Developmental Defects of Enamel: A Bibliometric Analysis of the Top 100 Most-Cited Papers.

BACKGROUND: Developmental defects of enamel (DDE) are a result of disturbances during formation and maturation of the enamel. Evaluating the most-cited DDE papers can provide important tools that point to the gaps and strengths of this important topic in dentistry. SUMMARY: This bibliometric study analyzed the 100 most-cited papers on DDE. Using a combined keyword search strategy, the 100 most-cited papers were selected in the Web of Science Core Collection. Papers that addressed any type of DDE were included. The extracted data were title, number of citations, study theme, authorship, journal, type of DDE, type of dentition (primary or permanent), type of diagnosis, study design, year, and country of publication. The bibliometric networks were generated through VOSviewer software. The 100 papers had a range from 78 to 459 citations. The main themes of studies were etiopathogenesis (53%), prevalence and incidence (22%), and diagnosis (8%). The authors with the highest number of citations were Goodman AH and Rose JC (459 citations). Most articles were published in dental journals (47%). The most studied types of DDE were fluorosis and amelogenesis imperfecta in the permanent dentition (47%). Observational (24%) and non-systematic reviews (24%) were the most common study designs and ranged from 1977 to 2019. The country with the highest number of publications was the USA (41%). KEY MESSAGES: Most of the top 100 DDE papers were about fluorosis and amelogenesis imperfecta, with top papers from three continents with English as the native language. This topic is of great importance in dentistry, and the need for further studies is highlighted, especially regarding the diagnosis and treatment of some DDEs.

Association of Papacarie Duo® and low-level laser in antimicrobial photodynamic therapy (aPDT).

Dental caries is a multifactorial, non-communicable disease. Effective treatment options for minimally invasive removal of carious tissue include Papacarie Duo® gel and antimicrobial photodynamic therapy (aPDT). aPDT involves a combination of a light source and photosensitizer. Given that Papacarie Duo® contains a percentage of blue dye, this study aims to explore the antimicrobial potential of Papacarie Duo® when associated with a light source against Streptococcus mutans strains. The chosen light source was a low-power diode laser (λ = 660 nm, E = 3 J, P = 100 mW, t = 30 s). To assess antimicrobial capacity, planktonic suspensions of Streptococcus mutans were plated on Brain Heart Infusion Agar (BHI) to observe the formation of inhibition halos. The studied groups included methylene blue (0.005%), Papacarie Duo®, distilled water (negative control), 2% chlorhexidine (positive control), Papacarie Duo® + laser, and methylene blue (0.005%) + laser. Following distribution onto plates, each group was incubated at 37 °C for 48 h under microaerophilic conditions. Inhibition halos were subsequently measured using a digital caliper. The results showed that chlorhexidine had the greatest antimicrobial effect followed by the group of irradiated methylene blue and irradiated Papacarie Duo®. All experimental groups demonstrated antimicrobial potential, excluding the negative control group. The study concludes that Papacarie Duo® exhibits antimicrobial properties when associated with a low-power diode laser.

Adhesive restorations in primary dentition: A retrospective analysis of survival rate and associated factors.

BACKGROUND: Several clinical and individual factors may play a role in the survival rate of dental restorations, such as characteristics related to the child's age and oral hygiene, and factors associated with the tooth, such as the type of material and number of surfaces to be restored. AIM: To analyse the survival rate of adhesive restorations on primary teeth and factors associated with restoration survival. DESIGN: The study included dental records of children aged 3-12 years having received adhesive restorations on primary teeth at a Brazilian dental school between 2009 and 2019. A Kaplan-Meier survival curve was used to plot survival rates using the log-rank test. A multivariate Cox regression model was run to identify individual and dental factors associated with restoration failure. RESULTS: The sample comprised 269 restored teeth in 111 children. Survival curves were similar for all materials (p = .20) and types of isolation (p = .05). The annual failure rate was 3.60% for glass ionomer cement, 1.23% for resin-modified glass ionomer cement and 0.40% for composite resin. The following variables were associated with more failures: Class II restoration compared with Class I (HR = 1.96; 95%CI: 1.28-2.99, p < .001), proportion of decayed teeth (HR = 11.89; 95%CI: 2.80-50.57, p < .001) and child's age (HR = 1.17; 95%CI: 1.06-1.29, p < .001). CONCLUSION: The different materials and types of isolation had similar survival rates. Children with more decayed teeth have an increased risk of restoration failure.

Frequency of missing data in clinical records in pediatric dentistry: a descriptive study.

The aim of the present study was to investigate the frequency of missing data on routine dental care appointments and restorative procedures from the clinical records of children treated at a pediatric dental clinic. A descriptive retrospective study was conducted involving the clinical records of children three to 12 years of age treated only with restorations. The inclusion criteria were clinical records from the past 10 years of children with at least one restored tooth. Data collection was performed by a trained examiner who extracted information from the clinical records on appointments for routine dental care and restorative procedures. The frequency of missing data on clinical records was submitted to descriptive analysis. Among the 249 clinical records analyzed, boys accounted for little more than half (54.2%) and mean patient age was 6.9 ± 1.8 years. Ninety-four of the 249 clinical records were of appointments for routine dental care. Missing data were found for the gingival bleeding index (18.1%), visible plaque index (22.3%) and dietary logs (74.5%). Forty-seven children were submitted to a total of 618 restorative procedures. Information was missing on the type of restorative material (5%), brand of the material used (65.2%), the type of isolation (50.8%) and whether pulp capping was performed (75.9%). The percentage of missing data from clinical records was substantial, demonstrating that important information is not recorded during routine dental care or restorative procedures.

Photobiomodulation therapy for hypersensitivity associated with molar-incisor hypomineralization: a case report.

Molar-incisor hypomineralization (MIH) is a qualitative defect of the dental enamel on permanent first molars and may be associated with permanent incisors. There is currently no defined therapeutic protocol for managing the hypersensitivity associated with this condition. The present case report describes the treatment of a patient with MIH and the impact on the patient's quality of life as assessed using the Child Perceptions Questionnaire for children aged 11 to 14 years (CPQ11-14). The maxillary central incisors, maxillary and mandibular first molars, and mandibular right canine of an 11-year-old girl were compromised by MIH. The long version of the CPQ11-14 was self-administered before treatment. Initially, the patient reported hypersensitivity of her maxillary right central incisor, maxillary and mandibular left first molars, and mandibular right canine when consuming cold food and beverages. This was confirmed by applying a jet of air to the teeth and asking the patient to report the level of sensitivity using the Wong-Baker FACES Pain Rating Scale. The patient reported that hypersensitivity was present every day or almost every day. Desensitizing treatment included 4 applications of photobiomodulation therapy (infrared diode laser) and 4 applications of fluoride varnish. After desensitization, the maxillary central incisors received direct composite resin restorations, while the maxillary left first molar, which had an amalgam restoration and recurrent caries, received a resin-modified glass ionomer cement restoration. At the conclusion of the treatment, the patient completed the CPQ11-14 again and reported less difficulty with consuming hot and cold foods and beverages, indicating that treatment had reduced hypersensitivity and its negative impact on her quality of life.

Amelogenesis imperfecta: use of cyanoacrylate as a desensitizing agent and its impact on oral health-related quality of life.

Amelogenesis imperfecta (AI) is a rare hereditary condition characterized by abnormal enamel formation and increased tooth sensitivity. There are no defined therapeutic recommendations for tooth sensitivity in patients with AI. The aim of the present case report of a 5-year-old girl with AI is to describe the use of cyanoacrylate as a desensitizing agent on the patient's permanent molars and report the impact of this treatment on her oral health-related quality of life (OHRQoL). After 4 sodium fluoride varnish applications were unsuccessful in relieving sensitivity affecting the molars, cyanoacrylate was applied 5 times (at intervals of 7, 15, 30, and 180 days after the first application). Pain scores were recorded on a visual analog scale before and after each intervention, and the OHRQoL was measured using a questionnaire (Early Childhood Oral Health Impact Scale [ECOHIS]) administered prior to the first cyanoacrylate application and on the last day of the protocol. In this patient, cyanoacrylate seemed to be effective at decreasing tooth sensitivity in immature permanent molars affected by AI, as demonstrated by reductions in the frequency of complaints of dental pain, difficulty in drinking cold beverages, and difficulty in eating some foods.

In Vitro Effect of Simulated Tooth Brushing and Children's Mouth Rinses on Physical Properties of Glass Ionomer Cement.

OBJECTIVE: The present study investigated the erosive potential of children's mouthrinses on glass ionomer cement (GIC) samples after simulated toothbrushing. STUDY DESIGN: Forty round-shaped samples of GIC were divided into 3 groups: G1- cetylpyridinium chloride, G2- xylitol and triclosan and G3-Malva sylvestris and xylitol and G4-distilled water as a control group. Prior to the main tests, the samples were submitted to the surface roughness measurement (Ra) and weight analysis (W). Afterward, they were brushed twice day (2× / day) for 15 days and immersed in mouthrinses after the last daily brushing. The final surface roughness (R2) and weight (W2) were determined after completing the tooth brushing-mouth rinsing cycles and the real increase in roughness (ΔRa) and real weight loss (ΔW) were calculated. In addition, stereoscopic images taken at 30× magnification. The data was analyzed by one-way ANOVA and Tukey-test post hoc tests for intergroup comparison and the T-test for dependent samples (α = 0.05). RESULTS: Only group G2 showed increased in roughness ΔRa (1.53 ± 0.94) whereas ΔW values were not significant. However, evident cracks and voids were verified for all tested children's rinses. CONCLUSION: Thus, children's mouthrinse containing xylitol / triclosan increased the GIC roughness, especially when associated with brushing.

Comparative analysis of microorganism adhesion on coated, partially coated, and uncoated orthodontic archwires: A prospective clinical study.

INTRODUCTION: This study aimed to compare the microorganism adhesion on coated, partially coated, and uncoated orthodontic archwires after clinical use. The correlation between surface roughness (SR) and bacterial colonization was also evaluated. METHODS: A total of 48 archwire segments (0.016 × 0.022-in) were equally divided into 4 groups: nickel-titanium coated, nickel-titanium partially coated, uncoated stainless steel, and uncoated nickel-titanium. The archwires were randomly inserted in a split-mouth study design. After 4 weeks of clinical use, the total number of microorganisms adhering to the archwire was quantified and transformed into colony-forming units. SR was evaluated using a profilometer. A one-way and two-way ANOVA, post-hoc Tukey test, paired-samples t test, and Pearson correlation coefficient were used for statistical analysis. RESULTS: All the archwires presented microorganism adhesion, with the nickel-titanium-coated group demonstrating the highest value (P < 0.001). A statistically significant increase in SR was observed after clinical use for all groups (P < 0.05). No correlation between SR and bacterial adhesion was detected. CONCLUSIONS: Microorganism adhesion occurred on all of the archwires tested, especially on the esthetic fully coated. Because SR was not correlated with microorganism adhesion, future studies should evaluate the effect of surface free energy and superficial chemical changes on in-vivo microorganism adhesion.

Impact of untreated dental caries on the quality of life of Brazilian children: population-based study.

BACKGROUND: The assessment of oral health should consider clinical and biopsychosocial aspects. AIM: To evaluate the impact of untreated dental caries on the quality of life of children. DESIGN: A cross-sectional study was conducted with 647 Brazilian children. The Child Perceptions Questionnaire (CPQ8-10 ) and the 'oral health' global indicator were administered to the children and used as the outcomes. Parents answered a general questionnaire, and oral clinical examinations were performed. Data analysis involved descriptive statistics, chi-squared test, Mann-Whitney test, and Poisson's regression analysis (α = 5%). The psychometric properties of the CPQ8-10 were tested for younger age group (6/7 years). RESULTS: Untreated caries was a predictor of impact on quality of life for the following items: 'pain in teeth/mouth' (PR = 1.69; 95% CI: 1.41-2.04), 'difficulty biting/chewing hard foods' (PR = 1.28; 95% CI: 1.05-1.56), 'difficulty eating what you wanted to eat' (PR = 1.61; 95% CI: 1.29-2.02), 'trouble sleeping' (PR = 1.64; 95% CI: 1.27-2.13), 'missed school' (PR = 1.62; 95% CI: 1.24-2.12), 'trouble doing homework' (PR = 1.61; 95% CI: 1.12-2.31), and 'difficulty paying attention in class' (PR = 1.41; 95% CI: 1.01-1.96). CONCLUSION: Children with untreated dental caries feel greater negative impacts on quality of life than children without untreated caries.

Eighteen-month clinical performance of composite resin restorations with two different adhesive systems for molars affected by molar incisor hypomineralization.

INTRODUCTION: The restorative management of molars with molar incisor hypomineralization (MIH) represents a challenge in the clinical practice with high failure rate. OBJECTIVE: The aim of this study is to evaluate the clinical survival of direct composite resin restorations in first permanent molars (FPMs) that are affected by MIH, comparing two adhesive systems. MATERIAL AND METHODS: We selected 41 FPMs with MIH from children aged 6-8 years. FPM fully erupted and with restorative treatment needed were the inclusion criteria. We excluded FPMs with destroyed crowns. The FPMs were randomly assigned to two groups: self-etching adhesive (SEA) and total-etch adhesive (TEA). Clinical evaluation was performed by a blinded examiner during 18 months according to the modified US Public Health Service (USPHS) criteria. The actuarial method was used to evaluate survival of the restorations, and Chi-square and Fisher's exact tests were used to compare differences between the groups (α = 5 %). RESULTS: The cumulative survival rates were 100 % at 1 month, 89 % at 6 months, 73 % at 12 months, and 68 % at 18 months in SEA, and 95 % at 1 month, 72 % at 6 months, 59 % at 12 months, and 54 % at 18 months in TEA; there was no significant difference between groups. CONCLUSIONS: There was no difference in clinical survival of restorations in FPMs affected by MIH using TEA or SEA adhesives in the end of 18 months. CLINICAL RELEVANCE: It was suggested that SEAs as well as TEAs can be applied to restore molars affected by MIH, when it is performed a conservative cavity preparation. Once, cavosurface margins (cavity design) in hypomineralized enamel have less bonding capability.

Longitudinal Evaluation of the Structural Integrity of Teeth Affected by Molar Incisor Hypomineralisation.

The aim of this prospective cohort study was to evaluate the risk of posteruptive breakdown and the development of caries lesions in teeth with molar incisor hypomineralisation (MIH). A total of 367 permanent incisors and first molars, affected and not affected by MIH lesions, of 45 children with MIH from Araraquara, São Paulo, Brazil, were evaluated at intervals from 6 to 12 months by assessing the severity of MIH, the presence of tooth caries lesions and the treatment needed. During the study period, all patients received preventive care. The data were analysed using Fisher's exact test and actuarial method survival analysis. Significant associations were also found in teeth between the presence of MIH and a DMFT index >0 in all periods and also between the need for treatment and the presence of MIH. The teeth affected by MIH opacities were healthy in 99% of incisors and 93% of molars at the end of the 12-month period. Due to the high likelihood of maintaining the tooth structure in opacities, the complete or premature removal of the affected area is not justified.

Photodynamic antimicrobial chemotherapy on Streptococcus mutans using curcumin and toluidine blue activated by a novel LED device.

Photodynamic antimicrobial chemotherapy (PACT) is an antimicrobial approach that uses photosensitizers (PS) in combination with light sources at specific wavelengths aiming the production of reactive oxygen species. The long illumination time necessary to active PS is a challenge in PACT. Thus, this study investigated the antimicrobial effect of a novel single source of light-emitting diode (LED) light that covers the entire spectrum of visible light beyond interchangeable probes at high power intensity. Blue and red LED probes were used into different exposure times to active different concentrations of curcumin (C) and toluidine blue (T) on planktonic suspensions of Streptococcus mutans UA 159 (S. mutans). S. mutans were standardized and submitted to (1) PACT treatment at three concentrations of C and T exposure at three radiant exposures of a blue LED (BL) (C+BL+) and a red LED (RL) (T+RL+), (2) C (C+BL-) or T alone (T+RL-), (3) both LED lights (C-BL+ and T-RL+), and (4) neither PS nor LED illumination (control group: C-BL- and T-RL-). Aliquots of the suspensions were diluted and cultured on blood agar plates. The number of colony-forming units was calculated after 48 h. The groups submitted to PACT presented a lethal photokilling rate to all PS concentrations at tested dosimetries. The comparison to control group when PS and LED lights used alone demonstrated no decrease in the number of viable bacterial counts. The novel LED device in combination with curcumin and toluidine blue promoted an effective photoinactivation of S. mutans suspensions at ultrashort light illumination times.

Longitudinal effect of curcumin-photodynamic antimicrobial chemotherapy in adolescents during fixed orthodontic treatment: a single-blind randomized clinical trial study.

White spot lesions are one of the concerns during the fixed orthodontic treatment. Thus, the aim of the present study was to evaluate the antimicrobial/anti-inflammatory effect of curcumin-photodynamic antimicrobial chemotherapy (c-PACT) and chlorhexidine varnish on the plaque accumulation and gingival bleeding in adolescents under fixed orthodontic treatment. A randomized clinical trial was performed with an initial number of 45 patients being distributed into three groups: group I-chlorhexidine varnish 2%, group II-placebo varnish, and group III-c-PACT (curcumin at 1.5 mg.mL(-1)) exposed to blue Light-emitting diode (LED) light at 450 nm (power density = 165 mW.cm(-2), fluency = 96 J.cm(-2), total dose = 150.7 J). The treatments were performed for four consecutive times with an interval of 1 week each. After the interventions, two calibrated examiners (Kappa value = 0.75) analyzed the dental plaque accumulation by plaque index (PI) and gingivitis condition by gingival bleeding index (GBI) with 1 and 3 months of follow-up after the treatments comprised a final sample of 35 patients. No significant difference was found to PI between the groups during baseline and 1-month period. Group III (1.52 ± 0.51) presented significance difference from group I (0.91 ± 0.75) and group II (1.03 ± 0.51) at 3 months of follow-up. In this same period, there was more plaque accumulation with significant statistical difference (P ≤ 0.05) in comparison to the other periods to all studied groups. There was a GBI reduction statistically significant to groups I and III at 1-month follow-up in comparison to other periods. No effect was verified to dental plaque accumulation after the photodynamic application mediated with curcumin activated with a blue LED light.

Comparative effects of photodynamic therapy mediated by curcumin on standard and clinical isolate of Streptococcus mutans.

AIM: The aim of this study was investigate the effect of photodynamic therapy (PDT) using curcumin (C) as a photosensitizing agent irradiated with an LED (L) in the blue wavelength as a light source on a standard and clinical isolate of Streptococcus mutans (S. mutans) in a planktonic suspension model. MATERIALS AND METHODS: Suspensions of both strains were divided into 4 groups as follows: absence of C and L (control group: C-L-), with C and without L (C group: C+L-), absence of C with L (L group: C-L+) and presence of C and L (PDT group: C+L+). Three different concentrations of curcumin (0.75 mg/ml, 1.5 mg/ml and 3 mg/ml) and three light fluences of studied light source (24, 48 and 72 J cm(-2)) were tested. Aliquots of each studied group was plated in BHI agar and submitted to colony forming units counting (CFU/ml) and the data transformed into logarithmical scale. RESULTS: A high photoinactivation rate of more than 70% was verified to standard S. mutans strain submitted to PDT whereas the clinical isolate showed a lower sensitivity to all the associations of curcumin and LED. A slight bacterial reduction was verified to C+L- and C-L+, demonstrating no toxic effects to the isolated application of light and photosensitizer to both S. mutans strains tested. CONCLUSION: Photodynamic therapy using a combination of curcumin and blue LED presented a substantial antimicrobial effect on S. mutans standard strain in a planktonic suspension model with a less pronounced effect on its clinical isolate counterparts due to resistance to this alternative approach. CLINICAL SIGNIFICANCE: Alternative antimicrobial approaches, as photodynamic therapy, should be encouraged due to optimal results against cariogenic bacteria aiming to prevent or treat dental caries.

Esthetic and function improvement by direct composite resins and biomimetic concept.

AIM: This case report describe a resin layering restorative technique based on biomimetic concept to improve esthetics in a patient with dental defects that affected both enamel and dentin in anterior teeth. BACKGROUND: Severe structural defect in anterior teeth compromises esthetics and it is a high challenge to become the defect imperceptible after the restoration. CASE DESCRIPTION: A clinical sequence of applying different composite resin layers allowed the reproduction of the interaction between hard dental tissues and the restorative material. CONCLUSION: This technique achieved a satisfactory final esthetic outcome, preserving sound teeth structure and at same time, improved the quality of life of the young patient. CLINICAL SIGNIFICANCE: The utilization of the biomimetic concept to increase a disharmonic smile with dental defects is based in a conservative approach, which reached a satisfactory and esthetic outcome.

Morphological changes and viability of Streptococcus mutans biofilm treated with erythrosine: A confocal laser scanning microscopy analysis.

Antimicrobial photodynamic therapy (a-PDT) is a modality that aims to induce microorganisms through visible light, a photosensitizer, and molecular oxygen. This therapy has shown promising results in controlling cariogenic biofilm in vitro and in vivo counterparts. This study investigated bacterial viability and morphological characterization of Streptococcus mutans mature biofilms after combination of erythrosine and a high potency dental curing light. Biofilms were formed on saliva-coated hydroxyapatite disks in batch culture. The samples were performed in triplicates. Fresh medium was replaced daily for five days and treated using 40 µM of E activated by HL 288 J/cm2 and total dose of 226 J at 1200 mW/cm2. Phosphate buffer saline and 0.12% of chlorhexidine were used as negative and positive control, respectively. After treatment, biofilms were assessed for microbial viability and morphological characterization by means of bio-volume and thickness. COMSTAT software was used for image analysis. Data were analyzed using two-way ANOVA followed by Tukey test with significance level 5%. The application of a-PDT and CHX treatments decreased S. mutans bacterial viability. The image analysis showed more red cells on biofilms when compared to other groups, demonstrating photobacterial killing. Erythrosine irradiated with a high potency curing light can potentially act as an antimicrobial tool in the treatment of cariogenic biofilms. The morphology and viability of microorganisms were impacted after treatment. Treatment with photodynamic therapy may be able to reduce the bio-volume and viability of bacteria present in biofilms. CLINICAL RELEVANCE AND RESEARCH HIGHLIGHTS: The use of the a-PDT technique has been applied in dentistry with satisfactory results. Some applications of this technique are in stomatology and endodontics. In the present study, we sought to understand the use of photodynamic therapy in the control of biofilm and the results found are compatible with the objective of microbiological control proposed by this technique, thus raising the alert for future studies in vivo using the combination of a-PDT with erythrosine, since they are easily accessible materials for the dental surgeon and can be applied in clinical practice.

Roughness assessment of colored compomers: Results after an erosive-abrasive in vitro cycling test.

Background: The present in vitro study aimed to evaluate and compare the surface roughness of a colored compomer and a composite resin, after 15 days of erosive-abrasive cycling. Material and Methods: The sample included ninety circular specimens, randomly divided (n = 10): G1 Berry, G2 Gold, G3 Pink, G4 Lemon, G5 Blue, G6 Silver, G7 Orange and G8 Green, referring to the different colors of compomer (Twinky Star®, VOCO, Germany) and G9 for composite resin (Z250®, 3M ESPE). The specimens were submerged in artificial saliva and stored at 37°C for 24 hours. After polishing and finishing, the specimens were submitted to initial roughness (R1). Then, the specimens were submerged in an acidic cola-based drink for 1 minute and then exposed to electric toothbrushing for 2 minutes for 15 days. After this period, the final roughness (R2) and the ΔRa were performed. Data were submitted to ANOVA and Tukey's test for intergroup comparison and paired T-test for intragroup comparison (p<0.05). Results: Among compomers, the green color presented the higher/lower initial and final roughness values (0.94 ± 0.44, 1.35 ± 0.55) with lemon color presenting the most prominent real roughness increase (ΔRa = 0,74) whereas composite resin showed the lower values (0,17 ± 0.06, 0,31 ± 0.15; ΔRa = 0,14). Conclusions: All compomers, after the erosive-abrasive challenge, presented an increase in roughness values when compared to composite resin with a highlight to green tones. Key words:Compomers, composite resins, surface properties.

Application of lasers in dentistry: a bibliometric study of the top 100 most-cited papers.

This bibliometric study analyzed the 100 most-cited papers about the use of lasers and their modalities in dentistry. A search strategy was created using specific keywords related to the topic. A comprehensive search was then conducted in the Web of Science Core Collection (WoS-CC) database up to July 2021. Papers that addressed the application of any type of laser and its modalities in dentistry were included. Each paper was cross-matched with the number of citations on Scopus and Google Scholar. The following data were extracted from papers: title, number of citations, authorship, country, year of publication, journal, study design, subject, laser type, and oral health outcomes. The VOSviewer software was used to generate bibliometric networks. The total number of citations ranged from 120 to 4,124 and 23 papers received more than 200 citations. Papers were published from 1964 to 2015. Most papers were from Europe (42%) and Anglo-Saxon America (27%). The USA was the country with more top 100 papers (25%). Papers were published mainly in Lasers in Surgery and Medicine (15%) and Lasers in Medical Science (7%). VOSviewer maps demonstrated the existence of national and international research collaborations among institutions and authors. Most studies had a laboratory design (57%) and were about restorative dentistry (32%) and periodontics (21%). This bibliometric study of the top 100 most-cited papers on lasers in dentistry allowed a quantitative and qualitative analysis of this very promising research field, revealing a net of collaboration and the importance of this topic in dentistry.

Modified Arnold expander: an alternative for mandibular arch expansion.

INTRODUCTION: Due to the anatomical constraints of the mandible, mandibular dental arch usually serves as a guideline to determine the required changes in the maxillary transverse dimension. The Schwarz appliance and the Lip Bumper are the traditional orthodontic appliances for mandibular arch expansion in patients with borderline amounts of crowding, and/or transverse discrepancy. However, they often require patient cooperation, which may be a concern for orthodontists in daily practice. OBJECTIVES: This article illustrates a simple fixed orthodontic device as an alternative to achieve mandibular arch expansion in patients with moderate tooth-size/arch-length discrepancy. The four reported cases refer to 8 to 10-year-old patients in the mixed dentition, with an Angle Class I or Class II malocclusion, transverse deficiency in both arches, moderate crowding and/or posterior crossbite, combined with compromised smile aesthetics. The patients were treated with rapid maxillary expansion (RME) using Hass expander appliance and the modified Arnold expander (MAE). CONCLUSION: This low-cost compliance-free orthodontic appliance provided dentoalveolar decompensation by means of uprighting the posterior teeth, with minimal or no adjustments during treatment. The final results were achieved in only three to four months, and fulfilled all treatment objectives, such as an increase in the arch perimeter and width, and a better teeth alignment.