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Language Journal of Clinical and Experimental Dentistry. 2020. Vol. 12, no. 9
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- Comparative analysis of trueness between conventional and digital impression in dental-supported fixed dental prosthesis with vertical preparation(2020) García Gil, Ignacio; Perez de la Calle, Celia; López Suárez, Carlos; Pontevedra, Paula; Suárez García, María JesúsBiologically oriented preparation technique (BOPT) is a vertical preparation technique without a finish line to create a new anatomic crown with a prosthetic emergence profile. This case report describe the protocol realized digitally in a patient who required a new fixed partial denture (FPD) in the anterior esthetic zone. After time of temporary restoration, definitive conventional (CI) (double-cord retraction and vinyl polysiloxane material), and digital impression (DI) with three different intraoral scanner (IOS) (Trios®, True Definition® and iTero®) were taken. All digital impression were obtained through three different scans: temporary restoration in the mouth after healing period, prepared teeth, and temporary restoration out of the mouth. To establish which of the IOS was the most accurate, it was necessary to compare the STL files obtained from each of the IOS with the STL file of the conventional impression, which was digitized with a laboratory scanner (3Shape D800). All these STL were imported to a software (ExoCAD 2.4 Plovdiv®), and they were superimposed. To establish the difference in trueness with SC, 6 points were chosen, 3 points in teeth, and another 3 points in soft tissue. The mean measurement in terms of trueness in teeth were: STS (0,039 mm), SI (0,054 mm), STD (0,067 mm); and in soft tissue were: STS (0,051 mm), SI (0,09 mm), STD [0,236 mm]. The IOSs showed differences between them in terms of trueness, being the Trios the most accuracy IOS. Final restoration was fabricated and cemented. The patient was examined at 3, 6 and 12 months, without any type of biological or mechanical complications. Digital impression with an IOS seems to be a viable alternative to perform zirconia FPD in the BOPT tecbique.
- Psychosocial and socioeconomically aspects of mothers having a child with cleft lip and/or palate (CL/P) : a pilot-study during the first year of life(2020) Scheller, Konstanze; Urich, Jasmin; Scheller, Christian; Watzke, StephanThe emotional impact on parents at the birth of their new-born with cleft lip and/or palate (CL/P) can be traumatic for parents, especially mothers, and affect the sensitive early parent-child relationship. Unlike many other congenital malformations facial deformities are visible to all. The uncommon facial appearance creates feelings and reactions in the mother, families and other people. Only few studies deal with this psychosocial burden of these mothers. This pilot-study deals with mothers? early experiences (n=84) having a child with CL/P. Mothers were asked to complete a questionnaire at diagnosis, birth and after lip surgery. The questions were focused on the social background of the mother (educational degree, marital status, lifestyle and prenatal care), the medical information at diagnosis and the following reaction. The surveys were administrated from 01/2014 ? 12/2016. 84 mothers of affected children (CL/P) replied the completed questionnaire (84/103, 81.5%). At diagnosis 65 mothers (77%) lived in a solid partnership and 44% worked full-time (40h). The diagnosis caused fear among the mothers (60.7%, p?0.01), despair (27.4%, p?0.01), grief (17.9%, p?0.01) and guilt (16.7%, p?0.01). Despite the emotional stress after the diagnosis only 5 mothers asked for psychological support (6.0%). The medical information by the gynecologist (41.6%) or maxillofacial surgeon (32.2%) was rated as ?good? (n=26) or ?very good? (n=26) in 60.2%. A lack of medical information and care was rated with ?insufficient? (11.9%) or ?poor? (14.3%). There are only few studies about mothers? early feelings and emotions having a child with a CL/P. We found high parental stress, physical and emotional strain among the mothers after diagnosis, mostly caused due to insufficient information?s. This stress was not correlated with the educational level and CLP appearance showed no relation about the socioeconomic status.
- Indirect evaluation of pit and fissure sealants : a 3D-based method validation(2020) Moreira, Kelly; Kantovitz, Kamila R.; Bueno, Tamires; Agulhari, Maria-Angélica; Rizzante, Fabio A.P.; Aguiar, Juliana; Pascon, Fernanda; Arias, Vanessa; Borges, Ana-Flávia; Rontani, Regina-MariaThe aim of the present study was to compare indirect methods to assess the clinical performance of pit and fissure sealants and validate the use of 3D scanners. Sample consisted of 58 plaster models of upper and lower first permanent molars, sealed with resin sealants, as well as photographs obtained during the 18-month follow-up. Pre-established criteria were applied to categorize the sealant presence/absence and marginal integrity. Two calibrated examiners performed the evaluations, independently, using Scanning Electron Microscopy (SEM; gold-standard), Photography, 3D (CEREC In Lab) and Stereomicroscope analysis. The intra-examiner Spearman correlation was 94% e 97%, respectively, and the inter-examiner was 96%. Data was submitted to Kappa test, Spearman correlation and Receiver Operating Characteristic Curve (ROC). 3D and SEM presented good concordance; Stereomicroscope showed regular concordance with SEM and 3D (p<0.001). There was no concordance among Photography and the other methods (p>0.05). SEM had a significant positive correlation with 3D and Stereomicroscope (r=0.76 and 0.71, respectively; p<0.01). There was significant positive correlation (r=0.65) between 3D and Stereomicroscope (p<0.01). The ROC estimated curve areas for Stereomicroscope and 3D were 0.90 (IC:0.81-0.99) and 1.0 (IC:1.0-1.0), respectively (p<0.001). Photography presented lower sensitivity and specificity (area=0.59). 3D method showed the best performance when compared to gold standard, exhibiting high sensitivity and specificity, therefore, it was validated as a reliable method to evaluate pit and fissure sealants.
- Association between periodontitis and serum c-reactive protein levels(2020) Lima, Rafael-Paschoal-Esteves; Reis, Christian-Santiago; Santirocchi-Júnior, Francisco; Abreu, Lucas G; Costa, Fernando-OliveiraPeriodontal disease may be associated with more bacteria and consequent induction of a systemic inflammatory process, with changes in the levels of C-reactive protein (CRP). The purpose of this cross-sectional study was to evaluate the association between periodontitis and serum levels of C-reactive protein. The sample comprised 100 individuals distributed into two groups according to serum levels of C-reactive protein: normal or altered. Social, biological and behavioral data were collected by means of a structured questionnaire. Additionally, a blood test was requested to measure C-reactive protein levels. CRP values less than 3 mg/l were considered normal. Periodontal clinical examination was conducted in each participant for analysis of probing depth, bleeding on probing and clinical attachment level. Descriptive statistics, univariate analysis and logistic regression were performed. Results were provided in odds ratio, confidence intervals and p values. Individuals with altered C-reactive protein levels showed a higher prevalence of periodontitis than individuals with normal C-reactive protein levels (p=0.008). In the final logistic regression model, individuals with periodontitis were more likely to present altered C-reactive protein than individuals without periodontitis (OR=3.27, CI=1.42-7.52, p=0.005). The alteration of the C-reactive protein levels among individuals with a higher prevalence of periodontitis corroborates clinical evidence that periodontal infection has a systemic impact.
- A randomized controlled trial of endodontic treatment using ultrasonic irrigation and laser activated irrigation to evaluate healing in chronic apical periodontitis(2020) Verma, Akansha; Yadav, Rakesh-Kumar; Prakash Tikku, Aseem; Chandra, Anil; Verma, Promila; Bharti, Ramesh; Kumar Shakya, VijayAim of this trial was to evaluate the combined clinical and radiographic success rate of endodontic treatment using passive ultrasonic irrigation (PUI) and laser activated irrigation (LAI) as compared to conventional syringe irrigation. Permanent incisors and single rooted premolars were assessed for eligibility and 69 patients were randomly divided into three treatment groups (n=23) by allocation concealment method and irrigation was performed in accordance with the allocated group. Teeth were evaluated clinically and radiographically with CBCT after 6 months and 12 months of the treatment. A significant difference was observed in the radiographic healing rates among three groups (?2=12.29, p=0.05). On comparing the final outcome among the three groups (n=19), it was found that 2 (10.5%) cases of group I(Conventional Syringe irrigation), 7 (36.8%) cases of group II (Passive ultrasonic irrigation) and 8 (42.1%) cases of group III(Laser activated irrigation) were healed while under healing category 13 (68.4%) cases of group I, 12 (63.2%) cases of group II and 11 (57.9%) of group III were observed whereas 4 (21.1%) cases were categorised as diseased in group I only. LAI and PUI can increase the predictability of the endodontic treatment success in cases of chronic apical periodontitis.
- Large-sized pleomorphic adenoma of the cheek treated with Nd:Yag laser : report of a case and review of the literature(2020) Veneri, Federica; Meleti, Marco; Corcione, Luigi; Bardellini, Elena; Majorana, Alessandra; Vescovi, PaoloPleomorphic adenoma (PA) mostly involves parotid glands, while extra-parotid localizations are relatively uncommon. Particularly, PAs of the cheek minor salivary glands with a size larger than 4 cm are exceedingly rare, with only few cases reported. Surgical treatment of PA usually consists in radical excision. However, despite a presumptive radicality, recurrences, sometimes followed by malignant transformation, may occur. Here we report a case of a large-sized (6 cm) PA of the cheek minor salivary glands in a 70 year-old female patient, successfully treated through a conservative approach, based on the use of Nd:YAG Laser (?=1064 nm). No recurrences were observed after a 2-year follow-up. A concise review of the literature, describing the features of 14 cases is also provided. Advantages of laser treatment include a precise cut, reduction of trauma on surrounding tissues, the possibility of a very good intraoperative hemostasis. Such features may sometimes allow to avoid general anesthesia, even for removal of big lesions. Post-operative course, in terms of pain and swelling, is usually better for intervention performed with laser, when compared to traditional surgery.
- Accessory submaxillary gland : two new case reports and a literature review(2020) Torres-Gaya, Jorge; Marqués Mateo, Mariano; Dualde Beltrán, Delfina; Sada-Malumbres, Álvaro; García-San Segundo, María del Mar; Puche Torres, M.The accessory submaxillary gland is a very uncommon anatomical variant, and incidence in the general population has not yet been quantified. The presence of pathology in these glands is rarer still, thus often going unnoticed. We describe two accessory submaxillary gland cases, one asymptomatic and the other with chronic sialadenitis in the main and accessory gland caused by sialolithiasis. Although our diagnosis was by computerized tomography, magnetic resonance sialography is helpful to understand and describe this entity with greater precision. The first case report is an incidental finding and no intervention was required. However, case report number two had clinical symptoms and required a first intervention in which the main submaxillary gland was resected, and a second intervention in which the accessory submaxillary gland was removed. Both patients are asymptomatic to date. Awareness of the possible presence of accessory submaxillary glands and of potential variations of the excretory ducts is useful in diagnosis, as well as leading to more precise treatment for salivary pathology, and allowing surgeons to avoid complications or injuries during surgery.
- Primary intra-osseous Hybrid Schwannoma-Perineurioma in the mandible(2020) Bergamini, Mariana-Lobo; Noberto, Luanna-Priscilla-Montenegro; Torres, Gabriel-Barroso-Marocco-de Abreu; Soares, Haroldo Arid; Martins, Fabiana; Costa, André Luiz Ferreira; de Souza, Suzana-Orsini-Cantanhede-Machado; Braz Silva, Paulo HenriqueBenign nerve sheath tumours include perineuriomas, schwannomas and neurofibromas. Hybrid schwannoma-perineurioma represents a cutaneous, subcutaneous or occasionally intra-osseous tumour with schwannian cytomorphology and perineurioma-like architecture consisting of a mixture of both types of cells. These tumours can develop at any age and there is no gender-predilection. Tongue is the most frequently affected site, followed by palate, mouth floor, jugal mucosa, lips and, more rarely, mandible. We present a case of hybrid tumour with schwannoma-perineurioma morphology located on the right mandibular body (intra-osseous) of a 54-year-old female patient. The tumour was symptomatic and evolving for six months. Microscopically, it was encapsulated and highly cellularised, presenting fascicular aspect and exhibiting scant mitotic activity. The tumour consisted of distinct cellular populations involving fusiform cells, cells with wavy and hyperchromatic nucleus or even epithelioid cells. Positive immunostaining for S-100 and epithelial membrane antigen (EMA) was observed. The lesion was completely removed under general anaesthesia, with the patient showing no clinical or radiographic sign of relapse after two-year follow-up. Despite the limited knowledge on the pathogenesis of Hybrid Schwannoma-Perineurioma, these tumours seem to present a non-aggressive biological behaviour. Conservative surgery provides adequate solution without recurrence, even after a long-term follow-up.
- The effect of pre-heating on monomer elution from bulk-fill resin composites(2020) Ebrahimi Chaharom, Mohammad Esmaeel; Safyari, Leila; Safarvand, Hossein; Jafari Navimipour, Elmira; Oskoee, Parnian Alizadeh; Ajami, Amir Ahmad; Abed Kahnamoii, Mehdi; Bahari, MahmoodThe present study was aimed to evaluate the effect of pre-heating of bulk -fill resin composites on monomer elution from them. Three different types of resin composites were used including Tetric N-Ceram Bulk Fill, X-tra Fill and X-tra Base. 10 cylindrical samples were prepared from each resin composites. Before light curing, 5 samples were pre-heated until reaching 68?C, then 5 other samples were polymerized at room temperature. After 24 hours, release of UDMA, TEGDMA and BIS-GMA monomers were measured by High-Performance Liquid Chromatography analysis. Data analysis was performed by two-way ANOVA test, Games-Howell and Sidak post hoc tests. Pre-heating did not have any statistically significant effect on the mean values of UDMA, TEGDMA and Bis-GMA elution (p>0.05). The greatest amount of released Bis-GMA and UDMA was obtained from Tetric N-Ceram Bulk-fill composite. The greatest amount of released TEGDMA was obtained from X-tra Fill composite. X-tra Base composite showed the lowest amount of monomer release (P<0.001). Pre-heating did not have any effect on monomer release from bulk-fill resin composites. Moreover, the amount and the type of monomers released from various bulk-fill resin composites were not similar.
- Investigation of water sorption and aluminum releases from high viscosity and resin modified glass ionomer(2020) Ayd?n, Numan; Karao?lano?lu, Serpil; Oktay, Elif-Aybala; Çetinkaya, Serdar; Erdem, OnurHigh viscosity glass ionomer cement (HVGIC) and resin-modified glass ionomer cement (RMGIC) have recently been clinically preferred thanks to their numerous advantages. However, initial moisture contamination has a negative effect on the mechanical and physical properties of these cements. The aim of this study was in vitro of HVGICs and RMGICs, with and without surface protection, on water sorption, solubility and release of aluminum. In this study, as HVGICs; Equia Forte, IonoStar Plus, Riva Self Cure; as RMCIS, Ionolux and Riva Light Cure; and as control, Z250 universal composite was used. Equia coat, Voco varnish and Riva coat were chosen as surface protective. Water sorption and solubility levels of the samples were measured according to ISO 4049:2009. Al levels released from samples were determined by graphite furnace atomic absorption spectroscopy (GFAAS) for 7, 14 and 21 days. Statistical evaluation of the results was made using one-way variance analysis (ANOVA) and Tukey post-hoc test (p<0.05). RMGICs from restorative materials showed more water absorption than HVGICs, but no differences in solubility. Among the materials tested, the water absorption values of the HVGIC and RMGIC materials without surface protection were higher than those with the surface protection (p<0.001). It was determined that the Al release of HVGIC and RMGIC groups with the surface protection were lower in all time periods than the groups without surface protection (p<0.001). The application of surface protection effectively reduced water sorption and Al release from HVGICs and RMGICs.
- Influence of operator?s professional experience in the postoperative course after surgical extrac-tion of the impacted lower third molar : a pilot study(2020) Ruiz Roca, Juan Antonio; Donoso-Martínez, Benjamin; Ameneiros-Serantes, Susana; Martínez Beneyto, Yolanda; Salmerón Martínez, Diego; Gay-Escoda, CosmeThird molars are present in 96.6% of humans, although they do not always erupt completely. Between 9.5% and 73% of them remain impacted. Surgical removal of impacted third molars is the most common practice in oral and maxillofacial surgery. This procedure results in traumatism and, consequently, the postoperative phase will involve symptomatology. It is uncommon to find studies that directly relate postoperative symptomatology and the operator?s experience. The aim of this study was to determine the differences regarding postoperative symp-tomatology in patients undergoing the bilateral extraction of lower impacted third molars and according to the operator?s experience. A prospective cohort double-blind study was conducted in 50 healthy patients (100 molar extractions) to whom both lower third molars were removed by two dentists with different degree of professional experience. The extractions were randomly assigned with a split?mouth design. If an operator extracted the lower third molar on one side, the other operator extracted the contralateral one. The variables studied after four days of postoperative period were Pain (EVA scale), Inflammation and Trismus, in addition to intraoperative time and local anesthesia administered. Statistically significant differences were detected in the time of intervention and in trismus, since the most experienced operator always needed less time and caused higher degree of trismus. However, this does not entail more inflammation or pain in patients, so there are no relevant differences between operators with more or less experience (p>0.05). The postoperative period is more favorable for the most experienced operator, although the results do not vary in a relevant manner between them.
- Publication trends in journal of clinical and experimental dentistry(2020) Bhalla, Vidhi-Kiran; Chockattu, Sherin-JoseJournal of Clinical and Experimental Dentistry (J Clin Exp Dent; JCED) is an English language journal published by the Spanish Society of Oral Surgery, and has been online since 2009. It is indexed in PubMed Central and Scopus since 2012, with monthly publications since 2016. The purpose of this article was to review and analyse the publications in this journal since its inception, over a period of 11 years (2009-2019). This paper assessed the number, type and subjects of the articles published in the journal over 11 years. The institutions of the first authors, number of PubMed citations and the Hirsch (h5) index was assessed and analysed. The manuscripts published in JCED have gradually increased over the years, with Original research articles accounting for the bulk of contributions. The journal publishes articles mainly from the subjects of Oral Pathology and Operative Dentistry and Endodontics. Articles published in JCED are indexed in PubMed Central (since 2012), Scopus, DOI system, and Google Scholar. A country-wise mapping of the (first) author?s institutions revealed significant contributions from researchers from all over the world. With an h5 index of 26, the journal was ranked among the top six multispeciality journals. The most cited articles were the literature reviews on common oral lesions (recurrent apthous stomatitis and candidiasis). The journal has contributed to the growth of scientific literature pertaining to subjects from all the fields of dentistry. Over the past 11 years, JCED has served as a platform for large number of manuscripts in all the disciples of dentistry, from researches all over the world.
- Effect of amount of biomaterial used for maxillary sinus lift on volume maintenance of grafts(2020) Mendes, Luciene-Dornas; Bustamante, Roberta-Paula-Colen; Vidigal, Bruno-César-Ladeira; Favato, Mario-Nazareno; Manzi, Flávio Ricardo; Cosso, Mauricio-Greco; Zenóbio, Elton GonçalvesRegardless of the kind of biomaterial used for the graft, it is clear that, over time, the graft undergoes dimensional changes that could influence the final bone volume obtained, which could alter the stability of the installed implants. The aim of the present study was to compared and correlated the graft behavior with the amount (in grams) of xenogeneic and alloplastic biomaterials used in grafts for maxillary sinus lift. This retrospective cohort study used 148 CBCT images of 74 grafts from 68 maxillary sinuses lift patients in a university, post-graduate clinic. The weights of biomaterials, categorized in intervals according to amount used, were correlated with the graft volumes at V1 (10 days) and V2 (180 days). Kruskal-Wallis test was used to evaluate the possible bias effect of weight on graft maintenance. Mean weights of biomaterials used were: Bio-Oss Small® (1.58g); Bio-Oss Large® (1.35g); Endobon® (0.72g); BoneCeramic®+Emdogaim® (0.96g); Cerasorb® (1.13g) and Osteogen® (2.70g). No significant differences (p>0.05). Were found for the influence of these mean amounts in graft maintenance: Bio-Oss Small® (18); Bio-Oss Large® (10); Endobon® (17); BoneCeramic®+Emdogaim® (10); Cerasorb® (11); and Osteogen® (08) at V1 and V2. However, when biomaterials were categorized by intervals, all Cerasorb® interval groups showed statistically significant differences (p<0.001) in graft volume at V2. The amounts of the biomaterials used could influence the final volume; depending on the biomaterial characteristics. Implant installation was possible with all studied grafts, although graft volume shrinkage should be considered when selecting biomaterial for sinus lift.
- Radiological implications of crestal and subcrestal implant placement in posterior areas. A cone-beam computed tomography study(2020) Pellicer Chover, Hilario; Rojo-Sanchis, Julio; Peñarrocha Diago, Miguel; Viña Almunia, José; Peñarrocha Oltra, David; Peñarrocha Diago, MaríaSubcrestal implant placement has been suggested as a method that could contribute to maintain the periimplant soft and hard tissues in comparison with crestal placement. The objective of this study was to investigate the relationship between implant placement at different depths in the alveolar bone and (a) the thickness of the buccal bone plate (BBP); and (b) crestal cortical bone thickness, based on the use of cone-beam computed tomography (CBCT). A cross-sectional study was performed, analyzing CBCT scans from the database of the Oral Surgery Unit of the University of Valencia. Individuals with single missing teeth in posterior sectors were included. Two trained dentists used a software application to plan implant placement at four different depths from the bone crest (from 0-2 mm subcrestal). The thickness of the BBP was measured at each established depth, tracing a line from the implant platform to the outermost part of the facial alveolar bone, and the ratio between the implant platform and cortical bone thickness was calculated. The study sample consisted of 64 patients. In the case of implants placed in a crestal position, the distance from the platform to the BBP was 1.99±1.10 mm. This distance increased significantly (p<0.001) with the planned implant placement depth, reaching an average of 2.90±1.22 mm when placement was 2 mm subcrestal. Subcrestal implant placement at this depth implied surpassing the cortical bone in 91% of the cases. Radiological planning of implant placement in a subcrestal position results in a greater distance from the implant platform to the BBP. In general terms, planning implant placement at a depth of 2 mm subcrestal surpassed the cortical bone in 91% of the cases.
- A novel digital approach for fixed full-mouth implant-supported rehabilitations : a case report(2020) Llobell, Arturo; Bergler, Michael; Fraiman, Howard; Korostoff, Jonathan; Cross, Caleb; Fiorellini, Joseph P.Successful rehabilitation of a patient?s entire dentition with implant-supported fixed prostheses requires restoration of function, esthetics and comfort. To achieve this goal, the clinician and laboratory technician must work in concert with one another to navigate the multiple steps from the patient?s initial evaluation to delivery of the final prostheses. Key to this is the ability of the clinician to provide the technician with detailed information regarding the patient?s extra- and intraoral characteristics in a manner that can be easily and accurately transferred to the lab bench where it then serves as the foundation for reconstruction of the dentition. In recent years, the impressive evolution of digital technology in dentistry has dramatically facilitated this complex process. The aim of this case report is to illustrate how digital profiles of a patient?s facial and intraoral features can be merged with one another and used to generate artificial teeth and gingival tissue of a full mouth implant supported rehabilitation via computer-aided design and computer-aided manufacturing (CAD/CAM) technology to successfully rehabilitate a patient that initially presented with a terminal dentition.
