Comparative analysis of the trueness of linear measurements using direct and indirect scanning protocols compared to actual clinical measurements.

OBJECTIVES: To assess the trueness of digital measurements using direct and indirect scanning approaches compared to the actual clinical measurements. MATERIALS AND METHODS: The crown length, width, and width/length ratio were measured in 36 anterior maxillary teeth using three different methods. The first was clinically using a digital caliper, the second was by scanning the teeth using a digital scanner and the third was by making an impression of the teeth, constructing a stone cast in the lab, and scanning it to obtain digital measurements. Bland-Altman test and intraclass correlation were used to assess the data and make comparisons. RESULTS: Measurements taken using both approaches were highly reliable, with intraclass correlations ranging from 0.934 to 0.977 (p ≤ 0.000). Bland-Altman plot reflected a minimal mean difference between measurements especially in crown width measurements. Crown width/crown length measurement displayed the highest mean difference. CONCLUSIONS: Both direct and indirect optical surface scans showed similar high trueness in linear measurements of teeth. A higher discrepancy was detected in the crown width/length ratio. CLINICAL SIGNIFICANCE: Digital dentistry is the new era in patient management. The use of conventional impression techniques and physical dental casts is associated with several disadvantages. Scanning dental casts to convert physical records into digital ones has multiple advantages. Optical surface scans (digital models) of the dentition are currently being more broadly used and advocated in the different dental disciplines including the construction of surgical guides for esthetic crown lengthening procedures. The trueness and reliability of linear measurements are of paramount importance to allow for proper fit and predictable outcomes. In this study, the trueness of these linear measurements obtained using direct and indirect methods was compared to the actual clinical measurements.

Oral processing behavior and dental caries; an insight into a new relationship.

INTRODUCTION: Previous evidence suggests an individual variation in the preferred oral processing behavior. Individuals can be classified as firm processing(FPL) or soft processing likers(SPL). FPL(crunchers and chewers) prefer using their teeth while SPL(smooshers and suckers) prefer using the tongue and the palate when processing different food items. Variation in the preferred oral processing behavior has been associated with differences in food texture preference and eating time. Time is one of the factors directly related to the development of dental caries(tooth decay). Oral retention and eating times are associated with greater caries experience. This study aims to explore if a relationship exists between the preferred oral processing behavior and the individual's caries experience. MATERIALS AND METHODS: This was a cross-sectional, dental center-based study conducted at Jordan University of Science and Technology. Five hundred participants consented to fill out the preferred oral processing behavior(POPB) questionnaire. Anthropometric measurements (including weight, height, and waist circumference) were recorded. A single trained and calibrated dentist registered each participant's caries experience and plaque levels using the DMFS index and plaque index of Silness and Loe. RESULTS: A total of 351(70.2%) and 149(29.8%) participants were typed as FPL and SPL, respectively. SPL demonstrated higher levels of dental caries experience compared to FPL. The mean DMFS score for SPL was 28.8(±25.43) while for FPL was 18.71(± 18.34). This difference remained significant after adjustment for confounders(P<0.001). SPL exhibited a significantly higher mean score for the "M" component(P <0.001) while no significant difference in the mean score of the "D"(P = 0.076) and "F"(P = 0.272) components was observed when compared to FPL. CONCLUSION: The current findings provide new insight into a possible relationship between the preferred oral processing behavior and an individual's caries experience. A relationship in which the preferred oral processing behavior can potentially affect and/or be affected by the dental caries experience.

Three-dimensional cultures of gingival fibroblasts on fibrin-based scaffolds for gingival augmentation: A proof-of-concept study.

OBJECTIVE: Gingival tissue regeneration is associated with several challenges. Tissue engineering regenerates the different components of the tissues, providing three major elements: living cells, appropriate scaffolds, and tissue-inducing substances. This study aimed to regenerate the gingival connective tissue in vitro, using human gingival fibroblasts cultured in three-dimensional fibrin gel scaffolds. DESIGN: Human gingival fibroblasts were seeded in a novel three-dimensional fibrin gel scaffold and maintained in two media types: platelet lysate media (control) and collagen-stimulating media (test). Cellular viability and proliferation were assessed, and the production of collagen and other extracellular matrix components in these constructs was investigated and compared. RESULTS: Human gingival fibroblasts cultured in three-dimensional cultures were metabolically active and proliferated in both media. Furthermore, histologic sections, scanning electron microscopy, and quantitative polymerase chain reaction confirmed the production of higher levels of collagen and other extracellular matrix fibers in three-dimensional constructs cultured in collagen-stimulating media. CONCLUSIONS: Culturing human gingival fibroblasts in a novel three-dimensional fibrin gel scaffold containing collagen-stimulating media resulted in a tissue-equivalent construct that mimics human gingival connective tissue. The impact of these results should be considered for further investigations, which may help to develop a compatible scaffold for gingival soft tissue regeneration and treatment of mucogingival deformities.

Alveolar bone density changes around miniscrews: a prospective clinical study.

INTRODUCTION: Our objective was to assess the effects of miniscrews on interproximal alveolar bone density and adjacent gingival tissue health. METHODS: Forty-four titanium miniscrews were inserted between maxillary second premolars and first molars on both sides of the dentition in 22 consecutive patients (15 female, 7 male; ages, 14-24 years). A control area (between the maxillary first and second premolars) was also assessed. Both miniscrew (study) and control areas were monitored clinically and radiographically at different time points: before insertion of the miniscrews and at 1 month, 3 months, and 6 months after insertion. Software associated with a digital intraoral radiography machine was used to assess changes in alveolar bone density. Clinical gingival parameters of the study and control areas were also recorded. A repeated-measures analysis of variance and the Bonferroni post-hoc pairwise comparison tests were used to assess the changes at the different time points. RESULTS: Thirty-nine miniscrews were successful for the study duration. Male subjects had significantly (P <0.001) higher alveolar bone density than did the females at baseline. Alveolar bone density around the miniscrews increased significantly (P <0.001) between 3 and 6 months after insertion upon loading. Alveolar bone density of the control area did not change significantly during the experiment (P >0.05). The width of keratinized gingiva increased significantly (P <0.001) in the study and control areas after insertion of miniscrews and remained with no significant change throughout the study. CONCLUSIONS: Miniscrews increased the alveolar bone density significantly after 3 months of insertion and were not associated with detrimental effects on the adjacent gingival tissues.

The effect of orthodontic treatment on the periodontium and soft tissue esthetics in adult patients.

OBJECTIVE: Most patients seek orthodontic treatment to achieve an esthetic outcome. Orthodontic treatment has possible negative sequelae. The aim of this study is to assess these possible effects on the periodontium and tissue esthetics. METHODS: One hundred fifty-six patients who have completed orthodontic treatment at Jordan University of Science and Technology clinics were recruited. They were divided into extraction and nonextraction subgroups. Another 155 patients never undergoing orthodontic treatment were assessed. The height of papilla, width of keratinized gingiva, gingival recession, degree of tooth display, smile line, crestal bone level, and proximal caries were assessed. Chi- square test was used for categorical/discrete variables while independent t-test was used for continuous variables. The level of significance was set at (p ≤ 0.05). RESULTS: The mean age was 22 years with no significant difference between the groups. There was a significant difference between "ortho" and "nonortho" groups in tooth display and keratinized gingiva (p = 0.006 and <0.001, respectively). The overall crestal bone level, smile line, recession, and papilla fill did not show any significant differences (p = 0.200, 0.067, 0.120, and 0.066, respectively). The crestal bone level in the upper and lower anterior segments was significantly lower in the "ortho" treated group compared to the "nonortho" treated group (p = 0.002 and 0.005, respectively). A significant difference between "extraction" and "nonextraction" groups was in the width of keratinized gingiva (p = 0.003) and the number of teeth displayed (p < 0.001). Despite reaching statistical significance these differences are not necessarily of clinical significance. CONCLUSION: Orthodontic treatment clearly affects the periodontal tissues; however, the detrimental effects appear to be minimal. Patients with history of orthodontic treatment might have lower crestal bone levels at certain sites and this should not be confused with periodontal disease.

Dimensional Changes in Alveolar Ridge Following Extraction of Teeth in the Maxillary Premolar Area in Subjects with Thick and Thin Gingival Biotypes: A Pilot Study.

This study investigated changes in residual ridge dimensions after tooth extraction among thin and thick gingival biotypes. Fifteen patients who required extraction of maxillary premolars were classified according to gingival biotypes (10 teeth in 9 participants were included in the thick group, and 6 teeth in 6 participants were included in the thin group). Minimally traumatic extractions were carried out using periotomes and rotational movement of teeth. At the time of extraction an osteometer was used to measure the thickness of the labial plate and the bony alveolar ridge at the extraction site by penetrating the tissues until bone was reached 5 mm, 7 mm, and 10 mm below the midpoint of the crest of the facial and palatal gingival margins. Standardized radiographs were taken immediately and after 3 months. The results of this study show minimal differences in dimensional changes following extraction of premolar teeth in thick and thin gingival biotypes. Significantly greater bone loss was detected in both gingival biotypes when the labial plate thickness was less than 1.5 mm, especially in alveolar ridge height.