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Dent. J., Volume 12, Issue 4 (April 2024) – 36 articles

Cover Story (view full-size image): Dental implants are becoming increasingly essential for managing both partial and complete tooth loss, offering significant functional and aesthetic improvements over traditional restorations. The success of these implants relies heavily on the precision of each clinical step within a coordinated workflow. The traditional methods involve creating a physical model from a detailed impression, whereas the digital approaches begin with an intraoral scan (IOS), enabling direct digital processing. This shift not only enhances the patients’ comfort, but also minimizes potential errors by eliminating manual interventions. This study focuses on optimizing the digital workflow using Exocad CAD software, specifically examining the impact of scanbody geometry on the accuracy of digital implant positioning. View this paper
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17 pages, 5460 KiB  
Systematic Review
Is a White Diet Necessary for Tooth Bleaching Procedures? A Systematic Review and Meta-Analysis
by Louis Hardan, Rim Bourgi, Abigailt Flores-Ledesma, Walter Devoto, Emma Devoto, Miguel Ángel Fernández-Barrera, Naji Kharouf and Carlos Enrique Cuevas-Suárez
Dent. J. 2024, 12(4), 118; https://doi.org/10.3390/dj12040118 - 22 Apr 2024
Viewed by 990
Abstract
The aim of this investigation was to conduct a systematic review and meta-analysis to determine the necessity of a white diet during or following a bleaching procedure. This systematic review and meta-analysis followed the PRISMA guidelines meticulously. The research question was: Is a [...] Read more.
The aim of this investigation was to conduct a systematic review and meta-analysis to determine the necessity of a white diet during or following a bleaching procedure. This systematic review and meta-analysis followed the PRISMA guidelines meticulously. The research question was: Is a white diet necessary during and/or after a bleaching treatment? In vitro studies or clinical trials reporting the color change in bleached enamel after the use of a free-staining diet were considered for full-text review. For the analyses, a random-effects model was employed. Statistical significance was defined as a p-value < 0.05. A total of 17 documents were eligible for qualitative analysis: 5 clinical trials and 12 in vitro studies. Only data from the clinical trials were included in the meta-analysis. For at-home bleaching, differences in the color among the subjects were not statistically significant during the first (p = 0.64), second (p = 0.26) or third (p = 0.43) weeks of treatment. Also, the color difference one month after finishing the bleaching treatment were not statistically significant (p = 0.27). The color difference one month after finishing an in-office treatment showed that the restrictions on diet did not significantly improve the bleaching outcomes (p = 0.90). According to the findings of this review, dietary restrictions are not necessary during or after bleaching procedures. Full article
(This article belongs to the Special Issue Esthetic Dentistry: Current Perspectives and Future Prospects)
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12 pages, 860 KiB  
Systematic Review
A Systematic Review of the Relationship between Serum Vitamin D Levels and Caries in the Permanent Teeth of Children and Adolescents
by Roxana Buzatu, Magda Mihaela Luca and Bogdan Andrei Bumbu
Dent. J. 2024, 12(4), 117; https://doi.org/10.3390/dj12040117 - 22 Apr 2024
Viewed by 683
Abstract
This systematic review critically evaluates the association between serum Vitamin D levels and dental caries incidence in the permanent teeth of children and adolescents. The search strategy comprised three databases (PubMed, Scopus, Embase), up to November 2023, targeting studies on the correlation between [...] Read more.
This systematic review critically evaluates the association between serum Vitamin D levels and dental caries incidence in the permanent teeth of children and adolescents. The search strategy comprised three databases (PubMed, Scopus, Embase), up to November 2023, targeting studies on the correlation between Vitamin D and dental caries in permanent dentition. The eligibility criteria focused on observational studies involving children and adolescents aged 12 to 19 years with permanent dentition. The screening process, guided by the PRISMA guidelines and the Newcastle–Ottawa Scale for quality assessment, resulted in the inclusion of eight studies conducted across various global regions from 2013 to 2023. The analysis revealed that Vitamin D insufficiency and deficiency were prevalent among the study populations, ranging from 17.3% to 69.4%. Specifically, children and adolescents with Vitamin D insufficiency (<50 nmol/L) were found to have significantly higher odds of developing caries, with odds ratios (ORs) ranging from 1.13 to 2.57. Conversely, two studies indicated a protective effect of higher Vitamin D levels, with an OR of 0.80 and 0.59, respectively, for caries among children and adolescents with serum levels ≥ 50 nmol/L, suggesting an inverse relationship between Vitamin D status and caries risk. The results indicate both the protective role of adequate serum levels of Vitamin D above 20 ng/mL and the increased risk associated with insufficient levels below this threshold. However, the variations in study quality, methodologies and geographic settings underscore the challenges in drawing universal conclusions. Despite these limitations, our review suggests that improving Vitamin D status could be a beneficial component of preventive strategies against dental caries in children and adolescents, warranting further research to clarify the clinical significance of our findings. Full article
(This article belongs to the Special Issue Updates and Highlights in Cariology)
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13 pages, 584 KiB  
Article
Clinical Use of Paraprobiotics for Pregnant Women with Periodontitis: Randomized Clinical Trial
by Andrea Butera, Maurizio Pascadopoli, Maria Gloria Nardi, Chiara Ogliari, Alessandro Chiesa, Camilla Preda, Giulia Perego and Andrea Scribante
Dent. J. 2024, 12(4), 116; https://doi.org/10.3390/dj12040116 - 19 Apr 2024
Viewed by 820
Abstract
Periodontal disease is very common in pregnant women. Paraprobiotics are a subset of probiotics. They can be defined as inactivated microbial cells providing health benefits to the host and are considered particularly safe. The aim of this study was to compare the periodontal [...] Read more.
Periodontal disease is very common in pregnant women. Paraprobiotics are a subset of probiotics. They can be defined as inactivated microbial cells providing health benefits to the host and are considered particularly safe. The aim of this study was to compare the periodontal health of pregnant women and puerperae after 6 months of home use of paraprobiotics. A total of 30 pregnant women were enrolled and divided into two groups: the test group, who had to use a paraprobiotic-based toothpaste (Biorepair Peribioma Pro, Coswell S.p.A., Funo di Argelato, BO, Italy) and mousse (Mousse Mouthwash Biorepair Peribioma, Coswell S.p.A.) twice a day, and the control group, who had to use only the paraprobiotic-based toothpaste. The time frames of the study were: 1 month (T1), 3 months (T2) and 6 months (T3), and data were collected during pregnancy and in the period immediately following delivery. The following indices were evaluated at T0, T1, T2 and T3: clinical attachment loss (CAL), probing pocket depth (PPD), bleeding on probing (BOP), plaque control record (PCR), modified marginal gingival index (mMGI), papillary marginal gingival index (PMGI) and recessions (R). All data were subjected to statistical analysis. PCR decreased significantly from T0 to T1 in the control group and from T0 to T2 and from T0 to T3 in the test group. BOP tended to decrease in both groups, but a significant reduction was observed only in the test group. CAL, PPD, PMGI and mMGI tended to decrease gradually in both groups without significant differences between or within groups. The combination of the paraprobiotic-based toothpaste and the paraprobiotic-based mousse significantly reduced BoP and plaque control over time, although there were no significant differences with the use of the paraprobiotic-based toothpaste alone. In addition, the combination of the two products promoted a trend towards the better stabilization of recessions. Full article
(This article belongs to the Special Issue Rising Stars: Oral Infections and Microbes)
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16 pages, 318 KiB  
Review
Oral Mycobiota: A Narrative Review
by Carmen Liliana Defta, Cristina-Crenguţa Albu, Ştefan-Dimitrie Albu and Claudia Florina Bogdan-Andreescu
Dent. J. 2024, 12(4), 115; https://doi.org/10.3390/dj12040115 - 19 Apr 2024
Viewed by 978
Abstract
Numerous studies have proven the important role of the oral microbiota in health and disease. The dysfunctionality of the oral microbiota, known as dysbiosis, is incriminated in dental caries, periodontal disease, oral infectious diseases, oral cancer, and systemic disease. The lesser-known component of [...] Read more.
Numerous studies have proven the important role of the oral microbiota in health and disease. The dysfunctionality of the oral microbiota, known as dysbiosis, is incriminated in dental caries, periodontal disease, oral infectious diseases, oral cancer, and systemic disease. The lesser-known component of the oral microbiota, the mycobiota, is now assiduously investigated. Recent technological developments have helped foster the identification of new fungal species based on genomic research. Next-generation sequencing has expanded our knowledge about the diversity, architecture, and relationships of oral microorganisms within the oral cavity. The mycobiome structure and relationships with the bacteriome have been studied to identify a mycobiotic signature. This review aimed to emphasize the latest knowledge of the oral mycobiome. Full article
(This article belongs to the Special Issue Rising Stars: Oral Infections and Microbes)
12 pages, 599 KiB  
Review
Different Methods of Teaching and Learning Dental Morphology
by Helene Lindén Overskott, Caroline Elisabet Markholm, Amer Sehic and Qalbi Khan
Dent. J. 2024, 12(4), 114; https://doi.org/10.3390/dj12040114 - 18 Apr 2024
Viewed by 1062
Abstract
Dental anatomy education is traditionally structured into theoretical and practical modules to foster both cognitive and psychomotor development. The theoretical module typically involves didactic lectures where educators elucidate dental structures using visual aids. In contrast, practical modules utilize three-dimensional illustrations, extracted and plastic [...] Read more.
Dental anatomy education is traditionally structured into theoretical and practical modules to foster both cognitive and psychomotor development. The theoretical module typically involves didactic lectures where educators elucidate dental structures using visual aids. In contrast, practical modules utilize three-dimensional illustrations, extracted and plastic teeth, and tooth carving exercises on wax or soap blocks, chosen for their cost, ease of handling, and fidelity in replication. However, the efficacy of these traditional methods is increasingly questioned. The criticism in this concern is that oversized carving materials may distort students’ understanding of anatomical proportions, potentially affecting the development of necessary skills for clinical practice. Lecture-driven instruction, on the other hand, is also criticized for its limitations in fostering interactive learning, resulting in a gap between pre-clinical instruction and practical patient care. In this study, we review the various educational strategies that have emerged to enhance traditional dental anatomy pedagogy by describing the effectiveness of conventional didactic lectures, wax carving exercises, the use of real and artificial teeth, the flipped classroom model, and e-learning tools. Our review aims to assess each method’s contribution to improving clinical applicability and educational outcomes in dental anatomy, with a focus on developing pedagogical frameworks that align with contemporary educational needs and the evolving landscape of dental practice. We suggest that the optimal approach for teaching tooth morphology would be to integrate the digital benefits of the flipped classroom model with the practical, hands-on experience of using extracted human teeth. To address the challenges presented by this integration, the creation and standardization of three-dimensional tooth morphology educational tools, complemented with concise instructional videos for a flipped classroom setting, appears to be a highly effective strategy. Full article
(This article belongs to the Section Dental Education)
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14 pages, 2550 KiB  
Article
Do Concurrent Peri-Implantitis and Periodontitis Share Their Microbiotas? A Pilot Study
by Ana Parga, José Manuel Pose-Rodríguez, Andrea Muras, María Baus-Domínguez, Paz Otero-Casal, Marcos Luis Ortega-Quintana, Daniel Torres-Lagares and Ana Otero
Dent. J. 2024, 12(4), 113; https://doi.org/10.3390/dj12040113 - 18 Apr 2024
Viewed by 806
Abstract
The microbial compositions from concurrent peri-implant and periodontal lesions were compared, since the results reported in the literature on the etiological relationship between these oral pathologies are contradictory. Microbial compositions from nine patients were evaluated using Illumina MiSeq sequencing of 16S rRNA gene [...] Read more.
The microbial compositions from concurrent peri-implant and periodontal lesions were compared, since the results reported in the literature on the etiological relationship between these oral pathologies are contradictory. Microbial compositions from nine patients were evaluated using Illumina MiSeq sequencing of 16S rRNA gene amplicons and Principal Components Analysis. Comparisons between the use of curettes or paper points as collection methods and between bacterial composition in both pathologies were performed. Paper points allowed the recovery of a higher number of bacterial genera. A higher bacterial diversity was found in peri-implantitis compared to periodontal samples from the same patient, while a greater number of operational taxonomic units (OTUs) were present in the corresponding periodontal samples. A higher abundance of oral pathogens, such as Porphyromonas or Treponema, was found in peri-implantitis sites. The opposite trend was observed for Aggregatibacter abundance, which was higher in periodontal than in peri-implantitis lesions, suggesting that both oral pathologies could be considered different but related diseases. Although the analysis of a higher number of samples would be needed, the differences regarding the microbial composition provide a basis for further understating the pathogenesis of peri-implant infections. Full article
(This article belongs to the Special Issue Oral Microbiology and Related Research)
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17 pages, 889 KiB  
Review
The Influence of Orthodontic Treatment on Periodontal Health between Challenge and Synergy: A Narrative Review
by Ionut Luchian, Zenovia Surlari, Ancuta Goriuc, Nicoleta Ioanid, Irina Zetu, Oana Butnaru, Monica-Mihaela Scutariu, Monica Tatarciuc and Dana-Gabriela Budala
Dent. J. 2024, 12(4), 112; https://doi.org/10.3390/dj12040112 - 17 Apr 2024
Viewed by 634
Abstract
By correctly repositioning teeth, orthodontic therapy improves both the function and appearance of an occlusion. The relationship between teeth and the tissues that surround and support them significantly influences these alterations. With ever more adults seeking orthodontic care, orthodontists are increasingly seeing patients [...] Read more.
By correctly repositioning teeth, orthodontic therapy improves both the function and appearance of an occlusion. The relationship between teeth and the tissues that surround and support them significantly influences these alterations. With ever more adults seeking orthodontic care, orthodontists are increasingly seeing patients with periodontal issues. Concerns about the patient’s appearance, such as uneven gingival margins or functional issues caused by inflammatory periodontal diseases, should be accounted for when designing orthodontic treatment plans. Furthermore, orthodontics may increase the chances of saving and recovering a degraded dentition in cases of severe periodontitis. Today, general dentists, dontists, and orthodontists play integrative roles that enable them to achieve the best possible results for their patients. This review will improve the results of interdisciplinary treatments and increase cooperation between dental specialists by drawing attention to the essential connection between orthodontics and periodontics in regular clinical practice. Full article
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13 pages, 1418 KiB  
Article
Shock Absorption Capacity of High-Performance Polymers for Dental Implant-Supported Restorations: In Vitro Study
by Maria Menini, Francesca Delucchi, Francesco Bagnasco, Domenico Baldi, Luigi Canullo, Paolo Setti, Marco Migliorati, Enrico Simetti and Paolo Pesce
Dent. J. 2024, 12(4), 111; https://doi.org/10.3390/dj12040111 - 17 Apr 2024
Viewed by 622
Abstract
Background: Restorative materials might significantly affect load transmission in peri-implant bone. The aim of the present study is to evaluate the shock absorption capacity of two different polymeric materials to be used for implant-supported prostheses. Methods: A masticatory robot was used to compare [...] Read more.
Background: Restorative materials might significantly affect load transmission in peri-implant bone. The aim of the present study is to evaluate the shock absorption capacity of two different polymeric materials to be used for implant-supported prostheses. Methods: A masticatory robot was used to compare the shock absorption capacity of veneered and non-veneered polyetherketoneketone (PEKK), Pekkton®ivory (Cendres+Mètaux), and the glass fiber-reinforced composite (GFRC), TRINIATM (Bicon). Five identical sample crowns for each of the three groups were tested. Forces transmitted at the simulated peri-implant bone were recorded and statistically analyzed. Results: The statistical analysis of forces transmitted at the simulated dental implant revealed significant differences between the materials tested and between these materials and zirconia, glass ceramic, composite resin, and acrylic resin. Only differences between PEKK and veneered PEKK and between PEKK and one of the previously tested composite resins were not statistically significant. PEKK samples demonstrated significantly greater shock absorption capacity compared to GFRC. Conclusions: PEKK revealed optimal shock absorption capacity. Further studies are needed to evaluate its efficacy in the case of long-span prostheses with reduced prosthetic volume. Full article
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9 pages, 1887 KiB  
Article
Analyzing Oral Health Conditions in Sex Workers—A Comparative Retrospective Clinical and Radiographic Study
by Tahel Oguen-Alon, Leon Bilder, Hadar Zigdon Giladi, Zvi Gutmacher and Yaniv Mayer
Dent. J. 2024, 12(4), 110; https://doi.org/10.3390/dj12040110 - 17 Apr 2024
Viewed by 824
Abstract
This study highlights the oral health condition of female sex workers (SWs), who face increased risks associated with habits such as excessive alcohol and tobacco use. These behaviors heighten the likelihood of issues like oral cancer and dental diseases, underscoring the need for [...] Read more.
This study highlights the oral health condition of female sex workers (SWs), who face increased risks associated with habits such as excessive alcohol and tobacco use. These behaviors heighten the likelihood of issues like oral cancer and dental diseases, underscoring the need for targeted health interventions. The study examines the oral health disparities between SWs and the general population (GP). A retrospective study analyzed the health records of 40 SWs and 40 controls matched by age and gender who were examined between 1 January 2020 and 30 May 2023. Intra-oral and panoramic radiographs, alongside clinical examination, were used to evaluate missing teeth, periodontal bone support, and caries. T-tests and chi-square tests were used to compare dental health indicators. A comparative analysis of these 80 patients revealed significant disparities: SWs had a higher incidence of missing teeth (5.8 ± 7.3 vs. 0.7 ± 1.4, p < 0.01) and caries (6.1 ± 6.2 vs. 0.8 ± 1.2, p < 0.05) compared to the GP. The DMFT (Decayed, Missing, and Filled Teeth) index was notably higher in SWs (16.1 ± 8.09) than in the GP (7.95 ± 5.48, p < 0.001). Additionally, 12% of SWs used removable dentures, unlike the GP. This study underscores significant oral health challenges in SWs, emphasizing the need for targeted healthcare strategies to improve their health conditions. Full article
(This article belongs to the Special Issue Preventive Dentistry and Dental Public Health)
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20 pages, 3499 KiB  
Review
The Impact of Vitamin Deficiencies on Oral Manifestations in Children
by Stjepanka Lešić, Zrinka Ivanišević, Bruno Špiljak, Matej Tomas, Magdalena Šoštarić and Aleksandar Včev
Dent. J. 2024, 12(4), 109; https://doi.org/10.3390/dj12040109 - 17 Apr 2024
Viewed by 1554
Abstract
Vitamins play a vital role in human health, particularly in the development and maintenance of oral health in children. These nutrients are broadly categorized into fat-soluble and water-soluble types, crucial for children’s well-being. The objective of this study is to investigate the impact [...] Read more.
Vitamins play a vital role in human health, particularly in the development and maintenance of oral health in children. These nutrients are broadly categorized into fat-soluble and water-soluble types, crucial for children’s well-being. The objective of this study is to investigate the impact of vitamin deficiencies on the oral health of children, focusing on how these deficiencies contribute to various oral health issues and determining the relationship between specific vitamin shortages and oral diseases. Findings indicate that shortages in vitamins A and D lead to enamel issues and a higher susceptibility to dental diseases, vitamin E assists in treating oral mucositis, and vitamin K is essential for blood clotting in dental surgeries. Deficits in B-complex and vitamin C result in enamel hypomineralization and soft tissue ailments, including aphthous stomatitis and gingival petechiae. Additionally, a lack of vitamin B7 compromises the immune response, increasing oral candidiasis risk. Therefore, vitamin deficiencies markedly affect children’s oral health, highlighting the need for joint efforts between dental professionals and caregivers for effective pediatric care. Addressing vitamin deficiencies through supplementation and tailored dental care emphasizes the significance of nutritional health in children’s overall and dental well-being, advocating for a collaborative approach to achieve optimal health outcomes. Full article
(This article belongs to the Special Issue Molecular Diagnostics in Oral Diseases: Volume II)
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19 pages, 6780 KiB  
Article
Effects of Improper Mechanical Force on the Production of Sonic Hedgehog, RANKL, and IL-6 in Human Periodontal Ligament Cells In Vitro
by Erika Yamashita, Shinichi Negishi, Jun Kikuta, Mami Shimizu and Hidenobu Senpuku
Dent. J. 2024, 12(4), 108; https://doi.org/10.3390/dj12040108 - 15 Apr 2024
Viewed by 791
Abstract
Improper mechanical stress may induce side effects during orthodontic treatment. If the roots and alveolar bones are extensively resorbed following excess mechanical stress, unplanned tooth mobility and inflammation can occur. Although multiple factors are believed to contribute to the development of side effects, [...] Read more.
Improper mechanical stress may induce side effects during orthodontic treatment. If the roots and alveolar bones are extensively resorbed following excess mechanical stress, unplanned tooth mobility and inflammation can occur. Although multiple factors are believed to contribute to the development of side effects, the cause is still unknown. Sonic hedgehog (Shh), one of the hedgehog signals significantly associated with cell growth and cancer development, promotes osteoclast formation in the jawbone. Shh may be associated with root and bone resorptions during orthodontic treatment. In this study, we investigated the relationships between Shh, RANKL, and IL-6 in human periodontal ligament (hPDL) cells exposed to improper mechanical force. Weights were placed on hPDL cells and human gingival fibroblasts (HGFs) for an optimal orthodontic force group (1.0 g/cm2) and a heavy orthodontic force group (4.0 g/cm2). A group with no orthodontic force was used as a control group. Real-time PCR, SDS-PAGE, and Western blotting were performed to examine the effects of orthodontic forces on the expression of Shh, RANKL, and IL-6 at 2, 4, 6, 8, 12, and 24 h after the addition of pressure. The protein expression of Shh was not clearly induced by orthodontic forces of 1.0 and 4.0 g/cm2 compared with the control in HGFs and hPDL cells. In contrast, RANKL and IL-6 gene and protein expression was significantly induced by 1.0 and 4.0 g/cm2 in hPDL cells for forces lasting 6~24 h. However, neither protein was expressed in HGFs. RANKL and IL-6 expressions in response to orthodontic forces and in the control were clearly inhibited by Shh inhibitor RU-SKI 43. Shh did not directly link to RANKL and IL-6 for root and bone resorptions by orthodontic force but was associated with cell activities to be finally guided by the production of cytokines in hPDL cells. Full article
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11 pages, 10236 KiB  
Case Report
A Novel Diagnostic and Treatment Approach to an Unusual Case of Dens Invaginatus in a Mandibular Lateral Incisor Using CBCT and 3D Printing Technology
by Lindsey LaLonde, Mazin Askar and Susan Paurazas
Dent. J. 2024, 12(4), 107; https://doi.org/10.3390/dj12040107 - 13 Apr 2024
Viewed by 862
Abstract
Background: This case report demonstrates the use of three-dimensional (3D) models produced from a cone beam computed tomographic (CBCT) volume to develop a treatment strategy for a rare type of dens invaginatus (DI) in a mandibular incisor. Methods: A patient with DI Type [...] Read more.
Background: This case report demonstrates the use of three-dimensional (3D) models produced from a cone beam computed tomographic (CBCT) volume to develop a treatment strategy for a rare type of dens invaginatus (DI) in a mandibular incisor. Methods: A patient with DI Type IIIa presented for endodontic treatment. Following CBCT evaluation, the complex morphologic nature of the invagination required additional diagnostic tools for treatment planning. The fabrication of 3D models provided clarity regarding the treatment strategy. Treatment involved intracanal medication with calcium hydroxide Ca(OH)2, nonsurgical root canal therapy (NS-RCT) of the main canal, and endodontic surgery for the DI anomaly using mineral trioxide aggregate (MTA), bone graft, and platelet-rich fibrin (PRF) membrane. Results: The use of 3D models provided an invaluable guide for proper treatment. Complicating factors were diagnosed and planned for accordingly. Conclusions: It is difficult to appreciate the anatomical complexity, the extent, and the nature of the invagination of rare Type III DI morphology. CBCT imaging and 3D models played a critical role in the pre-treatment planning to ensure a predictable outcome. A 3D model is recommended as a diagnostic tool in treating complex cases where the DI morphology is wide, oblique, or the foraminal opening is irregular. Full article
(This article belongs to the Special Issue Modern Endodontics)
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11 pages, 30784 KiB  
Article
Heat-Induced Changes in the Physical Properties of a New Premixed Calcium Silicate-Containing Root Canal Sealer: An In Vitro Study
by Ryota Ito, Satoshi Watanabe, Akira Kouno, Shinya Yamauchi and Takashi Okiji
Dent. J. 2024, 12(4), 106; https://doi.org/10.3390/dj12040106 - 12 Apr 2024
Viewed by 776
Abstract
This study aimed to examine how heating affects the physical properties of a newly developed premixed calcium silicate-containing sealer (AH Plus Bioceramic Sealer; AHB), in comparison with EndoSequence BC Sealer (ES), AH Plus Jet (AH), and Pulp Canal Sealer. The setting time, flow, [...] Read more.
This study aimed to examine how heating affects the physical properties of a newly developed premixed calcium silicate-containing sealer (AH Plus Bioceramic Sealer; AHB), in comparison with EndoSequence BC Sealer (ES), AH Plus Jet (AH), and Pulp Canal Sealer. The setting time, flow, and film thickness were tested with or without heating at 100 °C for 30 or 60 s, in accordance with ISO6876:2012 standards. Ultrastructural and elemental analyses were performed with scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS). Data were analyzed using one-way analysis of variance (ANOVA) with a Tukey post hoc test (α = 0.05). All sealers exhibited significantly shorter setting time and flow after heating at 100 °C for 30 and 60 s (p < 0.05). After heating, AHB showed a significantly higher film thickness compared to that of the other materials (p < 0.05). None of the tested properties of heat-applied AHB and ES met ISO standards, except the setting time in ES. The SEM/EDS results for AHB and ES were not affected by heating. The detected changes in physical properties can negatively impact the performance of premixed calcium silicate-containing sealers, particularly AHB, when warm vertical compaction is employed. Full article
(This article belongs to the Special Issue Endodontics and Restorative Sciences)
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11 pages, 621 KiB  
Article
Association of F. alocis and D. pneumosintes with Periodontitis Disease Severity and Red Complex Bacteria
by Hawaabi F. M. Shaikh, Pratima U. Oswal, Manohar Suresh Kugaji, Sandeep S. Katti, Kishore Gajanan Bhat, Eswar Kandaswamy and Vinayak M. Joshi
Dent. J. 2024, 12(4), 105; https://doi.org/10.3390/dj12040105 - 12 Apr 2024
Viewed by 835
Abstract
Oral biofilms are considered the principal etiological agent in the development of periodontitis. Novel species that may contribute to periodontitis and dysbiosis have been identified recently. The study aims to evaluate the presence of F. alocis and D. pneumosintes in healthy and diseased [...] Read more.
Oral biofilms are considered the principal etiological agent in the development of periodontitis. Novel species that may contribute to periodontitis and dysbiosis have been identified recently. The study aims to evaluate the presence of F. alocis and D. pneumosintes in healthy and diseased patients and their association with clinical parameters and with red complex bacteria. The study included 60 subjects, with 30 patients each in the healthy and periodontitis groups. The clinical parameters were noted, and samples were subjected to DNA extraction followed by a polymerase chain reaction. Statistical analysis was performed using the Graph Pad Prism software. Results: F. alocis and D. pneumosintes were detected at a significantly higher percentage in the periodontitis group compared to the healthy group (p < 0.05). D. pneumosintes was significantly associated with T. forsythia in the periodontitis group (p < 0.05). Both of these organisms were present in sites with higher clinical attachment loss (p < 0.05). This study demonstrated that both F. alocis and D. pneumosintes were detected at a significantly higher percentage in periodontitis subjects and were detected more frequently in sites with a greater clinical attachment loss. It was also evident that both F. alocis and D. pneumosintes can be present independently of other putative periodontal pathogens. Full article
(This article belongs to the Special Issue Oral Health and Dysbiosis)
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14 pages, 1772 KiB  
Article
Perceptions in Digital Smile Design: Assessing Laypeople and Dental Professionals’ Preferences Using an Artificial-Intelligence-Based Application
by Smaranda Buduru, Florin Cofar, Anca Mesaroș, Manuela Tăut, Marius Negucioiu and Oana Almășan
Dent. J. 2024, 12(4), 104; https://doi.org/10.3390/dj12040104 - 11 Apr 2024
Viewed by 712
Abstract
Digital Smile Design (DSD) is used in many fields of dentistry. This prospective observational study assessed laypeople’s and dental professionals’ perceptions of a DSD application. SmileCloud, an online DSD platform, was used to create two different designs for three patients; after that, the [...] Read more.
Digital Smile Design (DSD) is used in many fields of dentistry. This prospective observational study assessed laypeople’s and dental professionals’ perceptions of a DSD application. SmileCloud, an online DSD platform, was used to create two different designs for three patients; after that, the participants, in a 30-question online illustrated survey, were asked about the most attractive design and other features of the smile. Dentists’ and laypeople’s perceptions about specific DSD features were assessed. The Kolmogorov–Smirnov normality test was used. Descriptive and crosstab analyses compared the respondents’ opinions for each statement. Chi-square tests were used to determine the relationship between the questions and any association with age, gender, and profession. The test results were rated as significant at a p-value < 0.05. A total of 520 participants (dental professionals, students, dental technicians, and laypeople) were enrolled. The statistically significant features were self-esteem related to appearance (p = 0.05), facial and smile symmetry (p = 0.42, p < 0.0001), tooth color (p = 0.012), and symmetry of gums (p < 0.001). For each patient, the design with dominant round upper incisors and perfect symmetry was preferred (p < 0.001). Digital pre-visualization benefits diagnosis and enriches treatment planning. The dentist–dental technician–patient team should be involved in the decision-making process of pre-visualization. Full article
(This article belongs to the Section Digital Technologies)
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14 pages, 4115 KiB  
Article
Heat Treatment’s Vital Role: Elevating Orthodontic Mini-Implants for Superior Performance and Longevity—Pilot Study
by Tinela Panaite, Carmen Savin, Nicolae Daniel Olteanu, Nikolaos Karvelas, Cristian Romanec, Raluca-Maria Vieriu, Carina Balcos, Madalina Simona Baltatu, Marcelin Benchea, Dragos Achitei and Irina Zetu
Dent. J. 2024, 12(4), 103; https://doi.org/10.3390/dj12040103 - 11 Apr 2024
Viewed by 673
Abstract
Orthodontic mini-implants are devices used for anchorage in various orthodontic treatments. We conducted a pilot study which aimed to observe preliminary trends regarding the impact of heat treatment on the elastic modulus of Ti6Al4V alloy and stainless steel 316L mini-implants. The initial phase [...] Read more.
Orthodontic mini-implants are devices used for anchorage in various orthodontic treatments. We conducted a pilot study which aimed to observe preliminary trends regarding the impact of heat treatment on the elastic modulus of Ti6Al4V alloy and stainless steel 316L mini-implants. The initial phase involved testing the impact of heat treatment on the mechanical properties of Ti6Al4V alloy and stainless steel 316L mini-implants. Material and methods: Ten self-drilling mini-implants sourced from two distinct manufacturers (Jeil Medical Corporation® and Leone®) with dimensions of 2.0 mm diameter and 10 mm length were tested. They were separated into two material groups: Ti6Al4V and 316L. Using the CETRUMT-2 microtribometer equipment, indentation testing was conducted employing a diamond-tipped Rockwell penetrator at a constant force of 4.5 N. Results: Slight differences were observed in the elastic modulus of the Ti6Al4V alloy (103.99 GPa) and stainless steel 316L (203.20 GPa) compared to natural bone. The higher elastic moduli of these materials indicate that they are stiffer, which could potentially lead to stress-shielding phenomena and bone resorption. Heat treatment resulted in significant changes in mechanical properties, including elastic modulus reductions of approximately 26.14% for Ti6Al4V and 24.82% for 316L, impacting their performance in orthodontic applications. Conclusion: Understanding the effects of heat treatment on these alloys is crucial for optimizing their biomechanical compatibility and longevity in orthodontic treatment. To fully evaluate the effects of heat treatment on mini-implants and to refine their design and efficacy in clinical practice, further research is needed. Full article
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13 pages, 8329 KiB  
Article
Carotid Artery Calcification Detected on Panoramic Radiography Is Significantly Related to Cerebrovascular Accident, Coronary Artery Disease, and Poor Oral Health: A Retrospective Cross-Sectional Study
by Anmol Brar, Katherine DeColibus, D. Shane Rasner, Angela R. Haynes, Frank Pancratz, Oreoluwa Oladiran, Semiu O. Gbadamosi and Adepitan A. Owosho
Dent. J. 2024, 12(4), 99; https://doi.org/10.3390/dj12040099 - 10 Apr 2024
Viewed by 972
Abstract
Panoramic radiography imaging modality is widely used by dentists for diagnosing dental and jaw conditions. It can also detect carotid artery calcification (CAC), indicative of calcified atherosclerotic plaques in the carotid arteries. This cross-sectional retrospective study at the University of Tennessee Health Science [...] Read more.
Panoramic radiography imaging modality is widely used by dentists for diagnosing dental and jaw conditions. It can also detect carotid artery calcification (CAC), indicative of calcified atherosclerotic plaques in the carotid arteries. This cross-sectional retrospective study at the University of Tennessee Health Science Center investigated the link between CAC identified on panoramic radiograph (PR) and cerebrovascular accident (CVA), coronary artery disease (CAD), and poor oral health. Data from 314 CAC patients collected from 2014 to 2023 included age at diagnosis, gender, and clinical histories of hypertension, hyperlipidemia, diabetes mellitus, CVA, CAD, and the decay, missing, and filled permanent teeth (DMFT) index. These patients were age- and gender-matched with non-CAC patients for analysis. The findings revealed high prevalences of hypertension (86.2%), hyperlipidemia (57.6%), diabetes mellitus (30.7%), CVA (15.5%), and CAD (28.7%) amongst CAC patients and the average DMFT index was 26.6. A comparative analysis of 276 matched controls demonstrated significant differences in hypertension (85.9% vs. 57.6%), hyperlipidemia (58.3% vs. 33.7%), diabetes (32.6% vs. 22.1%), CVA history (14.9% vs. 5.1%), CAD (26.1% vs. 9.8%), and DMFT scores (26.3 vs. 23.7), all indicating strong associations between CAC and these health conditions. The adjusted analysis showed that hypertension (aOR: 3.20 [95% CI: 2.06–5.07]), hyperlipidemia (aOR: 1.70 [95% CI: 1.14–2.50]), CVA (aOR: 2.20 [95% CI: 1.13–4.30]), and CAD (aOR: 2.10 [95% CI: 1.28–3.60]) were significantly associated with CAC. Notably, only 41.7% of the patients received a medical consultation after CAC detection on PR. It is crucial for dentists to refer patients for further evaluation. Full article
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14 pages, 2438 KiB  
Article
Comparative Analysis of Endodontic ISO Size 06, 08, and 10 Stainless Steel K-Files Used for Glide Path Procedures
by Abayomi Omokeji Baruwa, Filipa Chasqueira, Sofia Arantes-Oliveira, João Caramês, Duarte Marques, Jaime Portugal and Jorge N. R. Martins
Dent. J. 2024, 12(4), 98; https://doi.org/10.3390/dj12040098 - 10 Apr 2024
Viewed by 735
Abstract
Small-sized stainless steel hand files are conventionally employed in root canal treatment procedures for canal scouting and for glide path establishment, owing to their superior flexibility and proficiency in navigating confined spaces. Given the diversity of brands available in the market, there exists [...] Read more.
Small-sized stainless steel hand files are conventionally employed in root canal treatment procedures for canal scouting and for glide path establishment, owing to their superior flexibility and proficiency in navigating confined spaces. Given the diversity of brands available in the market, there exists potential variability in their physical characteristics, thereby influencing clinical performance. Consequently, this study aims to conduct a comparative analysis of the design, metallurgy, and mechanical characteristics among seven stainless steel hand file brands across ISO sizes 06, 08, and 10. A total of 315 new 25 mm length stainless steel hand files with apical sizes of 0.06, 0.08, and 0.10 from seven distinct brands were included in the study. A meticulous inspection of all instruments was undertaken to identify any structural deformations that might render them ineligible for the study. The design inspection involved the random selection of instruments from each group, which were examined under various microscopes, including a dental operating microscope, optical microscope, and scanning electron microscope. Furthermore, two instruments from each group underwent energy-dispersive X-ray spectroscopy analysis for elemental composition documentation. Mechanical tests were conducted to evaluate the instruments’ resistance to lateral deformation (buckling) and their microhardness. Statistical analysis was executed using the nonparametric Mood’s median test, with a predetermined significance level of 0.05. Regarding the instruments design, all files exhibited an active blade length ranging from 16 to 17 mm. However, variations were observed in the number of spirals, tip designs, and sizes, with the API K-File notably larger in sizes 0.06 and 0.08 compared to the other instruments. Despite uniform elements composition, differences in geometric features and mechanical properties were evident. Concerning buckling strength, the API K-File demonstrated superior performance across all tested sizes, while the Dentsply ReadySteel, SybronEndo, and Mani K-Files exhibited lower results (p < 0.05). In microhardness assessments, both the API and Oro K-Files displayed the lowest outcomes, with medians of 531 HVN and 532 HVN, respectively, whereas the SybronEndo K-File exhibited the highest microhardness (657 HVN). Despite similar metallurgical composition, the observed distinctions in geometric features and mechanical properties underscore the impact of the manufacturing process on the characteristics of glide path stainless steel endodontic files. These disparities may ultimately influence their clinical performance. Full article
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12 pages, 922 KiB  
Article
Knowledge, Attitudes, and Practices of Dental Students from Romania Regarding Self-Perceived Risk and Prevention of Infectious Diseases
by Florentina Iuliana Dincă, Bogdan-Alexandru Dimitriu, Oana Săndulescu, Valentin Daniel Sîrbu and Mihai Săndulescu
Dent. J. 2024, 12(4), 97; https://doi.org/10.3390/dj12040097 - 10 Apr 2024
Viewed by 924
Abstract
University education is a leading source of information for dental practitioners. Particular emphasis should be given to determining the extent to which students acquire positive knowledge, attitudes, and practices (KAP) and positive metacompetences beyond the scope of each studied dental discipline. We performed [...] Read more.
University education is a leading source of information for dental practitioners. Particular emphasis should be given to determining the extent to which students acquire positive knowledge, attitudes, and practices (KAP) and positive metacompetences beyond the scope of each studied dental discipline. We performed a cross-sectional questionnaire-based study among dentistry students from Romania to assess self-perceived risk of infectious diseases and their KAP on topics related to infectious disease prevention. The surveyed students presented good knowledge regarding personal protective equipment (PPE), and their PPE practices significantly correlated with the perceived usefulness of PPE. Only 45.1% correctly recognized all vaccine-preventable diseases (VPDs), but knowledge regarding VPDs significantly improved with increasing year of study (τb = 0.298, p = 0.001), confirming a positive education effect. Awareness regarding the need for screening for bloodborne viruses is poor; the majority of students had never performed a test for hepatitis C virus infection (HCV) (59.4%) or for human immunodeficiency virus (HIV) infection (60.4%). Furthermore, most respondents incorrectly considered themselves at high or very high risk of acquiring BBV, and perceived risk was inversely correlated with willingness to treat patients with hepatitis B virus (HBV) infection (τb = −0.214, p = 0.018), HCV infection (τb = −0.234, p = 0.013), or HIV infection (τb = −0.242, p = 0.006). This led to 3.0% of respondents stating that they would hypothetically deny dental treatment to a patient with HBV infection, 5.0% for HCV infection, and 10.9% for HIV infection, the proportion being significantly higher for HIV (z = −2.2, p = 0.026). In conclusion, better knowledge is needed among dental students regarding their own vaccination history, screening for bloodborne viruses, accurate estimates for their risk of acquiring bloodborne viruses during routine dental practice, and the existence of post-exposure measures following occupational exposure. Improving student knowledge and awareness could translate into a higher willingness to treat patients with chronic viral infections and into a safer and more inclusive dental practice. We propose an adaptation to the university curriculum to cover these key areas for targeted focus to empower future dental practitioners and to facilitate the improvement of across-discipline metacompetences for infection prevention and control. Full article
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12 pages, 644 KiB  
Systematic Review
Effect of Probiotics Lactobacillus rhamnosus and Lactobacillus plantarum on Caries and Periodontal Diseases: A Systematic Review
by Silvia D’Agostino, Giulia Valentini, Francesca Iarussi and Marco Dolci
Dent. J. 2024, 12(4), 102; https://doi.org/10.3390/dj12040102 - 10 Apr 2024
Viewed by 1051
Abstract
Caries and periodontitis are the most prevalent oral diseases worldwide. Major factors contributing to the development of these oral conditions include poor oral hygiene, dental biofilm formation, high carbohydrates diet, smoking, other systemic diseases, and genetic factors. Various preventive measures have been established [...] Read more.
Caries and periodontitis are the most prevalent oral diseases worldwide. Major factors contributing to the development of these oral conditions include poor oral hygiene, dental biofilm formation, high carbohydrates diet, smoking, other systemic diseases, and genetic factors. Various preventive measures have been established to mitigate the risk of caries and periodontal disease development. The present review aims to discuss the role of the probiotics Lactobacillus rhamnosus and Lactobacillus plantarum in the prevention and treatment of caries and periodontal diseases. The study was conducted in accordance with PRISMA guidelines and was registered on PROSPERO. The search involved PubMed, Web of Science, and Scopus and considered the PICO format. Studies were screened by two reviewers independently, and disagreements were solved by consensus with a third reviewer. Data extraction included details about the type of probiotics, strains, and purpose of administration. A total of 15 RCTs were included, of which just 1 was about tooth cavities. Overall, 87% of the included studies were good-quality papers regarding the Jadad Scale. Several studies agreed on the potential of probiotics L. rhamnosus and L. plantarum, both alone and combined, to prevent and improve clinical outcomes in caries and periodontal treatments, weaker evidence is provided for the microbiological benefit. Full article
(This article belongs to the Special Issue Rising Stars: Oral Infections and Microbes)
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24 pages, 634 KiB  
Systematic Review
Effectiveness of Autologous Platelet Concentrates in the Sinus Lift Surgery: Findings from Systematic Reviews and Meta-Analyses
by Roberta Gasparro, Alessandro Espedito Di Lauro, Maria Domenica Campana, Nicola Rosiello, Mauro Mariniello, Gilberto Sammartino and Gaetano Marenzi
Dent. J. 2024, 12(4), 101; https://doi.org/10.3390/dj12040101 - 10 Apr 2024
Viewed by 854
Abstract
Maxillary sinus augmentation is one of the most predictable procedures for the rehabilitation of the posterior maxilla. The current overview aimed to summarize the findings provided by systematic reviews (SRs) and meta-analyses on the effectiveness of autologous platelet concentrates (APCs) in sinus lift [...] Read more.
Maxillary sinus augmentation is one of the most predictable procedures for the rehabilitation of the posterior maxilla. The current overview aimed to summarize the findings provided by systematic reviews (SRs) and meta-analyses on the effectiveness of autologous platelet concentrates (APCs) in sinus lift and to assess the methodological quality of the included SRs. Three electronic databases have been explored. SRs and meta-analyses addressing the effectiveness of APCs in sinus lift technique were included. Clinical, radiographic and histomorphometric findings were considered for APCs as solely grafting materials and APCs in combination with biomaterials. Outcomes were implant survival rate (ISR), implant stability (IS), implant failure (IF), postoperative complications, histomorphometric findings, radiographic bone gain, bone volume and bone density. The methodological quality of the included SRs was assessed using the updated version of “A Measurement Tool to Assess Systematic Review” (AMSTAR-2). Thirty SRs were included. The methodological quality of the included reviews ranged from critically low (3 studies) to high (9 studies). The included SRs showed favorable clinical outcomes, short-term new bone formation and no biological complications when APCs were used both as solely graft material or in combination with other biomaterials. However, no significant additional effects in the long-term period were observed. APCs did not add any further positive effects compared to the physiological healing derived by the natural blood clot. The current overview of SRs highlighted the need for high-quality SRs evaluating the role of APCs in sinus lift though network meta-analyses, in order to identify the most powerful material for sinus lift augmentation. The use of APCs improves the healing of soft tissues and the postoperative quality of life in the short-term period. Thus, its application can be recommended. Full article
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15 pages, 3555 KiB  
Article
The Effect of Chitosan Incorporation on Physico-Mechanical and Biological Characteristics of a Calcium Silicate Filling Material
by Sumaya Abusrewil, J. Alun Scott, Saeed S. Alqahtani, Mark C. Butcher, Mohammed Tiba, Charchit Kumar, Daniel M. Mulvihill, Gordon Ramage and William McLean
Dent. J. 2024, 12(4), 100; https://doi.org/10.3390/dj12040100 - 10 Apr 2024
Viewed by 778
Abstract
Objectives: A tricalcium silicate-based cement, Biodentine™, has displayed antibiofilm activity when mixed with chitosan powder. This study aimed to assess the effect of chitosan incorporation on the physico-mechanical and biological properties of Biodentine™. Methods: In this study, medium molecular weight chitosan powder was [...] Read more.
Objectives: A tricalcium silicate-based cement, Biodentine™, has displayed antibiofilm activity when mixed with chitosan powder. This study aimed to assess the effect of chitosan incorporation on the physico-mechanical and biological properties of Biodentine™. Methods: In this study, medium molecular weight chitosan powder was incorporated into Biodentine™ in varying proportions (2.5 wt%, 5 wt%, 10 wt%, and 20 wt%). The setting time was determined using a Vicat apparatus, solubility was assessed by calculating weight variation after water immersion, radiopacity was evaluated and expressed in millimeters of aluminum, the compressive strength was evaluated using an Instron testing machine, and the microhardness was measured with a Vickers microhardness tester. In addition, surface topography of specimens was analyzed using scanning electron microscopy, and the effect of chitosan on the viability of human embryonic kidney (HEK 293) cells was measured by a colorimetric MTT assay. Results: Incorporation of 2.5 wt% and 5 wt% chitosan powder delivered an advantage by speeding up the setting time of Biodentine material. However, the incorporation of chitosan compromised all other material properties and the crystalline structure in a dose-dependent manner. The chitosan-modified material also showed significant decreases in the proliferation of the HEK 293 cells, signifying decreased biocompatibility. Significance: Chitosan incorporation into calcium silicate materials adversely affects the physical and biological properties of the material. Despite the increased antimicrobial activity of the modified material, the diminution in these properties is likely to reduce its clinical value. Full article
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10 pages, 3026 KiB  
Article
Effects of Froggy Mouth Appliance in Pediatric Patients with Atypical Swallowing: A Prospective Study
by Andrea Scribante, Maurizio Pascadopoli, Simone Gallo, Paola Gandini, Pietro Manzini, Giulia Fadani and Maria Francesca Sfondrini
Dent. J. 2024, 12(4), 96; https://doi.org/10.3390/dj12040096 - 4 Apr 2024
Viewed by 1426
Abstract
Atypical swallowing has a high incidence in growing subjects. Orthopedic treatment with orthodontic appliances and speech therapy are the main approaches to this problem. The aim of this prospective study was to evaluate the changes in the dental arches induced by one year [...] Read more.
Atypical swallowing has a high incidence in growing subjects. Orthopedic treatment with orthodontic appliances and speech therapy are the main approaches to this problem. The aim of this prospective study was to evaluate the changes in the dental arches induced by one year of treatment with the Froggy Mouth myofunctional appliance designed to correct atypical swallowing. In total, 16 patients with atypical swallowing were instructed to use the Froggy Mouth appliance. A digital intraoral impression was taken at baseline (T0). The Froggy Mouth appliance had to be used for 15 min/day throughout the treatment period. At the end of the first year of treatment (T1), another impression was taken with the same intraoral scanner. Digital casts of the T0 and T1 impressions were obtained using software and the two casts were superimposed to record the following measurements: upper intercanine distance, upper arch diameter, upper arch width, overbite and overjet. The data were statistically analyzed (significance threshold: p < 0.05). Student’s t-test was used to compare pre- and post-treatment measurements. Linear regressions were performed to assess the influence of arch width on anterior and posterior diameters. A significant increase was found for the upper arch diameters (p < 0.05), whereas no statistically significant difference was found for the incisor relationship (overjet/overbite) (p > 0.05). To date, the efficacy of this appliance has not been extensively studied. According to the present prospective study, the Froggy Mouth protocol could be a valuable method as a myofunctional therapy for atypical swallowing, but further studies are needed to confirm these preliminary results. Full article
(This article belongs to the Special Issue Orthodontics and New Technologies)
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11 pages, 1132 KiB  
Article
Cone-Beam Computed Tomography for the Evaluation of Dental Pulp Chamber Volume: Implications for Clinics and Teaching
by Maria Llacer-Martínez, Benjamín Martín-Biedma, María T. Sanz, Juan I. Aura-Tormos, Pablo Fos-Galve, Zulima Fernández-Muñiz, José A. Vega and Mar Jovani-Sancho
Dent. J. 2024, 12(4), 95; https://doi.org/10.3390/dj12040095 - 3 Apr 2024
Viewed by 752
Abstract
The dental pulp chamber volume is a fundamental measurement in the field of endodontics, but also in forensic sciences, teaching and training, or tissue engineering. This study evaluates the precision of cone-beam computed tomography (CBCT) in comparison with computed micro-tomography (micro-CT) in evaluating [...] Read more.
The dental pulp chamber volume is a fundamental measurement in the field of endodontics, but also in forensic sciences, teaching and training, or tissue engineering. This study evaluates the precision of cone-beam computed tomography (CBCT) in comparison with computed micro-tomography (micro-CT) in evaluating the pulp chamber volume of the upper central incisors ex vivo. The intra-operator and inter-operator errors were evaluated, and the results for the two techniques were compared with those of a T-test for paired samples. The intra-operator and inter-operator errors were >0.05, indicating adequate reproducibility in each operator and no significant differences between their measurements. On the other hand, no significant differences between the two measurement techniques were found. The present results demonstrate that CBCT is a precise, feasible, and reproducible technique for the evaluation of the dental pulp chamber volume ex vivo. The results provided with this method are useful for different medical domains but also for the teaching and training of undergraduate and postgraduate students. Furthermore, the findings of this study carry significant clinical implications, as the accurate assessment of the pulp chamber volume is critical in the diagnosis and treatment of various endodontic conditions. The ability of CBCT to provide reliable 3D dental anatomy measurements can enhance the planning of endodontic treatments by allowing for a better understanding of the internal tooth morphology. Additionally, the precision and reproducibility of CBCT in assessing the pulp chamber volume can contribute to improved clinical outcomes and reduced complications during endodontic procedures. These findings further support the increasingly vital role of CBCT in modern clinical practice and underscore its value as an indispensable tool in the field of dentistry. Full article
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12 pages, 2543 KiB  
Article
Impact of Scanbody Geometry and CAD Software on Determining 3D Implant Position
by Judith Kropfeld, Lara Berger, Werner Adler, Katja Leonie Schulz, Constantin Motel, Manfred Wichmann and Ragai Edward Matta
Dent. J. 2024, 12(4), 94; https://doi.org/10.3390/dj12040094 - 3 Apr 2024
Viewed by 1116
Abstract
The implementation of CAD software in the digital production of implant prosthetics stands as a pivotal aspect of clinical dentistry, necessitating high precision in the alignment of implant scanbodies. This study investigates the influence of scanbody geometry and the method of superimposing in [...] Read more.
The implementation of CAD software in the digital production of implant prosthetics stands as a pivotal aspect of clinical dentistry, necessitating high precision in the alignment of implant scanbodies. This study investigates the influence of scanbody geometry and the method of superimposing in CAD software when determining 3D implant position. A standardized titanium model with three bone-level implants was digitized to create reference STL files, and 10 intraoral scans were performed on Medentika and NT-Trading scanbodies. To determine implant position, the generated STL files were imported into the Exocad CAD software and superimposed—automatically and manually—with the scanbody geometries stored within the software’s shape library. Position accuracy was determined by a comparison of the 3D-defined scanbody points from the STL matching files with those from the reference STL files. The R statistical software was used for the evaluation of the data. In addition, mixed linear models and a significance level of 0.05 were applied to calculate the p-values. The manual overlay method was significantly more accurate than the automatic overlays for both scanbody types. The Medentika scanbodies showed slightly superior precision compared to the NT-Trading scanbodies. Both scanbody geometry and the type of alignment in the CAD software significantly affect digital workflow accuracy. Manual verification and adjustment of the automatic alignment process are essential for precise implant positioning. Full article
(This article belongs to the Special Issue Dental Materials Design and Innovative Treatment Approach)
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16 pages, 1314 KiB  
Article
The Effect of Oral Care Foams and a Spray on Salivary pH Changes after Exposure to Acidic Beverages in Young Adults
by Maria Polyakova, Anna Egiazaryan, Vladlena Doroshina, Alexandr Zaytsev, Alexey Malashin, Ksenia Babina and Nina Novozhilova
Dent. J. 2024, 12(4), 93; https://doi.org/10.3390/dj12040093 - 3 Apr 2024
Viewed by 920
Abstract
Soft drinks may have a deleterious effect on dental health due to a high titratable acidity and a low pH that could be sufficient to induce tooth demineralization. The use of oral care products immediately after acidic challenge may diminish the erosive potential [...] Read more.
Soft drinks may have a deleterious effect on dental health due to a high titratable acidity and a low pH that could be sufficient to induce tooth demineralization. The use of oral care products immediately after acidic challenge may diminish the erosive potential of soft drinks. We assessed the effect of oral care foams and a spray on salivary pH changes after exposure to Coca-Cola® in young adults. Thirty-three consenting eligible patients were recruited in this double-blind, randomized, crossover study performed in six visits. Baseline examination included unstimulated salivary flow rate, stimulated salivary buffer capacity, and the simplified oral hygiene index (OHI-S) assessment. Salivary pH and time for pH recovery were registered after exposure to Coca-Cola® alone or that followed by the application of each of the studied products (an oral foam containing hydroxyapatite and probiotics, an oral foam containing amino fluoride, an alkaline oral spray, and tap water). Thirty-two patients completed the entire study protocol and were included in the final analysis. The mean minimum salivary pH and the mean oral clearance rate after rinsing with Coca-Cola® were 6.3 and 27 min, respectively. Further rinsing with any one of the tested solutions, including tap water, resulted in a significant improvement in these parameters. When the pH curves were plotted, the oral care products demonstrated a lower area under the curve that differed significantly from the area under the curve for Coca-Cola®; tap water did not differ significantly from Coca-Cola® and oral care products. Minimum salivary pH correlated positively with salivary buffer capacity and salivation rate, while salivary clearance correlated with OHI-S plaque scores. In conclusion, the effect of oral care foams and a spray on minimum salivary pH and salivary clearance after exposure to Coca-Cola® did not differ significantly among the tested products and tap water. Trial registration NCT06148662. Funding: none. Full article
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11 pages, 8898 KiB  
Article
The Evaluation of the Cervical Marginal Sealing of Direct vs. Indirect Composite Resin Restorations in MOD Cavities
by Bianca Tiron, Norina Consuela Forna, Ionuț Tărăboanță, Simona Stoleriu, Claudiu Topoliceanu, Mihaela Sălceanu, Răzvan Brânzan and Gianina Iovan
Dent. J. 2024, 12(4), 92; https://doi.org/10.3390/dj12040092 - 3 Apr 2024
Viewed by 814
Abstract
Introduction: The aim of this in vitro study was to compare the quality of marginal sealing at the cervical margins of indirect and direct composite resin restorations in mesio-occluso-distal (MOD) cavities. Material and method: MOD preparations were performed on 30 extracted teeth. The [...] Read more.
Introduction: The aim of this in vitro study was to compare the quality of marginal sealing at the cervical margins of indirect and direct composite resin restorations in mesio-occluso-distal (MOD) cavities. Material and method: MOD preparations were performed on 30 extracted teeth. The mesial cervical margin of each tooth was relocated using a flow composite resin (Enamel Plus HRi Flow, Micerium, Avegno, GE, Italy), then the samples were divided into three groups. In group A, the cavities were directly restored using a nanohybrid composite resin (Miris 2 Coltène Whaledent, Altstaetten, Switzerland) and a universal adhesive (ScotchBond Universal, 3M ESPE, St. Paul, MN, USA) by the etch-and-rinse strategy, for group B, the restoration procedure was similar but the self-etch strategy was used, and the samples in group C were filled using the inlay technique. Each sample was stored for 48 h in a 2% methylene blue solution, then it was cut in a mesio-distal direction using a Struers Secotom 50 device (Cleveland, OH, USA). The marginal sealing and adhesive interface were assessed for each sample at the cervical margin by optical microscopy (OM) and scanning electron microscopy (SEM). One-way ANOVA and Bonferroni post-hoc tests were used with a significance level of 0.05. Results: Significant differences were recorded within groups A and C, between mesial and distal margins (p = 0.02 in group A and p = 0.043 in group C). Conclusions: The marginal sealing is more effective in MOD inlay restoration compared to direct restorations. Relocation of the cervical margin with flow composite resin and the use of different adhesive strategies do not improve the marginal sealing. Full article
(This article belongs to the Section Preventive Dentistry)
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15 pages, 2173 KiB  
Article
Pilot Study on the Development and Integration of Anthropomorphic Models within the Dental Technician Curriculum
by Kristina Bliznakova, Minko Milev, Nikolay Dukov, Virginia Atanasova, Mariana Yordanova and Zhivko Bliznakov
Dent. J. 2024, 12(4), 91; https://doi.org/10.3390/dj12040091 - 2 Apr 2024
Viewed by 1142
Abstract
The effectiveness of modern medical education largely depends on the integration and utilization of digital technologies in teaching various disciplines. In this pilot usability study, we introduced 3D printed anthropomorphic dental models, specifically designed for the elective discipline “Digital and Metal-Free Techniques in [...] Read more.
The effectiveness of modern medical education largely depends on the integration and utilization of digital technologies in teaching various disciplines. In this pilot usability study, we introduced 3D printed anthropomorphic dental models, specifically designed for the elective discipline “Digital and Metal-Free Techniques in Dental Technology” from the curriculum of the Dental Technician specialty in the Medical University of Varna. The evaluation focused on dental technician students’ perception of this novel learning environment, its influence on their performance, and the potential for future application of these models and related 3D technologies in their professional practice. A validated satisfaction questionnaire was distributed among 80 students, comprising the total cohort. The results indicated a high acceptance rate, with nearly 95% of participants finding the use of digitally created 3D-printed dental models beneficial. More than 90% believed that exploring digital technologies would enhance their skills. The well-trained instructor’s competence in technology use convinced students of its value, with more than 98% expressing a willingness to incorporate these technologies into their future work for improved precision in dental models. However, due to the current high cost of needed equipment, only 10% of participants may practicably introduce this novel technology into their practical work. The use of anatomically accurate 3D printed models is a valuable addition to the current dental technician curriculum in medical colleges. Full article
(This article belongs to the Section Dental Education)
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15 pages, 8522 KiB  
Article
40-Year Outcome of Old-School, Non-Surgical Endodontic Treatment: Practice-Based Retrospective Evaluation
by Roland Frankenberger, Stephan Becker, Benedicta Beck-Broichsitter, Susanne Albrecht-Hass, Charlotte J. Behrens, Matthias J. Roggendorf and Andreas Koch
Dent. J. 2024, 12(4), 90; https://doi.org/10.3390/dj12040090 - 1 Apr 2024
Viewed by 819
Abstract
(1) Background: Non-surgical endodontic treatment has been shown to be clinically successful; however, clinical long-term data are scarce. This practice-based retrospective clinical investigation evaluated endodontic outcomes over 40 years and identified relevant clinical co-factors. (2) Methods: Two experienced dental practitioners in two different [...] Read more.
(1) Background: Non-surgical endodontic treatment has been shown to be clinically successful; however, clinical long-term data are scarce. This practice-based retrospective clinical investigation evaluated endodontic outcomes over 40 years and identified relevant clinical co-factors. (2) Methods: Two experienced dental practitioners in two different private dental practices treated 174 patients with 245 teeth from 1969 to 1993. After root canal obturation, either a new direct restoration (amalgam, resin composite, or glass-ionomer cement) or the re-cementation of a pre-existing prosthetic restoration or renewal of prosthetic restoration followed. Metal posts (operator A) or metal screws (operator B) were inserted when coronal substance loss was significant. The primary outcome (i.e., tooth survival) was achieved when the endodontically treated tooth was, in situ, painless and had full function at the end of the observation period. A secondary outcome, the impact of different prognostic factors on survival rate, was evaluated. (3) Results: The overall mean survival was 56.1% of all treated teeth after 40 years of clinical service, resulting in an annual failure rate of 1.1%. Most investigated clinical co-factors (jaw, tooth position, intracanal dressings, post/screw placement, and gender) showed no significant influence on survival. (4) Conclusions: Even with materials and techniques from the 1970s and 1980s, successful root canal treatment was achievable. Except for post-endodontic restorations, most of the evaluated factors had no significant influence on the clinical long-term survival of root canal-treated teeth. Full article
(This article belongs to the Special Issue Endodontics: From Technique to Regeneration)
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16 pages, 600 KiB  
Article
Prospective Cohort Study Identifies Medical Predictors of Treatment-Related Oral Toxicities in Oral and Oropharyngeal Cancer Patients
by Leticia Rodrigues-Oliveira, César Rivera, Xaviera A. López-Cortés, Milena Perez Mak, Ana Leticia Mores, Cesar Augusto Migliorati, Maria Cecília Querido de Oliveira, Natalia Rangel Palmier, Luiz Alcino Gueiros, Pablo Agustin Vargas, Thaís Bianca Brandão, Alan Roger Santos-Silva and Ana Carolina Prado-Ribeiro
Dent. J. 2024, 12(4), 89; https://doi.org/10.3390/dj12040089 - 1 Apr 2024
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Abstract
The dental treatment of patients with oral cavity and oropharyngeal squamous cell carcinoma (OOPSCC) may be challenging for dentists. This study aimed to characterize systemic changes in patients with OOPSCC undergoing dental treatment prior to cancer therapy, with a specific focus on laboratory [...] Read more.
The dental treatment of patients with oral cavity and oropharyngeal squamous cell carcinoma (OOPSCC) may be challenging for dentists. This study aimed to characterize systemic changes in patients with OOPSCC undergoing dental treatment prior to cancer therapy, with a specific focus on laboratory assessments. The primary objectives included identifying potential adverse events, such as infections or bleeding, resulting from dental procedures. Additionally, the study aimed to correlate baseline patient characteristics with treatment-related toxicities. This was a prospective cohort study that included 110 OOPSCC patients referred to the Dental Oncology Service at São Paulo State Cancer Institute, Brazil, between November/2019 and December/2020. Comorbidities, sociodemographic data, medication in use, cancer treatment-related toxicities, and altered laboratory tests results were correlated. The most common comorbidities and altered laboratory results were hypertension, dyslipidemia, diabetes, as well as elevated levels of C-reactive protein, hemoglobin, and hematocrit. Toxicities exhibited a progressive pattern over time, encompassing oral mucositis (OM), xerostomia, dysphagia, dysgeusia, trismus, and radiodermatitis. No correlation between comorbidities and cancer treatment-related toxicities, a positive correlation between medications in use and OM, and a negative correlation between medications and dysgeusia were found. OM was associated with altered thyroxine (T4) and free thyroxine (FT4), calcium, urea, creatinine, alkaline phosphatase, and syphilis. Family income and housing were OM predictors. Altered T4/FT4/urea/calcium/alkaline phosphatase/creatinine/syphilis may be useful clinical predictors of OM. Despite the elevated prevalence of comorbidities and abnormal laboratory findings, dental treatment prior to cancer treatment yielded no adverse events. Full article
(This article belongs to the Special Issue Dental Oncology)
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