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Purpose: This study aimed to assess the stress distribution in pulpotomized primary molars with different types of restorative materials using 3D-finite element analysis (FEA), and provide valuable insights into the selection and application of restorative materials, with the ultimate goal of reducing the risk of pulpotomy failure and protecting residual dental tissue. Methods: Four 3D models of pulpotomized primary molars with different restorative materials according to the material and its elastic modulus were analysed: resin composite, stainless steel crowns (SSCs), prefabricated zirconia crowns and endocrowns. The food layer was also designed before vertical and bucco-lingual forces were applied to simulate physiological masticatory conditions. The results were obtained by colorimetric graphs of the von Mises stresses (VMS) in the restoration and tooth remnant. The maximum shear stress on the bonding interfaces and pressure stress on the Mineral trioxide aggregate (MTA)-pulp interfaces were recorded. Results: The results of the 3D-FEA showed that all restorative materials generated stresses and strains on the tooth structure after pulpotomy. In the resin composite group, the marginal enamel exhibited the highest stress peaks. In the zirconia crown and SSC groups, there was a concentration of stress at the dentin-restoration margin. The shear stress concentrations were mainly at the adhesive margins, with lower levels around endocrowns compared to other groups. MTA in the resin composite group experienced more VMS than in the other group. The resin composite group also generated relatively higher pressure stress values at the MTA-pulp interface compared to the other groups. Significance: In the model of primary teeth following pulpotomy, the three types of restorations covering the occlusal surface can effectively reduce the stress on pulp capping materials under occlusal loads, thereby potentially decreasing the risk of pulpotomy failure. In addition, the group of endocrowns demonstrated reduced stress at the bonding interface and in the stress concentration zone near the dentist-restoration edge, making them more effective at protecting residual dental tissue.
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The study was conducted on the impact of thermophysical properties on eflornithine drug solute-solvent interactions in aqueous ethyl acetate and acetone at different concentrations and temperatures. The aim of this study is to enhance the understanding of eflornithine's behavior in different solvents, which is crucial for its effective use in pharmaceutical applications. The density, molar volume, viscometric, and conductometric characteristics of the eflornithine drug solutions (0.025, 0.05, 0.075, 0.1, and 0.125 mol/kg) in acetone and 25% (v/v) aqueous ethyl acetate were measured within a temperature range of 298.15 K-318.15 K. Based on the determined density parameters, the following parameters were assessed: viscosity (η), equivalent molar conductance, limiting apparent molar volume (V0φ), apparent molar volume of transfer (V0φtr), and apparent molar volume (Vφ). The Masson empirical relationship and the viscosity-to-Jones-Dole (JD) equation were used to evaluate the partial molar volume (Vφ), experimental slope (SV), viscosity, and density data. Temperature and concentration were used to determine each parameter. For each set of dilutions, conductometric studies were conducted in both study solvents. The gathered data was analyzed in order to evaluate the ion-solvent interactions. The Walden product Λomηo's positive temperature coefficient values indicate that the drug eflornithine functions as a structural modifier in acetone and aqueous acetyl acetate systems. The structure-making and breaking characteristics of the polar solvents acetone and ethyl acetate were identified.
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Objectives: We investigated which type of orthopantomography (OPG) was best able to predict neurological alterations of the inferior alveolar nerve (IAN) during extraction of a lower third molar (3 M). Methods: We analysed cone beam computed tomographies (CBCTs) that were performed at a private dental clinic in Cartagena, Spain over five consecutive years. The CBCTs, together with their corresponding OPGs, had been prescribed for the surgical extraction of a lower 3 M. Results: We analysed a total of 342 CBCTs and their corresponding OPGs. After explaining the risk of changes in the IAN sensitivity, 37 patients refused to undergo surgical extraction. The incidence of sensitivity alterations in the 332 dental extractions was 62 (19%): 44 were paraesthesias of the IAN, and 18 were associated with darkening of the root and interruption of the cortical line. Conclusion: When an OPG revealed darkening of the root and interruption of the cortical line, the risk of contact between the lower 3 M and the IAN-that is, the probability of changes in IAN sensitivity-increased by over three-fold.
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Background: The prevalence of molar incisor hypomineralisation (MIH) varies worldwide. In Saudi Arabia, data about this condition is limited to a few cities. Aim: To evaluate the prevalence, severity and associated aetiological factors of MIH in children seeking dental care in Armed Forces Hospital, Jazan, Saudi Arabia. Methodology: Participants were recruited by convenience sampling according to eligibility criteria. Diagnostic criteria used were according to the molar incisor hypomineralisation severity scoring system (MIH-SSS). Demographic data and past medical history were recorded using a carefully organised questionnaire, and MIH causal factors were evaluated. Results: A total of 1405 children participated in the study. Among the permanent first molars, mandibular teeth were more frequently affected by MIH than maxillary teeth. In the permanent central incisors group, maxillary teeth were more frequently involved than mandibular teeth, whereas lateral incisor was the least affected among the tooth types in all four quadrants. MIH had more frequently involved all four molars (66.1%), and two associated central incisors were found (31.3%). MIH in the incisors had mild to moderate severity, whereas molars presented with severe defects. Among prenatal factors, maternal anaemia and vitamin D deficiency, out-of-perinatal factors, caesarean delivery, low birth weight and perinatal jaundice, and early childhood tonsillitis and early childhood anaemia were the significant associated factors for MIH development. Conclusion: The prevalence of MIH was 8%, and maxillary incisors and mandibular first molars were frequently affected. Children with MIH showed prenatal, perinatal and postnatal aetiological factors involved in the development of MIH.
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Background: Forensic odontology plays an important role in mass disasters, house fires, criminal deaths, identification of missing persons, and child abuse cases. Teeth are the most stable part of the human body and are resistant to thermal, mechanical, and chemical insults. The aim of this study was to evaluate the effectiveness of mandibular intercanine distance and mesiodistal width of mandibular first molar in gender determination. Materials and Methods: The study comprised 100 participants (50 males and 50 females) in the age group of 18-23 years. The mandibular impressions were made, and casts were prepared using dental stone. The intercanine distance and mesiodistal width of the right mandibular first molar were measured using digital vernier callipers. The data obtained was statistically analysed using SPSS software version 23. Results: The mean mandibular intercanine distance was found to be 27.2 ± 2.3 in males and 25.94 ± 1.76 in females (P = 0.03). There was no statistical difference in the mesiodistal width of the mandibular molar between males and females (P = 0.166). However, the mean mesiodistal width of males was higher when compared to females. Conclusion: Males have a greater intercanine width and mesiodistal dimension when compared to females. This result will be helpful in forensic medicine, anthropology, orthodontic treatments, and clinical dentistry.
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PURPOSE: This study aims to compare the outcomes of suture-less and multiple suture closure methods on postoperative pain, swelling, and trismus, and associated complications. MATERIALS AND METHODS: This prospective, randomized clinical trial was conducted at the Department of Oral & Maxillofacial Surgery, Goa Dental College & Hospital. Inclusion criteria encompassed subjects aged between 17 and 55 years, classified as American Society of Anaesthesiologists (ASA) I, with asymptomatic impacted third molars falling within the moderately difficult impaction range (Pederson's difficulty index: 5-7). Study excluded individuals classified as ASA II, III, or IV, those with known or suspected allergies to the anaesthetic solution, immunocompromised patients, and individuals taking medications that could affect healing. Pregnant or lactating females and those with a history of bleeding disorders were also excluded. Wound closure methods were compared: Group A underwent primary closure with silk sutures, while Group B had suture-less closure. Subjects were allocated to the specific groups using a simple randomization method. This involved using a lottery-based random sequence to assign each participant to either Group A or Group B. Pain intensity, facial swelling, and trismus were key outcomes. Secondary outcomes included lingual nerve sensation and postoperative complications. Demographics factors, surgical details, radiographic and perioperative data, and physiological parameters were considered. Non-parametric tests and parametric test (repeated measure ANOVA) were employed. Statistical significance was set at P < 0.05. RESULTS: Among 101 participants, both closure techniques exhibited similar outcomes in pain, swelling, and lingual nerve function. However, suture-less closure resulted in significantly less trismus and fewer cases of delayed wound healing. CONCLUSIONS: Suture-less method after surgical removal of third molar may reduce trismus compared to multiple sutures. While pain, swelling, and lingual nerve function management were comparable.
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Sm3+ions doped Phospho-Borate glasses were synthesized and their physical and spectroscopic parameters were studied to evaluate its potential reddish-orange emission for photonic applications. Structural investigation made through XRD analysis confirms the amorphous nature. The evaluated bonding parameters from the absorption spectral analysis confirm the ionic bonding of the Sm-O network in the prepared glasses. Four emission bands were observed from the luminescence spectra, and the HT 4G5/2 â 6H7/2 is observed at 601 nm. The oscillator strength values elucidate the intensity of the absorption bands, and the PBKZnF:Sm sample exhibits a higher oscillator strength value. The Judd-Ofelt intensity parameters were observed to trail the trend Ω4 > Ω6. > Ω2 for the majority of the samples. The CIE 1931 color chromaticity investigation confirms that the present glass samples are suitable for reddish-orange media. Barium and strontium-incorporated glasses exhibit outstanding lasing potential, which was confirmed through the efficiency of the quantum yield and some of the radiative parameters like effective bandwidth, transition probability and stimulated emission cross-section. Radiative parameters have been calculated from the luminescence spectra. Amid all transitions, 4G5/2 â6H7/2 transition has higher transition probability and higher stimulated emission cross-section values for all the prepared glass samples. Barium-incorporated glass exhibits a higher emission cross-section of 30.55 × 10-22 cm2 and a transition probability of 30.89 s-1 compared to all other glasses. The non-exponential decay profiles of the fabricated samples were plotted by examining the excitation wavelength at 402 nm and emission wavelength at 600 nm. Of all the prepared glasses, the quantum efficiency is found to be higher for the glass sample PBKSrF:Sm (65 %).
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Distalization of mandibular molars comes with significant challenges, especially in adult and young adult patients. In selected cases, third molar extraction procedures offer the opportunity to place miniplates for anchorage to distalize mandibular molars, providing additional solutions to the traditional extraction of premolars or a single incisor. This approach can be of special interest to adult patients, who may have life commitments and time restraints that limit traditional orthodontic and surgical treatment options, and it can improve the efficiency of dental care. This case series describes 3 clinical scenarios in which miniplates were placed with minimal invasiveness during the removal of impacted third molars, offering the patients nontraditional orthodontic treatment options. Awareness of these options is essential for general dentists so that they can explain all treatment possibilities and provide appropriate referrals to patients with impacted third molars.
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Métodos de Anclaje en Ortodoncia , Diente Impactado , Humanos , Femenino , Métodos de Anclaje en Ortodoncia/instrumentación , Métodos de Anclaje en Ortodoncia/métodos , Diente Impactado/cirugía , Diente Impactado/terapia , Extracción Dental , Técnicas de Movimiento Dental/métodos , Técnicas de Movimiento Dental/instrumentación , Derivación y Consulta , Tercer Molar/cirugía , Placas Óseas , Masculino , Adulto , Odontología General , Adulto Joven , Mandíbula/cirugíaRESUMEN
Recovery from alcohol use disorder (AUD) is a dynamic process that often entails periods of drinking but has been defined primarily by abstinence. Recently, a broader interpretation of recovery was developed, including meeting the Diagnostic and Statistical Manual of Mental Disorders (DSM) remission criteria and improved psychosocial functioning. This new understanding of recovery has facilitated the development of novel theories and methodologies. This paper reviews a new theoretical perspective of recovery, Reinforcer Pathology, and two novel methodological approaches in light of this broader view of recovery. Using this theoretical framework as a foundation, we propose an alternative perspective to explain the recovery process as it relates to environmental factors and valuation of the future; we suggest that changing the environment in which substances are available (e.g., increasing non-alcohol-related activities) and extending one's temporal window are associated with improved recovery outcomes (e.g., remission and quality of life). In this review, we discuss two novel methodological approaches. The first uses latent profile analysis to show that using a measure of Relative Reinforcement Value of Alcohol-Free Activities is associated with a greater likelihood of belonging to a high functioning/infrequent heavy drinking recovery profile. The second developed an online national sample and used an accelerated longitudinal design to study longer-term recovery of up to 12 years over a 5-year study period. Reinforcer Pathology theory, novel methods, and measures may further our understanding of recovery and begin to address critical questions for future studies. Subsequent randomized clinical trials should examine whether the suggested targets and interventions based on the theoretical model improve recovery outcomes prospectively. Measuring and promoting alcohol-free activity engagement may facilitate improved recovery outcomes, while novel methodologies permit an understanding of returning to use or remission across different recovery durations.
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The determination of molar masses and their distributions is crucial in polymer synthesis and design. This work presents the current performance and limitations of diffusion-ordered spectroscopy (DOSY) on a low-field (benchtop) NMR spectrometer (at 90 MHz) as an alternative to size exclusion chromatography (SEC) for determining diffusion coefficient distributions (DCDs) and molar mass distributions (MMDs). After optimization for narrowly distributed homopolymers, MMDs obtained with inverse Laplace transformation (ILT) and log-normal distribution are compared with average molar masses obtained with mono- and bi-exponential fits, as well as MMDs obtained from SEC. This approach enables ILT to determine DCDs and MMDs even for bimodal homopolymers with fully spectrally overlapping signals and block copolymers with various chemical compositions, for which chemical composition profiles are determined. The feasibility of low-field diffusion NMR with samples dissolved in non-deuterated solvents is further demonstrated and methods for solvent suppression are discussed.
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This retrospective study assessed maxillary premolar and molar teeth and identified roots with incomplete apical bone coverage using cone beam computed tomography in 161 dogs. The associated dorsal anatomic sites that the roots communicated with were the ventral nasal meatus, maxillary recess, infraorbital canal, and pterygopalatine fossa. The study found that all roots of the maxillary premolar and molar teeth have the potential for incomplete apical bone coverage, with 26.7% having incomplete apical bone coverage. No significant association with sex was found. A significant association with weight was found, and this lowered with increasing body weight. Facial index, as a determinate of skull shape, was found to be significant in only 35.7% of roots in univariate and 14.2% of roots in multivariate modeling. Knowledge of the anatomy of these roots plays an important role in safe and effective extraction techniques, in reducing iatrogenic trauma, and in understanding the potential local effects of periodontal and endodontic disease.
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This work valorizes rejects from Tenebrio Molitor TM breeding through the production of chitin and chitosan. Two processes are proposed for extracting chitin from larval exuviae and adult. The first process P1 provides chitin with high contents compared to literature data but the characterization shows the presence of impurities in the exuviae chitin responsible for the shifts in the values of the physicochemical characteristics towards those presented by γ chitin. These impurities are removed by delipidation and pure α chitin is obtained. The effective delipidation of this chitin would be linked to its fibrous surface structure. The analysis of the results of P1 led us to develop a second extraction process P2 which provides pure chitin with improved yields using delipidation followed by deproteinization. The N-deacetylation of chitin according to Kurita or Broussignac process makes possible the preparation of pure, highly deacetylated chitosan samples (2 % < DA < 12 %) with high yields and controlled molar masses (Mv). A kinetic study of molecular degradation during deacetylation is carried out. A comparison with Hermetia illucens allows to extend the use of insects as a potential source of chitin and chitosan and confirms the role of the source and the processes in the determination of their characteristics.
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The presence of molar incisor hypomineralization (MIH) raises the likelihood of enamel degradation, which in turn raises the risk of plaque buildup and dental caries. Individuals impacted by this illness frequently incur large long-term costs. Therefore, it is of interest to evaluate prevalence and treatment need of MIH in school going children. Hence, 3030 school going students were included in this study. Considering the WHO 1997 guidelines for caries severity and the requirement of therapy for the damaged teeth and criteria for MIH, a full mouth visual assessment of moist teeth was conducted for every student. The overall prevalence of MIH was 174 (7.9%). Preventive caries restricting therapy was needed in 42(6.2%) maxillary right first molar,30(4.5%) maxillary left first molar, 30 (4.5%) mandibular right first molar, 36 (5.4%) in mandibular left first molar. Data shows that an incidence rate of 7.4 percent was noted, with a larger propensity among male children and a predominant impact on mandibular molars.
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Dental age assessment based on evaluating dental mineralization status is one of the most common methods used in forensic practice. The aim of this study is to enhance the accuracy of age diagnostics and provide reference data from the Syrian population for forensic application. After several selection steps, a total of 280 orthopantomograms (OPGs) from 140 males and 140 females from the Syrian population divided into 14 age groups between 12 and 25 years were analysed. Based on Demirjian's classification system, the mineralization stages of third molars (18, 28, 38 and 48) as well as lower second molars (37 and 47) were evaluated. Statistical investigations and evaluations were carried out to estimate the marginal probabilities of the subjects having attained ages 14 and 18 by generalized estimating equation models. Our results show that no significant differences can be revealed in the mineralization status with respect to jaw side and sex. In the Syrian population, third molars showing mineralization stage G provide evidence of reaching the age of 14 years with the highest standard of proof ("beyond reasonable doubt"). A completed mineralization in lower second molars (stage H) provides very high marginal probabilities (more than 90%) of the subjects having attained age 14 years. Nevertheless, this cannot exclude an age under 14 years. For the age threshold of 18 years, third molars showing incomplete root development (G dental stage or lower) are associated with a low probability (less than 40%) of the subject having reached 18 years of age. A person's probability of having attained 18 years of age is very high (82- 95%) when the roots of third molars are fully developed (stage H). Nevertheless, third molars at stage H do not conclusively exclude an age under 18 years.
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The aim of this proposal is to (1) review the current literature, (2) shed light on the importance of creating universally accepted guidelines, (3) provide help and guidance in the decision-making process with regard to the removal of mandibular third molars (M3Ms), and (4) reduce the risk of exposing the patient to unnecessary harm and complications due to the inappropriate removal or retention of M3Ms.It is obvious that the indications for the extraction of M3Ms will continue to be an area of controversy and strong debate. The evidence for or against prophylactic extraction is ambivalent; there is evidence to accept or reject the stance against prophylactic extraction in some specific cases, and there are published articles to support both opposing views. The available guidelines on the extraction of third molars are limited in number, and are mostly tailored to fit specific settings or countries. There are no available guidelines that might be widely used to help in the decision-making process for the international community. We hope this proposal will constitute an important first step toward creating universally accepted guidance.
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Mandíbula , Tercer Molar , Guías de Práctica Clínica como Asunto , Extracción Dental , Humanos , Tercer Molar/cirugía , Diente Impactado/cirugíaRESUMEN
BACKGROUND: Women who suffer an early pregnancy loss require specific clinical care, aftercare, and ongoing support. In the UK, the clinical management of early pregnancy complications, including loss is provided mainly through specialist Early Pregnancy Assessment Units. The COVID-19 pandemic fundamentally changed the way in which maternity and gynaecological care was delivered, as health systems moved to rapidly reconfigure and re-organise services, aiming to reduce the risk and spread of SARS-CoV-2 infection. PUDDLES is an international collaboration investigating the pandemic's impact on care for people who suffered a perinatal bereavement. Presented here are initial qualitative findings undertaken with UK-based women who suffered early pregnancy losses during the pandemic, about how they navigated the healthcare system and its restrictions, and how they were supported. METHODS: In-keeping with a qualitative research design, in-depth semi-structured interviews were undertaken with an opportunity sample of women (N = 32) who suffered any early pregnancy loss during the COVID-19 pandemic. Data were analysed using a template analysis to understand women's access to services, care, and networks of support, during the pandemic following their pregnancy loss. The thematic template was based on findings from parents who had suffered a late-miscarriage, stillbirth, or neonatal death in the UK, during the pandemic. RESULTS: All women had experienced reconfigured maternity and early pregnancy services. Data supported themes of: 1) COVID-19 Restrictions as Impractical & Impersonal; 2) Alone, with Only Staff to Support Them; 3) Reduction in Service Provision Leading to Perceived Devaluation in Care; and 4) Seeking Their Own Support. Results suggest access to early pregnancy loss services was reduced and pandemic-related restrictions were often impractical (i.e., restrictions added to burden of accessing or receiving care). Women often reported being isolated and, concerningly, aspects of early pregnancy loss services were reported as sub-optimal. CONCLUSIONS: These findings provide important insight for the recovery and rebuilding of health services in the post-pandemic period and help us prepare for providing a higher standard of care in the future and through any other health system shocks. Conclusions made can inform future policy and planning to ensure best possible support for women who experience early pregnancy loss.
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Aborto Espontáneo , COVID-19 , Investigación Cualitativa , Humanos , Femenino , COVID-19/epidemiología , COVID-19/psicología , Embarazo , Adulto , Aborto Espontáneo/psicología , Aborto Espontáneo/epidemiología , Reino Unido/epidemiología , SARS-CoV-2 , Accesibilidad a los Servicios de Salud , Servicios de Salud Materna , Aflicción , Adulto JovenRESUMEN
Objective: This systematic review aims to summarize the evidence on the use and applicability of AI in impacted mandibular third molars. Methods: Searches were performed in the following databases: PubMed, Scopus, and Google Scholar. The study protocol is registered at the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY202460081). The retrieved articles were subjected to an exhaustive review based on the inclusion and exclusion criteria for the study. Articles on the use of AI for diagnosis, treatment, and treatment planning in patients with impacted mandibular third molars were included. Results: Twenty-one articles were selected and evaluated using the Scottish Intercollegiate Guidelines Network (SIGN) evidence quality scale. Most of the analyzed studies dealt with using AI to determine the relationship between the mandibular canal and the impacted mandibular third molar. The average quality of the articles included in this review was 2+, which indicated that the level of evidence, according to the SIGN protocol, was B. Conclusions: Compared to human observers, AI models have demonstrated decent performance in determining the morphology, anatomy, and relationship of the impaction with the inferior alveolar nerve canal. However, the prediction of eruptions and future horizons of AI models are still in the early developmental stages. Additional studies estimating the eruption in mixed and permanent dentition are warranted to establish a comprehensive model for identifying, diagnosing, and predicting third molar eruptions and determining the treatment outcomes in the case of impacted teeth. This will help clinicians make better decisions and achieve better treatment outcomes.
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Introduction and importance: Third molars are often removed in order to prevent complications and various other problems associated with impacted teeth. Case presentation: A healthy 17-year-old girl with no history was referred to the Department of Oral Surgery by her orthodontist to remove mandibular third-molar germs. Panoramic radiography showed the presence of impacted mandibular third-molar germs, vertically positioned, with incomplete root formation. The tooth germs (48, 38) were extracted under local-regional anesthesia. The postoperative period was uneventful. Clinical discussion: Germectomy is still relevant in the management of mandibular third molars (MTM). It is a surgical removal of the dental germ at a particularly specific developmental period. However, the need to extract the MTM germs is still controversial. Conclusion: Germectomy is well justified in light of clinical symptomatology and/or a suspicious radiographic image. Nonetheless, in asymptomatic MTM, it is important to assess the procedure's cost-benefit ratio.
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Background: In human dentition, the most commonly impacted teeth are the mandibular third molars (M3M). The removal or extraction of these teeth often causes anxiety in patients due to the perceived pain involved in the process. Therefore, pain must be effectively managed using anesthesia. The use of newer local anesthetic drugs can help minimize side effects and drug interactions. Traditionally, adrenaline is used as a vasoconstrictor along with lignocaine. When combined with lignocaine, the alpha agonists dexmedetomidine and clonidine can extend the duration of anesthesia, thereby reducing the need for additional pain-relieving medications. Methods: This study used a randomized, triple-blind, parallel-arm design. Sixty patients were screened, and 45 systemically healthy patients requiring unilateral surgical removal of impacted mandibular third molars with similar difficulty (moderate-to-difficult according to the Modified Pederson's Index) were included in the study. Patients were allocated into three groups as follows: Group A: 2% Lignocaine Hydrochloride with 1:100,000 Adrenaline, Group C: 2% Lignocaine Hydrochloride with 15 µg/mL Clonidine, and Group D: 2% Lignocaine Hydrochloride with 1 µg/mL Dexmedetomidine. The evaluated parameters were the time of onset of anesthesia, depth of anesthesia, hemodynamic parameters, and duration of postoperative analgesia. Results: Group D had a faster onset of action and prolonged duration of postoperative analgesia compared with Groups A and C. No statistically significant differences were observed between the three groups in terms of the depth of anesthesia and hemodynamic parameters. Conclusion: Group D exhibited a significantly more rapid onset of anesthesia than Groups A and C, and the postoperative analgesic effect in Group D was significantly prolonged (7.22 hours) compared with that in Groups A (4.54 hours) and C (2.1 hours). Patients receiving the Group D solution experienced an extended period of comfort without the need for analgesics for up to 7.22 hours post-procedure.