Assessing dentists' awareness of the orthodontic-restorative interface.

OBJECTIVES: Awareness of the interface between restorative and orthodontic treatments is essential for dentists to facilitate a meaningful interdisciplinary approach by integrating the knowledge and skills of different dental disciplines into patients' treatment to enhance outcomes. The aim of this study was to investigate General Dental Practitioners' (GDPs) awareness of the orthodontic-restorative interface. METHODS: This was a mixed-method study involving the collection of a) quantitative data via a bespoke online questionnaire and b) qualitative data through open questions. A weblink was created to the questionnaire using Opinio®. The questionnaire was distributed to GDPs practising in the UK. Clinical vignette-based questions assessed GDPs awareness and the results were categorised into two groups: aware and unaware. Two months after the primary survey, respondents were sent an email with follow-up (reliability) survey. Reliability responses were compared against the primary responses to assess the repeatability using intraclass correlation coefficient. Data were analysed using independent t-test and X2 test. RESULTS: 118 complete responses were received. 63 GDPs (53.4 % [95 % CI 44 %-63 %]) demonstrated a good understanding of the orthodontic-restorative interface. These GDPs were characterised by greater age (t = 2.75, p = 0.007) and experience (t = 3.54, p < 0.001). Qualitative data showed that respondents perceived orthodontic-restorative treatments as minimally invasive and aesthetics enhancing. CONCLUSIONS: Orthodontic-restorative treatment aids in minimal invasive dentistry. GDPs lack adequate awareness of the orthodontic-restorative interface in relation to patient care and communication with patients. More quality and structured undergraduate and postgraduate training are imperative to facilitate GDPs to understand and utilise aspects of orthodontic-restorative treatments to raise the standard of patient care. Additionally, to support these patients, the educational pathway between GDPs and specialist orthodontists is crucial. CLINICAL SIGNIFICANCE: GDPs ability to assess and carry out orthodontic-restorative treatments would conserve natural teeth. Dependable access to orthodontic services would encourage GDPs to refer challenging cases to specialists or dentists with enhanced skills. When the circumstances call for it, patients should be given orthodontic-restorative alternatives, regardless of the potential consequences of their acceptance of the procedures.

Longevity of Anterior Composite Restorations for Localized Tooth Wear: A Scoping Review.

(1) Objective: This scoping review evaluates composite restorations as a treatment modality for anterior tooth surface loss and investigates the longevity of the direct and indirect composites used herein. (2) Method: The search encompassed Medline, Embase, Web of Science, the Cochrane Library, and hand search utilizing the PICO framework. (3) Results: Eight studies were included in this review, comprising one randomized controlled trial, one retrospective, and six prospective studies. Some studies reported favorable outcomes for composite restorations in anterior teeth. Although not statistically significant, evidence supported the anterior composite as a viable short- to medium-term solution for managing tooth wear. Direct resin composites were deemed clinically and cost-effective when managing localized anterior tooth wear. However, limitations and inconsistencies in this scoping review limited definitive clinical recommendations. (4) Conclusions: Further research, including well-managed randomized controlled trials using standardized protocols and longer follow-up periods, is essential to reconfirm the long-term efficacies of anterior composite restorations when managing tooth wear. A robust research design and exacting protocols could facilitate more meaningful clinical conclusions.

Evaluation and Comparison of the Effects of Mature Silkworm (Bombyx mori) and Silkworm Pupae Extracts on Schwann Cell Proliferation and Axon Growth: An In Vitro Study.

Background: Silkworm products were first used by physicians more than 8500 years ago, in the early Neolithic period. In Persian medicine, silkworm extract has several uses for treating and preventing neurological, cardiac, and liver diseases. Mature silkworms (Bombyx mori) and their pupae contain a variety of growth factors and proteins that can be used in many repair processes, including nerve regeneration. Objectives: The study aimed to evaluate the effects of mature silkworm (Bombyx mori), and silkworm pupae extract on Schwann cell proliferation and axon growth. Methods: Silkworm (Bombyx mori) and silkworm pupae extracts were prepared. Then, the concentration and type of amino acids and proteins in the extracts were evaluated by Bradford assay, sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), and liquid chromatograph-mass spectrometer (LC-MS/MS). Also, the regenerative potential of extracts for improving Schwann cell proliferation and axon growth was examined by 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide (MTT) assay, electron microscopy, and NeuroFilament-200 (NF-200) immunostaining. Results: According to the results of the Bradford test, the total protein content of pupae extract was almost twice that of mature worm extract. Also, SDS-PAGE analysis revealed numerous proteins and growth factors, such as bombyrin and laminin, in extracts that are involved in the repair of the nervous system. In accordance with Bradford's results, the evaluation of extracts using LC-MS/MS revealed that the number of amino acids in pupae extract was higher than in mature silkworm extract. It was found that the proliferation of Schwann cells at a concentration of 0.25 mg/mL in both extracts was higher than the concentrations of 0.01 and 0.05 mg/mL. When using both extracts on dorsal root ganglion (DRGs), an increase in length and number was observed in axons. Conclusions: The findings of this study demonstrated that extracts obtained from silkworms, especially pupae, can play an effective role in Schwann cell proliferation and axonal growth, which can be strong evidence for nerve regeneration, and, consequently, repairing peripheral nerve damage.

Denture Base Composites: Effect of Surface Modified Nano- and Micro-Particulates on Mechanical Properties of Polymethyl Methacrylate.

The most commonly used denture base material, polymethyl methacrylate, lacks ideal mechanical properties, which are reflected in its relatively high failure rate. Several methods have been explored to reinforce the material and reduce the cost of denture repair and replacement. In this study, various surface modified filler particles at different concentrations were dispersed in conventional and high-impact denture base materials and tested for their improvement in mechanical properties. Inorganic filler particles were coated with different silane coupling agents using an ultrasonic device. The particulates were dispersed in the resin and the composites polymerised through an innovative dual-cure technique. Charpy impact test, single-edge notch three-point bend fracture toughness test and Biaxial Flexural Strength (BFS) were performed on the specimens. The results showed that mechanical properties of the denture base resin can be improved by incorporating filler particles; however, the surface characteristics, quantity and level of dispersion of the particles play critical role in the mechanical behaviour of the composites. The results of this study are a promising step towards developing more fracture-resistant denture base materials.

One-Piece Implant-Retained Mandibular Overdentures By Pre-Fabricated Titanium Telescopic Attachments and Frictional Varnish: A Two-Year Prospective Study.

Clinical efficiency of one-piece screw-type implants with telescopic were attachments evaluated in this study. Twenty-four patients received a mandibular implant-supported overdenture and maxillary complete denture. Ninety-six one-piece implants were inserted in the inter-foraminal area. Implants were immediately loaded with an implant-retained overdenture and telescopic attachments which had frictional retention elements. There was 0.25±0.24 mm, 0.32±0.25 mm, 0.43±0.30 mm, 0.61±0.30 mm and of bone resorption after 3, 6, 12 and 24 months, respectively. The need to activate the frictional retention was the most common complication. Treatment outcomes for prefabricated telescopic retained overdentures on one-piece implants are similar to that obtained in cases of delayed loading.

Transforming growth factor beta (TGF-ß) isomers influence cell detachment of MG-63 bone cells.

Bone repair and wound healing are modulated by different stimuli. There is evidence that Transforming Growth Factor-beta (TGF-ß) super-family of cytokines have significant effects on bone structure by regulating the replication and differentiation of chondrocytes, osteoblasts and osteoclasts. There is also significant evidence that interactions with extracellular matrix molecules influence cell behaviour. In this study cell surface attachment was examined via a trypsinization assay using various TGF-ß isomers in which the time taken to trypsinize cells from the surface provided a means of assessing the strength of attachment. Three TGF-ß isomers (TGF-ß1, 2 and 3), four combined forms (TGF-ß(1+2), TGF-ß(1+3), TGF-ß(2+3) and TGF-ß(1+2+3)) along with four different controls (BSA, HCl, BSA/HCl and negative control) were investigated in this study. The results indicated that treatment with TGF-ß1, 2, 3 and HCl decreased cell attachment, however, this effect was significantly greater in the case of TGF-ß3 (p<0.001) indicating perhaps that TGF-ß3 does not act alone in cell detachment, but instead functions synergistically with signalling pathways that are dependent on the availability of hydrogen ions. Widefield Surface Plasmon Resonance (WSPR) microscope was also used to investigate cell surface interactions.