Environmentally friendly behavior in dentistry.

Background and aims: Sustainability is the sensitive and responsible way of using the natural resources, its goal being to prevent their depletion and preserving the ecological balance. An essential requirement to achieve this is to practice environmentally conscious behavior. The main objective of the present study was to carry out a survey among dentists about the importance of sustainability, feasibility of an environmentally friendly dental practice and the steps in favor of it. Methods: An online survey with 6 question groups, including a total of 50 questions, was performed. The survey was available online for dentists on different platforms. In total 98 responses were recorded during September - November 2020. Results: Out of the responding dentists, 74.49% liked the idea of an environmentally friendly dental practice and 98.97% would take some steps toward environmental awareness in their practice. A statistically significant (p<0.05) difference between those who prefer an environmentally conscious practice and those who had not yet thought about it was only in the questions related to environmentally conscious lifestyle in their household, the use of environmentally friendly cleaning products, the creation of a 'green wall' and selective waste collection in their practice. Conclusions: Most of the respondents were open to the idea of forming an environmentally conscious dental practice and they would act to achieve it. In order to reach this, it is necessary to provide dentists with feasible solutions for better practice. Some of the guidance issues, which would be easy to implement, are listed at the end of the present study. We intend to provide a guidance regarding sustainable dental practice.

Genetic and Morphological Variation in Hypodontia of Maxillary Lateral Incisors.

(1) Background: Hypodontia has a multifactorial aetiology, in which genetic factors are a major component. Associated with this congenital absence, the formed teeth may show differences in size and shape, which may vary with the specific genetic variants and with the location of the missing teeth. The aims of the present study were to investigate a specific variant of MSX1, derive morphometric tooth measurements in a sample of patients with isolated maxillary lateral incisor agenesis and matched controls, and model the findings. (2) Methods: Genotyping of the MSX1 rs8670 genetic variant and morphometric measurements with a 2D image analysis method were performed for 26 hypodontia patients and 26 matched controls. (3) Results: The risk of upper lateral incisor agenesis was 6.9 times higher when the T allele was present. The morphometric parameters showed significant differences between hypodontia patients and controls and between the unilateral and bilateral agenesis cases. The most affected crown dimension in the hypodontia patients was the bucco-lingual dimension. In crown shape there was significant variation the Carabelli trait in upper first molars. (4) Conclusions: The MSX1 rs8670 variant was associated with variations in morphological outcomes. The new findings for compensatory interactions between the maxillary incisors indicate that epigenetic and environmental factors interact with this genetic variant. A single-level directional complex interactive network model incorporates the variations seen in this study.

Study of dento-alveolar changes in patients with hypodontia / Dentoalveolaris elváltozások vizsgálata csírahiánnyal diagnosztizált betegekben

Introduction: Congenital absence of teeth is one of the most prevalent craniofacial malformation and dental disorder. Hypodontia may present with varying degrees of severity. The absence of all teeth (anodontia) is rare. Based on epidemiological studies, it is more common in the permanent dentition, then in deciduous teeth. Objective: The aim of the present study was to compare the dento-alveolar changes, on panoramic radiographs, between patients with hypodontia from the case group and subjects without tooth agenesis from the control group. Method: Measurements were performed on panoramic radiographs. The results were compared between the patients with hypodontia and the subjects from the control group. Dento-alveolar linear and angular measurements were performed. The mean age of the 60 subjects was 14.15 ± 4.48 years, to which a control group was assigned with a mean age 13.98 ± 4.07 years. 70% of the study population were female and 30% were male. Results: We found statistically significant differences between the case group and the control group in the case of transverse measurements and unilateral linear measurements (p<0.01). Conclusion: Hypodontia will affect the transversal development of mandibular dento-alveolar structures, and will cause the decrease of gonial angle.

Quantitative and Qualitative Assessment of Fluorescence in Aesthetic Direct Restorations.

Currently available direct restoration materials have been developed to have improved optical properties to interact with light in the same manner as the natural tooth. The objective of this study was to investigate the fluorescence of different enamel resin composites. In the present study, nine brands of enamel composites were tested in vitro, some of which are cited by manufacturers as having color adjustment potential. Fluorescence spectra of the composite specimens and the human natural enamel were measured with a fluorescence spectrophotometer immediately after preparation and after 6 months. Qualitative data of the specimens were also collected. Statistical analyses were conducted by Kruskal−Wallis and Mann−Whitney U nonparametric tests (p < 0.05). Almost all tested resin composites presented a significant decrease in the fluorescence values after a period of 6 months. There was no significant decrease in fluorescence in the case of Harmonize™ resin composite samples, which presented the lowest initial fluorescence values. The highest value in the reduction of the initial fluorescence intensity after 6 months (22.95%) was observed for the Charisma® specimens. Composites with a color adjustment did not perform significantly better than other composites in terms of reduction in fluorescence intensity.

Study of rs12532, rs8670 Polymorphism of Msh Homeobox 1 (MSX1), rs61754301, rs4904155 Polymorphism of Paired Box Gene 9 (PAX9), and rs2240308 Polymorphism of Axis Inhibitor Protein 2 (AXIN2) Genes in Nonsyndromic Hypodontia.

The etiology of hypodontia is complex, in which both genetic and environmental factors can be related. The main objective of our study was to contribute to elucidating the genetic background of nonsyndromic hypodontia (NSH). In this order, we selected 97 NSH subjects (70 females and 27 males) from patients referred to orthodontic treatment, and we matched to each NSH subject a control by age and sex. DNA was obtained from epithelial cells from the oral mucosa. Genotyping of the PAX9 (rs4904155 and rs61754301), MSX1 (rs8670 and rs12532), and AXIN2 (rs2240308) SNPs was performed by using TaqMan SNP Genotyping Assays on a real-time PCR system. Single-nucleotide polymorphisms (SNPs) were studied for the whole NSH group and for frontal and lateral agenesis NSH subjects separately. Our results showed that the variant genotype (p=0.0008, OR = 2.9, 95% CI = 1.58-5.3) and variant T allele (p=0.0002, OR = 2.65, 95% CI = 1.6-4.39) of the MSX1 rs8670 SNP increased the risk of hypodontia in the studied population when the whole NSH group was compared with controls. The variant genotype of the MSX1 rs8670 SNP was the most frequent in frontal agenesis; meanwhile in the lateral agenesis NSH group, the AXIN2 rs2240308 SNP showed a higher frequency of the variant genotype, with a trend towards statistical significance. In conclusion, the results of the present study showed that the variant genotype and variant T allele of the MSX1 rs8670 SNP increased the risk of hypodontia in the studied population. The presence of the variant A allele of AXIN2 rs2240308 is associated with frontal agenesis but not with lateral agenesis.

[Study of skeletal features in congenital hypodontia]. / Veleszületett csírahiánnyal társuló skeletalis eltérések vizsgálata.

INTRODUCTION: The incidence of congenital hypodontia is increasing in daily practice. Early diagnosis of this dental disorder and the associated skeletal malocclusions is crucial for successful and stable final rehabilitation. AIM: Comparison of cephalometric findings of patients with hypodontia of 1-4 teeth with the measurement results of the control group without teeth agenesis. MATERIAL AND METHOD: We evaluated the lateral X-ray of 41 patients with 1-4 teeth agenesis selected from patients referred for orthodontic treatment to the Orthodontic Department of the University of Medicine and Pharmacy from Târgu Mures within a two-year period. The results were compared with the values of the age and sex matched control group. RESULTS: Bilateral upper incisor and lower bicuspid were missing in most of the hypodontia cases. When looking at the NSGn angle predicting the growth direction of the mandible, statistically significant differences were found between the male (p = 0.012), the front (p = 0.010) and the hypodontia group (p = 0.024) and the control group. Regarding the ANB angle, which shows the sagittal position of the maxilla to the mandible, statistically significant differences were found between the subgroups (women, men, anterior or posterior hypodontia) and the control group. CONCLUSION: Larger number of skeletal class 3 and vertical hypodivergent tendency were observed in the hypodontia group. Orv Hetil. 2019; 160(6): 214-219.

[Dental morphological and metric characteristics in contemporary and historical population of Târgu Mureș]. / Fogak morfológiai és metrikus jellegzetességeinek vizsgálata marosvásárhelyi középkori leleteken és a jelenkori helyi populáció körében.

INTRODUCTION: Teeth, as an integral part of human organism, are not exceptions from the physical anthropology changes caused by biological evolution and the way of living. Different stress factors and the natural selection are contributing to the emphasis of certain morphological characteristics. AIM: Comparison of dental metric characteristics and the presence of accessory tooth cusps between human remains from the Middle Ages and dental study models of today's patients. MATERIAL AND METHOD: Morphological characteristics of 132 teeth from 19 skulls and 694 teeth on dental models of 30 patients were examined. The mesiodistal, incisivocervical and buccolingual diameters of crowns were measured by a validated 2D image analysis method. Carabelli and talon cusps were also examined using a magnifying glass. RESULTS: Statistically significant differences between the size of the 14th-century and the present-day teeth were found in some of the teeth groups. In medieval artifacts, lateral teeth had smaller crown width than teeth measured in the contemporary population. The Carabelli cusps found in the archeological human remains belonged to grades 1 and 3 on Dahlberg scale (23.07%), while the Carabelli cusps observed in the contemporary group belonged to grades 3, 4, 5, 6 and 7 (50.90%). Talon cusp occurred only once in the contemporary group. CONCLUSION: In case of the contemporary teeth, the Carabelli cusps appeared in a more pronounced morphological form and with a higher frequency, which emphasizes the European origin of today's population. Orv Hetil. 2018; 159(30): 1235-1240.

[Study of the canalis mandibulae morphology in different vertical facial types]. / A canalis mandibulae lefutásának vizsgálata különbözo vertikális arctípusokban.

INTRODUCTION: The precise knowledge of the position of canalis mandibulae and foramen mandibulae is important for surgical and endodontic interventions on the mandible. AIM: The aim of the study is to examine the position of these anatomical landmarks in different vertical facial types. METHOD: In the panorama radiograph of 26 normodivergent, 26 hypodivergent and 28 hyperdivergent arthritis (total of 1360 measurements) we measured the distance between the canalis mandibulae and interdental septums, the apex of the lateral teeth, the mandibular base, the goniac angle, and the steepness of the canal and the distance the foramen mandibulae to the anterior and posterior margin of the ramus. RESULTS: ANOVA and t-test statistical analysis showed that the foramen mandibulae is farer from the posterior margin of the ramus in hipodivergent facial types, in hyperdivergent facial types the canalis mandibulae was closer to the root apex of posterior teeth and in hypodivergent types to the base of the mandible. In normal and hyperdivergent individuals, the canalis mandibulae runs steeper and in the course of running it is increasingly distanced from the tangent to the base of the mandible. CONCLUSION: The position of the canalis mandibulae and the foramen mandibulae showed significant differences in the different vertical facial types. Orv Hetil. 2017; 158(46): 1841-1847.

Mild hypodontia is associated with smaller tooth dimensions and cusp numbers than in controls.

OBJECTIVE: The associations seen clinically between variations in tooth number, size and shape reflect the repetitive genetic interactions occurring between the epithelium and mesenchyme during the initiation and morphogenetic stages of the Complex Adaptive System that is dental development. The aim of this study was to investigate the clinical relationship further by comparing multiple crown parameters, including cusp numbers, between patients with mild hypodontia and controls in a Romanian sample. DESIGN: Digital images of dental casts of the permanent dentition from 28 patients with mild hypodontia and 28 controls were used. Measurements from the vestibular and occlusal surfaces were performed using a 2D image analysis method and cusps, including the Carabelli trait, were counted. Two-way analysis of variance was performed. RESULTS: The dimensions of the mild hypodontia group had smaller values than the controls, with many measurements being significantly different (significance values varied from p=0.049 to p=0.001). The most affected regions were the upper and lower anterior region in both sexes. Mesio-distal, bucco-lingual and occlusal area and perimeter dimensions were affected. Females from the hypodontia group had significantly less tricuspidated lower premolars when compared with the control group. Carabelli cusps were present in the hypodontia group less frequently, the difference being highly significant (p=0.0002) in women. CONCLUSIONS: The hypodontia patients presented with reduced crown dimensions and shape compared with controls. This is the first published study to demonstrate smaller cusp numbers in patients with hypodontia than in controls. The findings are compatible with a model of dental development as a Complex Adaptive System incorporating associations between tooth number, size and shape.

Complex analysis of multiple single nucleotide polymorphisms as putative risk factors of tooth agenesis in the Hungarian population.

OBJECTIVES: The role was studied of multiple single nucleotide polymorphisms in tooth agenesis in the Hungarian population using a complex approach. METHODS: Eight SNPs, PAX9 -912 C/T, PAX9 -1031 A/G, MSX1 3755 A/G, FGFR1 T/C rs881301, IRF6 T/C rs764093, AXIN2-8150 A/G, AXIN2-8434 A/G and AXIN2-30224 C/T, were studied in 192 hypodontia and 17 oligodontia cases and in 260 healthy volunteers. Case-control analysis was performed to test both allelic and genotypic associations as well as associations at the level of haplotypes. Multivariate exploratory Bayesian network-based multi-level analysis of relevance (BN-BMLA) as well as logistic regression analysis were performed. RESULTS: Conventional statistics showed that PAX9 SNP -912 C/T and the MSX1 SNP changed the incidence of hypodontia, although after Bonferroni correction for multiple hypothesis testing, the effects were only borderline tendencies. Using a statistical analysis better suited for handling multiple hypotheses, the BN-BMLA, PAX9 SNPs clearly showed a synergistic effect. This was confirmed by other multivariate analyses and it remained significant after corrections for multiple hypothesis testing (p < 0.0025). The PAX9-1031-A-PAX9-912-T haplotype was the most relevant combination causing hypodontia. Interaction was weaker between PAX9 and MSX1, while other SNPs had no joint effect on hypodontia. CONCLUSION: This complex analysis shows the important role of PAX9 and MSX1 SNPs and of their interactions in tooth agenesis, while IRF6, FGFR1 and AXIN2 SNPs had no detectable role in the Hungarian population. These results also reveal that risk factors in hypodontia need to be identified in various populations, since there is considerable variability among them.