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Brazilian Dental Journal Sep 2020The aim of this prospective, randomized, clinical study was to analyze the influence of occlusal adjustment on the prevalence of postoperative pain after endodontic... (Randomized Controlled Trial)
Randomized Controlled Trial
The aim of this prospective, randomized, clinical study was to analyze the influence of occlusal adjustment on the prevalence of postoperative pain after endodontic treatment. Seventy-eight patients, diagnosed with symptomatic irreversible pulpitis with indication for endodontic treatment, were selected to participate in the study. The participants were randomized and divided into two groups: in the occlusal adjustment group (OAG), endodontic treatment was performed with subsequent occlusal adjustment. In the control group (CG), endodontic treatment was performed without occlusal adjustment. Treatments were performed by the same operator. Pain occurrence and intensity were recorded on two scales: the verbal rating scale (VRS) and numerical rating scale (NRS). Pain assessment was carried out by a second examiner, blinded to the experiment, 6, 24 and 72 h after endodontic treatment. Data were analyzed using Mann-Whitney, chi-squared, and Fisher's exact tests. In the occlusal adjustment group, 71.1% reported postoperative pain and 67.5% reported pain in the control group. At the 6-hour assessment, 21 individuals reported pain in the occlusal adjustment group and 24 in the control group (p=0.672). At the 24-hour assessment, 18 and 19 individuals reported pain (p=0.991) and at the 72-hour assessment, 8 and 4 reported pain (p=0.219), respectively. Occlusal adjustment did not influence the prevalence of postoperative pain of endodontically treated teeth with symptomatic irreversible pulpitis.
Topics: Dental Pulp Cavity; Humans; Occlusal Adjustment; Pain, Postoperative; Prospective Studies; Root Canal Therapy
PubMed: 32901709
DOI: 10.1590/0103-6440202003248 -
Scientific Reports Dec 2023How to ensure dental stability in new positions and reduce the likelihood of relapse is a major clinical concern in the orthodontic field. Occlusal contacts between...
How to ensure dental stability in new positions and reduce the likelihood of relapse is a major clinical concern in the orthodontic field. Occlusal contacts between arches may affect the transmission of masticatory forces, thereby influencing the biological response of the periodontal and the oromandibular system. Occlusion factors that may influence the stability after orthodontic tooth movement (OTM) remain largely unknown. Hence, this research was conducted in order to investigate the influence of different occlusal contact patterns on tooth stability and oromandibular system including the masseter muscle and the temporomandibular joint following OTM. By modifying the occlusal surfaces, in vivo animal study models with distinct occlusal patterns corresponding to clinical circumstances were established. The relapse distance of teeth and the level of inflammatory factors in the gingival cervical fluid were analyzed. We also closely observed the histological remodeling of periodontal tissue, masseter tissue, and joint tissue after one week of relapse. Moreover, genes expression in the alveolar bone was analyzed to illustrate the potential biological mechanisms of relapse under the influence of different occlusal contact patterns following OTM. Different occlusal contact patterns after OTM in rats were established. The intercuspation contact between cusp and fossa group exhibited the lowest level of relapse movement, inflammatory factors and osteoclast activity (P < 0.05). On the other hand, groups with interferences or inadequate contacts exhibited more relapse movement, and tend to promote inflammation of periodontal tissue and activate bone resorption (P < 0.05). Adequate occlusal contacts without interference may enhance tooth stability and reduce the likelihood of relapse. After active orthodontic treatment, necessary occlusal adjustment should be made to achieve the desired intercuspation contact relationship and ensure adequate contact between the arches. The elimination of occlusal interferences is crucial to achieving optimal stability and promoting overall healthy condition of the oromandibular system.
Topics: Rats; Animals; Tooth Movement Techniques; Osteoclasts; Bone Resorption; Recurrence
PubMed: 38097596
DOI: 10.1038/s41598-023-46668-x -
The Journal of Prosthetic Dentistry Apr 2023Investigations on the effectiveness of new methods for optimizing the fabrication of oral devices are lacking.
STATEMENT OF PROBLEM
Investigations on the effectiveness of new methods for optimizing the fabrication of oral devices are lacking.
PURPOSE
The purpose of this in vitro study was to evaluate stress distribution with photoelastic analysis in the periradicular area of teeth supporting occlusal devices fabricated by 5 different processes.
MATERIAL AND METHODS
The occlusal devices were fabricated by vacuum thermoforming, heat-polymerized acrylic resin, chemical polymerized acrylic resin, 3-dimensional printing, and milling (computer-aided manufacturing). The devices were evaluated regarding initial fit, number of adjustments for passive fit, and stress distribution under 100-N and 400-N loads in the periradicular locations of posterior teeth.
RESULTS
The 3-dimensional printing device did not require any adjustment for initial adaptation to the photoelastic model and presented a little friction with the model. The heat-polymerized acrylic resin device did not seat initially, requiring more sites of adjustment until passive adaptation. At 100-N and 400-N loads, the use of the computer-aided manufacturing occlusal device resulted in the lowest stresses in periradicular areas (0.744 and 1.583, respectively), and the 3-dimensional printing occlusal device produced the highest stresses with a 400-N load application (2.427). The lowest mean of fringe pattern was observed for the computer-aided manufacturing device, and the highest mean of fringe pattern was observed for the vacuum thermoforming device.
CONCLUSIONS
The computer-aided design and computer-aided manufacturing milled occlusal device presented the best initial adaptation and transferred lower stresses to the periradicular areas than the other evaluated devices.
Topics: Computer-Aided Design; Printing, Three-Dimensional; Acrylic Resins; Research Design; Hot Temperature
PubMed: 34344528
DOI: 10.1016/j.prosdent.2021.06.037 -
The International Journal of... 2023To compare patient adaptation to and satisfaction with new complete dentures fabricated with a duplication construction protocol (DCP) using two different occlusal...
PURPOSE
To compare patient adaptation to and satisfaction with new complete dentures fabricated with a duplication construction protocol (DCP) using two different occlusal schemes, bilateral balanced (BBO) and lingualized (LO).
MATERIALS AND METHODS
Twenty complete denture wearers who received replacement DCP dentures participated in this study. Ten participants received complete dentures with a BBO scheme, and the other 10 received DCP dentures with an LO scheme. All of them evaluated their prostheses subjectively through the Oral Health Impact Profile-20 (OHIP-20) and the Complete Denture Satisfaction (CDS) questionnaires before treatment and at 3- and 6-month posttreatment intervals. The new prostheses were also normatively evaluated by recording the location and number of sore spots present at the scheduled early adjustment visits. Data were analyzed with nonparametric tests to identify differences in patient responses between groups and within each group at each evaluation interval point (α = .05).
RESULTS
The within-group comparisons revealed statistically significant improvement for both denture groups (P < .05), while the between-group comparisons did not record statistically significant differences at the overall evaluation period (P > .05). Significant within-group differences were recorded in the pain, functional limitation, and psychologic disability domains of the OHIP-20 questionnaire and the comfort, esthetics, and stability domains of the CDS questionnaire.
CONCLUSION
The patients' adaptation to and satisfaction with newly constructed DCP dentures improved significantly for both BBO and LO denture groups throughout the evaluation period. The mean number of early adjustment visits was equal for both the BBO and LO denture groups.
PubMed: 33662056
DOI: 10.11607/ijp.7367 -
The Japanese Dental Science Review Nov 2020The purpose of the present review was to survey the available literature on computer-aided design/computer-aided manufacturing (CAD/CAM)-produced resin composite... (Review)
Review
The purpose of the present review was to survey the available literature on computer-aided design/computer-aided manufacturing (CAD/CAM)-produced resin composite materials to provide clinicians with a current overview of the key components necessary for daily clinical use. An electronic search was conducted in the PubMed database. Peer-reviewed articles in English language on the use of resin composites in CAD/CAM dental crowns were included. A total of 122 full-text articles were identified, 15 of which were selected during the initial review. Two additional articles were also discovered through a manual search, to obtain a final total of 17 articles included in the present review. Of these, 16 were to studies, and one was an study. Findings from the studies indicate that resin composite block materials for CAD/CAM applications demonstrate excellent physical properties and are appropriate for the clinical restoration of premolars and molars. However, the study reported a low 3-year success rate, but high survival rate for resin composite CAD/CAM crowns placed in the premolar region. The key to ensuring the successful prognosis of a resin composite CAD/CAM crown is to ensure that all steps-such as proper case selection, abutment tooth preparation, occlusal adjustment, and bonding-are accurately performed.
PubMed: 33299502
DOI: 10.1016/j.jdsr.2020.10.002 -
Revista Cientifica Odontologica... 2022The aim of optimal dentistry is to stabilise the stomatognathic system (teeth, periodontium, muscles and temporomandibular joint). All of these must work in harmony, as...
The aim of optimal dentistry is to stabilise the stomatognathic system (teeth, periodontium, muscles and temporomandibular joint). All of these must work in harmony, as together they provide optimal care from diagnosis through planning to treatment. However, many clinicians currently give little importance to the identification of premature contacts and/or interferences prior to any dental treatment, which should be taken into account to provide improved stability in mandibular closure, correct anterior and canine guidance in mandibular movements.This clinical case describes the treatment of a patient with a diagnosis of functional occlusal disorder due to premature contact, whose treatment consisted of an occlusal adjustment by selective wear, following the technique described by the author Klineberg, with the aim of preserving the dental structure as much as possible while maintaining control during the occlusal adjustment and returning the greatest number of symmetrical and pointed contacts.
PubMed: 38389550
DOI: 10.21142/2523-2754-1003-2022-122 -
Journal of Dental Research Jul 2021The aims of this study were to 1) determine if continuous eruption occurs in the maxillary teeth, 2) assess the magnitude of the continuous eruption, and 3) evaluate the...
The aims of this study were to 1) determine if continuous eruption occurs in the maxillary teeth, 2) assess the magnitude of the continuous eruption, and 3) evaluate the effects of continuous eruption on the different periodontal parameters by using data from the population-based cohort of the Study of Health in Pomerania (SHIP). The jaw casts of 140 participants from the baseline (SHIP-0) and 16-y follow-up (SHIP-3) were digitized as 3-dimensional models. Robust reference points were set to match the tooth eruption stage at SHIP-0 and SHIP-3. Reference points were set on the occlusal surface of the contralateral premolar and molar teeth, the palatal fossa of an incisor, and the rugae of the hard palate. Reference points were combined to represent 3 virtual occlusal planes. Continuous eruption was measured as the mean height difference between the 3 planes and rugae fix points at SHIP-0 and SHIP-3. Probing depth, clinical attachment levels, gingiva above the cementoenamel junction (gingival height), and number of missing teeth were clinically assessed in the maxilla. Changes in periodontal variables were regressed onto changes in continuous eruption after adjustment for age, sex, number of filled teeth, and education or tooth wear. Continuous tooth eruption >1 mm over the 16 y was found in 4 of 140 adults and averaged to 0.33 mm, equaling 0.021 mm/y. In the total sample, an increase in continuous eruption was significantly associated with decreases in mean gingival height ( = -0.34; 95% CI, -0.65 to -0.03). In a subsample of participants without tooth loss, continuous eruption was negatively associated with PD. This study confirmed that continuous eruption is clearly detectable and may contribute to lower gingival heights in the maxilla.
Topics: Adult; Dental Occlusion; Follow-Up Studies; Humans; Incisor; Maxilla; Tooth Eruption
PubMed: 33655796
DOI: 10.1177/0022034521999363 -
Clinical Oral Investigations Feb 2024Single denture rehabilitated patients have negative appraisals regarding oral function, mostly associated by stability and retention issues regarding mandibular... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
Single denture rehabilitated patients have negative appraisals regarding oral function, mostly associated by stability and retention issues regarding mandibular prosthetics. Therefore, this study assessed patients' occlusal equilibration, muscle activity, and oral health-related quality of life (OHRQoL) receiving milled removable or fixed mandibular implant retained prostheses.
MATERIALS AND METHODS
Twenty-two edentulous mandibular ridges patients were randomly distributed into two groups based on the definitive prosthesis received. Group I: Removable mandibular implant-supported overdenture, Group II: Implant retained fixed prosthesis. Occlusal equilibration was evaluated utilizing Occlusense, muscle activity via Electromyograph (EMG) at delivery, after one, and three months. The OHRQoL was evaluated by Oral Health Impact Profile questionnaire (OHIP-19) before delivery and after follow-ups. Data were collected, tabulated, and analyzed, utilizing independent t-test and One-way ANOVA followed Tukey`s post-hoc test. Significance level set at P ≤ 0.05.
RESULTS
Groups I &II showed significant improvement in occlusal equilibration, muscle activity and OHRQoL. Group II demonstrated significantly higher improvement than group I in occlusal equilibration associated with muscle activity after 1 month, and in functional limitations domain in OHRQoL questionnaire after 3 months.
CONCLUSION
Implant retained mandibular prosthesis showed improvement in occlusal equilibration, muscle activity, and OHRQoL regardless of prosthesis type employed. Fixed implant-supported prosthesis revealed better outcomes than removable mandibular implant-supported overdenture concerning occlusal equilibration, muscle activity, and OHRQoL regarding functional limitations.
CLINICAL RELEVANCE
Implant retained mandibular prosthesis is one of best treatment options for single mandibular completely edentulous patients, as dental implants improved occlusal equilibration, muscle activity, and OHRQoL.
Topics: Humans; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Jaw, Edentulous; Mandible; Mouth, Edentulous; Muscles; Occlusal Adjustment; Patient Satisfaction; Quality of Life
PubMed: 38378935
DOI: 10.1007/s00784-024-05558-w -
Operative Dentistry Sep 2020This article describes an indirect composite restoration technique for diastema closure and tooth lengthening with a noninvasive approach using regularly available...
This article describes an indirect composite restoration technique for diastema closure and tooth lengthening with a noninvasive approach using regularly available materials such as silicone, composite resin, and an adhesive system. The procedure resulted in occlusal and functional improvement, with diastema closure, protrusive guide adjustment, and an increase in central incisor length. The procedure provided an adequate proportion of the central incisors with an esthetically natural appearance. It also resulted in simple, fast, and accurate manufacturing with a noninvasive esthetic indirect rehabilitation compared with more invasive preparation of ceramic veneers.
Topics: Composite Resins; Dental Veneers; Diastema; Esthetics, Dental; Humans; Incisor
PubMed: 32243254
DOI: 10.2341/18-330-T -
The Journal of Prosthetic Dentistry May 2023Although computer-aided design has become popular, restorations are typically designed from static occlusion and dynamically by using an average-value virtual...
STATEMENT OF PROBLEM
Although computer-aided design has become popular, restorations are typically designed from static occlusion and dynamically by using an average-value virtual articulator. Patient-specific motion recorded by using an intraoral scanner has rarely been used to design restorations, and its design ability has not been analyzed.
PURPOSE
The purpose of this clinical study was to record patient-specific motion by using an intraoral scanner and to analyze its ability to design the morphology of the wear facets on mandibular first molar crowns.
MATERIAL AND METHODS
An intraoral scanner was used to scan complete arch digital casts and to record patient-specific motion of 11 participants. Right and left mandibular first molars were selected as the target teeth. The complete crown preparations of the target teeth were virtually prepared on the digital mandibular casts by using the Geomagic Studio 2013 software program. High points were created by elevating the wear facets of the target teeth by 0.3 mm in the occlusal direction to generate digital wax patterns. The Dental System software program was used to design crowns with the anatomic coping design method. Occlusal adjustment with static occlusion (STA crown), with the average-value virtual articulator (DYN crown), and with patient-specific motion (FUN crown) was carried out. The crowns adjusted with these 3 methods were compared with the original wear facets. The mean value and root mean square (RMS) of 3D deviation were measured. One-way ANOVA was used to analyze the influence of the occlusal surface design methods on the morphology of the wear facets (α=.05).
RESULTS
The STA crowns had the poorest results with the mean ±standard deviation 3D deviation value of 0.15 ±0.05 mm and RMS value of 0.19 ±0.04 mm. The best results occurred in the FUN group, with the mean ±standard deviation 3D deviation value of 0.05 ±0.06 mm and RMS value of 0.13 ±0.03 mm. Significant differences were found among the 3 groups (P<.01). Except for the RMS value between the STA and DYN groups, significant differences were found between groups from the pairwise comparisons.
CONCLUSIONS
The occlusal surface of the crowns designed by using the patient-specific motion recorded with the intraoral scanner had the best coincidence with the morphology of the wear facets on the original teeth.
Topics: Humans; Crowns; Molar; Dental Occlusion; Tooth Crown; Computer-Aided Design
PubMed: 34426014
DOI: 10.1016/j.prosdent.2021.06.048