Introduction: Severe bimaxillary protrusion with open bite and TMD poses major orthodontic challenges, requiring balanced esthetics, occlusion, and function. Digital innovations enable comprehensive diagnosis and treatment, especially in multidisciplinary cases. Case description: A 25-year-old female presented with bimaxillary protrusion. Clinical examination revealed skeletal bimaxillary protrusion, 3-mm anterior open bite, and discolored resin restorations on 11, 12, 21, and 22. CBCT showed labial alveolar bone fenestration. MRI showed bilateral irreversible anterior TMJ disc displacement. The orthodontic-prosthodontic combined treatment was employed. Firstly, clear aligners were used to align and level the dentition, assisted with mini-screws for maximum anterior retraction. Following orthodontics, veneer restorations were placed on maxillary incisors. Post-treatment evaluation revealed significant improvement in patient's facial profile and frontal smile esthetics. Discussion: We integrated the patient's facial scan, CBCT, intraoral scan, and electronic axiography data to reconstruct a 4D virtual patient model. The digital workflow comprised: ①Digital orthodontic treatment simulation, enabling visualized treatment planning with precise tooth movement control to prevent worsening of alveolar bone fenestration. ② Electronic axiography, recording mandibular movements to evaluate dynamic occlusal function and TMJ stability. ③Virtual articulator, accurately transferring jaw relationships. ④Patient-centered aesthetic design with digital smile simulation. Conclusion/clinical significance: The transition from conventional 2D assessment to dynamic 4D digital evaluation represents a paradigm shift in contemporary dentistry. By integration of multimodal data, clinicians can achieve a more predictable treatment. Furthermore, digital solutions have effectively bridged the communication gap between different dental specialties and patients through visualized treatment planning and real-time data sharing.
Aim or purpose: Commercially available barrier membranes for guided tissue regeneration (GTR) often lack suitable mechanical properties, controllable degradation rate, and sufficient bioactivity, which would lead to unsatisfied bone regeneration capacity, thereby being unable to fulfill the demands of oral clinical treatment. Materials and methods: The multifunctional biomimetic GTR membrane composed of a dense layer and a porous layer was fabricated by emulsion template method: The dense layer with a stable structure acts as an effective physical barrier preventing the soft tissue from invading the bone defect areas; The porous layer functionalized by the DP7-C/miR-26a complex would promote efficient bone regeneration by regulating immune microenvironment. The physicochemical characterization of membranes were measured by SEM, universal mechanical testing machine and UV-vis spectrophotometer. The in vitro bioactivities of macrophage polarization and BMSCs differentiation were evaluated through flow cytometry, Western blot, qPCR and immunofluorescence. The in vivo therapeutic efficacy was also validated by the rat periodontitis model through micro-CT analysis, H&E staining, and immunohistochemical. Results: The membrane possesses heterogeneous bilayer microstructures, strain maintenance ability, good degradation property, and well biocompatibility. In vitro, it redirected macrophages toward regenerative M2 polarization (CD206↑/TNF-α↓/IL-10↑) while potentiating BMSCs osteogenesis via upregulated RUNX2/OCN expression and accelerated mineralization. The micro-CT reconstruction confirmed significant mitigation of alveolar bone destruction in vivo. Conclusions: In this study, the multifunctional biomimetic GTR membrane was developed to achieve rapid and efficient bone regeneration in inflammatory microenvironment, providing new means for oral clinical treatment of inflammatory bone defects.
Fawaz Alzoubi, Abdulkareem Abdullah Alhumaidan, Hamad Saleh AlRumaih
et al.
Objective: The present retrospective study aimed to determine the relationship between the secondary implant stability quotient and different parameters related to an oxidized implant. Methods: A total of 135 patients (305 oxidized implants) were included. Implant-related factors (length, diameter, surgical and loading protocols, grafting, insertion torque, and primary stability) were used for comparisons and linear regression analyses, using secondary ISQ as the dependent variable. Results: At the patient level, the mean time from implantation to secondary ISQ registration was 20.3 ± 29 weeks, and the mean secondary ISQ was 77.30 ± 7.22. The ISQ did not reveal significant differences regarding implant lengths, loading protocol, and simultaneous grafting. In contrast, platform diameters (3.5, 4.3, and 5.0), surgical protocols (one stage versus two stages), insertion torque (<35 Ncm versus >35 Ncm), and primary stability (achieved versus not achieved) all revealed significant secondary ISQ differences. Nevertheless, the regression analysis demonstrated that the platform diameter was the only variable significantly and positively predicted the secondary ISQ. Similar findings were found with the implant level analysis. Conclusions: Among different implant- and protocol-related parameters, the platform diameter of the oxidized implant appears to be the only significant predictor of high secondary ISQ values at the time of superstructure connection.
Karar Abdulzahra Mahdi, Muhassad H. Al-Mudhafar, Dunya Malhan Hanweet
Background:
Temporomandibular disorders are conditions that affect the structures of the jaw joint. These conditions can cause a variety of symptoms, including discomfort, restricted movement, and the inability to perform certain functions.
Objectives:
To investigate the impact of providing platelet-rich plasma (PRP) injections on the levels of interleukin 8 (IL-8) and tumor necrosis factor-alpha (TNF-α) in the synovial fluid of patients who were experiencing traumatic knee dislocations (TMDs), the objective of this study was to investigate the impact of these injections.
Methodology:
Intra-articular PRP injections were administered to 33 individuals diagnosed with TMDs. Samples of synovial fluid were taken both at baseline and two months after the PRP injection. The determination of TNF-α and IL-8 concentrations was carried out by utilizing ELISA Kits. For statistical analysis, the paired t-test was utilized.
Results:
TNF-α levels (baseline mean = 26.55 pg/mL, post-PRP, mean = 18.79 pg/mL) and IL-8 levels (baseline mean = 72.28 pg/mL, post-PRP mean = 6.83 pg/mL) were significantly reduced after PRP therapy.
Conclusion:
The decrease in TNF-α and IL-8 levels following PRP injection indicates a potential anti-inflammatory effect in TMDs. PRP’s growth factors may help reverse degenerative changes by promoting tissue regeneration and repair.
Dentistry, Medical physics. Medical radiology. Nuclear medicine
Background: To understand the process of biofilm formation in dental unit waterlines (DUWLs), it is necessary to assess the of
bacteria that constitute DUWL biofilms. This study assessed the coaggregation of bacterial species isolated from DUWL biofilms
and other related mechanisms.
Methods: Coaggregation was macroscopically evaluated. Cultures of the DUWLs isolates were adjusted to the same concentration
(optical density [OD]600=1.5). The isolates were mixed in pairs and incubated for 1 hour at room temperature. Subsequently, the
coaggregation values were scored. Some coaggregation pairs were observed through fluorescence microscope after staining
with SYTOⓇ 9 and propidium iodide. To assess their coaggregation properties, inhibition of coaggregation was performed by
adding sugars and amino acids to the coaggregation pairs and the coaggregation values were scored again post-addition.
Results: Coaggregation was observed in 360 out of 406 coaggregation pairs, whose coaggregation scores of ranged from one to
three points. Five pairs (1.4%) had a coaggregation score of 3 points. Among these five pairs, mannose most frequently inhibited
coaggregation. Among the isolates, Cupriavidus pauculus HY12 and Beijerinckia derxii subsp. venezuelae HY7 had the highest
number of coaggregation pairs, with scores of 2 and 3.
Conclusion: Cupriavidus pauculus HY12 and B. derxii subsp. venezuelae HY7 form many coaggregation pairs and may play
important roles in biofilm maturation. The results of this study can be used to propose methods to inhibit the formation of DUWL
biofilms by inhibiting coaggregation.
Dawn Yi Xin Lee, Chun En Yau, Maeve Pin Pin Pek
et al.
Background: Socioeconomic status (SES) is a well-established determinant of cardiovascular health. However, the relationship between SES and clinical outcomes in long-term out-of-hospital cardiac arrest (OHCA) is less well-understood. The Singapore Housing Index (SHI) is a validated building-level SES indicator. We investigated whether SES as measured by SHI is associated with long-term OHCA survival in Singapore. Methods: We conducted an open cohort study with linked data from the Singapore Pan-Asian Resuscitation Outcomes Study (PAROS), and the Singapore Registry of Births and Deaths (SRBD) from 2010 to 2020. We fitted generalized structural equation models, calculating hazard ratios (HRs) using a Weibull model. We constructed Kaplan–Meier survival curves and calculated the predicted marginal probability for each SHI category. Results: We included 659 cases. In both univariable and multivariable analyses, SHI did not have a significant association with survival. Indirect pathways of SHI mediated through covariates such as Emergency Medical Services (EMS) response time (HR of low-medium, high-medium and high SHI when compared to low SHI: 0.98 (0.88–1.10), 1.01 (0.93–1.11), 1.02 (0.93–1.12) respectively), and age of arrest (HR of low-medium, high-medium and high SHI when compared to low SHI: 1.02 (0.75–1.38), 1.08 (0.84–1.38), 1.18 (0.91–1.54) respectively) had no significant association with OHCA survival. There was no clear trend in the predicted marginal probability of survival among the different SHI categories. Conclusions: We did not find a significant association between SES and OHCA survival outcomes in residential areas in Singapore. Among other reasons, this could be due to affordable healthcare across different socioeconomic classes.
Hesam Abbasi, Rashin Bahrami, Mohammad Amin Amiri
et al.
Brown tumor is a condition associated with hyperparathyroidism that can affect various bones, including the facial skeleton. These tumors are typically well-defined radiolucent lesions but can grow large and cause disfigurement. It is crucial to diagnose brown tumors especially in the jaws early, as those involving the maxillo-mandibular region can exhibit highly aggressive behavior. Also, following parathyroidectomy or normalization of parathyroid hormone (PTH) levels, patients should be closely monitored for the presence of brown tumors. It is advisable to consider the removal of brown tumors even after the correction of underlying hyperparathyroidism. Regular follow-up examinations are necessary to assess the progression or regression of these tumors. In this study, we present a case of a 42-year-old female with renal failure and a history of parathyroidectomy presented with brown tumors in both jaws. The tumors showed aggressive characteristics such as cortical expansion and significant patient discomfort. After clinical and radiological evaluation, the patient underwent surgical excision, which involved total mandibulectomy and maxillectomy. The excised tissue was then subjected to histopathological analysis; the results confirmed brown tumor in both jaws.
Background Aerosols and droplets are produced during many dental procedures. With the advent of the droplet-spread disease severe acute respiratory syndrome, or SARS, a review of the infection control procedures for aerosols is warranted. Types of Studies Reviewed The authors reviewed representative medical and dental literature for studies and reports that documented the spread of disease through an airborne route. They also reviewed the dental literature for representative studies of contamination from various dental procedures and methods of reducing airborne contamination from those procedures. Results The airborne spread of measles, tuberculosis and SARS is well-documented in the medical literature. The dental literature shows that many dental procedures produce aerosols and droplets that are contaminated with bacteria and blood. These aerosols represent a potential route for disease transmission. The literature also documents that airborne contamination can be minimized easily and inexpensively by layering several infection control steps into the routine precautions used during all dental procedures. Clinical Implications In addition to the routine use of standard barriers such as masks and gloves, the universal use of pre-procedural rinses and high-volume evacuation is recommended.
Suzanne Van Hulle, Issaka Sagara, Momar Mbodji
et al.
Abstract Background Spatial repellents have been widely used for the prevention of mosquito bites but their efficacy in reducing mosquito-borne diseases has never been evaluated in Africa. Additionally, spatial repellents have the potential of being critical tools in the prevention of mosquito-borne diseases in contexts where typical vectors control efforts such as insecticide-treated nets (ITNs) and indoor residual spray (IRS) are inaccessible or underutilized such as among displaced populations or in emergency relief settings. To address this knowledge gap, Kolondieba District, Sikasso Region, Mali was selected as a site to estimate the impact of the Mosquito Shield™, a spatial repellent that incorporates transfluthrin on a plastic sheet, on malaria-related outcomes. Over the past decade, the Region of Sikasso, Health districts of Kadiolo, Yorosso, and Kolondieba have remained among the most afflicted, characterized by an annual parasite incidence of more than 116 cases per 1000 population [1] and a Plasmodium falciparum prevalence rate of 29.7% [2]. Methods Cluster-randomized, placebo-controlled, double-blinded clinical trial, whereby children ≥ 6 months to < 10 years old will be enrolled and followed to determine the time to malaria infection with monthly blood samples for microscopic diagnosis. A total of 1920 subjects (HHs) will be enrolled in 60 clusters (30 spatial repellent, 30 placebo). Malaria incidence will be estimated and compared to demonstrate and quantify the protective efficacy (PE) of a spatial repellent, in reducing malaria infection. Monthly mosquito collections using CDC light traps will be conducted to determine if there are entomological correlates of spatial repellent efficacy that may be useful for the evaluation of new spatial repellents. Quarterly human landing catches (HLC) will assess the behavioral effects of the intervention. Discussion Findings will serve as an efficacy trial of spatial repellent products for sub-Saharan Africa. Findings will be submitted to the World Health Organization Vector Control Advisory Group (WHO VCAG) for assessment of whether spatial repellents have “public health value.” Entomological outcomes will also be measured as proxies of malaria transmission to help develop guidelines for the evaluation of future spatial repellent products. Trial registration ClinicalTrials.gov NCT04795648 . Registered on March 12, 2021.
Abstract Introduction To analyze the stress distribution of the all-ceramic endocrown with different base materials and thicknesses using three-dimensional finite element analysis. Methods A endodontically treated maxillary premolar was scanned by micro-CT, a three-dimensional finite element model of the endocrown with fluid resin as the base material was divided into control (0 mm), 1 mm, 2 mm, and 3 mm groups according to base thickness. Three kinds of conventional base materials were used and divided into glass ion group (A), fluid resin group (B), and nanocomposite resin group (C), and a three-dimensional finite element model of the endocrown with 1.0 mm thickness of base was established. A static loading with axial and 45° direction was applied to each model, the stress distribution of each part of the endocrown was analyzed under different base materials and thicknesses. Results The different thickness of the base layer has an influence on the components of the restoration and the tooth. The stress in the control group was the largest. The stress was the lowest when the thickness of the base layer was 1 mm; The maximum of the equivalent stress, the first, second, and third principal stress in the endocrown, abutment, and alveolar bone, are basically the same with the different base materials. The stress on the base layer increases with the elastic modulus of base materials increases. Conclusions The base layer played a force buffering effect on the dental body restored with endocrowns, and the effect was the best at 1 mm; The selection of base material has little influence on the whole, but in order to protect the weak tissues of the cavity bottom, the base material with lower elastic modulus can be used.
Fernanda Leal Lopes Marcondes, Carla Cristina Neves Barbosa, Oswaldo Luíz Cecilio Barbosa
et al.
Hábito bucal é toda repetição de um ato, que se torna inconsciente. Podem ser classificados como nutritivos aqueles que permitem adquirir nutrientes essenciais (amamentação), ou não nutritivos, que não possuem obtenção de nutrientes, como sucção digital, de chupeta, de língua, de lábios ou de bochecha. Ele só vai ser deletério quando ocasionar um desequilíbrio neuromuscular, alterando assim o crescimento e o desenvolvimento do complexo crânio facial e da oclusão dentária, dependendo ainda de três fatores: intensidade, frequência e duração, de acordo com a tríade de Graber. Portanto, o objetivo deste estudo é revisar a literatura atual sobre os hábitos bucais de sucção e seus efeitos nas estruturas faciais, a fim de prevenir consequências futuras. Os trabalhos levantados nesta revisão de literatura mencionam que o hábito de sucção não nutritivo é o fator primordial para o desenvolvimento de más-oclusões. Com isso, entende-se que a amamentação sendo exclusiva até os seis primeiros meses de vida da criança, tem uma grande probabilidade destes hábitos deletérios não serem adquiridos.
Palavras-Chave: Aleitamento Materno; Sucção; Sistema Estomatognático.
Os autores têm como objetivo mostrar alguns aspectos morfológicos evidenciados em preparados histológicos de mandíbulas de cão, relativos ao fenômeno de reabsorção dos dentes temporários. Verificamos modificações celulares e vasculares na polpa dentária e a zona de reabsorção do dente temporário; e notamos um diverso comportamento da zona de predentina frente ao fenômeno de reabsorção.
Noura A. Almadhi, Ayman M. Sulimany, Hamad A. Alzoman
et al.
Objective: To evaluate parents’ knowledge about halitosis, and to compare parents’ perception of halitosis in their children to the presence of halitosis clinically. Methods: Children between 3 and 8 years attended to Dental University Hospital, King Saud University, were screened. Children satisfying inclusion criteria and their parents agreed to participate were included. Questionnaires regarding parents’ knowledge and perception about halitosis in their children were filled by attending parents. Then, the assessment of halitosis in the participating children carried out by portable gas chromatograph device (OralChromaTM). Results: A total of 67 children (44 girls and 23 boys) were included in this study with a mean age of 5.3 years (SD = 1.7). The majority of the questionnaires (n = 44, 65.7%) were filled by accompanying fathers. One in two (52.2%) parents obtained high knowledge score about halitosis. Parents’ knowledge was significantly associated with the mean age of the children (P = 0.02). Thirty-nine (58.2%) parents perceived halitosis in their children. Gender, child’s age, parents’ education level, or family income were not associated with parents’ perception of halitosis. Halitosis was detected clinically in 58 children (86.6%). Thirty-eight (57%) of parents’ perception of halitosis was in consistency with OralChromaTM readings; however, there was no significant association between parents’ perception and the OralChromaTM score. Conclusion: Half of the parents had good knowledge about halitosis and 6 in 10 parents perceived halitosis in their children which is quite less than the presence of halitosis detected clinically. Moreover, parents’ perception was not associated with the OralChromaTM score.
Zahra Hashemi Ardakani, Rashin Giti, Shima Dabiri
et al.
Background: The flexural strength (FS) of a denture base material is of great concern, and many approaches have been used to strengthen the denture acrylic resins. The present study aimed to evaluate the effect of high-performance polymer (BioHPP) and metal mesh reinforcement on the FS of a heat-cured poly methyl methacrylate (PMMA) acrylic resin.
Materials and Methods: This experimental study was done on 30 rectangular specimens (64 mm × 13 mm × 3 mm) of a heat-cured PMMA resin. The specimens were divided into three groups (n = 10) to be reinforced with either metal mesh or BioHPP mesh; one group was left nonreinforced, serving as the control group. The FS of specimens was assessed through a 3-point bending test by using a universal testing machine at a crosshead speed of 2 mm/min. Kruskal–Wallis H and Dunn's post hoc tests were used to compare the FS among the groups (alpha = 0.05).
Results: The FS in the metal-reinforced group was statistically significantly higher than the two other groups (P < 0.001). However, the FS of the BioHPP-reinforced samples was not statistically significantly higher than the nonreinforced ones (P = 0.614).
Conclusion: Reinforcing the PMMA with metal mesh significantly enhances its FS while BioHPP has no significant effect on the PMMA FS.
The history of dentistry, of course, has followed a constant development since the dawn of society. The dental profession, reserved in ancient times to people with special skills and high rank, after the Middle Ages was diminished and practiced by barbers. The pharmacological evolution of oral surgery techniques has led this branch, today as never before, to obtain a level of specialization and preparation comparable to all other specialist medical branches. Some milestones in the history of dentistry will be considered so as to finally understand how the importance of anesthetic drugs was of primary importance, and which drugs are used today.