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Journal of Functional Biomaterials May 2024There is a vast amount of published literature concerning dental veneers; however, the effects of tooth preparation, aging, veneer type, and resin cement type on the... (Review)
Review
There is a vast amount of published literature concerning dental veneers; however, the effects of tooth preparation, aging, veneer type, and resin cement type on the failure of dental veneers in laboratory versus clinical scenarios are not clear. The purpose of the present narrative review was to determine the principal factors associated with failures of dental veneers in laboratory tests and to understand how these factors translate into clinical successes/failures. Articles were identified and screened by the lead author in January 2024 using the keywords ''dental veneer", "complication", "survival rate", "failure", and "success rate" using PubMed/Medline, Scopus, Google Scholar, and Science Direct. The inclusion criteria included articles published between January 1999 and January 2024 on the topics of preparation of a tooth, aging processes of the resin cement and veneer, translucency, thickness, fabrication technique of the veneer; shade, and thickness of the resin cement. The exclusion criteria included articles that discussed marginal and internal fit, microhardness, water sorption, solubility, polishability, occlusal veneers, retention, surface treatments, and wear. The results of the present review indicated that dental veneers generally have a high survival rate (>90% for more than 10 years). The amount of preserved enamel layer plays a paramount role in the survival and success rates of veneers, and glass-ceramic veneers with minimal/no preparation showed the highest survival rates. Fracture was the primary failure mechanism associated with decreased survival rate, followed by debonding and color change. Fractures increased in the presence of parafunctional activities. Fewer endodontic complications were associated with veneer restorations. No difference was observed between the maxillary and mandibular teeth. Fractures can be reduced by evaluation of occlusion immediately after cementation and through the use of high-strength veneer materials, resin cements with low moduli, and thin layers of highly polished veneers. Debonding failures can be reduced with minimal/no preparation, and immediate dentin sealing should be considered when dentin is exposed. Debonding can also be reduced by preventing contamination from blood, saliva, handpiece oil, or fluoride-containing polishing paste; through proper surface treatment (20 s of hydrofluoric acid etching for glass ceramic followed by silane for 60 s); and through use of light-cured polymerization for thin veneers. Long-term color stability may be maintained using resin cements with UDMA-based resin, glass ceramic materials, and light-cure polymerization with thin veneers.
PubMed: 38786642
DOI: 10.3390/jfb15050131 -
Cureus Nov 2023Mandibular advancement devices (MADs) remain a popular non-invasive treatment modality for the management of obstructive sleep apnea (OSA). However, the occlusal side... (Review)
Review
Mandibular advancement devices (MADs) remain a popular non-invasive treatment modality for the management of obstructive sleep apnea (OSA). However, the occlusal side effects from long-term therapy may result in poor patient compliance and patient drop-outs. Hence, knowledge of the possible side effects of these devices on occlusion is necessary. This article attempts to systematically review the evidence available in support of the possible long-term effects of mandibular advancement therapy on occlusion in adult sleep apnea patients. A detailed search was conducted for unpublished and published literature and their references in various electronic databases. A grey literature search was also performed. Studies until June 30, 2022, were selected. Randomized controlled trials, non-randomized trials, and cohort studies investigating the occlusal side effects of MADs for the treatment of snoring or OSA with a follow-up of at least four years were included. Study selection, data extraction, and risk of bias assessment were performed individually and in duplicate. The risk of bias was assessed by Cochrane tools for randomized and non-randomized studies. Fourteen studies were selected for the final qualitative analysis. The side effects reported were upper incisor retroclination, lower incisor proclination, decreased overjet and overbite, and change in the total occlusal contact area. The review concludes that long-term MAD therapy has statistically and clinically significant effects on occlusion.
PubMed: 38090465
DOI: 10.7759/cureus.48682 -
Annals of Anatomy = Anatomischer... Oct 2023Evidence regarding the etiology or effective treatments for chronic orofacial pain, the majority diagnosed as temporomandibular disorder (TMD), is limited. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Evidence regarding the etiology or effective treatments for chronic orofacial pain, the majority diagnosed as temporomandibular disorder (TMD), is limited.
PURPOSE
To investigate whether occlusal equilibration therapy (ET) and decreasing the (higher) angle of the lateral guidance on the nonworking-side leads to a reduction in chronic TMDs intensity.
METHODS
It was conducted a randomized, explanatory, single blind with blinded assessment, placebo-controlled trial with strong protection against bias involving patients with chronic TMDs. Participants were randomly assigned to receive equilibration therapy or sham therapy. ET in this study consisted of minimal invasive occlusal remodeling to obtain balanced occlusion with reduction of the steeper angle of lateral mandibular movement with respect to the Frankfort plane. The primary outcome was a change in the pain intensity score (on a 0-10 point scale, with 0 indicating no pain and 10 the worst possible pain) at month 6. Secondary outcomes include maximum unassisted mouth opening and psychological distress.
RESULTS
A total of 77 participants underwent randomization, 39 of whom received ET and 38 sham therapy. The trial was stopped early for efficacy, according to preestablished rules when 67 participants (n = 34, n = 33, respectively) had completed the analysis. At month 6, the mean unadjusted pain intensity score was 2.1 in the ET and 3.6 in the sham therapy group (adjusted mean difference, -1.54; 95% confidence interval [CI] -0.5 to -2.6; P = 0.004; ANCOVA model). The mean increase in maximum unassisted mouth opening (main secondary outcome) was significantly higher in the real therapy group (adjusted mean difference 3.1 mm, 95% CI 0.5-5.7, p = 0.02).
CONCLUSION
ET significantly reduced the intensity of facial pain associated with chronic TMDs and increased maximum unassisted mouth opening, as compared with sham therapy, over the course of 6 months. There were no serious adverse events. Funded by the Instituto de Salud Carlos III from the Ministry of Science and Innovation of the Government of Spain and European Regional Development Fund, Grant nº PI11/02507; "una manera de hacer Europa".
Topics: Humans; Single-Blind Method; Pain; Temporomandibular Joint Disorders; Treatment Outcome; Mandible
PubMed: 37302432
DOI: 10.1016/j.aanat.2023.152117 -
Clinical and Experimental Dental... Oct 2023Improving the oral health of the elderly is crucial to improving their general health and quality of life. To reach this goal, it is necessary to start with a...
OBJECTIVES
Improving the oral health of the elderly is crucial to improving their general health and quality of life. To reach this goal, it is necessary to start with a comprehensive oral health assessment and a detailed treatment plan. The aim of this study was, therefore, to develop a comprehensive Oral Health Assessment Tool for the geriatric population.
MATERIAL AND METHODS
Following a panel of experts' consultation, a clinical form and a self-assessment questionnaire were developed, encompassing eight domains: dental caries, periodontal diseases, partial and complete edentulism, oral soft tissue lesions, occlusion, xerostomia, temporomandibular joints, and oral or oral prostheses hygiene. Subsequently, a pilot study was conducted to appraise the clinical form and questionnaire involving 84 residents of an Iranian nursing home. After securing ethics approval, both the qualitative and quantitative aspects of the self-assessment questions' validity and reliability were assessed, and specificity and sensitivity were calculated.
RESULTS
The mean age of the participants was 69.8 (±4.1) years, and 86% had less than 12 years of education. The questions regarding the number of remaining teeth and the number of decayed teeth had the highest sensitivity (97% and 88%), respectively. Questions regarding the presence of periodontitis and gingivitis had the highest specificity (both 100%).
CONCLUSIONS
A Comprehensive Geriatric Oral Health Assessment Tool has been developed and its validity and reliability evaluated in a pilot study. It should now be further evaluated in larger studies.
Topics: Humans; Aged; Oral Health; Dental Caries; Quality of Life; Iran; Pilot Projects; Reproducibility of Results; Dental Implants
PubMed: 37767734
DOI: 10.1002/cre2.791 -
American Journal of Orthodontics and... May 2024The purpose of this study was to investigate the longitudinal psychosocial effects of changes in malocclusion from adolescence to adulthood on oral health-related...
INTRODUCTION
The purpose of this study was to investigate the longitudinal psychosocial effects of changes in malocclusion from adolescence to adulthood on oral health-related quality of life (OHRQOL), self-rated dental appearance, and overall life satisfaction.
METHODS
The Dunedin Multidisciplinary Health and Development Study is a longitudinal birth cohort study of 1037 children born at Queen Mary Hospital, Dunedin, New Zealand, between April 1, 1972 and March 31, 1973. Data on their health and development, including dental examinations, has since been collected periodically. Malocclusion severity was measured using the Dental Aesthetic Index in participants aged 15 and 45 years (data collected at age 18 years was supplemented for data missing at age 15 years). Other data collected included clinically assessed oral health (dental caries and periodontal disease experience) and self-rated dental appearance, OHRQOL, life satisfaction, and personality traits.
RESULTS
Malocclusion data were available for 868 participants in adolescence and 834 aged 45 years. For those with a severe handicapping malocclusion at 15 years old, 46.6% who received orthodontic treatment transitioned to a resolved (ie, mild-moderate) malocclusion when aged 45 years, whereas only 16.2% of those who did not receive orthodontic treatment made that transition. A transition to a worse malocclusion was associated with impacts on OHRQOL when aged 45 years in the subdomains of functional limitation, psychological discomfort, and physical disability as well as worse self-ratings of dental appearance, and these findings were held after adjusting for potential confounders. Malocclusion was not associated with overall life satisfaction.
CONCLUSIONS
Maintenance of acceptable occlusion after orthodontic treatment requires a strong emphasis on achieving and maintaining excellent dental health and avoiding chronic oral conditions such as dental caries and tooth loss. The long-term benefits of orthodontic treatment may diminish by midlife unless good dental health is maintained. Orthodontists have the responsibility to raise awareness among their patients on how to maintain good oral health after orthodontic treatment.
PubMed: 38804994
DOI: 10.1016/j.ajodo.2024.04.013 -
The Angle Orthodontist Jul 2023To determine patient perceptions and attitudes regarding posttreatment changes at least 2 years after completion of orthodontic treatment.
OBJECTIVES
To determine patient perceptions and attitudes regarding posttreatment changes at least 2 years after completion of orthodontic treatment.
MATERIALS AND METHODS
A total of 125 patients (75 females, 50 males, aged 22.93 ± 2.98 years) were enrolled at least 2 years after debonding. Participants had either vacuum-formed retainers (VFRs) or bonded retainers (BRs). Posttreatment changes were evaluated digitally by comparing tooth positions at debonding and at least 2 years after debonding. A questionnaire was used to assess patient attitudes. Retainer usage, awareness of relapse, satisfaction with their current occlusion, and whether posttreatment changes were severe enough for them to consider retreatment were investigated.
RESULTS
All patients showed some posttreatment changes in irregularity. Only 74% of patients wearing VFRs and 47.1% of patients wearing BRs were aware of posttreatment changes. Patients were more likely to notice posttreatment changes if there was an increase in mandibular irregularity of 1-3 mm. Awareness of posttreatment changes in the upper arch was higher in both groups. The majority of participants were satisfied with the results even if they noticed some minor posttreatment changes (VFR, 69.4%; BR, 76.5%). Dissatisfaction with posttreatment changes did not necessarily mean that a patient wanted retreatment.
CONCLUSIONS
A total of 26% of patients wearing VFRs and 52.9% of patients wearing BRs were unaware of posttreatment changes. Approximately half of the patients who noticed posttreatment changes were still satisfied with the result 2 years after debonding. Even patients dissatisfied with the effect of posttreatment changes do not necessarily want retreatment.
Topics: Male; Female; Humans; Orthodontic Appliance Design; Dental Occlusion; Mandible; Orthodontic Appliances, Fixed; Orthodontic Retainers; Attitude
PubMed: 36946588
DOI: 10.2319/100222-677.1 -
Journal of Pharmacy & Bioallied Sciences Jul 2023The position of the canine has a key role in facial harmony, dental aesthetics, functional occlusion, and health of temperomandibular joint. Maxillary canine impaction...
INTRODUCTION
The position of the canine has a key role in facial harmony, dental aesthetics, functional occlusion, and health of temperomandibular joint. Maxillary canine impaction is the second most common tooth after third molars impaction. Maxillary canines are more prone to impaction due to longer path of eruption.
SETTINGS AND DESIGN
All the patients were examined in the Dental Chair light and referred to the department of Oral Radiology for Orthopantomogram. Yamamoto's classification was used to classify maxillary canine impaction. Position of mandibular canine from cement-enamel junction was used for mandibular canine impaction.
MATERIALS AND METHODS
The study was performed on 2300 patients who consulted the orthodontic department from January 2018 to July 2022. Orthopantomogram of each patient was examined for canine impaction, retained deciduous teeth, cyst, and other anomalies. The incidence and pattern of canine impaction was assessed.
STATISTICAL ANALYSIS
The data was then statistically analyzed using Graph Pad Prism software. The incidence of impacted canine was evaluated. The effect of gender was evaluated using a -test.
RESULTS
A total of 2300 subjects were examined out of which 52 individuals were diagnosed with canine impaction. The incidence of canine impaction among orthodontic patients is 2.26%. The amount of canine impaction in females (60%) is higher than males (40%). The ratio of canine impaction of the maxilla and mandible is 2.5.
CONCLUSION
The incidence of canine impaction was found to be 2.26 percent in the tribal dominant population of Jharkhand. Type II (50%) pattern in the maxilla and Level A (57%) impaction in the mandible was found to be the highest.
PubMed: 37693975
DOI: 10.4103/jpbs.jpbs_177_23 -
Journal of Clinical Medicine Aug 2023Currently, there is little clinical evidence to support the medium- and long-term survival and clinical performance of ultraconservative approaches using adhesive...
INTRODUCTION
Currently, there is little clinical evidence to support the medium- and long-term survival and clinical performance of ultraconservative approaches using adhesive restorations in full-mouth restorations. The aim of this case series study was to evaluate the medium-term clinical performance of anterior and posterior adhesive restorations applied with direct and indirect techniques using resin composites and glass-ceramic-based materials.
MATERIALS AND METHODS
The inclusion criteria were an esthetic problem as the main reason for consultation and severe generalized wear of grade 2 to 4 according to the Tooth Wear Evaluation System (TWES 2.0). In addition, at each follow-up appointment, patients were required to submit a clinical-parameter-monitoring record according to the modified United States Public Health Service (USPHS) criteria.
RESULTS
Eight patients with severe tooth wear were treated through full rehabilitation in a private dental clinic in Spain by a single operator (AFC). A total of 212 restorations were performed, which were distributed as follows: 66 occlusal veneers, 26 palatal veneers and 120 vestibular veneers. No signs of marginal microleakage or postoperative sensitivity were observed in any occlusal, vestibular and/or palatal restoration after the follow-up period. The estimated survival rate of the 212 restorations was 90.1% over 60 months of observation, with a survival time of 57.6 months. Only 21 restorations had complications, which were mostly resolved with a direct composite resin. The dichotomous variables of the restoration type (posterior veneer, anterior veneer) and the type of restored tooth (anterior, posterior) were the risk predictors with statistically significant influences ( < 0.005) on the survival of the restorations.
CONCLUSION
According to the results of this study, there is a significantly higher risk of restorative complications in posterior teeth compared to anterior teeth. Also, it can be concluded that the indication of adhesive anterior and posterior restorations is justified in the total oral rehabilitation of patients with severe multifactorial tooth wear, as they are associated with a low risk of failure.
PubMed: 37629264
DOI: 10.3390/jcm12165222 -
Indian Journal of Dental Research :... Oct 2023Studies comparing the clinical performance of titanium zirconium (Ti-Zr) and titanium (Ti) dental implants subjected to immediate loading in the posterior mandibular... (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
BACKGROUND
Studies comparing the clinical performance of titanium zirconium (Ti-Zr) and titanium (Ti) dental implants subjected to immediate loading in the posterior mandibular region where occlusal forces are higher are sparse in the current literature. Hence, the study aimed to evaluate and compare the clinical outcomes of Ti-Zr and Ti dental implants under immediate functional loading in the mandibular posterior region.
METHODS
Forty participants fulfilling the predetermined selection criteria were randomly grouped based on dental implant used; Titanium zirconium (Ti-Zr):20, and Titanium (Ti):20. Dental implants were placed through a standard full-thickness mucoperiosteal flap approach and loaded immediately fulfilling the principle of implant protective occlusion. Clinical parameters including crestal bone loss (CBL), modified plaque index (MPI), probing depth (PD) and modified sulcular bleeding index (MSBI) were measured at baseline and follow-up visits (4, 8, and 12 months). Obtained data were compared with standard tests such as the t-test, Chi-square test, and Mann-Whitney U test.
RESULTS
On intergroup comparison, CBL was more in the Ti-Zr group as compared to the Ti group at 4 months (0.72 ± 0.16 mm versus 0.70 ± 0.13 mm), but it was less at 8 months (1.08 ± 0.16 mm versus 1.13 ± 0.13 mm) and 12 months (1.19 ± 0.17 mm versus 1.24 ± 0.12 mm) but the difference was not statistically significant (P > 0.05). Mann-Whitney test also revealed no statistically significant difference in MPI, PD and MSBI at 4 months, 8 months and 12 months recall (P > 0.05).
CONCLUSIONS
CBL and periodontal parameters of Ti-Zr dental implants were found similar to Ti dental implants under immediate loading in the posterior mandibular region. However, further studies are needed to determine its long-term efficacy and cost-effectiveness.
Topics: Humans; Titanium; Zirconium; Male; Female; Adult; Mandible; Dental Implants; Treatment Outcome; Immediate Dental Implant Loading; Middle Aged; Periodontal Index; Alveolar Bone Loss; Young Adult
PubMed: 38739813
DOI: 10.4103/ijdr.ijdr_313_23 -
BMC Emergency Medicine Aug 2023Our study aimed to assess the ability of nonmedical civilians to self-apply extremity tourniquets in cold weather conditions while wearing insulating technical clothing...
BACKGROUND
Our study aimed to assess the ability of nonmedical civilians to self-apply extremity tourniquets in cold weather conditions while wearing insulating technical clothing after receiving basic training.
METHODS
A field study was conducted among 37 voluntary participants of an expedition party to the Spanish Antarctic base. The researchers assessed the participant's ability to self-apply five commercial extremity tourniquets (CAT, OMNA, RMT, SWAT-T, and RATS) over cold-weather clothing and their achieved effectiveness for vascular occlusion. Upper extremity self-application was performed with a single-handed technique (OHT), and lower extremity applying a two-handed technique (THT). Perceptions of self-application ease mean values ± standard deviation (SD) were compared by applying a 5% statistical significance threshold. Frequency count determined tourniquet preference.
RESULTS
All the tested ETs, except the SWAT-T, were properly self-applied with an OHT, resulting in effective vascular occlusion in the upper extremity. The five devices tested were self-applied correctly in the lower extremities using THT. The ratcheting marine-designed OMNA ranked the highest for application easiness on both the upper and lower extremities, and the windlass CAT model was the preferred device by most participants.
CONCLUSIONS
Civilian extremity tourniquet self-application on both upper and lower extremities can be accomplished in cold weather conditions despite using cold-weather gloves and technical clothing after receiving brief training. The ratcheting marine-designed OMNA ranked the highest for application ease, and the windlass CAT model was the preferred device.
Topics: Humans; Tourniquets; Extremities; Weather
PubMed: 37653492
DOI: 10.1186/s12873-023-00871-1