Mechanical Properties of Orthodontic Cements and Their Behavior in Acidic Environments.

The present research is focused on three different classes of orthodontic cements: resin composites (e.g., BracePaste); resin-modified glass ionomer RMGIC (e.g., Fuji Ortho) and resin cement (e.g., Transbond). Their mechanical properties such as compressive strength, diametral tensile strength and flexural strength were correlated with the samples' microstructures, liquid absorption, and solubility in liquid. The results show that the best compressive (100 MPa) and flexural strength (75 Mpa) was obtained by BracePaste and the best diametral tensile strength was obtained by Transbond (230 MPa). The lowestvalues were obtained by Fuji Ortho RMGIC. The elastic modulus is relatively high around 14 GPa for BracePaste, and Fuji Ortho and Transbond have only 7 GPa. The samples were also subjected to artificial saliva and tested in different acidic environments such as Coca-Cola and Red Bull. Their absorption and solubility were investigated at different times ranging from 1 day to 21 days. Fuji Ortho presents the highest liquid absorption followed by Transbond, the artificial saliva has the best absorption and Red Bull has the lowest absorption. The best resistance to the liquids was obtained by BracePaste in all environments. Coca-Cola presents values four times greater than the ones observed for artificial saliva. Solubility tests show that BracePaste is more soluble in artificial saliva, and Fuji Ortho and Transbond are more soluble in Red Bull and Coca-Cola. Scanning electron microscopy (SEM) images evidenced a compact structure for BracePaste in all environments sustaining the lower liquid absorption values. Fuji Ortho and Transbond present a fissure network allowing the liquid to carry out in-depth penetration of materials. SEM observations are in good agreement with the atomic force microscopy (AFM) results. The surface roughness decreases with the acidity increasing for BracePaste meanwhile it increases with the acidity for Fuji Ortho and Transbond. In conclusion: BracePaste is recommended for long-term orthodontic treatment for patients who regularly consume acidic beverages, Fuji Ortho is recommended for short-term orthodontic treatment for patients who regularly consume acidic beverages and Transbond is recommended for orthodontic treatment over an average time period for patients who do not regularly consume acidic beverages.

A Systematic Analysis of the Available Human Clinical Studies of Dental Implant Failure in Patients with Inflammatory Bowel Disease.

Background and objectives: The aim was to evaluate the current literature on the influence of inflammatory bowel disease (ulcerative colitis/Crohn's disease) in dental implant osseointegration in human clinical studies. Materials and methods: This review was conducted under the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. PubMed, Scopus, and Web of Science databases were electronic screened to find relevant articles published until October 2021. The inclusion criteria consisted of human clinical studies that reported the use of dental implant in patients diagnosed with inflammatory bowel disease. Risk of bias was assessed according to The Strengthening the Reporting of Observational studies in Epidemiology criteria. Results: A total of 786 studies were identified from databases. Of these, six studies were included in the review and reported the use of implants in patients with Crohn's disease. No articles were available for ulcerative colitis. Included articles indicated that Crohn's disease may determine early and late implant failure. Besides Crohn's disease, several patients presented associated risk factors and systemic disease that determined implant failure. Conclusions: The presence of clinical studies on the influence of IBD in implant therapy is low. When recommending an implant therapy to IBD patients, the multidisciplinary team should be aware of side effects and a close collaboration between members of this team is necessary. More data are needed to sustain the effect of IBD on implant therapy.

The Use of Laser Energy for Etching Enamel Surfaces in Dentistry-A Scoping Review.

BACKGROUND: In dental practice, different situations require etching the enamel layer. Acid etching, the present golden standard, may be replaced by other methods, such as laser etching. The main focus of our scoping review is to assess the existent literature regarding the effectiveness of different types of lasers, to identify the main aspects studied so far, and to understand where new search strategies are needed. METHODS: The search was conducted in several databases focusing on the laser etching of human definitive enamel. We included English language articles published between January 2000 and December 2021. RESULTS: The 34 articles reviewed showed that hard lasers, Er:YAG, Er,Cr:YAG, may represent an alternative etching method on enamel surfaces. They create a fractured, irregular surface and open dentin tubules, highly suitable for adhesion but with a lower risk of cavity formation. Nd:YAG, CO2, and Diode lasers do not help in creating sufficient shear bond strength. There is, however, evidence suggesting that microcracks in the enamel layer may appear after thermomechanical ablation using laser energy. CONCLUSIONS: While the use of acid etching is still successfully used for enamel conditioning, some researchers have emphasized the role played by saliva in the enamel-remineralization process a few days after the procedure. In this context, laser energy can be used, especially for bonding ceramic brackets in the case of orthodontic treatments. However, as thermomechanical ablation can generate microcracks, further research is required in order to establish clear findings concerning the use of laser energy on enamel etching.

Vitamin D and Temporomandibular Disorders: What Do We Know So Far?

BACKGROUND AND AIMS: Vitamin D is synthesized in the skin with the aid of ultraviolet-B radiation, playing a variety of roles in the body. Temporomandibular disorders (TMDs) are a group of pathological conditions involving the temporomandibular joints as well as the masticatory muscles and othersurrounding tissues. In the present narrative review, we investigated the potential role of vitamin D in the etiology of temporomandibular disorders in order todetermine whether the current knowledge supports 25-hidroxyvitamin D (25-OHD) supplementation in temporomandibular disorders associated with insufficient or deficient levels of vitamin D. METHODS: A literature research was performed in PubMed, Scopus, Science Direct, and Google Scholar databases, and a total of 10 articles were included for analysis. RESULTS: Among the observational studies published to date, investigating the role for vitamin D in the etiology of TMDs, six of them suggest that there is a connection between the two aspects. In this context, patients suffering from TMD, with deficient levels of vitamin D (<30 ng/mL), are most likely to benefit from supplementation, whereas individuals with vitamin D level >50ng/mL probably have little benefit from supplementation. CONCLUSION: Vitamin D might be a safe, simple, and potentially beneficial way to prevent TMDs or to reduce pain; however, more randomized and placebo-controlled trials are required before any firm conclusions can be drawn.

Orthodontic Attachment Adhesion to Ceramic Surfaces.

Ceramic materials are constantly evolving, achieving good functionality and aesthetics. Bonding to ceramics may be difficult because of high toxicity procedures and risk of surface damage. The review aims to answer several research questions: Is there a golden standard for bonding to ceramic? Are there adhesives or types of photopolymerization lamps that produce a higher bond strength on certain types of ceramics rather than others? Articles focusing on the bonding process of orthodontic attachments to ceramic surfaces searched in Pubmed, Medline and Embase, published between 1990 and 2018 were revised. Exclusions concerned bonding to non-ceramic surfaces, bonding to ceramic surfaces that are not destined for orthodontics or laser usage. Forty-nine articles that matched the inclusion criteria were researched. The following categories of original research articles were compared and discussed: metallic brackets bonding to ceramic surfaces, ceramic brackets to ceramic surfaces, bonding to new types of ceramics, such as zirconia, lithium disilicate, different photopolymerisation devices used on bonding to ceramics. Some types of adhesive may achieve minimal bond strength (6-8 MPa) even on glazed ceramic. Ceramic surface preparation may be done by sandblasting or hydrofluoric acid (60s application and 9.6%) with generally similar results. Studies rarely show any statistical difference and there are reduced number of samples in most studies. Ceramic brackets show better adhesion to ceramic surfaces and the same bonding protocol is advised. A higher bond strength may lead to ceramic surface. Few studies focus on newer types of ceramics; additional research is necessary. There is no clear evidence that a certain type of photopolymerization device produces higher shear bond strength values.

Psycho-social impact of orthodontic treatment in Romanian teenagers and young adults.

BACKGROUND AND AIMS: This survey evaluated the psycho-social impact of oral health on the quality of life in Romanian teenage and young adult orthodontic patients. METHODS: Of the 300 standard questionnaires distributed in four dental offices, 125 questionnaires were returned. Each questionnaire contained 110 items, focusing on aspects like patients' satisfaction, self-confidence, school/work performances and aesthetic concern, in relation to oral health. The patients were 16-25 years of age and all were undergoing or had undergone orthodontic treatment in the previous two years. Data analysis was performed using the Statistical Package for the Social Science software (SPSS), version 19.0. RESULTS: 57.90% of the orthodontic patients participating in this study were happy about their dental status, 56.52% declared themselves not shy because of their oral health issues, 52.33% considered themselves as attractive to other people, and 57.29% replied (awarding a score between 8 and 10) that they were confident when smiling. Regarding self-confidence and school/work performances, 58% of the participants declared they avoided speaking in public because of the aspect of their teeth and 47.42% considered that their school/work performances during the fix appliance therapy stayed the same as before appliance. Nevertheless, the self-perceived facial aspect improved during orthodontic treatment (64.74% of replies had scores between 8 and 10 during the treatment versus 24.67% before the treatment). Several correlations were found between aspects such as psycho-social and functional variables, physical self-evaluation, and oral health issues. CONCLUSION: Patients' satisfaction was improved during and after appliance therapy, for more than half of the participants. Self-confidence was low in relation to school/work performances; almost half of the patients reported stagnation in their school/work performances during the fix appliance therapy. However, more than 64% of the patients participating in this study were quite satisfied about their facial aspect during and after the orthodontic treatment. Thus, the common concerns of the patients anxious about their aspect during appliance therapy are not supported by the findings of this study.

Dentists' perspectives on the choice of treatment of teeth with apical periodontitis.

BACKGROUND AND AIM: Therapeutic decision in dentistry is a complex cognitive process for the practitioners because it involves taking into consideration several factors, including patients' preferences. The hypothesis of this study was that apicoectomy might be indicated more often than necessary and in order to confirm or invalidate it a survey was designed. We also aimed to explore whether the preferences were associated or not with dentist-related or practice-related characteristics. METHODS: The survey included questions about treatment options in case of four scenarios, each one concerning an anterior and a posterior tooth with apical periodontitis, with or without previous endodontic treatment and also general questions, such as medical specialties, age and years of experience. The distribution of the questionnaires was done by email and direct distribution in the dental offices, in Cluj County, Romania. RESULTS: After descriptive statistical analysis was performed, preferences rates were subjected to Chi-square test (including McNemar test for significance). Statistically significant differences were considered when p≤0.05. CONCLUSIONS: The results indicate that dentists prefer nonsurgical endodontic treatment in case of a tooth with apical periodontitis. Apicoectomy was the second option treatment preferred by general dentists, oral and maxillo-facial surgeons, prosthodontists and endodontists.

In vivo orthodontic retainer survival - a review.

BACKGROUND: Relapse following orthodontic treatment is a constant concern of orthodontists. Fixed retention is preferred especially for the lower arch by most orthodontists. OBJECTIVES: This review focuses on in vivo studies. The main objective is to determine the survival rates of different types of retainer: glass-fiber reinforced composite resin, polyethylene or multistrand stainless steel wire bonded to each tooth from canine to canine in the mandibular arch. A second objective is to assess which of these types is less likely to cause additional problems and the third objective is to evaluate the factors that may influence retainer survival. RESULTS AND CONCLUSIONS: There were 8 studies identified that matched the objectives stated. Current in vivo studies on survival rate take little notice of the role of the material used for bonding of the fixed retainer. It is not possible to draw a conclusion on reliability of new types of retainers glass fiber reinforced composite resin or polyethylene compared to multistrand stainless steel wire. The multistrand wire remains the gold standard for fixed retention. Although it is a logical outcome that retainer survival is dependent on the application technique, there seems to be no research outcome proving that operator experience, moisture control are essential, nor does patient age or sex have statistically proven effects on survival rates. Adequate studies that involve such aspects should be performed.