JOURNAL OF DENTAL RESEARCH, DENTAL CLINICS, DENTAL PROSPECTS
Year:2024 | Volume:18 | Issue:1|Papers Count:10

Background. This study aimed to systematically and comprehensively review the effect of various treatment variables on apically extruded debris (AED) during non-surgical root canal retreatment (NSRCRT). Methods. The study protocol is shared in the Open Science Framework database (https: //osf. io/kjtdg/? view_only=17060180705745ec9dae9a01614f3880). An electronic search was conducted up to July 2022 to reveal related studies. Two reviewers critically assessed the studies for eligibility against inclusion and exclusion criteria and data extraction. Quantitative data synthesis was performed, and the risk of bias in the studies was also evaluated. Results. Forty-six studies were included in the systematic review and 14 in the meta-analysis. Conflicting or limited evidence was found for the effect of sealer type, obturation technique, and solvent use. The manual instrumentation increased the amount of AED compared to rotary instrumentation during the removal of filling materials (P<0. 001). There was no significant difference in the amount of AED between the use of rotary and reciprocating files during the removal of filling materials (P=0. 181). Conclusion. Rotary instruments can be recommended instead of manual instruments during the removal of filling materials to control the amount of AED. Further studies with a low risk of bias are needed to clarify the effect of other treatment variables on AED during NSRCRT.

Background. The widespread use of dental implants as a predictable treatment choice has drawn attention to their complications as a major challenge despite their high clinical success rates. In this context, loosening of the abutment screw in posterior single crowns is the most common problem,the use of adequate preload and proper anti-rotational features at implant‒abutment interface appear to be two main solutions to such a problem. The present study evaluated the effect of implant‒abutment connections in four different implant systems before and after cyclic loading. Methods. Intra-Lock, Dentis, Xive, and Dio implant systems were used in this study. Each system underwent one million cycles of dynamic forces eight times with a magnitude of 110 N. For each specimen after tightening the screw with a torque of 32 Ncm, the detorque values were measured and recorded by a digital torquemeter after and before cyclic loading. Data were analyzed by Kolmogorov-Smirnov, Levene’s, one-way ANOVA, and post hoc Tukey tests. Results. Initial detorque values between the study groups showed significant differences (P<0. 0001). Pairwise comparisons showed significantly lower primary detorque values in the Dentis system compared to the three other systems (P<0. 0001). After cyclic loading, significant differences were observed between the study groups (P<0. 0001). Pairwise comparisons of the groups showed significant differences between all the systems after loading. Conclusion. The type of implant‒abutment connection is an essential factor influencing the amount of abutment screw loosening.

Background. In recent years, fluoride concentrations in toothpaste for children and adults have increased. However, the effects of different concentrations on bacterial activity have rarely been compared. We aimed to investigate and compare the antibacterial activity of children’s and adults’ toothpaste containing 500, 1000‒1100, and 1450‒1500 ppm fluoride. Methods. Three strains of bacteria (Streptococcus mutans, Streptococcus salivarius, and Lactobacillus casei) were cultured in brain heart infusion agar. Thirty commercially available toothpaste products for children and adults containing 500, 1000‒1100, and 1450‒1500 ppm fluoride were selected and tested. Toothpaste’s ability to inhibit bacterial growth was evaluated by agar diffusion assay, in which plates were incubated for 24 hours, and then the diameter of the microbial inhibition zone was measured. Comparisons between children’s and adults’ fluoride toothpastes were made using the Mann-Whitney U test. The association between bacterial growth inhibition and sodium lauryl sulfate (SLS) was analyzed by the chi-square test. A P value of <0. 05 was considered statistically significant. Results. No difference in the inhibition zone was observed for different fluoride concentrations. However, there were significant differences between toothpastes for children and adults, with higher inhibition zones for adults’ toothpastes. Most toothpastes for adults contained SLS, which was associated with antibacterial activity. Conclusion. Fluoride concentrations ranging from 500 to 1500 ppm did not affect bacterial growth. The antibacterial activity of toothpastes for adults was significantly higher than that of toothpastes for children, which was mainly attributed to the SLS usually added to adult formulations.

Background. Insufficient information exists regarding the fracture resistance and failure pattern of newly developed zirconia-reinforced lithium disilicate (ZL, Vita Ambria) onlays. This in vitro study compared the fracture resistance of two types of onlays: monolithic lithium disilicate (LD) and monolithic ZL. Methods. Forty-eight ceramic onlay restorations were fabricated on epoxy dies using a maxillary first premolar model. The samples were divided into two main groups: LD and ZL. Half of each group was subjected to thermomechanical fatigue loading (TML) using a chewing simulator. All the samples were cemented with self-adhesive resin cement. Subsequently, they were loaded until failure in a universal testing machine, and the fracture patterns and resistance were recorded. Results. Before TML, ZL demonstrated the highest statistically significant mean fracture resistance (499. 76±34. 14N) compared to LD (470. 40±27. 38N). After TML, ZL showed the highest non-statistically significant mean fracture resistance (429. 27±131. 42N), while LD’s mean fracture resistance decreased (377. 31±62. 18N). Conclusion. Monolithic zirconia-reinforced onlays demonstrated higher fracture resistance and a more favorable failure mode compared to LD. However, the impact of thermomechanical aging resulted in reduced fracture resistance for both materials, with a notable preference observed for ZL.

Background. This study assessed the impact of chelating agents, 17% ethylenediaminetetraacetic acid (EDTA), 10% citric acid (CA), and 18% etidronic acid (HEDP), on root dentin mineral content. Scanning electron microscopy-energy dispersive spectroscopy (SEM-EDS) was applied to analyze changes, and the push-out bond strength test was used to measure dentin adhesion of Well-Root ST, a bioceramic root canal sealer. Methods. A total of 80 extracted single-rooted lower premolar teeth were included in this study and randomly divided into four groups (n=20): group 1 (17% EDTA), group 2 (10% CA), group 3 (18% HEDP), and group 4 (distilled water, control). After irrigation and drying, SEM-EDS was applied to analyze eight samples from each group at coronal, middle, and apical root regions for mineral content and SEM images. The remaining 12 samples underwent a push-out bond strength test using Well-Root ST sealer and gutta-percha. Kruskal-Wallis and Dunn’s tests were used for statistical analyses. Results. Statistically significant differences were found between groups (P<0. 05). SEM-EDS showed significant differences in C, O, Ca, P, and Ca/P content, with no significant differences in Na and Mg. Push-out bond strength was significantly higher in the 17% EDTA, 10% CA, and 18% HEDP groups compared to the control group, with no significant differences between chelating agents. Conclusion. Chelating agents altered root dentin mineral content and improved the adhesive properties of the bioceramic sealer. These findings highlight the importance of considering the selection and use of chelating agents in the clinical practice for root canal treatment.

Background. Modifying the dental implant’s surface texture enhances its biological response to the bone and implant‒tissue interface, resulting in the successful support of forces. This study assessed the impact of sandblasting, sandblasting plus acid etching, Er, Cr: YSGG laser, and propolis implant surface treatments and occlusal load on the osseointegration of titanium dental implants in dogs. Methods. Seventy-two titanium dental implants with a diameter of 4 mm and a length of 10 mm were divided into four groups according to implant surface modifications (n=18 for each group): group A: sandblasting plus acid etching, group B: sandblasting with Al2 O3, group C: Er, Cr: YSGG laser, group D: propolis coating. Twenty-four local breed male dogs were used. Premolar teeth (P1, P2, and P3) were extracted on the left side of the mandible, and after 12 weeks of bone healing, implants were unilaterally installed. The osseointegration at three study times from implant installation (14, 90, and 180 days) was evaluated. The dog jaws were scanned using an intraoral scanner for the virtual design of screw-retained three-unit crowns after 90 days of osseointegration. Final radiographs were taken before the animals were sacrificed at 14, 90, and 180 days, and the histological analysis was performed. Results. Radiographic analysis showed new bone formation (NBF) along and in contact with the implant surface of the treated groups. The histological analysis after 14 days in groups A and B revealed a uniform and ongoing pattern of bone growth and many osteoblasts with few osteocytes within lacunae in new bone trabeculae. Group C showed an increase in the number of osteoblasts lining thin bone trabeculae. Group D showed a generative power concerning bone. At 90 days, there was increased bone ingrowth, and the new bone matured in all the treated implant groups. At 180 days, dense mature bone apposition was in direct contact with delayed-loaded implant surfaces. Conclusion. A radiographic examination revealed that surface modification significantly impacted osseointegration, with a strong bond between the implant surface and the surrounding bone. The histological sections at the 14-day interval revealed obvious bone remodeling activity, especially in sandblasting plus acid etching and sandblasting-modified implant surface groups. At the 90-day interval, bone ingrowth had increased, and the new bone became mature, especially in sandblasting and propolis surface modification groups. After 180 days of the delayed-loaded implant osseointegration, differences were observed between different implant-treated groups with a remarkable remodeling of the bone, especially in the propolis coating group.

Background. The present study investigated the skeletal and dental effect in class II division I growing patients due to mandibular deficiency treated with the hybrid aesthetic functional (HAF) appliance. Methods. A sample of 16 growing patients (5 boys and 11 girls,mean age: 9. 50 years, standard deviation: 1. 15) with class II division I malocclusion were treated using the HAF appliance for an average period of 10±3 months. For each patient, a cephalometric radiograph was taken before and after treatment, and digital analysis was applied using the WebCeph program. The statistical analysis was performed to evaluate dental and skeletal changes associated with the HAF appliance and determine if there were any statistically significant variations in anatomical measurements between the start and completion of the treatment. Results. The data showed a significant increase in SNB angle (P=0. 002), leading to a significant decrease in ANB angle (P=0. 001). The mandibular length significantly increased (P=0. 008), the lower incisors were flared significantly (P=0. 028), and the lower molars were extruded significantly (P≤0. 001). Also, this study revealed a significant decrease in Wits appraisal (P≤0. 001), overjet (P≤0. 001), and overbite (P=0. 041). Additionally, a significant increase in lower anterior facial height (P≤0. 001), total facial height (P=0. 001), and posterior facial height (P=0. 037) were observed. Conclusion. The HAF appliance showed that it could be used to correct class II division 1 skeletal discrepancy by mandibular advancement. The HAF appliance increased all facial heights significantly.

Background. The objectives were to assess the impact of dental caries on the daily living of the geriatric population and determine the factors that influence the relationship between dental health and the daily living of the geriatric population. Methods. A descriptive cross-sectional study was carried out over six months at Rawalpindi’s public and private dental hospitals. Participants aged≥60 years, both male and female, were selected. The calculated sample size was 281. Desired sample from one of the dental hospitals was collected using a non-probability consecutive sampling strategy. Data about sociodemographic characteristics and the DMFT index were collected. Adapted validated tool dental impact on daily living (DIDL) was used to assess the impact of dental health on daily living. Results. Chi-squared test of association showed a positive association between the DIDL and sociodemographic variables, including age (P=0. 001), gender (P=0. 001), education (P=0. 001), income (P=0. 001), occupation (P=0. 029), marital status (P=0. 001), living arrangement (P=0. 001), and history of chronic illnesses (P=0. 001). The association between the DMFT index and DIDL also showed statistically significant results (P=0. 001). Binary logistic regression analysis indicated that gender (OR=6. 98, P=0. 005) and the individual’s dental health (OR=6. 43, P=0. 001) were the strongest predictors of the impact experienced in daily life activities. The overall model was statistically significant (χ2=51. 24, P=0. 001), and the variables were responsible for 32. 4% of the variance in the outcome variable. Conclusion. The study provides strong evidence that sociodemographic factors, DMFT index, gender, and individual dental health significantly contribute to the impact of dental health on daily living. Gender and individual dental health emerge as particularly influential predictors. These findings emphasize the need for targeted interventions and awareness programs, especially for groups with a higher risk of experiencing a significant impact on daily life due to dental issues.

Background. Preterm birth is a heterogeneous condition with multiple underlying causes, and periodontal diseases are one of them. Approximately 900000 preterm births are reported in Pakistan each year. Oral infections such as periodontitis during pregnancy are associated with adverse pregnancy outcomes such as low birth weight and preterm births. However, different studies have reported contradictory findings. We conducted a cross-sectional study to assess the association of preterm birth with oral infection in pregnancy. Methods. We conducted a cross-sectional analytical study on 400 postpartum pregnant women in Khyber Teaching Hospital, Peshawar. Only women within the age bracket of 18‒40 years were recruited. Data were collected by an interview-based structured questionnaire. The extent and severity index were used to assess the periodontal health of participants. Frequency tables were generated, and the chi-squared test was used to determine associations between different categorical variables. Results. The mean age of the participants was 25. 8±4. 9 years. Approximately 87. 5% of the women had generalized periodontitis. Approximately 68% of mothers had moderate severity of periodontitis. The extent index showed no notable difference between the preterm and full-term birth groups. In contrast, the severity index displayed a statistically significant difference between the preterm and full-term birth groups. Conclusion. The majority of women had generalized periodontitis. The severity index demonstrated a significant association between maternal periodontitis and preterm births. There was no association between the age of mothers and preterm births. Complications in pregnancy were not associated with preterm births.

Background. This in-vivo study evaluated the accuracy of full-arch digital impressions obtained through different intraoral scanning technologies regarding trueness and efficiency against the standard alginate impressions. Methods. Alginate impressions were taken from 50 subjects, and the resulting stone casts were scanned using the Trios 3Shape desktop scanner. In-vivo scans were conducted on each participant using three intraoral scanners: Medit, CEREC Primescan, and 3Shape Trios. The scanned files were superimposed onto two software platforms: the 3Shape Orthoanalyser and Geomagic software. This superimposition was performed against the reference model to calculate 3D and 2D deviations, enabling efficiency comparisons between digital and traditional workflows based on work time in minutes. Measurements and comparisons were made in three planes: transverse, sagittal, and vertical dimensions for all the models and stone casts. Statistical analysis employed SPSS 23, with the significance level set at P<0. 05. Results. Significant deviations were observed between the three intraoral scanners and the alginate impression, with molar and premolar areas showing greater imprecision across dental arches. Compared to the alginate technique, Medit i500 tended to reduce the transverse dimension in the areas mentioned above, while CEREC exhibited higher precision. Molar and premolar areas emerged as the regions with the greatest discrepancies, both in excess and deficiency, compared to the alginate impression. This difference in dimensions was, however, statistically insignificant overall. 3Shape Trios exhibited the shortest scan times, indicating higher efficiency. Among the intraoral scanners, Medit recorded the longest scanning duration. Conclusion. Accepting the null hypothesis, the scans obtained using all three scanners were comparable with statistically insignificant differences in the measurements. The three scanners differed in the total scan time taken, with the Medit scanner requiring the longest scan time and the 3Shape TRIOS 3 scanner demonstrating the shortest scan duration.