A longitudinal pilot study examining the influence of the orthodontic system chosen in adult patients (brackets versus aligners) on oral health-related quality of life and anxiety.

BACKGROUND: In recent years, the demand for orthodontic treatment with aligners has increased, led by patient need, as aligners typically provide them with improved aesthetics and less physical discomfort. In deciding with the patient on an appropriate orthodontic system, it is important to take into account the potential discomfort and the perceptions that patients have in relation to their treatment. The objective of this study was to analyze the influence of brackets or aligners on oral health-related quality of life (OHRQoL) and anxiety levels in a sample of adult patients during the first month of treatment. METHODS: The pilot study was carried out at the Dental Clinic of the University of Salamanca between November 2023 and February 2024. Eighty adult patients who initiated orthodontic treatment were selected and divided into two groups: the brackets group (Victory®; 3 M Unitek, California, USA) (n = 40) and the aligners group (Invisalign®; Align Technology, California, USA) (n = 40). OHRQoL was analyzed using the Oral Health Impact Profile-14 (OHIP-14) questionnaire, and anxiety was analyzed using the State-Trait Anxiety Inventory (STAI). The follow-up time was one month, with scores recorded at the beginning (T0) and one month after starting treatment (T1). RESULTS: The mean patient age was 33.70 (± 5.45) years old. The total sample (n = 80) consisted of 66.2% men and 33.8% women. In the brackets group, one month after starting treatment, the dimension with the highest impact was that of physical pain (5.62 ± 1.51). In the aligners group, where the dimension of psychological disability had the highest score (4.22 ± 1.02). In the brackets group the total OHIP score was higher at one month (T1) (33.98 ± 6.81) than at the start of treatment (T0) (21.80 ± 3.34); this greater impact on OHRQoL one month after starting treatment was not observed in the aligners group (T1 = 27.33 ± 6.83; T0 = 27.33 ± 6.22). The orthodontic system used did not influence participants' anxiety (p > 0.05). Age and sex were not influential factors in either OHRQoL or anxiety. CONCLUSIONS: The bracket system significantly influenced patients' OHRQoL. In the sample studied, no influence of the orthodontic system (brackets versus aligners) on anxiety was observed.

Effect of a single-component ceramic conditioner on shear bond strength of precoated brackets to different CAD/CAM materials.

OBJECTIVES: To compare the shear bond strength (SBS) of the CAD/CAM material-bracket interface using three surface treatments: following manufacturers' instructions (MI), Monobond Etch & Prime (MEP) and 9.6% hydrofluoric acid plus silane (9.6% HF), after 24 h of water storage (24 h) and 10,000 cycles of thermocycling (TC). MATERIALS AND METHODS: A total of 126 crowns with four identical buccal surfaces were fabricated using seven different CAD/CAM materials: CEREC Blocs unglazed (CBU), CEREC Blocs glazed (CBG), IPS Empress CAD (EMP), IPS e.max CAD (EMA), VITA SUPRINITY PC (SUP), inCoris TZI (TZI) and VITA ENAMIC (ENA). A total of 504 APC Flash-Free (APC FF)-precoated brackets were bonded applying three surface treatments: (1) MI; (2) MEP and (3) 9.6% HF. SBS was performed after 24 h and TC. Results were analyzed by Kruskal-Wallis and Mann-Whitney U tests (p < 0.05). RESULTS: MEP conditioning yielded lower SBS results compared with MI and 9.6% HF for CBG (24 h and TC) and EMA (TC) materials. EMP conditioning with MEP after 24 h obtained lower SBS values compared with MI; however, after TC, SBS was similar to MI group and higher than with 9.6% HF. After TC for TZI ceramic, MI protocol (sandblasting) obtained higher SBS scores than MEP, but similar than 9.6% HF. Treatment of ENA with MI and MEP produced higher results than 9.6% HF after TC. SBS results were similar for CBU and SUP, regardless of the treatment. CONCLUSIONS: Although each CAD/CAM material requires specific surface treatment to obtain the highest SBS of APC FF brackets, the treatment with MEP is a valid orthodontic alternative for most of the materials tested. TC significantly decreased SBS for most of the materials. CLINICAL RELEVANCE: MEP can be considered a valid and promising product to condition most of the CAD/CAM ceramics evaluated for APC FF bracket bonding purposes, allowing a faster and safer procedure.

The Influence of Friction on Design of the Type of Bracket and Its Relation to OHRQoL in Patients Who Use Multi-Bracket Appliances: A Randomized Clinical Trial.

Background and objectives: The aim of this study was to evaluate the influence of friction on design of the type of bracket, patients' perception of pain and the impact on their oral health-related quality of life. Materials and Methods: A randomized clinical trial was carried out with 90 patients (62.2% women and 37.8% men) with three kinds of fixed multi-bracket appliances: Conventional (GC), fixed multi-bracket low friction (GS) and self-ligating (GA). The VAS (Visual Analogue Scale) was used to determine pain during the first seven days of treatment at different points in time. The patients were also given the OHIP-14 (Oral Health Impact Profile) questionnaire to analyse their oral health-related quality of life (OHRQoL) after the first 30 days of treatment. The ANOVA test was used for the analysis of the variables and the post hoc Bonferroni test for the comparison between groups. Results: Maximum pain was observed between one and two days after the start of treatment. The GC group showed the greatest degree of pain, with maximum values (4.5 ± 2.0) at 24 h. The self-ligation brackets show lower impact on patients' oral health-related quality of life (0.8 ± 2.2, p < 0.01). Conclusions: Friction in the type of bracket influences pain and the Oral Health-Related Quality of Life of patients who use multi-bracket fixed orthodontics.

Femtosecond laser settings for optimal bracket bonding to zirconia.

Bonding orthodontic brackets to ceramic materials is a challenging procedure; femtosecond (FS) laser conditioning could provide improved results, but the ideal settings for effective bracket-zirconia bonding have never been established. This study aimed to analyze the differences in surface roughness and shear bond strength (SBS) produced by different femtosecond laser settings and establish a protocol to prepare zirconia surfaces for optimal adhesion to metal orthodontic brackets. One hundred eighty zirconia samples were assigned to six groups according to surface treatment: (1) control; (2) air-particle abrasion (APA); (3) FS laser irradiation (300 mW output power, 60 µm inter-groove distance); (4) FS laser irradiation (200 mW, 100 µm); (5) FS laser irradiation (40 mW, 60 µm); and (6) FS laser irradiation (200 mW, 60 µm). Surface roughness was measured. Orthodontic brackets were bonded to the zirconia specimens, and SBS was measured. SBS in groups 3 and 6 was significantly higher than the other groups (5.92 ± 1.12 MPa and 5.68 ± 0.94 MPa). No significant differences were found between groups 1, 2, 4, and 5 (3.87 ± 0.77 MPa, 4.25 ± 0.51 MPa, 3.74 ± 0.10 MPa, and 3.91 ± 0.53 MPa). Surface roughness was significantly greater for FS laser than for control and APA groups (p = 1.28 × 10-8). FS laser at 200 mW, 60 µm can be recommended as the ideal settings for treating zirconia surfaces, producing good SBS and more economical energy use.

Influence of cyclic loading on the adhesive effectiveness of resin-zirconia interface after femtosecond laser irradiation and conventional surface treatments.

BACKGROUND AND OBJECTIVE: The aim of this study was to evaluate the influence of cyclic loading on the shear bond strength (SBS) of a self-adhesive resin cement to zirconia surfaces after femtosecond laser irradiation at different steps and several conventional surface treatments. MATERIALS AND METHODS: One hundred fifty square-shaped zirconia samples were divided into five groups according their surface treatment: NT Group-no surface treatment; APA25 Group-airborne abrasion with 25 µm alumina particles; TSC Group-tribochemical silica coating; FS20 Group-femtosecond laser irradiation (800 nm, 4 mJ, 40 fs/pulse, 1 kHz, step 20); and FS40 Group-femtosecond laser irradiation (same parameters except step 40). Self-adhesive resin cement cylinders were bonded at the centre of the zirconia surface. For each experimental group, half of the specimens were subject to cyclic loading under 90 N (50.000 cycles, 3 cycles/sec) and the rest of the specimens were stored in distilled water at 37°C. All subgroups were tested for SBS with a universal testing machine at a crosshead speed of 0.5 mm/min, until fracture. The results were analyzed statistically. RESULTS: When cyclic loading was applied, all surface treatments had lower SBS values, except APA25. The four surface treatments had the same SBS values when cyclic loading was employed. CONCLUSIONS: Use of femtosecond laser irradiation could be an alternative to conventional surface treatments to achieve suitable adhesion zirconia and resin cements. Femtosecond laser irradiation at step 40 is preferable because it is more efficient and faster.

Oral health-related quality of life in 6- to 12-year-old schoolchildren in Spain.

BACKGROUND: There is a lack of large epidemiological studies researching the major factors of the oral well-being in schoolchildren. AIMS: To quantify the impact of the different clinical conditions related to caries and periodontal and dento-facial anomalies on the quality of life captured by the Child-OIDP. DESIGN: A standardized epidemiological study was conducted on 2041 Spanish schoolchildren, aged 6-12 years, to assess caries and periodontal and dento-facial disease. Data on oral health-related quality of life were collected using the Child-OIDP. Bivariate and multivariate analyses were performed to evaluate the modulating factors in the perceived oral well-being. RESULTS: The prevalence of impact in this sample was 45.7%, mostly for eating (24.3%) but also for smiling (16.2%); however, 72.5% of the subjects had at least one type of normative needs, mainly for periodontal treatment (52.3%), followed by caries (32.3%) and orthodontic treatments (20.6%). The main predictors of the impact on quality of life were perceived dental treatment needs, caries, and periodontal diseases. Also, some demographic (age and gender) and behavioural factors (consumption of sweets) modulated the impact on several domains. Moreover, subjects who rated their general health as good or very good reported a significantly better oral well-being than their counterparts. CONCLUSIONS: Pain and aesthetic-related domains (i.e., problems when eating or smiling) are the major components of the oral health-related quality of life perceived by Spanish schoolchildren. Perceived treatment needs as well as dental and periodontal status were the strongest predictors of oral well-being.

Thermocycling effect on microshear bond strength to zirconia ceramic using Er:YAG and tribochemical silica coating as surface conditioning.

The purpose of this study is to evaluate the thermocycling effect on the microshear bond strength (µSBS) of different self-adhesive resin cements to zirconia using tribochemical silica coating Rocatec™ (ROC) and Er:YAG as surface conditioners. Two hundred forty square-like zirconia samples were polished and randomly assigned in four groups according surface treatment applied as follows: (1) no treatment (NT), (2) silica coating with ROC, 3) Er:YAG laser irradiation (LAS: 2.940 nm, 200 mJ; 10 Hz), and (4) laser followed by Rocatec™ (LAROC). Each group was divided into two subgroups according the resin tested as follows: (A) BiFix SE (BIF) and (B) Clearfil SA (CLE). After 24 h, half of the specimens from each subgroup were tested. The other half was stored and thermocycled (5-55 °C/5,000 cycles). A µSBS test was performed using a universal testing machine (cross head speed = 0.5 mm/min). Failure modes were recorded and observed by scanning electronic microscopy. Data was analyzed with ANOVA, Student's t test, and chi-square tests, and linear regression was performed (p < 0.05). Before thermocycling, both cements showed higher µSBS results with ROC and LAROC. After aging, (1) all BIF specimens evidenced severely decreased adhesion with mostly adhesive failures and (2) CLE maintained the initial results in ROC and LAROC groups, performing better with ROC. Thermocycling did not negatively influence the resin-zirconia µSBS results in the self-adhesive resin cement containing 10-MDP when used on zirconia surface coated with silica, independently of previous Er:YAG surface treatment.

Influence of the usual motivation for dental attendance on dental status and oral health-related quality of life.

OBJECTIVES: To evaluate the influence of dental visiting patterns on the dental status and Oral Health-related Quality of Life (OHQoL) of patients visiting the University Clinic of Salamanca (Spain). STUDY DESIGN: This cross-sectional study consisted of a clinical oral examination and a questionnaire-based interviewin a consecutive sample of patients seeking a dental examination. Patients were classified as problem-based dental attendees(PB) and regular dental attendees(RB). Clinical and OHQoL(OHIP-14 & OIDP)data were compared betweengroups. Pair-wise comparisons were performed and a Logistic Regression Model was fitted for predicting the Odds Ratio (OR) of being a PB patient. RESULTS: The sample was composed of 255 patients aged 18 to 87 years (mean age: 63.1 ± 12.7; women: 51.8%). The PB patients had a poorer dental status (i.e. caries, periodontal and prosthetic needs), brushed their teethless,and were significantly more impaired in their OHQoL according to both instruments.The logistic regression coefficients demonstrated that on average the OR of being a PB patient was high in this dental patient sample, but this OR increased significantly if the patient was a male (OR= 1.1-5.0) or referred pain-related impacts according to the OHIP and, additionally, the OR decreased significantly as a function of the number of healthy fillings and the number of sextants coded as CPI=0. CONCLUSIONS: Regular dental check-ups are associated with better dental status and a better OHQoL after controlling for potentially related confounding factors.

Accuracy in the legal age estimation according to the third molars mineralization among Mexicans and Columbians.

OBJECTIVES: This study aims to assess the accuracy of age estimation according to two cut-off points of Demirjian's developmental stages (G and H) in the wisdom teeth, using panoramic radiographs from Colombian and Mexican teenagers. STUDY DESIGN: The degree of maturation of the third molars was classified according to Demirjian in 8 stages (from A to H) by a blinded trained assessor. The sensitivity, specificity and efficacy of two cut-off points (G and H) were calculated for both samples. RESULTS: The orthopantomographies of 316 subjects, 171 Colombians (54.1%) and 145 Mexicans (45.9%), were analyzed. The stage H was found to be the best threshold for detecting juveniles (because the high specificity) in all the third molars assessed. The specificity was higher for lower third molars than for upper third molars, but no asymmetrical discrepancy was noted. CONCLUSIONS: The stage H is the best cut-off point for detecting the adulthood when a high-specificity test is required.

A pilot study analyzing the influence of the material and the size of the orthodontic archwire on the level of pain and anxiety in adult patients in treatment with brackets: A prospective triple-blind randomized clinical trial.

Background: The objective was to investigate the influence of the material and dimensions of the orthodontic archwire on the pain and anxiety in adult patients in orthodontic treatment with brackets. Material and Methods: A randomized prospective triple-blind clinical pilot study was conducted at the Dental Clinic of the University of Salamanca. The study sample comprised 30 adult patients who started orthodontic treatment with brackets. This sample was divided into two groups: the NiTi group (n=15) and Cu-NiTi group (n=15). Pain was analyzed with a visual analogue scale (VAS) and anxiety with the State-Trait Anxiety Inventory (STAI). Anxiety was assessed at the start of treatment (T0) and after one month (T1). Pain was analyzed at the start of treatment (T0), at different time points at the start (T01), and after 4 (T02), 24 (T03), and 48 hours (T04); these measurements were also recorded one month after starting orthodontic treatment (T11, T12, T13, and T14). Results: The mean age of patients was 31.3 (± 6.05) years old. The highest level of pain, at the beginning of treatment, was observed after 48 hours (5.57 ± 1.72) and at one month after starting treatment at 24 hours (5.13 ± 1.89), with no significant differences between the two groups. When analyzing anxiety, no differences were observed between groups; the anxiety levels were higher one month after starting treatment compared to the start. Regarding the correlation between pain and anxiety, the NiTi group showed a greater direct relationship (<0.05) between these two variables at the start of treatment in the anxiety trait in relation to pain at T02 and T03 and after a month in T12, T13, and T14. Conclusions: In the sample studied, there was no significant influence of the size or material of the orthodontic archwire on pain and anxiety levels. Key words:Orthodontics, Brackets, Archwire, Pain, Anxiety, NiTi, Cu-NiTi.

Intraoral Soft Tissue Lesions in 6-Year-Old Schoolchildren in Regions of Southern Ecuador: An Epidemiological Study.

Oral Mucosal Lesions (OMLs) are conditions of the oral mucosa that cause alterations in their presentation and pain in the affected patient, highlighting their importance for study. The aim of this research is to determine the prevalence of oral lesions in the Ecuadorian Austro. Descriptive statistics were used to associate variables, yielding statistically significant findings based on oral lesions, sex, and geographical environment. This study was conducted under the appropriate bioethical permissions. The results obtained correspond to the prevalence of lesions by province. Morona Santiago displays a rate of 17% for abscesses, surpassing the provinces of Azuay (13.50%) and Cañar (10.67%). However, gingivitis for pathology, Azuay stands out with 13.17%, while Cañar and Morona Santiago present 10.50% and 8.33%, respectively. There is also a predominant occurrence of abscesses in rural areas (41.17%) compared to urban ones (26.33%). Regarding sex, girls show a higher percentage of abscesses (41.17%) compared to boys who have a clear tendency to present GUM lesions (22.33%). The data indicates that in the studied provinces, geographical environment and sex are key variables to understand the distribution of oral lesions. These findings encourage us to continue pursuing this type of research, which contributes to improving the quality of life for children.

Potential Association of Molar-Incisor Hypomineralization (MIH) with Dental Agenesis and Infraoccluded Deciduous Molars: Is MIH Related to Dental Anomaly Pattern (DAP)? An Observational Cross-Sectional Study.

Background: Dental Anomaly Pattern (DAP) is a collection of morphologic, numeric, and eruptive anomalies of teeth that are often observed together, suggesting a potential genetic relationship. Our objective was to assess the potential associations of Molar-Incisor Hypomineralization (MIH), a common developmental defect of enamel mineralization with a controversial etiology, with two specific components of DAP: (1) agenesis (AG) and (2) infraoccluded deciduous molars (IODM). Establishing such an association between MIH and one or both anomalies would provide evidence supporting a genetic link between MIH and DAP. Methods: We examined pretreatment intraoral standardized photographies and panoramic radiographs from 574 children aged 8-14 years, 287 having MIH and 287 without MIH, comparing the frequencies of AG and IODM in both groups. The subject samples were sourced from the databases of the orthodontic department at a university hospital. Results: The frequencies of AG in the MIH and non-MIH groups were 7% and 8%, respectively (p = 0.751). The corresponding frequencies of IODM were 27% and 19.2%, respectively (p = 0.082). That is, children with MIH did not exhibit an increased frequency of AG or IODM compared to those without MIH. Conclusions: These findings do not support the inclusion of MIH in DAP. Nevertheless, further analysis of possible associations is necessary to definitively validate or invalidate this hypothesis.

Curricula for the teaching of complete dentures in Spanish and Portuguese dental schools.

OBJECTIVES: Given the need to ensure that dentists are sufficiently skilled to offer the best possible care to their patients, this study aims to evaluate the teaching methods and clinical experience achieved by undergraduate dental students in Spain and Portugal as regards complete dentures. STUDY DESIGN: In February 2011, a questionnaire seeking information about the preclinical and clinical teaching of complete dentures was e-mailed to all Spanish and Portuguese dental schools with fully developed undergraduate degree dental programs. RESULTS: A response rate of 82.6% was obtained. The distribution of lectures and hours spent at the laboratory and in clinical activities revealed that teaching complete dentures is eminently a practical issue, this being mostly performed by full-time prosthodontists. All surveyed schools teach the design of the record base, and most of them instruct students in the mounting of teeth in wax. Most schools (94.7%) used a semiadjustable articulator, alginate for primary impressions (73.7%) and elastomeric materials in border-molded custom trays for final impressions (68.4%). In most schools, within the clinical setting students work in pairs, the mean student/ professional staff member ratio being 2.3 ± 0.7. Most schools perform a competence-based assessment (83.3%), although innovative techniques such as problem-based learning are still rarely applied. On average, the students emplaced 1.8 ± 1.2 complete dentures during their clinical training, ranging from 0 to 4, although no clear trend was seen as regards the minimum number of dentures to be made for graduating. CONCLUSIONS: Variations in teaching programs and clinical experience concerning complete denture curricula among Spanish and Portuguese dental schools are evident, but all the schools base their teaching mainly on preclinical and clinical practice. However, the low number of dentures made by student per year seems insufficient to ensure clinical skills and cope with social needs.

Assessment of Orthodontic Treatment Need and Oral Health-Related Quality of Life in Asthmatic Children Aged 11 to 14 Years Old: A Cross-Sectional Study.

This study investigated the need for orthodontic treatment in asthmatic children aged 11 to 14 years and how the treatment affected their oral health-related quality of life (OHRQoL). MATERIALS AND METHODS: This cross-sectional study was conducted at the dental clinic of the University of Salamanca in 2020-2022. The study selected a consecutive sample of 140 children with asthma (52.1% girls; 47.9% boys). This study used the Orthodontic Treatment Needs Index (OTN) to analyze the need for orthodontic treatment and the Children's Perception Questionnaire (CPQ11-14) to assess OHRQoL. RESULTS: Sex and age did not significantly influence the need for orthodontic treatment, although age may be considered influential for OHRQoL concerning oral symptoms (p < 0.01), functional limitations (p < 0.05), and total score on the CPQ11-14 questionnaire (p < 0.05): the younger the age, the greater the effect of the need for orthodontic treatment on OHRQoL. The social well-being of the patients was much more significantly impacted by the need for orthodontic treatment (15.7 ± 1.91) than by oral symptoms (7.64 ± 1.39), which were the least impacted. In all parts of the CPQ11-14 questionnaire and in the patients' total scores, we observed significant agreement (p < 0.01) that treatment influenced OHRQoL. CONCLUSION: An inverse relationship exists between the severity of the treatment needed and OHRQoL.

Predictive Value of Hypomineralization of Second Primary Molars for Molar Incisor Hypomineralization and Other Relationships between Both Developmental Defects of Dental Enamel.

Molar incisor hypomineralization (MIH) and hypomineralized second primary molars (HSPM) are dental enamel developmental defects with significant prevalence and psychophysical impact, posing a public health concern. We examined the relationship between HSPM and MIH in 426 children aged 7 to 10 years (213 with MIH, 213 without MIH). The frequency of HSPM was higher in children with MIH (37.1% vs. 11.3%, p < 0.001). However, there was no correlation between MIH severity and presence of HSPM (p = 0.296). In patients with both defects (n = 79), 90% of severe MIH cases were associated with severe HSPM, while 87.8% of mild MIH cases were associated with mild HSPM (p < 0.001). The involvement of permanent incisors by MIH was not influenced by the presence of HSPM or HSPM severity. HSPM exhibited a positive predictive value of 76.7, negative predictive value of 58.8, sensitivity of 37.1% (95% CI = 30.6-43.6%), and specificity of 88.7% (95% CI = 84.5-93%). The odds ratio for MIH based on HSPM was 4.64 (95% CI). HSPM may serve as a predictor of MIH, but its absence does not rule out the occurrence of MIH. The results highlight the need for surveillance programs in children presenting with HSPM to facilitate early diagnosis and preventive measures for MIH-related complications.

Cross-Bite and Oral-Health-Related Quality of Life (OHRQoL) in Preadolescents Aged 11 to 14 Years Old: A Pilot Case-Control Study.

INTRODUCTION: Malocclusions have a negative impact on oral-health-related quality of life (OHRQoL). Posterior cross-bite is one of the most prevalent malocclusions in the preadolescent population. This study investigated the influence of posterior cross-bites (unilateral or bilateral) on OHRQoL in an 11- to 14-year-old population. MATERIALS AND METHODS: A pilot case-control study was carried out at the Dental Clinic of the University of Salamanca between 2021 and 2023. A consecutive sample of 120 preadolescent patients aged 11 to 14 years old was recruited. Three groups were analyzed: a control group (no posterior cross-bite) (n = 40), a group with unilateral posterior cross-bite (n = 40), and a group with bilateral posterior cross-bite (n = 40). To analyze the OHRQoL, the Spanish version of the Child Perception Questionnaire (CPQ-Esp11-14) was used. RESULTS: The mean age of the sample was 12.2 years old (±0.96 years). The group of patients with a bilateral posterior cross-bite was shown to have higher scores in all dimensions of the CPQ-Esp11-14, as well as a higher total score. Sex only influenced the oral symptom dimension of the CPQ-Esp11-14 questionnaire; in this dimension, the girls described a greater impact. Age did not influence OHRQoL. CONCLUSION: The presence of a posterior cross-bite had a negative impact on OHRQoL in the preadolescent population that was studied.

Comparison of screening methods for obstructive sleep apnea in the context of dental clinics: A systematic review.

OBJECTIVE: To review the available bibliographic data to identify the best screening methods to detect potential obstructive sleep apnea (OSA) patients during dental clinical practice. METHODS: Relevant studies published up to April 2020 were sourced from PubMed, Embase, MEDLINE, Cochrane, and LILACS databases. RESULTS: Thirty studies were selected. For adults, the screening methods available to the dentist included questionnaires, scales, indexes, pulse oximetry, and anatomical factors. A combination of questionnaires is potentially the most reliable method to detect OSA risk. For children, only information on questionnaires and anatomical factors was found; two questionnaires accurately identified potential OSA risk cases. Anatomical factors also displayed a significant relation with OSA for both populations. CONCLUSION: Dentists have a fundamental role in early detection of potential OSA cases since they can use the methods identified in this review to perform an initial screening of the population. ABBREVIATIONS: OSA: Obstructive sleep apnea; PSG: Polysomnography; HST: Home sleep study; BMI: Body mass index; PPV: Positive predictive value; NPV: Negative predictive value; AHI: Apnea hypopnea index; RDI: Respiratory disturbance index; ODI: Oxygen desaturation index; PSQ: Pediatric Sleep Questionnaire; SRBD: Sleep-related breathing disorder; CSHQ: Children's Sleep Habits Questionnaire; ESS: Epworth Sleepiness Scale; PSQI: Pittsburgh Sleep Quality Index.

Morphological alterations in dentine after mechanical treatment and ultrashort pulse laser irradiation.

The aim of this study was to evaluate and compare the morphological changes that occur in dentine after femtosecond laser irradiation and after mechanical treatment. The duration of the laser pulse is an important parameter, because within the time frame of the pulse heat diffusion plays a very important role in the mechanism of interaction between the light and the tissue. Six totally impacted human third molars were sectioned into sheets approximately 1 mm thick with an Accutom-50 precision cutting machine. The samples were randomly divided into two groups according to their cavity preparation: mechanical cavity preparation and laser cavity preparation. The samples were then examined by light microscopy and scanning electron microscopy. There were clear differences in the results obtained with the two techniques. Cavities prepared with the laser with pulses of <1 ps showed no microcracks, and the treated surface displayed a rough and irregular aspect with no smear layer and exhibited open dentinal tubules. On the contrary, cavities made with a rotatory instrument had a smooth surface and microcracks, a broad area of carbonization and merging, occluded dentinal tubules and a smear layer. This study showed that human dentine can be successfully ablated with the ultrashort pulse laser.

Evaluation of fit of cement-retained implant-supported 3-unit structures fabricated with direct metal laser sintering and vacuum casting techniques.

This study evaluated the vertical discrepancy of implant-fixed 3-unit structures. Frameworks were constructed with laser-sintered Co-Cr, and vacuum-cast Co-Cr, Ni-Cr-Ti, and Pd-Au. Samples of each alloy group were randomly luted in standard fashion using resin-modified glass-ionomer, self-adhesive, and acrylic/urethane-based cements (n = 12 each). Discrepancies were SEM analyzed. Three-way ANOVA and Student-Newman-Keuls tests were run (P < 0.05). Laser-sintered structures achieved the best fit per cement tested. Within each alloy group, resin-modified glass-ionomer and acrylic/urethane-based cements produced comparably lower discrepancies than the self-adhesive agent. The abutment position did not yield significant differences. All misfit values could be considered clinically acceptable.

Vertical misfit of laser-sintered and vacuum-cast implant-supported crown copings luted with definitive and temporary luting agents.

OBJECTIVES: This study aimed to evaluate the vertical discrepancy of implant-supported crown structures constructed with vacuum-casting and Direct Metal Laser Sintering (DMLS) technologies, and luted with different cement types. STUDY DESIGN: Crown copings were fabricated using: (1) direct metal laser sintered Co-Cr (LS); (2) vacuum-cast Co-Cr (CC); and (3) vacuum-cast Ti (CT). Frameworks were luted onto machined implant abutments under constant seating pressure. Each alloy group was randomly divided into 5 subgroups (n = 10 each) according to the cement system utilized: Subgroup 1 (KC) used resin-modified glass-ionomer Ketac Cem Plus; Subgroup 2 (PF) used Panavia F 2.0 dual-cure resin cement; Subgroup 3 (RXU) used RelyX Unicem 2 Automix self-adhesive dual-cure resin cement; Subgroup 4 (PIC) used acrylic/urethane-based temporary Premier Implant Cement; and Subgroup 5 (DT) used acrylic/urethane-based temporary DentoTemp cement. Vertical misfit was measured by scanning electron microscopy (SEM). Two-way ANOVA and Student-Newman-Keuls tests were run to investigate the effect of alloy/fabrication technique, and cement type on vertical misfit. The statistical significance was set at α = 0.05. RESULTS: The alloy/manufacturing technique and the luting cement affected the vertical discrepancy (p < 0.001). For each cement type, LS samples exhibited the best fit (p < 0.01) whereas CC and CT frames were statistically similar. Within each alloy group, PF and RXU provided comparably greater discrepancies than KC, PIC, and DT, which showed no differences. CONCLUSIONS: Laser sintering may be an alternative to vacuum-casting of base metals to obtain passive-fitting implant-supported crown copings. The best marginal adaptation corresponded to laser sintered structures luted with glass-ionomer KC, or temporary PIC or DT cements. The highest discrepancies were recorded for Co-Cr and Ti cast frameworks bonded with PF or RXU resinous agents. All groups were within the clinically acceptable misfit range.