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Language Journal of Clinical and Experimental Dentistry. 2020. Vol. 12, no. 10
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- Apical periodontitis and glycemic control in type 2 diabetic patients : cross-sectional study(2020) Perez-Losada, Flor-de-Liz; López López, José; Martín González, Jenifer; Jane Salas, Enric; Segura-Egea, Juan J.; Estrugo Devesa, AlbertThe objective of this study was to analyze the possible relationship between the glycemic control and the prevalence of apical periodontitis in type 2 diabetic patients. The null hypothesis was that apical periodontitis is not associated with glycemic control. In a cross-sectional design, the radiographic records of 216 type 2 diabetic patients (65.0 ± 10.7 years), 117 men (54.2%) and women (45.8%), were examined. Glycated hemoglobin (HbA1c) was used to assess glycemic control, considering an HbA1c level < 6.5% as well-controlled diabetes. Apical periodontitis was diagnosed as radiolucent periapical lesions using the periapical index score. The Student t test, chi-square test, and logistic regression analysis were used in the statistical analysis. The average HbA1c value was 7.0 ± 2.2%. Forty seven (21.8%) had HbA1c levels under 6.5% (mean ± SD = 6.0 ± 2.2%), being considered well-controlled patients, and 169 (78.2%) had an HbA1c level ? 6.5% (mean ± SD = 7.8 ± 2.24%), being considered poor controlled patients. Forty four per cent of diabetics had apical periodontitis, 12.5% had root-filled teeth, and 52.3% had root filled teeth with radiolucent periapical lesions. No significant differences were observed in any of these three variables between patients with good or poor glycemic control. In the multivariate logistic regression analysis the presence of radiolucent periapical lesions in at least one tooth did not correlate significantly with HbA1c levels (OR = 1.4; 95% C.I. = 0.70 ? 3.09; p = 0.31). The results reveal no association of glycemic control with the prevalence of apical periodontitis or root canal treatment in diabetic patients.
- The use of the endoscope in endodontic surgery : a systematic review(2020) Pallarés Serrano, Antonio; Glera-Suárez, Pablo; Soto-Peñaloza, David; Peñarrocha Oltra, David; Arx, Thomas von; Peñarrocha Diago, MiguelA systematic review of clinical studies with at least one year of follow-up was done to assess the success rate of endodontic surgery including endoscopy for magnification and illumination. Five electronic databases were searched, including MEDLINE (via PubMed), Embase, Web of Science, Scopus and the Cochrane Library of the Cochrane Collabora-tion (CENTRAL). There were no language restrictions, and the search covered the period up to October 2019. The risk of bias was evaluated with the Cochrane Collaboration tool for randomized clinical trials and the ROBINS-I tool for non-randomized studies of inter-ventions. From the 278 initially identified titles, finally 2 randomized controlled trials and 3 non-randomized studies met the inclusion criteria. All the included studies analyzed the success rate of endodontic surgery performed with the help of endoscope for magnifica-tion and illumination. The risk of bias was high for allocation sequence concealment and blinding of participants and personnel in the randomized controlled trials. The nonran-domized studies showed limitations in terms of confounding bias and blinding of outcome assessment. Endodontic surgery with the help of an endoscope is associated with high success rates (88.9-94.9%). The endoscope was associated with high success rates of endodontic sur-gery in the included studies. Future studies on this topic are warranted, due to the meth-odological issues and the scarce number of randomized clinical trials.
- Proposal for a provisional protocol for the care and identification of dental transmission routes of COVID-19 in Latin America : a Literature review(2020) Mayta-Tovalino, Frank; Diaz-Soriano, Ana; Munive-Degregori, Arnaldo; Pérez-Vargas, Fernando; Luza, Silvia; Bocanegra, Rocio; Mauricio, FrancoThe new coronavirus called COVID-19 originated in the city of Wuhan, China and has currently spread to different continents, leading the World Health Organization (WHO) to declare a ?pandemic?. Therefore, the aim of this review was to present a new proposal for a care protocol in Peruvian Dentistry: Provisional review of the diagnosis, treatment, epidemiological characteristics, routes of transmission and recommendations of COVID-19. A search of digital scientific literature was made in the databases: Science Direct, Pubmed and Google Scholar. The Boolean operators AND, OR and NOT: ?Covid-19? ?Dental? ?Routes of transmission. They were included Scientific articles published in English between December 2019 - March 2020. Different studies were found mainly of epidemiological, observational and experimental design. On March 6, 2020, the President of the Republic of Peru confirmed and declared in Peru the beginning of the first case of coronavirus. According to reports from the Ministry of Health (MINSA) as of July 30, there are: PCR (+) 108, 299; Rapid test (+) 292, 384 positive cases and 18, 816 deceased with a lethality of 4.7%. Within the limitations of this literature review, the presence of the virus is inevitable in dental practice. The dentist must understand the evolution of this microorganism like all vulnerable professionals in the health sciences.
- Orthodontists? preference on type of rigid fixed functional appliance for skeletal Class II correction : a survey study(2020) Borghei, Sarah; Broadbent, James; Stevens, Richard; Chaudhry, Kishore; Subramani, KarthikeyanRigid fixed functional appliances are most commonly used to correct skeletal Class II malocclusions. The objective of this study was to assess orthodontists? preference of different rigid fixed functional appliances used in the U.S.A for correction of skeletal Class II malocclusions. A survey on use and preference of rigid fixed functional appliances for skeletal Class II correction was emailed to 2,227 members of the American Association of Orthodontists (AAO) in the U.S.A. Frequency distribution of different responses and their association with demographic factors was assessed. Out of 140 orthodontists completing the survey, 110 responded as using rigid fixed functional appliances. Eight incomplete responses were eliminated from data analysis. 51.5% (68/132) orthodontists used rigid fixed functional appliances. The most preferred rigid fixed functional appliance was the Herbst appliance with 72% response followed by Mandibular Anterior Repositioning Appliance (24%) and AdvanSync (4%). There was no statistically significant difference in use of rigid fixed functional appliances between different age groups (p=0.284). However, the 40-54 age group used the most rigid fixed functional appliances in practice, followed by the 25-39 year age group and the 55-69 age group using these appliances the least. There was statistical significance between the type of practice setting one works in and the use of rigid fixed functional appliances in practice (p=0.022). About 52% of orthodontists use rigid fixed functional appliances to correct skeletal Class II malocclusions. The Herbst appliance is the most commonly used and most preferred amongst all rigid fixed functional appliances with a 72% preferred rate.
- Effect of a single initial phase of non-surgical treatment of peri-implantitis : abrasive air polishing versus ultrasounds. A prospective randomized controlled clinical study(2020) Aloy Prósper, Amparo; Pellicer Chover, Hilario; Peñarrocha Oltra, David; Peñarrocha Diago, MiguelNon-surgical treatment of peri-implantitis includes a correct mechanical debridement of the implant surface to reduce the inflammation and recondition the soft tissues. The aim of the study was to evaluate the results of a single phase of non-surgical therapy by comparing the effect of curettes and ultrasounds versus curettes and abrasive air polisher (Air-Flow) in the peri-implant tissue conditions, and patient satisfaction. A double-blind randomized and controlled prospective clinical study was conducted on patients in peri-implant maintenance phase diagnosed of peri-implantitis treated in the Oral Surgery Unit of the Stomatology Department of the Faculty of Medicine and Dentistry of the University of Valencia, between September of 2017 and May of 2018. They were divided into 2 groups: Group 1: curettes and ultrasounds, and Group 2: curettes and Air-Flow. The clinical and radiological baseline parameters were evaluated after 3-weeks of treatment, as well as patient satisfaction. The sample included 34 patients. Group 1 (17 patients, 38 implants) and Group 2 (17 patients, 32 implants). All the variables improved statistically significantly after treatment in both groups, with the exception of recessions and keratinized mucosa and bone loss that did not vary. When comparing both groups, the type of treatment did not influence the majority of the variables, with the exception of the plaque index (p=0.011) and modified bleeding index from the palatine (p=0.048), which reduced statistically significant in the group 2, as well as the patient satisfaction which was higher in the group 2 (p<0.001). An initial phase of non-surgical treatment achieves an improvement of the peri-implant clinical parameters, thought the method of debridement used seems not to influence.
- Tomographic evaluation of dentoskeletal effects of rapid maxillary expansion using Haas and Hyrax palatal expanders in children : a randomized clinical trial(2020) Araújo, Marília-Carolina; Bocato, Jéssica-Rico; Oltramari, Paula-Vanessa-Pedron; de Almeida, Marcio-Rodrigues; Conti, Ana-Cláudia-de Castro-Ferreira; Fernandes, Thais-Maria-FreireRapid maxillary expansion (RME) is a usual procedure for correcting the transversal maxillary deficiency. Among the most used appliances are the Haas type (tooth-tissue-borne) and Hyrax (tooth-borne) whose main difference is the design. This study aimed to evaluate the dentoskeletal effects of RME using two different expanders in children. The sample was composed of 42 children of both gender presenting unilateral or bilateral posterior crossbite with mean age 9.49 (SD± 1.35). Patients were randomized into two groups according to the type of expander: Hyrax (n= 21, 9 boys and 12 girls) and Haas (n= 21, 11 boys and 10 girls). Multiplanar coronal and axial slices obtained from cone-beam computed tomography images (i-Cat, Hartsfield, PA, USA) were used at pretreatment (T1) and after 6 months when the expander was removed (T2). Measurements were performed on Dolphin Imaging Systems 11.7 software (Chatsworth, California, USA). The following variables were evaluated: inclinations of the posterior teeth, transverse skeletal widths, length of maxillary dental arch, buccal bone thickness and level of buccal alveolar crest. Statistical analysis performed using chi-squared test to compare the sex ratios between groups and independent t test with the Bonferroni correction for multiple tests. RME increased all maxillary transverse dimensions, regardless of the type of expanders used. Subjects in the Hyrax group experienced significantly increase in the lingual bone thickness (0.94 mm) compare to Haas group (0.21 mm). The Hyrax-type expander produced greater increase in the lingual bone thickness than did the Haas-type expander, but this effect might not be clinically significant. Both appliances presented similar transversal gain and tended to produce similar orthopedic and orthodontic effects.
- What can we do with a dental avulsion? A multidisciplinary Clinical Protocol(2020) Bustamante-Hernández, Naia; Amengual Lorenzo, José; Fernández Estevan, Lucía; Zubizarreta Macho, Álvaro; Martinho da Costa, Cátia-Gisela; Agustín Panadero, RubénThe aim of this case report was to explain a multidisciplinary and conservative approach carrying out the replantation of an avulsed closed apex central incisor stored in dry conditions for a 16-hour period from the moment of trauma. This report describes a case of a 28 year-old male who suffered contusion of the upper lip, avulsion of right upper central incisor, enamel cracks after trauma of left upper central incisor and upper left lateral incisor crown fracture due to an accident. Avulsed tooth was dry stored and it was replanted 16h after the trauma. The root was disinfected and the necrotic periodontal tissue removed, the endodontic treatment was done before replantation and a flexible splint was applied to tooth 13 to tooth 23. Two months later a contralateral tooth presented crown discoloration occurred due to pulp necrosis an endodontic treatment as well as bleaching were carried out. An esthetic restoration for lateral incisor crown fracture was also done. In the one year review the patient remains asymptomatic, with no signs of root resorption or ankylosis of the damaged teeth. A conservative approach of tooth with delayed reimplantation can be a stable and functional with the appropriate treatment procedures. A clinical protocol for patients and professionals for the treatment of the avulsed tooth is proposed.
- Evaluation of effect of a vitamin-based barrier cream on the clinical severity of actinic cheilitis : a preliminary study(2020) Rodrigues, Mariana-Sudati; Kaefer, Eduardo-Oliveira; Sganzerla, Juliana-Tomaz; Gassen, Humberto-Thomazi; dos Santos, Rubem-Beraldo; Miguens-Jr, Sergio-Augusto-QuevedoActinic Cheilitis (AC) is a pathological condition of the labial mucosa considered potentially malignant. The aim of this study was to investigate the effect of treatment of AC with daily use of a vitamin-based barrier cream. For this clinical study, 36 participants with lower-lip AC were recruited from three oral medicine services. At baseline, participants were evaluated by clinical examination and clinical severity of AC was classified as grade I to IV. All participants were dispensed a tube of a barrier cream containing vitamins A, D, E and ZnO to apply once nightly for 90 consecutive days. Monthly follow-up was performed to reclassify AC clinial severity. The primary outcome of interest was clinical remission of AC at 90-day follow-up compared to baseline. Progressive remission of AC lesions was observed as early as the first month and throughout the assessment period (p = 0.000). The 3-month period was insufficient for remission of lesions, especially among male participants (p = 0.002) and with a longer sun exposure in years (p = 0.007). Daily use of the vitamin-based barrier cream had a promissing positive impact on the severity of actinic cheilitis. However, a 90-day course of treatment was not sufficient to achieve lesions remission. The findings of this study suggest a promising new avenue for the treatment of lower-lip AC.
- Pattern of distribution and etiologies of Midline diastema among Kurdistan-region Population(2020) Hasan, Hasan-Sabah; Al Azzawi, Arkan-Muslim; Kolemen, AyshanAim of study was to evaluate the prevalence and etiological factors that contribute in midline diastema in Kurdistan region-Iraq population among different age groups and genders. Orthodontic patients sample of (EX: 1021orthodontic patients (537 males and 484 females) were randomly selected from Kurdistan-region population, attending to orthodontic department of khanzad polyclinic teaching center (General directorate of hawler / Ministry of health/ Kurdistan region- Iraq) during 2018-2019 period. Aged (13-35 years) with mean age ± SD was 19.6 ± 4.8 years, with a median of 19 years. The examination included patient history taking, intraoral examination, photograph, intraoral periapical radiography of incisors area and panoramic radiographic. Diastema consider positive when the space between central incisors is 0.5mm and more, width was measured clinically used digital Vernier calipers at one millimeter above the incisors edge. The prevalence of midline diastema was 23.2%. located in the maxilla (97%), in mandible (1.3%) and in both was (1.7%). The prevalence of midline diastema differs significantly between the age groups (p< 0.001). The highest prevalence (55.8%) was among patients aged ? 30 years, and it was also high (37.7%) among those aged < 15 years. The prevalence among females (26.4%) was significantly higher than the prevalence (20.3%) among males (P= 0.020). The main causes of midline diastema in females was thumb sucking and missing lateral incisors (14.1% and 12.5% respectively) and in males was high labial frenum and super numerally teeth (39.4% and 30.3% respectively). Prevalence of diastema in Kurdistan regional- Iraq area was (23.2%), the location mostly in maxilla (97%). The prevalence of diastema in females more than males. The main causes of diastema in females was thumb sucking and missing lateral incisors while in the males was high labial frenum and super numerally teeth.
- Assessment of the stresses produced on the bone implant/tissue interface to the different insertion angulations of the implant - a three-dimensional analysis by the finite elements method(2020) Brum, Joelson-Rodrigues; Macedo, Fabiano-Rito; Oliveira, Millena-Barroso; Paranhos, Luiz-Renato; Brito Jr, Rui Barbosa de; Ramacciato, Juliana CamaThe present study aimed to assess the stresses produced on the surface of the bone tissue around dental implants with three different insertion angulations subjected to axial and oblique loading. The study was created according to the recommendations of the Checklist for Reporting In-vitro Studies (CRIS). The Straumann? bone level RC (4.1 x 10 mm) implant, Cone Morse connection (CM), RC Straumann Variobase? with abutment (3.5 mm) was placed in the region of element 16, with the platform positioned at the height of the bone crest. Three assessment models were produced: model M1 or control - implant perpendicular to the bone crest; model M2 - implant angulated at 17° relative to the bone crest; and model M3 - implant angulated at 30° relative to the bone crest. The masticatory loads were simulated with 100 N of intensity and two loading patterns (axial and oblique) were applied to each model. Then, the models were exported to the finite elements simulation software Ansys Workbench V19.2 (Ansys Inc., Canonsburg, PA, USA). To assess the finite elements, qualitative and quantitative analyses were performed. It was observed that, under axial loading, qualitatively, the peaks occurred in the cavosurface region, palatal aspect in M1 and M2, and buccal aspect in M3. Quantitatively, the greatest angulation resulted in a low stress peak. Under oblique loading, qualitatively, the peaks occurred in the cavosurface region, buccal aspect in the three groups. Quantitatively, the greatest angulation of the implant resulted in an increase in stress peaks on the buccal aspect. Under axial loading, the three insertion angulations of the implant - M1, M2, and M3 - were clinically viable. When subjected to oblique loading, the 30° angulation (M3) suggested a significant risk of bone loss and it was contraindicated.
- Analysis of fit on implants of chrome cobalt versus titanium frameworks made by cad / cam milling(2020) Oteiza Galdón, Begoña; Martínez González, Amparo; Vicente Escuder, ÁngelThis study analyzed the degree of passive and vertical fit achieved in frameworks using either cobalt-chromium (Co-Cr) or titanium (Ti) implant-supported fixed partial dentures ( FPDs) fabricated with a CAD/CAM milling technique. 33 3-unit FDPs, 17 of Co-Cr metal alloy (test group) and 16 of Ti (control group), were manufactured with two implants by copy milled technology. Optical microscopy was used to measure passive fit (PF) and vertical fit (VF) in all frameworks. The PF was evaluated by using the Single Screw test and the VF with the screws tightened at 20 Ncm. Descriptive and inferential analysis were performed to evaluate statistically significant differences in the tested groups for each fit. Brunner-Langer models were applied to assess potential material and implant area effects on the measurements. An ANOVA test was performed to estimate both main effects and interactions. The average PF values in the screwed implant were 4.43 ± 0.52 µm for Ti and 5.50 ± 1.61 µm for Co-Cr and in the non-screwed implant 5.59 ± 1.32 µm in the group Ti and 6.25 ± 1.55 µm the Co-Cr group. In this last implant, it was not observed statistically significant differences between both types of alloy (p = 0.178) nor between zones. Ti control group exhibited a significantly better VF than Co-Cr (p = 0.046) in the screwed implant but there were no differences in the implant not screwed. The VF in the non-screwed implant was better in lingual than in buccal zone. The PF and VF measurements observed in Co-Cr frameworks are clinically acceptable. 3-unit implant supported FPDs made with Co-Cr alloy using milling technique showed similar dimensional accuracy than those obtained with Ti.
- Peripheral odontogenic keratocyst : report of two new cases and review of the literature(2020) Rodrigues, Bruno-Teixeira-Gonçalves; Israel, Mônica Simões; de Moura, Kenia-Lorena-Monteiro; Pinheiro, Giulianna-Lima; Carlos, Román; Pires, Fábio-RamôaPeripheral odontogenic keratocyst (POKC) is a rare soft tissue entity showing the same histological characteristics of odontogenic keratocyst. Herein, we report two cases of POKC affecting the gingiva/alveolar mucosa. Case 1. A 43-year-old female was referred for evaluation of a painless well-defined nodular, sessile, non-tender swelling in the right maxillary buccal gingiva. No radiological alterations were observed. The patient was submitted to excisional biopsy and histological diagnosis was POKC. There were no signs of local recurrence after a 4-year follow-up. Case 2. A 63-year-old female was referred for evaluation of a painless well-defined nodular, sessile, yellowish swelling in the anterior mandibular alveolar mucosa. No radiological alterations were observed. The patient was submitted to excisional biopsy and histological diagnosis was POKC. Patient recovery was uneventful but she did not return for follow-up. POKC should be considered in the differential diagnosis of gingival cystic swellings and can be managed through conservative surgery.
- Shear force comparative evaluation for surface treated and non- treated 3D interim printed materials with different types of glass-ionomer cements(2020) Latz, Anna-Maria; See, Constantin von; Alevizakos, Vasilios; Sandmair, Maximilian; Othman, AhmedThe purpose of this investigation was to compare shear force of different glass-ionomer cements on 3D printed interim material in combination with and without surface pretreatment. 120 rectangular specimens made of printable provisional material (Bego, Bremen, Germany) were used. After post-processing the specimens were blasted with aluminum oxide 110µm (Bego, Bremen, Germany). Extra 120 non-surface treated specimens were used as an experimental negative test group. All 240 specimens were divided randomly into 6 groups. All were cemented with a compressive load of 20 N using universal testing machine Z010 (Zwick/Roell, Ulm, Germany) to ensure a comparable cementing process. Each of the six groups were cemented with different cements (CX Plus (Shofu, Ratingen, Germany), Vivaglass CEM PL (Ivoclar Vivadent AG, Schaan, Liechtenstein), Aqua Cem (Dentsply Sirona, Bensheim, Germany), Ketac Cem (3M, Neuss, Germany), Meron Plus AC (Voco, Cuxhaven, Germany), and Fuji 1 (GC, Tokyo, Japan). Shear force test was performed, and forces were statistically analyzed via Anova test (significance level p<0.001). All the pre-treated specimens showed a significantly higher bonding strength compared to not pretreated. Meron Plus AC showed the highest shear overall force. The Anova test showed a significant difference between all pretreated study groups (p<0.001). An increase of the necessary forces for all groups was shown in pretreated group. Within the limitations of this study, a surface pretreatment is recommended when bonding a 3D interim material with glass ionomer cements.
- Patient compliance to postoperative instructions after third molar surgery comparing traditional verbally and written form versus the effect of a postoperative phone call follow-up a : a randomized clinical study(2020) Aloy Prósper, Amparo; Pellicer Chover, Hilario; Balaguer Martínez, José; Llamas Monteagudo, Oscar; Peñarrocha Diago, MiguelThe understanding and adherence to postoperative care instructions may be influenced by how they are presented by the professional interfering the recuperation process after surgery. The aim of this study was to evaluate the effect of a postoperative phone call follow-up compared with a traditional verbally and written instructions regarding compliance of postoperative recommendations after third molar surgery; and secondly, to discover the main points of non-compliance. A randomized clinical study was performed including patients that underwent surgical extraction of an impacted mandibular or maxillary third molar in the Oral Surgery Unit of the University of Valencia from January 2016 to January 2017. Patients were randomly assigned to one of three different test groups according to how the post-operative instructions were delivered: brief written instructions, written extended instructions or brief written instructions plus a phone call follow-up at 3-day postoperative period. Patients were interviewed about their adherence to the instructions one week after surgery. The significance level was set at p<0.05. The higher score of compliance was found to the phone call follow-up group (p=0.001). No statistically significant differences were found between brief written group and the group that received written extended instructions. In the phone call follow-up group all variables assessed to the compliance were fulfilled. To brief written and written extended instructions groups, the main points of non-compliance were hygiene and smoking (p<0.001, p=0.026, respectively), and tended towards significance for chlorhexidine rinses and antibiotic, analgesic and anti-inflammatories medication prescribed. Telephone call follow-up can promote patient adherence to postoperative recommendations after third molar surgery. The main factors of non-compliance were not maintain a proper hygiene and not smoking, followed by not performing chlorhexidine rinses and not following medication prescribed.
- Two rare cases of oral metastasis arising from lung adenocarcinoma and esophageal carcinoma(2020) Rocha, Breno-Amaral; Paranaíba, Lívia M. R.; Dantas, Ciro-Dantas; de Carvalho, Maria Goretti Freire; Filho, Mário-Rodrigues-Melo; Lima, Lucianne-Maia-Costa; Souto, Giovanna Ribeiro; Horta, Martinho Campolina RebelloMetastasis to the oral cavity are rare, representing only 1% of all oral malignancies, and originate from various sites such as the breast, prostate, lung and kidney. Clinically, they can simulate reactive and inflammatory lesions common in the oral cavity, and the clinical and microscopic diagnosis of these metastasis is a challenge. In this article, we report two new cases of esophageal and lung metastasis to oral tissues, highlighting their clinical characteristics and the process of diagnostic elucidation. We emphasize the importance for clinicians to consider the possibility of metastatic lesions in the oral cavity in patients previously diagnosed with malignant lesions in distant tissues and organs.
