-
Journal of Medical Case Reports Jun 2024Free gingival graft is commonly used to augment the keratinized mucosa and vestibular depth around dental implants. The proper suturing technique is fundamental to...
BACKGROUND
Free gingival graft is commonly used to augment the keratinized mucosa and vestibular depth around dental implants. The proper suturing technique is fundamental to achieve a successful result following free gingival graft. However, there are limited studies that focus on the details of the suturing methods to optimize graft adaptation. The purpose of this technical note is to describe a new suturing technique for optimal approximation and stabilization of free gingival graft around dental implants.
CASE PRESENTATION
Here, we present a 53-year-old Persian female with peri-implantitis and lack of keratinized mucosa around mandibular implants who was a candidate for free gingival graft. A new suturing technique, double vertical interrupted suture, was conducted in the interimplant areas. In addition, the suspensory cross-mattress sutures were added to ensure the adaptation of the graft over the implants. The proposed suturing technique is useful for soft tissue augmentation around multiple implants with concave or uneven recipient bed.
CONCLUSION
The present article describes a novel suturing technique for good adaptation and fixation of free gingival graft around dental implants.
Topics: Humans; Female; Middle Aged; Gingiva; Suture Techniques; Dental Implants; Peri-Implantitis; Mandible
PubMed: 38918876
DOI: 10.1186/s13256-024-04611-2 -
BMC Oral Health Jun 2024Symmetrical and coordinated dental and alveolar arches are crucial for achieving proper occlusion. This study aimed to explore the association between dental and...
BACKGROUND
Symmetrical and coordinated dental and alveolar arches are crucial for achieving proper occlusion. This study aimed to explore the association between dental and dentoalveolar arch forms in children with both normal occlusion and malocclusion.
METHODS
209 normal occlusion subjects (5-13 years, mean 8.48 years) and 199 malocclusion subjects (5-12 years, mean 8.19 years) were included. The dentoalveolar arch form was characterized by the smoothest projected curve representing the layered contour of the buccal alveolar bone, referred to as the LiLo curve. Subsequently, a polynomial function was utilized to assess dental and dentoalveolar arch forms. To facilitate separate analyses of shape (depth/width ratio) and size (depth and width), the widths of dental and dentoalveolar arch forms were normalized. The normalized dental and dentoalveolar arch forms (shapes) were further classified into 6 groups, termed dental/dentoalveolar arch clusters, using the k-means algorithm.
RESULTS
The association between dental and dentoalveolar arch clusters was found to be one-to-many rather than one-to-one. The mismatch between dental and dentoalveolar arch forms is common in malocclusion, affecting 11.4% of the maxilla and 9.2% of the mandible, respectively.
CONCLUSIONS
There are large individual variations in the association between dental and dentoalveolar arch forms. Early orthodontic treatment may play an active role in coordinating the relationship between the dental and dentoalveolar arch forms.
Topics: Humans; Child; Cross-Sectional Studies; Dental Arch; Malocclusion; Female; Male; Child, Preschool; Adolescent; Alveolar Process; Dental Occlusion
PubMed: 38918757
DOI: 10.1186/s12903-024-04515-z -
Clinical Oral Investigations Jun 2024The study aims to compare the detection of the middle mesial canal (MMC) in mandibular molar teeth using cone beam computed tomography (CBCT) with different voxel sizes...
INTRODUCTION
The study aims to compare the detection of the middle mesial canal (MMC) in mandibular molar teeth using cone beam computed tomography (CBCT) with different voxel sizes when the mesiobuccal (MB) and mesiolingual (ML) canals have three distinct phases (unpreparation, preparation and obturation and the removal of the obturation and repreparation).
METHODS
Two hundred forty-two extracted human mandibular molars were collected and kept in a physiological saline solution prior to use. 0.2-, 0.28- and 0.35-mm voxel sizes CBCT (n = 242) were performed in three phases (Ph): Ph1, no MB and ML canal preparation or obturation; Ph2, after MB and ML canals preparation and obturation; and Ph3, after the removal of the obturation of MB and ML canals and canals repreparation. Images were analyzed using OnDemand3D® software. After the CBCT acquisition in Ph3, all the samples were clarified to visualize the presence of the MMC directly. A blinded, previously calibrated examiner analyzed all the images.
RESULTS
The MMC was detected in 15 of the 242 teeth after the clearing technique. The lowest MMC detection rate was observed at 0.35-mm voxel size regardless of the ML and MB canal condition, while the highest was observed at 0.2-mm voxel size (P < 0.05). There is no statistically significant difference between 0.2-mm and 0.28-mm voxel sizes (P > 0.05). In all voxel sizes, the highest rate of detectability of the MMC was seen in Phase 1, while the lowest was in Phase 2.
CONCLUSIONS
It may be appropriate to take a 0.20-mm voxel size CBCT image, especially after the removal of root canal filling.
CLINICAL RELEVANCE
An appropriate CBCT voxel size and the absence of root canal filling in the root canal system help to detect the missing MMC.
Topics: Cone-Beam Computed Tomography; Humans; Molar; Mandible; Dental Pulp Cavity; In Vitro Techniques; Root Canal Obturation; Root Canal Preparation; Root Canal Filling Materials
PubMed: 38916762
DOI: 10.1007/s00784-024-05773-5 -
Bone Research Jun 2024Stem/progenitor cells differentiate into different cell lineages during organ development and morphogenesis. Signaling pathway networks and mechanotransduction are...
Stem/progenitor cells differentiate into different cell lineages during organ development and morphogenesis. Signaling pathway networks and mechanotransduction are important factors to guide the lineage commitment of stem/progenitor cells during craniofacial tissue morphogenesis. Here, we used tooth root development as a model to explore the roles of FGF signaling and mechanotransduction as well as their interaction in regulating the progenitor cell fate decision. We show that Fgfr1 is expressed in the mesenchymal progenitor cells and their progeny during tooth root development. Loss of Fgfr1 in Gli1 progenitors leads to hyperproliferation and differentiation, which causes narrowed periodontal ligament (PDL) space with abnormal cementum/bone formation leading to ankylosis. We further show that aberrant activation of WNT signaling and mechanosensitive channel Piezo2 occurs after loss of FGF signaling in Gli1-Cre;Fgfr1 mice. Overexpression of Piezo2 leads to increased osteoblastic differentiation and decreased Piezo2 leads to downregulation of WNT signaling. Mechanistically, an FGF/PIEZO2/WNT signaling cascade plays a crucial role in modulating the fate of progenitors during root morphogenesis. Downregulation of WNT signaling rescues tooth ankylosis in Fgfr1 mutant mice. Collectively, our findings uncover the mechanism by which FGF signaling regulates the fate decisions of stem/progenitor cells, and the interactions among signaling pathways and mechanotransduction during tooth root development, providing insights for future tooth root regeneration.
Topics: Animals; Wnt Signaling Pathway; Tooth Root; Mechanotransduction, Cellular; Fibroblast Growth Factors; Mice; Cell Differentiation; Stem Cells; Receptor, Fibroblast Growth Factor, Type 1; Ion Channels
PubMed: 38910207
DOI: 10.1038/s41413-024-00345-5 -
Medicina Oral, Patologia Oral Y Cirugia... Jul 2024Brain-derived neurotrophic factor (BDNF) is a factor that implicate in the pathophysiology and treatment of depression and anxiety. The aim of this study was to... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Brain-derived neurotrophic factor (BDNF) is a factor that implicate in the pathophysiology and treatment of depression and anxiety. The aim of this study was to determine the relationship between dental anxiety and BDNF serum level through impacted third molar surgery.
MATERIAL AND METHODS
In this randomized, double-blind, cross-sectional study, the sample included patients who had been admitted for the impacted third molar extraction under local anesthesia between January to November 2020. The primary predictor variable was serum BDNF level and the second predictor variable was dental anxiety scores before and after operation in patients. The primary outcome variable was the correlation between anxiety scores (APAIS, MDAS, STAI, VAS) and serum BDNF level. The sample included 55 patients (22 Male, 33 Female) aged 18 to 42 (24,2+5,55).
RESULTS
Comparison of pre-operative scores (APAIS, MDAS, STAI, VAS and BDNF) and post-operative scores were statistically significant (P < .05). Post-operatively, MDAS and VAS scores decreased, while BDNF levels and STAI scores increased compared to the preoperative scores. BDNF was not correlated with APAIS, MDAS, STAI, and VAS preoperatively and postoperatively.
CONCLUSIONS
There may be a relationship between serum BDNF level and dental anxiety scale, but, no correlation was found between them.
Topics: Humans; Brain-Derived Neurotrophic Factor; Female; Male; Cross-Sectional Studies; Adult; Tooth, Impacted; Molar, Third; Young Adult; Dental Anxiety; Double-Blind Method; Adolescent; Tooth Extraction; Preoperative Period
PubMed: 38907644
DOI: 10.4317/medoral.26558 -
Medicina Oral, Patologia Oral Y Cirugia... Jul 2024Achieving the best outcomes in surgical procedures requires optimizing all patient-related psychological and physiological factors. This study was carried out to...
BACKGROUND
Achieving the best outcomes in surgical procedures requires optimizing all patient-related psychological and physiological factors. This study was carried out to evaluate the preoperative anxiety and fear levels, and postoperative symptoms in patients undergoing impacted third molar surgery, and to compare the relevant psychological and physical findings between genders and between women in different menstrual cycle phases.
MATERIAL AND METHODS
The population of this prospective and clinical study consisted of patients who applied to faculty of dentistry for the extraction of impacted third molars. The menstrual cycles of the female patients included in the study ranged from 26 to 32 days. The female patients included in the study were divided into three groups according to the first day of the menstrual cycle and bleeding status. All patients were administered Spielberger State-Trait Anxiety Inventory Short Version (STAI-S), Dental Fear Survey (DFS), Modified Dental Anxiety Scale (MDAS) preoperatively, and postoperative satisfaction and complication questionnaires.
RESULTS
The mean age of the 128 patients included in the study was 27.04±4.62 years. Of these patients, 79 (61.7%) were female and 49 (38.3%) were male. Female patients had significantly higher STAI-S, MDAS and DFS scores than male patients (94 vs. 53; 16 vs. 9; 58 vs. 27; p<0.001, respectively). In parallel, female patients had significantly higher complication rates, thus significantly lower satisfaction levels than male patients (116 vs. 51; 40 vs. 13; p<0.001, respectively). STAI-S, MDAS and DFS scores were high in women during the secretory phase (p<0.001). In the secretory phase, complications were high and satisfaction was low (p<0.001).
CONCLUSIONS
The findings of the study reveal that women have a harder time getting through the operation process and that timing is important in reducing preoperative anxiety and fear levels and increasing postoperative satisfaction levels and complication rates.
Topics: Humans; Female; Adult; Male; Prospective Studies; Menstrual Cycle; Sex Factors; Tooth Extraction; Cross-Sectional Studies; Molar, Third; Young Adult; Tooth, Impacted; Dental Anxiety
PubMed: 38907643
DOI: 10.4317/medoral.26443 -
Medicina Oral, Patologia Oral Y Cirugia... Jul 2024Sutures have been the standard flap closure method of choice following mandibular third molar surgery but can lead to some complications. Tissue adhesives, including... (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
BACKGROUND
Sutures have been the standard flap closure method of choice following mandibular third molar surgery but can lead to some complications. Tissue adhesives, including cyanoacrylate, have emerged as alternative flap closure method in this surgery to overcome such drawbacks. However, limited clinical trials can be found. Therefore, the aim of this clinical study was to compare two methods of flap closure in mandibular third molar surgery, cyanoacrylate and 4/0 silk sutures, by assessing post-operative outcome measures (pain, swelling, trismus, and healing) and patient-reported outcome measures (PROMs).
MATERIAL AND METHODS
A randomized split-mouth clinical trial was designed, in which mandibular third molar (M3M) extractions were performed, where the control side flap was closed with 4/0 silk sutures and the test side flap with cyanoacrylate. Swelling, pain, trismus, healing, and PROMs were recorded post-operatively. These variables were analyzed by means of the nonparametric Mann-Whitney U test, using SPSS statistical software version 28.0.0 (IBM® SPSS®, Chicago, IL, USA). For all results, a 95% confidence interval was recorded (significance level p < 0.05, two-tailed).
RESULTS
A total of 17 patients were recruited and 34 mandibular third molar extractions were performed. No statistically significant differences were found in terms of swelling, pain, trismus, healing, and PROMs between both groups (p<0.05).
CONCLUSIONS
No statistically significant differences were found between flap closure with 4/0 silk sutures and cyanoacrylate, in terms of surgical post-operative outcomes and PROMs. However, further studies with larger sample sizes are required to be able to affirm it with greater certainty.
Topics: Humans; Molar, Third; Male; Female; Adult; Surgical Flaps; Cyanoacrylates; Mandible; Young Adult; Sutures; Tooth Extraction; Suture Techniques
PubMed: 38907642
DOI: 10.4317/medoral.26375 -
BMC Oral Health Jun 2024A pulp stone is a calcified mass that develops in the dental pulp of any tooth. Despite many studies examining the relationship between pulp stone formation and non-oral...
BACKGROUND
A pulp stone is a calcified mass that develops in the dental pulp of any tooth. Despite many studies examining the relationship between pulp stone formation and non-oral factors, the methods used in these studies have been unable to explain the exact role of these factors alone as distinct from probable effects within the oral cavity environment. Considering that totally unerupted (impacted or developing) teeth are unexposed to the oral cavity's environmental and functional conditions, they provide a more suitable material for studying the effects of these non-oral factors on pulp stone formation. This research study aimed to investigate pulp stones in unerupted teeth and the associated factors in a Saudi subpopulation.
METHODS
The study included 644 cone-beam computed tomography images, with 496 (50.9%) maxillary and 479 (49.1%) mandibular teeth. Of the investigated patients, 293 (45.5%) were men, and 351 (54.5%) were women. The age range was 15-76 years. A chi-square test was used to investigate the associations between pulp stones and age, gender, and history of systemic disease and chronic medication use.
RESULTS
Pulp stones in unerupted teeth were present in 24.2% of the examined dental jaws and 18.6% of the examined teeth. There was no statistically significant relationship between pulp stones and gender (p > 0.05). A significantly greater percentage of pulp stones were found with increasing age (p = 0.000). Additionally, a significantly increased number of pulp stones was observed in patients with systemic diseases and chronic medications (p < 0.05).
CONCLUSIONS
The results support the idea that pulp stones can be present in any type of unerupted tooth. This study provides additional evidence of the increased incidence of pulp stones with age, systemic disease, and chronic medications.
Topics: Humans; Cone-Beam Computed Tomography; Female; Adult; Male; Retrospective Studies; Adolescent; Middle Aged; Dental Pulp Calcification; Young Adult; Aged; Tooth, Unerupted; Saudi Arabia; Age Factors
PubMed: 38907221
DOI: 10.1186/s12903-024-04503-3 -
Frontiers in Public Health 2024Limited attention has been given to oral health challenges faced by older Indigenous populations, especially in rural settings, where disparities exist. This study aims...
BACKGROUND
Limited attention has been given to oral health challenges faced by older Indigenous populations, especially in rural settings, where disparities exist. This study aims to assess oral health in a rural Mapuche community in southern Chile, utilizing geriatric technology support, and exploring the connection between geriatric health and oral well-being to fill a gap in this context.
METHODS
A cross-sectional study was conducted involving 76 independent older adults from a rural Mapuche community who required dental care. Assessments were in a remote care setting gathering extensive data including comprehensive geriatric assessments, medical and dental conditions using a geriatric teledentistry platform (TEGO). Statistical analysis involved descriptive analysis, logistic regression, and both multiple correspondence analysis and k-means cluster analysis.
RESULTS
The sample comprised individuals with limited formal education and a high degree of vulnerability. Geriatric assessments unveiled cognitive deterioration, frailty, depression risk, and multimorbidity. A distribution of the DMFT index, number of remaining teeth, number of occluding pairs, number of teeth with restorative needs and other relevant clinical findings was conducted based on sociodemographic, and medical-geriatric-dental characteristics, and additionally, a Multinomial Logistic Regression Analysis of Dentition Variables in Relation to Geriatric Assessments was performed. The dental burden was substantial, with an average DMFT index of 25.96 (SD 4.38), high prevalence of non-functional dentition (89.3%), periodontal disease (83%), xerostomia (63.2%) and oral mucosal lesions (31.5%). Age, lower education, depression, daily medication number and sugary consumption frequency were associated with a decreased average number of teeth ( < 0.05). Multiple correspondence analysis and k-means cluster analysis identified 4 clusters, with the edentulous and functional dentition groups being the most distinct.
CONCLUSION
This study uncovers a substantial dental burden and intricate medical-geriatric conditions interlinked among Indigenous older adults in a rural Chilean Mapuche community. The implementation of a geriatric technological ecosystem in the community enabled the resolution of less complex oral health issues and facilitated remote consultations with specialists, reducing the necessity for travel to health centers. This underscores the need for innovative dental public health initiatives to address health disparities and improve the overall well-being of older Indigenous adults.
Topics: Humans; Chile; Aged; Female; Male; Cross-Sectional Studies; Oral Health; Rural Population; Geriatric Assessment; Aged, 80 and over; Telemedicine
PubMed: 38903581
DOI: 10.3389/fpubh.2024.1356622 -
Unravelling the Complexities of Bite Force Determinants in Paediatric Patients: A Literature Review.Cureus May 2024The amount of maximum voluntary bite force (MVBF) is determined by the combined action of the jaw elevator muscles, which are altered jaw biomechanics and reflex... (Review)
Review
The amount of maximum voluntary bite force (MVBF) is determined by the combined action of the jaw elevator muscles, which are altered jaw biomechanics and reflex processes. Bite force (BF) measurements can yield valuable information on the activity and function of the jaw muscles. The accuracy of biting force measurements depends on several variables, including age, gender, malocclusion, dental caries, dental prostheses and temporomandibular joint (TMJ). This information is essential for evaluating the development and function of the masticatory system, identifying potential abnormalities or impairments and guiding appropriate treatment interventions for paediatric patients. The aim of this article is to review the literature on the factors affecting bite force and the importance of these factors in assessing dental development and guiding interventions for paediatric patients with bite force-related issues. Additionally, establishing normative values for bite force in different age groups can aid in monitoring growth and detecting any deviations from expected patterns. Measuring bite force in paediatric patients is significant in comprehensive oral health assessment and management.
PubMed: 38903313
DOI: 10.7759/cureus.60630