Oral health status, related behaviours and perceived stress in xerostomia, Sicca and Sjögren's syndromes patients - a cross-sectional study.

BACKGROUND: Mouth dryness increases the risk of some oral health-related conditions. Furthermore, it is unclear if patients with dry mouth engage in appropriate oral health-related behaviours. The study examined oral health, related behaviours, and perceived stress in dry-mouth patients and compared them to matched controls without mouth dryness. METHODS: Information about 182 dry-mouth patients and 302 age- and sex-matched subjects was retrieved. Three dry mouth groups: xerostomia, Sicca syndrome and Sjögren's syndrome, were formed based on patient self-reported and objectively assessed symptoms. The World Health Organization's Oral Health for Adults and Perceived Stress Scale (PSS-10) questionnaires inquired about sociodemographic characteristics, oral health-related behaviours, and self-perceived stress. Clinical oral health assessments included: caries experience measured as total numbers of decayed (DS), missing (MS), filled surfaces (FS), number of remaining teeth, erosive tooth wear and extent of periodontal pocketing. Data were analyzed using bivariate and multivariable tests. RESULTS: The dry-mouth participants had higher mean (SD) DMFS scores than their matched controls: xerostomia patients vs. controls: 74.6 (34.4) and 66.3 (35.4), Sicca syndrome patients vs. controls: 88.3 (34.0) and 70.1 (33.9), and Sjögren's syndrome patients vs. controls: 95.7 (31.5) and 74 (33.2). In comparison to controls, individuals with Sicca and patients with Sjögren's syndromes had lower mean (SD) number of remaining teeth, 15.9 (10.1) vs. 21.7 (8.4) and 13.8 (10.0) vs. 20.1 (9.2), and a lower mean (SD) extent of periodontal pocketing, 20.7 (28.6) vs. 41.1 (31.0), and 21.2 (24.1) vs. 34.8 (34.2), respectively. Xerostomia, Sicca syndrome and Sjögren's syndrome patients had higher odds of using fluoridated toothpaste; OR 1.8 (95%CI 1.1-2.9), OR 5.6 (95%CI 1.7-18.3) and OR 6.9 (95%CI 2.2-21.3), respectively. Participants with Sjögren's syndrome had lower odds of the last dental visit being within the last year; OR 0.2 (95%CI 0.1-0.8). CONCLUSIONS: Dry-mouth patients had higher caries experience and fewer teeth than comparison groups but a lower extent of periodontal pocketing. Even though more participants with dry mouth used fluoridated toothpastes, their oral health-related behaviours were not optimal.

The 20-Year Trends in Caries and Associated Determinants among Adults in Post-Soviet Lithuania: Repeated Cross-Sectional Studies.

AIM: The aim of the study was to examine the 20-year trend in dental caries and associated determinants among adults in Lithuania after the country restored its independence. MATERIAL AND METHODS: Data from two cross-sectional national surveys included samples of 35-44-year-olds (adults) and 65-74-year-olds (early elderly). The 1997/1998 survey (first survey) recruited a stratified random sample of 569 individuals from 10 selected areas in Lithuania (response rate 52%), and the 2017/2019 survey (second survey) recruited a stratified random sample of 723 individuals from 5 biggest Lithuanian cities and one randomly selected peri-urban/rural area from each of 10 Lithuanian counties (response rate 53%). The information about the social (sex, residence, education) and behavioral (toothbrushing frequency, use of fluoridated toothpaste, and last dental visit) determinants was collected via self-reports using the World Health Organization (WHO) Oral Health Questionnaire for Adults questions. Information about the fluoride level in the drinking water was retrieved from the water suppliers. Dental caries was recorded at the surface level following the WHO criteria by two calibrated examiners, one at each of the national surveys. Bivariate and multivariate analyses were used. RESULTS: According to multivariable negative binomial regression analysis, in adults, 67% lower DS scores (IRR 0.33, 95% CI 0.26-0.42) and in early elderly 47% lower DS scores (IRR 0.53, 95% CI 0.38-0.74) were observed in the second survey. Adults in the second survey (vs. first survey) had 62% lower MT scores (IRR 0.38, 95% CI 0.32-0.46), and the early elderly had 19% lower MT scores (IRR 0.81, 95% CI 0.72-0.92). Adults in the second survey had 21% lower DMFT scores (IRR 0.79, 95% CI 0.73-0.85). The changes in behavioral determinants were observed over the 20-year period. CONCLUSION: An improvement in dental health during the 20-year period, mainly related to reduction in untreated caries and missing teeth, was observed in adults and early elderly. However, early elderly still had high numbers of missing teeth. The decrease in total caries experience during the 20 years was significant only in adults. Our findings support an urgent need to design and implement national oral health promotion and prevention programs with increased focus on oral self-care and fluoridated toothpaste use.

Shaping and Centering Ability, Cyclic Fatigue Resistance and Fractographic Analysis of Three Thermally Treated NiTi Endodontic Instrument Systems.

The better understanding of the clinically important behavioral features of new instrument systems has an important significance for the clinical endodontics. This study aimed to investigate the shaping and centering ability as well as cyclic fatigue resistance of HyFlex CM (CM), HyFlex EDM (EDM) and EdgeFile (EF) thermally treated nickel-titanium (NiTi) endodontic instrument systems. Sixty curved root canals of the mesial roots of mandibular molars were randomly assigned into three groups (n = 20) and shaped using CM, EDM and EF files up to the size 40 and taper 04 of the instruments. µCT scanning of the specimens before and after preparation was performed and the morphometric 2D and 3D parameters were evaluated in the apical, middle and coronal thirds of root canals. In each group, 40.04 instruments (n = 20) were subjected to the cyclic fatigue resistance test in artificial root canals at 37 °C temperature until fractures occurred, and the number of cycles to failure (NCF) was calculated. The fractographic analysis was performed using a scanning electron microscope, evaluating topographic features and surface profiles of the separated instruments. The one-way analysis of variance with post hoc Tuckey's test was used for statistical analysis of the data; the significance level was set at 5%. All systems prepared the comparable percentage of root canal surface with the similar magnitude of canal transportation in all root thirds (p > 0.05), but demonstrated significantly different resistance to cyclic fatigue (p < 0.05). The most resistant to fracture was EF, followed by EDM and CM. The length of the fractured fragments was not significantly different between the groups, and fractographic analysis by SEM detected the typical topographic features of separated thermally treated NiTi instrument surfaces.

Porosity Distribution in Apically Perforated Curved Root Canals Filled with Two Different Calcium Silicate Based Materials and Techniques: A Micro-Computed Tomography Study.

The present study evaluated the porosity distribution of BioRoot RCS/single gutta-percha point (BR/SC) and MTA flow (MF) fillings, which were used as plugs for the apical perforation repair in curved canals of extracted mandibular molars using micro-computed tomography (µCT). Forty mesial root canals of mandibular first molars were shaped with ProTaper NEXT X1-X5 files 2 mm beyond the apex to simulate apical perforations that were randomly divided into two groups (n = 20) according to the material and technique used for the apical plug: BR/SC or MF. The specimens were scanned before and after canal filling at an isotropic resolution of 9.9 µm. The volumetric analysis of voids in the apical 5 mm of the fillings was performed. Data were analyzed using one-way ANOVA with Bonferroni correction (p < 0.05). Micro-computed tomography (µCT) evaluation revealed significant differences between the groups in terms of porosity: the total volume and percentage volume of voids was lower in the BR/SC group in comparison with the MF group (p < 0.05), with the predominance of open pores in both groups. Neither of the materials and/or application techniques were able to produce void-free root fillings in the apical region of artificially perforated curved roots of mandibular molars.

Oral health of 12 and 15 year-old adolescents living in the social care homes in south of Lithuania.

OBJECTIVES: To evaluate oral health conditions and determine risk factors of dental caries of adolescents living in social care homes in the South of Lithuania and to compare the results with adolescents of the same age in general population. MATERIALS AND METHODS: Subjects of study are 12 and 15 year-old adolescents from all social care homes and 3 schools of Alytus county, Marijampole county and Vilnius city. 55 adolescents living in social care homes (study group) and 55 adolescents living outside social risk families (control group) were clinically examined between February and September of 2019. The clinical study assessed: 1) the prevalence and incidence of caries using the decayed-missing-filled teeth (DMFT) index, 2) the oral hygiene status using the Silness and Loe index, 3) the salivary buffer capacity using Ivoclar Vivadent CRT Buffer indicators. The R-package was used for statistical analyses. Threshold for statistical significance set at p<0.05. RESULTS: Prevalence and incidence of caries in study group was higher compared with adolescents of the same age in general population - prevalence 81.82 % and 69.1 %, respectively, DMFT medians 3 and 1, respectively. Social living environment, age or gender were not statistically significant determinants for oral hygiene or salivary buffer capacity. The correlation between oral hygiene and DMFT indices was statistically significant. Both - oral hygiene and salivary buffer capacity - fit into linear regression model and were statistically significant. CONCLUSIONS: Adolescents, living in social care homes, were found to have poorer oral health with higher prevalence of caries than those living in families. Poor oral hygiene and low salivary buffer capacity have been identified as significant risk factors for the development of caries.

A theory-guided school-based intervention in order to improve adolescents' oral self-care: a cluster randomized trial.

AIM: To evaluate the efficiency of social-cognitive theory-guided oral hygiene interventions in adolescents and to identify predictors of adolescents' self-care practice. DESIGN: A cluster randomized trial included 197 15- to 16-year-olds from two secondary schools. The intervention group received three face-to-face educational hands-on sessions facilitated by a dentist and adolescents worked in pairs. Individual dental plaque levels were measured at baseline, after intervention, at six and at 12 months. The structured questionnaire inquired about gender, family socio-economic status (baseline), and different social-cognitive domain variables (baseline, six, and 12 months). RESULTS: At baseline, there were no statistically significant differences in dental plaque scores between the intervention and control groups (P = 0.183). At the 6-month follow-up, the intervention group had significantly less dental plaque than the control group (P = 0.047), but the intergroup difference in dental plaque levels was not significant at the 12-month follow-up (P = 0.400). Variations in dental plaque levels at different time periods were explained by the following predictors: family's socio-economic status, social-cognitive domain variables, group affiliation, and baseline plaque levels. CONCLUSIONS: Social-cognitive theory-guided interventions improved oral self-care of adolescents in the short term. After the intervention was discontinued, the improvement in oral self-care of adolescents lasted for another 5 months.

A five years clinical evaluation of sealed occlusal surfaces of molars.

BACKGROUND: Air-abrasion can be used for enamel preparation before fissure sealing as well as acid etching which is the evidence-based method for enamel preparation before sealing. AIM: The aim of this study is to evaluate the status of sealed occlusal surfaces of the first permanent molars after one, two, and five years and to compare consequence of using the two different methods for enamel preparation before sealing. MATERIALS AND METHODS: At the baseline of the study 88 children of the age from 6 to 9 with caries-free permanent molars randomly received 185 sealants after using the air-abrasion system KCP 2000 PLUS (ADT Inc.) and 121 sealants using the acid etching method with Vococid (VoCo). Fissurit F (VoCo) was used for sealing. The status of occlusal surfaces of molars was scored as caries- free or decayed/restored by visual clinical assessment evaluation after one, two, and five years. RESULTS: The sealants retention rate was 97.2%, 91.9%, 61.2% in the air-abrasion group and 96.3%, 92.6%, 62.4% in the acid etching group after one, two, and five years, respectively. The results showed 98.2%, 98.0%, 89.8% caries free occlusal surfaces of molars prepared with air-abrasion method and 100%, 100%, 94.6% caries free occlusal surfaces of molars prepared with acid etching method after one, two, and five years respectively. CONCLUSION: The differences between the two methods: air-abrasion and acid etching in terms of sealant retention rate and caries development appeared to be statistically insignificant (p>0.05).

In vitro study of microbial leakage in roots filled with EndoREZ sealer/EndoREZ Points and AH Plus sealer/conventional gutta-percha points.

OBJECTIVE: The aim of this study was to determine and compare the microbial leakage of roots filled with EndoREZ sealer/EndoREZ Points and AH Plus sealer/ conventional gutta-percha points. MATERIALS AND METHODS: 60 single-rooted teeth were prepared using step-back technique. The smear layer was removed with 18% EDTA. Teeth were divided into two experimental groups (n=25 each group) and two controls (n=5 each group). In AH Plus group root canals were obturated with AH Plus sealer/gutta-percha and in EndoREZ group with EndoREZ sealer/EndoREZ Points. Five teeth were served as negative controls and five as positive controls. All teeth were inserted into Eppendorf plastic tubes and suspended in glass bottles containing sterile Schaedler broth. The coronal chambers were filled with the mix of human saliva and broth (ratio 3:1). The medium was changed every 7 days. Microbial growth in the broth was evaluated every day up to the end of experiment. RESULTS: Leakage in the root canals of the teeth from experimental groups occurred between 4 and 75 days. The mean leakage in AH Plus group was 18.86 days, while in EndoREZ group it was 28.28. No statistically significant difference in microbial leakage between two tested filling materials was found. CONCLUSION: Both types of root fillings - EndoREZ sealer/EndoREZ Points and AH Plus sealer/gutta-percha points - showed microbial leakage.

Maxillary complete denture outcome with two-implant supported mandibular overdentures. A systematic review.

OBJECTIVES: Research data regarding maxillary complete denture outcome with two-implant supported mandibular overdentures are not consistent. Considering multiple publications on implant supported mandibular overdentures, it was decided to summarize currently present evidence on the maxillary complete dentures opposed by implant-supported mandibular overdentures, and analyze factors that could potentially influence the outcomes. METHODS: The articles from 1985 to 2007 related to the topic were identified in the online MEDLINE/Pubmed and other databases and manually. Primary articles were scanned, and irrelevant studies were excluded from the further review process. Potentially relevant titles and abstracts were provisionally included for consideration on the basis of full text articles. Full text articles were obtained from on-line and printed sources. The data from the studies were extracted and reviewed. RESULTS: The study has failed to identify any prospective satisfying inclusion/exclusion criteria RCT reporting on maxillary bone resorption. The number of maxillary complete denture relining incidences per patient was constantly increasing during the 10-year period. Maxillary complete denture remake incidences comprised 16-33 % of the number of patients followed during the 10-year period. Comparing patient satisfaction with upper dentures at the baseline and after two years, no decrease in satisfaction was noticed. CONCLUSIONS: There is no evidence that maxillary ridge resorption is accelerated with certain types of two-implant supported mandibular overdenture attachments. Most common complication for the maxilla - prosthetic maintenance. There is a risk of decreased patient satisfaction with bar-supported mandibular overdenture. Further studies are needed to provide evidence for the maxillary complete denture outcome with two-implant supported mandibular overdentures.

General health of dentists. Literature review.

UNLABELLED: The studies show a dental practitioner as a subject of a wide variety of physical and psychological ailments. It is induced or aggravated by the work specificity and greatly affects the health of dental professionals. Therefore, general health of dentists, especially effect of dental activity on it, is present-day, important and as a matter of fact not well documented subject. The aim of our review is to summarize and ascertain dental practice-related disorders influencing the physical and psychological health of practitioner. Also we would like to highlight the most vulnerable systems of the dental professional and to survey the best methods to overcome these ailments. RESULTS: There is growing body of evidence that suggests surprisingly high vulnerability within the dental profession to certain disorders and afflictions that can be categorized as practice-related. CONCLUSIONS: In different countries dentists reported having poor general health and suffer from various health-related problems. To enjoy and be satisfied with their professional and personal lives, dentists must be aware of the importance to maintain good physical and mental health.