mechanical implications of four-unit fixed dental prostheses (FDPs) made of (1) monolithic zirconium dioxide (ZR O2), (2) polymethylmethacrylate (PMMA), (3) metal ceramic (PFM) and (4) impression resin (3DPP). Methods: Four groups were [...] Read more.
The aim of this study was to determine the mechanical implications of four-unit fixed dental prostheses (FDPs) made of (1) monolithic zirconium dioxide (ZR O2), (2) polymethylmethacrylate (PMMA), (3) metal ceramic (PFM) and (4) impression resin (3DPP). Methods: Four groups were studied with eight samples for each material (n: 32). Each structure was weighed, subjected to compressive tests and analyzed using 3D FEA. Results: PMMA presented the lowest structural weight (1.33 g), followed by 3DPP (1.98 g), ZR O2 (6.34 g) and PFM (6.44 g). In fracture tests, PMMA presented a compressive strength of 2104.73 N and a tension of 351.752 MPa; followed by PFM, with a strength of 1361.48 N and a tension of 227.521 MPa; ZR O2, with a strength of 1107.63 N and a tension of 185.098 MPa; and 3DPP, with a strength of 1000.88 N and a tension of 143.916 MPa. According to 3D FEA, 3DPP presented the lowest degree of deformation (0.001 mm), followed by PFM (0.011 mm), ZR O2 (0.168 mm) and PMMA (1.035 mm). Conclusions: The weights of the materials did not have a direct influence on the mean values obtained for strength, stress or strain. Since the performance was related to the tension and forces supported by the structures in critical zones, the importance of considering design factors is clear. In vitro and 3D FEA assays allowed us to simulate different scenarios for the mechanical properties of certain materials before evaluating them clinically. Thus, they can generate predictions that would allow for the design of a better research methodology in future clinical trials. Full article
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10 pages, 898 KiB  
Article
Dental Maturation in Two Groups of Children Born in 1969–1973 and 2005–2010
Dent. J. 2023, 11(11), 248; https://doi.org/10.3390/dj11110248 - 25 Oct 2023
Viewed by 1105
Abstract
This study compared differences in dental maturation and dental age in Scandinavian children born in 1969–1973 and 2005–2010. The study was based on 130 ethnic Scandinavian children, who were divided in two groups corresponding to the time periods and matched on age and [...] Read more.
This study compared differences in dental maturation and dental age in Scandinavian children born in 1969–1973 and 2005–2010. The study was based on 130 ethnic Scandinavian children, who were divided in two groups corresponding to the time periods and matched on age and sex. Each group consisted of 65 children (30 girls, 35 boys, mean age 9.29 years and 9.30 years, respectively). Dental maturation was analysed by orthopantomographs, in accordance with Demirjian and Haavikko. Dental age was analysed by orthopantomographs in accordance with Demirjian. Boys and girls were analysed separately by linear regression analysis adjusted for age. For the children born in 2005–2010, teeth matured significantly earlier (Demirjian: 0.21 maturities, CI 95% 0.11–0.31, p < 0.000. Haavikko: maxilla: 0.39 maturities, CI 95% 0.21–0.56, p < 0.000. Mandible: 0.42 maturities, CI 95% 0.17–0.67, p = 0.001) and the dental age was significantly higher (Demirjian: 6.04 months, CI 95% 0.23–0.77, p < 0.000) in comparison with the children born in 1969–1973. In conclusion, the teeth of Scandinavian children born 2005–2010 matured significantly earlier than those of children born in 1969–1973. The results may prove valuable in forensic dentistry, pedodontics, and for the timing of pedodontic and orthodontic treatment. Full article
(This article belongs to the Special Issue Women's Research in Dentistry)
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11 pages, 867 KiB  
Article
A Multicenter Prospective Study on the Use of a Mandibular Advancement Device in the Treatment of Obstructive Sleep Apnea
Dent. J. 2023, 11(11), 247; https://doi.org/10.3390/dj11110247 - 24 Oct 2023
Viewed by 1772
Abstract
The main objective of this prospective study was the evaluation of 1 mm step titration of mandible advancement in the success of treating obstructive sleep apnea (OSA). For that, a multicenter prospective study was designed to recruit patients with OSA who were eligible [...] Read more.
The main objective of this prospective study was the evaluation of 1 mm step titration of mandible advancement in the success of treating obstructive sleep apnea (OSA). For that, a multicenter prospective study was designed to recruit patients with OSA who were eligible to receive a mandibular advancement device. Gradual titration of mandibular advancement (steps of 1 mm) from maximum intercuspidation was performed to determine the optimal mandibular advancement (highest reduction in the apnea-hypopnea index (AHI)). The principal variable was the percentage of patients where a reduction ≥50% of the AHI was achieved at the end of the titration phase. A total of 102 patients participated in this study. Fifty-six percent of the participants were males and 67% had a BMI ≥ 25 kg/m2. Most of the patients (79%) had an age ≥ 50 years and the majority (74%) were either non-smokers or ex-smokers. Excessive daytime sleepiness was reported by 40% of the patients. The mean AHI at baseline was 20.6 ± 12.7 events/h. The mean advancement of the mandible was 3.1 ± 1.6 mm. The device achieved a reduction in the AHI in 93% of the patients and success (≥50% reduction in the AHI) in 69% of the patients. Success was achieved in 50%, 81.6%, and 73.3% of the patients with mild, moderate, and severe OSA, respectively. Decreasing the magnitude of mandibular advancement could be possible by controlling the vertical mouth opening and step-by-step titration. Full article
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25 pages, 2243 KiB  
Review
Pain Assessment in Oral Medicine through Its Different Dimensions: A Comprehensive Review
Dent. J. 2023, 11(11), 246; https://doi.org/10.3390/dj11110246 - 24 Oct 2023
Cited by 1 | Viewed by 1780
Abstract
Orofacial pain is a complex experience made up of different features and involving various aspects of life. It has demonstrated a connection, especially when chronic, with conditions such as anxiety, depression, and sleep disorders, through paths that still have not been completely clarified. [...] Read more.
Orofacial pain is a complex experience made up of different features and involving various aspects of life. It has demonstrated a connection, especially when chronic, with conditions such as anxiety, depression, and sleep disorders, through paths that still have not been completely clarified. A deep understanding of orofacial pain and its impact on an individual’s life is critical for planning accurate diagnostic and therapeutic approaches. This review seeks to provide a comprehensive overview of the components constituting the pain experience, its implications in an individual’s life, the different tools for multidimensional pain assessment, and the specific applications for each tool. A comprehensive review was performed using the PubMed, Scopus, and Web of Science electronic databases. Ninety-five studies, including observational studies, clinical trials, case–control studies, and case reports, were included and analyzed in this review. Orofacial pain assessment exploits several methods, ranging from clinical evaluation to rating scales, questionnaires, and daily diaries. The choice of the correct instrument requires an evaluation of the type of pain experienced, of the patient’s characteristics and abilities to complete particular tasks, and finally, of the assessment tool features. Full article
(This article belongs to the Special Issue Feature Review Papers in Dentistry)
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11 pages, 662 KiB  
Systematic Review
A Systematic Review of In Vitro Studies Using Microchip Platforms for Identifying Periodontopathogens from the Red Complex
Dent. J. 2023, 11(11), 245; https://doi.org/10.3390/dj11110245 - 24 Oct 2023
Viewed by 1239
Abstract
Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola, collectively recognized as periodontopathogens within the red complex, have been extensively studied in clinical samples collected from individuals with periodontitis. A lab-on-a-chip (LOC) is a miniature mechanism that integrates various laboratory operations onto [...] Read more.
Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola, collectively recognized as periodontopathogens within the red complex, have been extensively studied in clinical samples collected from individuals with periodontitis. A lab-on-a-chip (LOC) is a miniature mechanism that integrates various laboratory operations onto a single microchip or a small-scale platform. This systematic review evaluates the application of LOC technology in identifying microorganisms from the red complex. This study adhered to PRISMA recommendations, and the review process encompassed several databases. In the electronic search, a total of 58 reports were found, and ultimately, 10 studies were considered relevant for inclusion. All these studies described effective, rapid, and reliable LOC systems for detecting and amplifying P. gingivalis, T. forsythia, and T. denticola. Compared to traditional methods, the LOC approach demonstrated minimal reagent requirements. Additionally, the results indicated that the amplification process took approximately 2 to 8 min, while detection could be completed in as little as 2 min and 40 s, resulting in a total experimental duration of around 11 min. Integrating miniaturization, speed, accuracy, and automation within microchip platforms makes them promising tools for detecting and amplifying microorganisms associated with the red complex in periodontal diseases. Full article
(This article belongs to the Section Oral Hygiene, Periodontology and Peri-implant Diseases)
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