Interventions In Dentistry Research Articles

MULTIPLE RESIDUAL ROOTS EXTRACTIONS AND ETIOPATHOGENESIS OF ASSOCIATED PERIAPICAL LESION: A SURGICAL CASE REPORT

Before any surgical intervention in dentistry, it is necessary to plan each case correctly, to induce a positive prognosis for patients, always enabling the functionality of the stomatognathic system. Men tend to have more teeth extracted than women, with more posterior teeth extracted in patients in more advanced age groups due to periodontal disease. The case presented leads to a discussion of the periapical lesions removed surgically. The etiology and study of the evolutionary process of pulp pathology and the supporting tissues of the dental element are substantial. The endo-periodontal interrelationship is unique and can be considered a single continuous system or biological unit with multiple forms of communication. In summary, this article seeks to highlight and report a surgical case of a patient diagnosed with periapical lesions associated with residual tooth roots, which were removed during the common exodontia protocol with the aim of total rehabilitation of the patient. The patient authorized all the images and information used in this study.

Reducing Dental Anxiety in Children Using a Mobile Health App: Usability and User Experience Study.

Dentistry interventions cause common anxiety and fear problems in children (6-11 years), and according to scientific evidence, this causes a decrease in their quality of life. Therapies mediated by IT-based tools have been shown to positively influence children's mood based on distraction as well as relaxing activities, but there is no evidence of their use to reduce dental anxiety in children. The aim of this study was to answer the following research question: Does our new children-centered codesign methodology contribute to achieving a usable mobile-based product with a highly scored user experience? A mobile health app was developed to reduce dental anxiety in children using rapid application development following the usage-centered design methodology. Structured interviews were conducted to test the usability and user experience of the app prototype among 40 children (n=20, 50%, boys and n=20, 50%, girls; age 6-11 years) using a children-adapted questionnaire and the 7-point Single Ease Question rating scale. The Smiley Faces Program-Revised questionnaire was used to assess the level of dental anxiety in participants. There were no significant differences between girls and boys. The task completion rate was 95% (n=19) for children aged 6-8 years (group 1) and 100% (n=20) for children aged 9-11 years (group 2). Group 1 found watching the relaxing video (task C) to be the easiest, followed by playing a video minigame (task B) and watching the narrative (task A). Group 2 found task C to be the easiest, followed by task A and then task B. The average time spent on the different types of tasks was similar in both age groups. Most of the children in both age groups were happy with the app and found it funny. All children thought that having the app in the waiting room during a dental visit would be useful. The findings confirmed that the app is usable and provides an excellent user experience. Our children-adapted methodology contributes to achieving usable mobile-based products for children with a highly scored user experience.

Essential domains, core outcome sets, and measurements to capture benefits and harms of implant dentistry interventions: The ID-COSM initiative.

Consensus on a valid and comprehensive set of outcomes to capture the full benefits and harms of implant dentistry interventions is key for progress towards better clinical guidelines and policy. In this field, outcome research remains fragmented and uses too many different outcomes. Accordingly, such efforts are still unable to cover the full breadth necessary to properly evaluate benefits, harms, and costs. Best practice examples from medicine have inspired the Implant Dentistry Core Outcome Set and Measurements (ID-COSM) initiative that identified four core outcome domain areas (pathophysiology, implant/prosthesis lifespan, life impact, and access to care) and five essential outcomes mandatory for all trials, plus six others that are mandatory in specific circumstances. The innovative multistep approach has combined input from scientific evidence, patients from multiple countries, methodologists, and industry representatives. It is an important step. The ID-COSM consensus aspires to contribute to better adoption of relevant and valid outcomes in trials and enable combining their results in high-quality meta-analyses to support better informed care and policy.

Chapter 9.4: Operative Treatment and Monitoring of Coronal Caries in Daily Practice.

After the caries lesion reaches a certain extent of tooth structure loss, a restoration is often needed to repair the defect. Operative interventions in cariology aim to aid biofilm removal and lesion arrest by cavity sealing, avoid pulpal damage, and restore form, function, and esthetics. There are no clear evidence-based parameters to determine the most appropriate treatment option for each clinical situation. Despite of this, direct composite resins have been the preferable restorative treatment. Scientific literature shows that composites and adhesive strategies play a minor role in treatment success. Patient-related risk factors (mainly those associated with lifestyle and health choices), in addition to the dentist's decision-making process, play a significant role in longevity of the restorations, which tend to fail for the same reasons that lead to the need for restoration (dental caries, tooth/restoration fracture, and esthetics). Therefore, monitoring old restorations in clinical service, even if those present clear signs of degradation, is possible and reasonable within the concept of minimal intervention in dentistry. Unnecessary reinterventions are harmful and costly to health systems, and the clinician's efforts must be directed to eliminating or reducing the etiological factors that can cause the restoration to fail. Thus, patient risk factors assessment is a crucial point in monitoring restorations. Clinician should - whenever possible - postpone operative reinterventions, monitoring the etiological factors that may compromise the restoration's longevity. Also, when operative reintervention is necessary, refurbishment, polishing, and repair should be prioritized over replacement.

The dentobiome and the minimum intervention in dentistry

All of us who observe the chilling figures of children with dental caries on a daily basis and more recently the more frequent presence of enamel alterations and among them incisor molar hypomineralization, we begin to think what really happens with that tissue considered the strongest. of the human body; however, it bows down to an acid attack resulting from bacterial metabolism. And the question arises: Could it be that the tooth is already born with a predisposition to develop certain microorganisms? This comprehensive review of the literature, summarizing the authors' perspectives; aims to explore the knowledge about the biome and apply it to the dental organ and make available the definition of dentobiome, as an appropriate term for dental flora. Starting from this knowledge, apply it to better understand today the execution of the philosophy of minimal intervention and the development of materials that must be biocompatible with the dental structure but must also prevent dysbiosis and establish homeostasis in the tooth.

Critical appraisal of systematic reviews of intervention in dentistry published between 2019-2020 using the AMSTAR 2 tool.

Introduction The number of systematic reviews (SRs) in dentistry published each year has grown considerably, and they have been essential in clinical decision-making and health policy.Objective The objective is to critically appraise SRs of intervention in dentistry using the 'A Measurement Tool to Assess Systematic Reviews 2' (AMSTAR 2) tool published within one year.Methods A search in the Medline/PubMed database was performed. The SRs were identified in two phases. The first phase identified SRs of interventions in dentistry by title and abstract. In the second phase, the full text was read, applying the eligibility criteria. Three calibrated reviewers methodologically assessed all SRs identified using the AMSTAR 2 tool. Data were analysed descriptively, and SRs were grouped according to methodological quality as moderate/high and low/critically low. A logistic regression model was applied to explore the associations between methodological quality and the study's characteristics.Results Two hundred and twenty-two SRs were included. The methodological quality of the SRs included in this study were: critically low (56.8%), low (27.9%), moderate (14.4%) and high (0.9%), according to AMSTAR 2. There were no statistical differences between moderate/high and low/critically low methodological quality and publication year, continent, journal Impact Factor and dental speciality.Conclusion Less than 1% of recently published SRs in dentistry were classified with high methodological quality. We hope that this study will alert researchers about the need to improve the methodological quality of SRs.

KNOWLEDGE, ATTITUDES AND PERCEPTIONS OF DENTISTRY PATIENTS AND THEIR RELATIVES ABOUT THE COVID-19 PANDEMIC

Objective: The purpose of this cross-sectional survey was to investigate the attitudes, perceptions, awareness, and knowledge of dental patients and their relatives through concrete questions about behavior and prediction patterns among the Coronavirus Disease 2019 (COVID-19) pandemic.Material and Methods: The questionnaire was administered face-to-face to 292 patients and their relatives who applied to the dental hospital during the COVID-19 pandemic. The data were run through univariate and multivariable regression analyses. Survey variables include demographics, comorbidities, compliance with protective measures, prediction of disease severity in case of coronavirus infection, hospital admission behaviors, the presence of coronavirus infection in the relative and the severity of the disease experienced by the relative and the risk of transmission in dentistry interventions during the pandemic.Results: Participants showed high compliance with the use of masks in the proper area (77.4%). Generally, women's attitudes, knowledge, and perception levels were higher than men during the pandemic. Participants in the elderly age group (55-85 years) and with comorbidities predicted that they would get more seriously ill in case of coronavirus infection, but their knowledge, awareness, attitudes, and perception levels were lower than younger age groups. It was revealed that the knowledge, attitudes, and perceptions of the participants with low education levels and existing comorbidities were lower in general than high educated and non-comorbid participants.Conclusion: In order to ensure full compliance with the protective measures, awareness and informative campaigns should primarily aim to inform male, low educated, comorbid, and elderly individuals.

Minimal Intervention in Dentistry: A Literature Review on Biodentine as a Bioactive Pulp Capping Material.

Root canal treatment has been the treatment of choice for carious pulp exposures. In the perspective of minimally invasive dentistry and preventive endodontics, a direct pulp capping procedure with a reliable bioactive material may be considered an alternative approach provided that the pulp status is favorable. However, the treatment of pulp exposure by pulp capping is still a controversial issue with no clear literature available on this topic, leaving the concerned practitioner more confused than satisfied. Biodentine is a relatively new bioactive material explored for vital pulp therapy procedures. This article discusses its role in direct pulp capping procedures. A thorough literature search of the database was done using PubMed, Google Scholar, and Scopus using the keywords preventive endodontics, calcium silicate cement, direct pulp capping, Biodentine, and vital pulp therapy. Reference mining of the articles that were identified was used to locate other papers and enrich the findings. No limits were imposed on the year of publication, but only articles in English were considered. This paper is aimed at reviewing the current literature on Biodentine as a direct pulp capping material. The review will provide a better understanding of Biodentine's properties and can aid in the decision-making process for maintaining the vitality of exposed dental pulp with minimal intervention.

Laborvizsgálat jelentősége implantációs betegeknél

A fogászati implantáció elterjedésével előtérbe kerülnek az implantációval kapcsolatos szövődmények vizsgálatai. Azegyik gyakori szövődmény az implantátum körüli szöveteket érintő gyulladás. Ennek kialakulásában számos tényezőjátszik szerepet, többek közt az általános egészségi állapotot befolyásoló betegségek, például a cukorbetegség, hiperlipidémiaés egyéb szisztémás betegségek [1]. Kutatásunk célja a vérvizsgálat – mint az implantációt megelőző szűrővizsgálat– effektivitásának felmérése és alkalmazása a periimplantáris gyulladások prevenciójában.Vizsgálataink során 33 beteg teljes fogászati státusz felvételét és nagy rutinlabor eredményeit vetettünk össze. Azadatokat Microsoft Excel (Remond, Washington, Egyesült Államok) program segítségével értékeltük. A vizsgált betegek81,8%-a szenvedett részleges foghiányban, közülük 66,7%-nál volt parodontális csontelváltozás diagnosztizálhatóorthopantomogram felvétel alapján. A betegpopuláció 21,2%-ának volt magas az éhomi vércukorszintje, 51,5%-nak pedigmegnövekedett a vérzsír értéke. Emellett megvizsgáltuk a parodontális érintettség és a laboreltérések együttes előfordulásigyakoriságát is. Magas vércukorszint és a parodontális érintettség a betegek 6,1%-ánál, parodontális érintettségés a magas gyulladásos paraméter a betegek 21,2%-ánál volt egyszerre megfigyelhető. A periimplantáris gyulladásokkialakulásának egyik rizikófaktora a nem vagy rosszul kezelt cukorbetegség. A hiperlipidémia negatívan befolyásoljaa periimplantáris szövetek lokális immunreakcióit és az implantáció hosszútávú sikerességét befolyásoló csontintegrációt.Bármely általános rizikófaktor, parodontális érintettséggel együtt fokozott kockázatot jelent az implantáció során,ezáltal fontos szerepe van ezeknél a pácienseknél a rizikóanalízisnek és a rendszeres kontrollvizsgálatnak. A Fogászatiés Szájsebészeti Oktató Intézet álláspontja szerint a vérvizsgálat már az implantációt megelőzően alkalmas az általánosrizikófaktorok kiszűrésére.

Minimal intervention in dentistry: which is the best approach for silorane composite restoration repairs?

BackgroundThis study aimed to evaluate surface treatments, adhesives and composites for repairing silorane based restorations. Material and MethodsOne hundred and twenty truncated cones (2 mm smaller diameter and 4 mm larger diameter) made of silorane composite were divided in 12 groups according with the surface treatment (diamond bur and oxide aluminum abrasion), the adhesive (Adper Scothbond Multipurpose (3M ESPE), Ecusit (Voco) and Filtek P90 Adhesive (3M ESPE)). Each group was subdivided in two according with the composite used for repair (methacrylate and silorane). The repair was made with a second truncated cone build over the first one and bond strength assssed by tensile strength. Data were submitted to ANOVA 3-way and Tukey’s test (p<0.05). ResultsThere was difference only for the adhesives and the composites, with conventional adhesives (Adper Scothbond Mutipurpose) and methacrylate-based composites (Filtek Z350) presenting superior tensile strength compared to the silorane ones (P90 Adhesive system and composite). ConclusionsTherefore, it must be concluded that silorane composite can be repaired with methacrylate base composites and adhesives. Key words:Silorane composites, composites, bond strength, minimal intervention.

MATHEMATICAL MODELING OF TELEROENTGENOGRAPHIC PARAMETERS ACCORDING TO THE METHOD OF SCHWARZ A. M. DEPENDING ON THE BASIC CEPHALOMETRIC PARAMETERS IN UKRAINIAN YOUNG MEN AND YOUNG WOMEN WITH DIFFERENT FACE TYPES

The aim: Is development and analysis of regression models of teleroentgenographic indices according to Schwarz A. M., which can be adjusted during surgery depending on the parameters that usually do not change in Ukrainian young men and young women with with normal occlusion close to orthognathic occlusion and different facial types. Materials and methods: Teleroentgenographic indices were obtained using a dental cone-beam tomograph Veraviewepocs 3D Morita and studied in 49 young men and 76 young women with normal occlusion close to orthognathic. Persons were divided into groups with different face types according to the recommendations of Schwarz A. M. In the license package "Statistica 6.0", regression models of teleroentgenographic indices were built according to Schwarz A. M. Results: For young men with orthognathic occlusion and with different types of faces according to Schwarz A. M. constructed 10 of 27 possible reliable regression models of the group of teleroentgenographic indicators, which can be corrected during surgical, orthopedic interventions in dentistry depending on the group of basic, invariable cephalometric indicators greater than 0.6 (R2 = from 0.609 to 0.996); and in young women with different face types, 8 of the 27 possible reliable regression models in which the coefficient of determination is greater than 0.6 (R2 = from 0.642 to 0.986). Conclusions: The developed regression models provide the most individualized approach in determining the method and scope of the required dental intervention.

Minimal Intervention in Dentistry: An emerging trend during Pandemic?

Minimal Intervention in Dentistry: An emerging trend during Pandemic?

Minimal Invasive Dentistry: Literature Review

Minimally invasive procedures are the new paradigm in health care. Everything from heart bypasses to gall bladder, surgeries are being performed with these dynamic new techniques. Dentistry is joining this exciting revolution as well. Minimally invasive dentistry adopts a philosophy that integrates prevention, remineralisation and minimal intervention for the placement and replacement of restorations. Minimally invasive dentistry reaches the treatment objective using the least invasive surgical approach, with the removal of the minimal amount of healthy tissues. This paper reviews in brief the concept of minimal intervention in dentistry.

A behavioural intervention for young adults with dental caries, using acceptance and commitment therapy (ACT): treatment manual and case illustration

BackgroundThere is a need for effective behavioural interventions in dentistry. This paper presents an innovative behavioural intervention for young adults with dental caries, in an interdisciplinary collaboration between dental personnel and licensed psychologist in general dental care. The intervention has been evaluated in an RCT, with positive effects on oral health behaviour.MethodThe intervention, Acceptance and Commitment Therapy (ACT), a recent form of cognitive behaviour therapy (CBT), was adapted to young adult patients (18–25 years of age) with high dental caries activity.ResultsThe intervention included two individual sessions, provided by a clinical psychologist at general dental clinics. The rationale for selecting ACT as the theory base is presented, together with the treatment manual and a case illustration.ConclusionsACT may be a promising alternative for behavioural interventions in dentistry for patients with oral diseases, specifically dental caries. Interprofessional collaboration between psychologists and dental personnel opens up for new possibilities to help and treat patients with various health issues in public dental care.Trial registrationTRN ISRCTN15009620www.isrctn.com, retrospectively registered 14/03/2018.

Antimicrobial stewardship in dental practice

BackgroundAntibiotic resistance is a global public health problem that is responsible for increased patient morbidity and mortality and financial burden. Dental antibiotic prescribing contributes to approximately 10% of all antibiotic prescriptions, and an estimated 80% of that prescribing is deemed inappropriate. Dental antimicrobial stewardship (AMS) has an important role to play in international efforts to tackle antibiotic resistance. The aim of the authors was to comment on the implementation of AMS strategies in outpatient dental practices. MethodsThe authors included previous studies regarding outpatient antibiotic stewardship, longitudinal studies quantifying dispensed dental antibiotic prescription use, and interventional studies aimed at implementing AMS interventions in dentistry. ResultsResearchers in several studies conducted trials regarding the use of various interventions, mostly comprising a combination of audit, feedback, dissemination of guidelines, and educational components to improve dental prescribing. Conclusions and Practical ImplicationsIn regard to the establishment of an AMS strategy, aspects to be considered should include raising awareness about the risks of unnecessary use of antibiotics. Engaging and educating the entire dental team and patients, as well as collaborating with other specialized professionals, are important elements. Context-specific interventions with a methodical and measured approach are ideal.

Acoustic parameters used in dental hypnosis practices

Dental hypnosis has been reported in many journals as a science since James Braid used hypnosis term in his publication in 18th century. Recent research supports the view that hypnotic communication and suggestions effectively changes aspects of the person’s physiological and neurological functions and can enhance the efficacy of various treatment interventions in dentistry. So, the dental hypnosis is truly science not a black magic. The acoustic parameter expression is a tool consisted of three parameters that are duration, pitch and intensity that is used to measure how effective the special sentences/phrases can bring the people consciousness state to unconsciousness state by giving some suggestion. It works by modifying people mind to change their fear of dental treatment for example, to be a contrary condition.

Dentists’ Decision to Conduct CRA in Adult Patients in Turkey: A Questionnaire-based Survey

Aim: The concept of minimal intervention in dentistry is one of the most important stages of the preventive dentistry, and caries risk assessment (CRA) is an application that needs to be primarily evaluated in order to perform minimal intervention approaches. This study was aimed to evaluate the awareness of CRA and whether CRA is included in daily practice by dentists in Turkey. Materials and Methods: This study used a questionnaire survey. A survey was prepared and sent to the dentists who were registered with the Turkish Dental Association via e-mail. A total of 790 dentists returned and 95 respondents were excluded. All the registered dentists filled and returned their survey. Descriptive and logistic regression analyses were performed (n = 695). Results: A total of 86.9 percent dentists who took the survey said that they performed CRA in daily practice. “Lack of time” was specified as the most important factor by the respondents who did not perform CRA in daily practice (61.5%). Current oral hygiene status (96.4%) and the presence of one or more active caries lesions (74.5%) were considered the most important risk factors for not performing CRA. Results of multiple logistic regression analysis showed that clinical experience, number of patients treated per day, and type of practice were mostly associated with whether or not performing CRA ( P = .012, .018, and .035, respectively). Conclusions: It can be concluded that most of the dentists are aware of the importance of conducting CRA and, with differences in the factors considered, CRA is required in their daily practice in Turkey. The concept of minimal intervention in dentistry is one of the most important stages of preventive dentistry, and CRA is an application that needs to be primarily evaluated in order to perform minimal intervention approaches.

Effect of hydroxyapatite nanoparticles on enamel remineralization and estimation of fissure sealant bond strength to remineralized tooth surfaces: an in vitro study

BackgroundThe management of noncavitated caries lesions before sealant therapy is a clinical challenge when the tooth needs sealant application. Sealing noncavitated carious lesions in pits and fissures may lead to failure of the fissure sealant (FS) due to incomplete sealing. Therefore the use of remineralizing agents such as nanoparticles has been suggested. This study investigated the ability of hydroxyapatite nanoparticles (nano-HA) to remineralize enamel, and their effect on sealant microleakage and shear bond strength (SBS).MethodsA total of 192 third molars were demineralized and pretreated with two concentrations of nano-HA with and without sodium hexametaphosphate (SHMP), followed by phosphoric acid etching and resin FS application. The study groups were 1) etching + FS, 2) etching + nano-HA 0.15% + FS, 3) etching + nano-HA 0.03% + FS, 4) etching + mixture of nano-HA 0.15% and SHMP 0.05% + FS, 5) etching + mixture of nano-HA 0.03% + SHMP 0.01% + FS. The laboratory tests included microleakage in 50 teeth, scanning electron microscopy (SEM) evaluation in 10 samples, and SBS in 100 samples. Enamel remineralization changes were evaluated in 32 teeth with energy-dispersive X-ray spectroscopy (EDS) and field emission scanning electron microscope (FESEM).ResultsNano-HA enhanced the SBS to remineralized enamel in a large percentage of nanoparticles. Mean SBS in group 2 was significantly greater than in groups 1, 3 and 4 (all P < 0.05). SBS was related to nano-HA concentration: nano-HA 0.15% yielded greater SBS (16.8 ± 2.7) than the 0.03% concentration (14.2 ± 2.1). However, its effect on microleakage was not significant. Nano-HA with or without SHMP led to enhanced enamel remineralization; however, the Calcium (Ca)/Phosphate (P) weight percent values did not differ significantly between the groups (P > 0.05). SEM images showed that SHMP did not affect sealant penetration into the deeper parts of fissures. FESEM images showed that adding SHMP led to increased nanoparticle dispersal on the tooth surface and less cluster formation.ConclusionsThe ultraconservative approach (combining nano-HA 0.15% and SHMP) and FS may be considered a minimal intervention in dentistry to seal demineralized enamel pits and fissures.

Smile Aesthetics Satisfaction Scale: development and validation of a new brief five-item measure of satisfaction with smile aesthetics in adults and the elderly

To create and validate a brief questionnaire designed for the assessment of satisfaction with smile aesthetics and to test its efficiency as a patient-centred outcome measure of aesthetic interventions in dentistry. A team of three specialists - two from prosthodontics and one psychologist - used a self-evaluation scale consisting of five elements in order to rate self-perceived smile aesthetics. A total of 671 subjects (63% female), 18-86years of age, were included in the investigation. The internal consistency, validity and stability of the questionnaire, along with the responsiveness induced by the tooth-whitening procedure, were evaluated. The relationship between self-perceived satisfaction with the smile aesthetics and the clinical status of the dentition was assessed. The questionnaire had one dimension accounting for 64.3% of variance and showed a high level of reliability (Cronbach α=0.859). It measured a construct similar to concern with tooth appearance and the desire to improve this appearance (r=-0.403 and r= -0.353, respectively; P<0.001). High test-retest reliability was demonstrated (intraclass correlation coefficient=0.985). The questionnaire was able to detect an increase in satisfaction with smile aesthetics as a result of the tooth-whitening procedure (P=0.016). Clinical predictors of greater satisfaction with smile aesthetics were greater tooth display when smiling, decreased chroma and the absence of gingivitis, as well as absence of crowded, fractured and restored teeth in the anterior segment. A new questionnaire, titled the Smile Aesthetics Satisfaction Scale (SASS), showed good psychometric properties and its use can be recommended.

Systemic Inflammation after Third Molar Removal: A Case-Control Study

Third molar extraction is one of the most frequent interventions in dentistry. Nevertheless, there is scarce evidence on the host response of individuals with impacted or semi-impacted third molars and the possible effects of surgical removal. A case-control study of 40 patients was designed to evaluate 1) the differences in biomarkers of systemic inflammation, vascular function, and metabolism (high-sensitive C-reactive protein, lipids, fibrinogen, oxidative stress, and endothelial function analysis) and 2) the acute and short-term effects of surgical removal in patients with bilateral impacted or semi-impacted third molars compared to controls with no third molars. Patients undergoing third molar extraction exhibited greater levels of systemic inflammation, oxidative stress, and triglycerides than controls. Raised white blood cell counts as well as peaks of serum levels of C-reactive protein and fibrinogen were noticed in the first postoperative week. Three months after the extraction, all markers returned to baseline values. Malondialdehyde, an indicator of oxidative stress indicator, was significantly reduced after third molar removal. Semi-impacted or impacted third molars are associated with higher systemic inflammation, and their removal may represent a useful human model to study acute inflammation and determine beneficial systemic effects (ClinicalTrials.gov NCT03048175).