Interproximal Areas Research Articles

Alternative Advancements: Hyaluronic Acid Vs. Connective Tissue Graft In Black Triangle Management

Introduction: The growing demand for aesthetic dentistry has increased the need to address the issue of the black triangle. This condition refers to the loss of the interproximal area leaving the gap in the gingival embrasure which eventually compromises the appearance of gingival harmony. Various treatment options have been explored to overcome the black triangle, from surgical to non-surgical approaches. Objective for this study is to compare the effectiveness between Connective Tissue Graft (CTG) and Hyaluronic Acid (HA) in black triangle management. Review: Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA)-adapted literature searches were conducted from four online databases (Pubmed, Google Scholar, Science Direct, and Embase) published in English from 2018 to 2023. A total of 1103 studies were retrieved, and following systematic review, 7 articles were selected as the inclusion criteria. Five studies employed HA as the therapeutic approach, while CTG was utilized in only two studies. Both treatments showed improvements in clinical parameters, such as increasing papila interdental height (PIH) and decreasing black triangle height (BTH). All the improvements are statistically significant. The recent trend in black triangle management suggests a shift towards the adoption of HA due to its minimally invasive procedures and high predictability results. Three out of five studies included stated that HA injection decreases BTH to 1mm at 6-month follow-up. Conclusion: HA presents itself as a promising alternative to the CTG for filling the papila deficiency, though it does not apply to all cases. Long-term studies are needed to observe the general use of HA for black triangle treatment.

Plaque cleaning efficacy of waist-shaped interdental brushes among individuals with open interproximal spaces: a systematic review.

The shape and design of interdental brushes are crucial for appropriate adaptation to the interproximal areas, despite their excellent cleaning efficacy. The aim of this review is to assess and compare the available data on the plaque cleaning efficacy of waist-shaped interdental brushes with any other shaped-interdental brushes among patients with wide interdental spaces. Scopus, PubMed, Cochrane, Science Direct, EBSCO Host, Lilacs, Science Direct, Web of Science, and Google Scholar were searched from the earliest available year (2011) till May 15, 2024. PICO Strategy: P: Individuals with open interproximal spaces; I: Waist-shaped interdental brushes; C: Any other shaped interdental brushes; O: Interproximal plaque cleaning efficacy. The review only comprised randomized controlled trials. The risk of bias assessment and quality of evidence was assessed using the RoB-2 Tool and GRADE Tool respectively. Three full-text publications that met the requirements for eligibility underwent additional processing for data extraction. The overall results of the review suggest that the plaque cleaning efficacy of waist-shaped interdental brushes is better than straight/cylindrical-shaped interdental brushes in patients with open interdental spaces; especially on the buccal and lingual line angles. However, the pooling of data was not possible due to the high heterogeneity between the studies. The current review suggests that the plaque cleaning efficacy of waist-shaped interdental brushes could be better than straight or cylindrical shaped-interdental brushes in patients with open interproximal spaces, especially in buccal and lingual line angles. However, further research should focus on appropriate methodological techniques to increase overall reporting quality and limit the possibility of bias.

Influence of Using a Puncturing Method and Cooldown Period Before Pressing the Second-Layered Sheet on the Final Thickness of Double-Layered Sports Mouthguards: An Experimental Study.

The thickness of the mouthguard is a crucial factor in its protective ability for athletes. This study aimed to investigate the final thickness of double-layered sports mouthguards, which were fabricated using different methods before pressing the second layer. Seven upper working models (n = 7 per group) were prepared for mouthguard fabrication. The first 3-mm mouthguard sheet underwent heating, pressing, and vacuuming onto the model, followed by various protocols before the second 3-mm sheet was pressed. Group 1: The second sheet was pressed immediately. Group 2: The first sheet underwent a 1-h cooldown period before pressing the second sheet. Group 3: The interproximal areas of the first sheet were punctured followed by immediate pressing of the second sheet. Group 4: The first sheet was punctured followed by a 1-hcooldown before pressing the second sheet. After 24 h, the mouthguard thickness was measured at various points on the left and right central incisors and first molars using a digital caliper. The thickness analysis was performed using SPSS 29.0 with one-way ANOVA and Tukey post hoc analysis. At the labial surface of the central incisors, Group 4 exhibited the highest thickness, while Group 3 had the lowest (p < 0.001). Groups 1 and 2 did not show significant differences in thickness. At the incisal edges, Group 3 again had the lowest thickness (p < 0.05), with no significant differences observed among the other groups. There were no significant differences in thickness across all areas at the first molars, including cusp tips, pits, and buccal surfaces (p > 0.05). Group 4 demonstrated greater uniformity at the central incisors in thickness compared with the other groups. Using the puncturing method at interproximal areas combined with a cooldown period could enhance mouthguard thickness at the labial surfaces of the central incisors and improve its thickness uniformity.

Effect of interproximal enamel reduction on interradicular bone volume in clear aligner therapy: a three-dimensional cone-beam computed tomography study.

To assess the effect of inter-proximal enamel reduction (IPR) on interradicular bone volume and incisal inclination in patients undergoing clear aligner therapy (CAT). The study sample consisted of 60 cases which underwent orthodontic CAT, in a private clinic in Dammam, KSA. A total of 120 CBCT scans (60 pre-treatment and 60 post- treatment) were measured using the CS 3D Imaging software to examine bone volume (using height, width, and depth of the interproximal area) and incisal inclination. The corresponding ClinCheck models were collected to determine the amount and locations of interproximal reduction performed. Little's Irregularity Index values were measured using OrthoCAD software. Paired sample t-test was used to address the measurements of bone height, width, depth, bone volume, and inclination of upper and lower incisors before and after IPR. IPR did not affect the upper or lower bone volume except at LR3-2 and UL 2 - 1 where a significant difference between the bone volume with and without IPR was detected (p = 0.02 and p = 0.04 respectively). Upper and lower incisor inclination showed a statistically significant decrease after IPR. There was no correlation between IPR and bone volume difference between upper and lower teeth except at LR3-2 and UL 2 - 1. IPR had no significant effect on inter-radicular bone volume except at areas of lower right canine-lateral and at areas of upper left central-lateral. There was a positive correlation between the amount of IPR and incisal inclination. The current study findings suggest that while IPR has a minimal and localized effect on bone volume in certain areas, it plays a role in adjusting incisal inclination, highlighting its significance in the careful planning of orthodontic treatment using clear aligners.

The Effectiveness of Individualized Oral Hygiene Education in Preventing Dental Diseases: A Clinical Study.

Background: Without mechanical cleaning, gingivitis can develop within three weeks. The first clinical sign is bleeding on positive probing. The accumulation of dental biofilm triggers an inflammatory gingival response. In the past decade, attention has focused mainly on interproximal areas and the use of customized interproximal toothbrushes. The aim of this study was to evaluate the effectiveness of individualized oral hygiene education and its role in dental disease prevention among patients with dental problems. Methods: Altogether, 102 patients, 38 males and 64 females, were included in the study. All patients were aged over 18 years. Before treatment, patients were clinically and radiologically examined, their full mouth plaque score (FMPS), full mouth bleeding score (FMBS), and bleeding on brushing (BOB) were recorded, and matrix-metalloproteinase-8 (MMP-8) was measured by using a chair-side MMP-8 measuring system. Patients in group A had gingivitis but no periodontal damage, and group B had periodontal damage. Patients in both groups were divided into four subgroups based on their toothbrushing habits and the oral health education they received. Three months after the initial examination, each patient was examined three more times (2, 4, and 12 weeks later). Results: It was concluded that subjects in groups A1 and B1 showed a significant reduction in BOB, MMP-8, FMBS, and FMPS levels after two weeks. Solo Prophylaxis (A1 and B1) remained a well-constructed protocol and caused the complete resolution of interdental inflammation after two weeks. Other subgroups achieved significant reductions only after 12 weeks. Conclusions: BOB and MMP-8 tests are valuable complements in preventive dentistry, and are able to detect potential pathological processes. The clinical relevance of BOB testing, in addition to FMBS, FMPS and gingival inflammation testing, can be demonstrated to patients, which may increase compliance.

The Influence of The Role of Parents on Dental and Oral Health From The Severity of Dental Caries in Deaf Children Aged 7-14 At SLB N 1 Bantul

Deaf children in their limitations really need the role of parents. Parental behavior is very important in the formation of behaviors that support or do not support children in maintaining dental and oral hygiene. Dental caries is a disease of dental tissue that is characterized by tissue damage, starting from the surface of the tooth (recess, fissure, and interproximal area) extending towards the pulp. The problem of high DMF-T scores in deaf children aged 7-14 years at SLB N 1 Bantul. The purpose of the study was to determine the influence of the role of parents on dental and oral health from the severity of dental caries in deaf children aged 7-14 at SLB N 1 Bantul. This type of analytical research research with a cross sectional design. The research target was parents (fathers/mothers) and deaf children aged 7-14 years at SLB N 1 Bantul with a total sampling technique using the purposive sampling method. Data collection instruments, questionnaire sheets and examination sheets. The data analysis technique used is the Spearman-rank test. The results of the study showed that the p value (0.020) &lt; 0.05, it can be concluded that there is an influence of the role of parents on dental and oral health reviewed from the severity of dental caries in deaf children aged 7-14 years at SLB N 1 Bantul with sufficient closeness.

Antibacterial Efficacy of Hiora: An Ayurvedic Mouthwash in Children.

Mouthwashes, as a form of antimicrobial delivery system, rank among the safest and most effective vehicles, particularly in the case of young children. This is attributed to their ability to distribute therapeutic components across all accessible oral surfaces, including interproximal areas. To evaluate the antibacterial efficacy of recently introduced Ayurvedic (Hiora) and triclosan-based mouthwashes among children. A total of 45 healthy children aged 10-15 years were randomly assigned to three groups: Herbal mouthwash (Hiora), triclosan-based mouthwash (Kidodent), and normal saline as the control group. Saliva samples were collected pre-rinse, 2 minutes, 30 minutes, and 60 minutes post-rinsing with the study mouthwashes. These samples were then inoculated onto Petri dishes containing blood agar culture media, followed by incubation under both aerobic and anaerobic conditions at 37°C for 48 hours. The resulting bacterial colonies of Streptococcus spp. and Lactobacillus spp. were counted (CFU/ml x 105). Statistical analysis, including ANOVA, Newman Keul's Post-hoc test, and a two-tailed 't' test, was conducted to determine the significance of the results. The Ayurvedic Hiora mouthwash demonstrated the most substantial reduction in salivary bacterial colony counts of Streptococcus spp. and Lactobacillus spp. with statistically significant results (p<0.01). The Ayurvedic Hiora mouthwash exhibited the highest antibacterial effectiveness, followed by the triclosan-based mouthwash in decreasing order, with saline showing the least efficacy.

Evaluating the tightness of proximal contact between natural tooth and adjacent implant supported prosthesis.

The changes in interproximal contact between implant supported prosthesis (ISP) and adjacent natural tooth is of interest to dentists. Hence, we evaluated the tightness of proximal contact (PCT) between adjacent natural tooth and ISP by applying a digital force gauge spanning over a period of 1.5 year with a regular follow-up of 3, 6, and 12 months.80 patients who received ISP were included in this study. In order to measure the PCT, every patient seated in the identical upright position in the dentist chair. The digital force gauge was used to take measurements for mesial PCT and distal PCT. The mesial as well as distal interproximal contacts was more tight as in case of natural tooth adjacent to other natural tooth as compared to interproximal contacts between ISP and adjacent natural tooth. It was also observed that as the time progressed there was decrease in PCT values in both categories. After 12 month follow up 30.6% cases in category 2 while 21.2% cases in category 1 showed complete loss of interproximal contact. There is significant change in proximal contact tightness in interproximal area between implant supported prosthesis and adjacent natural tooth over a period of time and necessary measures should be taken to prevent or reduce it.

Accuracy of Complete-Arch Scans Obtained by Intraoral Scanner and Smartphone Three-Dimensional Scanning Applications With Different Smartphone Position Setups: An In Vitro Study.

The high cost of intraoral scanners (IOS) for complete-arch scans makes them less accessible for many dental practitioners. As a viable alternative, smartphone scanner applications (SMP) provide comparable scanning capabilities at a significantly low cost. However, there is limited data on the accuracy of SMP, especially when used in various smartphone positions. This study aimed to compare the three-dimensional (3D) and linear accuracy of complete-arch scans acquired by an IOSand SMP (KIRI Engine, KIRI Innovations, Guangdong, China) at three shooting angles (0°, 45°, and 90° for SMP_3A) and two shooting angles (30° and 60° for SMP_2A). A stone dental cast was scanned with a laboratory scanner as a reference, with 11 scans performed by an IOS, SMP_2A, and SMP_3A. In 3D analysis, trueness and precision were evaluated through superimposition with the reference scanand within each group, respectively, using the best-fit algorithm of Geomagic Wrap software (3D Systems, Inc., Rock Hill, SC). Trueness in linear discrepancy was assessed by comparing the occlusal-cervical and mesiodistal dimensions of reference teeth (canine, premolar, and molar), intercanine width, and intermolar width on the digital casts to measurements of the stone cast, while precision was measured using the coefficient of variance. Differences between groups were analyzed using the Friedman test, followed by the Dunn-Bonferroni post hoc test with a significance level set at 0.05. IOS exhibited significantly lower trueness than SMP_2A (p = 0.003) with significantly greater width discrepancies on canines (p = 0.001) and molars (p < 0.001). Discrepancy patterns differed among the three scanning methods. The IOS showedgreater discrepancieson the occlusal surfaces of posterior teeth. While SMP_3A demonstrated higher variation on the palatal surfaces and interproximal areas of posterior teeth. For precision,SMP_3A (p = 0.028) and SMP_2A (p = 0.003) showed a significantly lower precision in 3D analysis, but a comparable reproducibility in linear measurement to IOS. TRIOS IOS (3Shape,Copenhagen, Denmark) exhibited lower trueness in 3D and linear accuracy analyses for complete-arch scans. The positions of the smartphonesignificantly enhanced trueness at the undercut region. SMP_2A and SMP_3A can be a potential alternative for precise linear measurement in complete-arch scans with selective use.

Three dimensionally printed template with an interproximal isolation design guide consecutive closure of multiple diastema with injectable resin composite.

This article describes a novel 3D-printed template armed with interproximal matrices to isolate interproximal contact areas and guide injectable resin composite for consecutive closure of multiple diastema. Among several treatment options proposed for diastema closure, direct resin composite is noninvasive and easy to repair. The "composite injection technique" has been introduced to improve time efficiency and reduce technique sensitivity for clinicians. However, in the case of multiple diastema, the overflow of excess resin materials onto the adjacent teeth during injection poses challenges for recontouring the interproximal anatomy. A 3D-printed template with special-designed gaps at interproximal areas was designed and fabricated based on a virtual diagnostic wax-up. Flowable resin composite was then consecutively injected through the template to close diastemata at multiple adjacent teeth. This technique using a 3D-printed template with interproximal isolation design contributed to an efficient and accurate operation for multiple anterior diastema closure. Efficient and accurate freehand buildups of composite restoration for multiple diastema are challenging in operative dentistry. The described noninvasive full digital workflow provides a predictable method to accurately recontour the multiple target restorations and reduce the chair-side time and technical sensitivity.

Evaluation of the efficacy of inter-dental brush and dental floss for peri-implant mucositis: A crossover randomized clinical trial.

To evaluate the most effective method for mechanical inter-dental plaque removal between inter-dental brushes (IDB) and dental floss (DF), in addition to toothbrushing in patients affected by peri-implant mucositis (PIM); to identify possible factors related to the patient or to the single implant-supported element that could influence plaque accumulation and inflammation of peri-implant tissues. Forty patients with PIM were recruited. They were randomly assigned to two different groups depending on inter-dental device used (IDB or DF). At baseline (T0), interproximal area (IA), interproximal emergence angle of the implant crown (A°) and manual dexterity (evaluated with Purdue Pegboard) have been recorded. At 14 days (T1), the inter-dental cleaning devices have been inverted between groups. After 14 days (T2), the Plaque Index (PI) and Gingival Index (GI) have been recorded. A questionnaire has been submitted to a patient for the analysis of preferences at T0, T1 and T2. Both inter-dental cleaning devices were effective in reducing PI and GI in the inter-dental area after 14 days of use. GI reduction was influenced by manual dexterity of the dominant hand. No significant differences were found for PI and GI at the variation of IA and A°. IDB was the most effective method for inter-dental plaque removal in all subjects regardless of their manual dexterity. DF seems to be more effective than IDB only in subjects with good dexterity.

Computerized Optical Impression Making of Fully Dentate Upper and Lower Jaws: An In Vitro Study

Objectives: The aim of this experimental study was to evaluate the accuracy of five intraoral scanners for digitizing fully dentate unprepared maxillae and mandibulae in vitro. Materials and Methods: One maxillary and one mandibular reference model with acrylic teeth, an industrial grade reference scanner, 3D evaluation software and the intraoral scanners CS 3500, iTero HD2.9, Planmeca PlanScan, TRIOS Standard and 3M True Definition were used. Scans of the entire arches, one front and two side segments of each arch scan of maxilla and mandibula were evaluated separately for trueness and precision. In addition, visual analyses of deviation patterns, surface properties and approximal areas were performed with the aid of 3D evaluation software. Results: The intraoral scanners CS 3500, TRIOS Standard and iTero HD2.9 showed a similar level of trueness. The True Definition scanner showed lower full arch trueness compared to the TRIOS Standard and to the iTero HD2.9 (p &lt; 0.05). Full arch trueness of the PlanScan was lower compared to the other scanners. Video-based systems showed higher numbers of datapoints per scan (127,300–169,730) compared to single image-based systems (64,115–88,124). The acquisition of interproximal areas was insufficient across all scanners. Limitations: The intraoral scanners were not tested under clinical conditions in this study. Conclusions: Apart from interproximal areas, clinically acceptable full arch trueness was achieved by the CS 3500, the iTero HD2.9 and the TRIOS Standard.

SDF-1 involvement in orthodontic tooth movement after tooth extraction

The stromal cell-derived factor 1 (SDF-1)/chemokine receptor type 4 (CXCR4) axis plays a key role in alveolar bone metabolism during orthodontic tooth movement (OTM). Herein, the effects of the SDF-1/CXCR4 axis on the regional acceleratory phenomenon (RAP) in OTM velocity and on changes in the surrounding periodontium after adjacent tooth extraction in rats were investigated. Six-week-old male Wistar/ST rats underwent left maxillary first molar (M1) extraction and mesial OTM of the left maxillary second molar (M2) with a 10-g force closed-coil spring. Phosphate-buffered saline, immunoglobulin G (IgG) isotype control antibody, or anti-SDF-1 neutralizing monoclonal antibody were injected at the M1 and M2 interproximal areas (10 μg/0.1 mL) for the first three days. Analyses were performed after 1, 3, and 7 days (n = 7). The results demonstrated a significant increase in SDF-1 expression from day 1, which was effectively blocked via anti-SDF-1 neutralizing monoclonal antibody injection. On day 3, the M2 OTM distance and the number of positively stained osteoclasts significantly reduced alongside a reduction in inflammatory markers in the experimental group. Our results demonstrated that serial local injection of the anti-SDF-1 neutralizing monoclonal antibody reduces M2 OTM, osteoclast accumulation, and localized inflammatory responses in an OTM model with tooth extraction-induced RAP.

Assessing the Reliability of Miller's Classification and Cairo's Classification in Classifying Gingival Recession Defects: A Comparison Study.

Background and Objectives: Gingival recession results in adverse aesthetics and root sensitivity, and there is a need to treat and prevent its further progression. To overcome these problems, various advances have been made by clinicians in treating gingival recession based on the type of gingival recession. Miller's classification has been used for a long time to classify the type of recession. However, certain limitations have been found with use of Miller's classification such as a lack of clarity in the method for measuring soft and hard tissue loss in the interproximal area. Cairo classification was proposed to overcome limitations of Miller's classification to classify gingival recession. Cairo's classification is a treatment-oriented classification based on buccal and interproximal attachment loss. Therefore, the study was conducted to assess and compare the reliability of Miller's and Cairo's classifications in determining gingival recession. Material and methods: A total of 220 buccal gingival recession defects were included in the study based on the inclusion and exclusion criteria. Four examiners were included in the study. Two examiners classified the recession defects according to Miller's classification and the other two examiners classified recession defects according to Cairo's classification at baseline and at a 1-week interval. Statistical analysis was conducted using SPSS software version 25.0 using Cohen's kappa correlation coefficient and Chi-square test statistics to determine the intra- and inter-rater agreement among the examiners for the two gingival recession classification systems. A p value of <0.05 was considered statistically significant. Results: The intra-rater agreement for Cairo's classification was 0.86 and 0.82, whereas for Miller's classification, it was found to be 0.68. The inter-rater reliability agreement for Cairo's classification was 0.82 and 0.8, whereas for the Miller's classification, it was 0.56 and 0.67. Conclusions: Within the limitations of the study, it was found that Cairo's classification is clearer and more reliable than Miller's classification in the assessment of gingival recession.

Knowledge and Practice of Interdental Aids among College Students of Dharwad City - A Cross-Sectional Study

Background Dental plaque is considered as one of the chief causative agents of periodontal disease. The routinely used mechanical plaque control tool in almost every household is the manual toothbrush. However brushing alone does not eliminate plaque completely. Deposits in inaccessible areas of the oral cavity such as interproximal areas can lead to severe periodontal conditions. In light of this scenario routine use of interdental cleaning devices as adjuncts to tooth brushing for oral hygiene maintenance becomes all the more important.Objective Assessing the practice and knowledge of interdental aids among college students of Dharwad city was the objective of the present study.Methods A descriptive cross-sectional close-ended questionnaire-based survey was conducted. The survey forms were distributed among the study subjects through WhatsApp social media.Results About 16.6 participants believed that toothbrush can effectively clean interproximal surfaces and 41 subjects were aware of interdental cleaning aids. The information regarding interdental aids was provided by dentists to 20 subjects. About 53 participants expressed to be motivated to use interdental aids for oral health maintenance.Conclusion The temperament of people towards oral health and the dentistsrsquo outlook plays a pivotal role in regulating good oral health conditions of any population. This survey concluded that large section of young population of Dharwad city had an insight about interdental aids.

Comparing the effectiveness of water flosser and dental floss in plaque reduction among adults: A systematic review.

Interdental aids such as dental floss and water flossers have been found to be effective in removing interdental plaque. This systematic review aimed to compare the available data on the efficacy of dental floss and water flossers in plaque removal among adults. Five databases: PubMed, Scopus, Cochrane, ScienceDirect, Lilac, and Google Scholar were searched from January 1, 2002, to October 31, 2022, to obtain the relevant articles. Based on the search strategy, the titles of the studies were screened independently by two reviewers. Randomized controlled trials were included in the review, in which the study participants were given either dental floss or water flosser. Reduction in plaque scores was the outcome that was assessed. Seven articles met the eligibility criteria and were further processed for qualitative analysis. The majority of the studies favored water flossers over dental floss in plaque reduction. Water flosser was also found to be effective in removing plaque from inaccessible interproximal areas of the tooth surfaces as compared to dental floss. Based on the scope of this review, results suggest that water flossers can be used as an effective alternative to dental floss in patients with manual dexterity, patients undergoing orthodontic treatment, and patients with dental prostheses.

Doppler ultrasonographic evaluation of tissue revascularization following connective tissue graft at implant sites.

To assess the Doppler ultrasonographic tissue perfusion at dental implant sites augmented with connective tissue graft (CTG) using coronally advanced flap (CAF) or tunnel technique (TUN). Twenty-eight patients presenting with isolated healthy peri-implant soft-tissue dehiscence (PSTD) were included in this randomized clinical trial. PSTDs were treated with either CAF + CTG or TUN + CTG. Ultrasound scans were taken at baseline, 1 week, 1 month, 6 months and 12 months. Tissue perfusion at the mid-facial, mesial and distal aspects of the implant sites was assessed by colour Doppler velocity (CDV) and power Doppler imaging (PDI). Early vascularization of the graft and the flap at 1 week and at 1 month were evaluated via dynamic tissue perfusion measurements (DTPMs), includingflow intensity (FI), mean perfusion relief intensity (pRI) and mean perfused area (pA). Regression analysis did not reveal significant differences in terms of mid-facial CDV and PDI changes between CAF and TUN over 12 months (p > .05), while significant differences between the two groups were observed at the interproximal areas (p < .001 for both CDV and PDI changes). Higher early DTPMs were observed at the TUN-treated sites in terms of mean FI of the graft (p = .027) and mean FI (p = .024) and pRI of the flap (p = .031) compared with CAF-treated sites at 1 week. Assessment of the FI direction showed that CTG perfusion at 1 week and at 1 month mainly occurred from the flap towards the implant/bone. Early tissue perfusion outcomes were found to be associated with the 12-month mean PSTD coverage and mucosal thickness gain. Doppler ultrasonography shows tissue perfusion changes occurring at implant sites augmented with CTG. The main differences in tissue perfusion between CAF and TUN were observed at the interproximal sites, with early perfusion associated with clinical and volumetric outcomes at 12 months.

What’s new for the clinician – summaries of recently published papers

Interdental cleaning devices in the form of dental floss and interdental brushes have traditionally being used as adjuncts to plaque removal in the interproximal areas of teeth. However, their routine use among younger adolescents has been reported in many studies to be less than optimal. In orthodontic patients, fixed braces promote supra- and subgingival accumulation of biofilm by impeding oral hygiene resulting in an altered oral microbiome, enamel decalcification and gingivitis1. It was recently shown that patients with upper and lower multibracket appliances are affected significantly more frequently by gingivitis (65%) and white spot lesions (30%).1 Additionally, in the predominantly young orthodontic patients, interdental spaces are often too narrow to use interdental brushes and flossing is challenging and time-consuming. Oral irrigators are easy to use even in the presence of orthodontic braces and are therefore favoured by many patients. Most oral irrigators use a stream of water only to mechanically remove plaque from interproximal areas but there are also oral irrigators which use a mixture of air and water, called microburst technology.

Optimal Insertion Torque for Orthodontic Anchoring Screw Placement: A Comprehensive Review

The optimal insertion torque (IT) for orthodontic anchoring screws (OASs) was hypothesized to vary with OAS features and insertion methods. This review examines the indexed English literature, to determine the appropriate IT range for OAS success based on area of insertion and OAS features. Eleven original articles with OAS placement in humans including IT and success rate were selected and were used to evaluate the relationships among IT, success rates, screw design, and placement methods at different sites. The ITs and success rates ranged from 6.0 ± 3.2 to 15.7 ± 2.3 Ncm and from 62.5 to 100.0% in the upper and lower buccal alveolar areas, respectively. For the mid-palatal area, the range was 14.5 ± 1.6 to 25.6 ± 5.5 Ncm and 83.0 to 100.0%, respectively. ITs of 5–12 and 6–14 Ncm were found to be optimal for the commonly used φ1.5–1.7 mm OASs in the upper and lower interproximal areas, respectively. In the mid-palatal suture area, ITs of 11–16 and 20–25 Ncm were considered suitable for tapered φ1.5 mm and φ2.0 mm OASs, respectively. Although identified optimal IT ranges deserve the recommendations, care must be taken to monitor the IT during placement constantly.

Description of knowledge levels about the maintenance of dental and oral health with the occurrence of dental caries in class VI at SDN Sindangbarang 2

Knowledge is the result of knowing someone about an object or something through the senses they have. Knowledge is very influential in shaping one's actions, one of which is in maintaining dental and oral health. One of the most common dental and oral health problems experienced by the community is dental caries. Dental caries is damage to the hard tissues of the teeth starting from the tooth surface (pits, fissures and interproximal areas) to extending to the dentin and pulp and can occur on one or more tooth surfaces. The purpose of this study was to describe the level of knowledge about the maintenance of dental and oral health with the occurrence of dental caries in class VI students at SDN Sindangbarang 2. This research is a descriptive study, the sampling technique used was total sampling technique. The results of research conducted on 38 students showed that the level of knowledge about dental and oral health maintenance which was categorized as good was 17 people (44.7%), medium category was 12 people (31.6%), and less category was 9 people ( 23.7%) and the average dental caries index in students was 1.26. The conclusion of this study is that the majority of students have a good level of knowledge about dental and oral health maintenance with 17 people (44.7%) and the average dental caries index in the low category with a value of 1.26.