Assessment of the efficacy of autologous blood preparations in maxillary sinus floor elevation surgery: a systematic review and meta-analysis.

OBJECTIVE: This study aimed to evaluate the efficacy of autologous blood preparations, namely Platelet-Rich Plasma (PRP), Platelet-Rich Fibrin (PRF), and Concentrated Growth Factor (CGF), in maxillary sinus floor elevation surgery. The focus was on their impact on new bone formation, maxillary sinus floor height, and soft tissue healing. METHODS: A systematic search was conducted across PubMed/MEDLINE, Web of Science, Embase, and Scopus databases up to April 2024. This systematic review included both randomized clinical trials (RCTs) and controlled clinical trials (CCTs) that evaluated the efficacy of autologous blood preparations in maxillary sinus floor elevation surgery. The primary outcomes measured were the percentage of new bone formation, maxillary sinus floor height, and he percentage of soft tissue area. Data from the selected studies were extracted and analyzed to determine the impact of autologous blood preparations on these outcomes. The risk of bias was assessed using Cochrane's risk of bias tool and ROBINS-I, and meta-analyses were performed using Review Manager 5.4 software to calculate effect sizes and integrate results from multiple studies. RESULTS: Among the 507 screened articles, 30 studies met the inclusion criteria. The results indicated that the application of PRP significantly increased new bone formation during maxillary sinus floor elevation surgery (primary outcome, MD = 4.40, CI = 0.37 to 8.44, P = 0.03), as well as improving maxillary sinus floor height elevation (secondary outcome, MD = 1.00, CI = 0.78 to 1.23, P < 0.00001). The absence of PRP during surgery had a statistically significant effect on the percentage of soft tissue area (secondary outcome, MD= -5.25, CI= -7.29 to 3.20, P < 0.00001). However, based on the research findings, PRF did not show significant effects on enhancing new bone formation, maxillary sinus floor height elevation, and promoting soft tissue regeneration. CONCLUSIONS: PRP demonstrates efficacy in maxillary sinus floor elevation surgery by enhancing new bone formation and increasing sinus height. Further studies are needed to validate the outcomes of PRF and CGF.

A Comprehensive Analysis of Clinical Crowns in Young of Han Nationality with Normal Occlusion Using Intraoral Scanning.

Background: The measurement and analysis of clinical crowns play a crucial role in stomatology, anthropology, and studies of genetic and environmental variables in oral and maxillofacial development. Purpose: The objective of the present study was to measure the parameters of clinical crowns of permanent dentition in youth of Han nationality using intraoral scanning and identify potential influencing factors. Materials and Methods: A total of 100 subjects (50 males and 50 females) of Han nationality aged 18-24 with normal occlusion were selected. An intraoral scanner was used to obtain the digital dental impressions, and Materialise Magics 21 software was used to measure the mesiodistal diameter (MDD), buccolingual diameter (BLD), height, mesiodistal angle (MDA), and vestibulo-oral angle (VOA) of clinical crowns. The central height was calculated based on the height of clinical crowns. SPSS 27.0 software was used for statistical analysis. The two-independent-samplet-test was used to assess discrepancies in clinical crowns between males and females. The paired t-test was used to determine differences between antimetric pairs of clinical crowns within the same arch. The repeatability of intraoral scanning was tested using the paired t-test between two measurements at one-month intervals. The overall estimated effect was considered significant where P < 0.05. Results: The MDD, BLD, height, MDA, and VOA of clinical crowns in the youth of Han nationality were measured, and the central height was calculated. No significant difference was found in terms of MDA and VOA between genders and antimetric pairs within the same arch. Regarding the distance parameters, the MDD, BLD, and height of clinical crowns in males were significantly larger than those in females (MDD: U1, U3, U7, L2, L3, L6, and L7: P < 0.01; BLD: U1: P=0.02; U3-U7 and L1-L7: P < 0.01; height: U2: P=0.03; and U1, U3-U7, and L3-L7: P < 0.01). No significant difference was found in clinical crowns between antimetric pairs within the same arch. Intraoral scanning demonstrated good repeatability in the measurement of clinical crowns. Conclusions: Apart from MDA and VOA, the parameters of clinical crowns in males were significantly larger than in females. Antimetric pairs of clinical crowns within the same arch demonstrated similar tooth dimensions. In future clinical practice and scientific research in the oral and maxillofacial region, a comprehensive design of sexual and ethnic characteristics should be considered.

Association between psychological stress, anxiety and oral health status among college students during the Omicron wave: a cross-sectional study.

BACKGROUND: Within 3 years of the COVID-19 pandemic, increasing interest has been given to its potential influence on health status due to lockdowns caused by the pandemic. However, the impact is inadequately understood, especially for college students. This study aimed to investigate the potential association between psychological stress, anxiety and oral health of college students during the Omicron wave of the COVID-19 pandemic. METHODS: An online survey with measurements of psychological stress, anxiety and oral health was completed by 1770 Chinese college students. The Perceived Stress Scale-14 (PSS-14) and Generalized Anxiety Disorder-7 (GAD-7) were used to measure psychological stress and anxiety, respectively. Oral health status was self-reported including toothache, gingival bleeding, and oral ulcer. Multivariable logistic regressions were performed to determine underlying associations for outcome variables. Structural equation modeling (SEM) was performed to confirm the relationship between mental and oral health status. RESULTS: Of the 1770 subjects, 39.2% presented high psychological stress and only 41.2% expressed no anxiety. A significant association was found between psychological stress, anxiety and oral health status. Anxiety has significant impacts on toothache (OR = 0.36; 95%CI: 0.23-0.55; p < 0.01), gingival bleeding (OR = 0.43; 95%CI: 0.29-0.65; p < 0.01), and oral ulcer (OR = 0.54; 95%CI: 0.36-0.80; p < 0.01). Anxiety significantly mediated the association between psychological stress and self-reported oral symptoms. CONCLUSIONS: Anxiety may be a significant risk indicator for mental health among college students and demonstrates a significant relationship with the occurrence of self-reported oral symptoms. Concerns about academic and life changes caused by the pandemic were the two most significant sources of stress.

A comprehensive biomechanical evaluation of length and diameter of dental implants using finite element analyses: A systematic review.

Background: With a wide range of dental implants currently used in clinical scenarios, evidence is limited on selecting the type of dental implant best suited to endure the biting force of missing teeth. Finite Element Analysis (FEA) is a reliable technology which has been applied in dental implantology to study the distribution of biomechanical stress within the bone and dental implants. Purpose: This study aimed to perform a systematic review to evaluate the biomechanical properties of dental implants regarding their length and diameter using FEA. Material and methods: A comprehensive search was performed in PubMed/MEDLINE, Scopus, Embase, and Web of Science for peer-reviewed studies published in English from October 2003 to October 2023. Data were organized based on the following topics: area, bone layers, type of bone, design of implant, implant material, diameter of implant, length of implant, stress units, type of loading, experimental validation, convergence analysis, boundary conditions, parts of Finite Element Model, stability factor, study variables, and main findings. The present study is registered in PROSPERO under number CRD42022382211. Results: The query yielded 852 results, of which 40 studies met the inclusion criteria and were selected in this study. The diameter and length of the dental implants were found to significantly influence the stress distribution in cortical and cancellous bone, respectively. Implant diameter was identified as a key factor in minimizing peri-implant stress concentrations and avoiding crestal overloading. In terms of stress reduction, implant length becomes increasingly important as bone density decreases. Conclusions: The diameter of dental implants is more important than implant length in reducing bone stress distribution and improving implant stability under both static and immediate loading conditions. Short implants with a larger diameter were found to generate lower stresses than longer implants with a smaller diameter. Other potential influential design factors including implant system, cantilever length, thread features, and abutment collar height should also be considered in future implant design as they may also have an impact on implant performance.

Applications of artificial intelligence for surgical extraction in stomatology: a systematic review.

OBJECTIVES: Artificial intelligence (AI) has been extensively used in the field of stomatology over the past several years. This study aimed to evaluate the effectiveness of AI-based models in the procedure, assessment, and treatment planning of surgical extraction. STUDY DESIGN: Following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, a comprehensive search was conducted on the Web of Science, PubMed/MEDLINE, Embase, and Scopus databases, covering English publications up to September 2023. Two reviewers performed the study selection and data extraction independently. Only original research studies utilizing AI in surgical extraction of stomatology were included. The Cochrane risk of bias tool for randomized trials (RoB 2) was selected to perform the quality assessment of the selected literature. RESULTS: From 2,336 retrieved references, 35 studies were deemed eligible. Among them, 28 researchers reported the pioneering role of AI in segmentation, classification, and detection, aligning with clinical needs. In addition, another 7 studies suggested promising results in tooth extraction decision-making, but further model refinement and validation were required. CONCLUSIONS: Integration of AI in stomatology surgical extraction has significantly progressed, enhancing decision-making accuracy. Combining and comparing algorithmic outcomes across studies is essential for determining optimal clinical applications in the future.

Influence of wearing mouthguards on performance among athletes: A systematic review.

OBJECTIVES: While the use of mouthguards is well established to prevent orofacial and dental trauma occurrence, limited evidence exists regarding their influence on athletic performance. The objective of this study was to conduct a systematic review of the literature to assess the effect of wearing mouthguards on athletic performance. DESIGN: Systematic review. METHODS: An extensive search was performed in the databases of PubMed/MEDLINE, Embase, Scopus and Cochrane Library for studies published up to August 2022. Only peer-reviewed studies involving humans in vivo and investigating the use of mouthguards on performance among athletes were included. Quality assessment was performed using the Cochrane Collaboration's risk of bias tool. RESULTS: The initial query yielded 4785 citations, of which 41 studies met the inclusion criteria, comprising a total of 852 athletes. Overall, wearing mouthguards was found to improve athletic performance compared to the control group (without mouthguards). Custom-made mouthguards were found to be more effective in enhancing athletic performance compared to other types of mouthguards. CONCLUSIONS: Wearing mouthguards should be advocated by athletes not only for the prevention of orofacial and dental trauma but also for their potential improvements in athletic performance in specific actions. However, caution must be exercised in interpreting these findings due to the variability in outcome measures and the lack of important methodological details.

Effectiveness of interventions to reduce aerosol generation in dental environments: A systematic review.

Certain dental procedures produce high levels of aerosols containing pathogenic microorganisms, posing a risk for the transmission of infections in dental settings. This study aimed to assess the effectiveness of various aerosol mitigation interventions during clinical dental procedures in real-world environments. A systematic literature search was conducted in PubMed/MEDLINE, Scopus, Web of Science, and Embase for English studies up to March 2023 according to the PRISMA guidelines. Only peer-reviewed controlled clinical trials (CCT) or randomized controlled trials (RCT) studies involving human subjects were included. The risk of bias of selected researches were evaluated by two independent authors using the Cochrane Collaboration tool. The literature search yielded 3491 articles, of which 42 studies met the inclusion criteria and were included in this study. Most studies evaluated bacterial contamination in bio-aerosols, while the viral and fungal contamination was assessed in only three studies. Overall, various approaches have been applied in reducing aerosol contamination in clinical scenarios, including high-volume evacuators (HVE), mouse rinses and rubber dams, air cleaning systems, and high-efficiency particulate air (HEPA) filters. The available evidence suggests that various aerosol mitigation strategies could be implemented to decrease the risk of cross-infection during clinical dental procedures in real-world environments. However, further clinical trials are necessary to establish statistical validity in measuring aerosol contamination and mitigation, as well as to evaluate the risk of infection transmission for viral and fungal contamination.

Accuracy of intraoral scanning versus conventional impressions for partial edentulous patients with maxillary defects.

This study aimed to evaluate the accuracy of digital dental impressions obtained by intraoral scanning (IOS) for partial edentulous patients with maxillary defects by comparing them with conventional impression techniques. Ten subjects underwent an experimental procedure where three ceramic blocks were affixed to the healthy palate mucosa. Digital dental impressions were captured using IOS and subsequently imported into software. Conventional impressions obtained by silicone rubber were also taken and scanned. Linear distance and best-fit algorithm measurements were performed using conventional impression techniques as the reference. Twenty impressions were analyzed, which included 30 pairs of linear distances and 10 best-fit algorithm measurements. Regarding linear distance, paired two-sample t-test demonstrated no significant differences between IOS and model scanning in groups A and C, whereas significant differences were found in group B (P < 0.05). Additionally, ANOVA revealed significant differences among the groups (P < 0.05). No significant differences were found for the best-fit algorithm measurement of the dentition. IOS can provide accurate impressions for partial edentulous patients with maxillary defects and its accuracy was found to be comparable with conventional impression techniques. A functional impression may be needed to ensure accurate reproduction of soft and hard tissues in defect or flap areas.