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Em Pauta : Teoria Social e Realidade Contemporânea
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  This is an Open Access Journal Open Access journal
ISSN (Print) 1414-8609 - ISSN (Online) 2238-3786
Published by Universidade do Estado do Rio de Janeiro Homepage  [43 journals]
  • Dentistry Journal, Vol. 9, Pages 98: Assessment of Oxygen Expansion during
           Internal Bleaching with Enamel and Dentin: A Comparative In Vitro Study

    • Authors: Alba Pallarés-Serrano, Sandra Pallarés-Serrano, Antonio Pallarés-Serrano, Antonio Pallarés-Sabater
      First page: 98
      Abstract: Internal bleaching is a conservative, non-invasive, and simple treatment that is frequently performed in daily clinical practice. The present in vitro study analyzes the oxygen expansion of different bleaching agents resulting from the oxidation reaction when interacting with enamel and dentin. Enamel and dentin were crushed separately until obtaining a fine powder with particles of an approximate size between 0.06 and 0.2 mm. Each enamel and dentin sample were mixed with 37% carbamide peroxide (CP 37%), 30% hydrogen peroxide (HP 30%), sodium perborate (SP) combined with HP 30% (HP 30% + SP) and SP with distilled water (SP). A total of 280 1 mm diameter glass tubes were used with 70 for each bleaching agent (30 for powdered enamel evaluation, 30 for powdered dentin evaluation, and 10 controls). The bleaching agents were placed in the prepared tubes immediately after mixing the components. As expansion occurred, the oil inside the tube was displaced, through which the resulting expansion was evaluated and measured for 10 days. A significant expansion was observed that varied in magnitude according to the bleaching agent and the tooth structure used. Student’s t test and Welch’s ANOVA were used to analyze the data obtained. The highest mean expansion of both enamel and dentin was observed with 30% HP (66.6 mm for enamel, 94.5 mm for dentin) followed by HP 30% + SP (48.6 mm for enamel, 52.7 mm for dentin), CP 37% (38.4 mm for enamel, 52.6 mm for dentin) and finally SP with water (12.7 mm for enamel, 4.4 mm for dentin). It was observed that the expansion in the SP group with enamel was significantly lower than in the rest of the groups, while that registered for HP 30% was significantly higher. (p < 0.001). The results with dentin were similar, with a significantly lower expansion for SP and higher for HP 30% (p < 0.001). The oxygen expansion observed as a result of the interaction between bleaching agents and dental tissues could contribute to improving our understanding of bleaching and its results. These results suggest that bleaching agents react with the organic component of the tooth structure.
      Citation: Dentistry Journal
      PubDate: 2021-08-24
      DOI: 10.3390/dj9090098
      Issue No: Vol. 9, No. 9 (2021)
  • Dentistry Journal, Vol. 9, Pages 99: 3D Guided Dental Implant Placement:
           Impact on Surgical Accuracy and Collateral Damage to the Inferior Alveolar

    • Authors: Amit Mistry, Cemal Ucer, John D. Thompson, Rabia Sannam Khan, Emina Karahmet, Farooq Sher
      First page: 99
      Abstract: An increase in the number of implants placed has led to a corresponding increase in the number of complications reported. The complications can vary from restorative complications due to poor placement to damage to collateral structures such as nerves and adjacent teeth. A large majority of these complications can be avoided if the implant has been placed accurately in the optimal position. Therefore, the aim of this in vitro pilot study was to investigate the effect of freehand (FH) and fully guided (FG) surgery on the accuracy of implants placed in close proximity to vital structures such as the inferior alveolar nerve (IAN). Cone-beam computed tomography (CBCT) and intraoral scans of six patients who have had previous dental implants in the posterior mandible were used in this study. The ideal implant position was planned. FG surgical guides were manufactured for each case. In this study, the three-dimensional 3D printed resin models of each of the cases were produced and the implants placed using FG and FH methods on the respective models. The outcome variables of the study, angular deviations were calculated and the distance to the IAN was measured. The mean deviations for the planned position observed were 1.10 mm coronally, 1.88 mm apically with up to 6.3 degrees’ angular deviation for FH surgery. For FG surgical technique the mean deviation was found to be at 0.35 mm coronally, 0.43 mm apically with 0.78 degrees angularly respectively. The maximum deviation from the planned position for the apex of the implant to the IAN was 2.55 mm using FH and 0.63 mm FG. This bench study, within its limitations, demonstrated surgically acceptable accuracy for both FH and FG techniques that would allow safe placement of implants to vital structures such as the IAN when a safety zone of 3 mm is allowed. Nevertheless, a better margin of error was observed for FG surgery with respect to the angular deviation and controlling the distance of the implant to the IAN using R2 Gate® system.
      Citation: Dentistry Journal
      PubDate: 2021-09-02
      DOI: 10.3390/dj9090099
      Issue No: Vol. 9, No. 9 (2021)
  • Dentistry Journal, Vol. 9, Pages 100: Periodontal and Peri-Implant
           Diseases and Systemically Administered Statins: A Systematic Review

    • Authors: Federica Di Spirito, Luigi Schiavo, Vincenzo Pilone, Antonio Lanza, Ludovico Sbordone, Francesco D’Ambrosio
      First page: 100
      Abstract: Hyperlipidemia is a well-recognized risk factor for cardiovascular disease, which, in turn, acts as a contributory factor in periodontitis development. Periodontitis has been associated with benign tumors and cancers and withseveral disorders, including hyperlipidemia. Correspondingly, periodontal treatment may exert a positive effect on lipid metabolism, although opposite evidence has also been reported. As a counterpart, the therapy for hyperlipidemia, conventionally based on statins, has been proposed to positively affect periodontal conditions, mainly due to statin pleiotropic effects, reducing periodontal inflammation and promoting osseointegration. Therefore, the present systematic review aimed to evaluate, in subjects with untreated periodontitis and peri-implant disease (Population), the effect of routine systemically administered statins (Intervention), compared to non-statin use (Comparison), on periodontal parameters around natural teeth and implants (Outcome). Discordant results were found in periodontal parameters, and the current lack of such data related to peri-implant tissues and to alveolar bone loss highlights the need for further studies on the topic, potentially paving the way for a more comprehensive approach to periodontitis and peri-implantitis management. Indeed, the validation of the beneficial effect provided by systemically delivered statins on periodontal and peri-implant tissues may direct recall scheduling, predict response to therapy and, therefore, guide treatment strategies of periodontal and peri-implant treatments in statin users.
      Citation: Dentistry Journal
      PubDate: 2021-09-04
      DOI: 10.3390/dj9090100
      Issue No: Vol. 9, No. 9 (2021)
  • Dentistry Journal, Vol. 9, Pages 101: Mesenchymal Stromal Cells Enhance
           Vascularization and Epithelialization within 7 Days after Gingival
           Augmentation with Collagen Matrices in Rabbits

    • Authors: Anatoliy Kulakov, Evgenia Kogan, Tatiana Brailovskaya, Anna Vedyaeva, Nickolay Zharkov, Olga Krasilnikova, Mikhail Krasheninnikov, Denis Baranovskii, Timur Rasulov, Ilya Klabukov
      First page: 101
      Abstract: Soft gingival tissue deficiency remains a severe problem leading to postoperative recession, peri-implantitis, and bone resorption. The use of collagen matrices does not always lead to complete rebuilding of the gingiva volume. The application of mesenchymal stromal cells (MSCs) simultaneously with collagen materials represents a promising approach for the restoration of soft gingival tissues. However, short-term effects of MSCs-enriched collagen grafts after gingival augmentation have not yet been studied properly. Mucograft and Mucoderm matrices were implanted in rabbits (n = 12) simultaneously with the intraoperative injection of rabbit bone marrow-derived mesenchymal stromal cells (BM-MSCs) or without cells. Collagen matrices were implanted under the flap or by the surface technique without intentional primary closure. The samples were harvested seven days after implantation, histological staining with hematoxylin and eosin, and immunohistochemical staining for VEGF, IGF1, and TGF were performed. The use of Mucoderm led to better augmentation outcomes on day 7 compared with Mucograft (p < 0.0001). Gingival augmentation in combination with the local administration of BM-MSCs led to better regeneration of the soft gingival tissues independently of the type of implanted collagen matrices (p < 0.0001). Furthermore, injection of BM-MSCs significantly enhanced gingival vascularization and epithelization with a clear positive correlation between vascular growth and epithelial response. Administration of BM-MSCs in combination with various collagen materials may potentially improve gingiva regeneration.
      Citation: Dentistry Journal
      PubDate: 2021-09-04
      DOI: 10.3390/dj9090101
      Issue No: Vol. 9, No. 9 (2021)
  • Dentistry Journal, Vol. 9, Pages 102: VIRDENTOPSY: Virtual Dental Autopsy
           and Remote Forensic Odontology Evaluation

    • Authors: Emilio Nuzzolese
      First page: 102
      Abstract: The identification of human remains relies on the comparison of post-mortem data, collected during the autopsy, with the ante-mortem data gathered from the missing persons’ reports. DNA, fingerprints, and dental data are considered primary identifiers and are usually collected during any human identification process. Post-mortem dental data should be collected and analyzed by forensic odontologists, as a dental autopsy must not be confused with a dental examination. The virdentopsy project was inaugurated in 2020, during the COVID-19 pandemic, to allow the correct process of human remains by collecting dental data from teeth and jaws, which was then transmitted to forensic odontologists remotely for an expert opinion to achieve a generic profile of the unidentified human remains. The post-mortem dental biography is paramount to narrow the search for compatible missing persons but requires knowledge and experience of forensic odontologists. The virdentopsy process uses radiographic imaging (periapical X-rays, CT scans, panoramics), 2D/3D photos and video recording, photogrammetry documentation, 3D scanning, and live streaming where possible. This registered term was created by merging the terms “virtual” and “dental autopsy” but with no commercial benefits. The proposed process combines research topics under the field of the human rights of the dead and humanitarian forensic odontology services. It should enhance and accelerate the human identification process of the deceased, age estimation of the living, analysis of panoramic X-ray images, and be an educational tool for remote live training in forensic odontology and anatomy of skulls. This paper presents an overview of the virdentopsy process in the field of forensic odontology as a remote consultation as well as an educational tool for undergraduates and postgraduates.
      Citation: Dentistry Journal
      PubDate: 2021-09-05
      DOI: 10.3390/dj9090102
      Issue No: Vol. 9, No. 9 (2021)
  • Dentistry Journal, Vol. 9, Pages 103: Influence of Dental Implant Diameter
           and Bone Quality on the Biomechanics of Single-Crown Restoration. A Finite
           Element Analysis

    • Authors: Eduardo Anitua, Naiara Larrazabal Saez de Ibarra, Iñigo Morales Martín, Luis Saracho Rotaeche
      First page: 103
      Abstract: Background: Success of an implant-supported prosthesis is highly dependent on implant diameter and bone quality. The objective of this study is to assess these two variables under axial or 30° angulated loading. Methods: The study was conducted using finite element model simulations of dental implants with an unchanging length of 6.5 mm and varying diameters of Ø3.3; Ø3.5; Ø3.75; Ø4, Ø4.25 and Ø4.75 mm. The implants were placed in an axial position and a 2 mm high straight transepithelial (intermediate abutment) was used to perform a single tooth restoration. Four bone quality scenarios, Type IV, III, II or 0-I bone, were simulated from a simplified model of the mandible. A 200N load was applied both axially and at a 30° angle to the occlusal surface of the prosthesis, which was 11 mm above the implant platform, and the equivalent Von Mises stress in the bone was analyzed. Results: The maximum stress value was obtained for the Ø3.3 implant in Type IV bone (235 MPa), while the lowest value was obtained for the Ø4.75 implant and in Type 0-I bone (41 MPa). Regardless of the implant diameter, an improvement in bone quality produced a reduction in bone stress. The same effect was observed as the implant diameter was increased, being this effect even more pronounced. Conclusions: Implant diameter has an important effect on bone stress, with a reduction in stress as the implant diameter increases.
      Citation: Dentistry Journal
      PubDate: 2021-09-06
      DOI: 10.3390/dj9090103
      Issue No: Vol. 9, No. 9 (2021)
  • Dentistry Journal, Vol. 9, Pages 104: Additive Manufacturing of Zirconia
           Ceramic and Its Application in Clinical Dentistry: A Review

    • Authors: Leila Nasiry Khanlar, Alma Salazar Rios, Ali Tahmaseb, Amirali Zandinejad
      First page: 104
      Abstract: Additive manufacturing (AM) has many advantages and became a valid manufacturing technique for polymers and metals in dentistry. However, its application for dental ceramics is still in process. Among dental ceramics, zirconia is becoming popular and widely used in dentistry mainly due to its outstanding properties. Although subtractive technology or milling is the state of art for manufacturing zirconia restorations but still has shortcomings. Utilizing AM in fabricating ceramics restorations is a new topic for many researchers and companies across the globe and a good understanding of AM of zirconia is essential for dental professional. Therefore, the aim of this narrative review is to illustrate different AM technologies available for processing zirconia and discus their advantages and future potential. A comprehensive literature review was completed to summarize different AM technologies that are available to fabricate zirconia and their clinical application is reported. The results show a promising outcome for utilizing AM of zirconia in restorative, implant and regenerative dentistry. However further improvements and validation is necessary to approve its clinical application.
      Citation: Dentistry Journal
      PubDate: 2021-09-06
      DOI: 10.3390/dj9090104
      Issue No: Vol. 9, No. 9 (2021)
  • Dentistry Journal, Vol. 9, Pages 105: Argon Bioactivation of Implants
           Installed Simultaneously to Maxillary Sinus Lifting without Graft. An
           Experimental Study in Rabbits

    • Authors: Yuki Omori, Daniele Botticelli, Mauro Ferri, Rafael Delgado-Ruiz, Vitor Ferreira Balan, Samuel Porfirio Xavier
      First page: 105
      Abstract: Background: The treatment of the surface of titanium implants with argon plasma improved its hydrophilicity and cell adhesion, resulting in higher bone apposition on implant and graft surfaces. The spontaneous perforation over time of the sinus mucosa after sinus augmentation has been documented in experimental studies at both implants and graft particles. The aim of the present study was to evaluate the influence of plasma argon treatment of the implant surface on bone apposition and on the rate of sinus mucosa perforations. Methods: A sinus lifting procedure was performed bilaterally in sixteen rabbits, and implants, either treated with argon plasma or left without treatment (control), were placed simultaneously without grafts. After 8 weeks, histological analyses were carried out. Results: A collapse of the sinus mucosa was observed at all implants. Twenty-four out of thirty-two implants presented sinus mucosa perforations at the apex. Several perforations were also found at the threads. Thinned mucosa sites (width < 40 µm) were found around almost all implants. About 2.6–2.9 mm of the apical regions of the implant did not present signs of osseointegration and about 1.3 mm were exposed to the sinus cavity. No statistically significant differences were found between plasma and control sites. Conclusions: In conclusion, the sinus mucosa was damaged and perforated by direct contact with treated and non-treated implant surfaces. The treatment of the implant surface with argon plasma did not affect the outcomes.
      Citation: Dentistry Journal
      PubDate: 2021-09-06
      DOI: 10.3390/dj9090105
      Issue No: Vol. 9, No. 9 (2021)
  • Dentistry Journal, Vol. 9, Pages 106: The Current and Potential
           Application of Medicinal Cannabis Products in Dentistry

    • Authors: Henry Lowe, Ngeh Toyang, Blair Steele, Joseph Bryant, Wilfred Ngwa, Kaveh Nedamat
      First page: 106
      Abstract: Oral and dental diseases are a major global burden, the most common non-communicable diseases (NCDs), and may even affect an individual’s general quality of life and health. The most prevalent dental and oral health conditions are tooth decay (otherwise referred to as dental caries/cavities), oral cancers, gingivitis, periodontitis, periodontal (gum) disease, Noma, oro-dental trauma, oral manifestations of HIV, sensitive teeth, cracked teeth, broken teeth, and congenital anomalies such as cleft lip and palate. Herbs have been utilized for hundreds of years in traditional Chinese, African and Indian medicine and even in some Western countries, for the treatment of oral and dental conditions including but not limited to dental caries, gingivitis and toothaches, dental pulpitis, halitosis (bad breath), mucositis, sore throat, oral wound infections, and periodontal abscesses. Herbs have also been used as plaque removers (chew sticks), antimicrobials, analgesics, anti-inflammatory agents, and antiseptics. Cannabis sativa L. in particular has been utilized in traditional Asian medicine for tooth-pain management, prevention of dental caries and reduction in gum inflammation. The distribution of cannabinoid (CB) receptors in the mouth suggest that the endocannabinoid system may be a target for the treatment of oral and dental diseases. Most recently, interest has been geared toward the use of Cannabidiol (CBD), one of several secondary metabolites produced by C. sativa L. CBD is a known anti-inflammatory, analgesic, anxiolytic, anti-microbial and anti-cancer agent, and as a result, may have therapeutic potential against conditions such burning mouth syndrome, dental anxiety, gingivitis, and possible oral cancer. Other major secondary metabolites of C. sativa L. such as terpenes and flavonoids also share anti-inflammatory, analgesic, anxiolytic and anti-microbial properties and may also have dental and oral applications. This review will investigate the potential of secondary metabolites of C. sativa L. in the treatment of dental and oral diseases.
      Citation: Dentistry Journal
      PubDate: 2021-09-10
      DOI: 10.3390/dj9090106
      Issue No: Vol. 9, No. 9 (2021)
  • Dentistry Journal, Vol. 9, Pages 107: Root Fracture and Extrusive Luxation
           in Primary Teeth and Their Management: A Case Report

    • Authors: Gianni Di Giorgio, Giulia Zumbo, Matteo Saccucci, Valeria Luzzi, Gaetano Ierardo, Roberto Biagi, Maurizio Bossù
      First page: 107
      Abstract: Background: Extrusion, lateral luxation, and intrusion are among the most serious types of dental trauma. Only a few studies have specifically focused on extrusion; the present one was aimed at reporting a case of domestic traumatic dental injury to primary tooth and describing the measures taken in managing the trauma in order to avoid future consequences to the underlying permanent tooth germ. Case report: A 3.5-year-old boy reported a dental injury with extrusion and root fracture of deciduous tooth 5.1. After intraoral and radiographic evaluation, the element was repositioned and stabilized by an orthodontic flexible splint attached to the adjacent teeth. Several follow-up checkups were made and showed good healing of the tissues and physiological exfoliation of the tooth, with a healthy and unaffected corresponding central permanent incisor. Conclusion: This case report strengthens the importance of well-timed diagnosis and treatment and of regular follow-up of traumatized teeth as they may affect both dentitions with a negative impact on Oral Health-Related Quality of Life. Conservative treatment should be taken into consideration when possible, being in some cases more appropriate.
      Citation: Dentistry Journal
      PubDate: 2021-09-11
      DOI: 10.3390/dj9090107
      Issue No: Vol. 9, No. 9 (2021)
  • Dentistry Journal, Vol. 9, Pages 108: Oral Healthcare and Idiopathic
           Thrombocytopenic Purpura: Early Recognition, Dental Management and Case

    • Authors: Antonio Lanza, Federica Di Spirito, Serena Petrosino, Ludovico Sbordone
      First page: 108
      Abstract: A 47-year-old Caucasian man, in good general, oral and periodontal health, presented with a non-bleeding bluish lesion on the back of his tongue, presumably due to an ecchymotic area of traumatic origin which was left untreated. The day after, other ecchymotic-type lesions on the mucous membranes of the cheeks and the upper lip, a bleeding lesion at the apex of the tongue and gingivorrhagia, along with petechiae on the back, scalp, lower limbs and feet, occurred, with rapid clinical deterioration, requiring immediate hospitalization. Oral, dermatological, and hematological evaluations lead to idiopathic thrombocytopenic purpura (ITP) diagnosis and hydrocortisone prescription, with a complete recovery in the next few days.The presented case of ITP, with early intra-oral manifestations, aimed both to emphasize the role of oral healthcare workers in theearly recognition of ITP, which may be especially relevant for those cases with extremely fast platelet depletion, high risk of internal bleeding and consequent potentially fatal complications, and in the differential diagnosis of the diseasethat may be aided by the diagnostic protocol described, and to provide dentists with recommendations on oral care management of cases of ITP, both in dental and multi-disciplinary settings.
      Citation: Dentistry Journal
      PubDate: 2021-09-12
      DOI: 10.3390/dj9090108
      Issue No: Vol. 9, No. 9 (2021)
  • Dentistry Journal, Vol. 9, Pages 82: Sinus Mucosa Thickness Changes and
           Ostium Involvement after Maxillary Sinus Floor Elevation in Sinus with
           Septa. A Cone Beam Computed Tomography Study

    • Authors: Shingo Kato, Yuki Omori, Masatsugu Kanayama, Atsuya Hirota, Mauro Ferri, Karol Alí Apaza Alccayhuaman, Daniele Botticelli
      First page: 82
      Abstract: Background: A thickening of the sinus mucosa is observed after sinus floor augmentation. The objective of this retrospective study was to evaluate the influence of the presence of septa in the dimensional variation and ostium involvement over time of the Schneiderian mucosa after sinus floor augmentation. Materials and Methods: Fifteen sinuses with septa (septa group) and 15 without (control group) were selected. CBCTs taken before surgery, and were analyzed after 1 week and after 9 months. Schneiderian membrane thickness changes over time and involvement of the ostium were evaluated. Results: Four perforations occurred in the septa group and none in the control group. After 1 week of healing, the sinus mucosa thickness increased in height by 5.7 mm and 7.1 mm in the septa and control groups, respectively. In this period, the patency of the ostium decreased in both groups, and three infundibula were obstructed in the septa group, and five in the control group. The mucosa was thicker and the edema was closer to the ostium in the control compared to in the septa group. After 9 months of healing, the dimensions regressed to normal pattern and no obstruction of the infundibula were observed. No statistically significant differences were found between septa and control groups. Conclusions: after one week of healing, the sinus mucosa increased in dimensions in both septa and control groups. However, the sinus mucosa presented a tendency of being thicker and closer to the ostium, resulting in a higher number of infundibula obstructions, in the control group compared to in the septa group. After 9 months, the sinus mucosa regressed to normal dimensions and no obstructions of the infundibula were observed in any group.
      Citation: Dentistry Journal
      PubDate: 2021-07-21
      DOI: 10.3390/dj9080082
      Issue No: Vol. 9, No. 8 (2021)
  • Dentistry Journal, Vol. 9, Pages 83: Improper Light Curing of Bulkfill
           Composite Drives Surface Changes and Increases S. mutans Biofilm Growth as
           a Pathway for Higher Risk of Recurrent Caries around Restorations

    • Authors: Haifa Maktabi, Maria Salem Ibrahim, Abdulrahman A. Balhaddad, Qoot Alkhubaizi, Isadora Martini Garcia, Fabrício Mezzomo Collares, Howard Strassler, Ana Paula P. Fugolin, Carmem S. Pfeifer, Mary Anne S. Melo
      First page: 83
      Abstract: How dentists cure a resin-based material has deleterious effects on the material’s properties and its interaction with surrounding dental tissues. Biofilm accumulation has been implicated in the pathogenesis of carious lesions around dental restorations, with its composition manifesting expressed dysbiosis in patients suffering from dental caries. To evaluate the influence of varying radiant exposure on the degree of conversion (DC%), Streptococcus mutans biofilm growth, and surface roughness of bulk-fill composites under different light-curing conditions. Two light-curing units (LCU) at 600 and 1000 mW/cm2 were used to simulate curing conditions with different angulations (∢20° and ∢35°) or 2 mm-distance displacements of the LCU tip. The radiant exposure (RE) was assessed, and the composites were analyzed for DC%. Biofilm formation was induced over the bulk-fill composites and analyzed via colony-forming units counting and scanning electron microscopy (SEM). The surface roughness was analyzed via a profilometer and SEM after biofilm formation. Curing conditions with different angulation or displacement decreased RE compared to the “optimal condition”. The moderately (∢35°) angulated LCU tip and low (600 mW/cm2) radiant emittance significantly reduced the DC% (p < 0.05). The difference in DC% between the top and bottom of the composites ranged from 8 to 11% for 600 mW/cm2 and 10 to 20% for 1000 mW/cm2. Greater S. mutans biofilm and surface changes were found in composites with non-optimal RE delivery (e.g., tip displacement and angulation) (p < 0.05). Inadequate polymerization of bulk-fill composites was associated with more biofilm accumulation and surface topography changes. Overall, non-optimally performed curing procedures reduced the amount of delivered RE, which led to low DC%, more biofilm formation, and higher surface roughness. The improper light-curing of bulk-fill composites compromises their physicochemical and biological properties, which could lead to inferior clinical performance and reduced restorative treatments’ longevity.
      Citation: Dentistry Journal
      PubDate: 2021-07-30
      DOI: 10.3390/dj9080083
      Issue No: Vol. 9, No. 8 (2021)
  • Dentistry Journal, Vol. 9, Pages 84: Adjuvant Effect of Titanium Brushes
           in Peri-Implant Surgical Treatment: A Systematic Review

    • Authors: Francisco Javier González, Estefanía Requena, Lucía Miralles, José Luis Sanz, Javier Barberá, José Juan Enciso, Carolina Larrazábal, María Dolores Gómez
      First page: 84
      Abstract: Background: the prognosis of peri-implant surgery can be affected by poor decontamination of the implant surface, which could be improved with the use of titanium brushes. The objectives of this systematic review were to evaluate the effectiveness of titanium brushes in the decontamination of the implant surface in terms of plaque index, probing depth, bleeding on probing and bone loss/gain; as well as its effectiveness according to the type of peri-implant bone defect. Methods: an electronic search was carried out in the PubMed, Scopus, Cochrane and Embase databases, as well as a manual search. The search strategy included four keywords: “Peri-implantitis”, “Periimplantitis”, “Implant Surface Decontamination” and “Titanium Brush”. Randomized controlled studies published in the last 10 years were included and systematic reviews, in vitro studies and animal studies were excluded. Results: 142 references were found, from which only four articles met the inclusion criteria. All of the studies included in the present review reported beneficial results in terms of probing depth, gingival index and radiographic bone loss and gain after implant surface decontamination adjuvated by titanium brushes. Conclusions: titanium rotary brushes show improvements in the evolution and prognosis of peri-implant surgery, although more long-term studies are needed to draw more solid conclusions.
      Citation: Dentistry Journal
      PubDate: 2021-07-30
      DOI: 10.3390/dj9080084
      Issue No: Vol. 9, No. 8 (2021)
  • Dentistry Journal, Vol. 9, Pages 85: Medication-Related Osteonecrosis of
           the Jaws Initiated by Zoledronic Acid and Potential Pathophysiology

    • Authors: Aya Alsalih, Annica Dam, Pia Lindberg, Anna Truedsson
      First page: 85
      Abstract: The aim of this systematic review is to present an up-to-date review of available publications investigating the cellular mechanisms initiating the development of medication-related osteonecrosis of the jaw caused by zoledronic acid. Electronic searches of MEDLINE/PubMed and Scopus were conducted on the 3 June 2019. A total of 804 publications were identified, of which 11 met the inclusion criteria and were, therefore, included in this study. All the included studies were in vitro studies investigating various human cells. The current review found that zoledronic acid in various concentrations increased apoptosis and decreased migration and proliferation of epithelial cells, fibroblasts, osteoblasts, endothelial cells and dental pulp stem cells, which can affect local tissue homeostasis. The consequences of zoledronic acid were found to be both time- and dose-dependent. The pathophysiology of medication-related osteonecrosis of the jaw is likely a multifactorial process involving prolonged wound healing, chronic inflammation and altered bone remodelling following the administration of zoledronic acid. Further research is needed to identify the exact pathophysiology to optimise management and treatment.
      Citation: Dentistry Journal
      PubDate: 2021-07-30
      DOI: 10.3390/dj9080085
      Issue No: Vol. 9, No. 8 (2021)
  • Dentistry Journal, Vol. 9, Pages 86: The New Normalcy in Dentistry after
           the COVID-19 Pandemic: An Italian Cross-Sectional Survey

    • Authors: Stefano Salgarello, Matteo Salvadori, Francesco Mazzoleni, Jacopo Francinelli, Paolo Bertoletti, Elisabetta Audino, Maria Luisa Garo
      First page: 86
      Abstract: Background: After the first lockdown, Italian dentists resumed their practice while handling several challenges. Reducing contagion risk by complying with the stringent measures recommended by the Italian Ministry of Health for dental activity while also balancing patient needs was a difficult task. This work aims to understand the procedures that were adopted in the second phase of the COVID-19 pandemic (5 May–30 September 2020) and the dentists’ expectations and concerns about returning to normalcy. Methods: A national survey with 38 questions was conducted from November 2020 to January 2021 and comparisons were performed among the five main Italian geographic areas. Results: Located mainly in northwest Italy, 1028 dentists were included in the survey. About 83% of the Italian dentists fully restarted their activities after the lockdown. The resumption was significantly marked in North Italy and the Center than in the South (p < 0.01). Over 80% adopted the recommended precautional guidelines, modifying them according to the specific dental treatment executed. Fifty percent of dentists were confident in returning to normalcy after the COVID-19 crisis. Many precautions adopted during the pandemic will be continued, especially in South Italy and the Islands (p < 0.01). Conclusions: Italian dentists reported excellent autonomous organizational skills and the maintaining of high-quality precautions during the reopening phase.
      Citation: Dentistry Journal
      PubDate: 2021-07-31
      DOI: 10.3390/dj9080086
      Issue No: Vol. 9, No. 8 (2021)
  • Dentistry Journal, Vol. 9, Pages 87: Accuracy of Guided Surgery and
           Real-Time Navigation in Temporomandibular Joint Replacement Surgery

    • Authors: Michael-Tobias Neuhaus, Alexander-Nicolai Zeller, Alexander K. Bartella, Anna K. Sander, Bernd Lethaus, Rüdiger M. Zimmerer
      First page: 87
      Abstract: Background: Sophisticated guided surgery has not been implemented into total joint replacement-surgery (TJR) of the temporomandibular joint (TMJ) so far. Design and in-house manufacturing of a new advanced drilling guide with vector and length control for a typical TJR fossa component are described in this in vitro study, and its accuracy/utilization was evaluated and compared with those of intraoperative real-time navigation and already available standard drilling guides. Methods: Skull base segmentations of five CT-datasets from different patients were used to design drilling guides with vector and length control according to virtual surgical planning (VSP) for the TJR of the TMJ. Stereolithographic models of the skull bases were printed three times for each case. Three groups were formed to compare our newly designed advanced drilling guide with a standard drilling guide and drill-tracking by real-time navigation. The deviation of screw head position, screw length and vector in the lateral skull base have been evaluated (n = 72). Results: There was no difference in the screw head position between all three groups. The deviation of vector and length was significantly lower with the use of the advanced drilling guide compared with standard guide and navigation. However, no benefit in terms of accuracy on the lateral skull base by the use of real-time navigation could be observed. Conclusion: Since guided surgery is standard in implant dentistry and other CMF reconstructions, this new approach can be introduced into clinical practice soon, in order to increase accuracy and patient safety.
      Citation: Dentistry Journal
      PubDate: 2021-08-02
      DOI: 10.3390/dj9080087
      Issue No: Vol. 9, No. 8 (2021)
  • Dentistry Journal, Vol. 9, Pages 88: Cariogenic Biofilms: Development,
           Properties, and Biomimetic Preventive Agents

    • Authors: Frederic Meyer, Joachim Enax, Matthias Epple, Bennett T. Amaechi, Barbara Simader
      First page: 88
      Abstract: Oral biofilms will build up within minutes after cleaning of the dental hard tissues. While the application of remineralizing agents is a well-known approach to prevent dental caries, modern oral care products offer also additional active agents to maintain oral health. Human saliva contains many different organic and inorganic compounds that help to buffer organic acids produced by cariogenic microorganisms. However, most oral care products only contain remineralizing agents. To improve the benefit of those products, further active ingredients are needed. Books, review articles, and original research papers were included in this narrative review. Putting all these data together, we give an overview of oral biofilms and active compounds used in modern oral care products to interact with them. The special focus is on inorganic compounds and their interaction with oral biofilms. While organic compounds have several limitations (e.g., cell toxicity), inorganic compounds based on calcium and/or phosphate (e.g., sodium bicarbonate, hydroxyapatite, calcium carbonate) offer several advantages when used in oral care products. Calcium release can inhibit demineralization, and the release of hydroxide and phosphate ions might help in the buffering of acids. Therefore, the focus of this review is to summarize the scientific background of further active ingredients that can be used for oral care formulations.
      Citation: Dentistry Journal
      PubDate: 2021-08-03
      DOI: 10.3390/dj9080088
      Issue No: Vol. 9, No. 8 (2021)
  • Dentistry Journal, Vol. 9, Pages 89: Behavior of Children during Dental
           Care with Rubber Dam Isolation: A Randomized Controlled Study

    • Authors: Tania Vanhée, Chloé Tassignon, Pierre Porta, Peter Bottenberg, Thierry Charles, Astrid Vanden Abbeele
      First page: 89
      Abstract: Background: The establishment of the dental dam improves dentist working conditions and patient protection. The purpose of this study was to analyze the behavior of the child during dental care with or without a dam. Methods: In this interventional randomized study, 51 patients are divided into two groups, one with a rubber dam and the other with cotton roll isolation. Their behavior was observed during the treatment of temporary molars. The duration of the treatment, the patient’s feeling with a visual analogue scale (VAS), the behavior (B) of the child measured with a hetero-evaluation scale (modified Venham scale) and the cardiac frequency (CF) were measured. Results: The group treated with a rubber dam has a significant decrease in the various stress parameters that have been identified (B, p value = 0.034; CF, p value = 0.015). Subgroups of patients with and without nitrous oxide sedation were compared and similar results were obtained. Conclusions: Isolation with a rubber dam reduces child’s stress during dental care. Although it is slightly more time-consuming and training is necessary for a quick and effective placement, it allows dentists to perform dental care in the best possible conditions, while reducing dental anxiety in young patients.
      Citation: Dentistry Journal
      PubDate: 2021-08-04
      DOI: 10.3390/dj9080089
      Issue No: Vol. 9, No. 8 (2021)
  • Dentistry Journal, Vol. 9, Pages 90: Benefits of Using Fluorescence
           Induced Theragnosis in Fixed Orthodontic Therapy: Status, Technology and
           Future Trends

    • Authors: Anand Marya, Liviu Steier, Mohmed Isaqali Karobari, Adith Venugopal
      First page: 90
      Abstract: Dental biofilm is often found to be the source of bacteria that releases toxins, peptides, lipopolysaccharides as well as organic acids, which lead to gingival inflammation and tooth caries. Further, the persistent plaque may result in the continued destruction of the surrounding soft and hard tissues. During fixed orthodontic therapy, arch-wires, brackets, and elastic modules have been shown to be sites of significant plaque accumulation, making it difficult for a patient to maintain proper oral hygiene. The problem most dentists face is that they cannot visualize this biofilm completely to be able to carry out efficient plaque removal. Visual assessment is, to date, the most common method for plaque visualization, and various indexes have been demonstrated to be sufficient for quantification of the amount of plaque present. However, the problem is that visual assessments are inconsistent, operator dependent and often subjective, which can lead to inconsistency in results. Fluorescence is one such method that can be explored for its use in effective plaque identification and removal. Literature has it that dentists and patients find it particularly useful for monitoring oral hygiene status during treatment. Fluorescence has the capability of offering clinical orthodontists and researchers a new method of detection of demineralization during orthodontic treatment, furthermore, for efficient removal of orthodontic adhesive cements, fluorescent light may be used in conjunction with high-speed burs to deliver fast, less time consuming, and safer results. The benefit of direct visual treatment using fluorescence enhanced theragnosis is that the patient receives controlled and guided therapy. It has multiple benefits, such as early diagnosis of caries, biofilm identification, and even helps to achieve improved treatment outcomes by better resin selection for esthetic procedures.
      Citation: Dentistry Journal
      PubDate: 2021-08-05
      DOI: 10.3390/dj9080090
      Issue No: Vol. 9, No. 8 (2021)
  • Dentistry Journal, Vol. 9, Pages 91: Early Clinical Experience and
           Mentoring of Young Dental Students—A Qualitative Study

    • Authors: Rod Moore, Simone Molsing, Nicola Meyer, Matilde Schepler
      First page: 91
      Abstract: The literature reports that student transition between preclinical and clinical dental education can be traumatic and stressful for many reasons. Early clinical experience has been reported to provide some relief. In this qualitative study, twelve final year dental students were interviewed about their perceptions and experiences with a mentee/mentor (FOAL) program in Aarhus, Denmark, to see if it (1) counteracted stress perceptions from preclinical education to the clinic, (2) inspired professionalism and a sense of study relevance, (3) helped in learning to reflect on competencies and attitudes, (4) helped with clinical social perspectives (communication/contact), (5) helped with motivation to learn and (6) helped to reaffirm one’s professional study choice. Using qualitative description methods with purposeful sampling, data from interviews were collected, transcribed, analyzed and validated with a short questionnaire. The FOAL program, today, has several benefits for mentees, including partially helping in the preclinic to clinic transition and the increased insight into mentors’ clinical tasks and communication with patients. Informants described that FOAL also contributed positively to both mentee and mentor students’ learning motivation, collaborative skills and professional attitudes. Challenges were lack of organization/planning, not enough clinical hours, lack of clinical knowledge and persistent stress levels at the clinical transition. These issues are already being considered in the curriculum reform currently in progress and are also relevant to other dental curricula internationally.
      Citation: Dentistry Journal
      PubDate: 2021-08-06
      DOI: 10.3390/dj9080091
      Issue No: Vol. 9, No. 8 (2021)
  • Dentistry Journal, Vol. 9, Pages 92: Hardness of Resin Cements Polymerized
           through Glass-Ceramic Veneers

    • Authors: Hanan Aldryhim, Omar El-Mowafy, Peter McDermott, Anuradha Prakki
      First page: 92
      Abstract: (1) Background: The aim of this study is to evaluate the hardness of resin cements polymerized through ceramic disks under different process factors (ceramic type and thickness, light-polymerization units and polymerization time); (2) Method: Three types of ceramic blocks were used (IPS e.max CAD; Celtra Duo; VITABLOCS). Ceramic disks measuring 0.5 mm, 1.0 mm and 1.5 mm were cut from commercial blocks. Two resin cements (Rely X Veneer and Variolink Esthetic) were polymerized through the ceramic specimens using distinct light-polymerization units (Deep-cure; Blue-phase) and time intervals (10 and 20 s). Hardness of cement specimens was measured using microhardness tester with a Knoop indenter. Data were statistically analyzed using factorial ANOVA (α = 5%); (3) Results: Mean microhardness of Rely X Veneer cement was significantly higher than that of Variolink Esthetic. Deep-cure resulted in higher mean microhardness values compared to Blue-phase at 0.5- and 1-mm specimen thicknesses. Moreover, a direct correlation was found between polymerization time and hardness of resin cement; (4) Conclusions: Surface hardness was affected by resin cement type and ceramic thickness, and not affected by ceramic types, within evaluated conditions. Increasing light-polymerization time significantly increased the hardness of the cement.
      Citation: Dentistry Journal
      PubDate: 2021-08-09
      DOI: 10.3390/dj9080092
      Issue No: Vol. 9, No. 8 (2021)
  • Dentistry Journal, Vol. 9, Pages 93: Education Regarding and Adherence to
           Recommended Nutrition Guidelines among Dental Students

    • Authors: Camille Frayna, Christoffer Devantier, Braden Harris, Karl Kingsley, Joshua M. Polanski
      First page: 93
      Abstract: The Dietary Guidelines for Americans (DGA) were developed to reduce or prevent many types of chronic illness, including cancer, heart disease and diabetes. Healthcare provider recommendations may be influenced by understanding of and adherence to the DGA, which may be incorporated into provider training, medical and dental clinical curricula—although few studies have evaluated adherence to the DGA among dental students. This approved retrospective study of voluntary student responses from a first-year dental school nutrition course included a short dietary and exercise survey administered as part of the DGA learning module. A total of N = 299 students completed the voluntary nutrition survey, yielding a response rate of 91.4%. Daily fruit and vegetable intake, dairy and whole grain servings among UNLV-SDM students were significantly lower than the DGA recommendations but higher than U.S. averages for 18–30-year-olds—although neither group met DGA recommendations. This study represents one of the first to evaluate the dietary intake of U.S. dental students for comparison with the DGA for positive health behaviors. These data demonstrate a lack of adherence to the DGA among highly educated dental students and the need for the curricular inclusion of diet and nutrition into the dental school curriculum.
      Citation: Dentistry Journal
      PubDate: 2021-08-09
      DOI: 10.3390/dj9080093
      Issue No: Vol. 9, No. 8 (2021)
  • Dentistry Journal, Vol. 9, Pages 94: Evaluating Classification Consistency
           of Oral Lesion Images for Use in an Image Classification Teaching Tool

    • Authors: Yuxin Shen, Minn N. Yoon, Silvia Ortiz, Reid Friesen, Hollis Lai
      First page: 94
      Abstract: A web-based image classification tool (DiLearn) was developed to facilitate active learning in the oral health profession. Students engage with oral lesion images using swipe gestures to classify each image into pre-determined categories (e.g., left for refer and right for no intervention). To assemble the training modules and to provide feedback to students, DiLearn requires each oral lesion image to be classified, with various features displayed in the image. The collection of accurate meta-information is a crucial step for enabling the self-directed active learning approach taken in DiLearn. The purpose of this study is to evaluate the classification consistency of features in oral lesion images by experts and students for use in the learning tool. Twenty oral lesion images from DiLearn’s image bank were classified by three oral lesion experts and two senior dental hygiene students using the same rubric containing eight features. Classification agreement among and between raters were evaluated using Fleiss’ and Cohen’s Kappa. Classification agreement among the three experts ranged from identical (Fleiss’ Kappa = 1) for “clinical action”, to slight agreement for “border regularity” (Fleiss’ Kappa = 0.136), with the majority of categories having fair to moderate agreement (Fleiss’ Kappa = 0.332–0.545). Inclusion of the two student raters with the experts yielded fair to moderate overall classification agreement (Fleiss’ Kappa = 0.224–0.554), with the exception of “morphology”. The feature of clinical action could be accurately classified, while other anatomical features indirectly related to diagnosis had a lower classification consistency. The findings suggest that one oral lesion expert or two student raters can provide fairly consistent meta-information for selected categories of features implicated in the creation of image classification tasks in DiLearn.
      Citation: Dentistry Journal
      PubDate: 2021-08-12
      DOI: 10.3390/dj9080094
      Issue No: Vol. 9, No. 8 (2021)
  • Dentistry Journal, Vol. 9, Pages 95: Effect of Polishing Systems on the
           Surface Roughness of Nano-Hybrid and Nano-Filling Composite Resins: A
           Systematic Review

    • Authors: Robinson Jaramillo-Cartagena, Eider J. López-Galeano, Federico Latorre-Correa, Andrés A. Agudelo-Suárez
      First page: 95
      Abstract: Background: The polishing of surface roughness is an important characteristic of composite resins and is directly related to the longevity of the restoration and patient comfort. Different polishing systems utilize different protocols, as reported in the literature. This systematic review (SR) aimed to synthesize and analyze the available scientific evidence about the effect of polishing systems on the surface roughness of nano-hybrid and nano-filling composite resins. Methods: The study protocol of this SR was registered at the International Prospective Register of Systematic Reviews -PROSPERO- (CRD4201705653). A search was conducted in PubMed-Medline, Scopus, LILACS, EMBASE, for the period 2007–2020. Quality appraisal and a descriptive analysis of the papers that met the inclusion criteria were conducted. Results: 18 records were included. Seven polishing systems (PS) of one step were found, seven PS of two steps, eight PS of three steps, three PS of four steps, and four PS of five steps. Polishing protocols (PP) varied, with application times ranging from 10 s to 60 s with speeds between 10,000 and 30,000 RPM. Regarding composition, the aluminum oxide was one of the most important components used to achieve a smooth surface. Conclusions: Multistep polishing systems were the most effective (i.e., Astropol and Sof-Lex Discs).
      Citation: Dentistry Journal
      PubDate: 2021-08-12
      DOI: 10.3390/dj9080095
      Issue No: Vol. 9, No. 8 (2021)
  • Dentistry Journal, Vol. 9, Pages 96: Biomedical Courses Should Also Be
           Designed for Dental Students: The Perceptions of Dental Students

    • Authors: Fanny Mussalo, Terhi Karaharju-Suvanto, Päivi Mäntylä, Eeva Pyörälä
      First page: 96
      Abstract: Introduction: It can be challenging integrating biomedical sciences into dentistry programs. The aim was to examine students’ perceptions of how joint biomedical courses with medical students and courses tailored for dental students supported their clinical studies. Materials and methods: The target group was clinical phase dental students. Cross-sectional survey data were collected using a questionnaire, which consisted of questions covering biomedical and clinical study content and learning methods. Results: A total of 110 (82%) students completed the survey. Students had difficulty recognising the relevance of joint biomedical courses for clinical work, but when the link was clear, their interest in the content increased. The closer the respondents were to graduation, the less relevance they expressed the biomedical sciences had. Almost all students (95%) wanted more dental content for the early study years. Discussion: The student perspective provides valuable information for the development of biomedical courses. Students should be offered customised courses that include dental content and perspectives on clinical work, whenever suitable to the didactic content of the basic science course. Our study shows that the dental perspective needs greater integration with the biomedical content. This also supports interprofessional learning and appreciation for the other field’s contribution to human health.
      Citation: Dentistry Journal
      PubDate: 2021-08-16
      DOI: 10.3390/dj9080096
      Issue No: Vol. 9, No. 8 (2021)
  • Dentistry Journal, Vol. 9, Pages 97: Abrasion Behaviour of Different
           Charcoal Toothpastes When Using Electric Toothbrushes

    • Authors: Andreas Greuling, Johanna Maria Emke, Michael Eisenburger
      First page: 97
      Abstract: Objectives: The purpose of this in vitro study was to compare the abrasion behaviour of different charcoal toothpastes when brushing with electric toothbrushes on human enamel. Materials and Methods: A self-designed brushing machine was built using six commercially available electric toothbrushes in abrasion chambers. Each chamber was constantly supplied with a toothpaste–water mix. Pieces of human enamel, which were embedded in PMMA, were brushed for 4 h. Before and after brushing, profilometer measurements were performed in order to determine the substance loss due to brushing. Results: The following calculated mean removal values (mean ± SD) were found: (4.6 ± 0.6) µm (Group C: Splat Blackwood), (3.2 ± 0.9) µm (Group D: Curaprox Black is White), (2.3 ± 0.7) µm (Group B: Sensodyne Pro Schmelz), (1.7 ± 0.6) µm (Group A: Water), (1.4 ± 0.6) µm (Group E: Prokudent Black Brilliant). A post hoc Tukey HSD test (p = 0.05) showed that the results for Group A/B/E, Group B/D and Group C each lie within subsets that differ statistically significantly from the other subsets. Conclusions: Within the limitations of this in vitro study, it can be stated that some charcoal toothpastes lead to significantly higher abrasion on human enamel, when brushing with electric brushes. Clinical Relevance: As low-abrasion toothpaste is generally advisable, and some charcoal toothpastes should be viewed critically with regard to their abrasive properties.
      Citation: Dentistry Journal
      PubDate: 2021-08-20
      DOI: 10.3390/dj9080097
      Issue No: Vol. 9, No. 8 (2021)
  • Dentistry Journal, Vol. 9, Pages 74: Autofluorescence Detection Method for
           Dental Plaque Bacteria Detection and Classification: Example of
           Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and
           Streptococcus mutans

    • Authors: Yung-Jhe Yan, Bo-Wen Wang, Chih-Man Yang, Ching-Yi Wu, Mang Ou-Yang
      First page: 74
      Abstract: The use of fluorescence spectroscopy for plaque detection is a fast and effective way to monitor oral health. At present, there is no uniform specification for the design of the excitation light source of related products for generating fluorescence. To carry out experiments on dental plaque, the fluorescence spectra of three different bacterial species (Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Streptococcus mutans) were measured by hyperspectral imaging microscopy (HIM). Three critical issues were found in the experiments. One issue was the unwanted spectrum generated from a mercury line source; two four-order low-pass filters were evaluated for eliminating the unwanted spectrum and meet the experimental requirements. The second issue was the red fluorescence generated from the microscope slide made of borosilicate glass; this could affect the observation of the red fluorescence from the bacteria; quartz microscope slides were found to reduce the fluorescence intensity by about 2 dB compared with the borosilicate slide. The third issue of photobleaching in the fluorescence of the Porphyromonas gingivalis was studied. This study proposes a method of classifying three bacteria based on the spectral intensity ratios (510/635 and 500/635 nm) under the 405 nm excitation light was proposed in this study. The sensitivity and specificity of the classification were approximately 99% and 99%, respectively.
      Citation: Dentistry Journal
      PubDate: 2021-06-22
      DOI: 10.3390/dj9070074
      Issue No: Vol. 9, No. 7 (2021)
  • Dentistry Journal, Vol. 9, Pages 75: A Comparison of Full Arch Trueness
           and Precision of Nine Intra-Oral Digital Scanners and Four Lab Digital

    • Authors: Adam B. Nulty
      First page: 75
      Abstract: (1) Background: The purpose of this study is to evaluate the full arch scan accuracy (precision and trueness) of nine digital intra-oral scanners and four lab scanners. Previous studies have compared the accuracy of some intra-oral scanners, but as this is a field of quickly developing technologies, a more up-to-date study was needed to assess the capabilities of currently available models. (2) Methods: The present in vitro study compared nine different intra-oral scanners (Omnicam 4.6; Omnicam 5.1; Primescan; CS 3600; Trios 3; Trios 4; Runyes; i500; and DL206) as well as four lab light scanners (Einscan SE; 300e; E2; and Ineos X5) to investigate the accuracy of each scanner by examining the overall trueness and precision. Ten aligned and cut scans from each of the intra-oral and lab scanners in the in vitro study were brought into CloudCompare. A comparison was made with the master STL using the CloudCompare 3D analysis best-fit algorithm. The results were recorded along with individual standard deviation and a colorimetric map of the deviation across the surface of the STL mesh; a comparison was made to the master STL, quantified at specific points. (3) Results: In the present study, the Primescan had the best overall trueness (17.3 ± 4.9), followed by (in order of increasing deviation) the Trios 4 (20.8 ± 6.2), i500 (25.2 ± 7.3), CS3600 (26.9 ± 15.9), Trios 3 (27.7 ± 6.8), Runyes (47.2 ± 5.4), Omnicam 5.1 (55.1 ± 9.5), Omnicam 4.6 (57.5 ± 3.2), and Launca DL206 (58.5 ± 22.0). Regarding the lab light scanners, the Ineos X5 had the best overall trueness with (0.0 ± 1.9), followed by (in order of increasing deviation) the 3Shape E2 (3.6 ± 2.2), Up3D 300E (12.8 ± 2.7), and Einscan SE (14.9 ± 9.5). (4) Conclusions: This study confirms that all current generations of intra-oral digital scanners can capture a reliable, reproducible full arch scan in dentate patients. Out of the intra-oral scanners tested, no scanner produced results significantly similar in trueness to the Ineos X5. However, the Primescan was the only one to be statistically of a similar level of trueness to the 3Shape E2 lab scanner. All scanners in the study had mean trueness of under 60-micron deviation. While this study can compare the scanning accuracy of this sample in a dentate arch, the scanning of a fully edentulous arch is more challenging. The accuracy of these scanners in edentulous cases should be examined in further studies.
      Citation: Dentistry Journal
      PubDate: 2021-06-23
      DOI: 10.3390/dj9070075
      Issue No: Vol. 9, No. 7 (2021)
  • Dentistry Journal, Vol. 9, Pages 76: Influence of Anatomical Parameters on
           the Dimensions of the Subantral Space and Sinus Mucosa Thickening after
           Sinus Floor Elevation. A Retrospective Cone Beam Computed Tomography Study

    • Authors: Yuki Omori, Yasushi Nakajima, Hideki Imai, Daichi Yonezawa, Mauro Ferri, Karol Alí Apaza Alccayhuaman, Daniele Botticelli
      First page: 76
      Abstract: Background: Various anatomical parameters might influence the surgical approach for maxillary sinus floor elevation. The objective of the present study was to retrospectively evaluate the influence of anatomical parameters on the dimensions of the subantral space and of the sinus mucosa thickening after sinus floor elevation. Material and Methods: Seventy-eight maxillary sinuses in sixty-five patients were evaluated on cone beam computed tomographies taken before surgery and after one week (t1w) and nine months (t9m). Several parameters such as the distance XF between an axis parallel to the base of the nose (X-axes) and the sinus floor (F) were correlated with the height gain (IF) at t1w and t9m and the post-surgical edema. Results: A weak significant positive correlation was observed between height gain vs. sinus height of interest (XF), the balcony, and the sinus floor angle. The post-surgical edema was influenced by the initial mucosa thickness and the xenograft used. Conclusions: Various parameters might affect height gain and sinus mucosa thickening after sinus floor elevation. The height of interest, the balcony, and the sinus floor angle showed significant correlations with height gain. The initial thickness of the mucosa and the biomaterial used influenced the post-surgical edema.
      Citation: Dentistry Journal
      PubDate: 2021-06-24
      DOI: 10.3390/dj9070076
      Issue No: Vol. 9, No. 7 (2021)
  • Dentistry Journal, Vol. 9, Pages 77: The Effect of Extra Educational
           Elements on the Confidence of Undergraduate Dental Students Learning to
           Administer Local Anaesthesia

    • Authors: Mats Sjöström, Malin Brundin
      First page: 77
      Abstract: Local anaesthesia is taught early in the practical part of dental programs. However, dental students express uncertainty and concern before their practical training in local anaesthesia. The aim of this study was to evaluate how extra educational elements in the teaching of local anaesthesia affect students’ confidence using local anaesthesia. The students were divided into three groups (A, B and C). Group A received the same education that was used the previous year (i.e., four hours of theoretical lectures followed by four hours of practical exercises performed on a fellow student). Group B did their practical training on fellow students in groups of three, with each student taking turns performing, receiving and observing the procedure. Group C received training using an anatomically correct model before their practical training on a fellow student. After each training step, the students completed a questionnaire about their confidence administering local anaesthesia. The students experienced a significant increase in confidence after each educational step. Combining theory and practical instruction, including the use of anatomically correct models and peer instruction, improved students’ confidence in administering local anaesthesia. The greatest increase in confidence was in the students placed in groups of three where each student performed, received and observed the procedure.
      Citation: Dentistry Journal
      PubDate: 2021-07-01
      DOI: 10.3390/dj9070077
      Issue No: Vol. 9, No. 7 (2021)
  • Dentistry Journal, Vol. 9, Pages 78: Effect of Water Storage on Hardness
           and Interfacial Strength of Resin Composite Luting Agents Bonded to
           Surface-Treated Monolithic Zirconia

    • Authors: Emmanouil-George Tzanakakis, Maria Dimitriadi, Ioannis Tzoutzas, Petros Koidis, Spiros Zinelis, George Eliades
      First page: 78
      Abstract: Background: Durable bonding between resin composite luting agents (CLA) and zirconia is still a matter of controversy. The purpose of this study was to evaluate the effect of water storage on hardness and interfacial strength of three CLA, a non-adhesive (Multilink Automix/ML), an adhesive (Panavia F 2.0/PF) and a self-adhesive (PermaCem 2.0/PC), bonded to polished (CL) and grit-blasted (AL: 50 μm alumina, SJ: Sil-Jet + Monobond Plus silane) monolithic zirconia surfaces. Methods: CLA specimens (n = 5/cement, condition) were prepared, stored under dry conditions or immersed in water, and Vickers hardness (VH) measurements were obtained at 1 h, 24 h, 1 week and 3 weeks intervals. Optical profilometry was used to determine the roughness parameters (Sa, Sz, Sdr, Sci) of zirconia surfaces (n = 5/treatment). A shear strength test (SBS, n = 10 × 2/cement) was performed to assess the strength and fractography of the cements bonded to zirconia after isothermal water storage and thermal-cycling (TC). Results: PF demonstrated significantly lower VHN after water storage at all time intervals, PC at 1 w, 3 w and ML at 3 w. SJ and AL showed significantly higher values from CL in all roughness parameters. Weibull analysis revealed the following significance in σο ranking within the same material: AL, SJ, ALTC > SJTC, CL > CLTC (PF); SJ, SJTC, AL, ALTC > CL, CLTC (PC) and SJ, SJTC > AL > ALTC > CL, CLTC (ML). Within the same surface treatment subgroups, the significance in σo ranking was PC, ML > PF (before/after TC) for SJ; PC > PF > ML (before TC), PC, PF > ML (after TC) for AL, and PC > PF > ML (before/after TC) for CL. For the m ranking, the only significant difference within each material group was found in PC (AL > ALTC) and for the same surface treatment in AL (PC > ML). Conclusion: There are significant differences in the water plasticization susceptibility of the CLA tested; the materials with adhesive monomers were the most affected. Tribo-chemical silica coating combined with a silane coupling agent was the most efficient bonding treatment for the non-adhesive and the self-adhesive materials. The adhesive CLA performed better on alumina-blasted than on tribo-chemically coated surfaces.
      Citation: Dentistry Journal
      PubDate: 2021-07-04
      DOI: 10.3390/dj9070078
      Issue No: Vol. 9, No. 7 (2021)
  • Dentistry Journal, Vol. 9, Pages 79: The “Pre-Finishing” Approach in
           Direct Anterior Restorations. A Case Series

    • Authors: Gaetano Paolone, Salvatore Scolavino, Enrico Gherlone, Gianrico Spagnuolo, Giuseppe Cantatore
      First page: 79
      Abstract: In esthetic restorations of anterior teeth the clinician has to manage several aspects in order to have a predictable outcome. A deep knowledge of the anatomy as well as the adhesive procedures and the optical properties of resin-based composites are mandatory to achieve esthetic results. Contemporary restorative materials present either several shades and different translucency properties and therefore they are able to mimic teeth’s optical behavior thus providing a natural aspect to anterior restorations. The wrong thickness of different composite layers may provide unpleasant results such as low value (grayish) restorations that often requires reintervention. A precise step-by-step procedure is therefore mandatory to provide the proper shade at the correct place. There is therefore the need of some corrections and adjustments during the layer procedure in order to avoid errors in shade positioning that could affect final result. The authors present a case series (six clinical cases) treated with the proposed technique with up to five years follow-up.
      Citation: Dentistry Journal
      PubDate: 2021-07-07
      DOI: 10.3390/dj9070079
      Issue No: Vol. 9, No. 7 (2021)
  • Dentistry Journal, Vol. 9, Pages 80: Effects of Extraoral Suction on
           Droplets and Aerosols for Infection Control Practices

    • Authors: Hidenobu Senpuku, Masahiko Fukumoto, Toshikazu Uchiyama, Chieko Taguchi, Itaru Suzuki, Kazumune Arikawa
      First page: 80
      Abstract: Dental professionals are at increased risk of being infected with airborne pathogens such as SARS-CoV-2 because they are often exposed to droplets/aerosols production during dental treatment. To scientifically clear the effects of extraoral and oral suctions on the droplets and aerosols produced by dental treatments using an ultrasonic scaler was analyzed. The adenosine triphosphate and bacteria in droplets and aerosols produced during simulated scaling were quantitatively observed by reactions with luciferin/luciferase and incubation in culture plates to grow bacteria, respectively. The protection against spreading droplets and aerosols by oral and extraoral suctions was recognized, and the areas were limited to the left and posterior sides of the dental chair head when a right-handed dentist and dental hygienist performed scaling. Extraoral suction is a very useful tool for reducing the infection risk of COVID-19 in dental care, but the effective area is limited depending on physical characteristics of dentist and dental hygienist.
      Citation: Dentistry Journal
      PubDate: 2021-07-07
      DOI: 10.3390/dj9070080
      Issue No: Vol. 9, No. 7 (2021)
  • Dentistry Journal, Vol. 9, Pages 81: Compound Odontoma Removed by
           Endoscopic Intraoral Approach: Case Report

    • Authors: Masakazu Hamada, Rena Okawa, Kyoko Nishiyama, Ryota Nomura, Narikazu Uzawa, Kazuhiko Nakano
      First page: 81
      Abstract: A 12-year-old Japanese boy was referred to our hospital for evaluation of a radiopaque area on the left side of the mandible. Radiographic and computed tomographic examinations revealed a radiopaque lesion located on the lingual side, along with permanent tooth eruption. Several small tooth-like structures were noted within the lesion and the mandibular left second premolar was inclined in a mesial direction. An odontoma was clinically diagnosed and surgical removal by an endoscopic intraoral approach under general anesthesia was planned. Reports of oral surgery using an endoscopic approach have been presented, though none for an odontoma. With the expectation that removal of the odontoma would improve dentition in this case, we planned future management. A minimally invasive surgical removal procedure by an endoscopic intraoral approach from the lingual side was performed and good early recovery was noted. The resected tumor consisted of several small tooth-like structures. Histopathological diagnosis was a compound odontoma. One-year follow-up findings showed that the post-surgical course was good.
      Citation: Dentistry Journal
      PubDate: 2021-07-07
      DOI: 10.3390/dj9070081
      Issue No: Vol. 9, No. 7 (2021)
  • Dentistry Journal, Vol. 9, Pages 58: Profiling of Microbiota at the Mouth
           of Bottles and in Remaining Tea after Drinking Directly from Plastic
           Bottles of Tea

    • Authors: Anna Wakui, Hiroto Sano, Yuka Hirabuki, Miho Kawachi, Ayaka Aida, Jumpei Washio, Yuki Abiko, Gen Mayanagi, Keiko Yamaki, Kaori Tanaka, Nobuhiro Takahashi, Takuichi Sato
      First page: 58
      Abstract: It has been speculated that oral bacteria can be transferred to tea in plastic bottles when it is drunk directly from the bottles, and that the bacteria can then multiply in the bottles. The transfer of oral bacteria to the mouth of bottles and bacterial survival in the remaining tea after drinking directly from bottles were examined immediately after drinking and after storage at 37 °C for 24 h. Twelve healthy subjects (19 to 23 years of age) were asked to drink approximately 50 mL of unsweetened tea from a plastic bottle. The mouths of the bottles were swabbed with sterile cotton, and the swabs and the remaining tea in the bottles were analyzed by anaerobic culture and 16S rRNA gene sequencing. Metagenomic analysis of the 16S rRNA gene was also performed. The mean amounts of bacteria were (1.8 ± 1.7) × 104 colony-forming units (CFU)/mL and (1.4 ± 1.5) × 104 CFU/mL at the mouth of the bottles immediately after and 24 h after drinking, respectively. In contrast, (0.8 ± 1.6) × 104 CFU/mL and (2.5 ± 2.6) × 106 CFU/mL were recovered from the remaining tea immediately after and 24 h after drinking, respectively. Streptococcus (59.9%) were predominant at the mouth of the bottles immediately after drinking, followed by Schaalia (5.5%), Gemella (5.5%), Actinomyces (4.9%), Cutibacterium (4.9%), and Veillonella (3.6%); the culture and metagenomic analyses showed similar findings for the major species of detected bacteria, including Streptococcus (59.9%, and 10.711%), Neisseria (1.6%, and 24.245%), Haemophilus (0.6%, and 15.658%), Gemella (5.5%, and 0.381%), Cutibacterium (4.9%, and 0.041%), Rothia (2.6%, and 4.170%), Veillonella (3.6%, and 1.130%), Actinomyces (4.9%, and 0.406%), Prevotella (1.6%, and 0.442%), Fusobacterium (1.0%, and 0.461%), Capnocytophaga (0.3%, and 0.028%), and Porphyromonas (1.0%, and 0.060%), respectively. Furthermore, Streptococcus were the most commonly detected bacteria 24 h after drinking. These findings demonstrated that oral bacteria were present at the mouth of the bottles and in the remaining tea after drinking.
      Citation: Dentistry Journal
      PubDate: 2021-05-21
      DOI: 10.3390/dj9060058
      Issue No: Vol. 9, No. 6 (2021)
  • Dentistry Journal, Vol. 9, Pages 59: Cold Atmospheric Plasma Improves
           Shear Bond Strength of Veneering Composite to Zirconia

    • Authors: Oskar Bunz, Paul Kalz, Carla I. Benz, Ella A. Naumova, Wolfgang H. Arnold, Andree Piwowarczyk
      First page: 59
      Abstract: Chipping of veneering is the most common clinical complication for zirconia restorations. Veneering composite could be a promising alternative to renew restorations. Zirconia discs (3-YSZ) were prepared with varying surface treatments and bonded to indirect composite as follows: air abrasion and Scotchbond Universal (A/SU); air abrasion and Clearfil Ceramic Primer (A/C); air abrasion and MKZ Primer (A/M); air abrasion and Monobond Plus (A/MP); silica-coating and Scotchbond Universal (S/SU); air abrasion (AP/SU), additional cold atmospheric plasma treatment, and Scotchbond Universal. An indirect composite material was then applied to the zirconia specimens. Specimens were divided into subgroups for short-term (14 days storage at 37 °C and 5000 thermal cycles) and long-term (250 days storage and 37,500 thermal cycles) artificial aging. Shear bond strength measurement (SBS) was performed, and data were analyzed by Kruskal–Wallis-test and multiple comparison testing with Dunn’s correction (p ≤ 0.05). The median SBS values (MPa) of short- and long-term artificial aging were: 3.09/1.36 (A/SU); 0.77/1.43 (S/SU); 2.82/2.15 (AP/SU); 1.97/1.80 (A/C); 2.01/1.58 (A/M); and 1.70/1.68 (A/MP). For short-term artificial aging A/SU showed the highest median SBS values, whereas in the long-term trial, AP/SU showed the highest values and the difference was significant. A prolonged artificial aging decreased SBS in all groups, except S/SU. In summary, treatment with CAP can improve SBS in the long-term.
      Citation: Dentistry Journal
      PubDate: 2021-05-21
      DOI: 10.3390/dj9060059
      Issue No: Vol. 9, No. 6 (2021)
  • Dentistry Journal, Vol. 9, Pages 60: Survival of Single-Unit
           Porcelain-Fused-to-Metal (PFM) and Metal Crowns Placed by Students at an
           Australian University Dental Clinic over a Five-Year Period

    • Authors: Chris Carey, Nick Del Din, Jessica Lamb, Hazel Wright, Nigel D. Robb, Menaka Abuzar
      First page: 60
      Abstract: The aim of this retrospective study was to determine the survival rate of single-unit porcelain-fused-to-metal (PFM) and metal crowns placed by dental students at an Australian university undergraduate dental clinic over a five-year period. Complications and the incidences of crown failures were recorded. Clinical records pertaining to single-unit PFM and metal crowns inserted over a five-year period were reviewed, including patient-related, tooth-related, and procedural factors for each crown. Crowns were evaluated as surviving, surviving with complications, or failed. Kaplan–Meier statistical analysis was used to estimate survival rate., This study is based on a sample of 232 (78.4%) PFM crowns and 64 (21.6%) metal crowns inserted between 2014 and 2018. Cumulatively, 224 (75.7%) were surviving, 48 (16.2%) were surviving but previously had complications, and 24 (8.1%) failed. The 5-year cumulative survival rate of all PFM and metal crowns was 83.9% (0.839 ± 0.038, Kaplan–Meier). The average survival time for all crowns was 4.432 ± 0.089 years. Comparatively, PFM crowns had a higher survival rate at 1 year (0.972 ± 0.010) and 2 years (0.919 ± 0.017), compared to metal crowns at 1 year (0.964 ± 0.011) and 2 years (0.894± 0.018). The survival rate of metal crowns remained constant from 2 years to 4 years and thereafter, whereas there was a continued decline in the survival rate of PFM crowns to 83.2% (0.832 ± 0.038) at 4 years and thereafter. Crowns placed on premolars had the highest cumulative survival rate whereas those placed on molars exhibited the lowest survival rate for the duration of the study period. Despite single-unit PFM crowns having a higher 1- and 2-year survival rate compared to metal crowns, metal crowns had a higher survival rate at 4 years and thereafter. Survival rates are comparable to previous studies.
      Citation: Dentistry Journal
      PubDate: 2021-05-28
      DOI: 10.3390/dj9060060
      Issue No: Vol. 9, No. 6 (2021)
  • Dentistry Journal, Vol. 9, Pages 61: Osteoconductivity of Bovine Xenograft
           Granules of Different Sizes in Sinus Lift: A Histomorphometric Study in

    • Authors: Eduardo Pires Godoy, Karol Alí Apaza Alccayhuaman, Daniele Botticelli, Andrea Amaroli, Vitor Ferreira Balan, Erick Ricardo Silva, Samuel Porfirio Xavier
      First page: 61
      Abstract: Background: Due to the lack of data on bone-to-graft contact (BGC) over time in the various regions within the subantral space of the augmented sinus floor, the present study aimed to evaluate the osteoconductivity of deproteinized bovine bone mineral (DBBM) with granules of different sizes applied in maxillary sinus floor elevation. Methods: A maxillary sinus augmentation was performed bilaterally in 18 rabbits using DBBM with particle dimensions of either 0.125–1.0 mm or 1–2 mm. The antrostomy was covered using a collagen barrier. The animals were euthanized in groups of six after 2, 4, and 8 weeks of healing. MicroCT and histological analyses were performed. Results: After 2 weeks of healing, BGC was 10.9% and 11.9% for the small and large granule sites, respectively. After 8 weeks of healing, the BGC increased to 65% and 62% at the small and large granule sites, respectively. The highest values were located close to the bony walls and the bony window. New bone content developed between 2 and 8 weeks from 7.0% to 27.6% and from 6.1% to 27.6% at the small and large granule sites, respectively. Conclusions: Similar outcomes in osteoconductivity and bone formation were found at both small and large DBBM granule sites.
      Citation: Dentistry Journal
      PubDate: 2021-05-31
      DOI: 10.3390/dj9060061
      Issue No: Vol. 9, No. 6 (2021)
  • Dentistry Journal, Vol. 9, Pages 62: Time Efficiency of Digitally and
           Conventionally Produced Single-Unit Restorations

    • Authors: Sofia Stromeyer, Daniel Wiedemeier, Albert Mehl, Andreas Ender
      First page: 62
      Abstract: The purpose of this in vitro study was to compare the time efficiency of digital chairside and labside workflows with a conventional workflow for single-unit restorations. The time efficiency in this specific sense was defined as the time, which has to be spent in a dental office by a dental professional performing the relevant steps. A model with interchangeable teeth on position 36 was created. These teeth were differently prepared, responding to several clinical situations to perform single-unit restorations. Different manufacturing techniques were used: For the digital workflows, CEREC Omnicam (CER) and Trios 3 (TN/TI) were used. The conventional workflow, using a dual-arch tray impression technique, served as the control group. For the labside workflow (_L) and the conventional impression procedure (CO), the time necessary for the impressions and temporary restorations was recorded and served as operating time. The chairside workflow time was divided by the time for the entire workflow (_C) including scan, design, milling and finishing the milled restoration, and in the actual working time (_CW) leaving out the chairside milling of the restoration. Labside workflow time ranged from 9 min 27 s (CER_L) to 12 min 41 s (TI_L). Entire chairside time ranged from 43 min 35 s (CER_C) to 58 min 43 s (TI_C). Pure chairside working time ranged from 15 min 21 s (CER_CW) to 23 min 17 s (TI_CW). Conventional workflow time was 10 min 39 s (CO) on average. The digital labside workflow and the conventional workflow require a similar amount of time. The digital chairside workflow is more time consuming.
      Citation: Dentistry Journal
      PubDate: 2021-06-01
      DOI: 10.3390/dj9060062
      Issue No: Vol. 9, No. 6 (2021)
  • Dentistry Journal, Vol. 9, Pages 63: Integration of Dental Implants in
           Conjunction with EDTA-Conditioned Dentin Grafts: An Experimental Study

    • Authors: Payam Farzad, Ted Lundgren, Adel Al-Asfour, Lars Andersson, Christer Dahlin
      First page: 63
      Abstract: This study was undertaken to investigate the integration of titanium micro-implants installed in conjunction with previously dentin-grafted areas and to study the morphological appearance, mineral content, and healing pattern of xenogenic EDTA-conditioned dentin blocks and granules grafted to cavities in the tibial bone of rabbits. Demineralized and non-demineralized dentin blocks and granules from human premolars were implanted into cavities prepared on the lateral aspects of the tibias of rabbits. After a healing period of six months, micro-implants were installed at each surgical site. Histological examinations were carried out after 24 weeks. Characterization of the EDTA-conditioned dentin blocks was performed by means of light microscopy, dental X-rays, scanning electron microscopy, and energy dispersive X-ray analysis (EDX). No implants were found to be integrated in direct contact with the dentin particles or blocks. On the EDTA-conditioned dentin surface, the organic marker elements C and N dominated, as revealed by EDX. The hydroxyapatite constituents Ca and P were almost absent on the dentin surface. No statistically significant difference was observed between the EDTA-conditioned and non-demineralized dentin, as revealed by BIC and BA. The bone-inductive capacity of the dentin material seemed limited, although demineralization by means of EDTA indicated higher BIC and BA values in conjunction with the installed implants in the area. A 12 h EDTA treatment did not fully decalcify the grafts, as revealed by X-ray analysis.
      Citation: Dentistry Journal
      PubDate: 2021-06-01
      DOI: 10.3390/dj9060063
      Issue No: Vol. 9, No. 6 (2021)
  • Dentistry Journal, Vol. 9, Pages 64: Fluoride Varnishes for Preventing
           Occlusal Dental Caries: A Review

    • Authors: Alaa Baik, Najlaa Alamoudi, Azza El-Housseiny, Amani Altuwirqi
      First page: 64
      Abstract: Dental caries are most likely to occur on occlusal surfaces from the early eruptive stages of the tooth. In children, about 80% to 90% of dental caries are occlusal caries. Different preventive modalities are used to prevent occlusal caries. One of the methods used for occlusal caries prevention is fluoride varnish. A vast number of clinical trials have evaluated several types of sealant material and fluoride varnish to assess their ability to prevent occlusal caries in both primary and permanent dentition. The purpose of the current study was to provide an updated overview of the development, composition, mechanism of action, application, and safety of fluoride varnish, as well as its effect on occlusal caries prevention. This review of recently published studies on fluoride varnish and its effect on occlusal caries prevention shows that in children at moderate to high risk of caries, fluoride varnishes prevent occlusal caries. Both resin-based fissure sealants and fluoride varnish are effective for occlusal caries prevention for first-permanent molars. However, it was not possible to identify which one has the best effect. It is recommend that fluoride varnish is applied for children at high risk of caries two to four times per year.
      Citation: Dentistry Journal
      PubDate: 2021-06-03
      DOI: 10.3390/dj9060064
      Issue No: Vol. 9, No. 6 (2021)
  • Dentistry Journal, Vol. 9, Pages 65: Maxillary Sinus Augmentation Using
           Ceramic Alloplastic Granules or Paste: An Experimental Study in Rabbits

    • Authors: Michael Medeiros Costa, Daniele Botticelli, Ofer Moses, Yuki Omori, Shigeo Fujiwara, Erick Ricardo Silva, Samuel Porfirio Xavier
      First page: 65
      Abstract: Background: Due to the lack of data comparing the biological behavior of two formulations, granules and paste, of alloplastic graft from microtomographic and histomorphometric points of view, the aim of the present experiment was to compare the histomorphometric and microtomographic healing of two formulations, i.e., granules (MR sites) or paste (MR-inject sites) of an alloplastic graft composed of a combination of beta-tricalcium phosphate and hydroxyapatite used for maxillary sinus lifting. Methods: A sinus lifting procedure was carried out bilaterally in 20 rabbits, and the elevated space was filled with either paste or granules of an alloplastic material. A collagen membrane was placed on the antrostomy and the animals were euthanized after 2 or 10 weeks, 10 animals each group. Microtomographic and histological analyses were performed. Results: Higher proportions of new bone formation were found at the MR, compared to the MR-inject sites both after 2 weeks (2.65 ± 2.89% vs. 0.08 ± 0.12%; p < 0.01) and 10 weeks of healing (34.20 ± 13.86 vs. 23.28 ± 10.35%; p = 0.022). Conclusions: It was concluded that new bone formation was faster in the MR sites, compared to the MR-inject. However, a longer time of healing should be allowed to make final conclusions about the efficiency in bone formation of the paste formulation of the biomaterial used in the present study.
      Citation: Dentistry Journal
      PubDate: 2021-06-03
      DOI: 10.3390/dj9060065
      Issue No: Vol. 9, No. 6 (2021)
  • Dentistry Journal, Vol. 9, Pages 66: Uncovering and Autonomous Eruption of
           Palatally Impacted Canines—A Case Report

    • Authors: Alessandra Impellizzeri, Martina Horodynski, Emanuela Serritella, Gaspare Palaia, Adriana De Stefano, Antonella Polimeni, Gabriella Galluccio
      First page: 66
      Abstract: The impaction of permanent maxillary canine is a common clinical occurrence, and it is observed in 2% of patients who require orthodontic treatment. This case report describes a new orthodontic-surgical approach through the use of CO2 laser, for the exposure of the palatally impacted canines. A 13-year-old female referred to our observation to make an orthodontic examination because of the maxillary primary canines’ persistence in upper arch. Orthopanoramic X-ray showed impaction of both permanent maxillary canines. The family history revealed that the patient’s mother had the same orthodontic problem. Cone Beam Computer Tomography (CBCT) was requested to plan the surgical-orthodontic treatment. Surgical exposure of the impacted canines was performed using a CO2 laser and subsequent periodontal pack application. No orthodontic devices were applied for impacted teeth traction on dental arch. Canines’ movement was monitored at 1, 8 and 16 weeks post-surgery with photo and intraoral scanner CS3500 (CS3500®, Carestream Health, Atlanta, GA, USA). When canine crowns were completely erupted on palatal side, the alignment in the arch with indirect bonding technique was performed. Complete disimpaction of canine crowns was obtained in only four months. As reported in the literature, this case confirms that impacted canines’ exposure to CO2 laser has advantages if compared with traditional surgery: no bleeding during and after the procedure, decontaminant effect on the surgical area, no suture, and a fast spontaneous eruption. Conclusions: The pre-orthodontic uncovering and autonomous eruption of palatally impacted maxillary canines provides simplified, predictable, and more aesthetic outcomes. Furthermore, a significant positive factor is that there is no need to carry out the orthodontic traction of the impacted element, undoubtedly better compliance by the patient during the next alignment phase with the fix orthodontic appliance.
      Citation: Dentistry Journal
      PubDate: 2021-06-09
      DOI: 10.3390/dj9060066
      Issue No: Vol. 9, No. 6 (2021)
  • Dentistry Journal, Vol. 9, Pages 67: Antibacterial Ability of Sodium
           Hypochlorite Activated with PUI vs. XPF File against Bacteria Growth on
           Enterococcus faecalis Mature Biofilm

    • Authors: Nerea Herce-Ros, Alejandro Álvarez-Sagües, Laura Álvarez-Losa, Estanislao Nistal-Villan, Ulises Amador, Jesús Presa, Magdalena Azabal
      First page: 67
      Abstract: The objectives of the present study were to assess the antibacterial effectiveness of two sodium hypochlorite (NaOCl) concentrations (2.5% and 5.25%) activated by means of two techniques, passive ultrasonic irrigation (PUI) and XP-endo® Finisher (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) (XPF) against bacteria growth in intracanal mature biofilm. Our aim was to determine if the effect of heating up NaOCl at body temperature (BT) contributed to an improvement of the efficacy of XPF. Sixty-two single-canal human roots previously instrumented were infected with E. faecalis inoculum at 0.5 McFarland and incubated at 37 °C for two weeks. Twelve specimens were randomly selected as positive control, and the remaining fifty were divided into five experimental groups (n = 10). The first two were irrigated with 2.5 vs. 5.25% NaOCl at room temperature (RT), activated with PUI, and the other three were irrigated with XPF. Of these three, two were irrigated using 2.5 vs. 5.25% NaOCl at RT and one was irrigated with 5.25% NaOCl at BT. Our results showed that NaOCl was effective in biofilm removal for all experimental groups (p > 0.05), especially in the groups irrigated with 5.25% NaOCl at room temperature (RT) activated with PUI and the group treated with 5.25% NaOCl at BT with XPF. These groups were the most successful ones (p < 0.001). NaOCl, activated with XPF, was as effective as PUI in biofilm removal from the apical third of the canal when it was used at higher concentration and heated up. This study indicates that XPF only reached the efficacy of PUI when NaOCl was heated up.
      Citation: Dentistry Journal
      PubDate: 2021-06-10
      DOI: 10.3390/dj9060067
      Issue No: Vol. 9, No. 6 (2021)
  • Dentistry Journal, Vol. 9, Pages 68: Understanding Motor Skill Learning as
           Related to Dentistry

    • Authors: Mohamed El-Kishawi, Khaled Khalaf, Tracey Winning
      First page: 68
      Abstract: Learning dental procedures is a complex task involving the development of fine motor skills. The reported use of theories and/or evidence for designing learning activities to develop the fine motor skills needed for dental practice is limited. The aim of this review is to explore the available body of knowledge related to learning motor skills relevant to dentistry. Evidence from studies investigating motor skill learning highlights the negative impact of self-focus and self-regulation on learning outcomes, particularly during the early stages of learning. The development of activities and schedules that enable novices to demonstrate characteristics similar to experts, without the reported long period of ‘deliberate practice’, is clearly of value. Outcomes of learning implicitly are important in dentistry because working under stressful conditions is common, either during undergraduate study or in practice. It is suggested that learning implicitly in the simulation stage can reduce disrupted performance when transitioning to clinical settings. Therefore, further investigation of effective methods for learning dental fine motor skills is indicated, using approaches that result in robust performance, even under stressful conditions.
      Citation: Dentistry Journal
      PubDate: 2021-06-11
      DOI: 10.3390/dj9060068
      Issue No: Vol. 9, No. 6 (2021)
  • Dentistry Journal, Vol. 9, Pages 69: The Best Dentistry Professional
           Visual Acuity Measured under Simulated Clinical Conditions Provides
           Keplerian Magnification Loupe: A Cross-Sectional Study

    • Authors: Iris Urlic, Josip Pavan, Zeljko Verzak, Zoran Karlovic, Dubravka Negovetic Vranic
      First page: 69
      Abstract: Visual acuity plays an important role in dentists’ vision in their daily clinical routine. This study aimed to determine dental students’ visual acuity without optical aids and when using magnification devices in simulated clinical conditions. The participants were forty-six students at the School of Dental Medicine with a visual acuity of 1.0 in decimal values or 100% in percentage. The central visual acuity was tested using a miniature Snellen eye chart placed in the molar cavity of a dental phantom, in simulated clinical conditions under five different settings (natural visual acuity, by applying head magnifying glasses x1,5 and binocular magnifying devices using Galileo’s x2,5/350 mm, Keplerx3,3/450 mm and Keplerx4,5/350 mm optical system). The Wilcoxon Signed Rank test shows that the distribution of measurements of the visual acuity undertaken by the application of magnifying devices (VNL, VGA2,5, VKP3,3, VKP4,5) contained higher values of visual acuity than those received by the use of natural vision (VSC) (p < 0.001 for the comparison to the VNL, VGA2,5, VKP3,3 and VKP4,5 groups). The highest and statistically most significant increase in visual acuity is achieved using the Keplerian telescope x4.5/350 mm. The application of magnifying devices provided dentistry professionals with better visual acuity, improving detail detection in an oral cavity during dental procedures by magnifying the oral structure. The use of magnification devices means much more precise work, decreases the operating time, improves posture and reduces muscle pain in the shoulder during dental treatment.
      Citation: Dentistry Journal
      PubDate: 2021-06-11
      DOI: 10.3390/dj9060069
      Issue No: Vol. 9, No. 6 (2021)
  • Dentistry Journal, Vol. 9, Pages 70: Effects of Different Application
           Times of Silver Diamine Fluoride on Mineral Precipitation in Demineralized

    • Authors: Surapong Srisomboon, Matana Kettratad, Phakkhananan Pakawanit, Catleya Rojviriya, Prathip Phantumvanit, Piyaphong Panpisut
      First page: 70
      Abstract: Silver diamine fluoride (SDF) is a cost-effective method for arresting active dental caries. However, the limited cooperation of patients may lead to an SDF application time that is shorter than the recommended 1–3 min for carious lesions. Therefore, the aim of this study was to assess the effect of different application times of SDF on the degree of mineral precipitation in demineralized dentin. Demineralized dentin specimens from permanent maxillary molars were treated by applying 38% SDF for 30, 60, or 180 s. Water was applied in the control group. The specimens were immersed in simulated body fluid for 2 weeks, and the mineral precipitation in demineralized dentin was then analyzed using FTIR-ATR, SEM-EDX, and synchrotron radiation X-ray tomographic microscopy (SRXTM). The FTIR-ATR results showed a significant increase in mineral precipitation in the 180 s group after 1 week. However, after 2 weeks, the SRXTM images indicated comparable mineral density between the 30, 60, and 180 s groups. The precipitation of silver chloride and calcium phosphate crystals that occluded dentinal tubules was similar in all experimental groups. In conclusion, an application time of either 30, 60, or 180 s promoted a comparable degree of mineral precipitation in demineralized dentin.
      Citation: Dentistry Journal
      PubDate: 2021-06-14
      DOI: 10.3390/dj9060070
      Issue No: Vol. 9, No. 6 (2021)
  • Dentistry Journal, Vol. 9, Pages 71: A Short Form of the Children’s
           Experiences of Dental Anxiety Measure (CEDAM): Validation and Evaluation
           of the CEDAM-8

    • Authors: Jenny Marie Porritt, Annie Morgan, Helen Rodd, Fiona Gilchrist, Sarah R. Baker, Tim Newton, Zoe Marshman
      First page: 71
      Abstract: Background: The Children’s Experiences of Dental Anxiety Measure (CEDAM-14) is a child-centred measure of dental anxiety which assesses a range of behaviours, thoughts and feelings/physical symptoms related to dental anxiety. A short form of the CEDAM-14, which places less time burden on patients and clinicians, could promote the feasibility and applicability of the CEDAM in clinical settings. The aim of the study was to develop a short version of the CEDAM that can be used to assess children’s dental anxiety in clinical practice. Methods: A short version of the CEDAM was developed using a combination of item impact and regression methods. Measurement properties including floor/ceiling effects, variance, criterion validity, construct validity and internal consistency was calculated for the short form. Results: An eight-item CEDAM short form was developed (CEDAM-8) that had good psychometric properties, was significantly correlated with the CEDAM measure (r = 0.90; p < 0.01), had minimal floor and ceiling effects (3.5% and 1.2%, respectively) and was sensitive to change. Conclusion: The CEDAM-8 is a useful assessment tool for clinicians that is easy and quick to administer and could help to understand children’s experiences of dental anxiety and changes in anxiety over time and following intervention.
      Citation: Dentistry Journal
      PubDate: 2021-06-15
      DOI: 10.3390/dj9060071
      Issue No: Vol. 9, No. 6 (2021)
  • Dentistry Journal, Vol. 9, Pages 72: External Root Resorption Management
           of an Avulsed and Reimplanted Central Incisor: A Case Report

    • Authors: Gianni Di Giorgio, Alessandro Salucci, Gian Luca Sfasciotti, Flavia Iaculli, Maurizio Bossù
      First page: 72
      Abstract: Background: Avulsion and reimplantation of permanent teeth represent a major challenge in terms of treatment and long-term prognosis. The present study reported clinical management of external root resorption of an avulsed and reimplanted maxillary central incisor. Case report: A 9-year-old boy reported an uncomplicated crown fracture and avulsion of tooth 11 and complicated crown fracture of tooth 21 due to trauma. Reimplantation of element 11 was obtained within 30 min post-trauma and 3 days after both elements were diagnosed with necrotic pulp. In addition, tooth 11 showed early external root resorption. Both elements underwent endodontic treatment and root closure with apical plug using calcium-silicate-based cement. At 6-month follow-up root resorption appeared to be arrested. Twenty-four months after trauma the clinical results were stable, although signs and symptoms of ankylosis were observed. Conclusions: An immediate endodontic approach and use of calcium-silicate-based cement seemed to contrast the progression of root resorption of an avulsed and reimplanted central incisor after 24 months of follow-up.
      Citation: Dentistry Journal
      PubDate: 2021-06-16
      DOI: 10.3390/dj9060072
      Issue No: Vol. 9, No. 6 (2021)
  • Dentistry Journal, Vol. 9, Pages 73: Molecular Screening and Analysis
           Reveal Novel Oral Site-Specific Locations for the Cariogenic Pathogen
           Scardovia wiggsiae

    • Authors: Steven McDaniel, Jaydene McDaniel, Katherine M. Howard, Karl Kingsley
      First page: 73
      Abstract: Introduction: Scardovia wiggsiae (SW) is a newly identified cariogenic pathogen associated with severe early childhood caries and oral disease. New studies have confirmed the presence of this organism among clinical samples from both pediatric and adult patients. However, the recent discovery of this organism has left researchers with only limited information available regarding the prevalence of this organism—and virtually no information regarding oral site-specific locations. Based upon this lack of information, the overall objective of this study was to perform an oral site-specific analysis of SW prevalence from clinical samples. Methods: Using an approved human subjects protocol, samples (n = 60) from an existing saliva and site-specific biorepository were identified and screened for SW presence using quantitative polymerase chain reaction (qPCR). These data were summarized and subsequently analyzed for correlations with demographic (age, sex, race or ethnicity) or clinical (body mass index or BMI, primary/mixed/permanent dentition, orthodontic brackets) variables. Results: These data revealed that average DNA concentrations from all sample sites (saliva, dorsum of tongue, gingival crevicular fluid (GCF), biofilm of upper buccal molar, and biofilm of lower lingual incisor) ranged between 13.74 and 14.69 μg/μL, with an overall average of 14.30 μg/μL ± 1.12 (standard error or SE). qPCR screening revealed a total of n = 34/60 or 56.7% of patient samples harboring SW. A total of n = 71/170 specific oral sites harbored this organism, with the majority of the SW-positive participant samples harboring SW at more than one oral site, n = 22/34 or 64.7%, including non-traditional sites such as GCF and the dorsum of the tongue. Weak correlations were found between specific SW outcomes in GCF and type of dentition (permanent; R = 0.2444), as well as SW outcomes in saliva with age (R = 0.228) and presence of orthodontic brackets (R = 0.2118). Conclusions: This study may be among the first to provide oral site-specific analysis to reveal the prevalence and location of Scardovia among clinical patient samples. Moreover, these data also provide some of the first evidence to suggest this organism may be present not only in traditional supragingival tooth-associated biofilm sites, but also in non-traditional oral sites including the dorsum of the tongue and the gingival crevice. Based upon these results, these data may represent a significant advance in our understanding of the potential sites and locations that harbor this organism and may help contribute to our understanding of the prevalence, distribution and potential for the development of oral disease among clinic patients.
      Citation: Dentistry Journal
      PubDate: 2021-06-17
      DOI: 10.3390/dj9060073
      Issue No: Vol. 9, No. 6 (2021)
  • Dentistry Journal, Vol. 9, Pages 55: Conservative Non-Surgical Management
           of Horizontal Root-Fractured Maxillary Incisors in a Young Male with Angle
           Class II, Division 2, Malocclusion

    • Authors: Roberto Biagi, Giulia Bardini, Giuseppe Guidazzi, Enrico Spinas
      First page: 55
      Abstract: Horizontal root fractures are a rare emergency in a dental office. The injury involves periodontal ligament, cementum, dentine and pulp. The healing is influenced by the location of the root fracture, the displacement of the fragments and the status of the pulp. This report presents a clinical case of horizontal fractures to both maxillary central incisors due to an act of violence. The type of occlusion has avoided a severe diastasis of the coronal parts with a subsequent damage to the pulp and periodontum. The fractures were treated with an orthodontic splint without any further therapy and hard tissue healing was observed. A careful diagnosis and well-timed treatment planning usually allow a cost-efficient and biologically-oriented therapy with a favorable outcome.
      Citation: Dentistry Journal
      PubDate: 2021-05-12
      DOI: 10.3390/dj9050055
      Issue No: Vol. 9, No. 5 (2021)
  • Dentistry Journal, Vol. 9, Pages 56: Psychometric Characteristics of Oral
           Pathology Test Items in the Dental Hygiene Curriculum—A Longitudinal

    • Authors: Mythily Srinivasan
      First page: 56
      Abstract: As the landscape of oral healthcare and the delivery of services continue to undergo change, the dental hygienist plays an increasing role in assisting dentists with oral diagnosis and preventive strategies. Hence, the dental hygiene curriculum standards require biomedical science instructions, including general and oral pathology. Student learning and cognitive competencies are often measured using multiple-choice questions (MCQs). The objectives of this study were to perform a longitudinal analysis of test items and to evaluate their relation to the absolute grades of the oral pathology course in the dental hygiene curriculum. A total of 1033 MCQs covering different concepts of oral pathology administered from 2015 through 2019 were analyzed for difficulty and discriminatory indices, and the differences between the years were determined by one-way ANOVA. Test reliability as determined by the average KR-20 value was 0.7 or higher for each exam. The mean difficulty index for all exams was 0.73 +/− 0.05, and that of the discriminatory index was 0.33 +/− 0.05. Wide variations were observed in the discriminatory indices of test items with approximately the same difficulty index, as well as in the grade distribution in each cohort. Furthermore, longitudinal data analyses identified low achieving cohorts amongst the groups evaluated for the same knowledge domain, taught with the same instruction, and using similar test tools. This suggest that comparative analyses of tests could offer feedback not only on student learning attributes, but also potentially on the admission processes to the dental hygiene program.
      Citation: Dentistry Journal
      PubDate: 2021-05-13
      DOI: 10.3390/dj9050056
      Issue No: Vol. 9, No. 5 (2021)
  • Dentistry Journal, Vol. 9, Pages 57: Peer Mentoring as a Tool for
           Developing Soft Skills in Clinical Practice: A 3-Year Study

    • Authors: Antonio M. Lluch, Clàudia Lluch, María Arregui, Esther Jiménez, Luis Giner-Tarrida
      First page: 57
      Abstract: Education currently focuses on improving academic knowledge and clinical skills, but it is also important for students to develop personal and interpersonal skills from the start of their clinical practice. The aim was to evaluate the effect of peer mentoring in third-year students and to gauge the evolution of non-technical skills (NTS) acquisition up to the fifth year. The study groups were selected between September 2015 and May 2018, based on the NTS training they had or had not received: (1) fifth-year students with no training (G1); (2) third-year students mentored in NTS (G2a); and (3) a small group of fifth-year students who became mentors (G2b). A total of 276 students who took part in this study were assessed using a 114-item self-evaluation questionnaire. Data were collected from seven surveys conducted between September 2015 and May 2018, and statistical analysis was performed using one-way ANOVA and Fisher’s post-hoc test. G2a improved their non-technical skill acquisition over three years of clinical training up to their fifth year. This group and G2b showed statistically significant differences compared to non-mentored students (G1). Peer mentoring at the beginning of clinical practice is a valid option for training students in non-technical skills.
      Citation: Dentistry Journal
      PubDate: 2021-05-17
      DOI: 10.3390/dj9050057
      Issue No: Vol. 9, No. 5 (2021)
  • Dentistry Journal, Vol. 9, Pages 139: Adjunctive Effect of Green Tea
           Mouthwash Prepared at Different Steeping Temperatures on Gingivitis: A
           Triple-Blind Randomized Controlled Clinical Trial

    • Authors: Hani T. Fadel, Alhanouf M. AlRehaili, Mona M. AlShanqiti, Afnan A. Alraddadi, Alhanouf M. Albolowi
      First page: 139
      Abstract: Purpose: To compare the effect of green tea mouthwashes prepared at different steeping temperatures as adjuncts to mechanical plaque control on gingivitis. Methods: Forty-five women with gingivitis participated in this 4-week randomized controlled clinical trial. They received professional mechanical plaque control and rinsed daily with either warm green tea, hot–cold green tea or placebo. Dental plaque control record (PCR) and gingival bleeding indices (GBI) were recorded at baseline and 7, 14 and 28 days after. Results: Participants’ mean age was 20.7 ± 2 years. The mean scores for the PCR and GBI at baseline were 82.4 ± 19 and 85.8 ± 7, respectively. All groups showed significant reduction in PCR and GBI between Days 0 and 28 (p < 0.01). No significant differences in PCR were observed between the groups at any of the examinations (p > 0.01). The warm green tea group demonstrated significantly lower GBI at all examinations compared to the hot–cold group (p < 0.01). Conclusions: Within study limits, green tea-made mouthwashes significantly reduced plaque and gingivitis when used as adjuncts to mechanical plaque control. The green tea mouthwash prepared in warm water demonstrated significantly higher efficacy in lowering gingivitis compared to that prepared in hot water followed by ice.
      Citation: Dentistry Journal
      PubDate: 2021-11-30
      DOI: 10.3390/dj9120139
      Issue No: Vol. 9, No. 12 (2021)
  • Dentistry Journal, Vol. 9, Pages 140: Micro versus Macro Shear Bond
           Strength Testing of Dentin-Composite Interface Using Chisel and Wireloop
           Loading Techniques

    • Authors: Ahmed M. Ismail, Christoph Bourauel, Ahmed ElBanna, Tarek Salah Eldin
      First page: 140
      Abstract: Shear bond strength (SBS) testing is a commonly used method for evaluating different dental adhesive systems. Failure mode analysis provides valuable information for better interpretation of bond strength results. The aim of this study was to evaluate the influence of specimen dimension and loading technique on shear bond strength and failure mode results. Eighty macro and micro flowable composite cylindrical specimens of 1.8 and 0.8 mm diameter, respectively, and 1.5 mm length were bonded to dentinal substrate. Four study groups were created (n = 20): Macroshear wireloop, Gp1; Microshear wireloop, Gp2; Macroshear chisel, Gp3; and Microshear chisel, Gp4. They were tested for SBS using chisel and wireloop loading devices followed by failure mode analysis using digital microscopy and SEM. Two- and one-way ANOVA were used to compare stress at failure values of different groups while the Kruskal–Wallis test was used to compare between failure modes of the tested groups. Gp4 recorded the highest mean stress at failure 54.1 ± 14.1 MPa, and the highest percentage of adhesive failure in relation to the other groups. Specimen dimension and loading technique are important parameters influencing the results of shear bond strength. Micro-sized specimens and chisel loading are recommended for shear testing.
      Citation: Dentistry Journal
      PubDate: 2021-11-30
      DOI: 10.3390/dj9120140
      Issue No: Vol. 9, No. 12 (2021)
  • Dentistry Journal, Vol. 9, Pages 141: Using a Machine Learning Algorithm
           to Predict the Likelihood of Presence of Dental Caries among Children Aged
           2 to 7

    • Authors: Francisco Ramos-Gomez, Marvin Marcus, Carl A. Maida, Yan Wang, Janni J. Kinsler, Di Xiong, Steve Y. Lee, Ron D. Hays, Jie Shen, James J. Crall, Honghu Liu
      First page: 141
      Abstract: Background: Dental caries is the most common chronic childhood infectious disease and is a serious public health problem affecting both developing and industrialized countries, yet it is preventable in most cases. This study evaluated the potential of screening for dental caries among children using a machine learning algorithm applied to parent perceptions of their child’s oral health assessed by survey. Methods: The sample consisted of 182 parents/caregivers and their children 2–7 years of age living in Los Angeles County. Random forest (a machine learning algorithm) was used to identify survey items that were predictors of active caries and caries experience. We applied a three-fold cross-validation method. A threshold was determined by maximizing the sum of sensitivity and specificity conditional on the sensitivity of at least 70%. The importance of survey items to classifying active caries and caries experience was measured using mean decreased Gini (MDG) and mean decreased accuracy (MDA) coefficients. Results: Survey items that were strong predictors of active caries included parent’s age (MDG = 0.84; MDA = 1.97), unmet needs (MDG = 0.71; MDA = 2.06) and the child being African American (MDG = 0.38; MDA = 1.92). Survey items that were strong predictors of caries experience included parent’s age (MDG = 2.97; MDA = 4.74), child had an oral health problem in the past 12 months (MDG = 2.20; MDA = 4.04) and child had a tooth that hurt (MDG = 1.65; MDA = 3.84). Conclusion: Our findings demonstrate the potential of screening for active caries and caries experience among children using surveys answered by their parents.
      Citation: Dentistry Journal
      PubDate: 2021-12-01
      DOI: 10.3390/dj9120141
      Issue No: Vol. 9, No. 12 (2021)
  • Dentistry Journal, Vol. 9, Pages 142: Use of a Knowledge-Based Governance
           Approach to Plan a Post-COVID-19 Predoctoral Dental

    • Authors: Natasha M. Flake, Daniel C. N. Chan, Arthur C. DiMarco, Bruce D. Silverstein
      First page: 142
      Abstract: COVID-19 abruptly changed dental education, forcing educators out of their comfort zones and into using new technologies and teaching approaches. At the University of Washington School of Dentistry, a task force evaluated the curricular changes that resulted from COVID and made recommendations for the future predoctoral dental curriculum. This manuscript reports the process employed, the findings of the task force, and how these findings will impact the curriculum. A knowledge-based governance (KBG) approach was employed. KBG focuses on gathering all relevant information and identifying all choices. It separates dialogue from deliberation. Information was gathered via literature review, focus group interviews, electronic surveys, and other metrics. The task force evaluated: (1) delivering didactic content remotely; (2) administering assessments remotely; (3) duplicating preclinical simulation lab courses due to social distancing; and (4) the conversion from a numerical to a credit/no credit grading scale. Key recommendations resulted from focus groups and electronic surveys that allowed any student or faculty member an opportunity to provide input. Some topics were relatively non-controversial and strong recommendations were evident. The most controversial issue was which grading scale should be utilized. A KBG approach is an effective means to address mega issues in the dental school environment.
      Citation: Dentistry Journal
      PubDate: 2021-12-01
      DOI: 10.3390/dj9120142
      Issue No: Vol. 9, No. 12 (2021)
  • Dentistry Journal, Vol. 9, Pages 143: Antibacterial Activities of Methanol
           and Aqueous Extracts of Salvadora persica against Streptococcus mutans
           Biofilms: An In Vitro Study

    • Authors: Abdulrahman A. Balhaddad, Lamia Mokeem, Mary Anne S. Melo, Richard L. Gregory
      First page: 143
      Abstract: The use of herbal products in oral hygiene care has a long history, and their use is popular today. A tree stick, named Salvadora persica (S. persica), is commonly used to remove dental plaque and clean teeth in many countries. In addition, extracts of S. persica can be used as a mouthwash, as they demonstrate antimicrobial properties. This study aimed to investigate the antibacterial effect of S. persica methanol and aqueous extracts against Streptococcus mutans (S. mutans) biofilm. A S. mutans biofilm formation assay was conducted using different concentrations of S. persica methanol or water extracts in tryptic soy broth (TSB) supplemented with 1% sucrose. The biofilm was stained with crystal violet dye, and the absorbance was assessed to examine biofilm formation. One-way analysis of variance (ANOVA) and Tukey tests were used to analyze the results. The S. persica methanol extract displayed a significant inhibition (p ≤ 0.001) against the S. mutans biofilm. The 10 mg/mL concentration of the S. persica methanol extract was determined as the minimum biofilm inhibitory concentration (MBIC). The used methanol concentration, mixed with TSB supplemented with 1% sucrose and without the S. persica extract, did not inhibit the S. mutans biofilm. The S. persica aqueous extract did not demonstrate any biofilm inhibition at any concentration (p ≥ 0.05). The findings of this study suggest the potential of using S. persica methanol extract as a mouthwash or adjunctive to oral hygiene tools.
      Citation: Dentistry Journal
      PubDate: 2021-12-01
      DOI: 10.3390/dj9120143
      Issue No: Vol. 9, No. 12 (2021)
  • Dentistry Journal, Vol. 9, Pages 144: A Synopsis of Signaling Crosstalk of
           Pericytes and Endothelial Cells in Salivary Gland

    • Authors: Ioana Cucu, Mihnea Ioan Nicolescu
      First page: 144
      Abstract: The salivary gland (SG) microvasculature constitutes a dynamic cellular organization instrumental to preserving tissue stability and homeostasis. The interplay between pericytes (PCs) and endothelial cells (ECs) culminates as a key ingredient that coordinates the development, maturation, and integrity of vessel building blocks. PCs, as a variety of mesenchymal stem cells, enthrall in the field of regenerative medicine, supporting the notion of regeneration and repair. PC-EC interconnections are pivotal in the kinetic and intricate process of angiogenesis during both embryological and post-natal development. The disruption of this complex interlinkage corresponds to SG pathogenesis, including inflammation, autoimmune disorders (Sjögren’s syndrome), and tumorigenesis. Here, we provided a global portrayal of major signaling pathways between PCs and ECs that cooperate to enhance vascular steadiness through the synergistic interchange. Additionally, we delineated how the crosstalk among molecular networks affiliate to contribute to a malignant context. Additionally, within SG microarchitecture, telocytes and myoepithelial cells assemble a labyrinthine companionship, which together with PCs appear to synchronize the regenerative potential of parenchymal constituents. By underscoring the intricacy of signaling cascades within cellular latticework, this review sketched a perceptive basis for target-selective drugs to safeguard SG function.
      Citation: Dentistry Journal
      PubDate: 2021-12-01
      DOI: 10.3390/dj9120144
      Issue No: Vol. 9, No. 12 (2021)
  • Dentistry Journal, Vol. 9, Pages 145: Dental Trauma at a University Dental
           Clinic in Milan including the SARS-CoV-2 Period

    • Authors: Sara Pederielli, Cristina Mirelli, Federico Pozzi, Aldo Bruno Giannì, Roberto Biagi
      First page: 145
      Abstract: The aim of this study i.e., is to present the distribution of traumatic dental injuries (TDI) in 306 patients registered at the Unit of Dental Emergencies at a University Dental Clinic in Milan, Italy, between June 2019 and May 2021. This time frame includes the beginning of the SARS-CoV-2 pandemic. Information regarding age, gender, number and type of injured teeth, type of traumatic injury, and data on where or how the injury happened were recorded. Seventy-nine percent of patients can be classified as pediatric (under 14 years old), and in all age groups, male patients were found to be more susceptible (1.6:1). A total of 480 teeth were involved, 59% of which were deciduous, and 41% permanent. The most affected teeth in both dentitions were upper central incisors. In deciduous teeth, periodontal lesions were more common, whereas in permanent dentitions, dental fractures were diagnosed more often. Most data found in this study confirms the results found in the literature. The biggest difference, due to changes in daily routine during the SARS-CoV-2 pandemic, can be found by analyzing the incidence and etiology. As a matter of fact, there was a decrease in school accidents, whereas domestic falls remained constant.
      Citation: Dentistry Journal
      PubDate: 2021-12-02
      DOI: 10.3390/dj9120145
      Issue No: Vol. 9, No. 12 (2021)
  • Dentistry Journal, Vol. 9, Pages 146: Influence of Methodological
           Variables on Fracture Strength Tests Results of Premolars with Different
           Number of Residual Walls. A Systematic Review with Meta-Analysis

    • Authors: Carlo Gaeta, Crystal Marruganti, Emanuele Mignosa, Giovanni Franciosi, Edoardo Ferrari, Simone Grandini
      First page: 146
      Abstract: The aim of the current meta-analysis was to assess the impact of methodological variables in performing fracture strength tests of upper premolars. Medline (Pubmed), Embase and Google Scholar were screened for studies performing ex vivo fracture strength tests of intact upper premolars or premolars with 0, 1 or 2 walls lost. The outcome variable for each study was the maximum breaking load expressed in Newton (kg × m/s2). Methodological variables (i.e., simulation of the periodontal ligament, load inclination, tip position, tip diameter and thermocycling) were registered to perform subgroup analyses and meta-regression. Overall, 25 studies and 78 study groups were included in the meta-analysis. Intact premolars (17 study groups) were not significantly influenced by any of the methodological variables considered. Subgroup analysis for load inclination (30°/45° vs. 90°/150°) was significant for premolars with 0 (10 study groups), 1 (6 study groups) and 2 (45 study groups) walls lost; thermocycling was significant for premolars with 1 and 2 walls lost. A strong methodological heterogeneity across studies evaluating the fracture strength of upper premolars was highlighted, especially when 0, 1 or 2 walls were lost. Further studies are needed to standardize the methodology used in order to allow for across-studies comparisons.
      Citation: Dentistry Journal
      PubDate: 2021-12-02
      DOI: 10.3390/dj9120146
      Issue No: Vol. 9, No. 12 (2021)
  • Dentistry Journal, Vol. 9, Pages 147: Minimally Invasive Therapies for the
           Management of Dental Caries—A Literature Review

    • Authors: Hetal Desai, Cameron A. Stewart, Yoav Finer
      First page: 147
      Abstract: In recent years, due to a better understanding of the caries pathology and advances in dental materials, the utilization of non-invasive and minimally invasive techniques that delay/obviate the need for traditional restorations has started gaining momentum. This literature review focuses on some of these approaches, including fluoride varnish, silver diamine fluoride, resin sealants, resin infiltration, chemomechanical caries removal and atraumatic restorative treatment, in the context of their chemistries, indications for use, clinical efficacy, factors determining efficacy and limitations. Additionally, we discuss strategies currently being explored to enhance the antimicrobial properties of these treatment modalities to expand the scope of their application.
      Citation: Dentistry Journal
      PubDate: 2021-12-07
      DOI: 10.3390/dj9120147
      Issue No: Vol. 9, No. 12 (2021)
  • Dentistry Journal, Vol. 9, Pages 148: A Radical-Free Approach to Teeth

    • Authors: Mauro Pascolutti, Dileusa de Oliveira
      First page: 148
      Abstract: Background: Traditional bleaching agents based on hydrogen peroxide (HP) or carbamide peroxide (CP) have adverse soft and hard tissue effects. Objectives: This study tested a novel formulation of phthalimidoperoxycaproic acid (PAP) with additives to optimise its safety and effectiveness. Methods: A novel gel (PAP+) was formulated. Laboratory studies assessed effects of six 10-minute exposures to PAP+ vs. commercial CP and HP gels, using surface profilometry and microhardness. The effectiveness of PAP+ in vitro against complex polyphenol stains on enamel was compared to 6% HP. Results: Unlike HP gels, PAP+ gel did not erode enamel. Unlike both CP and HP gels, PAP+ gel did not reduce the surface microhardness of enamel. PAP+ gel on used on polyphenol stains was superior to 6% HP. In this model, six repeated 10-minute treatments with PAP+ gel could improve the shade by approximately eight VITA® Bleachedguide shades. Conclusions: These laboratory results support the safety and effectiveness of this new PAP formula and its use as an alternative to CP and HP with superior safety and effectiveness.
      Citation: Dentistry Journal
      PubDate: 2021-12-09
      DOI: 10.3390/dj9120148
      Issue No: Vol. 9, No. 12 (2021)
  • Dentistry Journal, Vol. 9, Pages 149: Translation and Validation of
           Italian Version of Index of Dental Anxiety and Fear (IDAF-4C+): A
           Cross-Sectional Study

    • Authors: Stefano Salgarello, Maria Luisa Garo, Corrado Paganelli, Antonio Vita, Matteo Salvadori, Elisabetta Audino
      First page: 149
      Abstract: Dental anxiety (DA) is defined as unreasonable apprehension toward dental procedures. About 4–20% of the worldwide adult population presents DA, with peaks of 30% in the younger population. Managing patients with dental anxiety and fear with a reliable and valid instrument is necessary to understand the multidimensional dimensions of dental fear. This work aimed to validate the Index of Dental Anxiety and Fear (IDAF-4C+) into Italian. Two hundred and eighty dental students attending an Italian university were enrolled. The IDAF-4C+ was translated by experts and a native English translator, blinded to the original version. The Modified Dental Anxiety Scale (MDAS) was used to assess the validity of IDAF-4C+. Spearman correlation coefficients and Exploratory Factorial Analysis (EFA) were used. Reliability was evaluated by Cronbach’s alpha. The reliability of the Italian version of IDAF-4C+ was good (Cronbach’s alpha = 0.88). Correlation between IDAF-4C+ and MDAS ranged between 0.42 to 0.68. From EFA, one factor explained 58.76% of the common variance. Women showed a higher level of dental fear. The Italian IDAF-4C+ is a valid and reliable tool to assess DA in any clinical context. This instrument allows for a proper understanding and management of DA, and therefore a better patient oral health-related quality of life and compliance with the dentist’s instructions.
      Citation: Dentistry Journal
      PubDate: 2021-12-10
      DOI: 10.3390/dj9120149
      Issue No: Vol. 9, No. 12 (2021)
  • Dentistry Journal, Vol. 9, Pages 150: Subgingival Microbiota Profile in
           Association with Cigarette Smoking in Young Adults: A Cross-Sectional

    • Authors: Krešimir Bašić, Kristina Peroš, Zrinka Bošnjak, Ivana Šutej
      First page: 150
      Abstract: While smoking is recognized as one of the factors for the development and progression of periodontal diseases, a relation between the composition of the subgingival microbiota and smoking is yet to be elucidated. The aim of this study was to investigate the prevalence of subgingival bacteria in young smokers and non-smokers without clinical signs of periodontal disease. In this cross-sectional study, performed at the Department of Pharmacology, School of Dental Medicine, University of Zagreb, we enrolled 32 periodontally healthy smokers and 32 non-smokers, aged 25–35 years old. The number of oral bacteria and the prevalence of particular bacteria were assessed for each subject. Subgingival plaque samples were collected with sterile paper points from two first molars for microbiological analyses with MALDI-TOF mass spectrometry. In smokers, a significantly higher prevalence of Actinomyces odontolyticus was observed compared to non-smokers, and a significantly lower prevalence of Streptococcus sanguinis was observed compared to non-smokers. Smoking affects the composition of subgingival microbiota, either via depletion of beneficial bacteria or the increase in pathogenic bacteria.
      Citation: Dentistry Journal
      PubDate: 2021-12-11
      DOI: 10.3390/dj9120150
      Issue No: Vol. 9, No. 12 (2021)
  • Dentistry Journal, Vol. 9, Pages 151: Knowledge, Perceived Risk, and
           Preventive Behaviors amidst Covid-19 Pandemic among Dental Students in

    • Authors: Azlini Ismail, Nur Hanisah Ismail, Nur Yasrin Maisarah Abu Kassim, Widya Lestari, Ahmad Faisal Ismail, Cortino Sukotjo
      First page: 151
      Abstract: Purpose: Coronavirus disease 19 (COVID-19) has affected dental education in Malaysia. However, studies on dental students’ knowledge, perception, and behaviors with regards to COVID-19 are very limited. Thus, this study aims to determine the knowledge status, perceived risk, and preventive behaviors of dental students in Malaysia regarding COVID-19. Methods: A cross-sectional study was conducted among students from 13 dental schools across Malaysia using online questionnaires. Results: From 355 respondents, 93.5% obtained a high score of knowledge of COVID-19. Female respondents scored higher than males in perceived risks and preventive behaviors. Chinese respondents scored highest in knowledge, while Malay respondents had the highest perceived risk score. The mean preventive behavior score did not vary across ethnicity. On-campus students scored higher in knowledge and perceived risk whereas off-campus students practiced more preventive behaviors. Clinical students’ knowledge score was higher than preclinical students. Final year students scored higher in knowledge and perceived risk compared to their juniors. Conclusion: The majority of dental students have good knowledge and a high perceived risk of COVID-19, and they practiced most of the preventive behaviors. However, the latest information on this disease should be incorporated into dental schools’ curriculums and updated periodically.
      Citation: Dentistry Journal
      PubDate: 2021-12-14
      DOI: 10.3390/dj9120151
      Issue No: Vol. 9, No. 12 (2021)
  • Dentistry Journal, Vol. 9, Pages 152: Pediatricians’ Knowledge of
           Emergency Management of Dental Injuries and Use of Mouthguards: A
           Cross-Sectional Survey

    • Authors: Antonija Tadin, Danijela Delic, Ivana Kristina Delic Jukic, Kristina Gorseta, Lidia Gavic
      First page: 152
      Abstract: Aim: Dental injuries are one of the most frequent oral health problems in children and adolescents. This study aimed to evaluate Croatian pediatricians’ knowledge and practice regarding dental injuries management and the use of mouthguards as means of protection against traumatic injuries. Materials and methods: A questionnaire-based cross-sectional survey conducted among 186 pediatricians examined their demographic characteristics, knowledge and experience with dental injuries. Student t-test or one-way ANOVA, with Tukey’s post-hoc were used to analyze obtained data (p ≤ 0.05). Results: The overall mean score of knowledge on the management of dental injuries was 3.6 ± 1.53 points. Male pediatricians (p = 0.016), those who witnessed dental injuries (p = 0.003), and those who had more than ten years of pediatric practice (p = 0.027) showed better knowledge. The results of multiple linear regression analysis demonstrated impact between pediatricians’ knowledge in the emergency treatment of traumatic dental injuries concerning the level of health care (practice settings) (β = −0.254, p = 0.002) and the number of patients treated by a pediatrician per day (β = −0.187, p = 0.030). Conclusion: Pediatricians have a low level of knowledge regarding the primary care of traumatic dental injuries. An additional course on dental injurie management should be recommended as part of the physician and pediatricians’ educational training.
      Citation: Dentistry Journal
      PubDate: 2021-12-15
      DOI: 10.3390/dj9120152
      Issue No: Vol. 9, No. 12 (2021)
  • Dentistry Journal, Vol. 9, Pages 153: Treatment of Dental Anxiety and
           Phobia—Diagnostic Criteria and Conceptual Model of Behavioural

    • Authors: Ulla Wide, Magnus Hakeberg
      First page: 153
      Abstract: Dental anxiety and dental phobia are still prevalent among adult individuals and should be considered a dental public health issue. Dental anxiety/phobia is often described as a vicious cycle where avoidance of dental care, poor oral health, and psychosocial effects are common features, often escalating over time. Treatment should include therapy for dental anxiety/phobia and oral diseases. This paper discusses aetiology, prevalence, and diagnosis of dental anxiety/phobia and, in detail, presents a conceptual treatment model at the Dental Fears Research and Treatment Center in Gothenburg, Sweden. In addition, based on systematic reviews, evidence-based treatment for dental anxiety is revealed including the interdisciplinary approach between psychology and dentistry.
      Citation: Dentistry Journal
      PubDate: 2021-12-17
      DOI: 10.3390/dj9120153
      Issue No: Vol. 9, No. 12 (2021)
  • Dentistry Journal, Vol. 9, Pages 124: Contact Angle and Cell Adhesion of
           Micro/Nano-Structured Poly(lactic-co-glycolic acid) Membranes for Dental
           Regenerative Therapy

    • Authors: Naoyuki Kaga, Hiroki Fujimoto, Sho Morita, Yuichiro Yamaguchi, Takashi Matsuura
      First page: 124
      Abstract: Biodegradable membranes are used in regenerative dentistry for guided tissue regeneration (GTR) and guided bone regeneration (GBR). In this study, patterned poly(lactic-co-glycolic acid) (PLGA) membranes with groove, pillar, and hole structures were successfully fabricated by thermal nanoimprinting. Their surfaces were evaluated for topography by scanning electron microscopy and laser microscopy, for hydrophobicity/hydrophilicity by contact angle analysis, and for MC3T3-E1 cell adhesion. The sizes of the patterns on the surfaces of the membranes were 0.5, 1.0, and 2.0 μm, respectively, with the height/depth being 1.0 μm. The pillared and holed PLGA membranes were significantly more hydrophobic than the non-patterned PLGA membranes (p < 0.05). However, the 0.5 μm- and 1.0 μm-grooved PLGA membranes were significantly more hydrophilic than the non-patterned PLGA membranes (p < 0.05). The 0.5 μm-grooved, pillared, and holed membranes exhibited significantly superior adhesion to the MC3T3-E1 cells than the non-patterned PLGA (p < 0.05). These results suggest that patterned PLGA membranes can be clinically used for GTR and GBR in the dental regeneration field.
      Citation: Dentistry Journal
      PubDate: 2021-10-20
      DOI: 10.3390/dj9110124
      Issue No: Vol. 9, No. 11 (2021)
  • Dentistry Journal, Vol. 9, Pages 125: Use of Computer Simulation in Dental
           Training with Special Reference to Simodont

    • Authors: Angie Lok-Sze Leung, Conson Yeung, Samantha Chu, Amy Wai-Yee Wong, Ollie Yiru Yu, Chun-Hung Chu
      First page: 125
      Abstract: Simulation-based dental education has been increasingly implemented in dental training. Virtual reality simulators are being explored as an adjunct to dental education. Simulation-based dental education could serve as a powerful aid to preclinical instruction. This article provides an overview of how dental simulators can be used in dental instruction and manual dexterity training, utilizing the Simodont dental trainer as a reference. The Simodont dental trainer provides a platform for students to hone their manual dexterity skills and practice repeatedly prior to conventional clinical simulations. Additionally, it can reduce resource wastage. However, the financial cost of setting up and maintaining the system can be high. The high cost would ultimately limit the number of devices each individual school could afford, as a potential drawback to meeting the training needs of many dental students at one time. The machine’s force-feedback mechanism provides trainees with the tactile experience of drilling into various tissues. Students are empowered via self-learning and assessment, with guidance provided for diagnosis and treatment. From training students on basic operative skills to providing basic aptitude tests for entrance examinations, the Simodont dental trainer’s functions and potential for further development may make it a valuable tool in the field of simulation-based dental education.
      Citation: Dentistry Journal
      PubDate: 2021-10-21
      DOI: 10.3390/dj9110125
      Issue No: Vol. 9, No. 11 (2021)
  • Dentistry Journal, Vol. 9, Pages 126: 36 Months’ Clinical Performance of
           Primary Incisors Restorations Depending on the Type of Restorative
           Technique Used: A Randomized Controlled Trial

    • Authors: Maria Sarapultseva, Alexey Sarapultsev
      First page: 126
      Abstract: Background: Depending on the stage of the disease and the child’s age, different types of interventions can be used to treat early childhood caries. As a result, there is not enough clinical evidence to show that one kind of restoration is better than another. The objective of this longitudinal study was to compare the results of 36 months of clinical performance of primary incisors restorations using an incremental layering technique with the ceram.x® SphereTECTM nanoceramic composite (Dentsply) or a full coverage technique with transparent strip crowns (Frasaco GmbH) with the same composite in children with or without biological caries risk factors. Methods: 80 patients (females 42/52.5%) were included in the study. A total of 160 restorations were performed. Restorations were evaluated at baseline and at 6, 12, 24, and 36 months, according to modified Ryge criteria. Conclusion: Restorations with both techniques were clinically highly successful and showed similar clinical performance at postoperatively regardless of the presence of biological factors of caries risk.
      Citation: Dentistry Journal
      PubDate: 2021-10-22
      DOI: 10.3390/dj9110126
      Issue No: Vol. 9, No. 11 (2021)
  • Dentistry Journal, Vol. 9, Pages 127: Novel Histomorphometrical Approach
           to Evaluate the Integration Pattern and Functionality of Barrier Membranes

    • Authors: Nicola Ottenbacher, Said Alkildani, Tadas Korzinskas, Jens Pissarek, Christian Ulm, Ole Jung, Bernd Sundag, Olaf Bellmann, Sanja Stojanovic, Stevo Najman, Werner Zechner, Mike Barbeck
      First page: 127
      Abstract: GBR (guided bone regeneration) is a standard procedure for building up bony defects in the jaw. In this procedure, resorbable membranes made of bovine and porcine collagen are increasingly being used, which, in addition to many possible advantages, could have the potential disadvantage of a shorter barrier functionality, especially when augmenting large-volume defects. Thus, it is of importance to evaluate the integration behavior and especially the standing time of barrier membranes using specialized methods to predict its respective biocompatibility. This study is intended to establish a new histomorphometrical analysis method to quantify the integration rate of collagen-based barrier membranes. Three commercially available barrier membranes, i.e., non-crosslinked membranes (BioGide® and Jason® membrane), a ribose-crosslinked membrane (Ossix® Plus), and a newly developed collagen–hyaluronic acid-based (Coll-HA) barrier membrane were implanted in the subcutaneous tissue of 48 6–8-week-old Wistar rats. The explants, after three timepoints (10, 30, and 60 days), were processed and prepared into histological sections for histopathological (host tissue response) and histomorphometrical (cellular invasion) analyses. 10 days after implantation, fragmentation was not evident in any of the study groups. The sections of the Coll-HA, Jason® and BioGide® membranes showed a similar mild inflammatory reaction within the surrounding tissue and an initial superficial cell immigration. Only in the Ossix® Plus group very little inflammation and no cell invasion was detected. While the results of the three commercially available membranes remained intact in the further course of the study, only fragments of the Coll-HA membrane were found 30 and 60 days after implantation. Histomorphometrically, it can be described that although initially (at 10 days post-implantation) similar results were found in all study groups, after 30 days post-implantation the cellular penetration depth of the hyaluronic acid-collagen membrane was significantly increased with time (**** p < 0.0001). Similarly, the percentage of cellular invasion per membrane thickness was also significantly higher in the Coll-HA group at all timepoints, compared to the other membranes (**** p < 0.0001). Altogether, these results show that the histomorphometrical analysis of the cellular migration can act as an indicator of integration and duration of barrier functionality. Via this approach, it was possible to semi-quantify the different levels of cellular penetration of GBR membranes that were only qualitatively analyzed through histopathological approaches before. Additionally, the results of the histopathological and histomorphometrical analyses revealed that hyaluronic acid addition to collagen does not lead to a prolonged standing time, but an increased integration of a collagen-based biomaterial. Therefore, it can only partially be used in the dental field for indications that require fast resorbed membranes and a fast cell or tissue influx such as periodontal regeneration processes.
      Citation: Dentistry Journal
      PubDate: 2021-10-25
      DOI: 10.3390/dj9110127
      Issue No: Vol. 9, No. 11 (2021)
  • Dentistry Journal, Vol. 9, Pages 128: Sol–Gel Synthesis and
           Characterization of YSZ Nanofillers for Dental Cements at Different

    • Authors: Anastasia Beketova, Anna Theocharidou, Ioannis Tsamesidis, Athanasios E. Rigos, Georgia K. Pouroutzidou, Emmanouil-George C. Tzanakakis, Dimitra Kourtidou, Liliana Liverani, Marcela Arango Ospina, Antonios Anastasiou, Ioannis G. Tzoutzas, Eleana Kontonasaki
      First page: 128
      Abstract: Background: Yttria-stabilized zirconia nanoparticles can be applied as fillers to improve the mechanical and antibacterial properties of luting cement. The aim of this study was to synthesize yttria-stabilized zirconia nanoparticles by the sol–gel method and to investigate their composition, structure, morphology and biological properties. Methods: Nanopowders of ZrO2 7 wt% Y2O3 (nY-ZrO) were synthesized by the sol–gel method and were sintered at three different temperatures: 800, 1000 and 1200 °C, and their composition, size and morphology were investigated. The biocompatibility was investigated with human gingival fibroblasts (hGFs), while reactive oxygen species (ROS) production was evaluated through fluorescence analysis. Results: All synthesized materials were composed of tetragonal zirconia, while nanopowders sintered at 800 °C and 1000 °C additionally contained 5 and 20 wt% of the cubic phase. By increasing the calcination temperature, the crystalline size of the nanoparticles increased from 12.1 nm for nY-ZrO800 to 47.2 nm for nY-ZrO1200. Nano-sized particles with good dispersion and low agglomeration were received. Cell culture studies with human gingival fibroblasts verified the nanopowders’ biocompatibility and their ROS scavenging activity. Conclusions: the obtained sol–gel derived nanopowders showed suitable properties to be potentially used as nanofillers for dental luting cement.
      Citation: Dentistry Journal
      PubDate: 2021-10-29
      DOI: 10.3390/dj9110128
      Issue No: Vol. 9, No. 11 (2021)
  • Dentistry Journal, Vol. 9, Pages 129: Vitamin D and Its Role in Oral
           Diseases Development. Scoping Review

    • Authors: Ekaterina Diachkova, Daria Trifonova, Elena Morozova, Gyuzel Runova, Igor Ashurko, Maria Ibadulaeva, Valentin Fadeev, Svetlana Tarasenko
      First page: 129
      Abstract: Vitamin D is a fat-soluble secosteroid that plays a significant role in the whole body, including the maxillofacial region. The discovery of its receptors in many cells and organs made it possible to reveal the participation of vitamin D not only in the regulation of calcium phosphate metabolism, but also in immune processes, in providing anti-inflammatory and antimicrobial effects, slowing down cell proliferation and stimulating differentiation. In this literature review, we demonstrate the association between low vitamin D levels and the development of recurrent aphthous stomatitis, the course and response to treatment of squamous cell carcinoma of the oral cavity, the severity of periodontal diseases, and the processes of osseointegration and bone remodeling during dental implantation and guided tissue regeneration. The aim of our article was to demonstate a possible connection between vitamin D level and the oral diseases that can be presented at an oral surgery appointment, which will help clinicians to reduce the risk of early dental implant failure, ensure favorable outcomes of augmentative operations, as well as decrease the destructive effects of severe periodontitis and other conditions throug knowledge and timely lab tests and endocrinologist prescriptions.
      Citation: Dentistry Journal
      PubDate: 2021-11-02
      DOI: 10.3390/dj9110129
      Issue No: Vol. 9, No. 11 (2021)
  • Dentistry Journal, Vol. 9, Pages 130: Characterization and Pathogenic
           Speculation of Xerostomia Associated with COVID-19: A Narrative Review

    • Authors: Hironori Tsuchiya
      First page: 130
      Abstract: Patients with coronavirus disease 2019 (COVID-19) have become known to present with different oral symptoms. However, xerostomia remains poorly recognized compared with taste dysfunction. For better understanding of COVID-19 symptomatology, xerostomia associated withCOVID-19 was characterized and its possible pathogenesis was speculated by a narrative literature review. Scientific articles were retrieved by searching PubMed, LitCovid, ProQuest, Google Scholar, medRxiv and bioRxiv from 1 April 2020 with a cutoff date of 30 September 2021. Results of the literature search indicated that xerostomia is one of prevalent and persistent oral symptoms associated with COVID-19. In contrast to taste dysfunction, the prevalence and persistence of xerostomia do not necessarily depend on ethnicity, age, gender and disease severity of patients. COVID-19 xerostomia is pathogenically related to viral cellular entry-relevant protein expression, renin-angiotensin system disturbance, salivary gland inflammation, zinc deficiency, cranial neuropathy, intercurrent taste dysfunction, comorbidities and medications. Despite a close association with COVID-19, xerostomia, dry mouth and hyposalivation tend to be overlooked unlike ageusia, dysgeusia and hypogeusia. Although mouth dryness per se is not life-threating, it has an impact on the oral health-related quality of life. More attention should be paid to xerostomia in COVID-19 patients and survivors.
      Citation: Dentistry Journal
      PubDate: 2021-11-10
      DOI: 10.3390/dj9110130
      Issue No: Vol. 9, No. 11 (2021)
  • Dentistry Journal, Vol. 9, Pages 131: Influence of the Use of a Collagen
           Membrane Placed on the Bone Window after Sinus Floor Augmentation—An
           Experimental Study in Rabbits

    • Authors: Alessandro Perini, Jose Viña-Almunia, Carmen Carda, José Javier Martín de Llano, Daniele Botticelli, Miguel Peñarrocha-Diago
      First page: 131
      Abstract: Background: We studied the influence on healing of a resorbable membrane covering the osteotomy site after maxillary sinus grafting, evaluated in different regions of the augmented area. Methods: Maxillary sinus augmentation was performed in 24 New Zealand rabbits. Osteotomy, 4 × 6 mm, were performed bilaterally. A collagenated cortico-cancellous porcine bone was used to fill the elevated region. A collagen membrane was randomly placed over the osteotomy site on one side (MG), and the other side was left uncovered (NMG). The animals were euthanized after 2, 4, and 8 weeks; and histomorphometric analysis was performed in eight different regions. Results: New bone percentages were similar in both groups. There were no statistically significant differences. In MG, the overall percentages were 15.6 ± 7.3%, 22.9 ± 6.1%, and 24.9 ± 12.0% after 2, 4, and 8 weeks, respectively. In NMG, the percentages were 11.2 ± 4.5%, 24.1 ± 5.7%, and 24.5 ± 15.7%, respectively. The proportions of new bone in the various regions after 8 weeks were 31 ± 8.9% and 29.9 ± 9.1% in the bone walls region, 25 ± 10.1% and 32.8 ± 9.1% in the submucosa region, 22.6 ± 21.6% and 10.9 ± 11.5 in the middle region, 17.3 ± 14% and 13.4 ± 9.8% in the close-to-window region, and 21.8 ± 11.6%, 19.1 ± 6.4% in the osteotomy region—for MG and NMG, respectively. Conclusions: In both groups the greatest amounts of bone formation occurred near to the pre-existing bone walls, followed by the sub-mucosa region. The smallest amounts were found in the close-to-window region, followed by the central region. The placement of a collagen membrane to cover the osteotomy site did not influence the amount of new bone formation after sinus grafting.
      Citation: Dentistry Journal
      PubDate: 2021-11-12
      DOI: 10.3390/dj9110131
      Issue No: Vol. 9, No. 11 (2021)
  • Dentistry Journal, Vol. 9, Pages 132: Knowledge of Dental Students from
           Croatia, Slovenia, and Bosnia and Herzegovina about Dental Care of
           Oncology Patients

    • Authors: Iva Pedic, Livia Cigic, Danijela Kalibovic Govorko, Katarina Vodanovic, Ruzica Bandic, Robert Glavinic, Ivana Medvedec Mikic
      First page: 132
      Abstract: The central role of the dentist in the treatment of oncology patients is to care for the patient’s oral cavity before, during, and after radio/chemotherapy. The aim of this research was to determine the knowledge of dental students from five universities in three neighboring countries, Croatia (Split, Rijeka, and Zagreb), Bosnia and Herzegovina (Sarajevo), and Slovenia (Ljubljana), about oncology patients’ dental care. A total of 140 students in their fourth, fifth, and sixth year of dental medicine studies participated in this research. A questionnaire with 36 specific questions was designed for this research and included questions about dental care of oncologic patients before, during, and after the oncology therapy. Most students are familiar with the incidence and most common type of head and neck tumors, while knowledge about tumor treatment and the side-effects of radiation therapy and/or chemotherapy is weak. Students did not show satisfactory knowledge about osteoradionecrosis, which is the most serious side-effect of radiotherapy; therefore, the emphasis on additional education should be greatest in this area. Teaching staff should be aware of lack of student knowledge and try to offer more information and practice in providing dental care for oncology patients.
      Citation: Dentistry Journal
      PubDate: 2021-11-15
      DOI: 10.3390/dj9110132
      Issue No: Vol. 9, No. 11 (2021)
  • Dentistry Journal, Vol. 9, Pages 133: Knowledge, Attitude, and Practices
           of Dentists in Caribbean Countries during the COVID-19 Pandemic: A
           Multicenter Cross-Sectional Study

    • Authors: Ramaa Balkaran, Meghashyam Bhat, Shivaughn Marchan, William Smith
      First page: 133
      Abstract: Background: The COVID-19 pandemic has affected dentists globally, both financially and mentally. This study aimed to determine the knowledge, attitude, and practices of dentists in Caribbean countries during the COVID-19 pandemic. Methods: A non-probability sample was obtained from dentists in more than ten different Caribbean countries. They were invited to complete a self-reported questionnaire, which was conducted from December 2020 to March 2021. Ethics approval was sought and an exemption was received from the UWI ethics committee. Results: One hundred and fifty-two dentists responded. More than one-third (38.8%) were in the >35–45 age group, and 58.6% were females. Most (84.9%) were general dentists and 75% were stressed by the COVID-19 situation with 80.9% being affected financially. The majority, 94.7%, believed that the highest risk of transmission of COVID-19 was via aerosol-generating procedures and 87.5% were worried about contracting it clinically. The majority (69.1%) were willing to receive the vaccine, the main reason reported for vaccine hesitancy was due to the possible side effects (35.3%). Most (75%) consumed alcohol. When the locus of control was determined, 54.6% felt they were in control of protecting themselves while 52% felt that external factors controlled their lives. Conclusions: The findings suggest that most dentists in the Caribbean were knowledgeable about COVID-19 and followed current guidelines in their practice and were willing to receive the vaccine.
      Citation: Dentistry Journal
      PubDate: 2021-11-15
      DOI: 10.3390/dj9110133
      Issue No: Vol. 9, No. 11 (2021)
  • Dentistry Journal, Vol. 9, Pages 134: The Importance of Using Physical
           Tridimensional Models for the Management and Planning of Extended Osseous
           Odontogenic Lesions

    • Authors: Domenico Guerra, Marco Severino, Sara Caruso, Sofia Rastelli, Roberto Gatto
      First page: 134
      Abstract: (1) Surgical intervention becomes crucial in situations in which lack of action would cause a decrease in quality of life for the patient. As healthcare professionals, our next objective is to reduce patient fear perception. This work’s aim is to illustrate how physical tridimensional models can serve not only as confidence boosters for the patient, but also as a valid tool to aid both the clinician and the fostering of a patient–doctor relationship. (2) An example case managed using a stereolithographic model in the pre-surgical planning stage is presented in which surgical planning was carried out by analysis of radiographic investigations combined with a tridimensional resin model derived from the patient’s x-ray exam. (3) Successful enucleation, surgical debridement, and stable follow-up shows the effectiveness of the applied surgical protocol, confirming that planification using a physical representation of the tridimensional exam aids in the correct surgical management of said lesions. (4) The effectiveness o101f the surgical act itself as well as the follow-up showing ossification of the bony lesion and absence of relapse of a highly recurrent lesion confirms the effectiveness of the tools used for this surgical intervention.
      Citation: Dentistry Journal
      PubDate: 2021-11-15
      DOI: 10.3390/dj9110134
      Issue No: Vol. 9, No. 11 (2021)
  • Dentistry Journal, Vol. 9, Pages 135: Siloranes–Suitability of a Novel
           Adhesive for Orthodontic Bracket Bonding

    • Authors: Lorenz Brauchli, Markus Steineck
      First page: 135
      Abstract: Recently, an epoxy-based resin-Filtek Silorane-has been proposed for restorative fillings. It was the aim of the investigation to evaluate the suitability of this novel resin for orthodontic bracket bonding on unground enamel. Shear bond strength was measured for two adhesives-Filtek Silorane, Transbond XT-in combination with steel, ceramic and polymer brackets. For Filtek Silorane etching was performed with the Silorane self-etching primer, as well as phosphoric acid. The Transbond XT samples were etched with phosphoric acid only and served as the control group. All samples were thermo-cycled (1000×, 5–55 °C). Shear testing was carried out with an Instron 3344. In addition, ARI scores were evaluated. The Shear bond strength showed a weak adhesion of Filtek Silorane to unprepared enamel, either with the self-etching primer or the conventional etching (0.87–4.28 MPa). The Shear bond strength of the control group was significantly higher (7.6–16.5 MPa). The ARI scores showed a clear failure at the enamel-adhesive interface for all Filtek Silorane samples. For the combination of Transbond XT and different brackets the failure was found at the adhesive–bracket interface. The novel epoxy-based resin Filtek Silorane is not appropriate for bracket bonding to unprepared enamel.
      Citation: Dentistry Journal
      PubDate: 2021-11-17
      DOI: 10.3390/dj9110135
      Issue No: Vol. 9, No. 11 (2021)
  • Dentistry Journal, Vol. 9, Pages 136: An Objective Structured Clinical
           Examination (OSCE) for French Dental Students: Feedback after 2 Years

    • Authors: Claire Egloff-Juras, Pierre Hirtz, Amandine Luc, Anne-Sophie Vaillant-Corroy
      First page: 136
      Abstract: The Objective Structured Clinical Examination (OSCE) is a practical examination that provides a standardized assessment of clinical competence. The aim of this study is to evaluate the objectivity and the reliability of an OSCE in dentistry. To this end, a retrospective monocentric observational study was conducted at the Faculty of Dentistry of Nancy by analyzing the exam results of 81 students. The study population consisted of the fifth-year students. The examination was broken down into six stations which were doubled, and different juries of examiners were constituted (installed in different rooms) according to the same composition. The p-value was set at 0.05. We found an equivalence of the results between the different rooms on the global mean score obtained at the six stations (p = 0.021). In terms of gender, women have statistically significantly higher overall scores than men (p = 0.001). The evaluation of a difference in the scores between full-time and part-time teachers does not find any statistically significant difference or equivalence in the station where it was possible to realize the comparison. However, the students’ waiting time before the exam seems to negatively influence the results. Compared with other international OSCE studies, the results presented seemed sufficiently objective and reliable, although some adjustments are still necessary.
      Citation: Dentistry Journal
      PubDate: 2021-11-19
      DOI: 10.3390/dj9110136
      Issue No: Vol. 9, No. 11 (2021)
  • Dentistry Journal, Vol. 9, Pages 137: Oral Pemphigoid Recalcitrant Lesion
           Treated with PRGF Infiltration. Case Report

    • Authors: Eduardo Anitua, Mohammad H. Alkhraisat, Asier Eguia, Laura Piñas
      First page: 137
      Abstract: Mucous membrane pemphigoid (MMP) is a heterogeneous group of chronic autoimmune subepithelial blistering diseases. Oral involvement is present in almost all patients, may represent the onset of the disease, and causes different degrees of pain, dysphagia, soreness, and bleeding. Treatment is based on systemic and/or oral corticoids, or other immunosuppressants. Occasionally, oral lesions can show a poor response to standard treatments. We present the case of a 61-year-old female patient with a painful extensive MMP oral ulcerative lesion recalcitrant to previous systemic azathioprine and local triamcinolone treatment, which was successfully treated in a novel way using PRGF infiltrations as adjuvant. After four weekly infiltrations, pain was reduced from 10 to 0 in a VAS and the lesion was completely healed. The patient continued with a low dose maintenance immunosuppressive treatment (prednisone 5 mg/day PO), and after 13 months of follow-up, there was no relapse of the lesion and no side effects. Although future research is necessary to confirm these observations, PRGF could be a useful adjuvant for the management of extensive mucous membrane pemphigoid oral lesions.
      Citation: Dentistry Journal
      PubDate: 2021-11-19
      DOI: 10.3390/dj9110137
      Issue No: Vol. 9, No. 11 (2021)
  • Dentistry Journal, Vol. 9, Pages 138: Etching Patterns of Self-Etching
           Primers in Relation to Shear Bond Strength on Unground Enamel Samples

    • Authors: Lorenz Brauchli, Markus Steineck
      First page: 138
      Abstract: It was the intention of the study to evaluate the etching effects of several self-etching primers on unground enamel and their relevance for shear bond strength testing. Seven self-etching primers (Clearfil SE, Futurabond NR, M-Bond, One Coat, Optibond, Transbond SEP+, Xeno III) and a conventional 35% phosphoric gel acid were applied to bovine incisors according to the manufacturer’s instructions. All specimens were analyzed by electron microscopy. A visual four-step grading was used for the characterization of the macroscopic (5000×) and microscopic (20,000×) etching patterns. In addition, shear bond strength for all the products was tested with an Instron 3344 after 1000 thermocycles between 5 °C and 55 °C. Statistical analysis was carried out using Kruskal–Wallis with Dunn’s post-test and Pearson’s correlation coefficient. Very strong etching patterns with well-defined prisms were found for the conventional etching, Transbond SEP+, and to a lesser degree, for Xeno III. Clearfil SE and Futurabond NR revealed moderate etching patterns, and M-Bond, One Coat, and Optibond revealed very weak etching patterns. The bond strength correlated well with the etching patterns. The highest shear strength was obtained with conventional etching and Transbond SEP+, followed by Clearfil SE. Moderate shear bond strengths were found for Xeno III, Futurabond NR, One Coat, and M-Bond, and the lowest were found with Optibond.
      Citation: Dentistry Journal
      PubDate: 2021-11-20
      DOI: 10.3390/dj9110138
      Issue No: Vol. 9, No. 11 (2021)
  • Dentistry Journal, Vol. 9, Pages 109: Investigation of Patient-Specific
           Maxillofacial Implant Prototype Development by Metal Fused Filament
           Fabrication (MF3) of Ti-6Al-4V

    • Authors: Mohammad Qasim Shaikh, Subrata Deb Nath, Arulselvan Arumugam Akilan, Saleh Khanjar, Vamsi Krishna Balla, Gerald Thomas Grant, Sundar Vedanarayanan Atre
      First page: 109
      Abstract: Additive manufacturing (AM) and related digital technologies have enabled several advanced solutions in medicine and dentistry, in particular, the design and fabrication of patient-specific implants. In this study, the feasibility of metal fused filament fabrication (MF3) to manufacture patient-specific maxillofacial implants is investigated. Here, the design and fabrication of a maxillofacial implant prototype in Ti-6Al-4V using MF3 is reported for the first time. The cone-beam computed tomography (CBCT) image data of the patient’s oral anatomy was digitally processed to design a 3D CAD model of the hard tissue and fabricate a physical model by stereolithography (SLA). Using the digital and physical models, bone loss condition was analyzed, and a maxillofacial implant initial design was identified. Three-dimensional (3D) CAD models of the implant prototypes were designed that match the patient’s anatomy and dental implant requirement. In this preliminary stage, the CAD models of the prototypes were designed in a simplified form. MF3 printing of the prototypes was simulated to investigate potential deformation and residual stresses. The patient-specific implant prototypes were fabricated by MF3 printing followed by debinding and sintering using a support structure for the first time. MF3 printed green part dimensions fairly matched with simulation prediction. Sintered parts were characterized for surface integrity after cutting the support structures off. An overall 18 ± 2% shrinkage was observed in the sintered parts relative to the green parts. A relative density of 81 ± 4% indicated 19% total porosity including 11% open interconnected porosity in the sintered parts, which would favor bone healing and high osteointegration in the metallic implants. The surface roughness of Ra: 18 ± 5 µm and a Rockwell hardness of 6.5 ± 0.8 HRC were observed. The outcome of the work can be leveraged to further investigate the potential of MF3 to manufacture patient-specific custom implants out of Ti-6Al-4V.
      Citation: Dentistry Journal
      PubDate: 2021-09-23
      DOI: 10.3390/dj9100109
      Issue No: Vol. 9, No. 10 (2021)
  • Dentistry Journal, Vol. 9, Pages 110: Clinical Pilot Series of
           Non-Self-Contained Periodontal Infrabony Defects Treated with a Slowly
           Resorbable Bovine Pericardium Membrane in Combination with
           Low-Temperature-Treated Decellularized Bovine Bone Particles

    • Authors: Mariana A. Rojas, Lorenzo Marini, Paola Russo, Vittorio Blardi, Patrick R. Schmidlin, Andrea Pilloni
      First page: 110
      Abstract: The aim of this case series was to present the clinical outcomes of non-contained intrabony periodontal defects (IPDs) treated by means of papillary preservation flaps in association with a slowly resorbable bovine pericardium membrane (BPM) and a low-temperature-treated bovine bone graft (BBG). Eight healthy, non-smoking patients (two males and six females, mean age 48 ± 8 years) with stage 3 periodontitis and at least one site with residual probing depth (PD) ≥ 6 mm associated with a non-contained IPD ≥ 3 mm were treated. Two weeks after surgery, no adverse events were observed, and an early wound healing score (EHS) of 8.1 ± 1.0 was recorded. After 1 year, the mean probing depth (PD) reduction and mean clinical attachment level gain (CAL-gain) accounted for 4.8 ± 0.7 and 3.5 ± 0.7 mm, respectively, whereas the mean gingival recession (REC) was of 1.2 ± 0.3 mm. Radiographic bone fill was observed in all cases. In conclusion, the treatment of non-contained IPDs with a slowly resorbable BPM and a low-temperature-treated BBG could be considered safe and may result in significant clinical improvements 1 year after surgery.
      Citation: Dentistry Journal
      PubDate: 2021-09-26
      DOI: 10.3390/dj9100110
      Issue No: Vol. 9, No. 10 (2021)
  • Dentistry Journal, Vol. 9, Pages 111: Comparison of Different Methods of
           Education in the Adoption of Oral Health Care Knowledge

    • Authors: Lidia Gavic, Martina Marcelja, Kristina Gorseta, Antonija Tadin
      First page: 111
      Abstract: Aim: The scope of this study was to determine if there is a critical distinction in the usage of lectures, videos, and pamphlets as educational material utilized in the adoption of oral health care knowledge. Materials and methods: Three-hundred and thirty children from ages 11 to 13 from the city of Split, Croatia completed the questionnaire on oral health care knowledge. Consequently, they were educated by randomly using a method: lecture, pamphlet, or video. Finally, after education, their knowledge was tested again. Results: Different statistical tests were used for comparison of different sets of data. The Wilcoxon signed-rank test showed a statistically significant difference (p ˂ 0.001) compared to the results before and after education. The Kruskal–Wallis test comparing knowledge outcomes after three different types of education: video, lecture, and pamphlet, showed a statistically significant difference in the final knowledge between groups (p ˂ 0.05). A pairwise comparison between different types of education showed a significant statistical difference between education conducted by pamphlet and video material (p = 0.003) and pamphlet and lecture (p = 0.006). No difference was observed between the level of knowledge acquired through video material education and lectures (p = 0.928). Conclusion: Videos and lectures as means of education showed equal effectiveness in the adoption of oral health care knowledge, while the pamphlet was a method that proved to be less effective.
      Citation: Dentistry Journal
      PubDate: 2021-09-26
      DOI: 10.3390/dj9100111
      Issue No: Vol. 9, No. 10 (2021)
  • Dentistry Journal, Vol. 9, Pages 112: Assessment of Tooth Preparations
           Submitted to Dental Laboratories for Fabrication of Monolithic Zirconia

    • Authors: Ramtin Sadid-Zadeh, Hadjer Sahraoui, Brian Lawson, Robert Cox
      First page: 112
      Abstract: Purpose: The objective of this study was to assess the quality of posterior teeth prepared for monolithic zirconia crowns. Materials and Methods: A total of 392 STL-files of posterior preparations for monolithic zirconia crowns were evaluated in this study. Three-dimensional (3D) images were evaluated using a software (3D Viewer; 3Shape A/S, Copenhagen, Denmark) for finish line design, finish line width, occluso-cervical dimension, total occlusal convergence (TOC), intercuspal angulation, finish line quality, line angle form, and presence or absence of undercut at the axial wall and unsupported lip of enamel. The assessment was performed by two calibrated evaluators. Then, data were descriptively analyzed. Data for occluso-cervical dimension and TOC were descriptively analyzed according to their location. Results: Thirty-nine percent of premolars, 77% of first molars, and 91% of second molars had an average occluso-cervical dimension of less than 3 mm (premolars) and 4 mm (molars), with most of the preparations having a TOC of more than 20 degrees. More than 50% of preparations had undercut, unsupported enamel and/or unacceptable finish line quality. Conclusions: The quality of tooth preparation including finish line quality, absence of unsupported enamel and undercut at the axial wall should be evaluated when preparing monolithic zirconia crowns.
      Citation: Dentistry Journal
      PubDate: 2021-09-27
      DOI: 10.3390/dj9100112
      Issue No: Vol. 9, No. 10 (2021)
  • Dentistry Journal, Vol. 9, Pages 113: A Hands-On Exercise on Caries
           Diagnostics among Dental Students—A Qualitative Study

    • Authors: Heidi Kangas, Saujanya Karki, Tarja Tanner, Anne Laajala, Helvi Kyngäs, Vuokko Anttonen
      First page: 113
      Abstract: According to current care practices, the aim is to prevent the onset of caries lesions and to stop the progression of incipient lesions. A visual lesion assessment system, International Caries Detection and Assessment System (ICDAS), has been developed to promote reliability and repeatability of assessment of different stage caries lesions. The aims of this study were to evaluate the experiences of a hands-on exercise with authentic teeth as an adjunct to lecturing among third-year dental students and to evaluate the learning process during the hands-on exercise measured by qualitative (inductive content) analysis of the given feedback. In 2018, 51 third-year dental students at the University of Oulu, Finland, participated in a hands-on exercise on caries detection, where they assessed the depth and activity of lesions in extracted teeth using the ICDAS classification. After the lecture, students evaluated the exercise, giving feedback according to five given topics, three of which were analyzed using inductive content analysis. The exercise was considered useful and necessary but, overall, also challenging. The diverse activities and materials, as well as observational methods, promoted learning. The classification of lesions, the diagnostic methods, and the fact that there was not enough time to adopt things during the exercise were found to be challenging. For developing the exercise, the students suggested that more time should be scheduled for it and there should be more individual teaching. This qualitative study showed that, despite the challenge in caries diagnostics, dental students perceive the hands-on exercise as both a communal and individual learning experience.
      Citation: Dentistry Journal
      PubDate: 2021-09-28
      DOI: 10.3390/dj9100113
      Issue No: Vol. 9, No. 10 (2021)
  • Dentistry Journal, Vol. 9, Pages 114: Impact of Bone Augmentation of
           Facial Bone Defect around Osseointegrated Implant: A Three Dimensional
           Finite Element Analysis

    • Authors: Malik Hudieb, Mustafa AlKhader, Salah Mortaja, Mohammad Abusamak, Noriyuki Wakabayashi, Shohei Kasugai
      First page: 114
      Abstract: (1) Background: When dental implants are placed at the esthetic zone, facial bone fenestration might be expected. This study aimed to evaluate the biomechanical effect of bone augmentation around implants with facial bone fenestration defects using the finite element method. (2) Methods: An anterior maxillary region model with facial concavity was constructed with a threaded implant inserted following the root direction, resulting in apical threads exposure to represent the fenestration model. Several bone coverage levels were simulated by gradually shifting the deepest concavity point buccally, mimicking bone augmentation surgeries with different bone fill results. Oblique forces were applied, and analysis was performed. (3) Results: Peak compressive stress magnitude and distribution varied according to the level of exposure and facial concavity depth. The fenestration model demonstrated a slightly lower peak peri-implant bone stress, smaller implant displacement, and smaller bone volume with strain levels above 200 µ strain. A gradual increase in compressive stress, implant displacement, and bone volume exhibited strain level above 200 µ strain was observed with the increased bone fill level of the facial bone fenestration. (4) Conclusions: Exposure of implants apical threads at the maxillary anterior region does not significantly affect the peri-implant stress and strain results. However, increasing the buccolingual width and eliminating the buccal concavity might increase the peri-implant bone volume exhibited favorable loading levels.
      Citation: Dentistry Journal
      PubDate: 2021-10-03
      DOI: 10.3390/dj9100114
      Issue No: Vol. 9, No. 10 (2021)
  • Dentistry Journal, Vol. 9, Pages 115: The Fracture Resistance of
           Additively Manufactured Monolithic Zirconia vs. Bi-Layered Alumina
           Toughened Zirconia Crowns When Cemented to Zirconia Abutments. Evaluating
           the Potential of 3D Printing of Ceramic Crowns: An In Vitro Study

    • Authors: Amirali Zandinejad, Marta Revilla-León, Mohammad Mujtaba Methani, Leila Nasiry Khanlar, Dean Morton
      First page: 115
      Abstract: (1) Background: This study compared the fracture resistance of additively manufactured monolithic zirconia and bi-layered alumina toughened zirconia crowns on implants. (2) Methods: Maxillary model with a dental implant replacing right second bicuspid was obtained. Custom abutments and full-contour crowns for additively manufactured monolithic zirconia and bi-layered alumina reinforced zirconia crowns (n = 10) were fabricated. The crowns were cemented to implant-supported zirconia abutments and the assembly fixed onto resin blocks. Fracture resistance was measured using a universal testing machine at a crosshead speed of 2 mm/min. A Kruskal–Wallis test was used to analyze the data. (3) Results: Although additively manufactured monolithic zirconia crowns demonstrated a higher mean fracture resistance than bi-layered alumina toughened zirconia crowns, statistical analysis revealed no significant difference in fracture resistance between the two groups. All specimens fractured at the implant–abutment interface. (4) Conclusions: Additively manufactured bi-layered alumina toughened zirconia crowns demonstrated similar fracture resistance to additively manufactured monolithic zirconia crowns when cemented to implant-supported zirconia abutments.
      Citation: Dentistry Journal
      PubDate: 2021-10-08
      DOI: 10.3390/dj9100115
      Issue No: Vol. 9, No. 10 (2021)
  • Dentistry Journal, Vol. 9, Pages 116: The Impact of the COVID-19 Pandemic
           on Dental Education: An Online Survey of Students’ Perceptions and

    • Authors: Ana Badovinac, Matej Par, Laura Plančak, Marcela Daria Balić, Domagoj Vražić, Darko Božić, Larisa Musić
      First page: 116
      Abstract: Purpose: Dental education institutions worldwide experienced disruptive changes amid the COVID-19 pandemic, with a rapid switch to the online learning format. Thus, this study aimed to assess the impact of the COVID-19 pandemic on dental education and evaluates the perceptions and attitudes of students towards the introduction of online learning in the School of Dental Medicine in Zagreb, Croatia. Methods: A survey was conducted on a population of undergraduate students. It was comprised of perceptions and attitudes of students on the impact of the COVID-19 pandemic on their psychoemotional status, changes introduced in the educational system, and online learning in particular. Results: Of the 352 students that completed the survey, 66.2% of students reported being psychoemotionally affected by the lockdown. The most significant impact of the switch from in-person to online learning was observed in terms of missing contact with lecturers (60.3%) and peers (90.3%) and loss of practical courses, regarding which 65% of students agreed that they could not be compensated. While only 36.1% reported that online teaching fully met their expectations, the majority of the students (61.9%) agreed that online lectures were as valuable as in-person lectures and that the theoretical courses could be carried out online in the future as well (69.9%). Conclusions: Students reported relative satisfaction with changes in the learning format and a positive attitude towards online learning; however, several challenges and obstacles were identified.
      Citation: Dentistry Journal
      PubDate: 2021-10-09
      DOI: 10.3390/dj9100116
      Issue No: Vol. 9, No. 10 (2021)
  • Dentistry Journal, Vol. 9, Pages 117: Prevalence of Dental Malocclusions
           in Different Geographical Areas: Scoping Review

    • Authors: Niccoló Cenzato, Anna Nobili, Cinzia Maspero
      First page: 117
      Abstract: The World Health Organization (WHO) considers malocclusion one of the most important oral health problems, after caries and periodontal disease. Its prevalence is highly variable and is estimated to be between 39% and 93% in children and adolescents. Due to the importance of malocclusions in dentistry, the aim of our review is to assess the frequency of malocclusions among different geographical regions. A literature research was performed through the Pubmed, Medline, Scopus, Web of Science, LILACS, Open Grey and Cochrane Library databases. The “PRISMA” guidelines were used for the following review. Fourteen studies were analysed for this review. Class I was found most frequently, followed by class II and finally class III. Considering the other anomalies, crowding was one of the most frequent with a prevalence of up to 84%, followed by spacing, which reached a frequency of 60%. Prevalence of crossbite and openbite was quite variable, while the evaluation of deepbite revealed more uniform values. The prevalence varied widely for most of the types of malocclusion in relation to the different populations, which suggests a role of genetics and environmental influences, typical of each population in determining dental problems.
      Citation: Dentistry Journal
      PubDate: 2021-10-11
      DOI: 10.3390/dj9100117
      Issue No: Vol. 9, No. 10 (2021)
  • Dentistry Journal, Vol. 9, Pages 118: Usefulness of an Endodontic Case
           Difficulty Assessment Form of Root Canal Treatments in Dental Education in

    • Authors: Reetta Pesonen, Tarja Tanner, Taina Käkilehto, Kristiina Oikarinen-Juusola, Marja-Liisa Laitala, Vuokko Anttonen
      First page: 118
      Abstract: According to current care guidelines, it would be beneficial to evaluate the difficulty of a root canal treatment (RCT) after the decision of an indicated RCT. For this matter, several difficulty assessment forms have been developed. In this pilot study, fifth-year dental students evaluated the usefulness of the Endodontic Case Difficulty Assessment Form (ECAF) presented in the Finnish Current Care Guidelines for Endodontic Treatment (2014). Another aim was to postoperatively investigate how well the evaluation by dental students using the ECAF associated with the outcome of RCT evaluated by a specialist in endodontics. The dental students’ (n = 33) and the supervisor’s assessments of the RCTs were compared postoperatively at the Dental Educational Unit, Oulu, Finland. After completing the ECAF, the students’ experiences of its use were explored with a structured form. In ECAF, patient-derived factors, such as gagging, deviant crown morphology, and complications in previous endodontic treatment, were all significantly associated with complications in RCTs by the dental students (p < 0.05). The assessments by students and the supervisor differed in 55% of cases, especially in moderately difficult cases. In the majority of these cases (71%), the students evaluated the case to be easier than the teacher. Students found the ECAF user-friendly, even if it did not demonstrate their competence in accomplishing RCTs. The ECAF appears useful for junior dentists, specifically in terms of distinguishing the least and most difficult cases. A simpler form could be useful for students and clinicians.
      Citation: Dentistry Journal
      PubDate: 2021-10-14
      DOI: 10.3390/dj9100118
      Issue No: Vol. 9, No. 10 (2021)
  • Dentistry Journal, Vol. 9, Pages 119: Therapeutic Effect of Polidocanol
           Sclerotherapy on Oral Vascular Malformations

    • Authors: Satoshi Fukuzawa, Kenji Yamagata, Makiko Okubo-Sato, Kazuhiro Terada, Fumihiko Uchida, Naomi Ishibashi-Kanno, Hiroki Bukawa
      First page: 119
      Abstract: Various treatments for oral vascular malformation (VM) have been reported. Polidocanol and absolute ethanol have also been reported for sclerotherapy. However, there are still few reports on the therapeutic effect and dosage of polidocanol sclerotherapy. Therefore, we examined its therapeutic effects on oral VM. There were 17 sites of VMs, with nine patients diagnosed with oral VM at the Department of Dental and Oral Surgery, Tsukuba University Hospital. The medical records were retrospectively investigated to determine the site, hemangioma volume, polidocanol injection volume, and therapeutic effect. The volume of hemangiomas was calculated using magnetic resonance images. Based on the site, oral VMs were observed in the tongue, buccal mucosa, lips, and oral floor in eight, three, five, and one patients, respectively. The average size of the site was 3071 mm3. The average injection dose of polidocanol at one site was 2.86 mL, the average number of administrations was 1.6, and the response rate was 88.2%. No adverse events were observed. The median numerical rating scale scores were 2/10 (0–6/10) and 0/10 (0–1/10) the day after surgery and 1 week after surgery, respectively. Univariate regression analysis of the total dose in successful cases provided the following formula: 1.3 + 0.00025 × volume (mm3) (mg). Polidocanol sclerotherapy is an effective treatment method for oral VM.
      Citation: Dentistry Journal
      PubDate: 2021-10-14
      DOI: 10.3390/dj9100119
      Issue No: Vol. 9, No. 10 (2021)
  • Dentistry Journal, Vol. 9, Pages 120: Quality and Reliability of Halitosis
           Videos on YouTube as a Source of Information

    • Authors: Atik Ramadhani, Zenobia Zettira, Yuanita Lely Rachmawati, Ninuk Hariyani, Diah Ayu Maharani
      First page: 120
      Abstract: Halitosis is a common condition that adversely affects quality of life. Through YouTube, people access oral health information. This study aimed to analyze the quality and comprehensiveness of the content, and reliability of halitosis videos hosted on YouTube. In total, 300 videos were collected based on three search keywords, and the number of likes, dislikes, views, duration, interaction index, viewing rate, and source category. Subsequently, the video score, which represents the content quality and comprehensiveness was used to categorize videos as poor, good, and excellent. DISCERN score was used to assess video reliability. Of the 105 videos analyzed, 68 (64.8%) were uploaded by personal users. In general, videos were categorized as poor and have low reliability. Videos sourced from healthcare professionals showed the highest quality, comprehensiveness of the content, and reliability (p < 0.05). There was no difference in the number of viewers for video duration less than or more than 4 min (p > 0.05). YouTube users prefer low-quality videos over high-quality ones, indicating that viewers cannot differentiate between reliable and potentially biased content. It is critical to enable viewers to critically assimilate information hosted on YouTube to make effective oral healthcare decisions.
      Citation: Dentistry Journal
      PubDate: 2021-10-15
      DOI: 10.3390/dj9100120
      Issue No: Vol. 9, No. 10 (2021)
  • Dentistry Journal, Vol. 9, Pages 121: Nonrestorative Management of Dental

    • Authors: Ollie Yiru Yu, Walter Yu-Hang Lam, Amy Wai-Yee Wong, Duangporn Duangthip, Chun-Hung Chu
      First page: 121
      Abstract: The World Dental Federation (FDI) policy statement in 2016 advocated evidence-based caries-control measures for managing dental caries. The caries management philosophy has shifted from the traditional surgical manners to minimal intervention dentistry. Minimal intervention dentistry aims to extend the longevity of natural teeth. It places the nonrestorative approaches as a priority. The nonrestorative approaches for caries management aim to tackle the etiological factors of dental caries. Caries can be prevented or reversed by restricting the sugar intake and its frequency in the diet, improving oral hygiene practices, and using fluoride toothpaste. This article aims to present strategies for the nonrestorative management of dental caries, which are divided into four components to address the different etiological factors of dental caries. The first component is controlling dental plaque. Strategies for plaque control include oral hygiene instruction, motivational interviewing, mechanical plaque control, and chemical plaque control. The second component for nonrestorative management is reducing the risk of caries by identifying caries risk factors and protective factors, assessing personal caries risk, and customizing a treatment plan. Evidence-based measures for caries prevention include using fluoride, and dental sealants should be provided. The third component includes topical treatment to remineralise early carious lesions. The last component is long-term follow-up. Appropriate strategy adoption for the nonrestorative management of dental caries prolongs the life span of the teeth and sustains the good oral health of patients.
      Citation: Dentistry Journal
      PubDate: 2021-10-18
      DOI: 10.3390/dj9100121
      Issue No: Vol. 9, No. 10 (2021)
  • Dentistry Journal, Vol. 9, Pages 122: A Reliable Surgical Procedure for
           Sinus Floor Augmentation with Antral Pseudocysts

    • Authors: Yasuhiro Nosaka, Hitomi Nosaka, Yasushi Nakajima, Tadasuke Tanioka, Daniele Botticelli, Shunsuke Baba
      First page: 122
      Abstract: An antral pseudocyst (AP) is a common well-defined ‘dome-shaped’ faintly radiopaque lesion of the maxillary sinus, and usually does not require treatment in asymptomatic patients. However, when sinus floor augmentation is required to increase bone volume for implant installation, the elevation of the sinus mucosa might drive the AP against the ostium. This might cause its obstruction and, as possible consequence, sinusitis. The purpose of this study was to investigate the clinical and tomographic conditions of APs to identify a predictable cyst removal that might allow a safety sinus floor augmentation. A total of 52 maxillary sinuses in 46 patients (mean age 55.1 years) presenting AP were examined by cone beam computed tomographies (CBCTs). A two-stage approach was applied. At the first surgery, the cystic lesions were further inspected by an endoscope through the antrostomy, and histopathological diagnosis of the removed tissues was carried out. After the confirmation of decrease of the swelling of sinus membrane by CBCT, the sinus floor augmentation was performed, at least four months after cyst removal. The color and transparency of the 86 cystic lesions were classified into 4 types. The whitish transparent cysts were 34 (39.5%), the yellowish transparent cysts were 18 (20.9%), the dark purple transparent cysts were 8 (9.3%) and the milky-white opaque cysts were 26 (30.2%). The contents of the 60 (69.8%) transparent cysts were serous fluid, but those of milky-white cysts were composed of viscous or elastic soft tissues, and the aspiration of the contents was unsuccessful. The analysis of the preoperative CBCT did not provide certainty on the contents of the cystic lesions. All cystic lesions were diagnosed as AP, and an infection was identified in one AP, presenting marked infiltration of the inflammatory cells. Considering the difficulties of performing a correct diagnosis of the AP content by a CBCT analysis, the risk of failure of the surgery that creates severe afflictions to the patients, and the necessity of a histological evaluation of the cyst, a two-stage surgery appeared to be the most reliable procedure.
      Citation: Dentistry Journal
      PubDate: 2021-10-18
      DOI: 10.3390/dj9100122
      Issue No: Vol. 9, No. 10 (2021)
  • Dentistry Journal, Vol. 9, Pages 123: A Contemporary Evaluation on
           Posterior Direct Restoration Teaching among Undergraduates in Dental
           Schools in Malaysia

    • Authors: Muhammad Syafiq Alauddin, Norazlina Mohammad, Azlan Jaafar, Faizah Abdul Fatah, Aimi Amalina Ahmad
      First page: 123
      Abstract: There is a current trend to restore posterior teeth with composite resin due to increasing demands on natural tooth colour restoration and increased concern about the safety of amalgam restorations. The objective was to evaluate the current teaching of posterior direct restoration among restorative dental lecturers in Malaysia compared to available international literature. An online questionnaire, which sought information on the teaching of posterior restoration was developed and distributed to 13 dental schools in Malaysia. The response rate for the questionnaire was 53.8%. The most popular posterior restoration teaching methods among the respondents were lecture (95.7%), demonstration (87.0%) and problem-based learning (PBL) (73.9%), while continuous assessment and a practical competency test (82.6%) were the most popular assessment methods. Placing a hard setting calcium hydroxide and GIC base for deep cavity restored by composite restoration was taught in 79.2% of cases. The standard protocols for posterior composite restoration were incremental filling in deep cavity (87.5%), using circumferential metal bands with wooden wedge (91.7%), with a total etch system (95.8%), using a light emitting diode (LED) light curing unit (91.7%), finishing using water cooling (80%) and finishing with a disc (87.5%). Graduates from dental schools in Malaysia received similar theoretical, preclinical and clinical teaching on posterior restoration techniques, although there were variations in the delivery methods, techniques and assessments, pointing to a need for uniformity and consensus.
      Citation: Dentistry Journal
      PubDate: 2021-10-19
      DOI: 10.3390/dj9100123
      Issue No: Vol. 9, No. 10 (2021)
  • Dentistry Journal, Vol. 10, Pages 1: A Qualitative Exploration of Existing
           Reflective Practices Used by Undergraduate Dental Students in Paediatric

    • Authors: Faith Campbell, Kirsten Jack, Helen Rogers
      First page: 1
      Abstract: Background: Reflection is increasingly significant for dental students and professionals and is a continuing requirement of dental regulatory bodies. There is a paucity of evidence regarding how best to facilitate deep reflection for dental students. This study explored whether the use of clinical logbooks in undergraduate clinical attachments in Paediatric Dentistry was facilitating deep reflection. Methods: This qualitative study used individual interviews for data collection. This was conducted at the University of Sheffield with third year undergraduate dental students and clinical teaching staff. Interviews were immediately transcribed verbatim. A reflexive approach to thematic analysis was used to co-constitute the data, enabling the development of the thematic framework. Results: The sample compromised 10 students and 4 educators. Thematic analysis generated 4 key themes: understanding of reflection, preparation for reflection, importance of learning through experience, and suggestions for development. The findings indicated that students perceived that they were not being supported in engaging in deep reflection by the use of a clinical logbook and that greater preparation for reflection would be beneficial. Conclusions: The current study revealed that using clinical logbooks during clinical attachments in Paediatric Dentistry was not facilitating deep reflection. Further research is required to explore how deep reflection can be facilitated for undergraduate dental students undertaking clinical learning.
      Citation: Dentistry Journal
      PubDate: 2021-12-23
      DOI: 10.3390/dj10010001
      Issue No: Vol. 10, No. 1 (2021)
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