Factors affecting the outcomes of direct pulp capping using Biodentine.

INTRODUCTION: This study aimed to evaluate the prognostic value of factors with regard to the treatment outcome of direct pulp capping using Biodentine (Septodont, Saint-Maur-des-Fossés, France), in permanent teeth in which the pulps were exposed during caries removal. METHODS: Between 2010 and 2014, 112 teeth with deep carious lesions underwent direct pulp capping. The patients were followed up at 2-3 months and 1-1.5 years with a routine examination on both recall visits. Periapical radiographs were taken at 1-1.5 years. Lack of patient complaints, positive reactions to cold and electric testing, no sensitivity to percussion, and no widening of the periapical ligament indicated success. The Fisher exact test was used for statistical analysis. The significance level was P = .05. RESULTS: Eighty-six teeth were available for 1-1.5 years follow-up. The overall success rate was 82.6%. Only age had a significant effect on the pulpal survival rate: the success rate was 90.9% in patients younger than 40 years and 73.8% in patients 40 years or older (P = .0480). Sex, initial or secondary caries treatment, occlusal or cervical/proximal caries, delayed placement of permanent filling, tooth position, and arch type did not influence the outcome. CONCLUSIONS: A patient's age influenced the outcome of direct pulp capping using this new calcium silicate cement. CLINICAL RELEVANCE: Asymptomatic vital permanent teeth with cariously exposed pulp can be treated successfully by direct pulp capping using Biodentine.

[The association between oral diseases and stroke]. / Zwiazek pomiedzy chorobami jamy ustnej a udarem mózgu.

In recent years there have been many studies concerning the effect of periodontal disease on the vascular system, including the development of stroke, either ischemic or hemorrhagic. The aim of this study was to present the relationship between periodontal disease and stroke based on the available literature. As it is evident from studies, patients with periodontal disease are predisposed to the formation of chronic systemic inflammation, which in turn is a risk facto for cardiovascular diseases, particularly diseases of the large vessels, including atherosclerosis, as well as chronic inflammation in the atherosclerotic plaque Atherosclerosis is a recognized risk factor for stroke. Current knowledge indicates the relationship between periodontal inflammation and stroke. Periodonta diseases are considered as an independent risk factor for vascular disease of the brain. Therefore, the prevention of periodontal disease is important, also early detection and treatment. Dental care should be an essential element of primary and secondary prevention of vascular events of central nervous system.

Tooth Abnormalities and Their Age-Dependent Occurrence in Leukemia Survivors.

The multidrug nature of anticancer treatment and different treatment protocols used in the studies are likely to be a major limitation in establishing real risk factors determining the occurrence of dental abnormalities. The authors aimed to establish a relationship between the duration and the dose of chemotherapy and the number of tooth adverse effects in the group receiving the same treatment. Of the 40 anticancer therapy recipients who attended the outpatient dental clinic, 7 leukemia survivors receiving the treatment according to the ALL IC-BFM 2002 protocol were selected. The study group consisted of four females and three males aged 92 to 207 months at the time of dental examination and 29 to 91 months at leukemia diagnosis. As a result of the clinical and radiological examination, dental abnormalities such as agenesis, tooth size reduction, root abnormalities, and taurodontia were identified, and the medical records of all survivors were reviewed in terms of drugs administered, their doses, and treatment schedules. No correlation was observed between the treatment duration of an intensive therapy, the entire therapy, and the number of tooth abnormalities. No relationship was also found between the number of dental abnormalities and the cumulative dose of vincristine, L-asparaginase, methotrexate, cyclophosphamide, cytarabine, and 6-mercaptopurine. The age at the onset of antineoplastic therapy is likely to be the strongest risk factor for toxic injury during tooth development.

Systemic Anticancer Therapy Details and Dental Adverse Effects in Children.

An idea of therapy intensification in order to make anticancer treatment more effective is still being investigated. The study aimed to estimate the impact of the chemotherapy dose levels and treatment duration on the risk for dental development disturbance. The clinical examination and OPG analysis were carried out in 37 cancer survivors and germ agenesis, microdontia, size reduction, taurodontism, root and enamel abnormalities were identified. An analysis of anticancer treatment was carried out separately for vincristine (VCR), doxorubicin (DXR), cyclophosphamide (CP), etoposide (VP-16), carboplatin (CBDCA) and actinomycin D (ACTD) recipients in terms of treatment duration and drug doses administered. Individuals aged between three years and ten months, and seven years and four months, at diagnosis presented with no severe dental abnormalities, regardless of treatment duration and increasing cytotoxic drug doses. The largest number of abnormalities per one person was noted in the survivors treated with the highest single doses of VCR, DXR, CP and ACTD. No similar observation was made in the cases of cumulative and weekly doses analyzed. Moreover, there were no significant differences between the mean number of abnormalities across all the drug groups.

Duration and dose of chemotherapy and dental development.

BACKGROUND: Given the susceptibility of developing tissues to drugs, even small doses of anticancer drugs may affect odontogenesis. Although any toxic effect is transient, the treatment regimens are based on repeated drug administration. OBJECTIVES: The study aimed to establish the impact of antineoplastic therapy on the occurrence of longterm adverse dental effects in a dose-dependent manner in young survivors treated for cancer before 10 years of age. MATERIAL AND METHODS: In total, 37 cancer survivors treated with antineoplastic therapy before 10 years of age underwent a dental examination with a thorough analysis of panoramic radiographs. A total of 236 teeth with 243 different developmental abnormalities were revealed in 28 survivors. Agenesis, tooth size reduction, taurodontia, and enamel and root abnormalities were diagnosed. All survivors received multi-agent chemotherapy, with the most frequently used drugs being vincristine (VCR), doxorubicin (DXR), cyclophosphamide (CP), ifosfamide (IF), etoposide (VP-16), carboplatin (CBDCA), cisplatin (CDDP), and actinomycin-D (ActD). A detailed analysis of medical records was also performed to assess the relationship between the treatment duration as well as the cumulative drug dose administered and the occurrence of particular disturbances. RESULTS: When analyzing the treatment duration and the drug doses in the affected and non-affected participants, there were no statistically significant differences between the survivors with different disturbances within most of the specific drug groups. In some groups, the mean cumulative treatment dose was significantly higher in the non-affected patients. According to Spearman's rho, no significant relationships were observed. CONCLUSIONS: In the present study, no significant differences in terms of treatment duration or drug doses were observed between the patients with particular abnormalities. The developmental stage of tooth formation during chemotherapy is likely the most important factor influencing dental changes. For future research with respect to different treatment protocols, an analysis of a more homogenous group of survivors is warranted.

Prevalence and Possible Etiological Factors of Molar-Incisor Hypomineralization (MIH) in Population of Silesian Children in Poland: A Pilot Retrospective Cohort Study.

(1) Background: This pilot retrospective cohort research study regarded the frequency of the prevalence of molar-incisor hypomineralization (MIH) in a population of Silesian children in Poland. The evaluation of the potential environmental etiological factors was performed and the correlation between the environmental factors and MIH was analyzed. (2) Methods: A total of 613 children were randomly enrolled in the pilot study (9.0 years ± 1.9). A survey was carried out with mothers regarding the potential exposure to environmental etiological factors of MIH in their children. The patients' clinical assessments were carried out in the dental unit. (3) Results: The frequency of prevalence of MIH in the population of Silesian children was established at the level of 6.2% (p < 0.05). MIH symptoms were significantly associated with otitis in early childhood (OR = 2.50), atopic dermatitis (OR = 5.69), and premature delivery before 38 weeks of pregnancy (OR = 2.88). (4) Conclusions: MIH was observed in 6.2% of the population of Silesian children, and there was a relationship between environmental risk factors such as otitis, atopic dermatitis, premature birth, and MIH expression. Therefore, further research is needed to determine the influence of pre-, peri-, postnatal, and prophylactic factors on the frequency and severity of MIH symptoms in children.

Sleep Bruxism in Children: Etiology, Diagnosis, and Treatment-A Literature Review.

(1) Background: Bruxism, a condition characterized by grinding and involuntary clenching of the teeth, is a risk factor for the development of masticatory dysfunction. It can occur together with sleep disturbances and may be associated with abnormal body movements, breathing difficulties, increased muscle activity, and heart rate disturbances. This disorder is becoming an important dental concern in children. (2) Methods: A literature review was carried out based on a search in PubMed and Google Scholar databases for articles on bruxism in children, published between 2014 and 2021. The etiology, diagnosis, and treatment of bruxism in children were of particular interest in the study. (3) Results: A total of 40 articles were included in the review. The analyzed studies indicated that the prevalence rates of bruxism in children vary widely from 13% to 49%. The etiology of bruxism is complex and incomprehensible, and the main diagnostic criteria for this condition in children are subjective observation, clinical history, and clinical examination. The recommended therapy for sleep bruxism in children is physiotherapy and psychotherapy. (4) Conclusions: Dentists and primary care physicians should correctly diagnose bruxism in children, educate parents, prevent potential consequences for oral health, and identify possible comorbidities. Appropriate clinical guidelines for the treatment and prophylaxis of bruxism in children should also be developed.

Intramuscular Injections and Dry Needling within Masticatory Muscles in Management of Myofascial Pain. Systematic Review of Clinical Trials.

BACKGROUND: Myofascial pain is an important cause of disability among the whole population, and it is a common symptom of temporomandibular joint disorders (TMDs). Its management techniques vary widely; however, in recent years, there has been a growing interest especially in needling therapies within masticatory muscles, due to their simplicity and effectiveness in pain reduction. METHODS: The construction of the following study is based on PICOS and PRISMA protocols. A systematic literature search was conducted based on the PubMed and BASE search engines. Searching the abovementioned databases yielded a total of 367 articles. The screening procedure and analysis of full texts resulted in the inclusion of 28 articles for detailed analysis. RESULTS: According to analyzed data, clinicians manage myofascial pain either with wet or dry needling therapies. The most thoroughly studied approach that prevails significantly within the clinical trials is injecting the botulinum toxin into the masseter and temporalis. Other common methods are the application of local anesthetics or dry needling; however, we notice the introduction of entirely new substances, such as platelet-rich plasma or collagen. In the analyzed articles, the target muscles for the needling therapies are most commonly localized by manual palpation although there are a variety of navigational support systems described: EMG, MRI or EIP electrotherapy equipment, which often aid the access to located deeper lateral and medial pterygoid muscle. CONCLUSIONS: Needling therapies within masticatory muscles provide satisfactory effects while being simple, safe and accessible procedures although there still is a need for high quality clinical trials investigating especially injections of non-Botox substances and needling within lateral and medial pterygoid muscles.

The effect of simulated erosive conditions on the frictional behavior of different orthodontic bracket-wire combinations.

BACKGROUND: Frictional resistance is an important parameter in orthodontics that influences the effectiveness of archwire-guided tooth movement. Since the consumption of dietary acids has increased considerably over the last 2 decades, there is a rationale for investigating the process of degradation of orthodontic materials in an acidic environment and its effect on clinical efficiency. OBJECTIVES: The aim of this study was to evaluate the effect of simulated erosive conditions on the frictional behavior between the brackets of 3 different materials and 3 different wire alloys. MATERIAL AND METHODS: Three types of twin orthodontic brackets (stainless steel (SS), monocrystalline ceramic and titanium) and 3 types of archwires of the same dimension (SS, nickel-titanium (Ni-Ti) and beta-titanium (titanium-molybdenum alloy - TMA) were tested in 9 different combinations under simulated erosive and non-erosive conditions (18 groups, n = 10). Bracket-wire specimens in the erosivecondition groups were subjected to a pH cycling regimen with 1% citric acid and artificial saliva for 5 consecutive days. Bracket-wire specimens from the non-erosive-condition groups were incubated only in artificial saliva for 5 days. Static and kinetic friction were determined by measuring the force needed to move the wire through the bracket. A three-way analysis of variance and pairwise comparisons with the Student-Newman-Keuls test were performed. RESULTS: Irrespective of the conditions, SS brackets with SS wire demonstrated significantly lower mean static and kinetic frictional resistance than other bracket-wire combinations (p < 0.01). Ceramic and titanium brackets generated high frictional forces with all 3 types of wire tested. Erosive conditions did not significantly influence static and kinetic frictional resistance in all bracket-wire groups. CONCLUSIONS: Erosive conditions do not affect the frictional behavior of SS, Ni-Ti and TMA orthodontic archwires at a clinically significant level.

Diseases of the oral cavity in light of the newest epigenetic research: Possible implications for stomatology.

Epigenetics is the study of inheritable changes in gene expression without changes in the underlying deoxyribonucleic acid (DNA) sequence. The main mechanisms of epigenetic regulation include DNA methylation, modifications in histones, and micro-ribonucleic acids (miRNA). Recent research evidence has shown that environmental and lifestyle factors dynamically interact with the genome, influencing epigenetic changes, from development to the later stages of life. This happens across a spectrum, from physiological to pathological conditions, such as genetic defects, developmental disorders, infectious or inflammatory processes, cancers, mental disorders, and substance abuse. Epigenetic studies have been conducted in various medical disciplines (e.g., oncology, internal medicine or psychiatry), adding valuable insight to standard medical approaches. However, in stomatology, epigenetic research is still in its infancy; thus, this review is aimed at presenting the role of epigenetic mechanisms in diseases of the oral cavity, including periodontal diseases, caries, developmental anomalies, and oral carcinoma. In addition, this paper reveals new insights into epigenetic biomarkers that can be helpful in the detection, early diagnosis, prognosis, and treatment of different oral diseases. Moreover, this review is focused on the possible clinical implications (diagnostic and therapeutic) of epigenetics, in the form of some noninvasive methods that can possibly be used in the future for the screening, work-up, outcome prediction and novel treatments of some dental diseases. Finally, this paper highlights that an epigenetic approach can be useful for designing novel interventions that will improve the management of oral malignancies or developmental abnormalities.