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Brazilian Oral Research 2024The aim of this study was to analyze the expression of mast cell markers toluidine blue, c-kit, and tryptase and presence of mononuclear inflammatory cells in oral...
The aim of this study was to analyze the expression of mast cell markers toluidine blue, c-kit, and tryptase and presence of mononuclear inflammatory cells in oral lichen planus (OLP) and oral lichenoid lesions related to dental amalgam. Nineteen specimens of OLP, OLLC, and healthy oral mucosa were selected. Mononuclear inflammatory cells were analyzed. Histochemical and immunohistochemical analyses were performed using toluidine blue, anti-c-kit and anti-tryptase reagents, and the results were quantified in areas A and B of connective tissue. Mast cells of all OLP and OLLC samples were positive for toluidine blue, c-kit, and tryptase. The density of toluidine blue+, c-kit+ and tryptase+ mast cells was higher in tissue with OLP and OLLC compared with healthy controls (p < 0.05). No difference was noted in mast cells density between OLP and OLLC (p > 0.05). The density of tryptase+ mast cells was higher in the subepithelial region (area A) than the region below it (Area B) in OLLC (p = 0.047). The mononuclear inflammatory cell density was higher in OLLC compared to OLP, but without statistical significance (p > 0.05). A positive statistical correlation was found between mononuclear immune cells and density of c-kit+ and tryptase+ mast cells in OLP (r = 0.943 and r = 0.886, respectively). Our data demonstrate that the etiopathogenesis process of OLP and OLLC modulates the expansion and degranulation of mast cells; mast cells density, however, was similar between OLP and OLLC. The distribution of mast cells appears to vary along the lamina propria.
Topics: Humans; Mast Cells; Lichen Planus, Oral; Dental Amalgam; Tolonium Chloride; Tryptases
PubMed: 38198305
DOI: 10.1590/1807-3107bor-2024.vol38.0005 -
Dermatology and Therapy Oct 2023Interleukin-17 plays a pivotal role in both hidradenitis suppurativa (HS) and in maintaining oral homeostasis, but their potential link remains unknown. Thus, we aimed...
INTRODUCTION
Interleukin-17 plays a pivotal role in both hidradenitis suppurativa (HS) and in maintaining oral homeostasis, but their potential link remains unknown. Thus, we aimed to evaluate and quantify the oral burden of patients with HS.
METHODS
In this real-life, multicenter, cross-sectional study, patients with HS were clinically evaluated by two board-certified dermatologists and two board-certified dentists. Oral comorbidities were carefully collected with medical history and therapeutic information.
RESULTS
A total of 102 patients (44.0 ± 0.9 years, body mass index 27.0 ± 2.2 kg/m) were enrolled. Remarkably, 48% and 43% did not undergo at least an oral hygiene or a dental visit each year, respectively. Oral disorders were found in 55.9% of patients with HS, in particular 39.2% had caries and 46.7% reported at least one missing tooth. The main oral manifestations in patients with HS were recurrent aphthous stomatitis (N = 19, 19.2%), amalgam tattoo (N = 14, 14.1%), leukoplakia (N = 11, 11.1%), nicotinic stomatitis (N = 9, 9.1%), papilloma (N = 8, 8.1%), and geographic tongue (N = 8, 8.1%). Whilst the main predictor of oral pathological conditions was Hurley staging (P = 0.0276), multivariate regression analysis indicated that gender and International Hidradenitis Suppurativa Severity Score System (IHS4) were the main predictors for the presence of caries and number of missing teeth.
CONCLUSION
As a result of the relevant oral burden in patients with HS, dentists should be part of the multidisciplinary team and oral education should be promoted among patients with HS.
PubMed: 37653235
DOI: 10.1007/s13555-023-01006-x -
Brazilian Oral Research 2023A multicenter, randomized controlled clinical trial evaluated the effectiveness of two treatments for deep caries lesions in permanent molars - selective caries removal... (Randomized Controlled Trial)
Randomized Controlled Trial
A multicenter, randomized controlled clinical trial evaluated the effectiveness of two treatments for deep caries lesions in permanent molars - selective caries removal (SCR) to soft dentin with restoration in a single visit, and stepwise excavation (SW) - regarding pulp vitality for a 5-year follow-up period. The present study aimed to determine the cost-effectiveness of these treatments. Treatments were conducted in two Brazilian cities (Brasília and Porto Alegre). At baseline, 299 permanent molars (233 patients) were treated and 229 teeth (174 patients) were evaluated after 5 years. The discounted cash flow method was adopted. The total cost of each treatment was calculated, and the failure cost (endodontic treatment + restoration) was added to the final cost, according to the 5-year failure rates of each therapy (20% for SCR and 44% for SW). A public health service unit composed of three dentists in 4-hour work shifts was used to calculate the monetary value of the treatments, assuming a total of 528 treatments/month. Considering the 229 teeth evaluated after 5 years (115 SCR and 114 SW), SCR provided savings of 43% (amalgam) and 41% (resin composite) per treatment, compared to SW. The SCR technique provides benefits for public finances (direct economy) and for public health services (increase in the number of treatments performed). Considering that maximizing profit and reducing costs are powerful motivating factors for adopting a certain treatment, this study provides data to better support the decision-making process, regarding the management of deep caries lesions in permanent molars.
Topics: Humans; Cost-Benefit Analysis; Dental Caries Susceptibility; Dental Care; Molar; Brazil
PubMed: 37672417
DOI: 10.1590/1807-3107bor-2023.vol37.0083 -
BMC Oral Health Jul 2023Paediatric dentistry is a branch of dental specialty that focuses on dental care for children from infancy through adolescence. However, there is no standardised...
BACKGROUND
Paediatric dentistry is a branch of dental specialty that focuses on dental care for children from infancy through adolescence. However, there is no standardised national undergraduate paediatric dental curriculum in Malaysia. The present study aimed to identify relevant topics for undergraduate paediatric dental curricula and to determine the appropriate cognitive and psychomotor levels for each topic based on the consensus among paediatric dental experts.
METHODS
Potential relevant undergraduate paediatric dentistry topics were initially drafted and revised according to the revised national competency statement. The final draft included 65 topics clustered under 18 domains. A fuzzy Delphi method was used and experts who fulfilled the inclusion criteria were invited to anonymously ranked the importance of relevant topics using a five-point Likert scale and proposed suitable cognitive and psychomotor levels for each topic. Fuzzy evaluation was then performed, and experts were considered to have reached a consensus if the following three conditions were achieved: (a). the difference between the average and expert rating data was ≤ 0.2; (b). the average expert consensus was ˃70%; and (c). the average fuzzy number was ≥ 0.5. Subsequently, the mean ratings were used to determine the cognitive and psychomotor levels.
RESULTS
20 experts participated in the survey. 64 out of 65 paediatric dentistry topics were deemed acceptable. The average fuzzy number ranged from 0.36 to 0.85, while the average Likert score ranged from 3.05 to 5.00. The topic "Dental amalgam" was rejected based on expert consensus since the average fuzzy number was 0.36. The most significant topic was "Pit and fissure sealant", followed by "Preventive advice", "Early childhood caries", "Dental caries in children & adolescent", "Management of dental caries in paediatric patients", and "Consent" which were equally ranked as the second most important topics. According to Bloom's and Simpson's taxonomies, most of the paediatric dentistry topics were rated adequate for undergraduate students at the cognitive level of "Apply" (C3) and a psychomotor level of "Guided response" (P3).
CONCLUSION
The current study successfully identified relevant undergraduate paediatric dentistry topics using the fuzzy Delphi method, which can facilitate future educators to improve existing Malaysian undergraduate paediatric dental curricula.
Topics: Humans; Child; Child, Preschool; Adolescent; Consensus; Dental Caries; Students; Curriculum; Education, Dental
PubMed: 37407955
DOI: 10.1186/s12903-023-03130-8 -
Human & Experimental Toxicology 2024This study examined the impact of mercury (Hg) vapor exposure from amalgams among all American pregnant women. Amalgam-Hg vapor exposure among 1,665,890...
This study examined the impact of mercury (Hg) vapor exposure from amalgams among all American pregnant women. Amalgam-Hg vapor exposure among 1,665,890 weighted-pregnant women ( = 37) was examined in the 2015-2020 National Health and Nutrition Examination Survey (NHANES). Correlation coefficients between amalgam surfaces and daily micrograms (µg) of urinary Hg excretion and daily µg of Hg vapor exposure from amalgams per kilogram (Kg) bodyweight were calculated. Daily Hg vapor exposure from amalgams was compared to Hg vapor safety limits. About 600,000 pregnant women (∼36%) had at least one amalgam surface. Median daily urinary Hg excretion was ∼2.5-fold higher among pregnant women with amalgams as compared to pregnant women without amalgams. A significant correlation was observed between the number of amalgam surfaces and daily urinary Hg excretion. Among pregnant women with amalgams, it was estimated that the median daily Hg vapor dose from amalgams was 7.66 µg of Hg and 0.073 µg of Hg/Kg bodyweight. Among all pregnant women, ∼28% received daily Hg vapor doses from amalgams above the least restrictive United States (US) Environmental Protection Agency (EPA) safety limit and ∼36% received above the most restrictive California (CA) EPA safety limit. Given the potential for fetal toxicological effects from prenatal Hg vapor exposure, special emphasis needs to be placed on reducing/eliminating amalgams in pregnancy/women of reproductive age and future studies should evaluate adverse pregnancy outcomes.
Topics: Humans; Female; Pregnancy; Pregnant Women; Nutrition Surveys; Mercury; Dental Amalgam
PubMed: 38316638
DOI: 10.1177/09603271241231945 -
Dental Research Journal 2023Similarity in the appearance of a monolithic restoration with the adjacent teeth is necessary. This study aims to influence the foundation material type and ceramic...
BACKGROUND
Similarity in the appearance of a monolithic restoration with the adjacent teeth is necessary. This study aims to influence the foundation material type and ceramic thickness on the final color of zirconia-reinforced lithium silicate (ZLS) ceramic.
MATERIALS AND METHODS
In this experimental study, the A2 translucent blocks of ZLS were sectioned into rectangular specimens with thicknesses 1, 1.5, and 2 mm ( = 15). Substructure materials include resin composite (B1, D2, A2, A3, and C3), nickel chrome alloy, amalgam, and white and black substrate. Substructure material of resin composite with A2 color was proposed as the control group. The value of the color difference (ΔE) is calculated by the CIEDE2000 formula. Data analysis was accomplished by two-factor repeated measures ANOVA and one-sample -test (α =0.05).
RESULTS
The mean value of maximum ΔE with a black substrate (12.13 ± 0.17) at 1 mm ceramic thickness and the mean value of minimum ΔE with B1 resin composite foundation material (0.02 ± 0.17) at 2 mm ceramic thickness are visible. The significant effect of the foundation restoration type, thickness, and interaction between them is visible on ΔE ( < 0.001).
CONCLUSION
Different thickness is required to meet ideal esthetic outcomes with different substrates. Under the conditions of this investigation, zirconia-reinforced lithium silicate over black, white, nickel-chromium, and amalgam did not meet acceptable outcomes.
PubMed: 38020248
DOI: No ID Found -
Materials (Basel, Switzerland) Apr 2024Dental amalgams have been used by dentists for the restoration of posterior human teeth. However, there have been concerns about the release of mercury from amalgams...
Dental amalgams have been used by dentists for the restoration of posterior human teeth. However, there have been concerns about the release of mercury from amalgams into the oral cavity. The objective of the present research is to study the effect of titanium (Ti) nanoparticles on the microstructural mechanism of the release of mercury vapor in two commonly used brands of dental amalgam (the Dispersalloy: 11.8% Cu; the Sybralloy: 33% Cu). Ti powder was added to both the Dispersalloy and the Sybralloy in increments of 10 mg up to 80 mg. The addition of Ti powder to both brands of dental amalgam has been found to result in a considerable decrease in Hg vapor release. The decrease in the Hg vapor release due to Ti addition has been explained by the formation of strong Hg-Ti covalent bonds, which reduce the availability of Hg atoms for evaporation. The Ti atoms in excess of the solubility limit of Ti in Hg reside in the grain boundaries, which also reduces the evaporation of Hg from the amalgam. The binding of Hg with Ti via a strong covalent bond also results in a significant improvement in mechanical properties such as Vickers hardness.
PubMed: 38612175
DOI: 10.3390/ma17071662 -
PloS One 2023This study investigates the biomechanical performance of various dental materials when filled in different cavity designs and their effects on surrounding dental...
This study investigates the biomechanical performance of various dental materials when filled in different cavity designs and their effects on surrounding dental tissues. Finite element models of three infected teeth with different cavity designs, Class I (occlusal), Class II mesial-occlusal (MO), and Class II mesio-occluso-distal (MOD) were constructed. These cavities were filled with amalgam, composites (Young's moduli of 10, 14, 18, 22, and 26 GPa), and glass carbomer cement (GCC). An occlusal load of 600 N was distributed on the top surface of the teeth to carry out simulations. The findings revealed that von Mises stress was higher in GCC material, with cavity Class I (46.01 MPa in the enamel, 23.61 MPa in the dentin), and for cavity Class II MO von Mises stress was 43.64 MPa, 39.18 MPa in enamel and dentin respectively, while in case of cavity Class II MOD von Mises stress was 44.67 MPa in enamel, 27.5 in the dentin. The results showed that higher stresses were generated in the non-restored tooth compared to the restored one, and increasing Young's modulus of restorative composite material decreases stresses in enamel and dentin. The use of composite material showed excellent performance which can be a good viable option for restorative material compared to other restorative materials.
Topics: Finite Element Analysis; Composite Resins; Elastic Modulus; Glass Ionomer Cements; Dental Restoration, Permanent; Dental Stress Analysis; Stress, Mechanical
PubMed: 38128035
DOI: 10.1371/journal.pone.0295582 -
Dentistry Journal Apr 2024(1) Background: Non-surgical endodontic treatment has been shown to be clinically successful; however, clinical long-term data are scarce. This practice-based...
(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.
PubMed: 38668002
DOI: 10.3390/dj12040090 -
Journal of Dental Sciences Jul 2023As esthetic demands with direct restorations, tooth-colored materials were used to replace amalgam filling gradually. However, little is known about the tooth-colored...
BACKGROUND/PURPOSE
As esthetic demands with direct restorations, tooth-colored materials were used to replace amalgam filling gradually. However, little is known about the tooth-colored restorative materials for decayed teeth in Taiwan. In this study, the use of composite resin, glass ionomer cement, and compomer was analyzed by National Health Insurance Research Database (NHIRD).
MATERIALS AND METHODS
A retrospective study was conducted to analyze the registered database compiled by Taiwanese NHIRD from 1997 to 2013. The results were further to analyze the application of tooth-colored restorative materials by sex and age. In addition, time trends of dental visits for each tooth-colored restorative material were also investigated.
RESULTS
The average annual composite resin filling (CRF) ratio was 18.41% of nationwide population in Taiwan. The prevalence of CRF stratified by sex and age was significantly increased from 1997 to 2013 ( for trend <0.0001). The time trends of dental visits for CRF were significantly increased ( for trend <0.0001). The average annual glass ionomer cement filling (GICF) ratio was 1.79% of Taiwanese population. The prevalence of GICF stratified by sex and age was demonstrated a decreased pattern ( for trend <0.0001). The time trends of dental visits for GICF were significantly decreased ( for trend <0.0001). The average annual compomer filling ratio was 0.57% of whole population in Taiwan.
CONCLUSION
Form the results of this registry-based study, a significant increased trend of CRF for decayed teeth was observed in Taiwanese population during past 17 years.
PubMed: 37404646
DOI: 10.1016/j.jds.2023.01.033