Assessment of Children and "Young" Adult Patients' Quality of Life after Prosthetic Treatment of Disorders of the Craniofacial Region-A Retrospective Study.

BACKGROUND: Prosthetic rehabilitation for children and juvenile patients with congenital or acquired craniofacial disorders is the area of activity of many clinicians and is a major diagnostic and therapeutic challenge for dentists. METHODS: Studies were carried out on a group of 30 patients (10 female and 20 male) aged 2.5 to 30 years who were treated prosthetically due to congenital and acquired craniofacial disorders. The aim of this study was to assess the quality of life using the CPQ 11-14 (Child Perception Questionnaire 11-14), OQLQ (Orthognathic Quality of Life Questionnaire), and PIDAQ (Psychosocial Impact of Dental Aesthetics Questionnaire). RESULTS: Before the prosthetic treatments, the mean values in the individual questionnaires were, respectively, CPQ 11-14-54 points; OQLQ-44.4 points; and PIDAQ-47.6 points. The following values were obtained after the treatments: CPQ 11-14-12.43 points; OQLQ-22.27 points; and PIDAQ-34.03 points. All obtained differences were statistically significant. CONCLUSIONS: The total numerical results obtained in all questionnaires decreased, which means that prosthetic rehabilitation had a positive impact on the assessment of the quality of life based on individual categories.

Disinfection and Isotonic Drinks' Influence on Hardness and Color Stability of Ethylene-Vinyl-Acetate Copolymer Mouthguards Used in Martial Arts: An In Vitro Study.

This in vitro study aimed to evaluate the hardness and color change of an ethylene-vinyl-acetate copolymer (EVA) material for mouthguards after exposition to different cleaning agent solutions and isotonic drinks. Four hundred samples were prepared and divided into four equinumerous groups (n = 100), in which there were 25 samples from each color of EVA (red, green, blue and white). The hardness, using the digital durometer, and the color coordinates (CIE L*a*b*), using the digital colorimeter, were measured before the first exposition and after 3 months of exposition to spray disinfection and incubation in the oral cavity temperature, or immersion in isotonic drinks. The values of Shore A hardness (HA) and color change (ΔE-calculated by Euclidean distance) were statistically analyzed using the Kolmogorov-Smirnov test, multiple comparison ANOVA/Kruskal-Wallis and appropriate post-hoc tests. Statistically significant changes in color and hardness between the tested groups were demonstrated after the use of agents predestined for disinfecting the surface of mouthguards on the tested samples. There were no statistically significant differences in color and hardness between the groups immersed in isotonic sport drinks potentially consumed by competitors practicing combat sports using mouthguards. Despite the changes in color and hardness after the use of disinfectants, the deviations were minor and limited to specific colors of the EVA plates. The intake of isotonic drinks practically did not change either the color or the hardness of the samples, regardless of the tested color of the EVA plates.

Evaluation of Mechanical Properties of 3D-Printed Polymeric Materials for Possible Application in Mouthguards.

Custom mouthguards are used in various sports disciplines as a protection for teeth, temporomandibular joints, and soft tissues of the oral cavity from impact forces. The purpose of this research was to evaluate the mechanical properties of flexible polymeric 3D-printable materials and to select a material with the most favourable physical properties for making intraoral protectors. Four 3D-printable polymeric materials were selected for the evaluation: IMPRIMO LC IBT (Scheu-Dental, Iserlohn, Germany), Keyortho IBT (EnvisionTEC, Gladbeck, Germany), IBT (Formlabs, Somerville, MA, USA), and Ortho IBT (NextDent, Utrecht, Netherlands). A total of 176 samples (44 from each material) was 3D-printed using the stereolitography (SLA) technique. Tensile strength, flexural strength, notch-toughness, Shore hardness, sorption, and solubility tests were conducted. The materials were compared using a series of analyses of variance (one-way ANOVA) with Bonferroni post hoc tests. Statistical analyses were performed with the use of IBM SPSS Statistics 28.0.0 software (IBM, New York, NY, USA). Each material was assigned a score from 1 to 4 depending on the individual test results, and tests were given indexes according to the significance of the parameter in the mouthguard protective function. The number of points obtained by each material in each test was then multiplied by the test index, and the results were tabulated. The material with the highest result among the ones studied-most suitable for the application in mouthguard fabrication-was Keyortho IBT from EnvisionTEC.

Dimensions of Hybrid and Nanohybrid Mouthguards for Mixed Martial Arts Fighters-Evaluation of a New Method of Fabrication.

Ethylene vinyl acetate mouthguards are the most often used custom protective intraoral appliances by combat sports practitioners. However, due to the difficulties in maintaining the hygiene of such mouthguards and thinning during fabrication, resulting in difficulty in predicting final dimensions, they may not be the optimal solution. The aim of this research was to evaluate an innovative method of mouthguard formation using intraoral modeling of the mouthguard pattern, hybrid acrylic material, and the addition of ZnO nanoparticles. Seventeen mouthguards patterns and 34 custom mouthguards were evaluated: 17 hybrid and 17 nanohybrid. A total of 1122 measurements were performed: each mouthguard and pattern was measured at 22 points. Statistical analyses were performed with the use of IBM® SPSS® Statistics 27.0.0 software (IBM, Armonk, NY USA). The mean thickness of the patterns and mouthguards at all labial areas of central incisors were between 4.65 and 4.80 mm. The thickness at the buccal surface of the first molar was between 3.71 and 4 mm, and at the occlusal surface between 3.40 and 3.56 mm in the cusp area. All measurements of hybrid and nanohybrid mouthguards were strongly and highly correlated with the measurements of the mouthguard patterns. Hybrid and nanohybrid mouthguards are an advantageous alternative to thermoformed custom appliances.

Color Stability of Zinc Oxide Poly(methyl methacrylate) Nanocomposite-A New Biomaterial for Denture Bases.

(1) Background: The purpose of this in vitro study was to evaluate the color change and stability of a zinc oxide nanoparticle-poly(methyl methacrylate) (ZnO NP-PMMA) nanocomposite for denture base material after immersion in different dietary and cleaning agent solutions. (2) Methods: One hundred samples were prepared and divided into four equinumerous groups depending on the weight content of ZnO NPs. The color coordinates (CIE L*a*b*) were measured using a digital colorimeter, ColorReader (Datacolor AG Europe, Rotkreuz, Switzerland), before and after immersion of the specimens in five different solutions (distilled water, coffee, red wine, black tea, denture cleaning tablet solution) for 6 months. The color changes (ΔE) were calculated using Euclidean distance and analyzed by the Shapiro-Wilk test and the ANOVA/Kruskal-Wallis multiple comparison and adequate post hoc tests. (3) Results: All tested materials showed significant color changes after their exposure to all solutions. Color changes were greatest in the case of red wine and progressed with the duration of the study. (4) Conclusions: The modification of PMMA with ZnO nanoparticles is acceptable in aesthetic terms in 2.5% and 5% weight content; however, color changes are more noticeable with higher nanoparticle content and must be discussed with the patient prior to possible use.

Head Trauma Exposure in Mixed Martial Arts.

Combat sports training involves a high risk of head injury. Previously published research on head trauma exposure in MMA evaluated only the knockouts (KO), without calculating all head strikes. The aim of the research was to evaluate the total head trauma exposure during MMA competitions among male and female fighters. Two thousand four hundred and eighty-eight MMA fights from all numbered UFC events between 2000 and 2021 were analyzed. A database containing the results from officially published scorecards with information such as the outcome of a fight, its duration, number of strikes (significant and total amount of hits) depending on location and knockdowns was created. Additional video verification of the knockout technique was carried out. The athletes received an average of 2.41 significant head strikes out of a total of 6.30 head strikes per minute. Head strikes were more common in female fights than in male. Women executed more total and significant head strikes per minute than men. Head trauma caused the ending of 31.6% of all fights-more often in male fights (32.2%) than female (23.1%). It was the most common cause of knockouts-88.1%. Professional fights in mixed martial arts involve high exposure to head trauma. A careful evaluation of the risk involved in training in such a discipline is necessary to provide adequate prevention methods.

Comparison of Mechanical Properties of a Self-Adhesive Composite Cement and a Heated Composite Material.

(1) Background: Due to the limitations of composite cements, the authors carried out tests to compare such materials with preheated composite materials because the latter may be an alternative to cements in the adhesive cementation procedure. (2) Methods: The materials used in the adhesive cementation procedure, i.e., Enamel Plus Hri (Micerium, Avegno, Italy), a heated composite material, and RelyX U200 Automix (3M, Maplewood, MN, USA), a dual composite cement, were tested for microhardness, compressive strength, flexural strength, diametral compressive strength, and elastic modulus. Composite material was heated to the temperature of 50 degrees Celsius before polymerisation. (3) Results: Higher values of microhardness (by 67.36%), compressive strength (by 41.84%), elastic modulus (by 17.75%), flexural strength (by 36.03%), and diametral compressive strength (by 45.52%) were obtained using the Enamel Plus Hri composite material compared to the RelyX U200 self-adhesive cement. The survey results revealed statistically significant differences. (4) Conclusions: Due to its better mechanical properties, the heated composite material (Enamel Plus Hri) is a beneficial alternative to composite cements in the indirect restoration placement procedure. As the strength parameters of the heated composite material increase, a higher resistance to the compressive and bending forces present in the oral cavity, and hence a greater durability of the created prosthetic reconstructions can be expected.

Physicochemical Properties of Dentine Subjected to Microabrasive Blasting and Its Influence on Bonding to Self-Adhesive Prosthetic Cement in Shear Bond Strength Test: An In Vitro Study.

The aim of this in vitro study was to assess the influence of microabrasive blasting on the physicochemical properties of dentine and shear bond strength (SBS) of self-adhesive resin cement (Maxcem Elite, Kerr, Orange, CA, USA) bonded to the dentine surface. Ninety cylindrical specimens with exposed dentine of human teeth were prepared and divided into three randomized, parallel sample sets A, B, and C. Groups B and C were subjected to abrasive blasting using a micro-sandblasting device (Microetcher IIa, Danville Materials, Carlsbad, CA, USA) with two gradations of Al2O3 abrasives (Group B, abrasion with a gradation of 50 µm; group C, abrasion with a gradation of 27 µm). SEM imaging, profilometry, chemical composition analysis, contact angle measurements, surface free energy, and SBS tests were performed. The resulting data were statistically analyzed using the Statistica software (ver. 13.3, Tibco Software Inc., Palo Alto, CA, USA). Microabrasive blasting caused changes in surface topography, structural features, and the connection strength between the dentin surface and self-adhesive prosthetic cement. Air microabrasion through the multifactorial positive reorganization of the treated surface of dentine is recommended as a pretreatment method in fixed prosthodontics adhesive cementation protocols.

Preparation and Characterisation of Poly(methyl metacrylate)-Titanium Dioxide Nanocomposites for Denture Bases.

Introduction of titanium dioxide nanoparticles (TiO2 NPs) to poly(methyl methacrylate) (PMMA) aims to improve the mechanical, microbiological and tribological properties of dental prosthesis bases. The aim of the research was to assess the polymerisation time and the change in the colour of the new biomaterial. Samples with the 1 wt% and 2 wt% content of TiO2 additionally modified by ultrasounds were created. The effectiveness of ultrasounds was assessed by comparing the average size of conglomerates in a liquid acrylic resin monomer by means of a dynamic light scattering (DLS) analysis. The biomaterial structure was assessed by the energy-dispersive X-ray spectroscopy (EDS) analysis. The colour change was analysed by means of a colorimetric test and provided in the CIE (Commission internationale de l'éclairage) L*a*b* and RGB (Red Green Blue) colour palette. It was observed during the DLS test that the ultrasonic homogenisation process caused an increase in the suspension heterogeneity. The EDS analysis confirmed the presence of nanoparticles sized below 100 nm, which constitutes a ground for calling the new biomaterial a nanocomposite. The addition of TiO2 NPs as well as the ultrasounds result in the reduction of the average PMMA polymerisation time. The obtained data reveal that the addition of both 1 wt% and 2 wt% causes a considerable change in the PMMA colour: its whitening. To summarise, the reduced polymerisation time of the new biomaterial fully enables performance of standard procedures related to creation of dental prosthesis bases. Due to the considerable change in the colour, the clinical application is limited to performance of repairs or relining of the prosthesis, where the new material is located in an unaesthetic zone.

Zinc Oxide Nanoparticles Cytotoxicity and Release from Newly Formed PMMA-ZnO Nanocomposites Designed for Denture Bases.

The goal of the study was to investigate the level of zinc oxide nanoparticles (ZnO NPs) release from polymethyl methacrylate (PMMA)-ZnO nanocomposites (2.5%, 5%, and 7.5% w/w), as well as from the ZnO NPs layer produced on pure PMMA, and the impact of the achieved final ZnO NPs concentration on cytotoxicity, before the potential use as an alternative material for denture bases. The concentration of ZnO nanoparticles released to the aqueous solution of Zn2+ ions was assessed using optical emission spectrometry with inductively coupled plasma (ICP-OES). In the control group (pure PMMA), the released mean for ZnO was 0.074 mg/L and for individual nanocomposites at concentrations of 2.5%, 5%, and 7.5% was 2.281 mg/L, 2.143 mg/L, and 3.512 mg/L, respectively. The median for the ZnO NPs layer produced on PMMA was 4.878 mg/L. In addition, in vitro cytotoxicity of ZnO NPs against the human HeLa cell line was determined through the reduction of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) dye. The cytotoxicity studies demonstrate that ZnO nanoparticles in the concentrations up to 20 mg/L have no adverse effect on HeLa cells. When compared with the released and cytotoxic concentrations of ZnO NPs, it can be expected that ZnO released from dental prostheses to the oral cavity environment will have no cytotoxic effect on host cells.

The effect of decontamination procedures on elastic polymeric materials used in dental mouthguards fabrication.

PURPOSE: Mouthguards are commonly used in the prevention of head and mouth injuries in many sport disciplines. Elastic polymeric materials used in their fabrication absorb the energy of impact. However, decontamination procedures may cause damage to their surface causing deterioration of their properties and favouring pathogen colonization. The aim of the study was to determine the impact of different cleaning methods on mouthguard materials, surface quality. METHODS: The material for the research consisted of 81 samples made from polymeric materials used for custom mouthguard fabrication - Impak, Corflex Orthodontic and Erkoflex. Samples were viewed under a scanning electron microscope after exposure to different cleaning methods. RESULTS: Statistical analysis of tested decontamination procedures and disinfecting agents showed statistically important ( p < 0.05) results for the presence of small and big separated pieces, grooves and holes. Out of all the cases the lowest indicator for occurrence was in the disinfecting spray - Aftermat. CONCLUSIONS: Considering the importance of the surface material of the mouthguard, disinfection should be the method of choice for maintaining its hygiene. Impak material samples, cleaned with the Aftermat spray, showed the lowest range of damage.

Mechanical and Physicochemical Properties of Newly Formed ZnO-PMMA Nanocomposites for Denture Bases.

AIM: The aim of this study was to investigate the selected properties of zinc oxide- polymethyl methacrylate (ZnO-PMMA) nanocomposites that can influence the microorganism deposition on their surface. MATERIALS AND METHODS: Non-commercial ZnO-NPs were prepared, characterized and used for the preparation of PMMA nanocomposite. Roughness, absorbability, contact angle and hardness of this new nanomaterial were evaluated. PMMA without ZnO-NPs served as control. OUTCOMES: Compared to unenriched PMMA, incorporation of ZnO-NPs to 7.5% for PMMA nanocomposite increases the hardness (by 5.92%) and the hydrophilicity. After modification of the material with zinc oxide nanoparticles the roughness parameter did not change. All tested materials showed absorption within the range of 1.82 to 2.03%, which meets the requirements of International Organization for Standardization (ISO) standards for denture base polymers. CONCLUSIONS: The results showed no significant deterioration in the properties of acrylic resin that could disqualify the nanocomposite for clinical use. Increased hydrophilicity and hardness with absorbability within the normal range can explain the reduced microorganism growth on the denture base, as has been proven in a previous study.

Examination of Oral Microbiota Diversity in Adults and Older Adults as an Approach to Prevent Spread of Risk Factors for Human Infections.

The oral cavity environment may be colonized by polymicrobial communities with complex, poorly known interrelations. The aim of this study was to determine oral microbiota diversity in order to prevent the spread of infectious microorganisms that are risk factors for human health complications in patients requiring treatment due to various disabilities. The study examined Polish adults aged between 40 and 70 years; parasitological, microbiological, and mycological data collected before treatment were analyzed. The diversity of oral microbiota, including relatively high prevalences of some opportunistic, potentially pathogenic strains of bacteria, protozoans, and fungi detected in the patients analyzed, may result in increasing risk of disseminated infections from the oral cavity to neighboring structures and other organs. Increasing ageing of human populations is noted in recent decades in many countries, including Poland. The growing number of older adults with different oral health disabilities, who are more prone to development of oral and systemic pathology, is an increasing medical problem. Results of this retrospective study showed the urgent need to pay more attention to the pretreatment examination of components of the oral microbiome, especially to the strains, which are etiological agents of human opportunistic infections and are particularly dangerous for older adults.

A comparison of impact force reduction by polymer materials used for mouthguard fabrication.

PURPOSE: The essential function of mouthguards is protection against the effects of injuries sustained during sports activities. This purpose will be successfully achieved if appropriate materials ensuring sufficient reduction of the injury force are used for mouthguard fabrication. OBJECTIVE: The objective of the study was to investigate the force reduction capability of selected materials as well as to identify which material reduces the impact force to the highest degree. METHODS: The material for the study were samples of polymers (6 samples in total), obtained during the process of deep pressing (2 samples), flasking (3 samples) and thermal injection (1 sample), which were tested for impact force damping using an impact device - Charpy impact hammer. The control group comprised of the ceramic material samples subjected to the hammer impact. The statistical analysis applied in this study were one-way Welch ANOVA with post-hoc Games-Howell pairwise comparisons. RESULTS: The test materials reduced the impact force of the impact hammer to varying degrees. The greatest damping capability was demonstrated for the following materials: Impak with 1:1 powder-to-liquid weight ratio polymerized with the conventional flasking technique, and Corflex Orthodontic used in the thermal injection technique of mouthguard fabrication. CONCLUSIONS: Impak with 1:1 weight ratio and Corflex Orthodontic should be recommended for the fabrication of mouthguards since they demonstrated the most advantageous damping properties.

A method and a device for the evaluation of the retention of telescopic dental crowns.

Telescopic crowns are used as support for removable dental prostheses' construction. A distinctive feature of crowns often used in their description and comparison is retention, which is understood as resistance when removing the prosthesis or a force needed to disconnect crowns. The article describes a method for the evaluation of retention in simulated conditions using a dedicated testing device. By subjecting the crown to cyclic loads in the range of forces occurring during clinical use and in the range of cycles leading to visible effects of wear, the method provides the evaluation of crowns in a wide range of duration, up to the loss of functionality. It also facilitates the identification of dominant phases of crown behaviour, which may be correlated with the results of clinical trials.

Randomised Clinical Trial on Resin Infiltration and Fluoride Varnish vs Fluoride Varnish Treatment Only of Smooth-surface Early Caries Lesions in Deciduous Teeth.

PURPOSE: To clinically evaluate the effectiveness of resin infiltration in conjunction with fluoride varnish treatment vs fluoride varnish treatment alone on facial smooth-surface caries lesions in deciduous teeth. MATERIALS AND METHODS: This randomised clinical trial was conducted in 419 children aged 18-71 months with at least two active smooth-surface caries lesions in deciduous teeth (ICDAS II score 2). Eighty-one participants met the inclusion criteria and were allocated to one of the two treatment groups: resin infiltration and fluoride varnish (RI+FV) (n = 41) and fluoride varnish only (FV) (n = 40). The prevalence of treated white spot lesions (WSL) was scored. Fluoride varnish was applied in both groups every 3 months for a year. RESULTS: The mean baseline age of children was 3.8 ± 1.3 years. The effectiveness of resin infiltration measured as the percentage of children who did not present any progression of the treated lesions amounted to 43.1%. After one year, 92.1% of the infiltrated lesions (RI+FV) and 70.6% of the FV lesions had not progressed (p < 0.001). CONCLUSION: Resin infiltration in conjunction with fluoride varnish treatment of early facial smooth-surface caries lesions in deciduous teeth is superior to fluoride varnish treatment alone for reducing lesion progression.

Preparation and characterization of ZnO-PMMA resin nanocomposites for denture bases.

PURPOSE: The aim of the paper was to investigate the antifungal activity of zinc oxide nanoparticles (ZnONPs) against Candida albicans. Some attempts have been made to find out the best way to introduce ZnONPs into polymethyl methacrylate (PMMA) resin material and to determine some parameters of a newly formed composite. MATERIAL AND METHODS: Zinc oxide nanoparticles were manufactured and their basic physical parameters were determined (average particle size, density, specific surface area). Minimal inhibitory concentration (MIC) of ZnONPs was determined for the Candida albicans standard strain. The average size of ZnO conglomerates in the monomer solution of PMMA resin was measured using a dynamic light scattering instrument. PMMA resin samples with incorporated ZnONPs were produced. The morphology of nanopowder and the newly formed composite was examined under a scanning electron microscope (SEM). In addition, the roughness parameter of PMMA resin material was investigated before and after ZnONPs modification. RESULTS: Nanopowder with the average particle size of 30 nm, density of 5.24 g/cm3 and surface area of 39 m2/g was obtained. MIC was determined at the level of 0.75 mg/mL. The average size of ZnO conglomerates in the monomer solution of acrylic resin dropped by 11 times after ultrasound activation. SEM examination of a newly formed composite showed a successful introduction of ZnONPs confirmed by the energy dispersive X-ray spectroscopy (EDS) analysis. There were no statistically significant differences in the biomaterial roughness before and after the modification of ZnONPs. CONCLUSION: Zinc oxide nanoparticles were successfully incorporated into acrylic resin used for the production of denture bases. The presence of nanoparticles with sizes below 100 nm was confirmed. Nevertheless a newly created composite needs to be further investigated to improve its homogeneity, and to check its microbiological properties, strength and biocompatibility prior to its possible clinical use.

Significance of polymethylmethacrylate (PMMA) modification by zinc oxide nanoparticles for fungal biofilm formation.

The objective of this study was to obtain a material composite with antifungal properties for dentures to be used as an alternative protocol in denture stomatitis treatment and prevention. Denture stomatitis is still a clinical problem in patients particularly vulnerable to this disease. Composites of PMMA and doped ZnO-NPs (weight concentrations, 2.5%, 5%, 7.5%) and PMMA with sprayed solvothermal and hydrothermal ZnO-NPs were tested. The following investigations of newly formed biomaterials were undertaken: influence on Candida albicans solution, biofilm staining, XTT analysis and a quantitative analysis of adhered C. albicans. These studies evidenced the antifungal activity of both nanocomposites PMMA-ZnO-NPs and the efficacy of sputtering of zinc oxide nanoparticles on the PMMA. The study of the biofilm deposition on the surface showed that antifungal properties increase with increasing concentration of ZnO-NPs. The XTT assay in conjunction with testing the turbidity of solutions may indicate the mechanism by which ZnO-NPs exert their effect on the increased induction of antioxidative stress in microorganism cells. The denture base made of the aforesaid materials may play a preventive role in patients susceptible to fungal infections. Based on the results obtained a modified treatment of stomatitis Type II (Newton's classification) complicated by fungal infection was proposed.