Top Papers for 2018 - Dentistry

AIM: To assess the outcome of full pulpotomy using Biodentine in permanent teeth with carious exposures and symptoms indicative of irreversible pulpitis. METHODOLOGY: Sixty-four permanent molar teeth with symptomatic vital pulps in 52 patients aged 19-69 years were included. Preoperative pulpal and periapical diagnosis was established. After informed consent, the tooth was anaesthetized, isolated using rubber dam and disinfected with 5% NaOCl before caries excavation; subsequently, the pulp was amputated to the level of the canal orifices...

OBJECTIVES: Three-dimensional (3D) bioprinting, a method derived from additive manufacturing technology, is a recent and ongoing trend for the construction of 3D volumetric structures. The purpose of this systematic review is to summarize evidence from existing human and animal studies assessing the application of 3D printing on bone repair and regeneration in the craniofacial region. DATA & SOURCES: A rigorous search of all relevant clinical trials and case series was performed, based on specific inclusion and exclusion criteria...

Peri-implant and periodontal pockets share a number of anatomical features but also have distinct differences. These differences make peri-implant pockets more susceptible to trauma and infection than periodontal pockets. Inadequate maintenance can lead to infections (defined as peri-implant mucositis and peri-implantitis) within peri-implant pockets. These infections are recognized as inflammatory diseases, which ultimately lead to the loss of supporting bone. Diagnostic and treatment methods conventionally used in periodontics have been adopted to assess and treat these diseases...

In the past 10 years, several proprietary processing procedures for nickel titanium (NiTi) alloy were developed to improve the mechanical properties of NiTi endodontic instruments. Beside specific thermal and mechanical treatments, manufacturers introduced several machining procedures (e.g. twisting, electrical discharge machining), as well as techniques for final surface finishing. NiTi alloys used for endodontic instruments can be subdivided into instruments that mainly contain the austenite phase (austenitic: conventional NiTi, M-Wire, R-Phase) and those mainly containing the martensite phase (martensitic: CM Wire, Gold and Blue heat-treated NiTi)...

PURPOSE: The prevention of alveolar osteitis (AO) in dental extractions remains a controversial issue. Chlorhexidine is one of the most widely studied antiseptics for the prevention of AO. The purpose of this systematic review and meta-analysis was to assess the efficacy and effectiveness of chlorhexidine in the prevention of AO after third molar extractions. MATERIALS AND METHODS: The authors searched databases and the references of each article retrieved up to December 2015...

Periodontal diseases are initiated by bacteria that accumulate in a biofilm on the tooth surface and affect the adjacent periodontal tissue. Systemic diseases such as diabetes, rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE) increase susceptibility to destructive periodontal diseases. In human studies and in animal models, these diseases have been shown to enhance inflammation in the periodontium and increase the risk or severity of periodontitis. All 3 systemic diseases are linked to a decrease in bacterial taxa associated with health and an increase in taxa associated with disease...

This study estimated whether continued programming of a highly specialized four-year dentistry residency training in Saudi Arabia was cost-beneficial. We utilized a purposive sampling to administer a survey to trainees in major cities. Additionally, we used publically available market information about general practitioners. We employed Benefit-Cost Analysis accounting approach as a conceptual framework. Using general practitioners as the base category, we grouped overall social analytical perspectives into resident trainees and rest of society...

The goal of nonrestorative or non- and microinvasive caries treatment (fluoride- and nonfluoride-based interventions) is to manage the caries disease process at a lesion level and minimize the loss of sound tooth structure. The purpose of this systematic review and network meta-analysis was to summarize the available evidence on nonrestorative treatments for the outcomes of 1) arrest or reversal of noncavitated and cavitated carious lesions on primary and permanent teeth and 2) adverse events. We included parallel and split-mouth randomized controlled trials where patients were followed for any length of time...

The skeleton is a dynamic organ that is constantly remodeled. Proteins secreted from bone cells, namely osteoblasts, osteocytes, and osteoclasts exert regulation on osteoblastogenesis, osteclastogenesis, and angiogenesis in a paracrine manner. Osteoblasts secrete a range of different molecules including RANKL/OPG, M-CSF, SEMA3A, WNT5A, and WNT16 that regulate osteoclastogenesis. Osteoblasts also produce VEGFA that stimulates osteoblastogenesis and angiogenesis. Osteocytes produce sclerostin (SOST) that inhibits osteoblast differentiation and promotes osteoclast differentiation...

Loss of dentition leads to functional and esthetic challenges that are determined by the anatomic features of the edentulous area. These features can complicate the prosthetic rehabilitation of such patients, especially in situations where optimal esthetic outcomes are desired. For these reasons, reconstructive plastic surgery procedures, aimed at restoring the alveolar ridge to its former dimensions, have become of great clinical interest. These reconstructive plastic surgery procedures frequently involve soft-tissue augmentation, performed to improve the quality and quantity of mucogingival tissue with the aim to achieve an ideal esthetic result...

Although many studies support the efficiency of oral appliances in the treatment for sleep bruxism, the accepted evidence is insufficient to support its role in the long-term reduction of sleep bruxism.

AIM: To assess tooth loss in periodontally compromised patients 20 years after active periodontal therapy (APT) and to detect potential influencing factors for tooth loss on patient level. MATERIAL AND METHODS: From a total of 100 patients, who were re-evaluated ten years after APT, 70 could be re-examined 20 years ± 12 months after APT. Tooth loss during 20 years was detected and based on regression analyses the impact of patient-levelled factors was estimated...

We retrospectively audited the records of 708 patients who presented with the diagnosis of fractured mandible between January 2009 and July 2013 at the Queen Elizabeth Hospital, Birmingham. We assessed the different factors that may have altered their outcomes, and found that delay before definitive fixation caused no harm in either the short or the long term.

BACKGROUND: Collagen matrices used around immediate implants may reduce morbidity although there is limited evidence on their performance. PURPOSE: To evaluate soft and hard tissue changes when combining immediate implants, hard and soft tissue grafting, and an immediate provisional restoration. MATERIAL AND METHODS: In 12 patients, immediate implants were placed in the anterior maxillary and first premolar area together with a xenogeneic bone substitute...

No consensus has been reached regarding the influence of the flapless and open-flap surgical techniques on the placement of dental implants. This systematic review compared the effects of flapless implant placement and implant placement with elevation of the mucoperiosteal flap in terms of marginal bone loss, implant survival rate and complications rates. This review followed PRISMA guidelines and was registered in PROSPERO with the registration number CRD42017071475. Two independent reviewers performed a comprehensive search of the PubMed/MEDLINE, Scopus, and Cochrane Library databases for studies published until December 2017...

Concentrated growth factor (CGF) is an autogenuous product that contains highly concentrated number of platelets and can be derived from venous blood by selective centrifugation. It has been speculated that local growth factors in human platelets (insulinlike growth factor, IGF; transforming growth factor, TGF-b; platelet derived growth factor, PDGF) would enhance healing of grafts and also counteract resorption. The osteogensis effect of CGF and acellular dermal matrix (ADM) for alveolar cleft defects was evaluated in this study...

AIM: To analyse the regenerative potential of leucocyte- and platelet-rich fibrin (L-PRF) during periodontal surgery. MATERIALS AND METHODS: An electronic and hand search were conducted in three databases. Only randomized clinical trials were selected and no follow-up limitation was applied. Pocket depth (PD), clinical attachment level (CAL), bone fill, keratinized tissue width (KTW), recession reduction and root coverage (%) were considered as outcome. When possible, meta-analysis was performed...

OBJECTIVES: To evaluate the desensitizing effect of toothpastes that contain ingredients that act against dentine hypersensitivity (DH) and to compare this effect with negative controls. SOURCES: Five databases were searched to identify relevant articles published up to November 27, 2017. STUDY SELECTION: Randomized controlled trials (RCTs) comparing desensitizing toothpastes with a toothpastes without desensitizing component in adult patients that suffer from DH were included...

Drug use for both therapeutic and recreational purposes is very widespread in most societies. The range of drugs used, the variations in response to these drugs and other health and behavioral confounders mean that drug use may be an important contributor to individualized periodontal diagnoses. In this narrative review, we review the main reported effects of drugs on the periodontal tissues and periodontal disease processes. Although some of the more common adverse drug reactions on periodontal tissues are well described, in many other cases the evidence for these drug effects is quite limited and based on small case series or isolated reports...

In the esthetic zone, in the case of tooth extraction, the clinician is often confronted with a challenge regarding the optimal decision-making process for providing a solution using dental implants. This is because, after tooth extraction, alveolar bone loss and structural and compositional changes of the covering soft tissues, as well as morphological alterations, can be expected. Ideally, the therapeutic plan starts before tooth extraction and it offers three options: spontaneous healing of the extraction socket; immediate implant placement; and techniques for preserving the alveolar ridge at the site of tooth removal...