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Journal of Periodontal Research Feb 2024The objective of this study was to systematically review the literature regarding diagnostic applications of ultrasound imaging for evaluation of the periodontium in... (Review)
Review
The objective of this study was to systematically review the literature regarding diagnostic applications of ultrasound imaging for evaluation of the periodontium in humans. The search was conducted on Medline, EMBASE, Web of Science, Scopus, Cochrane, and PubMed up to April 3, 2023. The studies included were exclusively human studies that assessed the periodontium with ultrasound (US) imaging (b-mode). Outcomes measured included alveolar bone level, alveolar bone thickness, gingival thickness, and blood flow quantification. References were imported to Covidence. Two reviewers conducted phases 1 and 2. The JBI risk assessment tool for cross-sectional studies was used. Extracted data included the transducer and measurements used and the study's outcomes. The search yielded 4892 studies after removing duplicates. From these, 25 studies were included and selected for extraction. Included studies retrieved outcomes from US examinations of the periodontal tissues. From the selected studies, 15 used US on natural teeth, 4 used US on implants, 2 used US on edentulous ridges, and 4 used color flow/power in US to evaluate the blood flow. The results of the present systematic review suggest that US might be a feasible and valuable diagnostic tool for the periodontium, with the potential to complement shortfalls of current radiographic technologies.
Topics: Humans; Cross-Sectional Studies; Periodontium; Gingiva; Ultrasonography; Periodontal Ligament; Mouth, Edentulous
PubMed: 37872805
DOI: 10.1111/jre.13194 -
BMC Oral Health Oct 2023Tooth decay is an infectious disease which, in its initial phase, leads to the formation of cavities in the teeth through decalcification of the enamel and local tissue... (Review)
Review
BACKGROUND
Tooth decay is an infectious disease which, in its initial phase, leads to the formation of cavities in the teeth through decalcification of the enamel and local tissue destruction. In addition to proper oral hygiene, prophylactic sealing of fissures and cavities with a sealant is a method of preventing the development of caries. The aim of this study is to summarise the effectiveness of fissure sealing of permanent teeth with fissure sealants compared to other preventive methods or no intervention.
METHOD
An umbrella review was carried out to achieve the purpose of our study. Searches were performed in Medline (via PubMed), Embase (via OVID), and Cochrane Library databases. Quality assessment of the included studies was performed using the AMSTAR2 tool. In addition, a manual search for recommendations/clinical practice guidelines on dental prophylaxis was performed.
RESULTS
204 publications were identified, of which 15 met the inclusion criteria. Based on the results of 3 systematic reviews, there was a statistically significant reduced odds of caries occurrence or development with prophylactic sealing of permanent teeth compared with no intervention - depending on the review and follow-up period odds ratio (OR) ranged from 0.06 [95%CI: (0.01-0.32)] to 0.28 [95%CI: (0.20-0.38)]. In the eight systematic reviews that analysed different sealants, there were no statistically significant differences between the types of materials used for prophylactic tooth sealing. For systematic reviews comparing the efficacy of fissure sealants with fluoride varnish, three reported no statistically significant difference in the efficacy of caries incidence, with only one systematic review based on 1 RCT finding a statistically significant difference in favour of fissure sealants.
CONCLUSION
Compared to the no intervention, dental sealing is an effective method for the prevention of dental caries. However, it is not possible to conclude conclusively which type of sealant and which of the available prophylactic methods is more effective in preventing caries.
Topics: Humans; Dental Caries; Dentition, Permanent; Fluorides; Pit and Fissure Sealants; Systematic Reviews as Topic
PubMed: 37891656
DOI: 10.1186/s12903-023-03499-6 -
International Endodontic Journal May 2024There is an increased tendency towards adopting minimally invasive interventions in dentistry, supported by advancement in materials and techniques. However, the... (Review)
Review
BACKGROUND
There is an increased tendency towards adopting minimally invasive interventions in dentistry, supported by advancement in materials and techniques. However, the decision-making process in choosing conservative or invasive treatments is influenced by several factors, particularly in permanent teeth with irreversible pulpitis.
OBJECTIVES
The objective of the study was to systematically review the literature regarding factors that influence decision-making for vital pulp therapy (VPT) as definitive treatment option in permanent mature teeth diagnosed with irreversible pulpitis.
METHODS
Two independent reviewers searched five electronic databases (PubMed, Embase, Web of Science, Scopus and Cochrane Library). Grey literature was searched through Google Scholar and contact with experts. Defined search keys were applied, and all peer-reviewed literature published with no language nor publication date limits were included. The All studies investigating the factors influencing treatment decision-making in mature permanent teeth with irreversible pulpitis were included. The quality of included studies was assessed by two independent reviewers using the Joanna Briggs Institute quality assessment tool.
RESULTS
Six articles were included in the review. All included studies used questionnaires to characterize clinician preferences and attitudes in choosing treatment options for mature permanent teeth with irreversible pulpitis. The available evidence suggests that dentist-related factors have a significant influence on the chosen treatment in teeth with irreversible pulpitis, with speciality training and years of experience influencing the choice of VPT over other treatment options. COVID-19 reportedly swayed the dentists' decision to favour VPT. Only one article studied the influence of patient-related factors, such as age and presence of spontaneous pain on decision-making. Of note, a history of cardiovascular disease moved dentists towards prescribing VPT.
DISCUSSION
Collectively, the included studies demonstrated an overriding influence of dentist-related factors on choosing among treatment options for painful teeth diagnosed with irreversible pulpitis. Patient-related factors were acknowledged but there are also potential factors such as socio-economic constraints that were not included in the component studies.
CONCLUSION
In teeth with irreversible pulpitis clinicians educational background influence the decision towards a specific treatment option. Further data, preferably derived from clinical records, is necessary in future investigations to explore the effect of other important factors related to both dentists and patients.
REGISTRATION
PROSPERO database (CRD42022339653).
Topics: Humans; Pulpitis; Dentition, Permanent; Dental Care; Pain; Pulpotomy
PubMed: 38326290
DOI: 10.1111/iej.14036 -
Anatomical Record (Hoboken, N.J. : 2007) Apr 2024Gomphodonts form a Triassic radiation of small to medium-bodied (<0.5-2.5 m in length) quadrupedal cynodonts characterized by labiolingually expanded gomphodont...
Gomphodonts form a Triassic radiation of small to medium-bodied (<0.5-2.5 m in length) quadrupedal cynodonts characterized by labiolingually expanded gomphodont postcanines. They were the dominant cynodont group in Middle and Late Triassic ecosystems from the Southern Hemisphere and the first predominantly herbivorous cynodonts to evolve. Gomphodonts were also the first therapsids to develop hypsodonty and a dentition with complex occlusal patterns, and their highly diagnostic upper and lower postcanines show many different morphologies. Here, we explored dental complexity in gomphodont cynodonts through time using geographic information system analysis and orientation patch count applied on 3D crown surfaces of upper and lower gomphodont postcanines belonging to 32 gomphodont taxa. This study reveals that the peak in postcanine complexity was reached early in the evolution of gomphodonts with the emergence in the Early Triassic of omnivorous or insectivorous forms with postcanines made of well-separated cusps and cingular cuspules. Traversodontids evolved simpler postcanines via coalescence of cusps into crests and the development of large occlusal basins, and the Middle Triassic radiation of traversodontids led to a sharp decrease in mean postcanine complexity. Simplification of the postcanines in traversodontids is interpreted as being related to a gradual increase in the consumption of plant material. Interestingly, the trend of insectivory/omnivory high postcanine complexity and herbivory low dental complexity in gomphodonts is opposite to the trend of dental complexity reported in some extant mammals, with omnivorous having low dental complexity and herbivorous higher. Postcanine complexity remained relatively stable throughout the evolution of traversodontids and only slightly diminished in the Late Triassic due to the presence of minute forms with particularly simple postcanines in the Rhaetian. The major phylogenetic diversity and taxonomic richness of Gomphodontia are represented in two periods of time: at the end of the Anisian, an age in which the postcanine complexity is simplifying, and at the early Carnian when the postcanine complexity in traversodontids, the only Gomphodontia represented, is stable.
Topics: Animals; Phylogeny; Ecosystem; Fossils; Tooth; Mammals; Biological Evolution
PubMed: 38282465
DOI: 10.1002/ar.25386 -
European Journal of Paediatric Dentistry Sep 2023Proper development of deciduous and mixed dentition is essential to the oral health of growing patients, and early interceptive orthopedic or orthodontic treatments are...
BACKGROUND
Proper development of deciduous and mixed dentition is essential to the oral health of growing patients, and early interceptive orthopedic or orthodontic treatments are indicated in specific clinical situations. Nowadays, orthodontists are subjected to a lot of pressure from growing patients and their parents about the orthodontic appliances that should be used. The aim of this article is to indicate how, when and why it is possible to effectively use aligners in growing patients.
CASE REPORT
Two case reports are illustrated, one with a Cl.II subdivision, mono lateral cross-bite and vertical growth, and the other with a skeletal and dental Cl.II, vertical skeletal pattern, proclined and fractured upper incisors. The efficacy/efficiency ratio of aligners is analyzed in order to evaluate the suitability of this appliance for the treatment. Limits and advantages of aligners are widely discussed.
CONCLUSION
Aligner treatment in growing patients shall be carefully studied to reach an optimal result. At present, a hybrid treatment strategy represents the best solution in growing patients with a complex clinical situation.
Topics: Humans; Dental Care; Dentition, Mixed; Incisor; Oral Health; Orthodontic Appliances
PubMed: 37668457
DOI: 10.23804/ejpd.2023.1959 -
Clinical Anatomy (New York, N.Y.) Apr 2024Cervical enamel projections (CEPs) represent a unique developmental and anatomical anomaly wherein the enamel structure extends apically beyond the cemento-enamel... (Review)
Review
Cervical enamel projections (CEPs) represent a unique developmental and anatomical anomaly wherein the enamel structure extends apically beyond the cemento-enamel junction of the tooth. In this scoping review, the existing literature on CEPs was evaluated to delineate their characteristics, prevalence, predilection for specific teeth and surfaces, clinical significance, and management approaches. Searches were conducted on MEDLINE (PubMed), Cochrane Library, and Embase databases using the keywords "enamel projection(s)" or "ectopic enamel." In total, 24 studies meeting inclusion criteria were included in the review. The prevalence of CEPs varied widely (8.3%-85.1%), predominantly manifesting as grade I or grade III. Mandibular first and second molars exhibited a higher incidence of CEPs, with a notable predilection for buccal surfaces. The consensus in most studies was that CEPs are associated with localized periodontal diseases. Recommendations inclined toward the removal of ectopic enamel during periodontal surgery to enhance periodontal attachment formation. However, decision-making should involve careful consideration of the benefits and drawbacks based on individual circumstances.
Topics: Humans; Furcation Defects; Molar; Tooth Cervix; Neck; Dental Enamel
PubMed: 38348736
DOI: 10.1002/ca.24141 -
European Journal of Dental Education :... Aug 2023The aim of this study was to fabricate 3-Dimensional (3D) tooth models to overcome procedural errors that occur during treatment and to improve endodontic management of...
INTRODUCTION
The aim of this study was to fabricate 3-Dimensional (3D) tooth models to overcome procedural errors that occur during treatment and to improve endodontic management of teeth with complex pulp morphology and dental anomalies.
MATERIALS AND METHODS
Three natural teeth were used to fabricate resinous tooth models (n = 90) and 90 natural teeth were used during root canal treatment. Models were fabricated from 1 mandibular canine (n = 30) and 2 maxillary molars (n = 60). Natural teeth were 30 mandibular canines, 30 mandibular molars and 30 maxillary molars.
RESULTS
Natural teeth and opaque resin models were significantly better than the clear resin models during access preparation (p = .003). In addition, the clear resin models were significantly better than the natural teeth and opaque resin models during shaping, obturation and as an educational tool (p < .001, p < .001 and p < .001 respectively).
CONCLUSIONS
Although it takes more time and effort to produce 3D (3D) tooth models from each natural tooth used in the study, it can give more accurate results during evaluation.
Topics: Dental Pulp Cavity; Tooth Root; Education, Dental; Tooth; Treatment Outcome
PubMed: 36153811
DOI: 10.1111/eje.12857 -
Australian Endodontic Journal : the... Sep 2023The aims of this study were to develop a new classification for pre-eruptive intracoronal resorption(PIR) with different resorption areas and sizes and to compare the...
The aims of this study were to develop a new classification for pre-eruptive intracoronal resorption(PIR) with different resorption areas and sizes and to compare the new classification scores among observers from different specialities and professional experience. The PIR was evaluated according to the new classification by two dentomaxillofacial radiologists and two endodontists. Information regarding the patient's age, gender, systemic diseases, the number of PIR, the affected tooth area and the size of the PIR was recorded. The new classification system showed that PIR six and seven defects were the most detected. Regarding jaw regions, the highest reliability was seen in the maxillary central teeth between observers I and IV, and maxillary premolar-molar teeth between observers II and III. This study revealed that PIR can be found in both root and crown dentine. Professional experience and specialty and awareness of the PIR defect may affect the diagnosis.
Topics: Humans; Dentition, Permanent; Tooth, Unerupted; Reproducibility of Results; Tooth Resorption; Tooth Eruption; Tooth Crown; Exanthema
PubMed: 36317538
DOI: 10.1111/aej.12706 -
Journal of Orthodontics Mar 2024To compare the stress distribution and total strain applied to the dentition, periodontal ligament (PDL) and cortical and trabecular bones by three Class II correctors...
OBJECTIVE
To compare the stress distribution and total strain applied to the dentition, periodontal ligament (PDL) and cortical and trabecular bones by three Class II correctors using finite element analysis.
DESIGN
Three-dimensional analysis of stresses and total strain of the dentition with three Class II correctors.
SETTING
Computational study.
METHODS
Three-dimensional finite element models of Class II elastics, the Forsus Fatigue Resistant Device (FRD) and the Carriere Motion Appliance (CMA) were constructed from a cone-beam computed tomography (CBTC) image of an orthodontic Class II patient. The distribution of stress (von Mises and principal stress) and the total strain (mm) in maxillo-mandibular dentition, PDL, cortical and trabecular bone were analysed.
RESULTS
The highest von Mises yield and the maximum principal stress in the three models were found at the teeth, followed by the cortical bone, trabecular bone and PDL. The maximum stress and total deformation were located at the upper canines and lower molars in the Class II elastics and CMA models, in the upper first molars in the Forsus FRD and CMA, and in the lower first premolars in the Forsus FRD. In addition, stress was distributed in the anterior and posterior regions of the teeth, and the total deformation was found in the distal direction in the upper arch and in the mesial direction in the lower arch.
CONCLUSION
The stress concentrations in the three models were located close to the active components of each appliance, producing specific patterns of stress distribution and displacement that should be taken into account when planning the type of appliance to be used for the correction of the Class II malocclusion.
Topics: Humans; Finite Element Analysis; Tooth; Malocclusion, Angle Class II; Molar; Cone-Beam Computed Tomography
PubMed: 37646245
DOI: 10.1177/14653125231195096 -
Journal of Periodontal Research Apr 2024The aim of this study was to investigate the thickness of acellular extrinsic fibre cementum (AEFC) at four root positions of anterior and posterior teeth with special...
OBJECTIVE
The aim of this study was to investigate the thickness of acellular extrinsic fibre cementum (AEFC) at four root positions of anterior and posterior teeth with special focus on functional aspects. Furthermore, the correlations between cementum thickness and chronological age and sex are investigated.
BACKGROUND
While numerous studies confirm continuous cementum apposition with age, masticatory forces as well as physiological and orthodontically induced tooth movements also have the potential to affect tooth cementum thickness.
MATERIALS AND METHODS
Undecalcified teeth were embedded in resin and transverse-sectioned in the cervical third of the root. Two sections per root were selected, and digital images at four positions were obtained (mesial, distal, oral, and vestibular) using light microscopy. The AEFC thickness of 99 teeth (anterior = 66, posterior = 33, male = 54, female = 45) were measured in both sections. The differences in mean values between root positions and the association of root position variation with tooth type, age, sex, and subject as well as the overall effects of age and sex were analysed using a mixed model.
RESULTS
First incisors and canines showed the greatest mean AFEC thickness, in contrast to premolars which had the lowest values. Differences were found across the four root positions, with a pattern varying considerably between anterior and posterior teeth and between maxilla and mandible in the anterior teeth. An interaction between root position and subject pointed to the existence of an individual component in the variation of AEFC thickness across the four root positions. There was an age trend with an almost linear increase in cementum thickness of 1 μm per year. Overall, females tended to exhibit a significantly lesser AEFC thickness compared to males.
CONCLUSIONS
Distinct differences in the pattern of thickness values across the four root positions in anterior and posterior teeth support the assumption that the AEFC is strongly affected by functional processes. In addition to sex-specific differences and age-related trends, the root position variation of AEFC thickness varies from individual to individual.
Topics: Humans; Male; Female; Dental Cementum; Tooth Root; Bicuspid; Incisor; Maxilla
PubMed: 38126232
DOI: 10.1111/jre.13226