Introduction: Cleft lip/palate patients often present with maxillary constriction and dental anomalies. Impacted mandibular second molars may compromise occlusal function, requiring multidisciplinary intervention. This case combines soft tissue fenestration for vertically impacted second molar eruption with non-conventional extractions in a skeletal Class III hyperdivergent cleft patient. Case description: A 15-year-old male with repaired cleft lip/palate exhibited a severely narrow maxillary arch, anterior crossbite, lingual displacement of teeth 12/22, multiple open bites, and vertical impaction of tooth 47 with a dentigerous cyst (Angle Class II, skeletal Class III, hyperdivergent ). Treatment included: Phase 1: Surgical removal of soft tissue and cyst overlying tooth 47, followed by maxillary expansion. After 15 months, tooth 47 erupted into the arch. Phase 2: Extractions of teeth 12, 22, 34, and 44 to relieve crowding, coordinate the dental arches and retract the lower incisors to correct the overjet. Discussion: Soft tissue fenestration preserved alveolar bone by avoiding osteotomy while eliminating eruption resistance via cyst enucleation. Non-conventional extractions addressed anterior crowding (12/22) and coordinated arch width (34/44), compensating for skeletal Class III discrepancy. Conclusion/clinical significance: Rational utilization of soft tissue fenestration and non-conventional extractions facilitates assisted eruption of vertically impacted mandibular second molars and improves overbite/overjet in cleft lip/palate patients with dental arch discrepancies. This approach provides a therapeutic strategy for skeletal Class III hyperdivergent cleft cases, avoiding orthognathic surgery while achieving functional and aesthetic outcomes.
Laísa Araujo Cortines Laxe, Jordana Dias Martins, Mônica Calixto de Andrade
et al.
Objective: To investigate the influence of 3D-milled composite resin surface pre-treatment with universal adhesive to shear bond strength (SBS) of self-adhesive resin cement. Material and Methods: 45 samples from hybrid CAD-CAM resin blocks (Brilliant Crios, Coltene, Altstätten, Switzerland) were cut with 15 × 10 × 1.5 mm and divided into 3 groups (n=15) according to resin surface pre-treatment: OC group – One Coat 7.0 universal adhesive and SoloCem self-adhesive resin cement (Coltene, Altstätten, Switzerland); OCA group – One Coat 7.0 chemically activated and SoloCem; SC group (control) – SoloCem, without resin surface pre-treatment. The samples of each group were divided into 3 subgroups (n=5) according to period of aging in distilled water at 37 °C until theSBS test: 1h (baseline); 7 days; and 14 days. SBS test was performed by universal testing machine (5566A, Instron; Massachusetts, USA), operating with 0.5 mm/min speed and 1k-N weight. A stereomicroscope was used to investigate failure pattern. The statistical analysis was performed with two-way ANOVA followed by Tukey tests (α = 0.05). Results: OC and OCA groups showed greater SBS than SC-control group (p < 0.05) in all periods analysed. SC group showed a significantly SBS increase after 7 days which remained unchanged after 14 days. Adhesive failures were associated with SC group, and some mixed failures with OC and OCA groups after 7 e 14 days. Conclusion: The 3D-milled composite resin surface pre-treatment with an adhesive allowed best SBS of self-adhesive resin cement.
KEYWORDS
Composite resins; Computer-aided design; Dental cements; Dentin-bonding agents; Shear strength.
Dentistry is a part of the field of medicine which is advocated in this digital revolution. The increasing trend in dentistry digitalization has led to the advancement in computer-derived data processing and manufacturing. This progress has been exponentially supported by the Internet of medical things (IoMT), big data and analytical algorithm, internet and communication technologies (ICT) including digital social media, augmented and virtual reality (AR and VR), and artificial intelligence (AI). The interplay between these sophisticated digital aspects has dramatically changed the healthcare and biomedical sectors, especially for dentistry. This myriad of applications of technologies will not only be able to streamline oral health care, facilitate workflow, increase oral health at a fraction of the current conventional cost, relieve dentist and dental auxiliary staff from routine and laborious tasks, but also ignite participatory in personalized oral health care. This narrative article review highlights recent dentistry digitalization encompassing technological advancement, limitations, challenges, and conceptual theoretical modern approaches in oral health prevention and care, particularly in ensuring the quality, efficiency, and strategic dental care in the modern era of dentistry.
Objectives The present study aimed to assess the level of shear bond strength (SBS) of universal adhesives (G-premio Bond Universal (GBU) and All Bond Universal (ABU) on zirconia without surface preparation, zirconia sandblasted by 50-micron aluminum oxide particles, and zirconia glazed by low-fusing ceramics after the thermocycling process.
Methods Two Ceramill ZI zirconia blocks were used to prepare 18 cubes with dimensions of 10×10×10 mm. Then, based on the type of surface preparation, these 18 sintered zirconia cubes were classified into three groups of six, including the control group, sandblasted group, and glazed group. Each group was classified into two subgroups based on the type of universal adhesive (ABU/GBU). On each cube, four cylinders filled with Panavia F2 resin cement with a diameter of 1.5 mm and a height of 2 mm were attached by the universal adhesive of the related subgroup (n = 72). The samples were subjected to 5000 thermal cycles in the thermocycler, each sample was assessed to test SBS, and the type of failure observed in each group was finally observed under a stereomicroscope. The data were analyzed using a two-way analysis of variance (ANOVA) test, Tukey’s post hoc test, and independent t-test, with a significance level of 0.05.
Results There was a statistically significant difference in SBS between the control group and the other two groups (p-value < 0.05). At the same time, there was no statistically significant difference between the sandblasted zirconia group and the glazed zirconia group (p-value = 0.13).
Conclusion: Applying a low-fusing glazed layer to prepare the zirconia surface leads to an increased SBS of dual-cured self-etch resin cement, equivalent to sandblasting with 50-micron aluminum oxide after the thermocycling process.
Abstract Background A multi-component self-management intervention ‘CFHealthHub’ was developed to reduce pulmonary exacerbations in adults with Cystic Fibrosis (CF) by supporting adherence to nebuliser medication. It was evaluated in a randomized controlled trial (RCT) involving 19 CF centres, with 32 interventionists, 305 participants in the intervention group, and 303 participants in the standard care arm. Ensuring treatment fidelity of intervention delivery was crucial to ensure that the intervention produced the expected outcomes. Methods Fidelity of the CFHealthHub intervention and standard care was assessed using different methods for each of the five fidelity domains defined by the Borrelli framework: study design, training, treatment delivery, receipt, and enactment. Study design ensured that the groups received the intended intervention or standard care. Interventionists underwent training and competency assessments to be deemed certified to deliver the intervention. Audio-recorded intervention sessions were assessed for fidelity drift. Receipt was assessed by identifying whether participants set Action and Coping Plans, while enactment was assessed using click analytics on the CFHealthHub digital platform. Results Design: There was reasonable agreement (74%, 226/305) between the expected versus actual intervention dose received by participants in the CFHealthHub intervention group. The standard care group did not include focused adherence support for most centres and participants. Training: All interventionists were trained. Treatment delivery: The trial demonstrated good fidelity (overall fidelity by centre ranged from 79 to 97%), with only one centre falling below the mean threshold (> 80%) on fidelity drift assessments. Receipt: Among participants who completed the 12-month intervention, 77% (205/265) completed at least one action plan, and 60% (160/265) completed at least one coping plan. Enactment: 88% (268/305) of participants used web/app click analytics outside the intervention sessions. The mean (SD) number of web/app click analytics per participant was 31.2 (58.9). Additionally, 64% (195/305) of participants agreed to receive notifications via the mobile application, with an average of 53.6 (14.9) notifications per participant. Conclusions The study demonstrates high fidelity throughout the RCT, and the CFHealthHub intervention was delivered as intended. This provides confidence that the results of the RCT are a valid reflection of the effectiveness of the CFHealthHub intervention compared to standard care. Trial registration ISRCTN registry: ISRCTN55504164 (date of registration: 12/10/2017).
Additive manufacturing (AM) processes are increasingly used in dentistry. The underlying process is the joining of material layer by layer based on 3D data models. Four additive processes (laser stereolithography, polymer jetting, digital light processing, fused deposition modeling) are mainly used for processing dental polymers. The number of polymer materials that can be used for AM in dentistry is small compared to other areas. Applications in dentistry using AM are limited (e.g. study models, maxillo-facial prostheses, orthodontic appliances etc.). New and further developments of materials are currently taking place due to the increasing demand for safer and other applications. Biocompatibility and the possibility of using materials not only as temporarily but as definitive reconstructions under oral conditions, mechanically more stable materials where less or no post-processing is needed are current targets in AM technologies. Printing parameters are also open for further development where optical aspects are also important.
Advancement of materials technology has been immense, especially in the past 30 years. Ceramics has not been new to dentistry. Porcelain crowns, silica fillers in composite resins, and glass ionomer cements have already been proved to be successful. Materials used in the replacement of tissues have come a long way from being inert, to compatible, and now regenerative. When hydroxyapatite was believed to be the best biocompatible replacement material, Larry Hench developed a material using silica (glass) as the host material, incorporated with calcium and phosphorous to fuse broken bones. This material mimics bone material and stimulates the regrowth of new bone material. Thus, due to its biocompatibility and osteogenic capacity it came to be known as “bioactive glass-bioglass.” It is now encompassed, along with synthetic hydroxyapatite, in the field of biomaterials science known as “bioactive ceramics.” The aim of this article is to give a bird's-eye view, of the various uses in dentistry, of this novel, miracle material which can bond, induce osteogenesis, and also regenerate bone.
Breakthroughs in technology have not been possible without influencing the medical sciences. Dentistry and dental materials have been fully involved in the technological and information technology evolution, so much so that they have revolutionized dental techniques. In this study, we want to create the first collection of articles on the use of digital techniques and software, such as Digital Smile Design. The aim is to collect all of the results regarding the use of this software, and to highlight the fields of use. Twenty-four articles have been included in the review, and the latter describes the use of Digital Smile Design and, in particular, the field of use. The study intends to be present which dental fields use “digitization”. Progress in this field is constant, and will be of increasing interest to dentistry by proposing a speed of treatment planning and a reliability of results. The digital workflow allows for rehabilitations that are reliable both from an aesthetic and functional point of view, as demonstrated in the review. From this study, the current field of use of Digital Smile Design techniques in the various branches of medicine and dentistry have emerged, as well as information about its reliability.
L. Tolstunov, J. F. E. Hamrick, V. Broumand
et al.
Bone deficiency is the major obstacle in implant dentistry. Guided bone regeneration (GBR) with particulate bone and barrier membranes has been the primary surgical technique used to regenerate alveolar bone for dental implant therapy. This procedure has been used in implant dentistry for more than 30 years and continues to be developed and refined for more predictable surgical outcomes. This article reviews GBR and alternative ride expansion procedures and reviews the use of various particulate graft materials. Alveolar distraction osteogenesis, used as an augmentation technique, is also presented.
Better understanding of dental caries and other oral conditions has guided new strategies to prevent disease and manage its consequences at individual and public health levels. This article discusses advances in prevention and minimal intervention dentistry over the last century by focusing on some milestones within scientific, clinical, and public health arenas, mainly in cariology but also beyond, highlighting current understanding and evidence with future prospects. Dentistry was initially established as a surgical specialty. Dental caries (similar to periodontitis) was considered to be an infectious disease 100 years ago. Its ubiquitous presence and rampant nature—coupled with limited diagnostic tools and therapeutic treatment options—meant that these dental diseases were managed mainly by excising affected tissue. The understanding of the diseases and a change in their prevalence, extent, and severity, with evolutions in operative techniques, technologies, and materials, have enabled a shift from surgical to preventive and minimal intervention dentistry approaches. Future challenges to embrace include continuing the dental profession’s move toward a more patient-centered, evidence-based, less invasive management of these diseases, focused on promoting and maintaining oral health in partnership with patients. In parallel, public health needs to continue to, for example, tackle social inequalities in dental health, develop better preventive and management options for existing disease risk groups (e.g., the growing aging population), and the development of reimbursement and health outcome models that facilitate implementation of these evolving strategies. A century ago, almost every treatment involved injections, a drill or scalpel, or a pair of forceps. Today, dentists have more options than ever before available to them. These are supported by evidence, have a minimal intervention focus, and result in better outcomes for patients. The profession’s greatest challenge is moving this evidence into practice.