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European Journal of Dentistry Jun 2024The proper closure of the access cavity between appointments during endodontic treatment is paramount and relies on temporary fillings. This systematic review evaluates...
The proper closure of the access cavity between appointments during endodontic treatment is paramount and relies on temporary fillings. This systematic review evaluates the effectiveness of zinc oxide-based materials and glass-ionomer cement (GIC) as temporary coronal sealers after root canal treatment in extracted human teeth. Three databases were searched to identify randomized clinical trials that examined the sealing properties of various temporary sealing materials using dyes or stains as indicators. A total of seven studies that fulfilled the eligibility criteria were critically analyzed. These indicated significant variations in the relative sealing ability of the coronal breach of endodontically treated teeth, either by zinc oxide or GIC-based materials. While GIC-based material (e.g., Fuji IX and Fuji II) exhibited superior sealing of single-rooted teeth, zinc oxide-based material (e.g., Cavit, Coltosol, Caviton) also showed promising attributes. Resin-modified GIC formulations displayed enhanced physical properties, yet challenges related to adhesive failure and shrinkage during polymerization were observed. Zinc oxide-based materials have demonstrated superior coronal sealing effectiveness over certain GIC in controlled settings. Their premixed nature ensures consistent application and hygroscopic properties improve cavity sealing. However, the focus on dye penetration tests for microleakage may not fully represent the risk of bacterial infiltration. Thus, studies are crucial for validating these findings in clinical contexts.
PubMed: 38942056
DOI: 10.1055/s-0044-1782695 -
European Journal of Dentistry Jun 2024This study evaluated surface roughness, biaxial flexural strength, and phase transformation of 5Y-PSZ after grinding and polishing with different protocols.
Effect of Grinding and Polishing Protocols on Surface Roughness, Flexural Strength, and Phase Transformation of High-Translucent 5 mol% Yttria-Partially Stabilized Zirconia.
OBJECTIVES
This study evaluated surface roughness, biaxial flexural strength, and phase transformation of 5Y-PSZ after grinding and polishing with different protocols.
MATERIAL AND METHODS
Two commercial 5Y-PSZ, Lava Esthetic (L) and Cercon xt (C), were used and divided into 3 groups: LC and CC represented unpolished control groups; LE and CE were polished with protocol I (EVE DIASYNT® PLUS HP following with EVE DIACERA RA); and LJ and CJ were polished with protocol II (Superfine diamond bur following with Jota ZIR Gloss polishing kit). Surface roughness was evaluated after polishing step-by-step with a contact-type profilometer. After high-gross polishing, the specimens were subjected to biaxial flexural strength test, crystallographic microstructure analysis using an X-ray diffractometer (XRD), and surface micro-topography using scanning electron microscopy (SEM).
STATISTICAL ANALYSIS
Surface roughness differences after each step and biaxial flexural strength between groups were evaluated with one-way ANOVA, followed by Bonferroni post-hoc analysis. Changes in surface roughness across four different time points within groups were assessed using one-way repeated measures ANOVA, followed by Bonferroni post-hoc analysis.
RESULTS
After high-gross polishing, both polishing protocols showed significantly lower surface roughness than the grinding group ( < 0.05). The LE and CE groups exhibited the highest surface roughness values, which were significant differences from the LJ and CJ groups ( < 0.05). The LE group showed significantly lower biaxial flexural strength compared to the LC group ( < 0.05). However, there was no statistically significant difference in the CE and CJ groups compared to the control group ( > 0.05). Furthermore, all polishing protocols did not change the phase transformation of zirconia.
CONCLUSION
Polishing protocol II provided a smoother surface than the protocol I after high-gross polishing, while the biaxial flexural strength of materials remained unaffected.
PubMed: 38942054
DOI: 10.1055/s-0044-1787001 -
European Journal of Dentistry Jun 2024This study aims to investigate DSM 17938's antibiofilm effects on and , common causes of alveolar osteitis. It seeks topical alternatives to prevent this condition...
OBJECTIVES
This study aims to investigate DSM 17938's antibiofilm effects on and , common causes of alveolar osteitis. It seeks topical alternatives to prevent this condition posttooth extraction. The secondary objective is to assess these effects under different pH conditions (pH 4.5 and pH 7), mimicking oral cavity saliva pH dynamics.
MATERIALS AND METHODS
Ethical approval was secured for the saliva collection process involving five healthy adult participants who had undergone wisdom tooth extraction. Saliva samples were diligently collected on the 7th day post-surgery. The unstimulated saliva underwent a series of treatments, including the addition of phenylmethylsulfonyl fluoride (PMSF), pH adjustments, centrifugation, and filtration. The pH levels were re-measured, and subsequent adjustments were made to achieve pH values of 4.5 or 7. DSM 17938, with a concentration of 1×10 colony-forming units (CFU) per 5 drops, was utilized in the study. Biofilm testing involved incubating saliva samples with varying pH (4.5 or 7) alongside bacterial suspensions (, or a mixed species). The Interlac suspension was introduced, and plates were anaerobically incubated for 24 hours. Biofilm results were obtained using a spectrometer. The test is conducted in triplicate.
STATISTICAL ANALYSIS
To scrutinize the impact of pH on biofilm development, the acquired data underwent a two-way ANOVA test in SPSS as part of the statistical analysis. A significance level of <0.05 was used to determine statistical significance.
RESULTS
DSM 17938 significantly reduced biofilm formation across bacterial strains ( = 0.000). Statistical analysis indicated a significant impact of pH on biofilm development ( = 0.000) compared to no saliva samples, with higher formation observed under acidic conditions (pH 4.5). However, the pH levels of 4.5 and 7 did not result in significantly different bacterial biofilm formation ( = 0.529).
CONCLUSION
This research highlights DSM 17938's potency in inhibiting biofilm formation of and . Salivary pH variations significantly influence biofilm development, emphasizing the need to consider pH when assessing probiotic effectiveness. Despite limitations in saliva sample sterilization, this study provides valuable insights into alternative approaches for preventing alveolar osteitis. Further research should explore clinical applications and refine sterilization methods for more accurate results.
PubMed: 38942052
DOI: 10.1055/s-0044-1786846 -
The Lancet. Rheumatology Jun 2024Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a proinflammatory cytokine overproduced in several inflammatory and autoimmune diseases, including axial...
Granulocyte-macrophage colony-stimulating factor neutralisation in patients with axial spondyloarthritis in the UK (NAMASTE): a randomised, double-blind, placebo-controlled, phase 2 trial.
BACKGROUND
Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a proinflammatory cytokine overproduced in several inflammatory and autoimmune diseases, including axial spondyloarthritis. Namilumab is a human IgG1 monoclonal anti-GM-CSF antibody that potently neutralises human GM-CSF. We aimed to assess the efficacy of namilumab in participants with moderate-to-severe active axial spondyloarthritis.
METHODS
This proof-of-concept, randomised, double-blind, placebo-controlled, phase 2, Bayesian (NAMASTE) trial was done at nine hospitals in the UK. Participants aged 18-75 years with axial spondyloarthritis, meeting the Assessment in SpondyloArthritis international Society (ASAS) criteria and the ASAS-defined MRI criteria, with active disease as defined by a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), were eligible. Those who had inadequately responded or had intolerance to previous treatment with an anti-TNF agent were included. Participants were randomly assigned (6:1) to receive subcutaneous namilumab 150 mg or placebo at weeks 0, 2, 6, and 10. Participants, site staff (except pharmacy staff), and central study staff were masked to treatment assignment. The primary endpoint was the proportion of participants who had an ASAS ≥20% improvement (ASAS20) clinical response at week 12 in the full analysis set (all randomly assigned participants). This trial is registered with ClinicalTrials.gov (NCT03622658).
FINDINGS
From Sept 6, 2018, to July 25, 2019, 60 patients with moderate-to-severe active axial spondyloarthritis were assessed for eligibility and 42 were randomly assigned to receive namilumab (n=36) or placebo (n=six). The mean age of participants was 39·5 years (SD 13·3), 17 were women, 25 were men, 39 were White, and seven had previously received anti-TNF therapy. The primary endpoint was not met. At week 12, the proportion of patients who had an ASAS20 clinical response was lower in the namilumab group (14 of 36) than in the placebo group (three of six; estimated between-group difference 6·8%). The Bayesian posterior probability η was 0·72 (>0·927 suggests high clinical significance). The rates of any treatment-emergent adverse events in the namilumab group were similar to those in the placebo group (31 vs five).
INTERPRETATION
Namilumab did not show efficacy compared with placebo in patients with active axial spondyloarthritis, but the treatment was generally well tolerated.
FUNDING
Izana Bioscience, NIHR Oxford Biomedical Research Centre (BRC), NIHR Birmingham BRC, and Clinical Research Facility.
PubMed: 38942047
DOI: 10.1016/S2665-9913(24)00099-7 -
Journal of the Mechanical Behavior of... Jun 2024Tooth extraction is a common clinical procedure with biomechanical factors that can directly influence patient outcomes. Recent development in atraumatic extraction...
BACKGROUND AND OBJECTIVE
Tooth extraction is a common clinical procedure with biomechanical factors that can directly influence patient outcomes. Recent development in atraumatic extraction techniques have endeavoured to improve treatment outcomes, but the characterization of extraction biomechanics is sparse. An axisymmetric inverse finite element (FE) approach is presented to represent the biomechanics of vertical atraumatic tooth extraction in an ex-vivo swine model.
METHODS
Geometry and boundary conditions from the model are determined to match the extraction of swine incisors in a self-aligning ex vivo extraction experiment. Material parameters for the periodontal ligament (PDL) model are determined by solving an inverse FE problem using clusters of data obtained from 10 highly-controlled mechanical experiments. A seven-parameter visco-hyperelastic damage model, based on an Arruda-Boyce framework, is used for curve fitting. Three loading schemes were fit to obtain a common set of material parameters.
RESULTS
The inverse FE results demonstrate good predictions for overall force-time curve shape, peak force, and time to peak force. The fit model parameters are sufficiently consistent across all three cases that a coefficient-averaged model was taken that compares well to all three cases. Notably, the initial modulus ,u, converged across trials to an average value of 0.472 MPa with an average viscoelastic constant g of 0.561.
CONCLUSIONS
The presented model is found to have consistent parameters across loading cases. The capability of this model to represent the fundamental mechanical characteristics of the dental complex during vertical extraction loading is a significant advancement in the modelling of extraction procedures. Future work will focus on verifying the model as a predictive design tool for assessing new loading schemes in addition to investigating its applications to subject-specific problems.
PubMed: 38941913
DOI: 10.1016/j.jmbbm.2024.106641 -
The International Journal of Oral &... Jun 2024To investigate residual debris within internal features of new "as received" dental implants.
PURPOSE
To investigate residual debris within internal features of new "as received" dental implants.
MATERIALS AND METHODS
A total of 15 new dental implants representing various dental implant brands were obtained in sealed containers from the manufacturers. Batch numbers and implant types were documented. In a controlled setting, implants were carefully unpacked, and their internal aspects were visually examined. Further analysis involved light microscopy imaging to document and photograph any foreign material. The internal aspect of the implants were sampled with both an endodontic paper cone and a fine bristle brush swab. These were inserted into the implant, rotated three times, then removed and examined under a microscope at 30x magnification. Post sampling some of the brushes/swabs were washed with alcohol to remove debris that could be further examined under magnification.
RESULTS
Inspection of the implants without magnification revealed no visible foreign materials. However, under light microscopy (x10 and x30), all 15 implants exhibited small black particles at various internal sites, including connections, threads, and deep within screw channels. Swabs evaluated at magnification detected what appeared to be metal particles in all 15 implants, ranging from distinct metal shards to smaller particles.
CONCLUSION
This study suggests that implant manufacturers have not effectively removed all machining debris from within implant bodies, potentially producing prosthetic and clinical complications.
PubMed: 38941171
DOI: 10.11607/jomi.11002 -
The International Journal of Oral &... Jun 2024The aim of this study is to examine the stresses on the peri-implant bone under occlusal forces of 30% Carbon fiber reinforced PEEK (Cfr-PEEK) and 60% Cfr-PEEK materials...
PURPOSE
The aim of this study is to examine the stresses on the peri-implant bone under occlusal forces of 30% Carbon fiber reinforced PEEK (Cfr-PEEK) and 60% Cfr-PEEK materials that can be used as an alternative to titanium dental implants by finite element analysis.
MATERIALS AND METHODS
Single-tooth implants of 30% Cfr-PEEK, 60% Cfr-PEEK and titanium were modeled in each of the maxillary anterior, maxilla posterior, mandibular posterior regions. As a result of the applied vertical and oblique forces; Von Misses stress, maximum principal stress and minimum principal stress values and stress distributions in the implant, cortical bone and spongious bone in each of the models were examined.
RESULTS
30% Cfr-PEEK implants stress in the surrounding bone was higher than titanium and 60% Cfr-PEEK implants. The 60% Cfr-PEEK material displayed lower stress distribution on both cortical and spongious peri-implant bone in all models.
CONCLUSION
Titanium and 60% Cfr- PEEK implants exhibited biomechanically similar behavior and these implants conducted stresses to bone more homogeneous than the 30% Cfr-PEEK implants. Overall, oblique forces had more destructive effect than vertical forces and denser bone structure showed better stress distribution against incoming forces. For the routine use of Cfr-PEEK material as dental implant material; animal and long-term clinical studies are needed.
PubMed: 38941169
DOI: 10.11607/jomi.10954 -
The International Journal of Oral &... Jun 2024To evaluate multiple risk factors of peri-implant bone loss.
OBJECTIVE
To evaluate multiple risk factors of peri-implant bone loss.
MATERIALS AND METHODS
A case-control study was conducted on patients who had received dental implants treatment from January 2018 to December 2021. Implants with bone loss were included in the case group, and implants with no bone loss were included in the control group. Risk factors including history of periodontitis, abutment connection type, implant surface, diameter, location, three-dimensional position, opposing dentition, adjacent teeth, prosthetic type, retention type and custom abutment were evaluated. A multivariate logistic regression model was used to evaluate these risk factors, providing corresponding odds ratios (ORs) with 95% confidence intervals (CIs).
RESULTS
A total of 776 implants in 479 patients were included in the analysis. The number of implants in the case group and the control group were 84 and 692, respectively. Cement-retained prostheses (OR=2.439, 95%CI=1.241-4.795) and nonplatform switch design (OR=2.055, 95%CI=1.167-3.619) were identified as weak risk factors. Horizontal deviation (OR=4.177, 95%CI=2.265-7.703) was a moderate risk factor. Vertical deviation (OR=10.107, 95%CI=5.280-19.347) and implants located in the mandibular molar region (OR=10.427, 95%CI=1.176-92.461) were considered high risk factors.
CONCLUSION
Implants in the molar region, cement retained, non-platform switch design, and poor three-dimensional implant positioning are identified as significant risk factors for peri-implant bone loss.
PubMed: 38941164
DOI: 10.11607/jomi.10939 -
The International Journal of Oral &... Jun 2024There are several factors that may influence implant site preparation with implant design being a paramount factor; however, few studies investigate its impact. The...
PURPOSE
There are several factors that may influence implant site preparation with implant design being a paramount factor; however, few studies investigate its impact. The purpose of the study was to explore the comparative efficacy of using two different drilling protocols using burs with different design for preparing implant sites, by evaluating radiographic and clinical outcomes.
MATERIALS AND METHODS
The present randomized controlled clinical trial with an allocation ratio of 1:1 was carried on in two private practice offices by two experienced surgeons and researchers. In the control group the surgeons followed the protocol with standard straight burs while in the test group they used step burs. In both groups the patients received the same type of implants and prosthesis. The primary outcome was the marginal bone resorption one year after the prosthetic placement.
RESULTS
In the study were included and treated a total of 60 subjects (86 implants). At the one-year follow-up were screened 54 subjects (74 implants), and 50 at the 2-year follow-up (69 implants). This study showed no evidence of a difference in bone resorption, which increased significantly over time, between the two groups.
CONCLUSIONS
Both clinical parameters and patientcentered outcomes revealed no difference between the two protocols of implant site preparation with two different drill shape.
PubMed: 38941163
DOI: 10.11607/jomi.11037 -
Clinical Oral Investigations Jun 2024The COHQoL is a set of questionnaires used to evaluate the impact of oral health on children's quality of life. Although the CPQ8-10 and the P-CPQ have been translated...
OBJECTIVES
The COHQoL is a set of questionnaires used to evaluate the impact of oral health on children's quality of life. Although the CPQ8-10 and the P-CPQ have been translated and validated in French, the CPQ11-14 14 has not yet been validated. The aim was to develop a French version of the CPQ11-14 16-items.
MATERIALS AND METHODS
The French version of CPQ11-14 was obtained by a forward-backward translation process and pretested. The final version was tested on children aged 11-14 and divided into three groups: children with orofacial clefts, children with rare dental diseases other than clefts, and children without anomalies. We conducted a cross-sectional study and evaluated the reliability with test-retest and internal consistency, and the questionnaire validity with construct validity and discriminant validity. We performed an Exploratory Factory Analysis (EFA).
RESULTS
187 children tested the questionnaire. The ICC of the test-retest was 0.76 and the Cronbach's alpha was 0.77. The correlation between the CPQ11-14 and self-assessment of oral health and general well-being was > 0.2. Patients with orofacial clefts and rare diseases had significantly higher scores for overall short-form CPQ11-14. The EFA revealed six factors.
CONCLUSION
The French CPQ11-14 is valid to assess the impact of oral health on children's quality of life.
CLINICAL RELEVANCE
The translation of this questionnaire into French will enable us to assess the impact of oral health on the quality of life of adolescents. This questionnaire complements the 8-10 years version of the CPQ, as well as the parental version that can be used in conjunction with the questionnaire.
Topics: Humans; Child; Surveys and Questionnaires; Female; Adolescent; Male; Cross-Sectional Studies; Quality of Life; Reproducibility of Results; Oral Health; France; Translations; Cleft Palate; Cleft Lip
PubMed: 38940970
DOI: 10.1007/s00784-024-05793-1