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International Journal of Environmental... Apr 2024To assess the association between clinical orthodontic indicators and oral-health-related quality of life, adjusted for socio-demographic factors, focusing on...
OBJECTIVE
To assess the association between clinical orthodontic indicators and oral-health-related quality of life, adjusted for socio-demographic factors, focusing on 16-year-old patients with cleft lip and/or palate (CL/P).
PARTICIPANTS
One hundred and twenty-two patients with CL/P, representing cleft-lip (CL), cleft-palate (CP), unilateral/bilateral cleft-lip-palate (UCLP/BCLP), enrolled in the national CLP-Team, Bergen, Norway.
METHOD
A cross-sectional study by two orthodontists assessing the number of teeth, intermaxillary sagittal relation (ANB-angle), dental arch and occlusion of 16-year-old patients with CL/P. All completed a digital questionnaire including self-reported socio-demographic variables, OHIP-14 questionnaire and dental aesthetics. Cross-tabulations with Pearson's Chi-square test were used to identify associations between self-reported OHRQoL and socio-demographic and clinical indicators. Multiple variable analyses were conducted with binary logistic regression analysis using the odds ratio (OR) and 95% confidence interval (CI) to assess associations between OHRQoL and clinical indicators adjusted for socio-demographic variables. Ethical approval was granted by the regional ethics committee.
RESULTS
Patients with UCLP and BCLP had poorer clinical indicators compared to patients with CL and CP ( < 0.05). A total of 80% of the patients had OHIP-14 > 0. The highest oral impact was reported for psychological domains and articulation and the least for functional domains. Respondents with BCLP and those with poor intermaxillary relationships (ANB < 0°) reported a high impact on OHRQoL ( < 0.05). No statistically significant associations between other clinical indicators and socio-demographic variables such as gender, educational aspiration, and place of residence were reported.
CONCLUSIONS
The study revealed an association between severe cleft diagnosis, missing teeth, misaligned teeth, negative overjet, and poor OHRQoL, but a statistically significant association was found only between OHRQoL and poor intermaxillary sagittal relations (unfavorable profile). To improve OHRQoL among patients with clefts, there is a need for an individual follow-up and prioritization of oral healthcare.
Topics: Humans; Cleft Lip; Cleft Palate; Adolescent; Quality of Life; Male; Female; Norway; Oral Health; Cross-Sectional Studies; Surveys and Questionnaires; Malocclusion
PubMed: 38791765
DOI: 10.3390/ijerph21050550 -
Journal of Prosthodontics : Official... May 2024To evaluate the fracture resistance of chairside computer-aided design and computer-aided manufacturing (CAD-CAM) lithium disilicate mandibular posterior crowns with...
Influence of occlusal thickness on the fracture resistance of chairside milled lithium disilicate posterior full-coverage single-unit prostheses containing virgilite: A comparative in vitro study.
PURPOSE
To evaluate the fracture resistance of chairside computer-aided design and computer-aided manufacturing (CAD-CAM) lithium disilicate mandibular posterior crowns with virgilite of different occlusal thicknesses and compare them to traditional lithium disilicate crowns.
MATERIALS AND METHODS
Seventy-five chairside CAD-CAM crowns were fabricated for mandibular right first molars, 60 from novel lithium disilicate with virgilite (CEREC Tessera, Dentsply Sirona), and 15 from traditional lithium disilicate (e.max CAD, Ivoclar Vivadent). These crowns were distributed across five groups based on occlusal thickness and material: Group 1 featured CEREC Tessera crowns with 0.8 mm thickness, Group 2 had 1.0 mm thickness, Group 3 had 1.2 mm thickness, Group 4 with 1.5 mm thickness, and Group 5 included e.max CAD crowns with 1.0 mm thickness. These crowns were luted onto 3D-printed resin dies using Multilink Automix resin cement (Ivoclar Vivadent). Subsequently, they underwent cyclic loading (2,000,000 cycles at 1 Hz with a 275 N force) and loading until fracture. Scanning electron microscopy (SEM) assessed the fractured specimens. Statistical analysis involved one-way ANOVA and the Kruskal-Wallis Test (α = 0.05).
RESULTS
Fracture resistance varied significantly (<0.001) across mandibular molar crowns fabricated from chairside CAD-CAM lithium disilicate containing virgilite, particularly between crowns with 0.8 mm and those with 1.2 and 1.5 mm occlusal thickness. However, no significant differences were found when comparing crowns with 1, 1.2, and 1.5 mm thicknesses. CEREC Tessera crowns with 1.5 mm thickness exhibited the highest resistance (2119 N/mm), followed by those with 1.2 mm (1982 N/mm), 1.0 mm (1763 N/mm), and 0.8 mm (1144 N/mm) thickness, whereas e.max CAD crowns with 1.0 mm occlusal thickness displayed the lowest resistance (814 N/mm).
CONCLUSIONS
The relationship between thickness and fracture resistance in the virgilite lithium disilicate full-coverage crowns was directly proportional, indicating that increased thickness corresponded to higher fracture resistance. No significant differences were noted among crowns with thicknesses ranging from 1 to 1.5 mm. This novel ceramic exhibited superior fracture resistance compared to traditional lithium disilicate.
PubMed: 38790151
DOI: 10.1111/jopr.13870 -
British Dental Journal May 2024Dental implants are a regular feature in daily clinical practice and there is a need to undertake routine assessment and maintenance of implants and their restorations... (Review)
Review
Dental implants are a regular feature in daily clinical practice and there is a need to undertake routine assessment and maintenance of implants and their restorations on par with that provided for natural teeth. Occlusal checks form an important part of the maintenance regime for preserving the integrity of implants, their restorations, and health of the peri-implant tissues. Implant restorations are subjected to the full characteristics and magnitude of occlusal forces, including those associated with parafunction. Compared with the periodontal ligament around teeth, the biophysical response to occlusal forces of osseointegration is different through the more rigid link of implant to bone and reduced proprioception. Risks attributable to occlusal forces primarily affect implant restorations and they are elevated in the presence of bruxism. The occlusal guidelines recommended by the literature are aimed at reducing these risks and regular assessment and maintenance of the occlusion is essential. A four-step sequence is presented to ensure that the annual occlusal checks include the patient's input and evaluation of restoration integrity, occlusal scheme, additional protection, and spatial changes.
Topics: Humans; Dental Implants; Bite Force; Dental Occlusion; Bruxism
PubMed: 38789754
DOI: 10.1038/s41415-024-7407-7 -
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 Apr 2024Dentinal hypersensitivity is a brief and painful oral condition that is characterized by an abrupt shooting sensation. Stimulation occurs when hot, cold, sweet, or sour...
Comparative Evaluation of Er: YAG Laser, Diode Laser, and Novamin Technology for Dentinal Tubule Occlusion: An In-Vitro Scanning Electron Microscope (SEM) and Energy Dispersive X-Ray Analysis (EDX) Study.
BACKGROUND
Dentinal hypersensitivity is a brief and painful oral condition that is characterized by an abrupt shooting sensation. Stimulation occurs when hot, cold, sweet, or sour food comes into contact with exposed dentinal tubules. The present study used a scanning electron microscope (SEM) and energy dispersive X-ray analysis (EDX) to investigate the efficacy of Er: YAG, 810 nm diode LASER, and NovaMin Technology in obstructing dentinal tubules.
MATERIAL AND METHODS
We extracted the outer layers of 30 human teeth to expose the tubules and then treated the surfaces with 17% ethylenediaminetetraacetic acid (EDTA) to create an etched effect. Three cohorts were created from the portions. Group A was subjected to the application of Erbium:Yttrium-Aluminum-Garnet (Er: YAG) laser with a power output of 2W in the non-contact mode for 1 minute. Group B was subjected to the application of an 810nm diode laser with a power output of 1W in continuous mode for 30 seconds. Group C was subjected to the application of NovaMin paste, which contains a 927 ppm fluoride content. Following the therapy, occluded dentinal tubules were analyzed using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX) for both quantitative and qualitative examination. The data analysis was conducted using a one-way analysis of variance (ANOVA) and Tukey's test, with a significance threshold of 0.05.
RESULTS
The average percentages of complete blockage of dentinal tubules in Groups A, B, and C were evaluated using the number of entirely unobstructed dentinal tubules at magnifications of 2000X (F = 3.05, p = 0.064), 5000X (F = 5.33, p = 0.011), and 10000X (F = 8.63, p = 0.001). The count of partially open dentinal tubules seen at magnifications of 2000X, 5000X, and 10000X was F = 10.15 (P < 0.001), F = 5.97 (p = 0.007), and F = 2.12 (p = 0.140) accordingly.
CONCLUSION
NovaMin technology has demonstrated more effectiveness in blocking dentinal tubules compared to 810nm diodes and Er: YAG lasers.
PubMed: 38784366
DOI: 10.7759/cureus.58806 -
BMC Oral Health May 2024A change in professionals' perspectives on the value of general anesthesia (GA) for pediatric patients, including those with disabilities, medical conditions, severe...
BACKGROUND
A change in professionals' perspectives on the value of general anesthesia (GA) for pediatric patients, including those with disabilities, medical conditions, severe oral issues, and challenging behaviors. Full-mouth rehabilitation under GA allows for the comprehensive treatment of all oral health problems in a single visit, without requiring the child's active participation. Extensive dental problems are often associated with severe dental pain, which can impact cognitive function, including perception, attention, memory, reasoning, language, communication, and executive functions. Individuals experiencing pain tend to perform less optimally cognitively.
AIM
This study aimed to investigate changes in cognition, brain function, and cortical alterations in children who underwent extensive dental rehabilitation under GA.
PATIENTS ANDMETHODS
Thirty uncooperative, healthy children aged 6-12 with extensive dental issues were enrolled. Pain levels were assessed using the FLACC and WBFPS scales before treatment, one week after, and three months later. Cognitive assessments, including the WCST, processing speed, digit span, and Trail Making Test, as well as EEG measurements, were also performed.
RESULTS
The results showed a significant improvement in pain levels reported by the children or their caregivers after the dental procedures, both at one week and three months. All cognitive measures, such as digit span, processing speed, and WCST performance, demonstrated substantial improvements after the treatment. The Trail Making Test also exhibited statistically significant variations before and after the dental procedures. Additionally, the MOCA test revealed a notable improvement in cognitive skills following the treatment. Furthermore, the EEG power ratio, an indicator of changes in the power balance within each frequency band, showed a statistically significant difference after the dental procedures.
CONCLUSION
the findings of this study suggest that full-mouth rehabilitation under GA can lead to improved pain management, as well as enhanced cognitive and brain functions in children.
FUTURE PERSPECTIVES
More clinical studies with a longer follow-up period and a different age range of children are required to investigate the connection between brain function and oral rehabilitation involving restorations or occlusion issues.
Topics: Humans; Child; Male; Female; Pain Measurement; Cognition; Mouth Rehabilitation; Anesthesia, General; Electroencephalography; Cerebral Cortex
PubMed: 38778294
DOI: 10.1186/s12903-024-04356-w -
Dental Press Journal of Orthodontics 2024The superimposition of 3 dimensions (3D) digital models has been increasingly used for evaluating dental changes resulting from orthodontic treatment, and different...
INTRODUCTION
The superimposition of 3 dimensions (3D) digital models has been increasingly used for evaluating dental changes resulting from orthodontic treatment, and different superimposition techniques have been described. Although the maxilla has areas with greater stability for superimposition, such as the palatal rugae, there is still no reliable method for superimposing models of the lower arch.
OBJECTIVE
Therefore, this article aims to describe a technique for superimposing virtual models.
METHODS
To evaluate pre- and post-orthodontic treatment changes, the Geomagic Qualify 2013 software (3D Systems®, Rock Hill, South Carolina, USA) was used, with reference points in the maxilla, including the rugae and a reference area in the palate and midpalatal raphe. The lower arch was superimposed using the maximum habitual intercuspation (MHI) model as reference.
RESULTS AND CONCLUSION
3D models superimposition using palatal rugae and MHI occlusion seems to offer satisfactory results in the interpretation of clinical changes at different follow-up moments in terms of development and/or orthodontic treatment.
Topics: Humans; Imaging, Three-Dimensional; Models, Dental; Software; Maxilla; Palate, Hard; Palate; Dental Occlusion; Mandible
PubMed: 38775602
DOI: 10.1590/2177-6709.29.2.e24spe2 -
Dental Press Journal of Orthodontics 2024This study aimed to compare the nasopharynx and oropharynx airway dimensions of Caucasians, Blacks, Japanese, Japanese Brazilians, and Black Caucasians. (Comparative Study)
Comparative Study
OBJECTIVE
This study aimed to compare the nasopharynx and oropharynx airway dimensions of Caucasians, Blacks, Japanese, Japanese Brazilians, and Black Caucasians.
METHODS
A sample of 216 lateral radiographs of untreated young Brazilian subjects (mean age of 12.94 years; SD 0.88) were divided into five groups: Black Caucasian, Black, Caucasian, Japanese, and Japanese Brazilian. Lateral radiographs were used to measure the oropharynx (from the midpoint on the soft palate to the closest point on the anterior pharyngeal wall) and the nasopharynx (from the intersection of the posterior border of the tongue and the inferior border of the mandible to the closest point on the posterior pharyngeal wall). Analyses of variance (ANOVA) and Tukey's test were performed (p< 0.05).
RESULTS
The linear dimension of the oropharynx was similar among the different ethnic groups. Caucasian individuals presented a significantly greater linear dimension of the nasopharynx than Black Caucasian and Black individuals.
CONCLUSIONS
All the groups had similar buccopharyngeal values. However, Caucasian individuals had significantly higher values when compared to Black Caucasians and Black individuals.
Topics: Humans; Cephalometry; White People; Nasopharynx; Oropharynx; Black People; Child; Male; Female; Asian People; Mandible; Adolescent; Brazil; Tongue; Japan; Palate, Soft; Dental Occlusion; Ethnicity
PubMed: 38775599
DOI: 10.1590/2177-6709.29.2.e2423206.oar -
Clinical, Cosmetic and Investigational... 2024The need to increase the Vertical Dimension of Occlusion (VDO) to restore lost dental function or optimise specific dental treatments is a common occurrence in daily... (Review)
Review
The need to increase the Vertical Dimension of Occlusion (VDO) to restore lost dental function or optimise specific dental treatments is a common occurrence in daily dental practice. The common belief that the Vertical Dimension at Rest (VDR) is fixed hinders the development of restorations with a VDO that encroaches on or surpasses the interocclusal rest space (IRS), thereby preventing potential tissue damage to the masticatory apparatus. Recent studies have shown that the mandible rest position falls within a range termed as the "comfort zone". The range of this zone may vary from one person to another and within the same person over time due to factors such as age or health status. In this review, we have concluded that a permanent increase in the VDO, once indicated, is a safe procedure for dentulous patients. However, it is important to minimise the extent of the increase to simplify the prosthodontics treatment process. An inter-incisal increase exceeding 5 mm is seldom needed. Moreover, it is important to consider the functional, aesthetic, and biological elements associated with VDO. The biological and functional environment closely related to the VDO had great adaptive capacities, which have for a historically been underestimated. Patient adaptation has been observed in dentate patients, edentulous patients, and even cases involving implant-supported prostheses. Muscle relaxation and changes in muscle length are likely the primary adaptation mechanisms, rather than the restoration of the original VDO through dentoalveolar maturation. Intervention with a fixed restoration is more predictable and results in a higher and more rapid level of adaptation. Finally, the increase should include the entire arch to prevent relapse of the VDO to its previous value, and changes in VDO should be assessed by utilising temporary diagnostic restorations for a period before implementing definitive prostheses, in order to evaluate the adaptive muscle response.
PubMed: 38770218
DOI: 10.2147/CCIDE.S453704 -
European Journal of Dentistry May 2024Conventional glass ionomer cements (GICs) have been considered the most prevalent restorative material however; the reduced mechanical qualities and decreased wear...
OBJECTIVES
Conventional glass ionomer cements (GICs) have been considered the most prevalent restorative material however; the reduced mechanical qualities and decreased wear resistance have been the main challenges facing their wide clinical application. This study was designed to assess the mechanical properties of fluorinated graphene (FG) oxide-modified conventional GIC.
MATERIALS AND METHODS
Composites of FG/GIC samples were prepared using (Medifil from PROMEDICA, Germany, shade A3) at different concentrations (0wt%) control group and (1wt%, 2wt% and 3wt% FG) groups using cylindrical molds (3mm × 6mm). FG was prepared using hydrothermal technique and characterized using XPERT-PRO Powder Diffractometer system for X-ray diffraction analysis and JEOL JEM-2100 high resolution transmission electron microscope. Vickers' hardness and wear resistance of GI samples were measured. Mechanical abrasion was performed via three-body tooth brushing wear test using ROBOTA chewing simulator coupled with a thermocycling protocol (Model ACH-09075DC-T, AD-Tech Technology Co., Ltd., Leinfelden-Echterdingen, Germany).
STATISTICAL ANALYSIS
Comparisons between groups with respect to normally distributed numeric variables were performed using one-way analysis of variance test followed by posthoc test. While paired -test was utilized for comparing data within the same group.
RESULTS
The surface roughness values of GICs (1wt% FG) and (2wt% FG) composites were significantly lower than those of the control and 3wt%FG groups. Vickers' hardness numbers were significantly higher in FG/GICs composites than in the control group (≤0.05).
CONCLUSION
GIC/FG combinations have sufficient strength to resist the occlusion stresses with improved hardness as compared with conventional GIC. GIC/FG appeared to be a promising restorative material.
PubMed: 38759994
DOI: 10.1055/s-0044-1785188