Medicina

Editorial

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6 pages, 245 KiB

Open AccessEditorial

Dentistry: A Multidisciplinary Approach

by Giuseppe Minervini

Medicina 2024, 60(3), 401; https://doi.org/10.3390/medicina60030401 - 26 Feb 2024

Viewed by 1738

Abstract

In this special issue of Medicina, we delve into the dynamic and ever-evolving world of dentistry, highlighting the remarkable innovations that are shaping the future of oral health and clinical dentistry practice [...] Full article

(This article belongs to the Special Issue Dentistry: A Multidisciplinary Approach)

Research

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18 pages, 5623 KiB

Open AccessArticle

Cortical and Trabecular Bone Stress Assessment during Periodontal Breakdown–A Comparative Finite Element Analysis of Multiple Failure Criteria

by Radu Andrei Moga, Cristian Doru Olteanu, Stefan Marius Buru, Mircea Daniel Botez and Ada Gabriela Delean

Medicina 2023, 59(8), 1462; https://doi.org/10.3390/medicina59081462 - 15 Aug 2023

Cited by 9 | Viewed by 1775

Abstract

Background and Objectives: This numerical analysis investigated the biomechanical behavior of the mandibular bone as a structure subjected to 0.5 N of orthodontic force during periodontal breakdown. Additionally, the suitability of the five most used failure criteria (Von Mises (VM), Tresca (T), maximum [...] Read more.

Background and Objectives: This numerical analysis investigated the biomechanical behavior of the mandibular bone as a structure subjected to 0.5 N of orthodontic force during periodontal breakdown. Additionally, the suitability of the five most used failure criteria (Von Mises (VM), Tresca (T), maximum principal (S1), minimum principal (S3), and hydrostatic pressure (HP)) for the study of bone was assessed, and a single criterion was identified for the study of teeth and the surrounding periodontium (by performing correlations with other FEA studies). Materials and Methods: The finite element analysis (FEA) employed 405 simulations over eighty-one mandibular models with variable levels of bone loss (0–8 mm) and five orthodontic movements (intrusion, extrusion, tipping, rotation, and translation). For the numerical analysis of bone, the ductile failure criteria are suitable (T and VM are adequate for the study of bone), with Tresca being more suited. S1, S3, and HP criteria, due to their distinctive design dedicated to brittle materials and liquids/gas, only occasionally correctly described the bone stress distribution. Results: Only T and VM displayed a coherent and correlated gradual stress increase pattern for all five movements and levels of the periodontal breakdown. The quantitative values provided by T and VM were the highest (for each movement and level of bone loss) among all five criteria. The MHP (maximum physiological hydrostatic pressure) was exceeded in all simulations since the mandibular bone is anatomically less vascularized, and the ischemic risks are reduced. Only T and VM displayed a correlated (both qualitative and quantitative) stress increase for all five movements. Both T and VM displayed rotation and translation, closely followed by tipping, as stressful movements, while intrusion and extrusion were less stressful for the mandibular bone. Conclusions: Based on correlations with earlier numerical studies on the same models and boundary conditions, T seems better suited as a single unitary failure criterion for the study of teeth and the surrounding periodontium. Full article

(This article belongs to the Special Issue Dentistry: A Multidisciplinary Approach)

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13 pages, 1147 KiB

Open AccessArticle

Comparison of Mechanical Properties of Three Tissue Conditioners: An Evaluation In Vitro Study

by Marcin Mikulewicz, Katarzyna Chojnacka and Zbigniew Raszewski

Medicina 2023, 59(8), 1359; https://doi.org/10.3390/medicina59081359 - 25 Jul 2023

Cited by 3 | Viewed by 1887

Abstract

Introduction: Tissue conditioners have been widely used in various clinical applications in dentistry, such as treating inflamed alveolar ridges, temporarily relining partial and complete dentures, and the acquisition of functional impressions for denture fabrication. This study aimed to investigate the mechanical properties of [...] Read more.

Introduction: Tissue conditioners have been widely used in various clinical applications in dentistry, such as treating inflamed alveolar ridges, temporarily relining partial and complete dentures, and the acquisition of functional impressions for denture fabrication. This study aimed to investigate the mechanical properties of the most prevalent tissue conditioner materials on the market, including Tissue Conditioners (TC), Visco Gel (VG), and FITT (F). Materials and Methods: The three tissue conditioners, TC, VG, and F, were assessed based on the parameters mentioned above. The following tests were performed based on the ISO 10139-1 and ISO 10139-2 requirements: Shore A hardness, denture plate adhesion, sorption, water solubility, and contraction after 1 and 3 days in water. Additional tests are described in the literature, such as ethanol content and gelling time. The tests were carried out by storing the materials in water at 37 °C for 7 days. Results: The gel times of all tested materials exceeded 5 min (TC = 300 [s], VG = 350 [s]). In vitro, phthalate-free materials exhibited higher dissolution in water after 14 days (VG = −260.78 ± 11.31 µg/mm²) compared to F (−76.12 ± 7.11 µg/mm²) and experienced faster hardening when stored in distilled water (F = 33.4 ± 0.30 Sh. A, VG = 59.2 ± 0.60 Sh. A). They also showed greater contractions. The connection of all materials to the prosthesis plate was consistent at 0.11 MPa. The highest counterbalance after 3 days was observed in TC = 3.53 ± 1.12%. Conclusions: Materials containing plasticizers that are not phthalates have worse mechanical properties than products containing these substances. Since phthalates are not allowed to be used indefinitely in medical devices, additional research is necessary, especially in vivo, to develop safe materials with superior functional properties to newer-generation alternatives. In vitro results often do not agree fully with those of in vivo outcomes. Full article

(This article belongs to the Special Issue Dentistry: A Multidisciplinary Approach)

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11 pages, 2429 KiB

Open AccessArticle

Evaluation of Clinical and Oral Findings in Patients with Epidermolysis bullosa

by Yasemin Yavuz, Isa An, Betul Yazmaci, Zeki Akkus and Hatice Ortac

Medicina 2023, 59(7), 1185; https://doi.org/10.3390/medicina59071185 - 21 Jun 2023

Cited by 2 | Viewed by 3645

Abstract

Introduction: Epidermolysis bullosa (EB) is a genetically inherited disease characterized by recurrent bullae and erosions on the skin with numerous signs of dental caries and poor oral hygiene. The aim of this study was to investigate the general clinical and oral findings of [...] Read more.

Introduction: Epidermolysis bullosa (EB) is a genetically inherited disease characterized by recurrent bullae and erosions on the skin with numerous signs of dental caries and poor oral hygiene. The aim of this study was to investigate the general clinical and oral findings of patients with EB. Materials and Methods: In this prospective study, the clinical and oral findings and family history of 26 cases with EB were evaluated. The type of EB, gender, age, parental consanguinity, dental caries, oral findings, distribution of lesions and presence of associated anomalies, clinical and oral findings correlated with gender were recorded. Results: All 26 patients with EB had a history of consanguinity and siblings with EB to varying degrees. In our study, malnutrition, anemia and growth retardation, gastrointestinal system complications, hair thinning, hand and nail deformity, ocular problems and renal disease (in one case) were observed with variable frequencies. When the intraoral findings of the patients were investigated, extensive dental caries in all EB types, enamel hypoplasia in junctional EB (JEB) and the presence of tooth-root to be extracted in dystrophic EB (DEB), intraoral bullae and lesions, ankyloglossia, vestibular sulcus insufficiency, microstomia and maxillary atrophy were observed. Three cases had restorative treatment and one case had prosthetic rehabilitation. Conclusions: Oral involvement can be seen with varying frequencies depending on the type of EB and the severity of the disease. It may result from delayed oral and dental rehabilitation due to physical disabilities, limitations and more pressing medical problems. Microstomy, pain from mucosal lesions, and restricted access to the mouth can be caused by poor oral hygiene. Oral complications and caloric needs of individuals with EB should be determined, and individual prophylaxis should be applied to prevent caries formation and protect teeth. Full article

(This article belongs to the Special Issue Dentistry: A Multidisciplinary Approach)

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11 pages, 942 KiB

Open AccessArticle

Assessment and Correlation of Salivary Ca, Mg, and pH in Smokers and Non-Smokers with Generalized Chronic Periodontitis

by Saad Mohammad Alqahtani, Shankar T. Gokhale, Mohamed Fadul A. Elagib, Deepti Shrivastava, Raghavendra Reddy Nagate, Badar Awadh Mohammad Alshmrani, Abduaziz Mohammed Abdullah Alburade, Fares Mufreh Abdullah Alqahtani, Anil Kumar Nagarajappa, Valentino Natoli and Kumar Chandan Srivastava

Medicina 2023, 59(4), 765; https://doi.org/10.3390/medicina59040765 - 14 Apr 2023

Cited by 4 | Viewed by 2670

Abstract

Background and Objectives: Diagnostic evaluation with the aid of biomarkers has reached newer heights to assess disease activity. Salivary calcium, magnesium, and pH are one of the biochemical parameters which can be helpful in assessing the progression of periodontal disease. Smokers are [...] Read more.

Background and Objectives: Diagnostic evaluation with the aid of biomarkers has reached newer heights to assess disease activity. Salivary calcium, magnesium, and pH are one of the biochemical parameters which can be helpful in assessing the progression of periodontal disease. Smokers are at topnotch threat for having oral diseases, predominantly periodontal diseases. The aim of this study was to assess the salivary calcium, magnesium, and pH levels in smokers compared with non-smokers with chronic periodontitis. Materials and Methods: The current study was conducted on 210 individuals affected with generalized chronic periodontitis, with the age group between 25 and 55 years. Based on their smoking habit, an equal number of patients were categorized into two groups; namely, group I consisted of non-smokers and group II consisted of smokers. The clinical parameters that were measured included Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth (PPD), and Clinical Attachment Loss (CAL). The biochemical variables that were evaluated in the current study included salivary calcium, magnesium, and pH using an AVL9180 electrolyte analyzer (Roche, Germany). The gathered data were analyzed with an unpaired t test was using SPSS 20.0. Results: A statistically significant higher PPD (p < 0.01), CAL (p < 0.05), and salivary calcium levels (p < 0.001) were observed in the smokers’ compared with their non-smoking counterparts. Among the biochemical parameters, calcium showed a significantly (p < 0.001) higher level in smokers (5.79 ± 1.76) in contrast to non-smokers (3.87 ± 1.03). Additionally, a significant negative correlation (p < 0.05) between calcium and PPD was observed in non-smokers, whereas a non-significant inverse relation (p > 0.05) was seen in smokers. Conclusions: The present study indicates that the salivary calcium level can be a potential biochemical parameter to assess the progression of periodontal disease in smokers and non-smokers. Within the limitations of the current study, the salivary biomarkers appear to have an essential role in the identification and indication of the status of periodontal diseases. Full article

(This article belongs to the Special Issue Dentistry: A Multidisciplinary Approach)

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11 pages, 1617 KiB

Open AccessArticle

Different Designs of Deep Marginal Elevation and Its Influence on Fracture Resistance of Teeth with Monolith Zirconia Full-Contour Crowns

by Ali Robaian, Abdullah Alqahtani, Khalid Alanazi, Abdulrhman Alanazi, Meshal Almalki, Anas Aljarad, Refal Albaijan, Ahmed Maawadh, Aref Sufyan and Mubashir Baig Mirza

Medicina 2023, 59(4), 661; https://doi.org/10.3390/medicina59040661 - 27 Mar 2023

Cited by 5 | Viewed by 4306

Abstract

Background and objectives: Even with the demand for high esthetics, the strength of the material for esthetic applications continues to be important. In this study, monolith zirconia (MZi) crowns fabricated using CAD/CAM were tested for fracture resistance (FR) in teeth with class II [...] Read more.

Background and objectives: Even with the demand for high esthetics, the strength of the material for esthetic applications continues to be important. In this study, monolith zirconia (MZi) crowns fabricated using CAD/CAM were tested for fracture resistance (FR) in teeth with class II cavity designs with varying proximal depths, restored through a deep marginal elevation technique (DME). Materials and Methods: Forty premolars were randomly divided into four groups of ten teeth. In Group A, tooth preparation was conducted and MZi crowns were fabricated. In Group B, mesio-occluso-distal (MOD) cavities were prepared and restored with microhybrid composites before tooth preparation and the fabrication of MZi crowns. In Groups C and D, MOD cavities were prepared, differentiated by the depth of the gingival seat, 2 mm and 4 mm below the cemento-enamel junction (CEJ). Microhybrid composite resin was used for DME on the CEJ and for the restoration of the MOD cavities; beforehand, tooth preparations were conducted and MZi crowns were and cemented using resin cement. The maximum load to fracture (in newtons (N)) and FR (in megapascals (MPa)) were measured using the universal testing machine. Results: The average scores indicate a gradual decrease in the load required to fracture the samples from Groups A to D, with mean values of 3415.61 N, 2494.11 N, 2108.25 N and 1891.95 N, respectively. ANOVA revealed highly significant differences between the groups. Multiple group comparisons using the Tukey HSD post hoc test revealed that Group D had greater DME depths and showed significant differences compared with Group B. Conclusions: FR in teeth decreased when more tooth structure was involved, even with MZi crowns. However, DME up to 2 mm below the CEJ did not negatively influence the FR. Strengthening the DME-treated teeth with MZi crowns could be a reasonable clinical option, as the force required to fracture the samples far exceeded the maximum recorded biting force for posterior teeth. Full article

(This article belongs to the Special Issue Dentistry: A Multidisciplinary Approach)

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17 pages, 333 KiB

Open AccessArticle

The Impact of Anemia-Related Early Childhood Caries on Parents’ and Children’s Quality of Life

by Dila Özyılkan, Özgür Tosun and Aylin İslam

Medicina 2023, 59(3), 521; https://doi.org/10.3390/medicina59030521 - 7 Mar 2023

Cited by 3 | Viewed by 2197

Abstract

Background and Objectives: Today, oral diseases are well-known for their effects, not only on daily life but also on quality of life (QoL). Dental caries, especially early childhood caries (ECC), are considered a public health concern as regards their impact on the [...] Read more.

Background and Objectives: Today, oral diseases are well-known for their effects, not only on daily life but also on quality of life (QoL). Dental caries, especially early childhood caries (ECC), are considered a public health concern as regards their impact on the life quality of children and parents from multiple aspects. The present research was conducted to assess the effect of anemia on oral-health-related quality of life (OHRQoL) in terms of children and parents. Materials and Methods: The current study was performed in two independent stages. In the first stage, the Turkish version of the Early Childhood Oral Health Impact Scale (ECOHIS), and in the second stage, the Turkish version of the Parental-Caregivers Perceptions Questionnaire (P-CPQ) were used to measure the effect of anemia-related dental caries among children and parents. SPSS and Jamovi software were used for all calculations, graphs and comparisons. Results: A total of 204 participants (child–parent pairs) were incorporated in the present study. A considerable number of children (81.5%) reported occasional or more frequent oral/dental pain. Secondly, the subscale scores were determined for child symptoms (2.25 ± 0.067), child function (6.8 ± 0.22), child psychology (3.87 ± 0.128), self-image and social interaction (1.74 ± 0.063), parental distress (3.82 ± 0.143), and family function (3.5 ± 0.121). Additionally, more than half of the parents (56.3%) responded “fair” for the health of their children’s teeth, lips, jaws and mouth. Similarly, the child’s overall well-being was stated as being affected “a lot” by the condition of their child’s teeth, lips, jaws or mouth by half of the parents (49.5%). Conclusions: Anemia-related dental caries has a highly negative impact on the quality of life of children and parents according to both of the questionnaires. Therefore, children with high scores should be prioritized for preventive procedures and timely dental treatments. Full article

(This article belongs to the Special Issue Dentistry: A Multidisciplinary Approach)

15 pages, 1846 KiB

Open AccessArticle

The Impact of Simulated Bruxism Forces and Surface Aging Treatments on Two Dental Nano-Biocomposites—A Radiographic and Tomographic Analysis

by Amelia Anita Boitor, Elena Bianca Varvară, Corina Mirela Prodan, Sorina Sava, Diana Dudea and Adriana Objelean

Medicina 2023, 59(2), 360; https://doi.org/10.3390/medicina59020360 - 14 Feb 2023

Cited by 2 | Viewed by 2075

Abstract

Background and Objectives: Nowadays, indication of composite materials for various clinical situations has increased significantly. However, in the oral environment, these biomaterials are subjected (abnormal occlusal forces, external bleaching, consumption of carbonated beverages, etc.) to changes in their functional and mechanical behavior [...] Read more.

Background and Objectives: Nowadays, indication of composite materials for various clinical situations has increased significantly. However, in the oral environment, these biomaterials are subjected (abnormal occlusal forces, external bleaching, consumption of carbonated beverages, etc.) to changes in their functional and mechanical behavior when indicated primarily for patients with masticatory habits. The study aimed to recreate in our lab one of the most common situations nowadays—in-office activity of a young patient suffering from specific parafunctional occlusal stress (bruxism) who consumes acidic beverages and is using at-home dental bleaching. Materials and Methods: Sixty standardized class II cavities were restored with two nanohybrid biocomposite materials (Filtek Z550, 3M ESPE, and Evetric, Ivoclar Vivadent); the restored teeth were immersed in sports drinks and carbonated beverages and exposed to an at-home teeth bleaching agent. The samples were subjected to parafunctional mechanical loads using a dual-axis chewing simulator. A grading evaluation system was conducted to assess the defects of the restorations using different examination devices: a CBCT, a high-resolution digital camera, and periapical X-rays. Results: Before mechanical loading, the CBCT analysis revealed substantially fewer interfacial defects between the two resin-based composites (p > 0.05), whereas, after bruxism forces simulation, significantly more defects were identified (p < 0.05). Qualitative examination of the restorations showed more occlusal defects for the Evetric than the other nanohybrid composite. Conclusions: There were different behaviors observed regarding the studied nanocomposites when simulation of parafunctional masticatory forces was associated with aging treatments. Full article

(This article belongs to the Special Issue Dentistry: A Multidisciplinary Approach)

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27 pages, 13822 KiB

Open AccessArticle

Modular Digital and 3D-Printed Dental Models with Applicability in Dental Education

by Alexandru Eugen Petre, Mihaela Pantea, Sergiu Drafta, Marina Imre, Ana Maria Cristina Țâncu, Eduard M. Liciu, Andreea Cristiana Didilescu and Silviu Mirel Pițuru

Medicina 2023, 59(1), 116; https://doi.org/10.3390/medicina59010116 - 6 Jan 2023

Cited by 9 | Viewed by 4471

Abstract

Background and Objectives: The ever more complex modern dental education requires permanent adaptation to expanding medical knowledge and new advancements in digital technologies as well as intensification of interdisciplinary collaboration. Our study presents a newly developed computerized method allowing virtual case simulation [...] Read more.

Background and Objectives: The ever more complex modern dental education requires permanent adaptation to expanding medical knowledge and new advancements in digital technologies as well as intensification of interdisciplinary collaboration. Our study presents a newly developed computerized method allowing virtual case simulation on modular digital dental models and 3D-printing of the obtained digital models; additionally, undergraduate dental students’ opinion on the advanced method is investigated in this paper. Materials and Methods: Based on the digitalization of didactic dental models, the proposed method generates modular digital dental models that can be easily converted into different types of partial edentulism scenarios, thus allowing the development of a digital library. Three-dimensionally printed simulated dental models can subsequently be manufactured based on the previously obtained digital models. The opinion of a group of undergraduate dental students (n = 205) on the proposed method was assessed via a questionnaire, administered as a Google form, sent via email. Results: The modular digital models allow students to perform repeated virtual simulations of any possible partial edentulism cases, to project 3D virtual treatment plans and to observe the subtle differences between diverse teeth preparations; the resulting 3D-printed models could be used in students’ practical training. The proposed method received positive feedback from the undergraduate students. Conclusions: The advanced method is adequate for dental students’ training, enabling the gradual design of modular digital dental models with partial edentulism, from simple to complex cases, and the hands-on training on corresponding 3D-printed dental models. Full article

(This article belongs to the Special Issue Dentistry: A Multidisciplinary Approach)

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10 pages, 4145 KiB

Open AccessArticle

Evaluation of the Sensitivity of Selected Candida Strains to Ozonated Water—An In Vitro Study

by Anna Kuśka-Kiełbratowska, Rafał Wiench, Anna Mertas, Elżbieta Bobela, Maksymilian Kiełbratowski, Monika Lukomska-Szymanska, Marta Tanasiewicz and Dariusz Skaba

Medicina 2022, 58(12), 1731; https://doi.org/10.3390/medicina58121731 - 26 Nov 2022

Cited by 3 | Viewed by 1951

Abstract

(1) Background and Objectives: Oral candidiasis has increased significantly in recent years. Increasingly, we encounter treatment difficulties related to drug resistance. Therefore, it is necessary to search for other therapies such as ozone therapy, which has antimicrobial activity. The aim of this study [...] Read more.

(1) Background and Objectives: Oral candidiasis has increased significantly in recent years. Increasingly, we encounter treatment difficulties related to drug resistance. Therefore, it is necessary to search for other therapies such as ozone therapy, which has antimicrobial activity. The aim of this study was to determine the sensitivity of selected Candida strains to ozonated water based on concentration and contact time (2) Methods: The sensitivity of Candida strains to ozonated water with a concentration of 5 µg/mL, 30 µg/mL, and 50 µg/mL was assessed using Mosmann’s Tetrazolium Toxicity (MTT) assay. Statistical differences were assessed by the analysis of variance (ANOVA) and the Newman-Keuls post-hoc test. A p-value of ≤0.05 was considered to indicate a statistically significant difference. (3) Results: In all the strains and research trials, the number of viable cells was reduced by ozonated water. The reduction depended on the exposure time and concentration of ozonated water. The highest percentage reduction (34.98%) for the tested samples was obtained for the C. albicans strain after 120 s of exposure at the highest concentration-50 µg/mL. (4) Conclusions: The selected strains of Candida spp. were sensitive to ozonated water at all tested concentrations (5 µg/mL, 30 µg/mL, and 50 µg/mL). The sensitivity of strains to ozonated water increased with concentration and application time. Moreover, the sensitivity of Candida strains to ozonated water is comparable to that of 0.2% chlorhexidine gluconate. Full article

(This article belongs to the Special Issue Dentistry: A Multidisciplinary Approach)

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14 pages, 2885 KiB

Open AccessArticle

A Comparative Analysis of Dental Measurements in Physical and Digital Orthodontic Case Study Models

by Elena-Raluca Baciu, Dana Gabriela Budală, Roxana-Ionela Vasluianu, Costin Iulian Lupu, Alice Murariu, Gabriela Luminița Gelețu, Irina Nicoleta Zetu, Diana Diaconu-Popa, Monica Tatarciuc, Giorgio Nichitean and Ionuț Luchian

Medicina 2022, 58(9), 1230; https://doi.org/10.3390/medicina58091230 - 6 Sep 2022

Cited by 6 | Viewed by 3021

Abstract

Background and Objectives: Study models are essential tools used in the dental teaching process. The aim of the present study was to compare the values obtained by manual and digital orthodontic measurements on physical and digital case study models. Materials and Methods: The [...] Read more.

Background and Objectives: Study models are essential tools used in the dental teaching process. The aim of the present study was to compare the values obtained by manual and digital orthodontic measurements on physical and digital case study models. Materials and Methods: The physical experimental models were obtained by traditional pouring (improved stone-type IV gypsum products) and by additive manufacturing (resins). The digital experimental models were created by scanning the physical ones, using a white light-emitting diode (LED) source and an L-shaped dental scanner—Swing DOF (DOF, Seoul, Korea). The physical study models were first measured using a digital caliper, and then, they were scanned and evaluated using the DentalCad 3.0 Galway software (exocad GmbH, Darmstadt, Germany). The Pont, Linder–Harth, and Bolton indices, which are used in orthodontics for training students, were derived using the available data. Results: When comparing the linear measurement mean ranks taken on physical study models to those of digital models, no statistically significant differences (p > 0.05) were found. A similar result was also shown when the dentoalveolar growth indicators were analyzed. Conclusions: It can be concluded that dental study models made by direct light processing (DLP) and pouring type IV class gypsum are both acceptable for orthodontic teaching purposes. Full article

(This article belongs to the Special Issue Dentistry: A Multidisciplinary Approach)

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Review

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43 pages, 24166 KiB

Open AccessReview

Neural Basis of Etiopathogenesis and Treatment of Cervicogenic Orofacial Pain

by Jiří Šedý, Mariano Rocabado, Leonardo Enrique Olate, Marek Vlna and Radovan Žižka

Medicina 2022, 58(10), 1324; https://doi.org/10.3390/medicina58101324 - 21 Sep 2022

Cited by 5 | Viewed by 9043

Abstract

(1) Background and Objectives: The aim of this narrative review was to analyze the neuroanatomical and neurophysiological basis of cervicogenic pain in cervico-cranial pain syndromes, focusing particularly on cervico-orofacial syndromes as a background for the proper diagnosis and non-surgical treatment. Relevant literature [...] Read more.

(1) Background and Objectives: The aim of this narrative review was to analyze the neuroanatomical and neurophysiological basis of cervicogenic pain in cervico-cranial pain syndromes, focusing particularly on cervico-orofacial syndromes as a background for the proper diagnosis and non-surgical treatment. Relevant literature on the topic from past 120 years has been surveyed. (2) Material and Methods: We surveyed all original papers, reviews, or short communications published in the English, Spanish, Czech or Slovak languages from 1900 to 2020 in major journals. (3) Results: The cervicogenic headache originates from the spinal trigeminal nucleus where axons from the C₁–C₃ cervical spinal nerves and three branches of the trigeminal nerve converge (trigeminocervical convergence) at the interneurons that mediate cranio-cervical nociceptive interactions. The role of the temporomandibular joint in the broad clinical picture is also important. Despite abundant available experimental and clinical data, cervicogenic orofacial pain may be challenging to diagnose and treat. Crucial non-surgical therapeutic approach is the orthopedic manual therapy focused on correction of body posture, proper alignment of cervical vertebra and restoration of normal function of temporomandibular joint and occlusion. In addition, two novel concepts for the functional synthesis of cervico-cranial interactions are the tricentric concept of mouth sensorimotor control and the concept of a cervicogenic origin of bruxism. (4) Conclusions: Understanding the basis of neuroanatomical and neurophysiological neuromuscular relations enables an effective therapeutic approach based principally on orthopedic manual and dental occlusal treatment. Full article

(This article belongs to the Special Issue Dentistry: A Multidisciplinary Approach)

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28 pages, 1514 KiB

Open AccessReview

Cranial and Odontological Methods for Sex Estimation—A Scoping Review

by Laura Maria Beschiu, Lavinia Cosmina Ardelean, Codruta Victoria Tigmeanu and Laura-Cristina Rusu

Medicina 2022, 58(9), 1273; https://doi.org/10.3390/medicina58091273 - 14 Sep 2022

Cited by 9 | Viewed by 3078

Abstract

The estimation of sex from osteological and dental records has long been an interdisciplinary field of dentistry, forensic medicine and anthropology alike, as it concerns all the above mentioned specialties. The aim of this article is to review the current literature regarding methods [...] Read more.

The estimation of sex from osteological and dental records has long been an interdisciplinary field of dentistry, forensic medicine and anthropology alike, as it concerns all the above mentioned specialties. The aim of this article is to review the current literature regarding methods used for sex estimation based on the skull and the teeth, covering articles published between January 2015 and July 2022. New methods and new approaches to old methods are constantly emerging in this field, therefore resulting in the need to summarize the large amount of data available. Morphometric, morphologic and biochemical analysis were reviewed in living populations, autopsy cases and archaeological records. The cranial and odontological sex estimation methods are highly population-specific and there is a great need for these methods to be applied to and verified on more populations. Except for DNA analysis, which has a prediction accuracy of 100%, there is no other single method that can achieve such accuracy in predicting sex from cranial or odontological records. Full article

(This article belongs to the Special Issue Dentistry: A Multidisciplinary Approach)

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Other

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7 pages, 643 KiB

Open AccessCase Report

Identification of the Remains of an Adult Using DNA from Their Deciduous Teeth as a Reference Sample

by María-de-Lourdes Chávez-Briones, Gilberto Jaramillo-Rangel, Adriana Ancer-Arellano, Jesús Ancer-Rodríguez and Marta Ortega-Martínez

Medicina 2023, 59(10), 1702; https://doi.org/10.3390/medicina59101702 - 23 Sep 2023

Cited by 1 | Viewed by 1387

Abstract

In many forensic cases, the identification of human remains is performed by comparing their genetic profile with profiles from reference samples of relatives, usually the parents. Here, we report, for the first time, the identification of the remains of an adult using DNA [...] Read more.

In many forensic cases, the identification of human remains is performed by comparing their genetic profile with profiles from reference samples of relatives, usually the parents. Here, we report, for the first time, the identification of the remains of an adult using DNA from the person’s deciduous teeth as a reference sample. Fragments of a skeletonized and burned body were found, and a short tandem repeat (STR) profile was obtained. A woman looking for her missing son went to the authorities. When the DNA profile of the woman was compared to a database, a positive match suggested a first-degree kinship with the person to whom the remains belonged. The woman had kept three deciduous molars from her son for more than thirty years. DNA typing of dental pulp was performed. The genetic profiles obtained from the molars and those from the remains coincided in all alleles. The random match probability was 1 in 2.70 × 10²¹. Thus, the remains were fully identified. In the routine identification of human remains, ambiguous STR results may occur due to the presence of null alleles or other mutational events. In addition, erroneous results can be produced by false matches with close family members or even with people who are completely unrelated to the victim, such that, in some cases, a probability of paternity greater than 99.99% does not necessarily indicate biological paternity. Whenever possible, it is preferable to use reference samples from the putative victim as a source of DNA for identification. Full article

(This article belongs to the Special Issue Dentistry: A Multidisciplinary Approach)

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10 pages, 3354 KiB

Open AccessCase Report

Injectable Resin Technique as a Restorative Alternative in a Cleft Lip and Palate Patient: A Case Report

by Kelly R. V. Villafuerte, Alyssa Teixeira Obeid and Naiara Araújo de Oliveira

Medicina 2023, 59(5), 849; https://doi.org/10.3390/medicina59050849 - 28 Apr 2023

Cited by 4 | Viewed by 3787

Abstract

Objective: The objective of this study is to present a case report in which the injectable composite resin technique was used as a restorative alternative for dental re-anatomization in a patient with cleft lip and palate and aesthetic complaints. Materials and Methods [...] Read more.

Objective: The objective of this study is to present a case report in which the injectable composite resin technique was used as a restorative alternative for dental re-anatomization in a patient with cleft lip and palate and aesthetic complaints. Materials and Methods: The treatment plan included the re-anatomization of the maxillary premolars and canines using a flowable composite resin. This resin was injected and cured through a transparent matrix, which was a copy of the diagnostic wax-up model. Some parameters such as application time and marginal adaptation were also observed when performing the restorations. Additionally, old composite resin restorations on the upper lateral incisors were replaced using the incremental technique with conventional resins, which helped to assess color stability and fracture/wear deterioration for both restorative techniques. Results: The clinical case report shows that the injectable technique was a simple and quick method for restoring the anatomy of teeth (shape and contour) in one session, since the injectable resin can be easily applied in interproximal areas without the need to manually sculpt the resin. In this case, no clinical, visual, or photographic differences were found in marginal discoloration, color stability, and fracture/wear deterioration for the two restorative techniques after one year of follow-up. Conclusions: The professional may have another clinical option for restorative treatment in the case of small re-anatomizations. In addition, the injectable technique seems to require less operator skill and chair time and better marginal adaptation in cases of small anatomical changes. Full article

(This article belongs to the Special Issue Dentistry: A Multidisciplinary Approach)

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11 pages, 5106 KiB

Open AccessCase Report

Soft Tissue Grafting Procedures before Restorations in the Esthetic Zone: A Minimally Invasive Interdisciplinary Case Report

by Gerardo Guzman-Perez, Carlos Alberto Jurado, Francisco X. Azpiazu-Flores, Humberto Munoz-Luna, Kelvin I. Afrashtehfar and Hamid Nurrohman

Medicina 2023, 59(5), 822; https://doi.org/10.3390/medicina59050822 - 23 Apr 2023

Cited by 2 | Viewed by 3107

Abstract

An esthetically pleasing smile is a valuable aspect of physical appearance and plays a significant role in social interaction. Achieving the perfect balance between extraoral and intraoral tissues is essential for a harmonious and attractive smile. However, certain intraoral deficiencies, such as non-carious [...] Read more.

An esthetically pleasing smile is a valuable aspect of physical appearance and plays a significant role in social interaction. Achieving the perfect balance between extraoral and intraoral tissues is essential for a harmonious and attractive smile. However, certain intraoral deficiencies, such as non-carious cervical lesions and gingival recession, can severely compromise the overall aesthetics, particularly in the anterior zone. Addressing such conditions requires careful planning and meticulous execution of both surgical and restorative procedures. This interdisciplinary clinical report presents a complex case of a patient with esthetic complaints related to asymmetric anterior gingival architecture and severely discolored and eroded maxillary anterior teeth. The patient was treated using a combination of minimally invasive ceramic veneers and plastic mucogingival surgery, resulting in a successful outcome. The report emphasizes the potential of this approach in achieving optimal esthetic results in challenging cases, highlighting the importance of an interdisciplinary team approach in achieving a harmonious balance between dental and soft tissue aesthetics. Full article

(This article belongs to the Special Issue Dentistry: A Multidisciplinary Approach)

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12 pages, 716 KiB

Open AccessSystematic Review

Gaucher: A Systematic Review on Oral and Radiological Aspects

by Giuseppe Minervini, Rocco Franco, Maria Maddalena Marrapodi, Vini Mehta, Luca Fiorillo, Almir Badnjević, Gabriele Cervino and Marco Cicciù

Medicina 2023, 59(4), 670; https://doi.org/10.3390/medicina59040670 - 28 Mar 2023

Cited by 6 | Viewed by 2852

Abstract

Background and Objectives: Gaucher disease (GD) is a lysosomal storage disorder with the genetic autosomal recessive transmission. Bone involvement is a prevalent finding in Gaucher disease. It causes deformity and limits daily activities and the quality of life. In 75% of patients, [...] Read more.

Background and Objectives: Gaucher disease (GD) is a lysosomal storage disorder with the genetic autosomal recessive transmission. Bone involvement is a prevalent finding in Gaucher disease. It causes deformity and limits daily activities and the quality of life. In 75% of patients, there is bone involvement. This review aims to evaluate the principal findings in the jaw by a Cone-beam computed tomography (CBTC) and X-ray orthopantomography; Materials and Methods: PubMed, Web of Science, Lilacs and Scopus were systematically searched until 31 December 2022. In addition, a manual search was performed using the bibliography of selected articles and a Google Scholar search. Clinical studies were selected that considered principal radiographic findings in radiography in a group of patients affected by GD. Results: Out of 5079 papers, four studies were included. The main findings are generalized rarefaction and enlarged narrow space, anodontia. Conclusions: The exact mechanism of bone manifestation is probably due to the infiltration of Gaucher cells in the bone marrow and, consequently, the destruction of bone architecture. All long bones are a potential means of skeletal manifestation. The jaw is more affected than the maxilla, and the principal features are cortical thinning, osteosclerosis, pseudocystic lesions, mental demineralization, flattening in the head of the condyle, effacement of anatomical structures, thickening of maxillary sinus mucosa. The dentist plays a crucial role in diagnosing and treating these patients. Sometimes the diagnosis can be made by a simple panoramic radiograph. All long bones are affected, and the mandible is particularly involved. Full article

(This article belongs to the Special Issue Dentistry: A Multidisciplinary Approach)

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18 pages, 624 KiB

Open AccessSystematic Review

The Effect of Dentine Desensitizing Agents on the Retention of Cemented Fixed Dental Prostheses: A Systematic Review

by Mohammed E. Sayed

Medicina 2023, 59(3), 515; https://doi.org/10.3390/medicina59030515 - 6 Mar 2023

Cited by 2 | Viewed by 2656

Abstract

Background and Objectives: The use of desensitizing agents (DA) after tooth preparation to prevent hypersensitivity is well documented in the literature. A fixed dental prosthesis (FDP) should have good retention to be successful. Inadequate retention may result in microleakage, secondary caries, and, eventually, [...] Read more.

Background and Objectives: The use of desensitizing agents (DA) after tooth preparation to prevent hypersensitivity is well documented in the literature. A fixed dental prosthesis (FDP) should have good retention to be successful. Inadequate retention may result in microleakage, secondary caries, and, eventually, dislodgement of the FDP. The effect of DAs on the retention of FDPs has been widely studied in the literature, but the results are conflicting. Thus, this study aimed to conduct a systematic review to assess the effect of dentine desensitizing agents, used to prevent post-cementation hypersensitivity, on the retention of cemented FDPs. The null hypothesis framed was that there is no effect of dentine desensitizing agents on the retention of cemented FDPs. The focused PICO question was as follows: “Does the application of dentine desensitizing agents (I) affect the retention (O) of cemented fixed dental prosthesis (P) when compared to non-dentine desensitizing groups (C)”? Materials and Methods: Four electronic databases were systematically searched and, on the basis of the predefined inclusion and exclusion criteria, 23 articles were included in this systematic review. A modified CONSORT scale for in vitro studies was used to assess the quality of the selected studies, as all included studies were in vitro studies. Results: Most of the studies compared the effect of more than one type of DA on retention. The results of the selected studies varied due to differences in the composition of tested dentine DAs and types of luting cements. Conclusions: Within the limitations of this study, it can be concluded that the retention values of FDPs cemented using zinc phosphate cement were reduced with most of the DAs, whereas retention values increased when GIC, resin-modified GIC, and resin cements were used with the majority of DAs. These findings are important, as they can guide dentists in selecting the DA before cementing the crowns with the luting agent of their choice, without compromising the retention of the crowns. Full article

(This article belongs to the Special Issue Dentistry: A Multidisciplinary Approach)

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11 pages, 7402 KiB

Open AccessCase Report

Full-Mouth Rehabilitation of a Patient with Gummy Smile—Multidisciplinary Approach: Case Report

by Kinga Mária Jánosi, Diana Cerghizan, Florentin Daniel Berneanu, Alpár Kovács, Andrea Szász, Izabella Mureșan, Liana Georgiana Hănțoiu and Aurița Ioana Albu

Medicina 2023, 59(2), 197; https://doi.org/10.3390/medicina59020197 - 19 Jan 2023

Cited by 3 | Viewed by 3607

Abstract

The impairment of aesthetic function leads to a decreased quality of life. An unaesthetic smile due to excessive gingival exposure demands, most of the time, a complex treatment in which the objective is the vertical reduction of the amount of exposed fixed gingiva [...] Read more.

The impairment of aesthetic function leads to a decreased quality of life. An unaesthetic smile due to excessive gingival exposure demands, most of the time, a complex treatment in which the objective is the vertical reduction of the amount of exposed fixed gingiva by obtaining a complete exposure of the anatomical crown of the teeth and restoring the ideal dimensions of the biological width. This paper presents a case of a 48-year-old female patient who was unsatisfied with her aesthetics and had disturbed masticatory function due to the absence of some posterior teeth. The cone beam computed tomography was performed to evaluate the facial and dental morphology. The treatment plan included diode laser and piezo-surgery utilization for the frontal area of the upper arch and implants to restore the distal area of the lower and upper arch. Zirconia ceramic was used for the final restorations. This complex and multidisciplinary full-mouth rehabilitation lasted for two years, and the patient was pleased with the result. This case showed that a well-established treatment plan is necessary to obtain long-lasting results. The use of adequate procedures and equipment ensures a predictable result. Full article

(This article belongs to the Special Issue Dentistry: A Multidisciplinary Approach)

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12 pages, 5068 KiB

Open AccessCase Report

The Stability Guided Multidisciplinary Treatment of Skeletal Class III Malocclusion Involving Impacted Canines and Thin Periodontal Biotype: A Case Report with Eight-Year Follow-Up

by Juan Li, Xiaoyan Feng, Yi Lin and Jun Lin

Medicina 2022, 58(11), 1588; https://doi.org/10.3390/medicina58111588 - 3 Nov 2022

Cited by 1 | Viewed by 2256

Abstract

Skeletal class III malocclusion with severe skeletal disharmonies and arch discrepancies is usually treated via the conventional orthodontic-surgical approach. However, when associated with tooth impaction and periodontal risks, the treatment is more challenging and complex. The esthetic, occlusal, and periodontal stability of the [...] Read more.

Skeletal class III malocclusion with severe skeletal disharmonies and arch discrepancies is usually treated via the conventional orthodontic-surgical approach. However, when associated with tooth impaction and periodontal risks, the treatment is more challenging and complex. The esthetic, occlusal, and periodontal stability of the treatment outcome is more difficult to obtain. The 16-year-old female patient in this case was diagnosed with dental and skeletal Class III malocclusion, bilateral impacted maxillary canines, and scalloped thin gingiva. The multidisciplinary management included a segmental arch technique, extracting two premolars, a subepithelial connective tissue graft surgery, and orthognathic surgery. The esthetic facial profile, pleasant smile, appropriate occlusion, and functional treatment results were obtained and maintained in 8-year follow-up. Full article

(This article belongs to the Special Issue Dentistry: A Multidisciplinary Approach)

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10 pages, 3432 KiB

Open AccessCase Report

Diagnostic Mock-Up as a Surgical Reduction Guide for Crown Lengthening: Technique Description and Case Report

by Carlos A. Jurado, Venkata Parachuru, Jose Villalobos Tinoco, Gerardo Guzman-Perez, Akimasa Tsujimoto, Ramya Javvadi and Kelvin I. Afrashtehfar

Medicina 2022, 58(10), 1360; https://doi.org/10.3390/medicina58101360 - 28 Sep 2022

Cited by 19 | Viewed by 6332

Abstract

Background and Objectives: The report describes a technique using a diagnostic mock-up as a crown-lengthening surgical guide to improve the gingival architecture. Materials and Methods: The patient’s primary concern was improving her smile due to her “gummy smile” and short clinical crowns. After [...] Read more.

Background and Objectives: The report describes a technique using a diagnostic mock-up as a crown-lengthening surgical guide to improve the gingival architecture. Materials and Methods: The patient’s primary concern was improving her smile due to her “gummy smile” and short clinical crowns. After clinical evaluation, surgical crown lengthening accompanied by maxillary central full-coverage single-unit prostheses and lateral incisor veneers was recommended. The diagnostic mock-up was placed in the patient’s maxillary anterior region and used as a soft tissue reduction guide for the gingivectomy. Once the planned gingival architecture was achieved, a flap was reflected to proceed with ostectomy in order to obtain an appropriate alveolar bone crest level using the overlay. After six months, all-ceramic crowns and porcelain veneers were provided as permanent restorations. Results: A diagnostic mock-up fabricated with a putty guide directly from the diagnostic wax-up can be an adequate surgical guide for crown-lengthening procedures. The diagnostic wax-up was used to fabricate the diagnostic mock-up. These results suggested that it can be used as a crown-lengthening surgical guide to modify the gingival architecture. Several advantages of the overlay used in the aesthetic complex case include: (1) providing a preview of potential restorative outcomes, (2) allowing for the appropriate positioning of gingival margins and the desired alveolar bone crest level for the crown-lengthening procedure, and (3) serving as a provisional restoration after surgery. Conclusions: The use of a diagnostic mock-up, which was based on a diagnostic wax-up, as the surgical guide resulted in successful crown lengthening and provisional restorations. Thus, a diagnostic overlay can be a viable option as a surgical guide for crown lengthening. Full article

(This article belongs to the Special Issue Dentistry: A Multidisciplinary Approach)

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11 pages, 768 KiB

Open AccessSystematic Review

Misfit of Implant-Supported Zirconia (Y-TZP) CAD-CAM Framework Compared to Non-Zirconia Frameworks: A Systematic Review

by Hussain D. Alsayed

Medicina 2022, 58(10), 1347; https://doi.org/10.3390/medicina58101347 - 25 Sep 2022

Cited by 2 | Viewed by 2369

Abstract

Objective: The aim of the study was to systematically review the overall outcomes of studies comparing the misfit of yttria-stabilized zirconia (Y-TZP) CAD-CAM implant-supported frameworks with frameworks fabricated with other materials and techniques. Methods: An electronic literature search of English literature was performed [...] Read more.

Objective: The aim of the study was to systematically review the overall outcomes of studies comparing the misfit of yttria-stabilized zirconia (Y-TZP) CAD-CAM implant-supported frameworks with frameworks fabricated with other materials and techniques. Methods: An electronic literature search of English literature was performed using Google Scholar, Scopus, Web of Science, MEDLINE (OVID), EMBASE, and PubMed, using predetermined inclusion criteria. Specific terms were utilized in conducting a search from the inception of the respective database up to May 2022. After the search strategy was applied, the data were extracted and the results were analyzed. The focused question was: Is the misfit of the implant-supported zirconia CAD-CAM framework lower than that of non-Y-TZP implant-supported fixed restorations? Results: Eleven articles were included for qualitative assessment and critical appraisal in this review. In the included studies, Y-TZP CAD-CAM implant-supported frameworks were compared to Titanium (Ti), Ni-Cr, Co-Cr, PEEK and high-density polymer, and cast and CAD-CAM frameworks. The studies used scanning electron microscopy, one-screw tests, digital or optical microscopy, 3D virtual assessment, and replica techniques for analyzing the misfit of frameworks. Six studies showed comparable misfits among the Y-TZP CAD-CAM frameworks and the controls. Three studies showed higher misfits for the Y-TZP CAD-CAM frameworks, whereas two studies reported lower misfits for Y-TZP CAD-CAM implant frameworks compared to controls. Conclusion: Y-TZP CAD-CAM implant-supported frameworks have comparable misfits to other implant-supported frameworks. However, due to heterogeneity in the methodologies of the included studies, the overall numerical misfit of the frameworks assessed in the reviewed studies is debatable Full article

(This article belongs to the Special Issue Dentistry: A Multidisciplinary Approach)

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