Cadiax Compact 2 and MODJAW comparative analysis of condylar inclination: Innovative digital approaches in dentistry.

STATEMENT OF PROBLEM: Artificial intelligence has been used to enhance the digitalized workflow, especially when undergoing complex oral rehabilitations. However, the reliability of real-time jaw motion registration devices is unclear, and no standard measurement method of the sagittal condylar inclination (SCI) and Bennett angle (BA) has been established. PURPOSE: The purpose of this clinical study was to compare and evaluate the reliability of the SCI and BA values recorded by using 2 different digital devices. MATERIAL AND METHODS: A total of 17 participants, aged between 20 and 30 years (10 women and 7 men) were included in the study. For each participant, the Cadiax Compact 2 and MODJAW tracking devices were used to measure the SCI and BA values at 3 mm and 5 mm of condylar displacement during 3 separate recording sessions. The intraclass correlation coefficient (ICC) was used to assess the reliability of the recordings. Comparisons between the devices were performed with the Wilcoxson rank-sum test (α=.05). The Bland-Altman plot was used to evaluate the quantitative agreement between the 2 devices. RESULTS: All ICC intrarater reliability values for Cadiax and MODJAW were higher than 0.90. Both at 3 and 5 mm, the SCI measurements were higher for MODJAW registrations than for those recorded by Cadiax. The Bland-Altman plot showed that the SCI values were higher for MODJAW than for Cadiax by 5.9 (95% CI 3.9 to 8.2) and that the BA differences between the MODJAW and the Cadiax were not consistent with the measured value. CONCLUSIONS: Excellent reliability was found with the MODJAW and Cadiax recordings. The SCI and BA values for MODJAW measurements were higher at 3 mm and 5 mm than those acquired with Cadiax. MODJAW showed higher values than Cadiax, and the discrepancies were more pronounced for 3 mm than for 5 mm of condylar displacement, highlighting the need for precision in measurements at lower ranges of motion.

Autologous leucocyte and platelet rich in fibrin (L-PRF) - is it a competitive solution for bone augmentation in maxillary sinus lift? A 6-month radiological comparison between xenografts and L-PRF.

Maxillary lateral sinus floor elevation, or external sinus lift, is a widespread surgical intervention in the dental field. Insertion of implants in the posterior region of the maxilla often requires reconstruction of the remaining native bone that has insufficient volume. Background and aims: Much of the research published involves using artificial products, like xenografts and resorbable collagen membranes, after a prior Cone Beam Computer Tomography (CBCT) investigation. Nowadays, more accessible access, less financial costs, a biological approach, and faster healing are objectives that surround this procedure. Leucocytes and platelets rich in Fibrin (L-PRF) are a natural component with a high concentration of growth factors. Due to its regenerative properties and lack of complications, it is used in several medical fields, like orthopedics, dermatology, and oral surgery. This retrospective study aims to compare results in bone height and volume obtained through external sinus lift, either by using xenografts or autologous plasma rich in fibrin, by evaluating the quantity of new bone formation from a radiological point of view. Methods: Fifty-eight Caucasian patients were included in this retrospective study; 48 were submitted to xenograft procedure, and 10 were selected for L-PRF grafting material with simultaneous implant placement. Lack of clinical and histological studies performed on patients with L-PRF surgeries limited us in choosing a larger group for the radiological analysis. CBCT evaluation was performed before surgery and 6 months after. All patients selected for the study presented good general and oral health, acute oral and sinus infections excluded; smoking and periodontal disease were also criteria of exclusion. Two operators performed the measurements in pre-established landmarks in different time frames. The two independent groups were compared with the Wilcoxon rank-sum test for quantitative data. Qualitative characteristics were described as counts and percentages. All analyses were performed in an R environment for statistical computing and graphics. Results: Mean bone height gain in the xenograft group in the regions was as follows: 7.44 for the anterior landmark, 12.14 for the median and 8.28 for the distal. The mean group height gained for the L-PRF group was 0.1 anteriorly, -0.18 for the median measurement, and 0.23 distally. We obtained excellent overall reliability for all the height measurements between the two operators. Conclusions: Further studies must be conducted to establish new sets of surgical protocols in case L-PRF alone is found to be a reliable, stable, biological alternative to the well-documented xenografts in external sinus lifts. Radiological results, although promising, must be further applied in long term clinical survival of the implants in the grafted sites. Also, studies combining L-PRF in conjunction with xenograft might bring improved clinical results in terms of reduced postoperative complications and accelerated healing.

Perceptions in Digital Smile Design: Assessing Laypeople and Dental Professionals' Preferences Using an Artificial-Intelligence-Based Application.

Digital Smile Design (DSD) is used in many fields of dentistry. This prospective observational study assessed laypeople's and dental professionals' perceptions of a DSD application. SmileCloud, an online DSD platform, was used to create two different designs for three patients; after that, the participants, in a 30-question online illustrated survey, were asked about the most attractive design and other features of the smile. Dentists' and laypeople's perceptions about specific DSD features were assessed. The Kolmogorov-Smirnov normality test was used. Descriptive and crosstab analyses compared the respondents' opinions for each statement. Chi-square tests were used to determine the relationship between the questions and any association with age, gender, and profession. The test results were rated as significant at a p-value < 0.05. A total of 520 participants (dental professionals, students, dental technicians, and laypeople) were enrolled. The statistically significant features were self-esteem related to appearance (p = 0.05), facial and smile symmetry (p = 0.42, p < 0.0001), tooth color (p = 0.012), and symmetry of gums (p < 0.001). For each patient, the design with dominant round upper incisors and perfect symmetry was preferred (p < 0.001). Digital pre-visualization benefits diagnosis and enriches treatment planning. The dentist-dental technician-patient team should be involved in the decision-making process of pre-visualization.

SEM Evaluation of Marginal Adaptation E-Max Crowns Manufactured by Printing-Pressed and Milling.

Dental crown marginal adaptation is a matter of the success of dental restoration treatment. Nowadays, there are many technological ways for crown manufacturing, such as tridimensional printing of an exactly desired shape through CAD-assisted systems and the appropriate shape milling of a predesigned bulk crown. Both methods are developed for patient benefits. The current research aims to investigate the marginal adaptation of E-Max crowns manufactured by printing-pressed and milling methods. The in vitro cementation procedures were effectuated on healthy teeth extracted for orthodontic purposes according to the standard procedures and the marginal adaptation was investigated with SEM microscopy. The restoration overview was inspected at a magnification of 100× and the microstructural details at 400×. The integrity of marginal adaptation was properly inspected in identical samples on segments of 2 mm from each buccal, palatal, distal and mesial side. The obtained results reveal a good marginal adaptation for all samples, with some particularities. The statistical analysis shows that the best values of the marginal adaptation were obtained for vestibular/buccal and palatal sides of the teeth being situated around 90-95%, while the values obtained for distal and mesial sides are slightly lower such as 80-90%. Furthermore, it was observed that the milled crowns presents better marginal adaptations than the printed-pressed ones, sustained by the statistical p < 0.05. This indicates that the milling process allows a better fit of the crown to the tooth surface and preserves the integrity of the bonding cement layer.

Translucent Zirconia in Fixed Prosthodontics-An Integrative Overview.

Over the past two decades, dental ceramics have experienced rapid advances in science and technology, becoming the fastest-growing field of dental materials. This review emphasizes the significant impact of translucent zirconia in fixed prosthodontics, merging aesthetics with strength, and highlights its versatility from single crowns to complex bridgework facilitated by digital manufacturing advancements. The unique light-conducting properties of translucent zirconia offer a natural dental appearance, though with considerations regarding strength trade-offs compared to its traditional, opaque counterpart. The analysis extends to the mechanical attributes of the material, noting its commendable fracture resistance and durability, even under simulated physiological conditions. Various zirconia types (3Y-TZP, 4Y-TZP, 5Y-TZP) display a range of strengths influenced by factors like yttria content and manufacturing processes. The study also explores adhesive strategies, underlining the importance of surface treatments and modern adhesives in achieving long-lasting bonds. In the realm of implant-supported restorations, translucent zirconia stands out for its precision, reliability, and aesthetic adaptability, proving suitable for comprehensive dental restorations. Despite its established benefits, the review calls for ongoing research to further refine the material's properties and adhesive protocols and to solidify its applicability through long-term clinical evaluations, ensuring its sustainable future in dental restorative applications.

Zirconia-Reinforced Lithium Silicate Ceramic in Digital Dentistry: A Comprehensive Literature Review of Our Current Understanding.

Zirconia-reinforced lithium silicate (ZLS) ceramic is a new innovative dental material with unique a chemical composition that is designed to combine harmoniously with the appropriate optical properties of lithium disilicate and the enhanced mechanical strength of zirconia. A thorough understanding of ZLS materials is essential for both clinicians and dental technicians. At present, the mechanical behavior and optical properties of the ZLS ceramic system have not been extensively researched, and there is still a lack of consensus regarding the fabrication process and clinical behavior of ZLS all-ceramic restorations. The aim of the present study was to present a selection of comprehensive information concerning zirconia-reinforced lithium silicate ceramics and their optical and mechanical properties, as well as to assess data regarding cementation procedures and clinical outcomes for ZLS all-ceramic restorations. Three electronic databases (PubMed, Web of Science, and the Cochrane Library) were used for the research by two independent reviewers. The search was limited to articles published in the English language, as well as clinical and in vitro studies of color and studies on mechanical behavior and the cementation procedures of ZLS restorations. The exclusion criteria comprised abstracts, questionnaire-based studies, case reports, literature reviews, and studies that were not available in English. Zirconia-reinforced lithium-silicate-based ceramic presents a unique and complex microstructure that increases mechanical resistance but decreases aesthetic appearance, especially its translucency, due to tetragonal zirconia content. A material's thickness, the color of the underlying tooth structure, and the resin cement shade are important factors that influence the final shade and aesthetic appearance of ZLS restorations. Mechanical properties, which are defined by the fracture toughness, flexural strength, elastic modulus, and hardness of ZLS ceramic are higher compared to feldspathic, lithium disilicate, and hybrid ceramics, as well as resin nanoceramics; however, they are lower than translucent or high-translucency zirconia. Acid etching, sandblasting, and laser etching represent the most used methods to prepare the ZLS restoration surfaces for proper bonding procedures.

Endocrowns - a literature review.

Introduction: The opportunity of using Endocrown-type restorations in the current prosthetic dentistry practice as an alternative to other, well-established methods of corono-radicular restorations and the evolving palette of adhesive materials has made these restorations more popular in the last few years. Objective: The purpose is to review the available literature about Endocrown restorations regarding mechanical properties - fracture strength and resistance, survival rate, the preparation design - marginal and internal adaptation, and esthetics. Method: The search was carried out on four databases: PubMed, Scopus (ScienceDirect), Web of Science, and Scielo using the following terms: "endocrowns", "endodontic crown", and" no buildup crown". Initially, a total of 163 articles published between 2015 and May 2021 were selected. After the duplicates, papers presented only as abstracts, articles in any other languages except English, and review articles were eliminated; a total of 72 articles remained to be considered for this review.After assessing the 72 considered articles, 37 were chosen as fit for this review. The reasons for the elimination of the other 35 articles were: their main focus was other than endocrowns, e.g., direct restorations, indirect restorations of vital teeth; case reports; study protocols. Results: From the 37 articles selected, 34 were focused on mechanical properties, including the influence of the preparation design, and three on survival rate, of which one also had a point of view regarding esthetics. Conclusions: The literature included in this review shows that endocrowns perform similarly or even better in some cases than other coronal restorations. However, this statement must be interpreted cautiously, given that most articles were in vitro or finite element analysis studies. Given the high degree of conflicting results found in the articles included in this review, the authors consider as reasonable to conclude that further studies are needed to confirm the feasibility of endocrowns and the best choice of material.

Survival Rates of Glass versus Hybrid Ceramics in Partial Prosthetic Restorations: A Scoping Review with Emphasis on Adhesive Protocols.

As dental practices and methodologies evolve, the emergence of novel materials adds complexity to clinical choices. While glass ceramics, particularly those based on lithium disilicate and leucite-reinforced variants, have been extensively researched and are well regarded for their attributes, hybrid ceramics remain relatively recent area of research that is less investigated. This review aims to evaluate the durability of glass and hybrid ceramics while assessing the role of various adhesive techniques on restoration longevity. Using a comprehensive search of PubMed and EMBASE, 84 articles from the past decade were found. Only eleven met the set criteria for analysis. The results underscore the urgent need for the extended monitoring of partial prosthetic restorations. The existing literature has significant gaps, hindering the attainment of dependable insights about these materials' long-term performance. For a clearer understanding of how different ceramic systems affect restoration survival rates, rigorous research involving more participants and uniform outcome documentation is vital.

Smile Design and Treatment Planning-Conventional versus Digital-A Pilot Study.

INTRODUCTION: Several methods are currently available for providing a preview of the prosthodontic treatment, including computer simulations, 3D models, wax-ups, and mock-ups. The aim of this study is to compare the aesthetic aspects and assessment of conventional versus digital prefigurative methods. METHODS: The study included 5 patients and 3 observers, for each of whom a wax-up was made in both the conventional and digital techniques. The analog method, which implied a mock-up molding with a silicone matrix of the wax-up, was compared to a digital workflow, which consisted of a mock-up milling from a digital design. The patient's clinical mock-ups were recorded with digital photographs and assessed for nine different criteria by three observers. RESULTS: The analysis has shown a balanced assessment of the aesthetic criteria without any significant difference between the analog and digital prefigurative methods. CONCLUSIONS: Between the two wax-ups (conventional and digital), there were some variations in smile and dental criteria; however, the obtained data were very similar. When it comes to the smile criteria, the general average grades of the mock-ups conducted using the conventional method are slightly higher than the ones using the digital technique.

Identification of a miRNA Panel with a Potential Determinant Role in Patients Suffering from Periodontitis.

In recent years, the role of microRNA (miRNA) in post-transcriptional gene regulation has advanced and supports strong evidence related to their important role in the regulation of a wide range of fundamental biological processes. Our study focuses on identifying specific alterations of miRNA patterns in periodontitis compared with healthy subjects. In the present study, we mapped the major miRNAs altered in patients with periodontitis (n = 3) compared with healthy subjects (n = 5), using microarray technology followed by a validation step by qRT-PCR and Ingenuity Pathways Analysis. Compared to healthy subjects, 159 differentially expressed miRNAs were identified among periodontitis patients, of which 89 were downregulated, and 70 were upregulated, considering a fold change of ±1.5 as the cut-off value and p ≤ 0.05. Key angiogenic miRNAs (miR-191-3p, miR-221-3p, miR-224-5p, miR-1228-3p) were further validated on a separate cohort of patients with periodontitis versus healthy controls by qRT-PCR, confirming the microarray data. Our findings indicate a periodontitis-specific miRNA expression pattern representing an essential issue for testing new potential diagnostic or prognostic biomarkers for periodontal disease. The identified miRNA profile in periodontal gingival tissue was linked to angiogenesis, with an important molecular mechanism that orchestrates cell fate.

Studies on the use of glassionomer.

Background and aims: This study is focused on the analysis of the properties of glassionomers following the choice of the type of material by the dentists. The study evaluated the properties of glassionomers used for restorations directly by comparing those prepared manually with those prepared mechanically, to find an "ideal" glassionomer and to counteract the disadvantages of the material. Method: The study was conducted on the basis of a questionnaire and included 254 dentists from Romania. It took place between April 6 - 24, 2020 and the questionnaire was administered online. The questions focused on: the type of glassionomer chosen by every dentist, the doctor's opinion about the properties, type and clinical indications of the material. Results: The results showed that in Romania, the dentists use the glassionomer for a permanent filling in adults because of the financial aspect, as they stated. In their opinion the best advantages are the fluoride release and adhesion to dental tissues and, on the other hand the biggest disadvantage is aesthetics. Conclusions: Among the conclusions are the following: the glassionomer is frequently used in dental offices, especially the powder-liquid system, as a commercial product; no standard type of glassionomer was found.

Oral splints in the management of nociceptive pain and migraines: A scoping review.

Temporomandibular disorders (TMDs) are characterized by numerous pain manifestations. Their treatment often involves the use of an oral splint. Recent research has found a relationship between migraines, nociceptive pain and TMDs. The aim of the present study was to perform a scoping review of studies in order to evaluate the effectiveness of the various types of oral splint in the treatment of migraine or nociceptive pain. Publications were retrieved from seven databases (PubMed, Web of Science, EMBASE, Scopus, ProQuest, SpringerLink and Ovid). Out of the 15 included publications, three studies were before and after studies, with no control group, whereas the other twelve studies were clinical trials, among which two publications were crossover studies. A clear, single distinction of pain was difficult to describe. Therefore, numerous publications focused on a combination of various types of pains, including myofascial, temporomandibular joint, headaches and migraine-like symptoms, all of which mimicked TMD pain. Overall, six studies used the stabilization splint (SS), three explored the comparison between the SS and the nociceptive trigeminal inhibition splint (NTIS) and two the NTIS. The majority of publications reported a positive outcome of splint therapy. Regarding the type of oral splint usage, the most commonly used one was the SS, followed by the NTIS. The definition and assessment of pain were heterogenous in the identified articles. The findings of the current study showed that occlusal splints may help with pain management, and that effective treatment of TMD-related pain at an early stage can enhance the quality of life of patients.

Psoriatic arthritis of the temporomandibular joint: A systematic review.

OBJECTIVES: Psoriasis is an inflammatory condition brought on by the immune system. This study aimed to perform a systematic review related to psoriatic arthritis (PsA) of the temporomandibular joint (TMJ). METHODS: The search strategy was developed by a radiologist expert with more than 20 years of experience. The search was performed without time restrictions in five electronic databases: PubMed, Web of Science, Embase, Scopus and Ovid. The search strategy was based on MeSH and Emtree terms. The methodological quality of the studies was rated using the quality assessment tools from the National Heart Lung and Blood Institute (NHLBI). RESULTS: Twenty-three publications were included, 10 being case reports. One hundred-fifty-one patients with TMJ PsA were reported. Psoriasis evolution ranged from 1.5 years to 24 years. Clinical symptoms of TMJ involvement included: TMJ pain and sounds, limited range of jaw movements, preauricular swelling, malocclusion, headache, tinnitus, neck stiffness and altered dietary function. TMJ was evaluated by magnetic resonance imaging (six studies), computed tomography (eight articles) and by ultrasonography findings (two articles). For TMJ treatment, topical and systemic medication was reported in 11 studies. Five studies included patients needing surgical procedures for TMJ ankylosis. CONCLUSIONS: A relationship between TMD and psoriasis has been revealed. TMJ PsA has been investigated and debated, although the radiographic findings or clinical symptoms of PsA are not noticeably different from other forms of TMJ arthritis. Conservative therapy can lead to significant improvement of TMJ function.

Occlusal Splint Therapy Combined with Cranio-Temporomandibular Kinesiotherapy in Patients with Temporomandibular Disorders-A CBCT Study.

Occlusal splints are used as a non-invasive treatment for patients diagnosed with temporomandibular disorders (TMD). Another non-invasive treatment option for TMD patients is kinesiotherapy, which may be used alone or in conjunction with occlusal splint therapy. The aim of this study was to evaluate the changes in the intra-articular spaces of the temporomandibular joint (TMJ) after occlusal splint therapy combined with cranio-temporomandibular kinesiotherapy in TMD patients. Twenty-four patients (N = 24) diagnosed with TMD according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were included. Cone beam computed tomography (CBCT) images were taken before and after treatment. The anterior, superior, posterior, and medial joint spaces were measured on the CBCT images, and the condylar ratio was calculated using Pullinger and Hollender's formula. Additionally, the thickness of the glenoid fossa (GFT), condylar medio-lateral widths (MLW), and condylar height (HCo) were measured. The condylar ratio was significantly higher after treatment (p = 0.049). The changes in dimensions of the anterior, superior, posterior and medial joint spaces were not statistically significant after treatment. No statistically significant differences were found in the dimensions of the GFT, MLW, and HCo post treatment. The condylar position did not shift anteriorly in a statistically significant way after occlusal splint therapy combined with cranio-temporomandibular kinesiotherapy in TMD patients.

Petrotympanic Fissure Architecture and Malleus Location in Temporomandibular Joint Disorders.

The aim of this research was to assess possible relationships between petrotympanic fissure (PTF) characteristics, malleus position, and temporomandibular joint disorders (TMD). A retrospective study was performed, including patients with TMD. Magnetic resonance imaging (MRI) and cone-beam computed tomography (CBCT) examination were used to evaluate temporomandibular joint (TMJ) disc position and condylar bone changes. Fifty-eight TMJs from twenty-nine patients (23:6 females: males) were assessed. Erosive changes (DDR-disc displacement with a reduction of 6 (24%), DDwR-disc displacement without a reduction of 8 (61.5%) vs. normal disc position 3 (15%), p = 0.012) and condyle osteophytes production (DDR 6 (24%), DDwR 9 (69.2%) vs. normal condyle 7 (35%), p = 0.012) were more frequent in subjects with disc displacement compared to normal disc position; malleus was closer to PTF in cases with erosive changes (median 2.15 interquartile range: (1.85-2.75) vs. 2.75 (2.25-3.15), p = 0.029) as well as those with condylar osteophytosis (2.25 (1.91-2.75) vs. 2.75 (2.33-3.32), p = 0.015); the PTF length was higher in cases with condylar osteophytosis compared to those without (4.45 (3.50-4.77) vs. 3.67 (3.34-4.28), p = 0.039). The disc position and disc shape were not related to PTF or malleus position. Malleus position and PTF dimensions were not associated with the PTF type. In cases with erosive changes and condylar osteophytosis, malleus was closer to PTF.

Disc Displacement of the Temporomandibular Joint and Facial Asymmetry in Children and Adolescents: A Systematic Review and Meta-Analysis.

Subjects with facial skeletal asymmetries have a higher incidence of anterior temporomandibular joint disc displacement. The objective of the study was to consolidate existing evidence on the connection between temporomandibular joint disc displacement and mandibular asymmetry in youngsters and adolescents. A thorough examination was undertaken in the following databases: PubMed, Scopus, EMBASE, Web of Science, and Cochrane. To judge the publications' methodological quality Newcastle Ottawa Scale was used. From the 1011 identified records, eight were selected for the qualitative synthesis and five for the quantitative synthesis, amounting to 692 subjects. Fifteen cephalometric variables were meta-analyzed. The distance from menton (Me) to midline (lateral mandibular asymmetry) was significantly shorter [-1.75 (95% CI -2.43--1.07), p ≤ 0.001] in subjects with disc displacement compared to those without disc displacement. The distance from articulare (Ar) to gonion (Go) was significantly longer [3.74 (95% CI 1.04-6.44), p = 0.007] in subjects with disc displacement compared to those without disc displacement. The relationship between distance from articulare (Ar) to gonion (Go) or sella (S) to gonion (Go) and disc displacement was shown to be close to statistical significance level, but not for other cephalometric data. Disc displacement was associated with several cephalometric measurement variations in children and adolescents.

Bruxism's Implications on Fixed Orthodontic Retainer Adhesion.

BACKGROUND: Fixed retainers assist in maintaining the outcomes of orthodontic treatment. Fixed retention may be affected by bruxism. OBJECTIVE: Evaluate two adhesives (an ormocer and a flowable composite) used for fixed orthodontic retention in simulated bruxism settings, compared to regular mastication, using a dual axis chewing simulator. METHODS: Eighty human teeth were used. Periodontal tissues were simulated and exposed to 120,000 mechanical cycles, corresponding to 6 months of clinical service. Each set of two teeth was supplied with a pre-shaped, fixed, multi-braided, stainless steel wire retainer, in 1.5 cm portions, to establish passive contact with the lingual surface of the teeth. The Adhesive Remnant Index (ARI) was used to evaluate the shear bond strength. A stereomicroscope was used to assess the micro-infiltration. RESULTS: There was no significant difference in the mean value of micro-infiltration between adhesives in the mastication group but in the bruxism group. During testing, one composite sample (ARI score 1) was broken in the mastication group, while three ormocer samples (ARI score 2) and one composite sample (ARI score 1) were broken in the bruxism group. CONCLUSIONS: The mean value for micro-infiltration in composite (0.31) was more than double that in ormocer (0.13).

Human Enamel Fluorination Enhancement by Photodynamic Laser Treatment.

Poor oral hygiene leads to serious damages of theteeth's surface enamel such as micro-abrasions and acid erosion. These alterations combined with bacterial plaque result in cavity appearance. Prophylactic measures include various techniques for enamel surface restoration. Fluorination is one of the most important treatments for this purpose. Therefore, in the present research, we investigated the classical fluorination treatment compared with laser photodynamic fluorination performed on human enamel samples with poor surface quality. Three sample groups were investigated: veneer (F), inlay (I), and crowns (C). The general morphologic aspect was investigated by scanning electron microscopy (SEM), and the specific details such as the fine microstructure and nanostructure were investigated by atomic force microscopy (AFM) of the surface roughness. The samples were also investigated by Fourier transformed infrared attenuated total reflectance (FTIR-ATR) to evidence the fluorination effect on the enamel surface. Results showed that all initial samples had an altered state with micro-abrasions and erosion with mineral loss, which increase the surface roughness. The F group was the most damaged, having a higher roughness, and the I group was less damaged. Classic fluorination treatment partially restored the enamel by local re-mineralization, but did not obtain the parameters of healthy enamel. However, a significant decrease of the roughness was observed (statistical relevance p = 0.001 with the Breusch-Pagan Test). This fact was supported by the presence of newly formed fluorides in the FTIR-ATR spectra. The photodynamic laser fluorination restores the enamel in an enhanced manner by a strong re-mineralization, which implies a significant roughness value decrease comparable to healthy enamel. The Breusch-Pagan Test confirmed the relevance with p = 0.001. This is due to an extended re-mineralization abundant in fluoride crystals as observed by AFM and FTIR. Statistical p-values regarding laser application were in the range of 0.02-0.06, supporting its relevance in the fluorination effect. The final conclusion is that the photodynamic effect is able to favor the newly formed fluoride deposition onto the affected sites of the enamel surface.

Intrusion of Maxillary Posterior Teeth by Skeletal Anchorage: A Systematic Review and Case Report with Thin Alveolar Biotype.

This study aimed to review the literature related to the intrusion of maxillary posterior teeth in subjects needing pre-prosthetic restoration or orthodontic treatment due to anterior open bite, and to report a thin alveolar biotype case needing a pre-prosthetic intrusion of maxillary teeth by introducing a novel, personalized method of intrusion measurement. An electronic search was conducted between February 2022 and March 2022 in the following databases: PubMed, Scopus, Embase, Web of Science, and Lilacs; the terms "tooth movement techniques", "orthodontic anchorage procedures", "tooth intrusion", "intrusion", "molar", "premolar", and "human" were surveyed. Eighteen articles were included in this review; the mean amount of intrusion ranged from between 2.1 ± 0.9 mm and 4.57 ± 0.98 mm (being mostly 2-3 mm). The intrusion force varied between 100 and 500 g; 10 articles reported miniscrews (MS), 7 reported zygomatic plates (ZP), and 1 publication reported both anchorage types. The average treatment time was 6.9 months for MS and 7.9 months for ZP. Levelling the occlusal plane by intrusion of the upper posterior teeth can be achieved by skeletal anchorage. The stability of the obtained results, shortening treatment time, and controlling treatment outcome are the main goals for a complex surgical and orthodontic treatment approach.

Is Teledentistry a Method for Optimizing Dental Practice, Even in the Post-Pandemic Period? An Integrative Review.

BACKGROUND: For the past two and half years, dentists all across the world, along with their patients, have faced numerous challenges. In this context, the aim of this integrative review was to assess if dentists' and patients' attitudes regarding teledentistry (TD) have changed since the COVID-19 outbreak, and if the use of TD will continue to rise, even in the post-pandemic period; (2) Methods: A literature search was performed between August 2021 and January 2022. The PubMed, Scopus, and Science Direct databases were searched for articles published between 2012 and 2022 using a combination of the following Mesh terms: "COVID-19", "pandemic", "oral telemedicine", "teledentistry"; (3) Results: Among the 52 included papers, nine papers were published between 2011 and 2019, and 43 articles were published after 2020 (12 were published in 2020, 29 papers were published in 2021, and two in 2022). Among the articles published before 2020, seven out of nine included papers were reviews, and two were original research. Among the 43 papers published after 2020, 18 were reviews and 25 original research. (4) Conclusions: Based on the results of this integrative review, there is clear evidence that the interest in teledentistry and teleassistance in the dental field has increased rapidly, especially in the context of the COVID-19 pandemic. Therefore, while dental practitioners should be encouraged to keep themselves updated about new technologies, patients should also be constantly informed about their options for receiving special oral health care.