Dentistry Journal

To assess the reliability and failure modes of Ti-base abutments supported by narrow and wide-diameter implant systems. Narrow (Ø3.5 × 10 mm) and wide (Ø5 × 10 mm) implant systems of two different manufacturers with internal conical connections (16°) and their respective Ti-base abutments (3.5 and 4.5 mm) were evaluated. Ti-base abutments were torqued to the implants, standardized metallic maxillary incisor crowns were cemented, and step stress accelerated life testing of eighteen assemblies per group was performed in three loading profiles: mild, moderate, and aggressive until fracture or suspension. Reliability for missions of 100,000 cycles at 100 and 150 N was calculated, and fractographic analysis was performed. For missions at 100 N for 100,000 cycles, both narrow and wide implant systems exhibited a high probability of survival (≥99%, CI: 94–100%) without significant differences. At 150 N, wide-diameter implants presented higher reliability (≥99%, CI: 99–100%) compared to narrow implants (86%, CI: 61–95%), with no significant differences among manufacturers. Failure mode predominantly involved Ti-base abutment fractures at the abutment platform. Ti-base abutments supported by narrow and wide implant systems presented high reliability for physiologic masticatory forces, whereas for high load-bearing applications, wide-diameter implants presented increased reliability. Failures were confined to abutment fractures. Full article

Ectopic permanent molar is a condition in which the permanent tooth deviates from its normal path of eruption. The etiology of this eruption anomaly is multifactorial, with both general and local factors. The principal results suggest that a valid indicator of irreversible consequences is the degree of impaction of the first permanent molar. Self-correction is most common between the ages of 7 and 8, after which help may be required. Accordingly, early management can assist in preventing subsequent potential challenges that could interfere with maintaining a balanced occlusion. Several variables, including the degree of mesial tilting, the level of root resorption, and the condition of the second primary molar, may be crucial in choosing the most effective method of treatment. Interproximal wedging and distal tipping are the two basic therapeutic strategies for ectopic permanent molars. Additionally, the use of fixed or removable appliances might also be required. Delaying treatment until a later stage is not recommended because early diagnosis and treatment are essential for optimal management. This review aims to provide a comprehensive overview of ectopic permanent molars, including their prevalence, etiologic factors, self-correction rates, clinical implications for adjacent teeth, and various treatment techniques, that emphasizes the importance of early detection and intervention in the successful management of ectopic permanent molars. In addition, it highlights the importance of future research into the contributing variables of irreversible ectopic molar outcomes. Full article

Aim: This study aimed to investigate the relationship between dental caries, dental anxiety, and salivary cortisol levels in children visiting pediatric dental clinics and their implications on pediatric oral health. Materials and Methods: A cross-sectional study was conducted at a dental university in the UAE. A total of 60 children, aged 4–12 years, were included. Salivary cortisol levels were measured using an Enzyme-Linked Immunosorbent Assay (ELISA) kit. Dental caries status was evaluated, and dental anxiety levels were assessed using the Modified Dental Anxiety Scale (MDAS). Statistical analyses, including Mann-Whitney U test and Pearson’s correlation coefficient, were performed to determine significant differences and associations. Results: The study group showed significantly higher salivary cortisol levels compared to the control group (p < 0.0001). A strong positive correlation was found between salivary cortisol levels and dental caries status (p < 0.001). However, no significant difference in dental anxiety levels was observed between the study and control groups (p = 0.85). A strong positive correlation was found between dental anxiety levels and dental caries status (p < 0.001). Conclusion: The findings indicate a significant association between salivary cortisol levels and dental caries, suggesting that higher cortisol levels are associated with active caries. Dental anxiety levels were positively correlated with dental caries. Understanding the relationship between these variables can contribute to better oral health strategies and interventions for children, emphasizing the importance of managing dental anxiety and stress in pediatric dental care. Clinical Significance: This study highlights the potential of salivary cortisol as a biomarker for assessing stress and its impact on oral health in children. By addressing dental anxiety and stress, dental professionals can provide child-friendly dental care, enhance preventive measures, and improve oral health outcomes in pediatric patients. Full article

The purpose of this study is a new method that can help to identify the sex through the study of palatal rugae, comparing sagittal sections of the hard palate using Cartesian coordinates and evaluating the assistance given by digital technology and its applicability in this method. In this study, 57 digital impressions were examined and divided in two groups based on sex. Results: 2223 impression sections were studied and 145 coordinates that were present with a frequency greater than 50% in one or both groups were obtained: 52 discriminating traits (DT) in the male group, 29 discriminating traits in the female group, and 64 common traits (CT). The DTs in the female group showed no statistically significant difference from the same coordinates in the male one (p = 0.832). Statistically significant differences were observed in the DTs in the male group compared to the same coordinates in the female group (p = 0.018). No statistically significant differences were observed in the frequency of DTs in both sexes (p = 0.056). Further research in forensic odontology is needed to determine its scientific certainty. It is certain that digital technology may one day be a valuable support for the forensic odontologist but to date the lack of dedicated and certified programs limits its reliability. Full article

Objective: This study aimed to identify the key aspects of patients’ dental care experience that influenced their self-perceived satisfaction and loyalty. Also examined was the agreement between patients and dentists regarding these factors. Methods: Questionnaires were administered to 1121 patients and 77 dentists, focusing on demographic information and 15 selected items related to the patients’ last dental visit. Descriptive and linear regression analyses were conducted. Results: The study included participants from 41 practices. Factors significantly influencing satisfaction and loyalty included location convenience, treatment quality, trust in dentists’ decisions, visit frequency satisfaction, clear treatment explanations, dentist’s interest in symptoms, patient-dental personnel attachment, and dentist’s knowledge of the patient and their medical records. While overall agreement between patients and dentists was high, some areas exhibited notable disagreement. Conclusions: The findings mostly align with existing literature, underscoring the importance of communication, trust, and a personal patient-dentist relationship in promoting satisfaction and loyalty. However, they also show that local, generally not reported factors might be at play, which necessitates dentists’ awareness and consideration of the local context for optimal outcomes. Full article

The purpose of the study is to compare the hardness of different metallic brackets to enamel and to determine their chemical composition and microstructure. Five metallic brackets (0.022″ × 0.028″ inch) from seven orthodontic firms produced in different alloys (Discovery^® Smart/Empower^®/Genius^®2 Metal/Victory^TM series/Equilibrium^®/Damon Q) were chosen (n = 35). The hardness of the brackets and enamel was measured using a microhardness tester. The study of the chemical composition of brackets was carried out on a single bracket per series. A scanning electron microscope (SEM) equipped with an energy dispersive spectroscopy (EDS) detector was used. Analysis of the chemical composition of metallic brackets was obtained with Oxford Instruments Ultim Max Aztec software. Metallic brackets’ hardness varied from 203 to 439 HV. A significant difference exists between Ti Equilibrium^® brackets, the rest of the brackets and the enamel (p-value = 0.003). No significant difference was found between SS_a(stainless-steel alloy), Co-Cr_a(Cobalt-Chrome) brackets and the enamel. The chemical study confirms that the alloys used to produce metallic brackets validate all the data of the manufacturers except for Genius^®2 Metal; according to this study, they are considered to be Co-Cr_a alloys. The study of the composition of brackets made it possible to confirm manufacturers’ data. Genius^®2 Metal brackets, Empower^®2 and Victory^TM series brackets filled the properties needed for orthodontic treatment. The hardness of metallic brackets is influenced by the alloy used and manufacturing method. Co-Cr_a brackets with hardness comparable to enamel can be considered as an alternative to SS_a brackets in patients allergic to nickel. Full article

Objective: To assess the perceptions of faculty members from dental schools in Southeast Asian countries regarding the implementation of online learning during the COVID-19 pandemic. Methods: A previously implemented questionnaire comprising 43 questions was utilized in this study. Lecturers from four universities in Southeast Asia were invited to participate in the study. Statistical analysis: The data were analyzed using SPSS version 25.0 through several types of comparative and correlation analyses. Results: There were 183 lecturers who participated in the study. The overall responses suggest that the perceived effectiveness of online learning in dentistry was centered on a neutral value. The participants faced challenges when implementing online learning during the COVID-19 pandemic, with the lack of interaction being the most challenging factor. They agreed that online learning had many advantages, specifically in time flexibility and communication. The participants had stronger perceptions relating the advantages and opportunities of online teaching, and recognized that the effectiveness of offline teaching alone was limited. Conclusion: The perceptions of Southeast Asian dental school faculty members were inclined toward a positive outlook on blended learning for implementation in dentistry, as a means of providing opportunities to use online learning beyond COVID-19 in the future. Full article

Objective: To evaluate the clinical outcome of root canal treatment by obturation technique, root canal filling quality, and tooth- and patient-related variables. Methods: This clinical study investigated the endodontic outcome of 114 teeth treated between the years 2009 and 2012. Three different obturation methods were used: (1) adhesive obturation using the continuous wave of condensation technique with Resilon^® (CWR), (2) matching-taper single-cone technique with gutta-percha and AH Plus^® (SCGP), and (3) matching-taper single-cone technique with gutta-percha and GuttaFlow^® (SCGF). Pre- and postoperative periapical radiographs were performed to detect the presence of endodontic lesions (PAI classification) and to assess the quality of both the obturation and the restoration. Tooth- and patient-related data were collected. Results: The overall endodontic success rate was 75.4% after a mean observation period of 6.3 years. There were no significant correlations between the type or overall quality of obturation and the treatment outcome. Teeth with preoperative lesions had the highest odds ratio (factor of 4.98) for endodontic failure. Tooth- and patient-related variables had no significant effect on endodontic outcome. Conclusions: The preoperative periapical status of teeth requiring endodontic treatment was a substantial prognostic factor for endodontic outcome, whereas the type of obturation material or technique did not affect it. Full article

Data regarding the mechanical properties of three-dimensionally (3D) printed materials for occlusal splint manufacturing are scarce. The aim of the present study was to evaluate the flexural strength and surface hardness of modern 3D-printed occlusal splint materials and compare them with two control groups, namely, milled and conventional cold-polymerized occlusal splint materials. A total of 140 rectangular specimens were manufactured for the present study. The specimens were prepared in accordance with the International Organization for Standardization standards (ISO 20795-1:2013). Five 3D-printed (NextDent Ortho Rigid, Dental LT Clear, Dentona Flexisplint, Cosmos Bite Splint, and ProArt Print Splint), one milled (ProArt CAD Splint), and one cold-polymerized (ProBase Cold) occlusal splint materials were used to determine flexural strength and surface hardness values. The three-point flexure test was used for the determination of flexural strength values, while Vickers hardness was measured to determine surface hardness. Ten specimens (n = 10) of each material were tested using these procedures. One-way ANOVA and Tukey’s post-hoc test were used to analyze the obtained results (α = 0.05). The values of flexural strength ranged from 46.1 ± 8.2 MPa to 106 ± 8.3 MPa. The Vickers hardness values ranged from 4.9 ± 0.5 VHN to 20.6 ± 1.3 VHN. Significant differences were found among the tested materials (p < 0.0001). The milled and cold-polymerized materials yielded higher values for both flexural strength (only one 3D-printed resin had comparable results to cold-polymerized acrylics) and surface hardness. There are differences in the mechanical properties of the various tested occlusal splint materials. The flexural strength of most of the 3D-printed materials and their surface hardness values are still inferior when compared to the milled or cold-polymerized materials. Full article

The aim of this study was to assess, whether patients prior to endoprosthesis (EP) visit their dentist for need-oriented therapy and whether this would be associated with the occurrence of complications. Based on a cohort of patients, which was orally investigated prior to EP surgery between 04/2020 and 12/2021, a telephone interview was performed at least six months after EP implantation. Patients were classified into either low-risk (LR), moderate-risk (MR), or high-risk (HR) groups. Participants were interviewed based on a structured questionnaire regarding dental visits, dental therapy, and potential complications during the observational period. Out of the 311 patients from the baseline cohort, 96 patients after EP implantation could be included (participation rate of 31%). Nineteen patients were in LR (20%), 41 in MR (43%), and 36 in the HR group (37%). Overall, 79% (n = 76) of the patients followed the recommendation to visit their dentist; 94% of patients within the HR group visited the dentist (p = 0.02). Dental treatment procedures included tooth cleaning (57%), periodontal treatment (31%), restorative therapy/filling (28%), and tooth extraction (28%). In 64% of the HR patients (n = 23), the potential oral foci with a risk of EP infection were eliminated by their general dentist. Fourteen different complications occurred within the observation period, without any group effect (p > 0.05). In conclusion, most patients prior to EP visit their general dentist following referral, especially if they have a potential oral focus. The effect of dental clearance on infectious complications of EP remains unclear, whereby further clinical studies are needed. Full article

The heat produced during tooth preparation could be a source of damage for dental pulp, and many variables are involved in this process. The aim of this in vitro study was to evaluate whether the different degrees of wear of the diamond burs significantly influenced the temperature changes in the pulp chamber during tangential veneer preparation. The sample comprised 30 intact permanent monoradicular teeth, randomly assigned to three study groups of 10 teeth each, of which 5 had the pulp tissue preserved and 5 had thermoconductive paste in the pulp chamber. For prosthetic preparation, we used new burs in the first group, burs at their fifth use in the second group, and burs at their eighth use for the third group. The pulp chamber temperature was evaluated at the start, after one minute, and after three minutes of preparation, using a k-type thermocouple. The results of the three-way ANOVA and Tukey post hoc comparisons showed a highly significant effect of the time of measurement, while the pulp condition and the degree of wear of the burs had no effect. In conclusion, the different degrees of wear of conventional diamond burs do not produce statistically significant different changes in the pulp chamber temperature. Full article

After tooth extraction, the alveolar ridge undergoes a physiological process of remodelling and disuse atrophy. Socket augmentation (SA) has been shown to preserve alveolar bone volume in order to facilitate implant placement and reduce the need for staged grafting at a later date. Although autogenic grafting has been shown to be the gold standard in bone regeneration, it has significant disadvantages. To prevent post-extraction volumetric alterations and alveolar bone resorption occurring, alternative grafting materials, including xenografts, alloplasts, and allografts, have been used successfully in fresh extraction sites. However, these materials act mostly as bio-scaffolds and require a slower integration period of 6–8 months prior to implant placement. Recently, the use of autologous platelet-rich fibrin (PRF) has been advocated alongside socket augmentation as a method of bio-enhancement of healing of soft and hard tissues. PRF contains platelet-derived growth factors, hormones, and bioactive components such as cytokines that have been shown to promote angiogenesis and tissue regeneration during wound healing. The aim of this article is to review the evidence base for the SA technique Clinical benefits of SA will be discussed with a reference to two cases. Therefore, this narrative review will discuss the post-extraction bone changes, the importance of SA, and the bio-enhancement role of PRF in the management of extraction site defects when the alternative technique of immediate implant placement is not possible or contraindicated. Full article

Sports activities may induce long-lasting changes in mandibular trajectories. The aim was to compare condylar and mandibular movements in athletes with orofacial injuries with values measured in non-injured athletes. The group of 132 athletes without mandibular injury included asymptomatic athletes with a history of a blow to the right side (N = 43) and the group included asymptomatic athletes with a history of a blow to the left side (N = 41) of the mandible. The injured athletes suffered from stiffness/pain and/or limitation of jaw movements. The symptoms disappeared shortly after the injury. Athletes with a history of injury have smaller mean values of Bennett angle on the side of impact, and Bennett angle on the opposite side is greater than the mean found in non-injured athletes. Significantly smaller Bennett angle values in athletes with a history of a blow to one side of the mandible are due to the adaptability of the orofacial system. The larger Bennett angle on the opposite side of the injury is also due to the adaptive mechanism of the TMJ. Clinical Relevance: An individualized approach to TMJ values is mandatory in restorative procedures in every patient, especially in patients with a history of trauma to the orofacial system. Full article

Oral microbiota play a pivotal role in maintaining homeostasis, safeguarding the oral cavity, and preventing the onset of disease. Oral dysbiosis has the potential to trigger pro-inflammatory effects and immune dysregulation, which can have a negative impact on systemic health. It is regarded as a key etiological factor for periodontitis. The emergence and persistence of oral dysbiosis have been demonstrated to mediate inflammatory pathology locally and at distant sites. The heightened inflammation observed in oral dysbiosis is dependent upon the secretion of interleukin-17A (IL-17A) by various innate and adaptive immune cells. IL-17A has been found to play a significant role in host defense mechanisms by inducing antibacterial peptides, recruiting neutrophils, and promoting local inflammation via cytokines and chemokines. This review seeks to present the current knowledge on oral dysbiosis and its prevention, as well as the underlying role of IL-17A in periodontitis induced by oral dysbiosis and its impact on systemic inflammatory disease. Full article

Aim of this study was to demonstrate the diagnostic ability to differentiate odontogenic keratocysts (OKCs) from ameloblastomas (AMs) based on computed tomography (CT) or cone beam computed tomography (CBCT) scans. Preoperative CT and CBCT scans from 2004 to 2019 of OKCs and AMs were analyzed in 51 participants. Lesions were three-dimensionally (3D) assessed and Hounsfield units (HU) as well as gray scale values (GSV) were quantified. Calculated HU spectra were compared within the same imaging modalities using unpaired t-tests and correlated with participants characteristics by calculating Pearsons correlation coefficients. Within the CT scans, AMs had highly significantly higher HU values compared to OKCs (43.52 HU and 19.79 HU, respectively; p < 0.0001). Analogous, within the CBCT scans, AMs had significantly higher GSV compared to OKCs (−413.76 HU and −564.76 HU, respectively; p = 0.0376). These findings were independent from participants’ gender and age, anatomical site, and lesion size, indicating that the HU- and GSV-based difference reflects an individual configuration of the lesion. HU and GSV spectra calculated from CT and CBCT scans can be used to discriminate between OKCs and AMs. This diagnostic approach represents a faster and non-invasive option for preoperative diagnosis of such entities and has potential to facilitate therapeutic decision making. Full article

Background: The complex traditional treatment of inflammation diseases in oral cavity includes the prescription of antibiotic and antiseptic therapy. This systematic review aims to evaluate the effect of photodynamic therapy as a part of management of inflammatory diseases in oral cavity; Methods: The study is presented in accordance with the preferred reporting points for systematic reviews and meta-analyses (PRISMA). This systematic review was conducted using electronic databases such as Medline PubMed, Scopus and the Cochrane Central Register of Controlled Trials. All the studies in this systematic review, were randomized, the risk of bias 2 (ROB 2) were assessed; Results: Considering the inclusion and exclusion criteria, we included 10 randomized clinical trials, published up to 2023 investigating the application of photodynamic therapy as a part of management of inflammatory diseases in oral cavity. The diode laser was used in the oral cavity in the zone of inflammatory process (gingivitis, mucositis, periimplantitis, marginal periodontitis, abscess, periostitis, osteomyelitis etc.) in nine studies or in the zone before surgical procedures in one study; Conclusion: Based on the results of clinical studies, it can be stated that photodynamic therapy shows good results for operations performed in the oral cavity and pharynx. Full article

Introduction: Myobrace^® is an orthodontic device that has the purpose of correcting oral dysfunctions, thus predisposing the physiological growth of the jaws, aligning teeth, and optimizing face development. This device is usually associated with Myobrace^® Activities to reach this target. Considering the lack of studies in the literature about peripheral blood oxygen saturation (SpO₂) and the use of preformed oral devices, the aim of this study is to quantify the change in blood oxygen saturation (SpO₂) in patients treated with the Myobrace^® System in mixed dentition. Materials and Methods: In this study, 23 children (11 females and 12 males) were involved, who were affected by different oral dysfunctions and were treated with a Myobrace^®. Blood oxygen saturation measurements were taken at baseline and after every four months for a year. The SpO₂ measurements were taken in the rest position and with a closed mouth for a total of 12 min—6 min with and 6 min without the Myobrace^® oral device. All data points were anonymized and recorded on an Excel spreadsheet. A statistical analysis was carried out. Results: Therapy with a Myobrace^® in patients with mixed dentition resulted in a statistically significant increase in oxygen saturation. In particular, in patients with a closed mouth, a statistically significant increase in oxygen saturation was observed, bringing it from 97.66% to 99.00%, while in the rest position, the increase was from 98.03% to 99.07%. Conclusions: The use of Myobrace^® devices in patients with mixed dentition could lead to a significant improvement in blood oxygen saturation. Full article

Background: Children who undergo painful experiences such as traumatic dental injury (TDI) during their early years are more likely to be at an increased risk of developing dental fear and anxiety (DFA). The purpose of this study was to identify potential risk factors for DFA of these children. Methods: The study participants were 220 parents/caregivers and their children who experienced TDI. Their socio-demographic backgrounds were investigated with the modified WHO Oral Health Questionnaire for Children that included questions about parents’ knowledge and attitudes, while the DFA level was determined using the Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS) and the Simplified Oral Hygiene Index (OHI-S Index) was used to assess oral hygiene status. Results: The confirmed risk factors are parental knowledge, female gender, and degree of oral hygiene and pain in the last three months, while age, type of TDI, presence of soft-tissue injury, and number of subjective complaints were not confirmed. The overall model predicted approximately 54% of variance in DFA, R² = 0.545, F (4.215) = 64.28 p < 0.001. Conclusions: These findings emphasise the importance of addressing pain management, improving oral hygiene, and enhancing parental knowledge to mitigate DFA in children with TDIs. Full article

Oral diseases are largely preventable. However, as the number of older adults is expected to increase, along with the high cost and various barriers to seeking continuous professional care, a sustainable approach is needed to assist older adults in maintaining their oral health. Mobile health (mHealth) technologies may facilitate oral disease prevention and management through oral health education. This review aims to provide an overview of existing evidence on using mHealth to promote oral health through education among older adults. A literature search was performed across five electronic databases. A total of five studies were identified, which provided low to moderate evidence to support using mHealth among older adults. The selected studies showed that mHealth could improve oral health management, oral health behavior, and oral health knowledge among older adults. However, more quality studies regarding using mHealth technologies in oral health management, oral health behavior, and oral health knowledge among older adults are needed. Full article