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One of the most promising approaches to correct periodontal bone defects and achieve periodontal regeneration is platelet-rich fibrin (PRF). This systematic review and meta-analysis aimed to evaluate the regeneration of periodontal bone defects using PRF compared to other regenerative treatments. The data search and retrieval process followed the PRISMA guidelines. An electronic search of MEDLINE, Cochrane, and PubMed databases was performed, selecting exclusively randomized clinical trials where the following were measured: probing depth reduction (PD), clinical attachment level gain (CAL), and radiographic bone fill (RBF). Out of 284 selected articles, 32 were chosen based on inclusion criteria. The use of platelet-rich fibrin (PRF) + open flap debridement (OFD), PRF + metformin, PRF + platelet-rich plasma (PRP), and PRF + OFD/bone graft (BG) significantly reduced PD and improved CAL and RBF. However, the combination of PRF + BG, PRF + metformin, and PRF + STATINS reduced CAL. The intervention of PRF combined with different treatments such as metformin, OFD, PRP, BG, and STATINS has a significant impact on improving PD and CAL. The use of PRF significantly improved the regeneration of periodontal bone defects compared to other treatments.
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The aim of this study was to evaluate the efficacy of mesenchymal stem cells (MSCs) in the regeneration of periodontal bone defects in animal models. A systematic review and meta-analysis were conducted following the PRISMA guidelines, and the study was recorded in PROSPERO under reference number CDR42021247462. The PICO question was: is periodontal regeneration (cementum, periodontal ligament and alveolar bone) with MSCs more effective than other techniques? Three groups were considered: Group 1: MSCs alone or mixed with regenerative materials. Group 2: only regenerative materials. Group 3: no regenerative material nor MSCs. The search was conducted using MeSH with a total of 18 articles for qualitative analysis and 5 for quantitative analysis. For the meta-analysis, a modification of the effect size algorithm was developed, which considered a comparison of means between treatments using the Student's t sample distribution. When comparing the effect size between Group 1 and Group 2, the effect size for the new cementum was 2.83 mm with an estimated confidence interval of 95% (CI 95%) between 0.48 and 5.17 mm. When considering the fit to a random-effects model, the combined variance (τ2) was 6.1573 mm, with a standard deviation (SD) of 5.6008 mm and a percentage of total heterogeneity I2 of 92.33% (p < 0.0001). For new bone, the effect size was 0.88 mm, CI 95% - 0.25 to 2.01 mm, τ2 = 1.3108 mm (SD = 1.2021 mm) and I2 = 80.46%, p = 0.0004). With regard to the new periodontal ligament, it was not possible for the meta-analysis to be performed. MSCs have a greater capacity for tissue regeneration in root cementum than in alveolar bone compared to other regenerative materials.
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Pérdida de Hueso Alveolar , Células Madre Mesenquimatosas , Animales , Pérdida de Hueso Alveolar/cirugía , Regeneración Ósea , Regeneración Tisular Guiada Periodontal/métodos , Modelos Animales , Ligamento PeriodontalRESUMEN
Purpose: The aim of this study is to evaluate the understanding of the management of methods and practices of disinfection of dental impressions applied by general dentists and specialists in oral rehabilitation, post SARS-COV-2 pandemic. Introduction: The oral cavity has a favorable environment for the growth and multiplication of bacteria and viruses, serving as the gateway to viruses such as SARS CoV-2 virus. Given that patients may be hosts of this infectious disease, stricter biosecurity measures in dental offices and a better understanding of the disinfection processes of dental impressions should be considered in addition to avoiding cross-infections, which are very common in our work environment. Materials and methods: Descriptive, analytical, survey with the topic "Methods and practices of disinfection of dental impressions" that was composed of 14 questions based in OHPD (Oral Health Preventive Dentistry), n = 452 respondents who met the following inclusion criteria: general practice dentists from Ecuador who actively take dental impressions, specialists in oral rehabilitation with 5 years of experience, surveys with information of complete items, n = 270 professionals; n = 192 general dentists, dental hygienist and n = 78 oral rehabilitation specialists. Results: n = 270 professionals evaluated, with a mean of p = 0.0. At 426 responses with a p value of <0.05, 30.4 % of responses indicated ignorance in the management of dental impressions, with a standard deviation of 2.744, with significant differences between professions (p = 0.035) and higher average knowledge of sample management within specialist dentists, (Chi p = 0.410 p > 0.05). Conclusion: The understanding of the management of dental impressions among general dentists and specialists in oral rehabilitation is limited.
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The Damon system is an effective, less-invasive treatment that provides orthodontic dentists with an adequate biomechanical process, offering a reduction in treatment time; patients with temporomandibular dysfunction present even greater complexity in their clinical picture, relying on clinical and radiographic differential diagnoses to facilitate a good prognosis. The objective was to apply the orthodontic treatment (Damon technique) to stabilize patients with temporomandibular dysfunction. The patient with premature loss of the first lower molars (36 and 46) experienced pathological alterations in the temporomandibular joints (TMJs) (bilaterally). The diagnosis was reached using the clinical history of temporomandibular joint disorders (diagnostic criteria) axis II: moderate pain (VAS) in muscles, moderate stress (Hamilton 51/60), lateral and panoramic cephalic radiographs, magnetic resonance imaging of bilateral TMJ, cephalometry, photographs, and models. Treatment with the Damon system is recommended to recover optimal functional occlusion in a short period, followed by referral for oral rehabilitation as an adjunct to the treatment plan. The verticalization of the second molars, maximum optimal intercuspidation, appropriate overbite and overjet, and pain control in the TMJ were evaluated. Stabilization of the disc condyle complex by eliminating interference and premature points of contact providing cervical/cranio/mandibular balance.
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Background: Burnout syndrome (BS) is composed of three interrelated dimensions (emotional exhaustion, depersonalization, and personal fulfillment), and it has been documented that it affects health professionals from an early age. Aims: Determine the prevalence of BS and associated factors in the integral clinic of the Dentistry Pilot School. Material and Methods. Two instruments were applied: (1) Maslach Burnout Inventory, which measures the degree of professional burnout through 22 items that describe the professional's attitudes and feelings toward work, as well as symptoms associated with this phenomenon; (2) the second questionnaire determines the possible symptoms of BS and consists of 14 questions that describe tiredness, sleep problems, digestive problems, respiratory problems and headaches, temporomandibular joint (TMJ), neck pain, back pain, and upper and lower extremity pain. The instruments were answered anonymously by a total of 300 students who participated in the study. Results: The emotional exhaustion of the participants was 48.3% at a higher level, the depersonalization was 46.7% at a higher level, and the low perception of personal fulfillment was 73%. In addition, it was shown that BS is significantly related to marital status (p < 0.001∗), with single people reporting being more exhausted, with the 6-month level (p = 0.011) and with the following symptoms: non-neck pain, head, TMJ, back, waist, upper and lower body pain. Conclusion: It was found that the BS had a prevalence of high levels of exhaustion and depersonalization correlated with the marital status and level of preparation (academic degree) of the person, finding a prevalence of symptoms such as pain in the neck, head, TMJ, and back.
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Background. Bruxism is a topic of much controversy and is continually debated in the field of dentistry due to the multifaceted clinical relationship that results in painful conditions and consequences to patients. The aim of this review was to determine the effectiveness of a smartphones app in monitoring awake bruxism. Methods. PROSPERO (registration number: CRD42021271190). The eligibility criteria were as followed: observational studies, case-control studies, studies that reported odds ratios, and studies on awake bruxism. The following keywords were searched: [smartphones apps] AND [apps] AND [awake bruxism], OR [sleep bruxism], OR [sleep hygiene], OR [parasomnias], AND [habits]. Results. All the authors agree that the use of the smartphone app allows controlled awake bruxism monitoring. The results also show that the two bruxism are interactive, having negative synergism and substantially increasing the risks of temporomandibular joint pain and temporomandibular disorders. Discussion. In the AB it was possible to identify 70% symptoms through the different frequencies of behavior provided by the App, within the present technological tools have become daily in young and adult population. The app is effective and easy to use by patients, effectively limiting biases the time of evaluation.
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Aplicaciones Móviles , Bruxismo del Sueño , Trastornos de la Articulación Temporomandibular , Adulto , Humanos , Vigilia , Bruxismo del Sueño/diagnóstico , Bruxismo del Sueño/epidemiología , Trastornos de la Articulación Temporomandibular/diagnóstico , HábitosRESUMEN
Resumen Introducción: el uso de implantes personalizados es un tratamiento utilizado con mayor frecuencia, valorando y comparando su comportamiento frente a implantes convencionales. Este estudio tuvo como objetivo analizar si las zonas de esfuerzo del implante personalizado son diferentes a las que presenta el implante prefabricado convencional mediante fotoelasticidad. Métodos: muestra n=10 dientes premolares superiores, n=10 implantes personalizados sinterizados y n=10 implantes prefabricados convencionales, sometidos a 3 presiones fijas y controladas, observados a través de un polariscopio para analizar la distribución del esfuerzo generados. Resultados: zonas de esfuerzo presentes en las diferentes muestras analizadas aplicando 3 presiones. La cantidad de esfuerzo en la presión 1 (test de Chi-cuadrado, p=0,596) es diferente entre los dos tipos de implantes al igual que con la presión 2 (test de Chi-cuadrado, p=0,407), al aplicar la presión 3 (test de Levene, p=0,899) no hay diferencia en la distribución de fuerzas entre los dos tipos de implantes. Conclusiones: se determinó que el implante prefabricado convencional distribuye y concentra mejor el esfuerzo generado bajo diferentes presiones en comparación con el implante personalizado sinterizado.
Abstract Introduction: the use of custom implants is a very common treatment; we assess and compare their behavior against that of conventional implants. This study aimed to make sure that the stress zones of the custom implant are different from those presented by the conventional prefabricated implant by photoelasticity. Methods: we subjected samples of n=10 bicuspid teeth, n=10 sintered custom implants, and n=10 conventional prefabricated implants to 3 fixed and controlled forces and observed the samples through a polariscope to analyze the distributions of effort generated. The effort zones present in the different samples were analyzed under 3 different forces. Results: the amounts of effort in the two types of implants under force 1 (chi-square test, p=0.596) are different, as is also the case under force 2 (chi-square test, p=0.407). Under force 3 (Levene test, p=0.899), there is no difference in the distributions of effort between the two types of implants. Conclusions: it was determined that the conventional prefabricated implant distributes and concentrates the effort generated under different forces better than the sintered custom implant.
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Implantes Dentales , Diente Premolar , Prótesis Dental , Análisis del Estrés DentalRESUMEN
Resumen Objetivo. Comparar posición condilar y espacio articular en articulación témporo-mandibular, en pacientes con y sin disfunción témporo-mandibular mediante tomografía Cone Beam. Métodos. Criterios diagnósticos de investigación para trastornos témporo-mandibulares Eje II, n=50 pacientes ambos sexos, edad comprendida 18 - 27 años. Muestra aleatoria n= 50 pacientes equivalente a 100 articulaciones, se obtuvo: n=25 pacientes sin disfunción témporo-mandibular, considerados asintomáticos 25 con y sin disfunción témporo-mandibulares, considerados sintomáticos. Mediante tomografía Cone Beam de articulación témporo-mandibular boca abierta - boca cerrada se avaluó de forma manual los espacios interarticulares. Resultados. El espacio condilar anterior en pacientes con y sin disfunción témporo-mandibular no presentó diferencia significativa, p=0,30. La posición condilar tampoco mostró diferencia significativa p=0,58. En pacientes con y sin disfunción témporo-mandibular (sintomáticos) la posición central y posterior del cóndilo (35,2%), pacientes con y sin disfunción témporo-mandibular (asintomáticos) la posición anterior y central fue más significativa (37,0%); seguido de la posición posterior del cóndilo (26,1%). Conclusión. No existe diferencia significativa en la posición condilar y el espacio interarticular en pacientes sintomáticos y asintomáticos.
Abstract Aim. To compare the condylar position and joint space of the temporomandibular join in individuals with and without temporomandibular dysfunction, using cone beam computed tomography (CBCT). Methods. Research Diagnostic Criteria for Temporomandibular Disorders Axis II (n= 50) patients both sexes, age 18 - 27 years. Random sample (n=50) patients equivalent to 100 joints, obtaining: n-25 patients without temporomandibular dysfunction, considered asymptomatic and 25 patients with and without temporomandibular dysfunction, considered symptomatic. By tomography Cone Beam of open mouth temporomandibular joint - closed mouth was manually evaluated the interarticular spaces. Results. The anterior condylar position space and condylar position not significantly different in induvials with and without temporomandibular dysfunction temporomandibular disorders p=0,30 and p=0,58, respectively. Conclusions. There is no significant difference in the condylar position and intraarticular.
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Humanos , Masculino , Femenino , Adolescente , Adulto , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Síndrome de la Disfunción de Articulación Temporomandibular/diagnóstico , Cóndilo Mandibular/diagnóstico por imagen , Tomografía Computarizada de Haz CónicoRESUMEN
Resumen Evaluar la influencia del tipo de terminación marginal; filo de cuchillo (F) y chamfer (C) sobre la resistencia flexural de coronas de disilicato de litio CAD/CAM en espesores de 0,8 mm y 0,5 mm. Materiales y métodos: 40 premolares superiores sanos, en 2 grupos de acuerdo con el tipo de terminación G1=F y G2=C; 2 subgrupos referentes al espesor del material Sg1=0,8mm y Sg2 0,5 mm (5 coronas por cada subgrupo), se sometieron a fuerzas de compresión vertical (v) y horizontal (h). Se observó el tipo de fractura más frecuente; cohesivas en porcelana (cp), adhesiva en porcelana (ap), mixta pequeña (mp) y mixta larga (ml). Resultados: En preparaciones a 0,8 mm y 0,5 mm, existió diferencia significativa en relación con la mejor terminación, esta fue el C; sus valores fueron, Sg1 (h=1347,2 N / v=1402,0. F; Sg1 (h=965,6 N/ v= 794,8 N). F a 0,5 mm mostró mejor desempeño ante fuerzas horizontales. C; Sg2 (h=924,8 N /v=813,4 N) y para F; Sg2 (h=1217,0 N /v= 576,0 N). Conclusiones: Tipo de fractura más frecuente es cp y ap. Terminación chamfer y filo de cuchillo pueden ser utilizados con seguridad, pues muestran valores aceptables de resistencia flexural, al reducirse el grosor de la restauración en chamfer reduce su resistencia, el filo de cuchillo la aumenta.
Abstract Objective: To evaluate the influence of the type of shoulder margins; Knife edge (F) and Chamfer (C) on the flexural strength of CAD / CAM lithium disilicate crowns in thicknesses of 0.8 mm and 0.5 mm. Materials and Methods: 40 healthy upper premolars, in 2 groups according to the type of termination G1 = F and G2 = C; 2 subgroups referring to the material thickness Sg1 = 0.8mm and Sg2 0.5mm (5 crowns for each subgroup), were subjected to vertical (v) and horizontal (h) compression forces. The most frequent type of fracture was observed; cohesive in porcelain (cp), adhesive in porcelain (ap), mixed small (mp) and mixed long (ml). Results: In preparations with 0.8 mm and 0.5 mm thicknesses, there was a significant difference in relation to the best termination, this was C; their values were Sg1 (h = 1347.2 N / v = 1402.0.F; Sg1 (h = 965.6 N / v = 794.8 N) .F at 0.5 mm showed better performance against horizontal forces C; Sg2 (h = 924.8 N / v = 813.4 N) and for F; Sg2 (h = 1217.0 N / v = 576.0 N) Conclusions: The most frequent type of fracture is cp and ap finishing chamfer and knife edge can be used safely show acceptable values of flexural strength, by reducing the thickness of the chamfer restoration reduces its strength, the knife edge increases it.
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Coronas , Materiales Dentales/análisisRESUMEN
ABSTRACT Introduction: the clinical success of adhesive systems is based on the use of a responsible for creating microporosity in the dental structure acid and arises assess in vitro the degree of microfiltration in direct restorations with cavities class V where two adhesive systems differently used composition and at different periods of time. Methods: in the cervical third of 60 third molars extracted by therapeutic indication performed by diamond instruments, two cavities one on the vestibular side and one on the palatal or lingual side; It separated into two groups of 30 in the first acid conditioning was performed and then applied -Voco Admire bond while the second group Futurabond-Voco applied; both groups were restored with resin composite Admira-Voco, each group was divided into two subgroups of 15 subgroups A were subjected to thermal cycling for 10800 cycles and 5400 cycles B subgroups. It concluded these periods proceeded to staining with methylene blue and then a cut is made lengthwise to assess the income of the dye in the interface formed; this pigmentation was evaluated and measured under stereomicroscope. Results: the obtained data were statistically analyzed by Tukey′s test, which showed the existence of differences between the groups evaluated, so evident at the level of cervical margin with a p > 0.05 Conclusions: it is evident that the artificial aging increased microfiltration resin composite restorations regardless of the type of adhesive system used.
RESUMEN Introducción: el éxito clínico de los sistemas adhesivos está basado en el empleo de un ácido responsable de crear microporosidades en la estructura dental, así se plantea evaluar in vitro el grado de microfiltración existente en restauraciones directas con cavidades clase V donde se emplean dos sistemas adhesivos de diferente composición y en diferentes períodos de tiempo. Métodos: en el tercio cervical de 60 terceros molares extraídos por indicación terapéutica se realizaron, mediante instrumentos diamantados, dos cavidades: una en la cara vestibular y otra en la cara palatina o lingual, y fueron separados en dos grupos; en el primero se efectuó acondicionamiento ácido y luego se aplicó Admira bond- Voco, mientras que en el segundo se aplicó Futurabond NR-Voco. Ambos grupos fueron restaurados con resina compuesta Admira-Voco, cada grupo fue dividido en dos subgrupos de 15, los subgrupos A fueron sometidos a termociclado por 10800 ciclos y los subgrupos B por 5400 ciclos. Concluidos estos períodos, se procedió a su tinción con azul de metileno y luego se efectuó un corte en sentido longitudinal para evaluar el ingreso del colorante en la interface formada; esta pigmentación fue evaluada y medida bajo microscopio estereoscópico. Resultados: los datos obtenidos fueron analizados estadísticamente mediante el test de Tukey, que demostró la existencia de diferencias entre los grupos evaluados, de forma más evidente a nivel del margen cervical, con un p > 0,05. Conclusiones: se evidencia que el envejecimiento artificial aumentó la microfiltración de las restauraciones de resina compuesta independientemente del tipo de sistema adhesivo empleado.
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Resinas Compuestas , MicrocribadoRESUMEN
Objetivo. Comparar posición condilar y espacio articular en articulación témporo-mandibular, en pacientes con y sin disfunción témporo-mandibular mediante tomografía Cone Beam. Métodos. Criterios diagnósticos de investigación para trastornos témporo-mandibulares Eje II, n=50 pacientes ambos sexos, edad comprendida 18 - 27 años. Muestra aleatoria n= 50 pacientes equivalente a 100 articulaciones, se obtuvo: n=25 pacientes sin disfunción témporo-mandibular, considerados asintomáticos 25 con y sin disfunción témporo-mandibulares, considerados sintomáticos. Mediante tomografía Cone Beam de articulación témporo-mandibular boca abierta - boca cerrada se avaluó de forma manual los espacios interarticulares. Resultados. El espacio condilar anterior en pacientes con y sin disfunción témporo-mandibular no presentó diferencia significativa, p=0,30. La posición condilar tampoco mostró diferencia significativa p=0,58. En pacientes con y sin disfunción témporo-mandibular (sintomáticos) la posición central y posterior del cóndilo (35,2%), pacientes con y sin disfunción témporo-mandibular (asintomáticos) la posición anterior y central fue más significativa (37,0%); seguido de la posición posterior del cóndilo (26,1%). Conclusión. No existe diferencia significativa en la posición condilar y el espacio interarticular en pacientes sintomáticos y asintomáticos.
Aim. To compare the condylar position and joint space of the temporomandibular join in individuals with and without temporomandibular dysfunction, using cone beam computed tomography (CBCT). Methods. Research Diagnostic Criteria for Temporomandibular Disorders Axis II (n= 50) patients both sexes, age 18 - 27 years. Random sample (n=50) patients equivalent to 100 joints, obtaining: n-25 patients without temporomandibular dysfunction, considered asymptomatic and 25 patients with and without temporomandibular dysfunction, considered symptomatic. By tomography Cone Beam of open mouth temporomandibular joint - closed mouth was manually evaluated the interarticular spaces. Results. The anterior condylar position space and condylar position not significantly different in induvials with and without temporomandibular dysfunction temporomandibular disorders p=0,30 and p=0,58, respectively. Conclusions. There is no significant difference in the condylar position and intraarticular.