New Insights Regarding the Use of Relevant Synthetic Compounds in Dentistry.

Worldwide, synthetic compounds are used for both in-office and at-home dental care. They are a valuable resource for both prophylactic and curative treatments for various dental problems, such as tooth decay, periodontal diseases, and many more. They are typically preferred due to their broad range of actions and ability to produce targeted, rapid, and long-lasting effects. Using a 0.12% chlorhexidine mouthwash is capable of reducing the plaque index from 47.69% to 2.37% and the bleeding index from 32.93% to 6.28% after just 2 weeks. Mouthwash with 0.1% OCT is also highly effective, as it significantly lowered the median plaque index and salivary bacterial counts in 152 patients in 5 days compared to a control group (p < 0.0001), while also reducing the gingival index (p < 0.001). When povidone-iodine was used as an irrigant during the surgical removal of mandibular third molars in 105 patients, it resulted in notably lower pain scores after 2 days compared to a control group (4.57 ± 0.60 vs. 5.71 ± 0.45). Sodium hypochlorite is excellent for root canal disinfection, as irrigating with 1% NaOCl completely eliminated the bacteria from canals in 65% patients. A 0.05% CPC mouthwash proved effective for perioperative patient care, significantly decreasing gingival bleeding (p < 0.001) and suppressing Streptococcus levels even one week post-surgery. Lastly, a 6% H2O2 paint-on varnish and 6% H2O2 tray formulations successfully bleached the teeth of 40 patients, maintaining a noticeably whiter appearance up to the 6-month follow-up, with significant color differences from the baseline (p < 0.005). Synthetic compounds have a large research base, which also provides a greater awareness of their mechanism of action and potential adverse effects. For a better understanding of how they work, several methods and assays are performed. These are protocolary techniques through which a compound's efficacy and toxicity are established.

A Bibliometric Analysis (2010-2020) of the Dental Scientific Literature on Chemo-Mechanical Methods of Caries Removal Using Carisolv and BRIX3000.

Reports in the literature have proposed and analyzed several minimally invasive techniques for caries removal in recent decades. In light of recent events surrounding the ongoing epidemiological context, concerns have been raised regarding the generation of aerosols during dental procedures. The aim of our research was to provide an overview of the scientific literature on the topic of chemo-mechanical caries removal (CMCR) methods, focusing on two products (Carisolv, BRIX3000), commercially available in Europe. A bibliometric analysis was used to investigate the scientific articles included in Web of Science (WoS) Core Collection database, published from January 2010 to December 2020. We analyzed the co-occurrence of all keywords (Author Keywords and the KeyWords Plus section), co-authorship and co-citation, using the free software VOSviewer. Our bibliometric analysis revealed a worldwide interest in the subject of chemo-mechanical methods of caries removal, which has transcended the area of pediatric dentistry. The analyzed studies have been conducted mainly in high-income countries that have developed sanitary policies regarding prevention and early treatment of carious lesions as a health priority.

[Objective evaluation of orthodontic treatment need with Dental Aesthetic Index]. / Fogazati rendellenességek kezelési szükségletének tárgyilagos felmérése a Dental Aesthetic Index segítségével.

INTRODUCTION AND AIM: To evaluate the frequency and severity of the malocclusions and treatment need in a group of adult patients in Târgu-Mureș, dividing them up according to age and gender. METHOD: Sixty-four, randomly selected patients were divided up according to age and gender. Ten occlusal traits related to dentofacial anomalies according to missing teeth, spacing, crowding and occlusion were used to evaluate the malocclusions on each of their study cast. The Dental Aesthetic Index (DAI) regression equation was used to obtain the DAI score that defines severity. RESULTS: The average DAI score was 38 with a range of 18-79, showing that the majority of patients needed mandatory orthodontic treatment. No statistically significant difference was found between gender, age groups and need for treatment. CONCLUSION: More than two-fifths of the examined patients have a mandatory need for orthodontic treatment if the DAI scores are the main screening tool. Orv Hetil. 2018; 159(9): 352-356.

Insights into the Cytotoxicity and Irritant Potential of Chlorhexidine Digluconate: An In Vitro and In Ovo Safety Screening.

Chlorhexidine (CHX) represents one of the most commonly used antiseptics in dentistry and other medical-pharmaceutical fields due to its broad-spectrum antimicrobial activity. However, the potential toxic events arising from its common use in practice has become a subject of increasing concern. Thus, the present study was designed to investigate the potential toxicity of CHX digluconate at concentrations covering its antibacterial properties (0.0002-0.2%) in HGF primary gingival fibroblasts, HaCaT immortalized human keratinocytes, and JB6 Cl 41-5a epidermal cells, as well as its irritant action in ovo. Our results indicate that CHX exerted a concentration- and time-dependent cytotoxicity in all cell lines, which was evidenced by the reduction in cell viability, number, and confluence, damaged cell membrane integrity, impaired cell morphology, and specific apoptotic nuclear shape. The highest cytotoxicity was caused by CHX digluconate 0.02% and 0.2%, concentrations, at which an irritant effect on the chorioallantoic membrane was also observed. The novel findings revealed in this research contribute to the overall safety profile of CHX and stand as a basis for further investigations in this regard.

Effects of Disinfection and Steam Sterilization on the Mechanical Properties of 3D SLA- and DLP-Printed Surgical Guides for Orthodontic Implant Placement.

Three-dimensional printed surgical guides increase the precision of orthodontic mini-implant placement. The purpose of this research was to investigate the effects of disinfection and of two types of autoclave sterilization on the mechanical properties of 3D printed surgical guides obtained via the SLA (stereolithography) and DLP (digital light processing) printing methods. A total of 96 standard specimens (48 SLA and 48 DLP) were printed to analyze the tensile and flexural properties of the materials. A total of 80 surgical guide (40 SLA and 40 DLP) specimens from each printing method were classified into four groups: CG (control group); G1, disinfected with 4% Gigasept (Gigasept Instru AF; Schülke & Mayer Gmbh, Norderstedt, Germany); G2, autoclave-sterilized (121 °C); and G3, autoclave-sterilized (134 °C). Significant differences in the maximum compressive load were determined between the groups comprising the DLP-(p < 0.001) and the SLA- (p < 0.001) printed surgical guides. Groups G2 (p = 0.001) and G3 (p = 0.029) showed significant parameter modifications compared with the CG. Disinfection with 4% Gigasept (Gigasept Instru AF; Schülke & Mayer Gmbh, Norderstedt, Germany) is suitable both for SLA- and DLP-printed surgical guides. Heat sterilization at both 121 °C and 134 °C modified the mechanical properties of the surgical guides.

Retrospective Long-Term Clinical Outcome of Feldspathic Ceramic Veneers.

The purpose of this study was to evaluate the clinical outcome of feldspathic ceramic laminate veneers over a 7-year period using minimally invasive techniques, such as vertical preparation (without prosthetic finish line), or no preparation (no-prep). A total of 170 feldspathic ceramic veneers were cemented in the anterior region, including 70 maxillary and 100 mandibular veneers, after special conditioning of the teeth and restorations. The veneers were evaluated using the FDI World Dental Federation criteria evaluation kit after recalling all the patients between February and June 2021. In total, 14 feldspathic veneers failed and were replaced with lithium disilicate because of core fracture, and 10 cases of chipping occurred on the ceramic surface and were polished. The overall survival rate was 91.77% for up to 7 years of function, with a failure rate of 8.23%. In this retrospective survival analysis, the failures, including the fracture of veneers and dental hard tissue, occurred both in prep and no-prep teeth. No failures were observed in veneers with a maximum thickness of 0.5 mm compared to those with a maximum thickness of 1 mm, 1.5 mm, 2 mm, and 2.5 mm.

Gingival proliferative growth - stress and cytoarchitecture related with fixed and mobile orthodontic therapy.

The fixed orthodontic measures taken induce significant stress to the gingival growth process during arch wire maneuvers of aligning and leveling. We observed, for a period of one to four years, fixed orthodontic devices in 80 human subjects. From these, we selected 44 subjects (22 women and 22 men) where the inflammatory process exhibited following the orthodontic fixed treatment, and with vacuum-formed orthodontic retainers (VFR) succeeding to fixed treatment. Samples were collected from each patient and histological and immunohistochemical (IHC) methodology was made to analyze the cytoarchitecture. Statistics were made after one-way analysis of variance (ANOVA), with the Bonferroni's correction. The IHC examination performed in the early stage revealed the presence in the inflammatory infiltrate of CD8-type T-lymphocytes, and of dendritic cells in large numbers. The examination performed in the late stage revealed the presence in the inflammatory infiltrate of CD20-type B-lymphocytes, which are mature cells capable of immunoglobulin synthesis, their activation being an important step in the maturation of the antibody response. The stress generated by arch wires in both genders was significantly higher than in the case of VFR. This observation was pointed out also by the cytohistological investigation outcome but was also based on an original scale conceived by our research team, following gingival hyperplasia evaluation. Also, with statistical significance, the comparative obtained values for men (p=0.01) and for women (p=0.001) illustrate clinical observations, allowing to affirm that, in our case, men were more stressed in bearing arch wire devices (AWD) and VFR, in comparison with women.

Clinical and morphological aspects of lateral femoral condyle status after an osteochondral fracture. A case report.

Although osteochondral fractures of the lateral femoral condyle are uncommon, fixation of the fragments is recommended, mostly when is about young athletes with such post-traumatic pathology. We present a case of a professional handball player teenager female, with a lateral femur condylar osteochondral fracture after a fall with the right knee in extension and in internal rotation. Magnetic resonance imaging (MRI) showed an osteochondral fracture of the lateral femoral condyle, 34.6 mm on long axis, impossible to manage arthroscopically, because of the size and the location of the detached fragment. The solution was the lateral knee arthrotomy allowing the evacuation of the hemarthrosis and preparation of the fracture site, then reduction and fixation of the fracture with absorbable cannulated pins. This procedure is of choice only when is enough bone in the detached fragment to permit the internal fixation and bone-to-bone healing with cartilaginous tissue stabilization through the fibro-cartilaginous rim that would seal the cartilage surface. Postoperative MRI proves that the fragment is settled in its hooked position with repairing of the articular congruity, so the recovery exercises program allow the regaining of the knee mobility with a restart of her sportive activity later.

Crestal bone remodeling around implants placed using a short drilling protocol.

PURPOSE: The aim of the study was to examine the influence of a short drilling protocol on peri-implant crestal bone levels. MATERIALS AND METHODS: Forty implants were placed in the posterior mandibles of 20 patients. The implants (diameter, 4.2 mm; length, 10 to 11.5 mm) were inserted in pairs: one implant was inserted using the standard drilling protocol (five drills in sequence), while the other was inserted using the short drilling protocol sequence (three drills). All implants received healing abutments and were restored with single-unit restorations after 3 months of healing. Analysis of crestal bone level was based on radiographs taken at insertion and at 3, 6, and 12 months after insertion. The results were analyzed using software Image J 1.46r (National Institutes of Health). Crestal bone level was measured in millimeters at the distal aspect of each implant. RESULTS: None of the implants in either group was lost during the 12-month follow-up period, and all patients completed the follow-up examination. The drilling time for the insertion of one implant with the short drilling protocol was 1.03 ± 3.63 minutes compared to 1.57 ± 2.88 minutes for the standard protocol. The mean values of crestal bone loss at 12 months were 0.94 ± 0.43 mm for implants placed using the standard protocol and 0.90 ± 0.33 mm for implants placed using the short drilling protocol. No statistically significant differences were noted. CONCLUSION: Using the short drilling protocol reduced the surgery time by approximately 50% and did not affect crestal bone remodeling during the first year postinsertion.

The assessment of lower face morphology changes in edentulous patients after prosthodontic rehabilitation, using two methods of measurement.

Using two measurement methods (a three-dimensional laser scanning system and a digital caliper), this study compares the lower face morphology of complete edentulous patients, before and after prosthodontic rehabilitation with bimaxillary complete dentures. Fourteen edentulous patients were randomly selected from the Department of Prosthodontics, at the Faculty of Dental Medicine, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania. The changes that occurred in the lower third of the face after prosthodontic treatment were assessed quantitatively by measuring the vertical projection of the distances between two sets of anthropometric landmarks: Subnasale - cutaneous Pogonion (D1) and Labiale superius - Labiale inferius (D2). A two-way repeated measures ANOVA model design was carried out to test for significant interactions, main effects and differences between the two types of measuring devices and between the initial and final rehabilitation time points. The main effect of the type of measuring device showed no statistically significant differences in the measured distances (p=0.24 for D1 and p=0.39 for D2), between the initial and the final rehabilitation time points. Regarding the main effect of time, there were statistically significant differences in both the measured distances D1 and D2 (p=0.001), between the initial and the final rehabilitation time points. The two methods of measurement were equally reliable in the assessment of lower face morphology changes in edentulous patients after prosthodontic rehabilitation with bimaxillary complete dentures. The differences between the measurements taken before and after prosthodontic rehabilitation proved to be statistically significant.

Alveolar and dental arch morphology in Angle Class II division 2 malocclusion: a comparative study.

OBJECTIVE: The aim of this study was to analyze the dental and alveolar intercanine, interpremolar and intermolar widths in patients with Class II/2 malocclusion and to compare the data with a patient group with normal occlusion and also with a patient group with Class II/1 malocclusion. MATERIALS AND METHODS: The study was conducted on 140 untreated patients with permanent dentition, aged 16 to 25 years, which were divided into three groups, according to Angle's classification of occlusion. The measurements of the dento-alveolar intercanine, interpremolar and intermolar widths were made on virtual study models, scanned using an optical 3D scanner. The unpaired (Student's) t-test was used to determine whether there were any significant differences between the Class II/2 and Class I groups and between Class II/2 and Class II/1 groups, respectively (p<0.05). RESULTS: Significant differences were found between Class II/2 and Class II/1 groups in the maxillary and mandibular intercanine widths. Comparing the Class II/2 and Class I groups, significant differences were found in the mandibular intercanine width, in the maxillary and mandibular interpremolar widths and also in the maxillary and mandibular intercanine and interpremolar alveolar widths. CONCLUSIONS: The maxillary and mandibular interpremolar widths and the intercanine and interpremolar alveolar widths were larger, while the mandibular intercanine width was shorter in the Class I group than in the Class II division 2 group. The mandibular intercanine width was longer and the maxillary intercanine width was shorter in the Class II division 1 group compared to the Class II division 2 group.

Experimental morphologic and radiologic study of the integration of bone grafts into the host tissue and of the dynamics of the graft-receptor interface.

Bone is the second tissue in terms of number of transplants after blood. There is an increased trend of incidence of severe bone lesions with comminuted fractures, with significant lack of substance, as well as an increased incidence of cancer types combined with therapeutic advances in recent decades, allowing for large surgical interventions that affect the bones and create significant defects in bone and contribute to the overall increase in the number and complexity of bone transplants. Autografts may be used singly or in various combinations, with significantly better effects than other implant materials. Use of autografts is limited by complications from the receptor site, mainly related to infections and undetectable necrotic areas on initial microscopic examination, which prevent proper incorporation of autografts, but also those of the donor situs. The aim of the study was to assess the integration of tibial bone grafts into the femur of Wistar rats by radiologic exam and histological evaluation. We concluded that the fixing of the graft to the host tissue may be subject to some microenvironment influences. The presence of the periosteum on the grafts is certainly an asset during transplantation. We confirm once again that the ability of transplanted periosteum of osteoformation and reactivation. Our observations regarding the contribution of bone marrow endorse the view of its active role in bone formation.

Implant survival rate and marginal bone loss of 6-mm short implants: a 2-year clinical report.

PURPOSE: This study aimed to evaluate (1) the association between implant diameter and marginal bone loss (MBL) of short (6 mm) implants and (2) the survival rates of short implants. MATERIALS AND METHODS: Thirty-three 6-mm implants were placed in the mandibles of 16 qualified patients. The selected sites had > 5 mm ridge width and < 9 mm bone height. None of the implant sites required bone augmentation procedures. All implants were uncovered 3 months after placement, and all patients were rehabilitated with 2- or 3-unit implant-supported fixed partial dentures. Standardized periapical films were taken after 24 months of function. Radiographs were digitalized, and MBL was assessed. RESULTS: For all implants, the mean MBL was 0.17 mm at the point of uncovering. At the 2-year follow-up, all implants were immobile and functional. Implants with 4.2-mm diameters had significantly more MBL (1.95 mm) than wider implants (0.47 mm and 0.35 mm for 5.0-mm and 6.0-mm implants, respectively). CONCLUSION: This 2-year study illustrated that short implants are a viable option in selected clinical scenarios. Short implants with wider diameters are preferred because they have less marginal implant bone loss.

Craniofacial morphology in patients with Angle Class II division 2 malocclusion.

Cephalometric analysis is frequently used in orthodontics for diagnostic purposes, in order to evaluate the positional relationship of the upper and lower jaw to the cranial base, as well as to objectively asses the way dental arches relate to one another and to the skeletal base. As with other dento-skeletal anomalies, the normal growth process can induce changes in these parameters. The purpose of this study is to evaluate the skeletal and dental changes that occur in growing patients with Angle Class II division 2 malocclusion. The study also focuses on analyzing and comparing several parameters in three groups of young patients of different ages, diagnosed with Class II division 2 malocclusion, in order to determine whether the anomaly worsens or improves during the patients' growth period. A total of 25 lateral skull teleradiographs were analyzed using cephX. The patients were divided into three groups (Group 1: 6-8 years, Group 2: 9-14 years, Group 3: 15-18 years). We used the cephalometric parameters described in Björk-Jarabak and Tweed analyses, as well as the relationship of the upper and lower central incisors to the skeletal landmarks. The statistical methods used in this study were the analysis of variance (ANOVA) and the unpaired Student's t-test (p<0.05). We concluded that, during the physiological growth process, the Angle Class II division 2 malocclusion has the following cephalometric characteristics: the maxillary central incisors were in accentuated retroclination, the interincisal angle was very obtuse, the gonial angle showed lower than normal values towards the end of the growth period, the lower anterior face height was definitely decreased, the mandibular body length was shorter than normal in the early growth period and the tendency towards a hypodivergent skeletal pattern remained stable during growth.

Skeletal and dentoalveolar changes in the maxillary bone morphology using two-arm maxillary expander.

OBJECTIVE: The purpose of this study was to evaluate the dental and skeletal changes in the maxillary bone morphology, produced by two-arm rapid palatal expansion appliances. PATIENTS AND METHODS: The study included 22 girls with an average age of 11.9 years treated with RPE appliances at the Department of Pedodontics and Orthodontics, Faculty of Dentistry, Timisoara, Romania. We evaluated the changes on study casts, using an optical 3D scanner--Activity 101 (SmartOptics) and also on radiographs. The level of statistical significance was set by comparing the changes between pre and post treatment values. We also used the Pearson's correlation coefficient (r) to measure the strength of the association between the recorded measurements. The correlations were significant at p<0.05. RESULTS: Significant changes were found in intermolar width change, interpremolar width change, molar tipping and alveolar tipping. Less significant changes were found in molar rotation and palatal depth change. After rapid maxillary expansion, five of the 21 correlations were found to be statistically significant. Positive medium correlations were found between intermolar width change and alveolar tipping and between interpremolar width change and alveolar tipping. A negative medium correlation was found between palatal depth change and alveolar tipping. Weak, but statistically significant correlations were found between intermolar width change and interpremolar width change and between intermolar width change and palatal depth change. No statistically significant correlation was found between the other variables. CONCLUSIONS: This type of maxillary expander is capable of expanding the maxillary dentition and alveolar process, opening the midpalatal suture and changing the maxillary bone morphology. The most remarkable changes occurred in the transverse plane. Future research is required to evaluate a larger group of patients.