Log In 
Language Journal of Clinical and Experimental Dentistry. 2024. Vol. 16, no. 01
Permanent URI for this collection
Browse
Recent Submissions
- Challenges in the assessment of epithelial dysplasia in oral lichen planus and oral lichenoid lesion: Inter and intra-observer variability of the WHO criteria and binary system(Medicina Oral S.L, 2024) Marques, Letícia-Côgo; Montovani, Pâmella-de Pinho; Gonçalves, Lúcio-Souza; Cunha, Karin-Soares; Junior, Arley-Silva; Conde, Danielle-CastexBACKGROUND: Assessment of oral epithelial dysplasia is the gold standard for investigating the risk of malignant progression. The World Health Organization (WHO) methods and the binary system have limitations. This study assess the inter- and intra-observer variability of the architectural and cytological criteria and the classification of the presence and degree of epithelial dysplasia in oral lichen planus (OLP) and oral lichenoid lesion (OLL), using both the 2017 WHO criteria and the binary system. MATERIAL AND METHODS: The sample consisted of 65 biopsies from lesions classified as OLP and OLL according to the American Academy of Oral and Maxillofacial Pathology (AAOMP) criteria. The histological slides were reevaluated by two oral pathologists. RESULTS: The individual alterations with most inter-observer disagreement were atypical mitotic figures (43.1%), loss of cohesion between epithelial cells (38.5%) and drop shape rete ridges ridges (38.5%). Inter-observer agreement analysis did not show statistically significant agreement regarding the classification of epithelial dysplasia grade by WHO criteria, only regarding the binary system classification (k=0.257; p=0.035). Intra-observer agreement analysis by evaluator 1 showed that the classification of epithelial dysplasia grade according to both methods had statistically significant agreement (k=0.546; p=0.004, k=0.861; p<0.001). Considering evaluator 2, only the evaluation of the WHO system classification showed statistically significant agreement (k=0.593; p=0.010). CONCLUSIONS: The evaluation of epithelial dysplasia is subjective and focal changes and inflammatory infiltrate, characteristic of OLP and OLL, can increase the degree of disagreement among evaluators. The binary system presents better inter-observer agreement, while the WHO system presents better intra-observer agreement. Key words:Oral lichen planus, oral lichenoid lesion, oral lichenoid disease, dysplasia, inter-observer variation.
- Enamel fluorosis related with fluoride-containing water ingestion and urinary excretion in schoolchildren(Medicina Oral S.L, 2024) González-Martínez, Farith; Gómez-Scarpetta, Ruth; Salcedo, Olga-Bibiana; Bermúdez-Reyes, Patricia; Castro-Villamizar, Patricia; Cerezo, María Del Pilar; Martínez, Carmen; Tirado-Amador, Lesbia; Salas-Zambrano, Andrés; Saldarriaga, Alexandra; Sánchez-Molina, Marisol; Vila, Luis-ArmandoBACKGROUND: Natural water sources are considered as the major environmental exposure of fluoride, resulting in increased prevalence of enamel fluorosis. This type of natural exposure should be permanently monitored to avoid the interactions with other non-natural fluoride sources. We evaluated the prevalence of enamel fluorosis in Colombian schoolchildren and its relationship with fluoride-containing water ingestion exposure dose and urinary fluoride excretion. MATERIAL AND METHODS: We included 923 schoolchildren aged 7-12 years residing in eight municipalities in Colombia. Sampling of consumption water was performed in major aquifers used for daily supply. Samples were collected in 98 polyethylene containers and refrigerated until analysis. Water and urine fluoride concentrations were measured using the fluoride selective electrode method. Enamel fluorosis was evaluated using Thylstrup and Ferjerskov Index (TFI). Demographic and anthropometric characteristics were assessed. Besides, other exposures to non-natural fluoride were also evaluated. Logistic regression was applied for multiple analyses. RESULTS: The median fluoride concentration in water and urine samples was 10.5 mg/L and 0.63 mg/L respectively, with the highest value found in Algarrobo-Magdalena, and the lowest value found in Manzanares-Caldas. The overall prevalence of enamel fluorosis was 86.1%, being more frequent the mild codes with TFI-1 to TFI-2. The highest prevalence was found in Margarita-Bolívar and Manzanares-Caldas, and the most severe codes (TFI-5 to TFI-9) were detected in Manzanares-Caldas. The multiple analysis revealed water ingestion exposure dose, urinary excretion, involuntary intake of toothpaste, amount of table salt consumption and sex as significant factors (p< 0.001). CONCLUSIONS: The fluoride ingestion exposure dose and its subsequent urinary excretion could be used as estimators of past fluoride exposure, explaining the current prevalence of enamel fluorosis in Colombian schoolchildren. Key words:Fluoride, groundwater ingestion, enamel fluorosis, prevalence, severity.
- External root thermal analysis of three different obturation techniques(Medicina Oral S.L, 2024) Neto, José-Cordeiro-Lima; Suassuna, Fernanda-Clotilde-Mariz; Silva, Diego-Filipe-Bezerra; Firmino, Ramon-Targino; Bento, Patrícia-Meira; de Melo, Daniela-PitaBACKGROUND: The purpose of this study was to assess the external root surface thermal behavior when submitted to three different obturation techniques. MATERIAL AND METHODS: Forty-five single-rooted premolars were selected, prepared and randomly divided into three groups according to the studied obturation techniques: lateral condensation (LC), single cone technique (SCT) and injectable thermoplasticized technique (IT). Each tooth was placed in a customized apparatus and connected to a thermocouple. A FLIR T650sc infrared thermal camera was used to assess root temperature in a room under controlled temperature and humidity. Temperature values were recorded using the thermal camera and thermocouples before, during and 30, 60, 90, 120, 150s after obturation. Shapiro-Wilk, QQ-plot, Levene's, ANOVA-three-way, Mauchly's sphericity, Box's M and Bonferroni tests were used to assess data. The significance level was set at 5%. RESULTS: Infrared assessment showed significant temperature changes between time intervals, obturation techniques and root thirds. Temperature increase was observed 30s after obturation for STL, LC and IT, followed by a gradual temperature decline, with temperature values similar to the initial temperature at 150s for LC and IT. SCT temperature values only returned to normal 60s after obturation in the apical third and 90s in the middle and cervical thirds. In all techniques, the temperature did not rise above the critical limit of 10°C. CONCLUSIONS: All studied obturation techniques increased root surface temperature with IT showing the highest temperature increase. However, the temperature increase does not exceed the acceptable limits, not causing damage to the surrounding tissues. Key words:Endodontics, changes in body temperature, root canal filling, thermography.
- Endoperiodontal lesions: diagnosis first, then treatment and not always tooth extraction: a cross-sectional survey in Spain and a proposal of a clinical treatment protocol(Medicina Oral S.L, 2024) García-Tuñón-Pérez, Paula; Fernández-Jiménez, Aitziber; Lafuente Ibáñez de Mendoza, Irene; Estefanía-Fresco, Ruth; Marichalar-Mendia, Xabier; García-De-La-Fuente, Ana-MaríaBACKGROUND: Endoperiodontal lesion (EPL) is defined as a pathological communication between pulpal and periodontal tissues. Currently, accurate diagnosis and treatment of this pathology are challenging. This study aims to identify the different endoperiodontal therapies to propose a clinical protocol to simplify and unify the criteria for EPL treatment. MATERIAL AND METHODS: Observational cross-sectional study through an electronic survey. This study matches STROBE guidelines. The anonymous questionnaire contained open-ended and close-ended questions and was distributed to dentistry professors of the UPV/EHU and different professionals from Spanish associations and scientific societies. The data collected were analyzed using descriptive and analytical statistics. RESULTS: A total of 128 responses were obtained, of which 120 were active professionals or had not been so for less than 5 years. The majority of professionals were women (65.6%) and from the Basque Country (63.9%). A total of 86.6% reported having complementary studies to a degree or a bachelor's degree. The treatments performed by these professionals were similar to those reported in the literature, which started with root canal treatment when there was an endodontic origin (91.5%), and with basic periodontal treatment when periodontal (51.3%). CONCLUSIONS: Considering the current scientific evidence and the clinical practice of professionals in the treatment of EPL, we designed a clinical protocol. This protocol needs validation in larger populations and with longer follow-ups. Key words:Clinical protocol, Dental pulp diseases, Periodontal diseases, Review, Surveys and questionnaires.
- Notch-1/2 receptors and Jagged-1 ligand, but not HERP-1 transcription factor, are immunohistochemically expressed in the epithelial lining of periapical cysts(Medicina Oral S.L, 2024) Nikoloudaki, Georgia; Basdeki, Eirini-Iouliani; Kerezoudis, Nikolaos P.; Tosios, Konstantinos I.BACKGROUND: To further understand the involvement of Notch pathway signaling in the pathogenesis of periapical cyst the immunohistochemical expression of Notch-1 and Notch-2 receptors, Jagged-1 ligand, and HERP-1 transcription factor in the lining epithelium of periapical cysts was investigated. MATERIAL AND METHODS: Thirty human periapical cysts were immunohistochemically stained with antibodies against Notch-1, Notch-2, Jagged-1, and HERP-1. Epithelial expression of each antibody was correlated with the presence of inflammation in the connective tissue of the cystic wall. RESULTS: Notch-1 was identified in the basal and suprabasal epithelial cells of 30/30, Notch-2 in 19/24, and Jagged-1 in 27/30 cysts. HERP-1 was detected in scattered subepithelial inflammatory cells, but not in the lining epithelium of cysts. There was no significant correlation between the immunohistochemical expression of each antibody and the presence of inflammation in the connective tissue of the cystic wall. CONCLUSIONS: This immunohistochemical study showed expression of Notch-1/2 and Jagged-1 in periapical cysts that combined with the expression of HES1/5 found in a previous report, are indicative of the activation of Notch an endocrine-paracrine mechanism. Further research on the activity of Notch and other pathways in periapical cysts may contribute both to elucidate their pathogenesis and select molecular targets for future novel treatments. Key words:Odontogenic cyst, radicular cyst, etiology, epithelial cells, Notch, Jagged, HERP.
- Ex vivo evaluation of the accuracy of four electronic foraminal locators(Medicina Oral S.L, 2024) Lima, Ilana-Thais-de Freitas; Paula, Ana-Letícia-Linhares-de Sousa; Palheta-Filho, Reuton-Dos Santos; Santos, Amanda-Brito; Freitas, Nathalia-de Aguiar; Candeiro, George-Táccio-de MirandaBACKGROUND: To evaluate the accuracy of four different Electronic Foraminal Locators (EFLs): Root ZX II (J. Morita, Tokyo, Japan), Romiapex A15 (Romidan, Kiryat-Ono, Israel), FinePex (Schuster, Porto Alegre, Brazil), and VDW Gold (VDW, Munich, Germany), in determining root canal length. MATERIAL AND METHODS: Twenty-seven human single-rooted teeth had their crowns sectioned at the cementoenamel junction, and the actual length of the tooth was obtained by visualizing with an operative microscope a #15 file placed adjacent to the apical foramen. The teeth were instrumented with R25 and R40 files, and at the end of each instrumentation, measurements of the lengths of the root canals were made with #25 and #40 files. The data were statistically analyzed by ANOVA and chi-square tests and were considered significant when P0.05), both with diameters of 0.25 mm and 0.40 mm. CONCLUSIONS: It was concluded that the devices presented similar and adequate efficacy when observing the limits of acceptable measurements. It was observed that increasing the apical diameter did not influence the accuracy of EFLs in determining root canal lengths. Key words:Endodontics, working length, electronic foraminal locators, endodontic treatment.
- A comparative evaluation of concordance and speed between smartphone app-based and artificial intelligence web-based cephalometric tracing software with the manual tracing method: A cross-sectional study(Medicina Oral S.L, 2024) Gupta, Shantam; Shetty, Shravan; Natarajan, Srikant; Nambiar, Supriya; Mv, Ashith; Agarwal, SaloniBACKGROUND: This study compared the accuracy and speed of cephalometric analysis using an artificial intelligence web-based method and a smartphone app-based system with manual cephalometric analysis as the reference standard. MATERIAL AND METHODS: In this cross-sectional study, the lateral cephalograms were analysed using four methods: manual tracing, smartphone app tracing, artificial intelligence web-based automated tracing without manual landmark identification correction and artificial intelligence web-based automated tracing with manual landmark identification correction. The principal investigator obtained linear and angular cephalometric measurements to compare the accuracies of the four methods being assessed. Additionally, the duration required for landmark identification and subsequent analysis was recorded. RESULTS: The analyses included 40 lateral cephalograms that were selected based on the inclusion and exclusion criteria. Very good to excellent agreement was observed in the accuracies of the artificial intelligence web-based and smartphone app-based systems compared with manual tracing (interclass correlation coefficient values ranging from 0.707 to 0.9, p< 0.001). Of the artificial intelligence web-based systems, the method without correction of automated landmark detection showed less reliable measurements than the other methods. Cephalometric analysis using artificial intelligence web-based and smartphone app-based systems consumed less time than manual tracing (p< 0.001). CONCLUSIONS: Artificial intelligence web-based automated tracing with manual landmark identification correction and smartphone-based app provide results that are comparable to those from the manual tracing method. However, artificial intelligence web-based systems require improvements in terms of automated landmark identification to obtain results that are similar to those from the other methods being assessed. Key words:Artificial Intelligence, Cephalometry, Computer software, Mobile application.
- Comparison of dynamic cyclic fatigue resistance of Reciproc® Blue and WaveOne® Gold after sterilization and/or immersion in sodium hypochlorite(Medicina Oral S.L, 2024) Ríos-Osorio, Néstor; Caviedes-Bucheli, Javier; Murcia-Celedón, Juan; Gutiérrez, Cristina; Sierra-Collazo, Diana; Alvarado-Caicedo, Brandon; Serchiaro-Monsalve, Mariangel; Echavarria-Sarabia, Paola; Leon-Lazzo, Andrea; Rivera-Rojas, Helen; Castrillón-Ramos, Kathy; Supelano-Gallego, Alfredo; Bermúdez-Zuluaga, Luisa; Jimenez-Peña, OscarBACKGROUND: This study aims to compare the cyclic fatigue resistance (CFR) of the Reciproc Blue and WaveOne Gold instruments under a dynamic cyclical fatigue test. MATERIAL AND METHODS: 210 Reciproc Blue "R25" and WaveOne Gold "primary" files were assigned into 7 groups (n =15) for each brand. Groups G: Files were not exposed to NaOCl or sterilization. Groups A and D: files were immersed for 3 minutes in NaOCl 1 and 3 times, respectively. Groups B and E: Files were autoclaved 1 and 3 times, respectively. Groups C and F: files were exposed to both, NaOCl immersion and autoclaving 1 and 3 times, respectively. Subsequently, files underwent a dynamic CFR test. The chemical composition of the files' surface from Group G was analysed by energy-dispersive X-ray spectroscopy (EDS). Cyclic fatigue resistance time was statistically analysed using 1-way and 2-way analyses of variance (ANOVA) and T-test. A p-value ≤0,05 was set to be statistically significant. RESULTS: There was a significantly higher CFR of RB files than WOG in groups A, B, C, D and G (p0.05). There were no statistically significant differences between files in group F (p>0.05). RB files from groups B, C, D, E and F had significantly lower resistance than new ones (Group G) (p<0.05). WaveOne Gold files exposed to 5 % NaOCl immersion in combination with sterilization cycles (Groups C and F) had significantly lower CFR than new ones (p<0.05). Reciproc Blue and WaveOne Gold NiTi alloys differed in atomic wt % of carbon, oxygen, nickel and titanium. CONCLUSIONS: The Reciproc Blue files outperformed the WaveOne Gold files in terms of CFR. The Reciproc Blue files were more vulnerable to the cycles of NaOCl immersion or autoclave sterilisation. The combined autoclaving and NaOCl cycles had the most significant impact on the mechanical properties of both files. Key words:Cyclic fatigue, Reciproc blue, Wave one gold, Dynamic test, Simulated channels, Sodium hypochlorite, Sterilization.
- Chemical painful post-traumatic trigeminal neuropathy induced by dental bleaching: A case report(Medicina Oral S.L, 2024) Lebel, Ashley; Wizman, Tal; Lescaille, Géraldine; Dahan, Sandrine; Boucher, Yves; Bosco, JuliaBACKGROUND: Teeth whitening is a frequent request in clinical practice. The most widely used whitening agent on vital teeth is carbamide peroxide. This article reports a rare adverse effect following a whitening procedure. CASE DESCRIPTION: A 29-year-old patient was referred to the dental emergency department for severe pain that exhibited the characteristics of neuropathic pain. In the absence of any visible lesion or traumatic event, this pain was linked to the recent application of carbamide peroxide (10%) during a bleaching procedure. The diagnosis of painful post-traumatic trigeminal neuropathy (PTTN) of chemical origin was made. Treatment with the anticonvulsant gabapentin (900mg per day) gradually reduced the pain until its complete disappearance. After presenting the clinical characteristics of the case, the pathophysiological hypotheses are discussed. PRACTICAL IMPLICATIONS: Carbamide peroxide application may elicit nerve damage through a cascade of cellular and biological reactions, resulting in neuropathic pain. The successful management of this clinical case may provide useful information for similar situations. Key words:Case report, carbamide peroxide, painful neuropathy, pain, gingiva.
- Effect of Milling Speed on the Properties of Zirconia Restorations(Medicina Oral S.L, 2024) Wallum, Adam J.; Raimondi, Christopher; Lien, Wen; Hoopes, Wyeth L.; Vandewalle, Kraig S.BACKGROUND: The purpose of this study was to evaluate the effect of milling speed on the surface roughness, marginal gap, marginal gap volume, marginal offset, and fracture load of zirconia restorations. MATERIAL AND METHODS: A mandibular molar #30 typodont tooth was digitally scanned and an ideal crown preparation for a zirconia restoration was digitally created. A single master model die of the crown preparation was milled out of a resin material. The master die was scanned, and a final restoration was designed using the bio-copy feature of the typodont tooth. Ten zirconia restorations were milled (CEREC Primemill, Dentsply Sirona) per each of three milling speeds (super-fast, fine, and extra-fine), sintered, and seated on the master die. Surface roughness, marginal gap, marginal gap volume, and marginal offset were measured using a non-contact profilometer. Then, all restorations were cemented to the dies and loaded to failure in a material testing device. Data were analyzed with one-way ANOVA and Tukey's post hoc tests per property (alpha=0.05). RESULTS: Super-fast milling speed resulted in restorations with statistically significant greater surface roughness and marginal gap volume compared to fine and extra-fine milling speeds. No significant difference in marginal gap, marginal offset, and fracture load were found based on milling speed. CONCLUSIONS: Zirconia restorations milled at slower speeds may result in similar or slightly better properties compared to super-fast speed. Key words:Milling speed, properties, zirconia restorations.
- Shear bond strength of three different metal bracket base designs on human premolars: An in vitro comparative study(Medicina Oral S.L, 2024) Corahua-Raymi, Nataly; Guardia-Huamani, Seber; Cervantes-Ganoza, Luis; Castro-Ramírez, Leonor; López-Gurreonero, Carlos; Cornejo-Pinto, Alberto; Cayo-Rojas, CésarBACKGROUND: Adequate bracket-enamel bonding is critical to prevent detachment during orthodontic treatment and minimize any potential delay in results. The aim was to compare the shear bond strength of three metal bracket base designs: laser-structured base, mesh base, and retention grooves base. MATERIAL AND METHODS: In this experimental in vitro study, 54 human premolars were immersed for one week in 0.1% thymol solution, then placed in distilled water with weekly replacement until the start of the study. The premolars were cemented with brackets of varying base designs: A. Discovery® Smart (laser structured), B. Mini Master® Series (base with mesh), and C. Roth Max (base with retention grooves). All brackets were cemented using TransbondTM XT. A universal testing machine was used to evaluate the shear bond strength at a crosshead speed of 0.75 mm/min. Welch's one-factor ANOVA with robust variance and Tukey's post hoc test were used to compare means, with a significance level of p<0.05. RESULTS: The average shear bond strength values were for the bracket with laser-structured base (14.78 ± 5.79 MPa), the bracket with mesh base (9.64 MPa ± 2.54 MPa) and the bracket with retention groove base (15.38 MPa ± 2.67 MPa). It was found that brackets with mesh bases had significantly lower shear bond strength than brackets with laser-structured bases (p=0.001) and brackets with retention grooves bases (p<0.001). No significant differences were observed between the latter two types of brackets (p = 0.893). CONCLUSIONS: The bracket base design influenced in vitro shear bond strength with significantly higher values observed for Roth Max and Discovery® Smart brackets compared to Mini Master® Series brackets. Key words:Shear strength, laser-structured bracket, bracket with mesh base, bracket with retention groove base.
- Analysis of translucency parameter and fluorescence intensity of 5 resin composite systems(Medicina Oral S.L, 2024) Hirata, Ronaldo; de Abreu, João-Luiz-Bittencourt; Benalcázar-Jalkh, Ernesto-Byron; Atria, Pablo; Cascales, Álvaro-Ferrando; Cantero, Jon-Salazar; Sampaio, Camila-SobralThe natural outcome of dental composite restorations highly depends on the translucency of the enamel layer and fluorescence. This study aimed to evaluate the Translucency Parameter (TP) and Fluorescence Intensity (FI) of five different resin composite systems. Seven discs of each composite brand were prepared in a circular increasing thickness. For TP, a spectrophotometer measured the samples' colors. The color difference within the white/black backgrounds obtained the translucency parameter. For FI, samples were exposed to UV light, and ten photographs per group were taken. Each specimen was analyzed digitally. A mixed model analysis to a 95% confidence level analyzed groups differences. Higher values of TP were observed for ED and EL, followed by FZ. The lowest values were observed for EO and FO. FI values descending order was EL>FO>EO>ED>FZ. The composition of fillers and organic matrix influenced the behavior of fluorescence and translucency of resin composites. Key words:Resin composite, fluorescence, color, translucency parameter.
