Dentistry Journal

13 pages, 712 KiB

Open AccessSystematic Review

Asymmetric Dimethylarginine as a Potential Mediator in the Association between Periodontitis and Cardiovascular Disease: A Systematic Review of Current Evidence

by Biagio Rapone, Francesco Inchingolo, Giulia Margherita Tartaglia, Jr., Maurizio De Francesco and Elisabetta Ferrara

Dent. J. 2024, 12(9), 297; https://doi.org/10.3390/dj12090297 - 21 Sep 2024

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Abstract

Background: Periodontitis, a chronic inflammatory disease, has been associated with an elevated risk of cardiovascular disease (CVD). Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, has emerged as a potential biomarker linking periodontitis, endothelial dysfunction, and CVD. This systematic review aimed [...] Read more.

Background: Periodontitis, a chronic inflammatory disease, has been associated with an elevated risk of cardiovascular disease (CVD). Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, has emerged as a potential biomarker linking periodontitis, endothelial dysfunction, and CVD. This systematic review aimed to synthesize the existing evidence on the relationship between ADMA, periodontitis, and CVD, and to evaluate ADMA’s potential as a biomarker for periodontal disease progression and its correlation with endothelial dysfunction. Methods: A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science databases from their inception to March 2023. Observational and interventional studies assessing ADMA levels in patients with periodontitis and/or CVD were included. The methodological quality of the included studies was evaluated using the NIH Quality Assessment Tools. Due to the heterogeneity of the included studies, a qualitative synthesis was performed. Results: Cross-sectional studies consistently demonstrated significantly elevated ADMA levels in patients with periodontitis and CVD compared to healthy controls. The prospective cohort study indicated that successful periodontal treatment was associated with a significant reduction in ADMA levels and concomitant improvement in endothelial function. The pilot cohort study reported a significant decrease in ADMA levels following periodontal therapy in patients with chronic kidney disease. However, the randomized controlled trials did not demonstrate significant alterations in ADMA levels or endothelial function subsequent to periodontal treatment in patients with periodontitis alone. Conclusions: Periodontal treatment may effectively reduce ADMA levels and improve endothelial function, particularly in patients with comorbidities. These findings suggest that ADMA is a promising biomarker linking periodontitis, endothelial dysfunction, and CVD. However, the limitations of this study include the small number of studies, heterogeneity in the study designs, and a lack of long-term follow-up data. Further high-quality, longitudinal studies are required to confirm its clinical utility and elucidate the underlying mechanisms of these relationships. The integration of periodontal care into CVD prevention and management strategies warrants consideration, as it may contribute to mitigating the cardiovascular risk associated with periodontitis. Full article

(This article belongs to the Special Issue Feature Review Papers in Dentistry)

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11 pages, 634 KiB

Open AccessArticle

Effect of a Novel Ergonomic Sheath on Dental Device-Related Muscle Work, Fatigue and Comfort—A Pilot Clinical Study

by Steven Dang, Cherie Wink, Susan Meishan Yang, Kairong Lin, Thair Takesh, Ali A. Habib and Petra Wilder-Smith

Dent. J. 2024, 12(9), 296; https://doi.org/10.3390/dj12090296 - 21 Sep 2024

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Abstract

Background: Dental instrumentation with hand-held devices is associated with discomfort, fatigue and musculoskeletal diseases or repetitive stress injuries. The goal of this in vivo study was to determine the effect of an ergonomic handle sheath on muscle work, comfort and fatigue associated with [...] Read more.

Background: Dental instrumentation with hand-held devices is associated with discomfort, fatigue and musculoskeletal diseases or repetitive stress injuries. The goal of this in vivo study was to determine the effect of an ergonomic handle sheath on muscle work, comfort and fatigue associated with (a) piezoelectric scaling by hygienists with and without musculoskeletal disorders (MSDs), and (b) dental cavity preparation by healthy dentists using a dental micromotor. Materials and Methods: Two groups of ten hygienists each tested the piezoelectric scaler. Hygienists in Group 1 had no MSDs, while those in Group 2 had been diagnosed with MSDs. Additionally, ten dentists with no MSDs used a dental micromotor to prepare four standardized cavities. Time-based work in four muscles, comfort and fatigue were recorded in the presence and absence of an add-on soft, insulating handle sheath. Data were analyzed using a repeated measures analysis of variance model with Tukey’s post-hoc test. Results: Comfort, fatigue and muscle work were significantly better for both devices when the sheath was used. While hygienists with MSDs used more muscle work to complete the set scaling task, and the sheath-related reduction in work was somewhat greater, these MSD-related differences did not quite reach significance. Conclusions: The results of this pilot study show that the ergonomic performance of an ultrasonic scaler and a dental micromotor may be improved by the use of an ergonomic handle sheath. Full article

(This article belongs to the Special Issue Feature Papers to Celebrate the First Impact Factor of Dentistry Journal)

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11 pages, 234 KiB

Open AccessReview

Evaluating Treatment Modalities for Reducing Recurrence in Central Giant Cell Granuloma: A Narrative Review

by Flamur Aliu, Donika Bajrami Shabani, Iliriana Aliu, Etleva Droboniku Qeli, Gerta Kaçani, Luca Fiorillo and Aida Meto

Dent. J. 2024, 12(9), 295; https://doi.org/10.3390/dj12090295 - 19 Sep 2024

Cited by 1 | Viewed by 887

Abstract

Treating central giant cell granuloma (CGCG) is challenging due to high recurrence rates and variable therapy responses. This study examines the efficacy of various treatments in reducing CGCG recurrence. A literature review explored outcomes of surgical excision, curettage, intralesional corticosteroid injection, and adjuvant [...] Read more.

Treating central giant cell granuloma (CGCG) is challenging due to high recurrence rates and variable therapy responses. This study examines the efficacy of various treatments in reducing CGCG recurrence. A literature review explored outcomes of surgical excision, curettage, intralesional corticosteroid injection, and adjuvant therapy, considering factors like lesion location, size, and histological features. Aggressive surgical techniques such as en bloc resection were found to potentially lower recurrence rates compared to conservative approaches. However, treatment should be tailored to individual patient needs. Further research is needed to confirm these findings and improve treatment strategies. A concise literature review was conducted using PubMed, MEDLINE, and Google Scholar, focusing on papers published from 1986 to 2024. Search terms included “central giant cell granuloma”, “recurrence”, “treatment modalities”, and “surgical excision”. Studies reporting recurrence rates and treatment outcomes for CGCG were analyzed. Twenty-nine studies were reviewed, including six studies on surgical excision and curettage, eight studies on intralesional corticosteroid injections, six studies on calcitonin therapy, five studies on interferon-alpha therapy, and four studies on the therapy with denosumab. Analysis indicated that aggressive surgical treatments like en bloc resection were associated with lower recurrence rates compared to conservative methods. Predictors of recurrence included lesion size (>3 cm), location (mandible), and aggressive histopathological features. Aggressive surgical excision combined with nonsurgical methods may lower recurrence rates, while conservative techniques remain viable in some cases. Further prospective research is needed to validate these findings and enhance CGCG treatment options. Full article

(This article belongs to the Special Issue Endodontics and Restorative Sciences: 2nd Edition)

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Graphical abstract

13 pages, 2944 KiB

Open AccessArticle

Influence of Direct Coronal Restoration Materials on the Fracture Resistance of Endodontically Treated Premolars: An In Vitro Study

by Georgiana Florentina Gheorghe, Ana Maria Cristina Țâncu, Oana Elena Amza, Ioana Suciu, Laura Iosif, Stanca Cuc, Ioan Petean, Marioara Moldovan and Bogdan Dimitriu

Dent. J. 2024, 12(9), 294; https://doi.org/10.3390/dj12090294 - 19 Sep 2024

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Abstract

(1) Background: The long-term survival of an endodontically treated tooth depends on a successful root canal treatment as well as an adequate definitive coronal restoration. This study aimed to evaluate the strength of endodontically treated premolars with mesial–occlusal–distal (MOD) cavity preparation restored with [...] Read more.

(1) Background: The long-term survival of an endodontically treated tooth depends on a successful root canal treatment as well as an adequate definitive coronal restoration. This study aimed to evaluate the strength of endodontically treated premolars with mesial–occlusal–distal (MOD) cavity preparation restored with different direct coronal restoration materials but from the same manufacturer against fracture. (2) Methods: sixty intact premolars were selected and placed into five groups (n = 12): G1—intact teeth, G2—endodontic treatment and unrestored MOD cavities, G3—endodontic treatment and MOD cavities restored with Tetric PowerFlow and Tetric EvoCeram, G4—endodontic treatment and MOD cavities restored with Multicore Flow and Tetric EvoCeram, and G5—endodontic treatment and MOD cavities restored with Multicore Flow. The specimens were subjected to an axial compression load at a speed of 1.6 mm/min and optically inspected before and after with a stereomicroscope. For each premolars group, the following data were recorded: the compression resistance, the compressive strength, and the maximum force supported. The microstructure of the samples after the compression test was analyzed using scanning electron microscopy (SEM). (3) Results: statistical analysis (ANOVA and Tukey test) showed that there was a statistically significant difference between G1 and the other groups. Even though there was no statistically significant difference between the restored groups, a better mechanical behavior was registered within the G3. (4) Conclusions: this in vitro study indicated that none of the materials used can lead to a higher or at least similar fracture resistance as the intact teeth. The coronal restoration only with nano-hybrid composites may lead to a higher therapeutic benefit for the fracture-susceptible premolars. Full article

(This article belongs to the Section Restorative Dentistry and Traumatology)

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15 pages, 878 KiB

Open AccessArticle

Qualitative Analysis of Student Reflections on Preclinical Dental Implant Education

by Hassan Ziada, Michael Webberson, Rassilee Sharma and Neamat Hassan Abubakr

Dent. J. 2024, 12(9), 293; https://doi.org/10.3390/dj12090293 - 13 Sep 2024

Viewed by 901

Abstract

Dental implant education is required to prepare students for independent general practice. This investigation aimed to assess students’ perceptions of their educational experience and training in a preclinical dental implant introduction course, using reflective logs anonymously extracted from course portfolios. Methods: This study [...] Read more.

Dental implant education is required to prepare students for independent general practice. This investigation aimed to assess students’ perceptions of their educational experience and training in a preclinical dental implant introduction course, using reflective logs anonymously extracted from course portfolios. Methods: This study employed qualitative research methodology to analyze second-year dental students’ reflections on their educational and development of psychomotor skills in a preclinical course focusing on dental implants at the University of Nevada, Las Vegas. These reflections served as the primary data source for qualitative analysis. The analysis was facilitated using NVivo software version 12 plus, which assisted in data coding and the organization of these codes into meaningful units, patterns, and themes. Results: Four themes emerged, which interrelated to each other and to the research question. Students reported positive course outcomes in dental implant learning, improvements in applying theoretical implant knowledge while developing practical skills, digitally scanning implant cases for the final restoration, and enhancement of their insight in evidence-based restoratively driven implant planning. They generally found the hands-on experience to have improved their understanding of the dental implant as an option for restoration. Although there were challenges, students viewed these as learning opportunities. For us, as educators, it provided invaluable feedback to understand students’ perceptions of difficulties in knowledge acquisition and psychomotor skill development in placing and restoring dental implants. Conclusions: Within the limitation of this study, students expressed a positive perception of their learning experience in the introductory course on dental implants. Full article

(This article belongs to the Special Issue Feature Papers to Celebrate the First Impact Factor of Dentistry Journal)

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12 pages, 1537 KiB

Open AccessFeature PaperArticle

Clinical Performance of Extra-Short (≤5.5 mm) Compared to Longer Implants Splinted under the Same Prosthesis: A Randomized Clinical Trial

by Eduardo Anitua, Adriana Montalvillo, Asier Eguia and Mohammad Hamdan Alkhraisat

Dent. J. 2024, 12(9), 292; https://doi.org/10.3390/dj12090292 - 13 Sep 2024

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Abstract

Objective: This randomized controlled split-mouth trial compared the performance of 5.5 mm length implants (test group; TG) splinted within the same fixed prosthesis as longer implants (≥6.5 mm; control group; CG) in posterior regions. Methods: The primary hypothesis was that implant length does [...] Read more.

Objective: This randomized controlled split-mouth trial compared the performance of 5.5 mm length implants (test group; TG) splinted within the same fixed prosthesis as longer implants (≥6.5 mm; control group; CG) in posterior regions. Methods: The primary hypothesis was that implant length does not affect marginal bone loss (MBL) one year post-implantation, while the secondary hypotheses included implant survival, peri-implant clinical variables, and prosthetic complications. Fifteen patients (eight males, seven females) with a mean age of 67 ± 9 years were included. Results: No significant difference in the implant position between groups (p = 0.808) was observed. Implant diameters ranged from 3.00 to 4.25 mm, and the most common bone type was type I (67%). Bone density (p = 0.574) and implant insertion torque (p = 0.888) were similar between groups. Mesial MBL (mean: −0.1; range: −1.19 to 0.24 for TG, and −0.03; −1.75 to 0.45 for CG; p = 0.955) and distal MBL (mean: −0.05; range: −1.41 to 0.27 for TG, and 0.08; −1.45 to 0.72 for CG; p = 0.118) did not show statistical differences. There were no implant failures or technical complications. Conclusions: These findings suggest that 5.5 mm length implants could be a viable option for use in posterior regions, providing similar clinical outcomes to longer implants one year post-implantation. Full article

(This article belongs to the Special Issue Risk Factors in Implantology)

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16 pages, 338 KiB

Open AccessReview

Multifactorial Contributors to the Longevity of Dental Restorations: An Integrated Review of Related Factors

by Maria Jacinta Moraes Coelho Santos, Elham Zare, Peter McDermott and Gildo Coelho Santos Junior

Dent. J. 2024, 12(9), 291; https://doi.org/10.3390/dj12090291 - 12 Sep 2024

Viewed by 1961

Abstract

Purpose: This integrated review aims to identify and analyze the multifactorial contributors to the longevity of direct restorations, focusing on tooth-, patient-, and dentist-related factors. Materials and Methods: A search of the literature was performed using an electronic database, PubMed/Medline, Web of Science, [...] Read more.

Purpose: This integrated review aims to identify and analyze the multifactorial contributors to the longevity of direct restorations, focusing on tooth-, patient-, and dentist-related factors. Materials and Methods: A search of the literature was performed using an electronic database, PubMed/Medline, Web of Science, and Scopus, on papers published between 1980 and 2024. The titles and abstracts of papers that evaluated aspects categorized into tooth-related, patient-related, and dentist-related factors influencing restoration failure were selected and screened. Full-text assessments were conducted, and the extracted data were compiled, summarized, and synthesized. The reference lists of the collected papers were also screened, and relevant citations were included in this review. Data were gathered from clinical and laboratorial studies, systematic reviews, and meta-analyses to provide a comprehensive understanding of restoration longevity. Results: Among the tooth-related factors, multiple-surface restorations, deep margins, tooth location, and tooth vitality significantly impact restoration survival. Patient-related factors such as medical conditions, risk predictors of caries, age, sex, parafunctional habits, smoking, periodontal health, number of restorations, and socioeconomic status all play crucial roles. Regarding dentist-related factors, the decision-making process, age, experience, and dentist manual dexterity are vital aspects. Furthermore, the technique used, including isolation methods for moisture control, as well as the type of dental practice (large group vs. small practice), notably influenced the restoration survival. Conclusions: The longevity of dental restorations is influenced by a complex interplay of tooth-related, patient-related, and dentist-related factors. Strategies to improve restoration outcomes should consider all these multifactorial contributors. Continuing professional education, diligent patient guidance on the factors that influence restoration survival, careful material selection and restorative technique, and tailored individual treatment are crucial factors to reduce failure rates and improve the lifespan of restorations. Full article

(This article belongs to the Special Issue Feature Review Papers in Dentistry)

10 pages, 1242 KiB

Open AccessArticle

Effectiveness of New Isomalt-Containing Toothpaste Formulations in Preventing Dental Caries: A Microbial Study

by Bennett Tochukwu Amaechi, Parveez Ahamed Abdul Azees, Sahar Mohseni, Maria Camila Restrepo-Ceron, Yuko Kataoka, Temitope Olabisi Omosebi and Kannan Kanthaiah

Dent. J. 2024, 12(9), 290; https://doi.org/10.3390/dj12090290 - 12 Sep 2024

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Abstract

This study investigated the efficacy of Isomalt-containing toothpaste in preventing development of dental caries. Methods: Human dental enamel slabs were allocated to six groups (30/group) at random: De-ionized distilled water (DDW), and toothpaste containing 10% Isomalt, 1100 ppm fluoride, 0.05% cetylpyridinium chloride [CPC] [...] Read more.

This study investigated the efficacy of Isomalt-containing toothpaste in preventing development of dental caries. Methods: Human dental enamel slabs were allocated to six groups (30/group) at random: De-ionized distilled water (DDW), and toothpaste containing 10% Isomalt, 1100 ppm fluoride, 0.05% cetylpyridinium chloride [CPC] (ICT); 10% Isomalt, 1100 ppm fluoride (IT); 10% Isomalt, 1100 ppm fluoride, 1.5% Sodium lauryl sulfate [SLS] (IST); 1100 ppm fluoride only (FT); 1100 ppm fluoride with SLS (FST). The enamel slabs were exposed to caries development via plaque growth in a Microbial Caries Model for 7 days. Toothpastes were applied as slurries (one toothpaste–three DDW) for 2 min twice daily. Demineralization was measured as the change in surface microhardness (ΔSMH) and amount of mineral lost (∆Z), and these metrics were assessed using Transverse Microradiography. Intra-group (SMH) and intergroup (%∆SMH and ∆Z) comparisons were paired t-test and Tukey’s test (α = 0.05), respectively. Results: With SMH, demineralization was found to be significant (p < 0.001) in all groups compared to sound enamel baseline, except ICT group. With %ΔSMH, all other groups had significantly (p < 0.001) less demineralization compared to DDW. Significantly (p < 0.001) greater demineralization was observed in IT, FT and FST compared to ICT, and no significant difference was observed between IST and ICT or FT. With ∆Z, relative to the DDW group, the inhibition of demineralization was significant (p < 0.0001) in all groups at varying percentages. Conclusions: Toothpaste containing 10% Isomalt, 1100 ppm fluoride, and 0.05% CPC demonstrated greater efficacy in inhibiting caries development amid dental plaque compared to toothpaste containing only 1100 ppm fluoride. Full article

(This article belongs to the Special Issue Prevention of Dental Caries and Erosive Tooth Wear)

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9 pages, 1333 KiB

Open AccessArticle

Dental Erosion in Competitive Swimmers and Preventive Treatments: An In Vitro Study

by Riccardo Favero, Marianna Nicetto, Martina Barone, Alessandra Dorigotti, Andrea Volpato and Vincenzo Tosco

Dent. J. 2024, 12(9), 289; https://doi.org/10.3390/dj12090289 - 11 Sep 2024

Viewed by 1254

Abstract

The aim of this in vitro study was to evaluate the effectiveness of highly concentrated fluoride products and remineralizing products (F-APC) in preventing erosive dental lesions in competitive swimming patients. A total of 48 teeth were extracted, preserved in saline solution and divided [...] Read more.

The aim of this in vitro study was to evaluate the effectiveness of highly concentrated fluoride products and remineralizing products (F-APC) in preventing erosive dental lesions in competitive swimming patients. A total of 48 teeth were extracted, preserved in saline solution and divided into three groups. In G1 (control group), each tooth was half-immersed in chlorinated pool water; in G2 (fluoride-treated group), after being totally immersed in chlorinated water, each tooth had half of its surface treated with a highly concentrated fluoride product once a week; in G3 (remineralization product-treated group), each tooth was totally immersed in chlorinated water and half of its surface was treated with a remineralizing product after each immersion. The study was conducted over a 4-week period, immersing the teeth for 4 h per day. In G1, statistically significant differences were observed in submerged versus non-submerged tooth surfaces at week 3 (T3) (p = 0.019) and week 4 (T4) (p = 0.0007), with four and eight surfaces showing erosive tooth wear (ETW), respectively. In G2, a difference was observed between fluoride-treated and non-fluoride-treated surfaces at T4 (p = 0.039), with three surfaces with ETW among the non-treated ones. In G3, the difference was observed between portions treated with F-APC and those not treated at T4 (p = 0.019), with four surfaces with ETW among the untreated ones. Chlorinated pool water is a potential erosive agent for teeth if water pH values reach a critical value. Treating the teeth surface with highly concentrated fluoride products, once a week for 5 min, and F-APC are effective in protecting teeth against tooth erosion. Full article

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11 pages, 2250 KiB

Open AccessArticle

Histological Analysis of Oral Tissue Grafting: A Focus on Donor Site Selection

by Piero Antonio Zecca, Alice Ronchetti, Doris Cangelosi, Marcella Reguzzoni and Davide Farronato

Dent. J. 2024, 12(9), 288; https://doi.org/10.3390/dj12090288 - 10 Sep 2024

Viewed by 805

Abstract

The science of dental tissue grafting is evolving, with an increased understanding of factors influencing graft behavior. Despite the widespread clinical use of soft tissue grafts, the histological characteristics of different gingival harvesting sites are still underexplored. This study aimed to fill this [...] Read more.

The science of dental tissue grafting is evolving, with an increased understanding of factors influencing graft behavior. Despite the widespread clinical use of soft tissue grafts, the histological characteristics of different gingival harvesting sites are still underexplored. This study aimed to fill this gap by analyzing 50 tissue samples harvested from 25 patients across three sites: the hard palate, maxillary tuberosity, and palatal rugae. Each sample underwent thorough histological and histomorphometric analysis. Conventional statistical analysis was performed using SPSS, while predictive modeling was conducted with RapidMiner Studio. The study identified significant histological differences among the graft sites, with notable variations in total graft height, epithelial height, and interdigitation perimeter. These findings underscore the importance of donor site selection in influencing graft success. Pair plots and principal component analysis (PCA) further highlighted the distinct histological features of each tissue type. The random forest classifier identified total graft height, epithelial height, and perimeter as the most influential factors in predicting graft site behavior. This study offers valuable insights into the histological characteristics of soft tissue grafts, potentially leading to more predictable clinical outcomes. Full article

(This article belongs to the Special Issue Advances in Periodontal and Peri-Implant Tissues Health Management)

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10 pages, 3158 KiB

Open AccessArticle

Role of Pulsed Electromagnetic Field on Alveolar Bone Remodeling during Orthodontic Retention Phase in Rat Models

by Hafiedz Maulana, Yuyun Yueniwati, Nur Permatasari and Hadi Suyono

Dent. J. 2024, 12(9), 287; https://doi.org/10.3390/dj12090287 - 9 Sep 2024

Viewed by 723

Abstract

Alveolar bone remodeling during the retention phase is essential for successful orthodontic treatment. Pulsed electromagnetic field (PEMF) therapy is an adjunctive therapy for bone-related diseases that induces osteogenesis and prevents bone loss. This study aimed to examine the role of PEMF exposure during [...] Read more.

Alveolar bone remodeling during the retention phase is essential for successful orthodontic treatment. Pulsed electromagnetic field (PEMF) therapy is an adjunctive therapy for bone-related diseases that induces osteogenesis and prevents bone loss. This study aimed to examine the role of PEMF exposure during the retention phase of orthodontic treatment in alveolar bone remodeling. A total of 36 male Wistar rats were divided into control, PEMF 7, and PEMF 14 groups; a 50 g force nickel–titanium closed-coil spring was inserted to create mesial movement in the first molar for 21 d. Furthermore, the spring was removed, and the interdental space was filled with glass ionomer cement. Concurrently, rats were exposed to a PEMF at 15 Hz with a maximum intensity of 2.0 mT 2 h daily, for 7 and 14 days. Afterwards, the cements were removed and the rats were euthanized on days 1, 3, 7, and 14 to evaluate the expression of Wnt5a mRNA and the levels of RANKL, OPG, ALP, and Runx2 on the tension side. The data were analyzed with ANOVA and post hoc tests, with p < 0.05 declared statistically significant. PEMF exposure significantly upregulated Wnt5a mRNA expression, OPG and ALP levels, and Runx2 expression, and decreased RANKL levels in the PEMF 7 and 14 groups compared to the control group (p < 0.05). This study showed that PEMF exposure promotes alveolar bone remodeling during the orthodontic retention phase on the tension side by increasing alveolar bone formation and inhibiting resorption. Full article

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10 pages, 1580 KiB

Open AccessArticle

In Vitro Evaluation of Sodium Hypochlorite, Chlorhexidine, Propolis, and Calcium Hydroxide Effect on Lipoteichoic-Acid-Induced Proinflammatory Cytokines Production

by Luciane Dias de Oliveira, Lara Steffany de Carvalho, Ana Claudia Carvalho Xavier, Felipe Eduardo de Oliveira, Mariella Vieira Pereira Leão, Mariana Gadelho Gimenez Diamantino, Rayana Duarte Khoury, Marcia Carneiro Valera, Cláudio Antonio Talge Carvalho and Amjad Abu Hasna

Dent. J. 2024, 12(9), 286; https://doi.org/10.3390/dj12090286 - 5 Sep 2024

Cited by 1 | Viewed by 1020

Abstract

This study aimed to evaluate the effects of sodium hypochlorite (NaOCl), chlorhexidine (CHX), and the glycolic extract of propolis (GEP) as endodontic irrigants and of calcium hydroxide [Ca(OH)₂], CHX, or Ca(OH)₂ + CHX as intracanal medications on the capacity of [...] Read more.

This study aimed to evaluate the effects of sodium hypochlorite (NaOCl), chlorhexidine (CHX), and the glycolic extract of propolis (GEP) as endodontic irrigants and of calcium hydroxide [Ca(OH)₂], CHX, or Ca(OH)₂ + CHX as intracanal medications on the capacity of the lipoteichoic acid (LTA) of Enterococcus faecalis in macrophages’ proinflammatory cytokines production. Freshly extracted 108 human single-rooted teeth were used in this study. The LTA of E. faecalis was standardized in double-distilled pyrogen-free water (250 µg/mL) and inoculated into the specimens subdivided into nine subgroups (n = 12). Cultures of murine macrophages (RAW 264.7) were treated with 30 µL of each sample collected from root canals and incubated (37 °C, 5% CO₂) for 24 h. Lastly, anti-TNF-α, anti-IL-6, anti-IP-10, anti-MIP-1α, anti-G-CSF, and anti-IL-1β DuoSet kits were used to perform an ELISA assay. Data were analyzed using one-way ANOVA and Tukey test (p ≥ 0.05). It was found that 1% NaOCl was the most effective irrigant in reducing the capacity of LTA in cytokines production, followed by 12% GEP and 2% CHX, respectively. Ca(OH)₂ + CHX presented the best results when associated with NaOCl or GEP. Thus, NaOCl or GEP associated with Ca(OH)₂ + CHX were effective in reducing the capacity of LTA in different macrophages pro-inflammatory cytokines production. Full article

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12 pages, 623 KiB

Open AccessArticle

Color Stability Assessment of Single- and Multi-Shade Composites Following Immersion in Staining Food Substances

by Vittorio Checchi, Eleonora Forabosco, Giulia Della Casa, Shaniko Kaleci, Luca Giannetti, Luigi Generali and Pierantonio Bellini

Dent. J. 2024, 12(9), 285; https://doi.org/10.3390/dj12090285 - 4 Sep 2024

Viewed by 788

Abstract

Composite resins are the material of choice for direct restorations, and their success depends mainly on their color stability, since discoloration causes color mismatch, and consequent patient dissatisfaction. A single- and a multi-shade resin were compared in order to evaluate their pigmentation after [...] Read more.

Composite resins are the material of choice for direct restorations, and their success depends mainly on their color stability, since discoloration causes color mismatch, and consequent patient dissatisfaction. A single- and a multi-shade resin were compared in order to evaluate their pigmentation after immersion in staining substances and to investigate the effect of the polymerization time on their color stability. Two-hundred-and-forty composite specimens were created, half made of a single-shade (Group ONE, n = 120) and half of a multi-shade composite (Group OXP, n = 120). Each group was further divided into ONE30 (n = 60) and OXP30 (n = 60), polymerized for 30″, and ONE80 (n = 60) and OXP80 (n = 60), polymerized for 80″. Randomly, the specimens were immersed in turmeric solution, soy sauce, energy drink, or artificial saliva. By means of a spectrophotometer, ΔE₀₀ and WI_d were calculated at 24 h (T₀), at 7 (T₁), and 30 (T₂) days. Single-shade composites showed statistically significant differences in color change from the turmeric solution, energy drink, and soy sauce than the multi-shade composites (p < 0.005), showing a higher discoloration potential. The polymerization time did not have significative effects on color stability. Single-shade composites showed more color change than multi-shade systems after immersion in staining substances, and the curing time did not influence color variations. Full article

(This article belongs to the Special Issue State of the Art in Dental Restoration)

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15 pages, 1561 KiB

Open AccessArticle

Dental Color-Matching Ability: Comparison between Visual Determination and Technology

by Maria Menini, Lorenzo Rivolta, Jordi Manauta, Massimo Nuvina, Zsolt M. Kovacs-Vajna and Paolo Pesce

Dent. J. 2024, 12(9), 284; https://doi.org/10.3390/dj12090284 - 3 Sep 2024

Viewed by 1000

Abstract

Background: The choice of the correct color is of paramount importance in esthetic dentistry; however, there is still no consensus on the best technique to determine it. The aim of the present study is to compare the accuracy of a recently introduced colorimeter [...] Read more.

Background: The choice of the correct color is of paramount importance in esthetic dentistry; however, there is still no consensus on the best technique to determine it. The aim of the present study is to compare the accuracy of a recently introduced colorimeter in shade matching with human vision. In addition, possible variables affecting color-matching by human eye have been analysed. Methods: 18 disc-shaped composite samples with identical size and shape were produced from a composite flow system (Enamel plus HriHF, Micerium): Nine were considered control samples (UD 0-UD 6), and nine were test samples with identical flow composite shade to the control ones. Parallelly, 70 individuals (dental students and dental field professionals) were individually instructed to sit in a dark room illuminated with D55 light and to perform visual shade matching between control and test discs. An error matrix containing ΔE₉₄ between control and test discs was generated, containing four match-clusters depending on perceptibility and acceptability thresholds. The frequency and severity of errors were examined. Results: The colorimeter achieved a 100% perfect matching, while individuals only achieved a 78%. A higher occurrence of mismatches was noted for intermediate composite shades without a statistically significant difference. No statistically significant differences were reported for age, sex, and experience. A statistically significant difference was present among the Optishade match and the visual determination. Conclusions: The instrumental shade-matching evaluation proved to be significantly more reliable than the human visual system. Further research is needed to determine whether the same outcomes are achieved in a clinical setting directly on patients. Full article

(This article belongs to the Special Issue Esthetic Dentistry: Current Perspectives and Future Prospects)

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12 pages, 276 KiB

Open AccessArticle

Current Endodontic Practices among Romanian Dental Practitioners: A Cross-Sectional Study

by Cezar Tiberiu Diaconu, Lelia Mihaela Gheorghiță, Anca Elena Diaconu, Mihaela Jana Țuculină, Alexandru Gliga, Carlo Gaeta, Simone Grandini, Iulia Roxana Marinescu, Marina Olimpia Amărăscu and Oana Andreea Diaconu

Dent. J. 2024, 12(9), 283; https://doi.org/10.3390/dj12090283 - 3 Sep 2024

Viewed by 707

Abstract

Root canal therapy (RCT) is usually performed in Romania by general dentists (GDPs) because they are more readily available and more reasonably priced than endodontists. Concerns have been raised about the quality of RCTs performed by GDPs, possibly due to insufficient equipment or [...] Read more.

Root canal therapy (RCT) is usually performed in Romania by general dentists (GDPs) because they are more readily available and more reasonably priced than endodontists. Concerns have been raised about the quality of RCTs performed by GDPs, possibly due to insufficient equipment or knowledge; therefore, this study aims to investigate current endodontic practices in Romania. Materials and Methods: A cross-sectional study was conducted via a questionnaire distributed to 400 randomly selected Romanian dentists, with 285 fully validated completed responses (71.25% response rate). Respondents were grouped by speciality, and statistical analysis, including cross-tabulation and the χ² (chi-square) test, was used, with a significance level set at p ≤ 0.05 for all tests. Results: Significant differences were found in the use of magnification, rubber dam, sodium hypochlorite concentration, and bioceramics (p < 0.001). No significant differences were observed in preferences for measuring working length (p = 0.166) or rotary instrument motion (p = 0.289). Approximately 6% of the respondents used laser technology with no significant difference across specialities (p = 0.571). Additionally, 77.9% preferred using sodium hypochlorite, with no significant difference between groups (p = 0.006) regarding concentration. Conclusions: Most participants, including GDPs, use modern equipment and techniques during RCT, indicating their awareness and competence in current endodontic practices. Full article

(This article belongs to the Special Issue Modern Endodontics)

11 pages, 1487 KiB

Open AccessArticle

Traumatic Dental Injuries among Adolescents and Young Adults in Iași, Romania: Legal and Medical Perspectives

by Giuvara Constantin Răzvan, Victor Vlad Costan, Otilia Boisteanu, Adina Armencia, Mihai Ciofu, Carina Balcos, Gabriela Calin, Diana Bulgaru Iliescu and Loredana Liliana Hurjui

Dent. J. 2024, 12(9), 282; https://doi.org/10.3390/dj12090282 - 2 Sep 2024

Viewed by 733

Abstract

Adolescents and young adults’ active lifestyles make dental trauma a significant medical concern. Aim: This study aims to assess the etiology, frequency, and localization of dental and periodontal trauma in adolescents and young adults, along with these individuals’ predisposition based on age, gender, [...] Read more.

Adolescents and young adults’ active lifestyles make dental trauma a significant medical concern. Aim: This study aims to assess the etiology, frequency, and localization of dental and periodontal trauma in adolescents and young adults, along with these individuals’ predisposition based on age, gender, and residence. Materials and Methods This retrospective study included 109 adolescents and young adults from a database of the Emergency and Oral and Maxillofacial Surgery department at “Sf. Spiridon” Hospital, Iasi, Romania. The collected data included demographic details, mechanisms of dental and periodontal trauma, treatment approaches, and clinical outcomes. Statistical analysis was performed using SPSS 26.0, with comparisons based on age, gender, and residence. Results: Enamel fractures (23.9%) and enamel-dentin fractures without pulp exposure (20.2%) were the most frequent dental injuries. Concussion (58.7%), subluxation (21.1%), luxation, avulsion (7.3%), and extrusion (5.5%) were common periodontal injuries. The anterior region of the dental arch accounted for the majority (60.6%) of injuries. Adolescents under 17 years were more prone to enamel-dentin fractures without pulp exposure (23.8%), enamel-dentin fractures with pulp exposure (20.6%), and root fractures (20.6%), while young adults over 18 years had a higher incidence of enamel fractures (32.6%) and crown-root fractures (30.4%). Falls (66.7%) were the predominant cause of trauma for female patients, whereas male patients were more often injured during sports activities (49.3%). The younger age group was 0.29 times more likely to sustain enamel-dentin fractures without pulp exposure (p = 0.049, OR = 0.291) and root fractures (p = 0.047, OR = 0.241). Conclusions: Traumatic dental injuries are more prevalent in young adults compared to adolescents, with falls and sports activities being the most common causes, particularly among males. These findings emphasize the need for targeted preventive programs aimed at reducing the incidence of dento-periodontal trauma in these age groups. Full article

(This article belongs to the Special Issue Feature Papers in Restorative Dentistry, Endodontology and Traumatology)

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13 pages, 2458 KiB

Open AccessArticle

Evaluation of Cleaning Methods for Lithium Disilicate Ceramic Post Try-In Paste Application: An SEM Analysis

by Gildo Coelho Santos Junior and Maria Jacinta Moraes Coelho Santos

Dent. J. 2024, 12(9), 281; https://doi.org/10.3390/dj12090281 - 31 Aug 2024

Viewed by 824

Abstract

This in vitro study assessed the efficacy of three cleaning methods on lithium disilicate ceramic after the application of different try-in pastes through SEM analysis. Ten rectangular specimens of IPS e.max CAD were prepared using a diamond disc, crystallized, etched with 5% hydrofluoric [...] Read more.

This in vitro study assessed the efficacy of three cleaning methods on lithium disilicate ceramic after the application of different try-in pastes through SEM analysis. Ten rectangular specimens of IPS e.max CAD were prepared using a diamond disc, crystallized, etched with 5% hydrofluoric acid, and subjected to three try-in pastes—Calibra ©, Variolink (V), RelyX Veneer^®—and three cleaning techniques—air–water spray (RD), ultrasonic bath in distilled water for five minutes (ULT/W), and ultrasonic bath in distilled alcohol for five minutes (ULT/A). A control specimen was also included. After one-minute paste application and subsequent cleaning method application, SEM evaluation was conducted. The results indicate that RD was as effective as CTRL in removing remnants from R-RD, V-ULT/W and V-ULT/A samples, but ineffective for all Calibra paste-contaminated specimens. In conclusion, the optimal removal of try-in paste residues from lithium disilicate restorations is paste-dependent; however, ultrasonic baths with distilled water or alcohol proved effective for most pastes tested. Full article

(This article belongs to the Special Issue Esthetic Dentistry: Current Perspectives and Future Prospects)

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10 pages, 2851 KiB

Open AccessArticle

Perceived Enablers of and Barriers to Serious Game as Oral Histology Learning Strategy for Undergraduate Dental Students

by Lisa R. Amir, Salsabila N. Dewatmoko, Irene C. Leonardy, Rezon Yanuar, Dewi F. Suniarti, Erik Idrus, Kawin Sipiyaruk, Ria Puspitawati and Yuniardini Wimardhani

Dent. J. 2024, 12(9), 280; https://doi.org/10.3390/dj12090280 - 31 Aug 2024

Viewed by 875

Abstract

Previously, we reported the serious game HistoRM as an innovative learning approach for an oral histology course. This study aimed to examine the impact of HistoRM on summative assessment and the enablers and barriers factors affecting HistoRM as an interactive learning strategy in [...] Read more.

Previously, we reported the serious game HistoRM as an innovative learning approach for an oral histology course. This study aimed to examine the impact of HistoRM on summative assessment and the enablers and barriers factors affecting HistoRM as an interactive learning strategy in an oral histology course. A crossover randomized controlled trial was performed. Study participants were first-year dental students at the Universitas Indonesia. The average final grades of students who participated in HistoRM serious game were significantly higher than those of students who did not participate in this trial (p < 0.001). Positive responses of HistoRM were observed in the learning content, games and learning experience domains. The enabler factors most recognized by the students were the game method, which helped students to understand the learning materials; the immediate feedback provided following each gameplay; as well as the fun and interesting gameplay. The barrier factors most recognized by the students were some challenges of the gameplay, which resulted in a longer time needed to study. While the HistoRM serious game can stimulate student motivation and engagement in learning oral histology, overcoming the barriers is essential for the implementation of serious games as a complementary learning approach in the dental curriculum. Full article

(This article belongs to the Special Issue Feature Papers to Celebrate the First Impact Factor of Dentistry Journal)

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12 pages, 946 KiB

Open AccessArticle

Direct Oral Anticoagulants and Bleeding Management Following Tooth Extractions—A Prospective Cohort Study

by Rossana Izzetti, Chiara Cinquini, Marco Nisi, Marco Mattiozzi, Monica Marotta and Antonio Barone

Dent. J. 2024, 12(9), 279; https://doi.org/10.3390/dj12090279 - 30 Aug 2024

Viewed by 1090

Abstract

The aim of the present study was to assess the occurrence of intra-, peri-, and post-operative bleeding following tooth extractions in patients treated with direct oral anticoagulants (DOACs). Consecutive patients requiring at least one dental extraction were enrolled. The DOAC regimen was either [...] Read more.

The aim of the present study was to assess the occurrence of intra-, peri-, and post-operative bleeding following tooth extractions in patients treated with direct oral anticoagulants (DOACs). Consecutive patients requiring at least one dental extraction were enrolled. The DOAC regimen was either maintained or suspended. Patients were classified in subgroups depending on the number of teeth extracted per procedure (≤3 or >3), the need for flap elevation, and the performance of osteotomy. Bleeding was recorded intra-operatively; peri-operatively at 20, 40, 60, and 80 min after the procedure; and daily in the first seven days following tooth extractions. Forty-nine patients treated with DOACs (17 with rivaroxaban, 16 with apixaban, 8 with edoxaban, and 8 with dabigatran) were enrolled. Of them, 33 refrained from DOAC administration pre-operatively. The performances of >3 teeth extractions, flap elevation, and osteotomy were significantly associated with higher bleeding rates (p < 0.05). In patients treated with rivaroxaban and apixaban, bleeding episodes were more frequent. Although DOAC treatment may increase the rates of intra-operative, peri-operative, and post-operative bleeding, the recorded episodes were mild and manageable. DOAC suspension may reduce peri-operative bleeding, while no effect could be observed for post-operative bleeding. Full article

(This article belongs to the Special Issue Feature Papers to Celebrate the First Impact Factor of Dentistry Journal)

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16 pages, 4840 KiB

Open AccessArticle

Occlusal Plane, Mandibular Position and Dentoalveolar Changes during the Orthodontic Treatment with the Use of Mini-Screws

by Julián David Gómez-Bedoya, Pablo Arley Escobar-Serna, Eliana Midori Tanaka-Lozano, Andrés A. Agudelo-Suárez and Diana Milena Ramírez-Ossa

Dent. J. 2024, 12(9), 278; https://doi.org/10.3390/dj12090278 - 30 Aug 2024

Viewed by 794

Abstract

This study aimed to describe the changes produced on the occlusal plane (OP), the mandibular position and the dentoalveolar compensations of patients with distalization of the maxillary/mandibular arch assisted by mini-screws (MS). A descriptive case–series study was performed using the digital lateral cephalograms [...] Read more.

This study aimed to describe the changes produced on the occlusal plane (OP), the mandibular position and the dentoalveolar compensations of patients with distalization of the maxillary/mandibular arch assisted by mini-screws (MS). A descriptive case–series study was performed using the digital lateral cephalograms (DLC) of nine patients who underwent orthodontic treatment and required the use of MS for a complete distalization of the maxillary/mandibular arch. Records were collected at three different times (T1–T2–T3) and digitally analyzed (variables: Skeletal diagnosis; maxillary occlusal plane; position of the maxilla/mandible; and dentoalveolar changes of the distalization arch tracing the longitudinal axis of incisors/molars regarding the palatal/mandibular plane). Findings show that the OP varied from T1–T2–T3 in all cases, indicating its stepping or flattening. ODI, APDI, SNA, SNB, and ANB changed minimally in all cases, without variations in the mandibular position or in the skeletal diagnosis. Dentoalveolar measurements also showed differences between T1–T2–T3. In summary, conventional orthodontic treatment modified the OP during the first phase of treatment. Moreover, the distalization mechanics with MS changed the OP and produced dentoalveolar changes, mainly in the inclination of incisors and molars. Other measures considered in the study did not change substantially. Full article

(This article belongs to the Special Issue Feature Papers to Celebrate the First Impact Factor of Dentistry Journal)

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12 pages, 228 KiB

Open AccessArticle

Evaluation of General Anesthesia and Sedation and Follow-Up Compliance in Pediatric Dental Procedures: A Comprehensive Analysis of Long-Term Outcomes and Gender Differences

by Maria Sarapultseva and Alexey Sarapultsev

Dent. J. 2024, 12(9), 277; https://doi.org/10.3390/dj12090277 - 28 Aug 2024

Viewed by 936

Abstract

This retrospective study evaluated the effectiveness of different types of general anesthesia (GA) and sedation in pediatric dental procedures, focusing on treatment outcomes and follow-up compliance with an emphasis on gender differences. Clinical records of 1582 pediatric patients, aged 0–18 years, were analyzed [...] Read more.

This retrospective study evaluated the effectiveness of different types of general anesthesia (GA) and sedation in pediatric dental procedures, focusing on treatment outcomes and follow-up compliance with an emphasis on gender differences. Clinical records of 1582 pediatric patients, aged 0–18 years, were analyzed to examine the distribution, duration and impact of anesthesia types on dental procedure complexity. The study population was divided into three age groups: 0–6, 7–12 and 13–18 years. We assessed follow-up attendance rates by gender and anesthesia type, calculated the decayed, missing and filled (DMF) index and evaluated the need for further treatment and reasons for retreatment. Our findings indicated that general anesthesia with inhalational agents and muscle relaxants was the most frequently used method (1260 instances), followed by nitrous oxide sedation (163 instances) and sevoflurane GA with a laryngeal mask airway (158 instances). Inhalational GA with muscle relaxants had the longest average duration (2.78 h) and the highest DMF index (7.43), reflecting its use in more severe dental conditions. Gender analysis revealed a slight male predominance in using inhalational GA with muscle relaxants (55.87% male vs. 44.13% female). Female patients demonstrated higher follow-up compliance across all periods. Overall, our results highlight the importance of tailored anesthesia and sedation plans, as well as follow-up protocols, in pediatric dentistry. This study provides valuable insights for practitioners in selecting appropriate anesthesia and sedation types and developing strategies to improve follow-up compliance and treatment success. Full article

(This article belongs to the Section Restorative Dentistry and Traumatology)

18 pages, 19065 KiB

Open AccessSystematic Review

Correlation between Implant Surface Roughness and Implant Stability: A Systematic Review

by Marta Romero-Serrano, Manuel-María Romero-Ruiz, Mariano Herrero-Climent, Blanca Rios-Carrasco and Javier Gil-Mur

Dent. J. 2024, 12(9), 276; https://doi.org/10.3390/dj12090276 - 23 Aug 2024

Viewed by 1043

Abstract

The aim of this study was to find in the literature data on the relationship between implant surface roughness and implant stability achieved, from the time of placement to three months afterward, to help us to know what type of surface roughness is [...] Read more.

The aim of this study was to find in the literature data on the relationship between implant surface roughness and implant stability achieved, from the time of placement to three months afterward, to help us to know what type of surface roughness is more favorable to guarantee implant stability and osseointegration. A systematic review was conducted in accordance with the PRISMA 2020 (Preferred Reporting Items for Systematic Review and Meta-analysis) statement, and the protocol was registered on the Open Science Framework. The specific inclusion and exclusion criteria were selected using the PICOS framework. The databases Medline (PubMed), Scopus, the Web of Science and The Cochrane Library were searched up to October 2023. The selection of studies and data extraction were conducted by two independent reviewers. The review included a total of 11 studies. A total of 1331 dental implant placements were identified. Two of the eleven selected studies were on humans in vivo, eight were on animals in vivo, and one was on animals in vitro. A statistically significant correlation between surface roughness and implant stability as measured by resonance frequency analysis (RFA) was not identified in ten of the eleven selected studies. It appears that there is no correlation between primary stability and the degree of implant roughness. However, there appears to be a correlation between the roughness of the implant and the degree of osseointegration, as indicated by bone-implant contact values. This correlation is more closely related to secondary stability. The great methodological variability makes it difficult to compare data and draw conclusions, so it would be desirable to agree on a common methodology to help draw appropriate conclusions from published studies. Full article

(This article belongs to the Special Issue Risk Factors in Implantology)

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11 pages, 2125 KiB

Open AccessArticle

Bond Strength of Nanocomposite Hard Liner to CAD-CAM Milled, 3D Printed, and Conventionally Fabricated Denture Base Resins

by Zainab Albazroun, Atheer Alabdullatif, Sarah Aldehaileb, Ferdoos Alhalimi, Faris A. Alshahrani, Soban Q. Khan, Shaimaa M. Fouda, Hamad S. AlRumaih and Mohammed M. Gad

Dent. J. 2024, 12(9), 275; https://doi.org/10.3390/dj12090275 - 23 Aug 2024

Viewed by 1170

Abstract

Background: To investigate the effect of zirconium dioxide nanoparticles (ZrO₂NPs) on the shear bond strength (SBS) of hard denture lines bonded to different denture base resins. Methods: Five different denture bases were used in this study: conventional heat-cured resin, IvoCad, AvaDent, [...] Read more.

Background: To investigate the effect of zirconium dioxide nanoparticles (ZrO₂NPs) on the shear bond strength (SBS) of hard denture lines bonded to different denture base resins. Methods: Five different denture bases were used in this study: conventional heat-cured resin, IvoCad, AvaDent, NextDent, and FormLabs, in acrylic specimens of 10 × 10 × 2.5 mm³ (N = 150, n = 10). Specimens were centered at the bottom of a silicon mold to create an auto-polymerized holder. Three major groups of reline material were used: no ZrO₂NPs (control), 2 wt.%, and 4 wt.% ZrO₂NPs. Reline was bonded to the resin surface using a customized jig. After polymerization, specimens were stored in distilled water, and 5000 thermal cycles were performed. Each specimen was fixed to an Instron machine, and SBS was tested using a blade loaded (1 mm/min) at the resin interface until failure. Data was collected and analyzed using two-way ANOVA and post hoc Tukey test (α = 0.05). Results: AvaDent showed the highest SBS when compared with other denture base materials (p < 0.001) except for IvoCad. The addition of ZrO₂NPs significantly decreased the SBS of AvaDent (p = 0.003) and IvoCad (p = 0.001), while heat polymerized resin, Formlabs, and NextDent showed no significant change in SBS (p > 0.05). Conclusion: CAD-CAM milled denture base resin showed higher SBS with pure denture reline. The addition of ZrO₂NPs decreased the SBS of reline with CAD-CAM milled denture base resins but did not change bond strength with 3D printed and conventional denture base resins. Full article

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25 pages, 709 KiB

Open AccessFeature PaperSystematic Review

The Fracture Resistance Comparison between Titanium and Zirconia Implant Abutments with and without Ageing: Systematic Review and Meta-Analysis

by Marek Chmielewski, Wojciech Dąbrowski and Iwona Ordyniec-Kwaśnica

Dent. J. 2024, 12(9), 274; https://doi.org/10.3390/dj12090274 - 23 Aug 2024

Viewed by 1051

Abstract

Implant abutments are essential components of implant prosthetic restorations. The golden standard for abutment material is titanium; however, due to its properties, the esthetic result can be compromised. The most popular esthetic material alternatives are one- and two-piece zirconia. The study aimed to [...] Read more.

Implant abutments are essential components of implant prosthetic restorations. The golden standard for abutment material is titanium; however, due to its properties, the esthetic result can be compromised. The most popular esthetic material alternatives are one- and two-piece zirconia. The study aimed to answer the questions of whether zirconia abutments can be used interchangeably with titanium in both anterior and posterior regions and how aging of the abutment affects durability. For this study, an electronic search of MEDLINE (PubMed) and Scopus (Embase) was conducted. The PRISMA guidelines were followed, and a systematic review was registered with PROSPERO. The search revealed 4031 results, of which 17 studies were selected. The strongest material for abutments is titanium, closely followed by two-piece zirconia. One-piece zirconia abutments were the weakest. The cyclic loading above 1,000,000 cycles decreased the fracture resistance of the abutments. Differences in implant diameter, angulation, and restoration affected the fracture strength of all compared materials. The main mode of failure for titanium abutments was screw bending or screw fracture. One-piece zirconia most often presented catastrophic failure with internal hexagon fracture below the implant neck. Two-piece zirconia exhibits a combination of failure modes. Two-piece zirconia abutments may be suitable for use in the posterior region, given their comparable fracture resistance to titanium abutments. Despite the fact that one-piece zirconia is capable of withstanding forces that exceed those exerted during mastication, it is recommended that it be employed primarily in the anterior dentition due to its propensity for unfavorable failure modes. Full article

(This article belongs to the Special Issue Dental Materials Design and Innovative Treatment Approach)

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Dent. J., Volume 12, Issue 9 (September 2024) – 24 articles

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