Environmental sustainability related to dental materials and procedures in prosthodontics: A critical review.

This article aims to review the status, challenges, and directions of environmentally sustainable oral healthcare by focusing on the dental materials and procedures used in prosthodontics. Sustainable development is a global priority and requires a systemic, integrative approach from all sectors of society. The oral healthcare sector is responsible for substantial greenhouse emissions throughout its value chain, including raw material extraction, industrial production, supply distribution, clinical practice, and management of waste. Of all dental specialties, prosthodontics has been one of the main generators of carbon emissions by fabricating a single product such as dentures or crowns in multiple steps. Dental prosthetic procedures involve chemicals and materials such as polymers, ceramics, metals, gypsum, and wax, which are often used in large quantities and for a single use. Thus, environmental risks and socioeconomic burdens can result from residuals and improper disposal, as well as waste and the embedded costs of unused materials retained by manufacturers, retail suppliers, dental laboratories, and dental clinics. To mitigate the environmental impact generated by conventional prosthodontics, we urge awareness and the adoption of sustainable good practices in the daily routine of dental clinics and laboratories. Capacity building and investment in a circular economy and digital technology can reduce the carbon footprint of prosthetic dentistry and improve the quality of life for present and future generations.

Importance of phytotherapy for oral health care and quality of life in adults: A scoping review.

Medicinal plants and herbal medicines are used as integrative and complementary practices to provide comprehensive care, disease prevention, health promotion, and to improve quality of life (QoL). This scoping review aimed to identify and describe the use of phytotherapy in oral health care by adults and their outcomes, with a focus on perceptions of oral health-related QoL, healthcare access, and costs. A systematic search was conducted in six databases and supplemented in grey literature. According to a PRISMA-ScR protocol and eligibility criteria, publications were assessed for final inclusion, data charting, and narrative synthesis. Out of 4124 records, 542 publications were selected for full-text reading. A total of 32 studies were included: 21 studies assessed QoL, 7 reported access issues, and 11 reported costs issues. Herbal mouthwashes to prevent or treat non-infectious oral conditions were the most frequent treatment. Efficacy of phytotherapy was usually better than placebo or control treatment. Most studies reported QoL improvement, but several instruments were used with heterogeneous results. Limited healthcare access and high costs favoured traditional folk herbal medicine in underserved populations. It can be concluded that phytotherapy for oral health is used by adults worldwide, following modern clinical pharmacology and traditional knowledge concepts. Further studies should incorporate assessment of QoL, access, and costs in addition to clinical efficacy and safety, which are complementary aspects for delivering a comprehensive and efficient health care for all people.

Decontamination of dental implant surfaces by means of photodynamic therapy.

Several implant surface debridement methods have been reported for the treatment of peri-implantitis, however, some of them can damage the implant surface or promote bacterial resistance. Photodynamic therapy (PDT) is a new treatment option for peri-implantitis. The aim of this in vitro study was to analyze implant surface decontamination by means of PDT. Sixty implants were equally distributed (n = 10) into four groups and two subgroups. In group G1 there was no decontamination, while in G2 decontamination was performed with chlorhexidine. G3 (PDT - laser + dye) and G4 (laser, without dye) were divided into two subgroups each; with PDT performed for 3 min in G3a and G4a, and for 5 min in G3b and G4b. After 5 min in contact with methylene blue dye (G3), the implants were irradiated (G3 and G4) with a low-level laser (GaAlAs, 660 nm, 30 mW) for 3 or 5 min (7.2 and 12 J). After the dilutions, culture media were kept in an anaerobic atmosphere for 1 week, and then colony forming units were counted. There was a significant difference (p < 0.001) between G1 and the other groups, and between G4 in comparison with G2 and G3. Better decontamination was obtained in G2 and G3, with no statistically significant difference between them. The results of this study suggest that photodynamic therapy can be considered an efficient method for reducing bacteria on implant surfaces, whereas laser irradiation without dye was less efficient than PDT.

Accuracy of four transfer impression techniques for dental implants: a scanning electron microscopic analysis.

PURPOSE: The aim of this study was to evaluate, using scanning electron microscopy (SEM), the accuracy of four impression techniques for osseointegrated implants (with or without acrylic resin splinting and with irreversible hydrocolloid or polyvinyl siloxane [PVS] impression material). MATERIALS AND METHODS: A metal master model was made with three implant analogs and two prosthetic spaces. This model was used as the standard for all impressions. Two impression materials were used (irreversible hydrocolloid and PVS) and two transfer techniques were used (squared impression copings indexed by the impression material and squared impression copings splinted with acrylic resin). Four groups were therefore analyzed (n = 5): IH = irreversible hydrocolloid only, IHS = irreversible hydrocolloid + splint, P = PVS only, and PS = PVS + splint. A reference framework made with palladium-silver alloy over the UCLA abutment was created on the master model. The fit of this structure to the master model was used as a reference. SEM images of the front and side gaps between the abutments and the implant analogs were created and then measured using image analysis software. RESULTS: IH presented the largest misfit. The splinted impression copings generated a smaller marginal gap than the indexed material technique, irrespective of the impression material used. There was no significant difference between IHS, P, PS, and the reference (multivariate test, Wilks criteria). However, PS presented a standard deviation that was three times lower than those of the other groups, and its mean was closer to the reference. CONCLUSIONS: The IH impression technique was the least accurate technique. There was no difference between IHS, P, and PS techniques with regard to the reference constant. The impression techniques that used splinted impression copings generated more accurate casts, irrespective of the impression material.