Minimally invasive techniques in the management of muscular temporomandibular joint disorders: A five-year observational study.

Background: To evaluate the effectiveness of three minimally invasive techniques for managing patients with myofascial pain dysfunction, determine their association with sociodemographic factors, habits, medication usage, comorbidities, treatment history, pain duration, complaint intensity, and diagnosis limitations. Material and Methods: This five-year observational study scrutinized 1,000 medical records from individuals treated at the TMD Orofacial Dental Research Center. TMD treatments were organized into Group 1 (thermotherapy, exercises, and CBT), Group 2 (Group 1 plus intramuscular manual therapy), and Group 3 (Group 1 and Group 2 plus occlusal appliances) and correlated with sociodemographic factors, habits, prior medication usage, comorbidities, history of prior treatments, duration of pain, intensity of complaint, and diagnosis limitations or without limitations regarding the symptoms of muscular temporomandibular disorders (TMD). Results: Treatment durability was proportionally higher in Groups II and III (p<0.05). Although no significant differences were found for habits (p= 0.051) and pain duration (p= 0.001), clenching was more prevalent in Groups II n= 77 (57.0%) and III n= 39 (63.9%) and among those with therapy duration equal to or greater than 6 months for n=102 (59.3%). Statistically significant correlations were noted between age and education (rho=-0.198; p<0.001) and between pain duration and treatment durability (rho=0.317; p<0.001). Conclusions: Intraoral devices do not constitute the primary treatment for myofascial pain. For cases of prolonged pain, comorbidities, limited mouth opening, and a history of prior medication or treatments, a splint combined with other therapies is recommended for effective management. Key words:Temporomandibular disorders, myofascial pain, occlusal appliances, clinical diagnosis, thermotherapy, exercise therapy, cognitive behavioral therapy.

Depth distortion and angular deviation of a fully guided tooth-supported static surgical guide in a partially edentulous patient: A systematic review and meta-analysis.

PURPOSE: This systematic review and meta-analysis aimed to evaluate the depth distortion and angular deviation of fully-guided tooth-supported static surgical guides (FTSG) in partially edentulous arches compared to partially guided surgical guides or freehand. MATERIAL AND METHODS: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in the Open Science Framework (OSF). The formulated population, intervention, comparison, and outcome (PICO) question was: "In partially edentulous arches, what are the depth distortion and angular deviation of FTSG compared to partially guided surgical guides or freehand?" The search strategy involved four main electronic databases, and an additional manual search was completed in November 2023 by following an established search strategy. Initial inclusion was based on titles and abstracts, followed by a detailed review of selected studies, and clinical studies that evaluated the angular deviations or depth distortion in FTSG in partial arches, compared to partially guided surgical guides or freehand, were included. In FTSG, two surgical approaches were compared: open flap and flapless techniques, and two digital methods were assessed for surgical guide design with fiducial markers or dental surfaces. A qualitative analysis for clinical studies was used to assess the risk of bias. The certainty of the evidence was assessed according to the grading of recommendations, assessment, development, and evaluations (GRADE) system. In addition, a single-arm meta-analysis of proportion was performed to evaluate the angular deviation of freehand and FTSG. RESULTS: Ten studies, published between 2018 and 2023, met the eligibility criteria. Among them, 10 studies reported angular deviations ranging from -0.32° to 4.96° for FTSG. Regarding FTSG surgical approaches, seven studies examined the open flap technique for FTSG, reporting mean angular deviations ranging from 2.03° to 4.23°, and four studies evaluated flapless FTSG, reporting angular deviations ranging from -0.32° to 3.38°. Six studies assessed the freehand surgical approach, reporting angular deviations ranging from 1.40° to 7.36°. The mean depth distortion ranged between 0.19 mm to 2.05 mm for open flap FTSG, and between 0.15 mm to 0.45 mm for flapless FTSG. For partially guided surgical guides, two studies reported angular deviations ranging from 0.59° to 3.44°. Seven studies were eligible for meta-analysis, focusing on the FTSG in open flap technique, with high heterogeneity (I2 (95%CI) = 92.3% (88.7%-96.4%)). In contrast, heterogeneity was low in studies comparing freehand versus FTSG in open flap techniques (I2 (95%CI) = 21.3% (0.0%-67.8%)), favoring the FTSG surgical approach. CONCLUSION: In partially edentulous arches, FTSG systems exhibited less angular deviation than freehand and partially guided surgical guides. Flapless surgical approaches were associated with reduced angular deviation and depth distortion, suggesting a potential preference for the FTSG method in these procedures.

Fracture resistance of CAD/CAM milled versus direct hand-made interim laminate veneers.

Background: Comparative studies of interim veneer restorations crafted using subtractive computer-aided manufacturing (s-CAM) milling technology and traditional direct hand-made approaches are needed. Purpose: This comparative in vitro study evaluated the fracture resistance of two types of provisional veneer restorations for maxillary central incisors: milled (s-CAM) and traditional direct hand-made bis-acryl veneers. Materials and methods: Fifty maxillary right central incisor veneers (25 specimens per group) were fabricated and divided according to the fabrication method: (1) s-CAM milled (Structure CAD, VOCO Dental); and (2) hand-made (Protemp Plus, 3M). The restorations were cemented onto 3D-printed resin dies using temporary cement and subjected to 1000 cycles of thermal cycling between 5° and 55 °C. These restorations subsequently were subjected to compressive loading until fracture occurred. Images of the fractured samples were captured using a scanning electron microscope (SEM). Statistical analysis was performed using the one-way ANOVA test and the Mann-Whitney U test. Results: Significant differences (p < 0.001) in the fracture resistance were observed between the two groups. s-CAM milled interim veneers displayed higher fracture resistance values (439.60 ± 26 N) compared to the traditional method (149.15 ± 10 N). Conclusion: The manufacturing method significantly influences the fracture resistance of interim veneer restorations. s-CAM interim laminate veneer restorations for maxillary central incisors exhibit a fracture resistance superior to that of the traditional method using bis-acryl.Clinical relevanceClinicians should consider CAD/CAM milled veneers for scenarios demanding long-term interim restoration and the withstanding of high occlusal forces.

Influence of occlusal thickness on the fracture resistance of chairside milled lithium disilicate posterior full-coverage single-unit prostheses containing virgilite: A comparative in vitro study.

PURPOSE: To evaluate the fracture resistance of chairside computer-aided design and computer-aided manufacturing (CAD-CAM) lithium disilicate mandibular posterior crowns with virgilite of different occlusal thicknesses and compare them to traditional lithium disilicate crowns. MATERIALS AND METHODS: Seventy-five chairside CAD-CAM crowns were fabricated for mandibular right first molars, 60 from novel lithium disilicate with virgilite (CEREC Tessera, Dentsply Sirona), and 15 from traditional lithium disilicate (e.max CAD, Ivoclar Vivadent). These crowns were distributed across five groups based on occlusal thickness and material: Group 1 featured CEREC Tessera crowns with 0.8 mm thickness, Group 2 had 1.0 mm thickness, Group 3 had 1.2 mm thickness, Group 4 with 1.5 mm thickness, and Group 5 included e.max CAD crowns with 1.0 mm thickness. These crowns were luted onto 3D-printed resin dies using Multilink Automix resin cement (Ivoclar Vivadent). Subsequently, they underwent cyclic loading (2,000,000 cycles at 1 Hz with a 275 N force) and loading until fracture. Scanning electron microscopy (SEM) assessed the fractured specimens. Statistical analysis involved one-way ANOVA and the Kruskal-Wallis Test (α = 0.05). RESULTS: Fracture resistance varied significantly (<0.001) across mandibular molar crowns fabricated from chairside CAD-CAM lithium disilicate containing virgilite, particularly between crowns with 0.8 mm and those with 1.2 and 1.5 mm occlusal thickness. However, no significant differences were found when comparing crowns with 1, 1.2, and 1.5 mm thicknesses. CEREC Tessera crowns with 1.5 mm thickness exhibited the highest resistance (2119 N/mm2), followed by those with 1.2 mm (1982 N/mm2), 1.0 mm (1763 N/mm2), and 0.8 mm (1144 N/mm2) thickness, whereas e.max CAD crowns with 1.0 mm occlusal thickness displayed the lowest resistance (814 N/mm2). CONCLUSIONS: The relationship between thickness and fracture resistance in the virgilite lithium disilicate full-coverage crowns was directly proportional, indicating that increased thickness corresponded to higher fracture resistance. No significant differences were noted among crowns with thicknesses ranging from 1 to 1.5 mm. This novel ceramic exhibited superior fracture resistance compared to traditional lithium disilicate.

A proof of concept on implant-supported bilateral cantilever bridges: The T-Bridge approach.

The concept of bilateral cantilevers on a single central implant (T-design) for three-unit implant-supported fixed dental prostheses (ISFDPs) has not been explored nor tested. This technical hypothesis aimed to explore the feasibility of such an approach as a cost-effective alternative to conventional treatments. Careful considerations regarding implant diameter, length, ideal position, occlusal scheme, and bone remodeling are essential to ensure adequate support, stability, and prevention of complications. In this proof of concept, we present a preliminary case with this novel design to replace missing posterior teeth in a patient with narrow bone conditions. In addition, a series of planned investigations and preliminary results, including preclinical studies, are presented to illustrate our concept and its potential clinical implications. Clinically, after two-year follow-up, healthy and stable peri-implant tissues around the ISFDP exemplarily demonstrated excellent stability, functionality, and comfort, which is supported by acceptable fracture resistance data in vitro, suggesting indeed the practical potential and suitability. Thus, we claim that such a treatment modality has the at least theoretical potential to revolutionize implant dentistry by providing innovative and cost-effective treatment options for patients with partial ISFDPs in very specific cases. Of course, further research and evaluations are necessary to validate the clinical implications of this innovative hypothesis. Implementing the 3-on-1 T-bridge approach in partial ISFDPs could offer a promising alternative to traditional methods. If proven successful, this technique may lead to significant advancements in clinical practice, providing a less invasive cost-effective treatment option.

Effect of preparation design and endodontic access on fracture resistance of zirconia overlays in mandibular molars: An in vitro study.

PURPOSE: To evaluate the fracture resistance of zirconia overlays, considering various preparation designs and the presence of endodontic access. MATERIALS AND METHODS: Ninety translucent zirconia (5Y-PSZ) overlay restorations were divided into six groups (n = 15/group) based on different preparation designs, with and without endodontic access: chamfer margin 4 mm above the gingival level without (group 1) and with endodontic access (group 2); margin 2 mm above the gingival level without (group 3) and with endodontic access (group 4); overlay with no chamfer margin without (group 5) and with endodontic access (group 6). Restorations were bonded to mandibular first molar resin dies, and the groups with endodontic access were sealed with flowable resin composite. All restorations underwent 100,000 cycles of thermal cycling between 5°C and 55°C, followed by loading until fracture. Maximum load and fracture resistance were recorded. ANOVA with Tukey post-hoc tests were used for statistical comparison (α < 0.05). RESULTS: Fracture resistance significantly varied among overlay designs with and without endodontic access (p < 0.001), except for the no-margin overlays (groups 5 and 6). Overlays with a 2 mm margin above the gingival margin with endodontic access (group 4) exhibited significantly higher fracture resistance compared to both the 4-mm supragingival (group 2) and no-margin (group 6) designs, even when compared to their respective intact groups (groups 1 and 5). There were no significant differences between the no-margin and 4-mm supragingival overlays. CONCLUSION: The more extensive zirconia overlay for mandibular molars is the first choice since the 2 mm margin above the gingival level design withstood considerable loads even after undergoing endodontic access. A no-margin overlay is preferred over the 4-mm supragingival design as it preserves more tooth structure and there was no outcome difference, irrespective of endodontic access. Caution is warranted in interpreting these findings due to the in vitro nature of the study.

Short-term data suggests cognitive benefits in the elderly with single-implant overdentures.

DESIGN: This study was an extension of a randomized crossover clinical trial approved by the institutional ethics committee (approval number: D2014-148) and adhered to the CONSORT guidelines. The original study juxtaposed patient contentment with single-implant overdentures (1-IODs) against conventional complete dentures (CCDs), with patient satisfaction being the primary focus. In this follow-up study, the cognitive function of edentulous patients receiving 1-IODs was assessed, specifically monitoring for the emergence of mild cognitive impairment (MCI) throughout a three-year period. Patient outcomes were systematically recorded at predetermined intervals: initially, two months post-1-IOD placement, after one year (with groups alternated between denture types at eight-month marks), then after two and three years. A prosthodontist with a decade of expertise performed all denture-related procedures. This follow-up emphasized the cognitive outcomes using the Montreal Cognitive Assessment (MoCA-J), considering it alongside previously documented results on masticatory function, bone resorption, survival rates, and patient-reported outcomes. CASE SELECTION: Between 2015 and 2016, a follow-up study enrolled edentulous patients over 50 years of age who were proficient in Japanese, had sufficient mandibular bone for implants, and were free of systemic health issues and habits that could impact oral health. The participants were randomly divided into two groups after receiving a central mandibular implant. Group 1 initially used 1-IODs, and Group 2 used unloaded CCDs. After two months and subsequent periods, they swapped denture types. Eventually, all patients chose 1-IODs for continued use. Implant success was monitored over three years. The design featured block randomization and accounted for a sample size of 22, determined to be sufficient for evaluating the primary outcome of patient satisfaction. All patients underwent careful allocation and received customized dental interventions, with detailed radiographic planning and surgical precision guiding the implantation process. DATA ANALYSIS: Multivariable linear mixed models were used to assess within-group changes in both overall and specific cognitive function scores across five timepoints. Age, assessment interval, and upper jaw denture status were incorporated as consistent variables, while individual participants were considered variable elements in the analysis. SPSS software version 22.0 was utilized to conduct the statistical tests, and a p value threshold of 0.05 was predetermined to establish statistical significance. RESULTS: Twenty-two patients with edentulous mandibles received 1-IODs. Memory and executive functions saw significant score increases at multiple timepoints over the three-year period, with statistical significance. Though one participant dropped out and another passed away, and two did not complete the 3-year follow-up, the remaining 18 participants provided comprehensive data. Age and type of maxillary denture were significant factors, influencing MoCA-J scores with older participants and those with fixed dentures showing lower scores in certain domains. Overall, the findings illustrated the positive correlation between 1-IODs and cognitive function in older adults. CONCLUSIONS: Older adults with no natural teeth left in their mandible showed improved cognitive function after one and three years of using 1-IODs, as reflected by their total and specific cognitive domain scores. The study suggests that such implant therapy may offer protective benefits against cognitive decline, demonstrating clinical relevance for patient care, regardless of the maxillary arch (antagonist) condition.

Salivary levels of inflammatory and anti-inflammatory biomarkers in periodontitis patients with and without acute myocardial infarction: implications for cardiovascular risk assessment.

Background: Periodontitis is initiated by a dysbiotic activity and furthermore leads to a chronic inflammatory response. The presence of pro-inflammatory markers plays an important role in the inflammatory load. Macrophage inflammatory protein-1 alpha (MIP-1α) and C-reactive protein (CRP) are pro- inflammatory biomarkers that quantify clinical and subclinical inflammation in cardiac ischemia in cardiac inflammation and disease. Adiponectin is an anti-inflammatory marker associated with good health. The susceptibility of periodontitis patients to cardiovascular events needs to be evaluated. Objective: This study aims to assess the levels of biomarkers in periodontitis patients with and without acute myocardial infarction (AMI) compared to controls. Material and methods: Pro-inflammatory and anti-inflammatory analytes were examined by collecting unstimulated saliva from three groups (n = 20/each): healthy individuals, individuals with stage III periodontitis, and post-myocardial infarction patients with stage III periodontitis. The samples were collected within 48 h of AMI. Results: Adiponectin levels were significantly lower in patients with periodontitis with and without AMI compared to controls, while CRP and MIP-1α were significantly higher in patients with periodontitis with and without AMI compared to controls. The highest titers for MIP-1α and CRP were detected among patients with periodontitis with and AMI. Conclusion: Our study provides possible evidence of the association between periodontitis and salivary analytes that occur in tandem with cardiovascular disease. The lower levels of Adiponectin and higher levels of CRP and MIP-1α in patients with periodontitis indicate that this condition is a potential risk factor for cardiovascular disease. The findings emphasize the importance of early detection and intervention for periodontitis patients to prevent cardiovascular events.

LONG-TERM OUTCOMES OF IMPLANT PLACEMENT VERSUS TOOTH PRESERVATION IN PERIODONTALLY COMPROMISED TEETH MAY BE COMPARABLE.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Sarafidou K, Lazaridi I, Gotsis S, Kirmanidou Y, Vasilaki D, Hirayama H, Michalakis K. Tooth preservation vs. extraction and implant placement in periodontally compromised patients: A systematic review and analysis of studies. J Prosthodont. 2022 Oct;31(8):e87-e99. doi:10.1111/jopr.13560. Epub 2022 Aug 2. PMID: 35794083 SOURCE OF FUNDING: No external funding was received for this research. TYPE OF STUDY/DESIGN: Systematic review (without meta-analysis).

Impact of restoration thickness and tooth shade background on the translucency of zirconia laminate veneers: An in vitro comparative study.

Purpose: Our in vitro comparative study aimed to investigate the impact of thickness and tooth shade background on the translucency of highly translucent zirconia veneers. Materials and Methods: A total of 75 5Y-TZP zirconia veneers of shade A1 were fabricated with thicknesses of 0.50 mm (n = 25), 0.75 mm (n = 25), and 1.0 mm (n = 25). The translucencies were measured on composite resin teeth with shades A1, A2, A3, A3.5, and A4 using a digital color imaging spectrophotometer. Data were analyzed using ANOVA and post hoc Tukey's test (p < 0.05). Results: The translucency values were optimal for the veneers placed over the substrate teeth with shades A1 and A2, regardless of the veneer thickness. Additionally, veneers with a thickness of 0.50 mm exhibited significantly higher translucency than those with thicknesses of 0.75 mm and 1.0 mm. Conclusions: Our study demonstrated that the translucency of the highly translucent zirconia veneers was influenced by both veneer thickness and tooth shade background. The optimal veneer thickness for achieving the highest translucency was 0.50 for the veneers with A1 and A2 shades placed over the substrate teeth. Clinical Relevance: The optimal thickness for achieving the highest translucency of the highly translucent zirconia laminate veneers was 0.50 mm for the veneers with A1 and A2 shades placed over the substrate teeth. Clinicians and dental technicians could consider this when selecting materials for aesthetic restorations.

Effect of incisal preparation design on the fracture strength of monolithic zirconia-reinforced lithium silicate laminate veneers.

PURPOSE: This study aimed to assess the fracture resistance of monolithic zirconia-reinforced lithium silicate laminate veneers (LVs) fabricated on various incisal preparation designs. MATERIALS AND METHODS: Sixty maxillary central incisors with various preparation designs were 3D-printed, 15 each, including preparation for: (1) LV with feathered-edge design; (2) LV with butt-joint design; (3) LV with palatal chamfer; and (4) full-coverage crown. Restorations were then designed and manufactured from zirconia-reinforced lithium silicate (ZLS) following the contour of a pre-operation scan. Restorations were bonded to the assigned preparation using resin cement and following the manufacturer's instructions. Specimens were then subjected to 10,000 thermocycles at 5 to 55°C with a dwell time of 30 s. The fracture strength of specimens was then assessed using a universal testing machine at a crosshead speed of 1.0 mm/min. One-way ANOVA and Bonferroni correction multiple comparisons were used to assess the fracture strength differences between the test groups (α = 0.001). Descriptive fractographic analysis of specimens was carried out with scanning electron microscopy images. RESULTS: Complete coverage crown and LV with palatal chamfer design had the highest fracture resistance values (781.4 ± 151.4 and 618.2 ± 112.6 N, respectively). Single crown and LV with palatal chamfer had no significant difference in fracture strength (p > 05). LV with feathered-edge and butt-joint designs provided significantly (p < 05) lower fracture resistance than complete coverage crown and LV with palatal chamfer design. CONCLUSION: The fracture resistance of chairside milled ZLS veneers was significantly influenced by the incisal preparation designs tested. Within the limitation of this study, when excessive occlusal forces are expected, LV with palatal chamfer display is the most conservative method of fabricating an indirect restoration.

Influence of hydrothermal aging on the shear bond strength of 3D printed denture-base resin to different relining materials.

OBJECTIVES: This study evaluated the repairability of three-dimensional printed (3DP) denture bases based on different conventional relining materials and aging. MATERIAL AND METHODS: The groups for surface characterization (surface-roughness and contact-angle measurements) were divided based on the denture base and surface treatment. Shear bond strength test and failure-mode analysis were conducted by a combination of three variables: denture base, relining materials, and hydrothermal aging (HA). The initial characterization involved quantifying the surface roughness (n = 10) and contact angle (n = 10) of denture base specimens with and without sandblasting (SB) treatment. Four relining materials (Kooliner [K], Vertex Self-Curing [V], Tokuyama Rebase II (Normal) [T], and Ufi Gel Hard [U]) were applied to 3DP, heat-cured (HC), and self-cured (SC) denture-base resin specimens. Shear bond strength (n = 15) and failure-mode analyses (n = 15) were performed before and after HA, along with evaluations of the fractured surfaces (n = 4). Statistical analyses were performed using a two-way analysis of variance (ANOVA) for surface characterization, and a three-way ANOVA was conducted for shear bond strength. RESULTS: The surface roughness peaked in HC groups and increased after SB. The 3DP group displayed significantly lower contact angles, which increased after treatment, similar to the surface roughness. The shear bond strength was significantly lower for 3DP and HC denture bases than for SC denture bases, and peaked for U at 10.65 ± 1.88 MPa (mean ± SD). HA decreased the shear bond strength relative to untreated samples. Furthermore, 3DP, HC, and SC mainly showed mixed or cohesive failures with V, T, and U. K, on the other hand, trended toward adhesive failures when bonded with HC and SC. CONCLUSION: This study has validated the repairability of 3DP dentures through relining them with common materials used in clinical practice. The repairability of the 3DP denture base was on par with that of conventional materials, but it decreased after aging. Notably, U, which had a postadhesive application, proved to be the most effective material for repairing 3DP dentures.

Manifestaciones orales en pacientes cubanos con COVID-19 hospitalizados y no hospitalizados: Análisis transversal a través de una encuesta / Oral Manifestations in Hospitalized and Non-Hospitalized Cuban Patients with COVID-19: A Cross-Sectional Analysis through a Survey

Introduction: COVID-19 continues to drive research aimed at elucidating the disease's behavior and clinical aspects for improved diagnosis. Objective: To describe oral manifestations reported through a survey by dentate and denture-wearing Cuban individuals hospitalized due to confirmed COVID-19 infection. Methods: A cross-sectional descriptive study was conducted through a survey, involving Cuban individuals aged 18 years and above, confirmed COVID-19 positive by PCR. Exclusions encompassed smokers, alcoholics, regular medication users, those with poor oral hygiene, and individuals with pre-existing oral manifestations. A questionnaire was administered to over a thousand individuals, of which 264 met the criteria. Variables related to COVID-19 infection and oral hygiene were assessed. Data were processed using SPSS, adhering to ethical principles. Results: The study comprised 264 participants with an average age of 39.96 years. Xerostomia emerged as the most prevalent oral manifestation (40.2 por ciento), followed by mandibular pain, TMJ, or bone pain (18.9 por ciento), and non-dental mouth pain (12.5 por ciento). Xerostomia was more prevalent in the 35 to 39 age group, while mandibular pain predominated in the 50 to 54 age group. No statistically significant evidence was found for dentate individuals or denture wearers, but significance was observed for those requiring hospitalization, exhibiting painless tongue lesions, single ulcers, and painful tongue lesions. Conclusions: Xerostomia was the most prevalent oral manifestation, followed by mandibular pain, TMJ or bone pain, and non-dental mouth pain. A statistically significant association was noted between the need for hospitalization and certain oral manifestations. The use of dentures was not significantly related to the studied manifestations(AU)

Introducción: La COVID-19 continúa generando interés en investigaciones que buscan esclarecer el comportamiento de la enfermedad y sus aspectos clínicos para facilitar el diagnóstico. Objetivo: Describir las manifestaciones orales informadas por individuos cubanos dentados, con prótesis, que fueron hospitalizados al dar positivo por COVID-19. Métodos: Se llevó a cabo un estudio descriptivo transversal a través de una encuesta con una muestra de individuos cubanos mayores de 18 años, infectados por COVID-19 y confirmados mediante PCR. Se excluyeron fumadores, alcohólicos, usuarios regulares de medicamentos, personas con mala higiene bucal y aquellos con manifestaciones bucales previas a la infección. Se aplicó un cuestionario a más de mil individuos, de los cuales 264 cumplieron con los criterios. Se utilizaron variables relacionadas con la infección por COVID-19 y la higiene bucal. Los datos se procesaron con SPSS, respetando los principios éticos. Resultados: El estudio incluyó a 264 participantes con una edad promedio de 39,96 años. La xerostomía fue la manifestación bucal más prevalente (40,2 percent), seguida por el dolor mandibular, ATM o hueso (18,9 percent) y el dolor de boca no dental (12,5 percent). La xerostomía fue más frecuente en el grupo de 35 a 39 años, mientras que el dolor mandibular predominó en el grupo de 50 a 54 años. No se encontró evidencia estadística significativa para pacientes dentados o portadores de prótesis, pero sí para aquellos que necesitaron hospitalización, con lesiones en la lengua sin dolor, úlceras únicas y lesiones en la lengua con dolor. Conclusiones: La xerostomía fue la manifestación bucal más prevalente, seguida por el dolor mandibular, ATM o hueso, y el dolor de boca no dental. Se observó una asociación estadísticamente significativa entre la necesidad de hospitalización y ciertas manifestaciones bucales. No se encontró significativo el uso de prótesis en relación con las manifestaciones estudiadas(AU)

An immediate implant approach to replace failing maxillary anterior dentition due to orthodontically induced severe root resorption.

Incomplete orthodontic therapy can lead to severe root resorption, resulting in mobile and non-restorable teeth. This clinical report presents the diagnosis, treatment planning and oral rehabilitation of a young woman with failing dentition in the anterior maxilla due to orthodontically induced root resorption. The patient's chief complaint was mobile maxillary anterior teeth 2 years after discontinuing orthodontic treatment. Radiographic and clinical evaluations revealed a missing right first premolar and left premolars and grade III mobility from the right canine to the left lateral incisor. Due to a hopeless prognosis, extraction of the maxillary anterior teeth was planned, followed by grafting procedures. Four implants were immediately placed in the fresh sockets of the canine and central sites, and a removable provisional appliance was delivered to contour the soft tissues involved. The final restorations consisted of two three-unit layered zirconia implant-supported fixed dental prostheses. Well-planned immediate implant therapy and zirconia restorations can successfully replace mobile teeth with severe root resorption caused by external surface resorption from incomplete orthodontic treatment. Combining grafting procedures during implant placement can replace hard tissue lost due to extractions, whereas provisional restorations can re-establish optimal tissue architecture in the aesthetic zone. The present case offers insight into effective strategies for treating non-compliant or uncooperative patients with failing dentition due to orthodontically induced root resorption.

Novel strategies enhancing endodontic disinfection: Antibacterial biodegradable calcium hydroxide nanoparticles in an ex vivo model.

Due to the high failure rates associated to endodontic disinfection, this study aimed to investigate the antibacterial properties of poly(lactic-co-glycolic acid) (PLGA) nanoparticles (NPs) loaded with Ca(OH)2 for endodontic disinfection procedures. Ca(OH)2 NPs production and physicochemical characterization were carried out as well as multiple antibacterial tests using three bacterial strains and an ex vivo model of endodontic infection with extracted human teeth. Agar diffusion test and broth dilution determined the inhibition growth zones (n = 5) and the minimal inhibitory concentration (MIC, n = 5), respectively. Cell viability was assessed using Live/Dead staining with confocal microscopy (n = 5). Data was analysed using ANOVA followed by post-hoc analysis. After 24 h of incubation, Ca(OH)2 NPs demonstrated a MIC of 10 µg/mL for Porphyromonas gingivalis (p < 0.001) and Enterococcus faecalis and 5 µg/mL for Fusobacterium nucleatum (p < 0.001). Although the agar diffusion test did not exhibit any inhibition area for Ca(OH)2 nor for Ca(OH)2 NPs, this was probably due to the buffering effect of the agar medium. However, the antibacterial capacity was confirmed in an ex vivo model, where instrumentalized teeth were infected with Enterococcus Faecalis and treated after 28 days of culture. A significant reduction in bacterial metabolic activity was confirmed for Ca(OH)2 NPs (40 % reduction with a single dose) and confirmed by Live/Dead staining. In conclusion, Ca(OH)2-loaded PLGA NPs present promising antibacterial efficacy for endodontic disinfection procedures.

Tooth-reduction 3D-printed guides for facilitating the provision of ultrathin laminate veneers.

Tooth-reduction guides offer a more controlled and conservative tooth preparation. Many types of tooth-reduction guides are available such as those with horizontal or vertical reduction grooves. A transparent cross-shaped tooth-reduction guide allows the clinician to make vertical and horizontal depth grooves to evaluate tooth reduction in all directions. The reference grooves on the guide enable the clinician to use a periodontal probe to measure the reduction accurately, and the transparent material provides a clear view of the entire tooth. Controlled tooth reduction offers a more conservative approach that is key for long-term bonded ceramic restorations. The multiaxial rigid transparent tooth-reduction guide could facilitate the provision of ultrathin handcrafted porcelain veneers to predictably fulfill patients' esthetic demands while preserving more tooth structure. The use of technically sound and artistically documented photographic evidence further underscores the effectiveness of this approach, particularly when intra-enamel preparations and adhesive luting under rubber dam isolation are employed. The present article describes a novel 3D-printed guide design that allows the clinician to perform the reduction grooves and evaluate the preparation in the horizontal and vertical directions within the same guide.

THE DENTAL PROFESSION EXPERIENCES HIGH PREVALENCE RATES OF BURNOUT AND EMOTIONAL EXHAUSTION.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Moro JDS, Soares JP, Massignan C, Oliveira LB, Ribeiro DM, Cardoso M, Canto GL, Bolan M. Burnout syndrome among dentists: a systematic review and meta-analysis. J Evid Based Dent Pract. 2022 Sep;22(3):101,724. doi: 10.1016/j.jebdp.2022.101724. Epub 2022 Apr 2. PMID: 36162888 SOURCE OF FUNDING: University funds. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis.

AUTONOMOUS ROBOTIC SURGERY SEEMS PROMISING AS AN ACCURATE TECHNOLOGY FOR SINGLE-TOOTH IMPLANT PLACEMENT IN THE ESTHETIC ZONE.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Yang S, Chen J, Li A, Deng K, Li P, Xu S. Accuracy of autonomous robotic surgery for single-tooth implant placement: a case series. J Dent. 2023;132:104451. doi:10.1016/j.jdent.2023.104451. Epub 2023 Feb 11. PMID: 36781099. SOURCE OF FUNDING: This case series study was supported by grants from the Guangdong Basic and Applied Basic Research Foundation, Science and Technology Projects in Guangzhou, Science Research Cultivation Program, and Clinical Research Initiation Plan of the Stomatological Hospital, Southern Medical University, China. TYPE OF STUDY/DESIGN: Case series. No a priori power calculation or pilot data. Nonconsecutive participant recruitment.