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Photodiagnosis and Photodynamic Therapy Jun 2024Distinguishing between discoloration caused by caries and organic stains is challenging for dentists in clinical settings. Biofluorescence (BF)-bleaching assesses caries...
Distinguishing discolored caries lesions using biofluorescence and dental bleaching: an in vitro simulation model study: Discolored caries lesion using biofluorescence and dental bleaching.
BACKGROUND
Distinguishing between discoloration caused by caries and organic stains is challenging for dentists in clinical settings. Biofluorescence (BF)-bleaching assesses caries lesions by evaluating BF changes after removing organic stains through dental bleaching, leaving cariogenic discoloration. This study aimed to apply BF-bleaching to a simulation model mimicking cariogenic discoloration and compare the BF color changes between organic staining and cariogenic discoloration.
METHODS
Thirty artificial caries lesions in bovine incisors were equally divided into three groups: non-stained (NS), organic-stained (OS), and cariogenic-stained (CS) groups. The specimens were treated with bleaching agent, then BF color of each specimen was evaluated using red BF intensity (ΔR), BF hue angle (h°), and hyperspectral BF spectrum.
RESULTS
The ΔR of CS was approximately 2.74 and 1.73 times higher than that of OS, at baseline and after bleaching for 20 minutes, respectively. After 20 min of bleaching, the h° of CS increased by approximately 8.1° compared to the baseline, while maintaining the red BF hue range (345‒15°). In contrast, the BF hue of OS shifted from orange (15‒45°) to yellow (45‒75°) simultaneously, and the h° change was approximately 21.9°. Both CS and OS exhibited first emission peaks near 515 nm, and CS showed second peaks in the red range (620‒780 nm). After bleaching, the first peaks were restored to the sound enamel direction (peak at 486 nm), whereas the second peak of red BF in CS was maintained.
CONCLUSION
Applying BF-bleaching to discolored caries lesions allowed differentiation between cariogenic discoloration and organic staining based on BF color changes.
PubMed: 38945385
DOI: 10.1016/j.pdpdt.2024.104262 -
Progress in Orthodontics Jul 2024The American Association of Orthodontists white paper on obstructive sleep apnea and orthodontics remains the most authoritative statement on the topic. This was... (Review)
Review
BACKGROUND
The American Association of Orthodontists white paper on obstructive sleep apnea and orthodontics remains the most authoritative statement on the topic. This was produced in 2019 due to increasing orthodontic interest in obstructive sleep apnea (OSA) and the lack of formal guidelines for orthodontists. Since the white paper's release, advocacy for contrarian ideas and practices remain. Orthodontists are sometimes acting as primary care providers for OSA. Procedures appropriate only for screening are sometimes being used for diagnosis. The side effects of effective treatments such as mandibular advancement devices need further consideration. Also, research has clarified the effectiveness and ineffectiveness of treatments such as palatal expansion.
RESULTS
Part of an orthodontist's role is screening for OSA. The correct action when this is suspected remains referral to the appropriate physician specialist for diagnosis and treatment or coordination of treatment. Orthodontists may participate in the treatment of patients with OSA as a member of a multi-disciplinary team. Effective orthodontic treatments may include orthognathic surgery with maxillomandibular advancement and mandibular advancement devices. The negative effects of the latter make this a choice of last resort. Current research indicates that OSA alone is not sufficient indication for palatal expansion.
CONCLUSIONS
Orthodontists should appropriately screen for obstructive sleep apnea. This may be done as part of our health histories, our clinical examination, and review of radiographs taken for purposes other than the diagnosis and screening for OSA. Orthodontic treatment for OSA can be helpful and effective. However, this may be done only after referral to the appropriate physician specialist, as part of a multi-disciplinary team, with consideration of the likely effectiveness of treatment, and after all likely and potential negative consequences have been considered and thoroughly discussed with the patient.
Topics: Sleep Apnea, Obstructive; Humans; Orthodontists; Mandibular Advancement; Palatal Expansion Technique; Professional Role; Orthodontics; Orthodontics, Corrective; Referral and Consultation
PubMed: 38945976
DOI: 10.1186/s40510-024-00524-4 -
Journal of Dentistry Jun 2024Tooth preparation is complicated because it requires the preparation of an abutment while simultaneously predicting the ideal shape of the tooth. This study aimed to...
OBJECTIVES
Tooth preparation is complicated because it requires the preparation of an abutment while simultaneously predicting the ideal shape of the tooth. This study aimed to develop and evaluate a system using augmented reality (AR) head-mounted displays (HMDs) that provide dynamic navigation capabilities for tooth preparation.
METHODS
The proposed system utilizes optical see-through HMDs to overlay digital information onto the real world and enrich the user's environment. By integrating tracking algorithms and three-dimensional modeling, the system provides real-time visualization and navigation capabilities during tooth preparation by using two different visualization techniques. The experimental setup involved a comprehensive analysis of the distance to the surface and cross-sectional angles between the ideal and prepared teeth using three scenarios: traditional (without AR), overlay (AR-assisted visualization of the ideal prepared tooth), and cross-sectional (AR-assisted visualization with cross-sectional views and angular displays).
RESULTS
A user study (N=24) revealed that the cross-sectional approach was more effective for angle adjustment and reduced the occurrence of over-reduction. Additional questionnaires revealed that the AR-assisted approaches were perceived as less difficult, with the cross-sectional approach excelling in terms of performance.
CONCLUSIONS
Visualization and navigation using cross-sectional approaches have the potential to support safer tooth preparation with less overreduction than traditional and overlay approaches do. The angular displays provided by the cross-sectional approach are considered helpful for tooth preparation.
CLINICAL SIGNIFICANCE
The AR navigation system can assist dentists during tooth preparation and has the potential to enhance the accuracy and safety of prosthodontic treatment.
PubMed: 38944264
DOI: 10.1016/j.jdent.2024.105217 -
BMC Oral Health Jun 2024There are more than one million children and adolescents living with type 1 diabetes mellitus, and their number is steadily increasing. Diabetes affects oral health... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
There are more than one million children and adolescents living with type 1 diabetes mellitus, and their number is steadily increasing. Diabetes affects oral health through numerous channels, including hyposalivation, immune suppression, and the inflammatory effect of glycation end-products. However, patients with type 1 diabetes must follow a strict sugar free diet that is proven to be carioprotective. Therefore, the aim of this systematic review and meta-analysis is to investigate whether children with type 1 diabetes have a difference in Decayed, Missing, Filled Teeth index (DMFT), salivary function, and periodontal status than children without diabetes, with an emphasis on glycemic control.
MATERIALS AND METHODS
PubMed, Embase and Cochrane libraries were screened for articles, using predefined search keys without any language or date restrictions. Two independent authors performed the selection procedure, extracted data from the eligible articles, carried out a manual search of the reference lists, and assessed the risk of bias using the Newcastle-Ottawa scale. Meta-analysis was performed in R using the random-effects model. Effect sizes were mean differences; subgroup analysis was performed on glycemic control.
RESULTS
33 studies satisfied the eligibility criteria. 22 studies did not show a significant difference regarding the DMFT index between the diabetes and non-diabetes groups; six studies found that children living with diabetes had higher DMFT scores, compared to five studies that found significantly lower scores. Meta-analysis found no statistically significant differences in plaque, gingival, and calculus indexes, however it found significant differences in pooled DMFT indexes, and salivary flow rate. Subgroup analysis on glycemic control using DMFT values found significant differences in children with good and poor glycemic control with results of 0.26 (CI95%=-0.50; 1.03) and 1.46 (CI95%=0.57; 2.35), respectively.
CONCLUSIONS
Children with poor glycemic control face higher risk of developing caries compared to good control and non-diabetes children. Regular dental check-ups and strict control of glycemic levels are highly advised for children living with type 1 diabetes, further emphasizing the importance of cooperation between dentists and diabetologists.
Topics: Humans; Diabetes Mellitus, Type 1; Child; Oral Health; Glycemic Control; Adolescent; DMF Index
PubMed: 38943074
DOI: 10.1186/s12903-024-04516-y -
British Dental Journal Jun 2024For many people, being a parent of five children is more than enough to keep oneself occupied. Mitzi Coyle (Macey-Dare) did that, and gained a top post in the community...
For many people, being a parent of five children is more than enough to keep oneself occupied. Mitzi Coyle (Macey-Dare) did that, and gained a top post in the community dental service, with a string of dental and other postgraduate qualifications. Her children are equally talented.
Topics: History, 20th Century; History, 21st Century; Humans; Forensic Dentistry; Dentists; Community Dentistry
PubMed: 38942868
DOI: 10.1038/s41415-024-7509-2 -
British Dental Journal Jun 2024
Topics: Humans; Endodontics; Artificial Intelligence
PubMed: 38942866
DOI: 10.1038/s41415-024-7567-5 -
British Dental Journal Jun 2024
Topics: Humans; Periodontics; Education, Dental
PubMed: 38942865
DOI: 10.1038/s41415-024-7566-6 -
British Dental Journal Jun 2024
Topics: Humans; Orthodontics, Corrective; Time Factors
PubMed: 38942864
DOI: 10.1038/s41415-024-7565-7 -
British Dental Journal Jun 2024
Topics: Humans; Periodontitis
PubMed: 38942863
DOI: 10.1038/s41415-024-7564-8 -
British Dental Journal Jun 2024
Topics: Humans; Oral Health; United Kingdom; Healthcare Disparities
PubMed: 38942860
DOI: 10.1038/s41415-024-7554-x