A Systematic Review and Meta-Analysis on the Efficacy of Locally Delivered Adjunctive Curcumin (Curcuma longa L.) in the Treatment of Periodontitis.

This meta-analysis intended to assess evidence on the efficacy of locally delivered curcumin/turmeric as an adjunctive to scaling and root planing (SRP), on clinical attachment level (CAL) and probing pocket depth (PPD), compared to SRP alone or in combination with chlorhexidine (CHX). RCTs were identified from PubMed, Cochrane Library, BASE, LIVIVO, Dentistry Oral Sciences Source, MEDLINE Complete, Scopus, ClinicalTrials.gov, and eLibrary, until August 2022. The risk of bias (RoB) was assessed with the Cochrane Risk of Bias tool 2.0. A random-effects meta-analysis was performed by pooling mean differences with 95% confidence intervals. Out of 827 references yielded by the search, 23 trials meeting the eligibility criteria were included. The meta-analysis revealed that SRP and curcumin/turmeric application were statistically significantly different compared to SRP alone for CAL (-0.33 mm; p = 0.03; 95% CI -0.54 to -0.11; I2 = 62.3%), and for PPD (-0.47 mm; p = 0.024; 95% CI -0.88 to -0.06; I2 = 95.5%); however, this difference was considered clinically meaningless. No significant differences were obtained between patients treated with SRP and CHX, compared to SRP and curcumin/turmeric. The RoB assessment revealed numerous inaccuracies, thus raising concerns about previous overestimates of potential treatment effects.

A blind randomized controlled pilot trial on recombinant human bone morphogenetic protein-2 in combination with a bioresorbable membrane on periodontal regeneration in mandibular molar furcation defects.

OBJECTIVES: In preparation of a definitive randomized clinical trial (RCT), the current parallel-grouped triple-blind pilot RCT assessed the efficacy of recombinant human bone morphogenetic protein-2 (rhBMP-2) with polylactic acid/polyglycolic acid (PLA/PGA) membrane for improvement of periodontal tissue regeneration in Class II furcation type defects. METHOD AND MATERIALS: With the present single-center investigation, 24 patients/24 mandibular molars revealing Class II furcation lesions with involved buccal surfaces were randomly allocated and treated surgically, using either a PLA/PGA membrane alone (control, n = 12) or in combination with rhBMP-2 (n = 12). Assessors, participants, and the statistician were blinded to the treatment groups. Clinical parameters including Plaque Index (PI), Papillary Bleeding Index (PBI), clinical attachment level, vertical probing depth, horizontal probing depth, and gingival recession were assessed at baseline and 6 months postsurgery. RESULTS: Baseline values concerning the investigated parameters were comparable between both groups (P > .05). After 6 months, clinical attachment level gain was similar (P = .76), while greater reductions in vertical probing depth (P = .01) and horizontal probing depth (P = .05), along with less gingival recession (P = .03) were observed in the PLA/PGA + rhBMP-2 group (compared to the controls). An increased number of completely closed furcation type defects was observed in the PLA/PGA + rhBMP-2 group (with no adverse effects). CONCLUSIONS: When treating Class II furcation lesions, the use of rhBMP-2 (combined with PLA/PGA membranes) seems advantageous. The presented set-up seems feasible with regards to recruitment, randomization, acceptance, retention, and adherence to the study protocol. (Quintessence Int 2023;54:112-124; doi: 10.3290/j.qi.b3631815).

Traumatized teeth: clinical practice guideline for the interim management of teeth with various poor prognosis scenarios in growing patients.

OBJECTIVES: Many treatment options accepted for unsalvageable traumatized teeth in adults would seem contraindicated in children and adolescents. Instead, growing patients need interim restorative measures, thus extensively preserving their local bone and soft tissue structures and, ideally, preparing the involved site for later definitive restoration while they transform to skeletal maturity. This narrative topic review addresses the interim management in case of very deep intra-extra-alveolar fractures, extensive infection-related root resorption, tooth ankylosis, and anterior tooth loss in growing patients, and seeks to empower the clinician to select the appropriate treatment approach. DATA SOURCES: The literature up to 2021 was reviewed based on several scoping searches on PubMed and the Cochrane Library using relevant terms. Due to the complexity of the topic (with various poor prognosis scenarios and the differing therapeutic options), a systematic review was deemed inappropriate. CONCLUSION: Suitable interim treatment options include extrusion of teeth showing deep intra-extra-alveolar fractures, and decoronation of ankylosed teeth as well as resin-bonded fixed dental prostheses, natural tooth pontics, and primary tooth autotransplantations after tooth loss. The interim management options described in this article represent compromises chosen in the absence of better alternatives after a careful risk-benefit analysis. However, if adequately performed, the presented treatment options have the potential to achieve the temporary restoration of function and esthetics in growing patients. Close clinical and (if appropriate) radiologic monitoring of these patients is considered mandatory to ensure early detection of possible complications that might jeopardize or could render impossible subsequent therapeutic measures. (Quintessence Int 2022;53:722-731; doi: 10.3290/j.qi.b3236409; Modified from a previously published article (in German) Quintessenz 2022;73(2):162-169).

Systematic Review on Saliva Biomarkers in Patients Diagnosed with Morbus Alzheimer and Morbus Parkinson.

Extracellular plaques composed of the hydrophobic peptide amyloid-ß and intraneuronal accumulation of the hyperphosphorylated protein tau (p-tau) are pathological hallmarks found in the brains of most people affected by Alzheimer's disease (AD). In Parkinson's disease (PD), Lewy bodies, i.e., intraneuronal protein deposits comprising the protein α-synuclein, are a typical disease feature. As these hallmarks located in the brain are hardly traceable, reliable biomarkers from easily accessible body fluids are key for accurate diagnosis. The aim of the present work was to review the available literature regarding potential biomarkers of AD and PD in the saliva. The databases PubMed, Google Scholar, LILACS, LIVIVO, VHL regional portal, Cochrane Library, eLIBRARY, and IOS Press were consulted for the literature search. Screening of titles and abstracts followed the PRISMA guidelines, while data extraction and the assessment of full texts were carried out in accordance with the Newcastle-Ottawa Scale assessment. The review shows significant increases in levels of the amyloid-ß Aß1-42 and elevated p-tau to total tau (t-tau) ratios in salivary samples of AD patients, in comparison with healthy controls. In PD patients, levels of α-synuclein in salivary samples significantly decreased compared to healthy controls, whereas oligomeric α-synuclein and the ratio of oligomeric α-synuclein to total α-synuclein markedly increased. Salivary biomarkers represent a promising diagnostic tool for neurodegenerative diseases. Further high-quality case-control studies are needed to substantiate their accuracy.

Prospective case series on possible effects of local factors on the development of halitosis in new complete denture wearers.

OBJECTIVES: To assess the development of halitosis in participants wearing new removable complete dentures (RCD). METHOD AND MATERIALS: Seventy-five completely edentulous patients receiving RCD were recruited. Halitosis was assessed by means of FitScan Breath Checker on the day of denture insertion (T0), as well as after 1 month (T1), and after 2 months (T2). Risk factors were studied using a validated questionnaire about oral and denture hygiene, and tongue scoring followed for each participant. A modified plaque scoring technique assessed the percentage of newly formed biofilms accumulated on all surfaces of the RCD. RESULTS: At T0, 44% of the participants revealed halitosis. This percentage insignificantly increased at T1 (66.7%) and T2 (65.6%), respectively (P > .109). At T1, halitosis was significantly lower among persons who reported tongue brushing compared to refraining participants (14.3% vs 72.6%; P = .002). At T2, halitosis was significantly higher among patients suffering from moderate to heavy tongue coatings compared to those with no or only light coatings (83.3% vs 50.0%; P = .006), those who did wear their dentures during sleeping (77.5% vs 45.8%; P = .010), and those who did not brush their tongues at all (87.5% vs 29.2%; P < .0001). With a 16-fold increased probability (95% CI 10.0 to 23.31; P < .001), the multivariate analysis revealed that non-brushing the tongue was the only variable significantly linked to halitosis at both follow-ups. CONCLUSION: Non-brushing of tongues as well as sleeping with dentures seems to be the main causes of halitosis in new RCD wearers.

In vitro wear of (resin-coated) high-viscosity glass ionomer cements and glass hybrid restorative systems.

OBJECTIVES: The aim of the present study was to investigate the volumetric abrasive wear of a high-viscosity glass ionomer cement (hvGIC; Equia Fil) and a glass hybrid restorative system (ghRS; Equia Forte), each being recommended as amalgam alternatives. Both materials were applied with or without their respective resinous coating, and were compared with a conventional GIC (Ketac Fil) and a hybrid composite resin (CR; G-ænial Posterior). METHODS: 78 standardized occlusal Class I cavities were restored with the various materials (n = 13 per group). Before and after chewing simulation (30,000 cycles at 40 N), each sample underwent optical scanning procedures (Omnicam). A comparison of the total wear using a fluorescence-aided identification technique (OraCheck) followed, and differences (α = 5%) between groups were compared by means of MANOVA. RESULTS: Regarding the wear rates of hvGIC and ghRS, no differences could be observed (p > .050), and this was not affected by the resinous coating. All hvGIC and ghRS restorations showed significantly higher abrasive wear than CR (p < .001), while the conventional GIC displayed a significant underperformance compared with any other material (p < .001). CONCLUSIONS: Resinous coating of hvGIC or ghRS does not appear to exert an effective long-term protection against advanced abrasive wear. Compared to the conventional GIC showing a considerable substance loss, both hvGIC and ghRS materials revealed an improved abrasion resistance, but clearly failed to meet the excellent values of the CR. CLINICAL SIGNIFICANCE: Occlusal loading should be carefully considered when using hvGIC or ghRS as amalgam (or composite resin) alternatives for the restoration of posterior teeth.

Improving oral health: a short-term split-mouth randomized clinical trial revealing the superiority of resin infiltration over remineralization of white spot lesions.

OBJECTIVES: To evaluate masking effects of resin infiltration on labial white spot lesions (WSL), by comparing the latter with a remineralization approach (using hydroxyapatite and fluorides) and conventional oral care (using fluoride-free toothpaste). METHOD AND MATERIALS: Fifteen patients with at least three WSL were enrolled for a within-person randomized controlled trial, thus allowing for intrapersonal comparisons. Each WSL per tooth in every patient was randomly assigned to one of the following groups. Group 1: lesions were resin-infiltrated with Icon (RI; DMG); Group 2: Remin Pro (RP; VOCO) was used as remineralizing agent; and Group 3 (control): affected teeth were brushed with Complete Care toothpaste (CC; Himalaya). RP and CC were applied by means of a polishing brush, using a low-speed handpiece (5 min), and these procedures were repeated chairside thrice daily for 7 consecutive days. Digital photographs were captured before and after lesion treatment under standardized conditions. The CIE L*a*b* color system was used to analyze the optical outcome, and intrapersonal color differences were statistically evaluated. RESULTS: Compared to RP and CC, RI showed prompt and subjectively satisfactory color improvements, and this was primarily driven by L* and b* shifts. Statistical analysis of the objective color differences (ΔE*) between the three groups revealed significant differences for RI vs RP (P = .029), RI vs CC (P < .001), and RP vs CC (P = .001). CONCLUSION: Resin infiltration is considered a time-effective treatment option for esthetically camouflaging WSL, while RP and CC failed to improve lesion appearance and oral health in the current short-term trial.

Erratum: Denture-related stomatitis in new complete denture wearers and its association with Candida species colonization: a prospective case-series Denture-related stomatitis in new complete denture wearers and its association with Candida species colonization: a prospective case-series.

The following amendments are made to the published article: Quintessence Int 2020;51(7):554-565; First published 5 June 2020; doi: 10.3290/j.qi.a44630.

Knowledge, attitude, and practice of institutional dental professionals regarding management of patients taking oral antithrombotic medications.

OBJECTIVES: Nowadays, there is an increasing number of patients prescribed regular antithrombotics. With these long-term medications, complications like postoperative bleeding are extremely important. Despite available guidelines on this issue, disparities in approach have been noticed. The current study aimed to explore the knowledge, attitude, and practice of dental professionals associated with a dental school in Saudi Arabia regarding the management of patients with oral antithrombotic medications. METHOD AND MATERIALS: A cross-sectional study was conducted on institutional-based dental professionals in Saudi Arabia. Fifty-six subjects, including 12 interns, 20 demonstrators, and 24 faculty members were included in the study. A modified semistructured questionnaire comprising 20 questions was used to gather respondents' knowledge, attitude, and practice related to oral antithrombotic medications. The chi-square test was applied for computing inferential statistics. Spearman correlation coefficient was performed for significant variables. RESULTS: The faculty members had comparable knowledge (P = .010) as well as practice (P = .001) levels, and significantly outscored the other two groups. The interns displayed a significantly higher knowledge score over the demonstrators, whereas the reverse scenario was seen for practice scores. Interestingly, participants were frequently found to be significantly overestimating the bleeding risk for procedures falling into the "no risk" category. A significantly positive correlation regarding the professional level could be shown in all domains. CONCLUSION: Professionals need to regularly update about novel anticoagulants, and should strictly comply with the established practice guidelines, thus improving the quality, safety, and value of dental health care.

Denture-related stomatitis in new complete denture wearers and its association with Candida species colonization: a prospective case-series.

OBJECTIVES: To assess the relationship between the development of denture-related stomatitis (DRS) and the identification of commonly isolated yeast species, and to evaluate various predisposing factors in Saudi participants wearing new removable dental prostheses. METHOD AND MATERIALS: A total of 75 edentulous male participants were recruited, and 64 patients finished the present case-series. All participants received new conventional complete dentures. Colonization of Candida species was assessed, and species were identified by means of the VITEK 2 (bioMérieux) laboratory components. RESULTS: The most prevalent type of Candida at baseline was C albicans, followed by non-C albicans species (C glabrata). Counts of Candida species significantly increased from the day of insertion to the first month (P < . 05), but there were no significant changes between the first and second month (P > . 05). On the day of insertion, C tropicalis, C dubliniensis, and C krusei were extracted from few subjects only, with no significant changes over the first and second month (P > .05). Patients revealing habits of sleeping with their dentures were found to frequently suffer from DRS; development of the latter was rapid, and mixed Candida biofilms (with high CFU/mL counts), along with inadequate oral and denture hygiene, turned out to be contributing factors (P < .05). CONCLUSION: DRS can develop faster than previously reported, even with new dentures; continued denture wearing and poor cleaning of dentures revealed a considerable impact on DRS onset. In the present cohort, C albicans was the most identified kind of yeast, and was followed by C glabrata infection in cases with DRS.

Publisher Correction: A systematic review of the caries prevalence among children living in Chernobyl fallout countries.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Ex vivo investigation on internal tunnel approach/internal resin infiltration and external nanosilver-modified resin infiltration of proximal caries exceeding into dentin.

This ex vivo proof-of-concept study aimed to investigate the effect of nanosilver particles (AgNP) added to a conventional infiltrant resin (Icon) on external penetration into natural proximal enamel caries exceeding into dentin after internal tunnel preparation and internal infiltration. Carious lesions (ICDAS codes 2/3) of extracted human (pre-)molars revealing proximal caries radiographically exceeding into dentin (E2/D1 lesions) were preselected. Then, 48 of those specimens showing demineralized areas transcending the enamel-dentin border as assessed by means of near-infrared light transillumination (DIAGNOcam) were deproteinized (NaOCl, 5%). Using an internal tunnel approach, occlusal cavities central to the marginal ridge were prepared. Excavation of carious dentin, total etch procedure (H3PO4, 40%), and internal resin infiltration (FITC-labeled) followed, along with final restorations (flowable composite resin). Outer lesion surfaces were etched (HCl, 15%) prior to external infiltration (RITC-labeled). Group 1 (control; n = 24) used non-modified infiltrant, while an infiltrant/AgNP mixture (20 nm; 5.5 wt%) was used with experimental Group 2 (n = 24). Non-infiltrated pores of cut lesions were stained (Berberine), and specimens were analyzed using confocal laser scanning microscopy. Compared to the non-filled infiltrant, incorporation of AgNP had no effect on the resin's external penetration. Between the groups, no significant differences regarding internal or external infiltration could be detected, and non-infiltrated lesion areas did not differ significantly (p>0.109; t-test). The internal tunnel preparation in combination with both an internal resin infiltration and an additional external infiltration approach using a nanosilver-modified infiltrant resin leads to increased infiltrated lesion areas, thus occluding and adhesively stabilizing the porous volume of the demineralized enamel. While exerting antimicrobial effects by the nanosilver particles, this approach should have the potential as a viable treatment alternative for proximal lesions extending into dentin, thus avoiding the sacrifice of sound enamel, postponing the frequently inevitable restoration/re-restoration cycle of conventional proximal caries treatment, and improving dental health.

Application of a standard autoclaving protocol does not harm structural integrity of two-piece zirconia abutments under detachment force testing.

OBJECTIVE: Aim was to assess the influence of a standard autoclaving protocol on the retention of zirconia abutments glued on titanium bases in two-piece implant abutments. MATERIALS AND METHODS: Twenty-four CAD/CAM-generated zirconia abutments were adhesively cemented on prefabricated titanium bases. Before mechanical and thermal aging, the specimens were divided into two groups. Group 1 was subjected to a standard steam autoclaving protocol and Group 2 remained untreated (control). The tensile strength in all specimens was evaluated by a standardized pull-off test limited to a maximum force of 1000 N. RESULTS: Eleven samples in both groups could be subjected to pull-off testing. Ten samples in Group 1 and three samples in Group 2 failed, while all others reached the maximum pull-off force. This difference was statistically significant. The mean retention values for the failed samples were 694.53 ± 369.10 N in Group 1 and 890.78 ± 25.90 N in Group 2. This difference was not statistically significant. CONCLUSIONS: A standard autoclaving protocol does not reduce detachment force of two-piece zirconia abutments. CLINICAL RELEVANCE: Clinical sterilization processes as recommended by regulatory authorities seem to be harmless to the structural integrity of two-piece zirconia implant abutments, at least with regard to the retention of the components.

Relationship Between Dental Students' Personality Profiles and Self-reported Oral Health Behaviour.

PURPOSE: The objective of this study was to investigate the relationships between oral health behaviour and personality profiles among dental students. MATERIALS AND METHODS: One hundred six consecutive (pre-)clinical dental students (58 females and 48 males) were recruited for this observational study. Participants' oral health behaviour was evaluated using the Hiroshima University-Dental Behavioral Inventory (HU-DBI). The NEO Five Factor Inventory (NEO-FFI) was used to assess the participants' personality profiles. Main outcome measures were personality dimensions measured by NEO-FFI (neuroticism, extraversion, openness, agreeableness, and conscientiousness) and oral health behaviours measured by HU-DBI (dental visits, toothbrushing, oral health awareness, and oral hygiene practices). Statistical significance was set at p < 0.05. RESULTS: All participants were completely analysed. The students' level of education and age had no relationship to the HU-DBI and NEO-FFI scores (p > 0.05). The conscientiousness personality scores were associated with better oral health attitude and behaviour (p = 0.018). CONCLUSIONS: Higher scores of the conscientiousness personality dimension were associated with better oral health attitudes and behaviour. Therefore, it is recommended to consider assessment of personality dimensions when oral health attitudes and behaviours are evaluated. Personality profiles might affect oral health behaviour and attitudes of dental care providers. This interaction should be considered as it might potentially impact professionals' capacities to offer oral health care, and this would influence patients' oral health.

A systematic review of the caries prevalence among children living in Chernobyl fallout countries.

The present study analyzed the data concerning the caries prevalence in children born and permanently residing in Chernobyl fallout areas. Setting forth to evaluate if differences regarding the caries prevalence can be observed compared to non-contaminated sites of affected East European countries. Methods used to assess the caries prevalence were limited to DMFT/dmft (decayed, missing and filled teeth) for the primary and the permanent dentitions. The databases PubMed, EMBASE/Ovid, Cochrane Library, Scopus, and eLIBRARY were consulted for the electronic literature search. Screening of titles and abstracts followed the MOOSE guidelines, while data extraction and the assessment of the full texts were performed in accordance to the Newcastle Ottawa Scale. The statistical analysis revealed considerable heterogeneity of DMFT/dmft values (from I2 = 94% up to I2 = 99.9%; p < 0.05) in children of different ages (5-7; 12-15; and average of 12 years). Scattering of the weighted mean differences (95% CI) ranged from -1.03 (-1.36; -0.7) to 6.51 (6.11; 6.91). Although individual studies demonstrated a greater prevalence of dental caries in children residing in radiation-contaminated areas, no conclusive statement is possible regarding the effect of small dose radiation on the dentition. Hence, further high-quality epidemiologic investigations are needed.

Undesirable course of an oral implant rehabilitation in a patient with a long history of bulimia nervosa: case report and review of the literature.

BACKGROUND: Bulimia nervosa is an eating disorder resulting in an intended weight loss due to decreased food intake, induced vomiting, or hyperactivity, and is observed frequently between 12 and 25 years of age. One of the complications is early tooth loss. Moreover, since bulimia nervosa patients suffer from increased atrophy of the alveolar processes, oral rehabilitation even with short dental implants may be impossible. In these cases, lateralization or transposition of the inferior alveolar nerve (IAN) followed by implant placement can be useful. CASE PRESENTATION: A 40-year-old woman with a long-lasting history of bulimia nervosa requested a fixed rehabilitation of her partially edentulous mandible. In 2012, a bilateral IAN transposition approach was performed using piezosurgery, and without any postoperative neurosensory alterations. Two years later, bilateral insertion of each two implants was followed by an inflammatory destabilization of the lower left mandible; subsequent to the implant removal, a fracture occurred, and the latter was stabilized by osteosynthesis plates. In 2017, three additional implants were placed, finally providing the patient with a fixed restoration on five implants. CONCLUSION: Eating disorders may have a tremendous impact on both physical condition and oral health, resulting in early tooth loss and severe bone atrophy. IAN transposition is a viable treatment option to enable installing fixed prostheses via dental implants, but the latter will clearly increase the risk of inflammation and interruption of mandibular continuity. Close clinical and radiologic monitoring is mandatory to adequately respond to complications such as peri-implant mucositis, peri-implantitis, osteomyelitis, or concomitant fractures.

Development of an analytical prepCheck-supported approach to evaluate tutor-based assessments of dental students' practical skills.

The aim of the present study was to develop an analytical computer-supported assessment concept for the objective evaluation of students' practical skills, and to investigate the assessor-dependent differences by setting tolerance limits applied during the 'glance and grade' evaluation. A sample of 54 conventionally supervised dental undergraduates were given training in the preparation of a macroretentive Class II cavity. The course participants then took a mandatory practical examination. Three (plus one) course instructors performed the visual evaluations of the examination tasks according to predefined assessment criteria, followed by optical impressions (quadrant scan using Omnicam; Cerec; Dentsply Sirona, Wals, Austria) and subsequent assessment of the prepared cavities (tooth 46) using the prepCheck application (Dentsply Sirona). In this course, the maximum permissible deviation was set at ± 10% from the predefined assessment criteria. If no tolerance was applied, the statistical analysis revealed a significant difference between the actually achieved cavity dimensions and the predefined values of a master preparation (P = 0.0001; Student's t-test), thus leading to an overall failure rate of 100%. The application of the initially targeted 10% tolerance led to an insignificant reduction (96.3%), while the stepwise elevation of the permissible deviation up to 35% finally matched with the result of the visual assessment (total failure rate of approximately 20%). Unlike the pronounced subjectivity of the tutors during the assessment of students' practical skills, the utilization of the prepCheck application enables precise evaluations. Further studies are clearly warranted to investigate the possible educational outcome of an advanced interactive computer-supported training with implemented tolerance corridors.

Randomized clinical trial on the comparison of bleaching outcomes using either ozone or hydrogen peroxide.

OBJECTIVE: To evaluate the efficacy of in-office tooth bleaching following application of either ozone (O3) or hydrogen peroxide (H2O2). METHOD AND MATERIALS: 32 participants were randomly distributed into two groups (n = 16 each). Participants' maxillary anterior teeth were treated with ozone (produced via a healOzone X4 device; Curozone) for 60 seconds in Group 1, or with 38% H2O2 for 20 minutes in Group 2. Tooth shades were evaluated by means of a colorimeter (CR-400, Minolta) measuring Vita classic shades in addition to L*a*b* shade values before and following bleaching in each group. A visual analog scale was used to evaluate tooth sensitivity before and after bleaching. Statistically significant differences were identified at P < .05. RESULTS: Teeth obtained lighter shades (increased L* and reduced a* and b* values) following bleaching in both groups (P < .001). Both groups revealed comparable bleaching outcomes (P > .05). However, bleaching with ozone did not result in tooth sensitivity, whilst using H2O2 was accompanied with significantly increased bleaching sensitivity (P < .001). CONCLUSION: Similar bleaching outcomes and lighter tooth shades (both for Vita shades and L*a*b* values) were obtained following in-office bleaching with either 60 seconds of ozone or 20 minutes of 38% H2O2. Notwithstanding, tooth sensitivity was significantly increased following bleaching with H2O2 in comparison to ozone. Ozone obviously does reduce the regularly clinically observed inconveniences of bleaching by means of H2O2; thus, ozone would seem worth considering for patients asking for in-office tooth bleaching.

Hypobaric Conditions and Retention of Dental Crowns Luted with Manually or Automixed Dental Cements.

BACKGROUND: There is only scant information on the influence of the hypobaric environment on luting agents and their efficacy on dental crown cementation. The objective of this study was to provide data on the retentive characters of two cements commonly used on implant abutment surfaces both under normal and under hypobaric conditions. METHODS: There were 56 implant abutments supplied with CAD/CAM milled zirconia oxide crowns. 1) A zinc phosphate cement (ZP), and 2) a resin-modified glass ionomer cement (RMGI), each mixed either A) manually or B) by means of automix capsules, were used for cementation. The cemented crowns of the 4 × 2 subgroups were either kept on the ground or were transported in an aircraft at altitudes up to 13,730 m (45,045.9 ft; N = 28 each), thus being subjected to the pressure changes (80×) every aircrew member or frequent flyer is exposed to. All cemented crowns were stored in climatized boxes during the experimental phase. RESULTS: Hand-mixing of ZP resulted in a significant reduction of mean (± SD) retention forces (581.6 ± 204.5 N) when compared to the control group on the ground (828.4 ± 147.9 N). Automixed ZP (931.9 ± 134.4 N in flight; 996.0 ± 107.4 N on the ground) and RMGI subgroups (ranging from 581.0 N ± 114.3 N to 662.4 N ± 92.5 N) were not affected by hypobaric conditions. DISCUSSION: When treating patients frequently exposed to hypobaric environments, automixing of ZP would seem favorable, while manual mixing should be avoided. RMGI is considered suitable and is not influenced by hand-mixing or barometric pressure changes.Kielbassa AM, Müller JAG. Hypobaric conditions and retention of dental crowns luted with manually or automixed dental cements. Aerosp Med Hum Perform. 2018; 89(5):446-452.

Randomized controlled clinical trial on bleaching sensitivity and whitening efficacy of hydrogen peroxide versus combinations of hydrogen peroxide and ozone.

The clinical efficacy regarding bleaching sensitivity and tooth shade lightening using a standard hydrogen peroxide (H2O2) bleaching gel was compared with the additional use of ozone either before or after application of H2O2. Using computer-generated tables, 45 participants were randomly allocated into three groups (n = 15 each) in this investigator-driven, single-centre trial. In Group 1, upper anterior teeth were bleached using ozone (produced via a healOzone X4 device) for 60 seconds, then 38% H2O2 for 20 minutes; in Group 2, 38% H2O2 application (20 min) was followed by ozone (60 s); air produced by the healOzone machine (60 s) followed by 38% H2O2 (20 min) was used in Group 3 (control). Bleaching sensitivity was evaluated via visual analogue scales, and a treatment-blinded reader objectively recorded tooth shades using a colorimeter before and 24 hours after bleaching (at α = 0.05). The H2O2/ozone combination did not result in pain sensations, while both ozone/H2O2 and H2O2 alone increased bleaching sensitivity (p < 0.001). Teeth achieved lighter shades (higher L*/lower b* values) after bleaching in all groups (p < 0.001), while Ozone boosted lighter tooth shades, irrespective of its use before or after H2O2 (p < 0.05). Due to the complimentary effects, applying ozone after H2O2 seems preferable for bleaching.