Effectiveness of desensitizing toothpastes in reducing tooth sensitivity after tooth bleaching: a systematic review.

OBJECTIVE: To evaluate the effectiveness of desensitizing toothpastes in reducing post-bleaching tooth sensitivity. MATERIALS AND METHODS: A systematic review of randomized clinical trials was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Electronic searches were conducted in the PubMed/MEDLINE, Scopus, Web of Science, The Cochrane Library and Embase databases, using the following terms: (dentifrices OR toothpaste) AND (sensitive OR sensitivity OR dental sensitivity) AND (dental bleaching OR tooth bleaching OR dental whitening OR tooth whitening). RESULTS: Five studies involving 387 individuals undergoing in-office or at-home teeth bleaching were reviewed. Desensitizing toothpastes reduced sensitivity effectively after home bleaching with 22% carbamide peroxide and single-session in-office bleaching with 35% hydrogen peroxide. However, they were ineffective for home bleaching with 16% carbamide peroxide and in-office bleaching across two sessions with 35% or 38% hydrogen peroxide. CONCLUSION: Desensitizing toothpastes are effective for home bleaching with high concentration carbamide peroxide and single-session in-office bleaching with highly concentrated hydrogen peroxide, but ineffective for home bleaching with low concentration carbamide peroxide and two-session in-office bleaching with concentrated hydrogen peroxide.

Effect of Cantilever Extension on Bone Loss in Mandibular Complete-Arch Implant-Supported Fixed Prostheses with Three and Four Implants.

PURPOSE: To compare the peri-implant bone loss of mandibular complete-arch implant-supported fixed prostheses (FPSs) supported by three and four implants and to correlate with the size of the horizontal and vertical distal cantilever at prosthesis placement (T1) and after 1 year (T2). MATERIALS AND METHODS: A total of 72 external hexagon (EH) type implants were placed in 20 participants. Of these, 24 supported an FPS with three implants (G3I) and 48 with four implants (G4I). The mandibular implants were named 1, 2, 3, and 4 according to their location in the arch, in a clockwise direction. Digital periapical radiographs were taken at times T1 and T2 for analysis and measurement of peri-implant bone loss. The horizontal and vertical distal cantilevers were measured with a digital caliper and correlated with peri-implant bone loss. RESULTS: The survival rate of implants in G3I was 91.66%, and in G4I it was 97.91%. The mean bone loss in G3I was 0.88 ± 0.89 mm, and in G4I it was 0.58 ± 0.78 mm (P = .225). There was no correlation between distal horizontal cantilevers and bone loss in the studied groups, with G3I being -0.25 (P = .197) and G4I -0.22 (P = .129). Larger vertical cantilevers of implants 1 (P = .018), 3 (P =.015), and 4 (P = .045) correlated with greater bone loss in G4I. CONCLUSIONS: The number of implants in an FPS did not influence peri-implant bone loss after 1 year of follow-up. Larger vertical cantilevers influenced greater bone loss in complete-arch implant-supported fixed prostheses supported by four implants.

Effect of cantilever extension on bone loss in mandibular complete-arch implant-supported fixed prosthesis about 3 and 4 implants.

STATEMENT OF PROBLEM: The assessment of bone loss around implants has been widely studied, but the effect of cantilever length as a risk factor is not fully understood. PURPOSE: The objective of this randomized controlled clinical trial was to compare the peri-implant bone loss of mandibular complete-arch implant-supported fixed prosthesis supported (FPS) by 3 and 4 implants and to correlate with the size of the horizontal and vertical distal cantilever at prosthesis installation (T1) and after one year (T2). MATERIALS AND METHODS: 72 external hexagon (EH) type implants were installed in 20 participants. Of these, 24 support FPS with 3 implants (GI3) and 48 with 4 implants (GI4). The inferior implants were named 1, 2, 3, and 4 according to their location in the mandibular arch, in a clockwise direction. Digital periapical radiographs were taken at times T1 and T2 for analysis and measurement of peri-implant bone loss. The horizontal and vertical distal cantilevers were measured with a digital caliper and correlated with peri-implant bone loss. RESULTS: The survival rate of implants in GI3 was 91.66%, in GI4 it was 97.91%. The mean bone loss in GI3 was 0.88 (± 0.89) mm and in GI4 it was 0.58 (± 0.78) mm (P = 0.225). There was no correlation between distal horizontal cantilevers and bone loss in the studied groups, with GI3 being -0.25 (P=0.197) and GI4-0.22 (0.129). Larger vertical cantilevers of implants 1 (P=0.018), 3 (P=0.015) and 4 (P=0.045) correlated with greater bone loss in GI4. CONCLUSION: The number of implants in FPS did not influence peri-implant bone loss after 1 year of follow-up. Larger vertical cantilevers influenced greater bone loss in complete-arch implant-supported fixed prosthesis supported by 4 implants. Int J Prosthodont. 10.11607/ijp.8347.

Incidence and risk factors for non-adaptation of new mandibular complete dentures: a clinical trial.

OBJECTIVE: To investigate the incidence and risk factors for non-adaptation of the conventional mandibular complete denture (CMCD). MATERIALS AND METHODS: A total of 108 edentulous patients were rehabilitated with complete dentures (CDs) and followed up at 3- and 6-month intervals. Adaptation was confirmed based on chewing, phonetics, and comfortable swallowing with the CDs. The risk factors among sociodemographic and patient-centered factors were analyzed. Statistical analyses included the chi-square test and then a multivariate analysis. RESULTS: After 3 months, 38.0% of patients showed non-adaptation to CMCDs. Non-adaptation was significantly associated with the absence of previous mandibular denture experience (p = 0.042), ulcerations after 15 days of rehabilitation (p < 0.001), and a reduced posterior mandibular ridge (p = 0.035). After 6 months, this incidence decreased to 14.1%. The factors associated with non-adaptation were ulcerative lesions after 15 (p < 0.001) and 30 (p < 0.001) days of the delivery of CDs and the non-regular use of mandibular CDs (p < 0.001). CONCLUSION: The incidence of non-adaptation was higher after 3 months, with reduction after 6 months. Sociodemographic variables did not influence the adaptation. After 3 months, the absence of previous experience, traumatic ulcers, and reduced mandibular ridges hindered the adaptation of patients to mandibular CDs. After 6 months, only the occurrence of ulcerative lesions and non-regular wear of dentures were risk factors for non-adaptation. CLINICAL RELEVANCE: A considerable number of patients have difficulties in adapting to the mandibular dentures. Identifying the factors of non-adaptation of the dentures will contribute to increasing the predictability of this critical adaptation period.

Factors associated with edentulous patients' willingness about implant-supported complete denture: a multivariate analysis.

OBJECTIVE: The aim of this study was to evaluate the factors influencing edentulous patients' willingness about mandibular implant-supported complete denture. MATERIALS AND METHODS: A cross-sectional study was carried out with 117 bimaxillary edentulous patients wearing removable complete dentures (CDs). Patients were assessed concerning denture-related items (number of previous mandibular CDs, previous denture wearing period, dentures maker professional, and regular wearing of previous mandibular dentures) and individual-related aspects, such as mandibular edentulousness period, mandibular bone height, and willingness to the use of mandibular implant-supported complete denture. Masticatory performance was evaluated by the median particle diameter. Mandibular bone height and satisfaction were assessed using a validated method. The Chi-square test was used for data analysis and prevalence ratios were adjusted by using multivariate Poisson regression, both with 95% confidence interval. RESULTS: A total of 78 participants (66.7%) were interested in mandibular implant-supported overdenture (mean age 65.33 ± 9.49). Masticatory performance was not influenced by choosing mandibular implant-supported complete denture. The preference about mandibular implant-supported complete denture was correlated with longer mandibular complete denture experience (p = 0.021) and it was significantly associated with dissatisfaction about retention (p = 0.005). CONCLUSION: Previous experience with mandibular complete dentures and dissatisfaction about retention influence the willingness about mandibular implant-supported overdenture. CLINICAL RELEVANCE: Many factors are associated with rehabilitation preferences for edentulous patients and mandibular implant-supported complete denture is one of the available alternatives. Therefore, this study has demonstrated the factors influencing the decision to replace a mandibular conventional complete denture by dental implant treatment based on patient's outcomes. Such finding may be considered as a relevant aspect towards shared decision-making for prosthodontic rehabilitation of edentulous patients.

Manual Therapy in the Treatment of Myofascial Pain Related to Temporomandibular Disorders: A Systematic Review.

AIMS: To evaluate the effectiveness of manual therapy in the treatment of myofascial pain related to temporomandibular disorders. METHODS: Randomized clinical trials were searched in the Cochrane Library, MEDLINE, Web of Science, Scopus, LILACS, and SciELO databases using the following keywords: temporomandibular joint disorders; craniomandibular disorders; myofascial pain syndromes; myofascial pain; exercise therapy; myofunctional therapy; physical therapy modalities; clinical trial; prospective studies; and longitudinal studies. Studies using the RDC/TMD and manual therapy for myofascial pain were included. All studies were evaluated using the Cochrane Risk of Bias tool. RESULTS: Five studies were included in the present review. Of 279 total patients, 156 were treated with manual therapy only or manual therapy with counseling. Manual therapy was efficient for pain relief in all studies evaluated; however, manual therapy was not better than counseling or botulinum toxin. CONCLUSION: Manual therapy was better than no treatment in one study and better than counseling in another study; however, manual therapy combined with counseling was not statistically better than counseling alone, and manual therapy alone was not better than botulinum toxin. Manual therapy combined with home therapy was better than home therapy alone in one study. Further studies are required due to the inconclusive data and poor homogeneity found in this review.

Improvement in Quality of Life of Elderly Edentulous Patients with New Complete Dentures: A Systematic Review.

PURPOSE: To evaluate whether treatment with new complete dentures improves quality of life in elderly patients. MATERIALS AND METHODS: A literature search was conducted in the MEDLINE/PubMed, Scopus, LILACS, SciELO, Web of Science, and Cochrane Library databases using specific keywords for relevant articles published up to March 2018. Three reviewers obtained the data and compared the results from reports that evaluated denture wearers 60 years of age or older whose old dentures were replaced with new ones. RESULTS AND CONCLUSION: Of 282 published studies, 7 met the inclusion criteria (5 evaluated quality of life before and after treatment using the Oral Health Impact Profile, 1 using the Oral Impacts by Daily Performance, and 1 using the Geriatric Oral Health Assessment Index). The articles showed a similar increase in quality of life after elderly patients were treated with new complete dentures; however, the limited methodologic quality in the reported and analyzed studies underscores the need for more robust controlled investigations to strengthen the current body of evidence, which is limited.

Comparative evaluation of peri-implant tissues in patients wearing mandibular overdenture with different implant platforms.

BACKGROUND: The poor hygiene of peri-implant tissues causes inflammation at tissue-implant interface, which may impair the rehabilitation success. The aim of this study was to evaluate the influence of external hexagon and Morse taper implants on peri-implant health in patients wearing mandibular overdentures for 1 year. MATERIALS AND METHODS: A total of 46 implants were evaluated, 28 external hexagon and 18 Morse taper. Plaque index in the mini-abutment, bleeding index, peri-implant inflammation, keratinized mucosa zone, probing depth, and marginal mucosa level were evaluated after 3 months and 1 year of prostheses insertion. RESULTS: Deeper probing was found in the external hexagon group compared with Morse taper (P = 0.024) after 1 year of rehabilitation. Although the Morse taper group exhibited worse scenario of peri-implant inflammation than the external hexagon group (P = 0.001), both groups showed reduced inflammation after 1 year. A larger keratinized mucosa zone was observed with external hexagon implants (P = 0.020). No significant difference was found between the groups for plaque index in the mini-abutment, bleeding index, and marginal mucosa level. CONCLUSION: In a follow-up period of 1 year, it was concluded that the external hexagon group had a larger probing depth than the Morse taper group. However, better periodontal conditions about inflammation and keratinized mucosa zone were found in external hexagon implants. It was found no influence of implant platform on plaque index in the mini-abutment, bleeding index, and marginal mucosa level.

Inhibitory effect of cranberry extract on periodontopathogenic biofilm: An integrative review.

BACKGROUND: Combating biofilm-dependent oral infections involves the use of synthetic antibiotics, which are often associated with bacterial resistance and adverse effects. As a result, herbs such as cranberry have emerged as an alternative treatment. The aim of this study was to evaluate, through an integrative literature review, the effectiveness of cranberry extract on cultures and biofilms of periodontopathogenic bacteria. MATERIALS AND METHODS: In vitro and in vivo studies evaluating the action of cranberry extract on the growth, coaggregation and formation of periodontopathogenic bacteria and periodontal biofilm were identified. Searches were carried out in the "Cochrane Library," "MEDLINE," "Web of Science," "Scopus," "LILACS," "Scielo," and "Google Scholar" databases, using the terms: "vaccinium macrocarpon;" "cranberries;" "cranberry;" "biofilms;" "periodontitis;" "chronic periodontitis;" "aggressive periodontitis;" "periodontal diseases;" and "periodont*." RESULTS: a low number of studies evaluating the effectiveness of cranberry extract on periodontal disease were found, and no human studies were identified. In general, the eight studies included in the revision found that the compounds effectively inhibited the formation of a biofilm of Porphyromonas gingivalis and Fusobacterium nucleatum at concentrations equal or superior to 62.5 µg/ml, but did not significantly inhibit bacterial growth or promote the breakdown of preformed biofilm. CONCLUSIONS: while most of the studies presented certain methodological limitations, they did identify an inhibiting effect of cranberry on periodontal bacteria. These results serve as support for the development of further studies evaluating the most effective vehicle and ideal concentration that can be used without causing adverse effects on oral tissues.