Background:The posterior anatomical position and complex biomechanics of mandibular angle fractures (MAF) make their management more complicated than other mandibular fractures. The shortcomings of semi-rigid and rigid fixations have led to the development of a biplane three-dimensional (3D) miniplate design to fixate angle fractures in two perpendicular planes. The aim is to determine whether using a Biplane 3D miniplate could provide a feasible, effective, and reliable fixation for displaced MAFs. Materials and Methods:This prospective, quasi-experimental, clinical study was conducted on adult patients with displaced MAFs. The primary outcome (occlusion) and secondary clinical outcomes (fracture stability and adequate mouth opening) were recorded in the first 2 weeks and the 2nd and 6th months postoperative. Appropriate reduction (secondary outcome) was assessed with novel radiographic criteria in the vertical and horizontal planes. Statistical analysis was performed using SPSS version 22 and included Fisher's exact and Chi-square tests. The level of significance was set at P < 0.05. Results:Twenty-one patients with MAFs (nine isolated fractures) were operated on and followed for 3-6 months (mean: 4.95 months). Only two cases (9.52%) in the nonisolated fracture group showed mild occlusal derangement, which resolved with heavy elastic therapy. Adequate mouth opening was gradually resumed in both groups within the 1st month. No postfixation complications were observed. Radiographic criteria measurement revealed 14.29% and 28.6% mild vertical and horizontal radiographic malalignment without detectable clinical signs. Conclusion:Biplane 3D miniplate fixation shows promising results in the management of MAFs with minimal complications, suggesting that it is safe and effective. Concomitant management of displaced mandibular fractures does not seem to affect treatment outcomes.
Background:Iran's oral health reform plan aimed to shift primary dental care toward prevention through the family dentist program, yet longitudinal evidence on real-world service mix is limited. We assessed 6-year trends in dental service utilization in rural and semiurban primary healthcare facilities in Isfahan, Iran. Materials and Methods:This retrospective, longitudinal, observational, descriptive study analyzed aggregated service counts extracted from Iran's integrated health system (SIB) for two healthcare networks in Isfahan from 2016 to 2021. We included Level 2 clinical procedures recorded under the family dentist program and categorized them as preventive (fluoride varnish, fissure sealants, and scaling) or curative/treatment (restorations, extractions, and pulpotomy). Trends were summarized using annual volumes, year-to-year percentage change, and the proportional share of preventive versus curative services. Data were analyzed using descriptive statistics; no inferential statistical tests were applied, and a significance threshold was not defined, given the descriptive nature of the study. Results:A total of 133,075 Level 2 dental services were delivered over the study period. Utilization peaked in 2017 (28,290 services) and remained high in 2019 (28,027), suggesting a period of increased throughput during the implementation and maturation of the oral health reform package in primary health care, followed by a sharp decline in 2020 (11,215; -60.0% vs. 2019) and partial recovery in 2021 (20,691; +84.5% vs. 2020). Preventive share dropped to 7.2% in 2017, increased to 21.0% by 2019, and remained near 19% in 2020-2021. Health Center No. 2 delivered a higher cumulative volume than No. 1 (76,697 vs. 56,378 services). Permanent tooth extractions were the most frequent procedure (66,152), exceeding the total number of restorations (28,160). Conclusion:Despite a stable preventive component in later years and postpandemic recovery, service delivery remained strongly treatment- and extraction-oriented, indicating a limited shift toward prevention within the primary care dental package.
Background:This study aimed to assess how effective hand K-files and XP-Endo Finisher rotary files, combined with two different irrigation solutions (chlorhexidine [CHX] and sodium hypochlorite), are in eliminating calcium hydroxide (CH) from the walls of root canals. Materials and Methods:Eighty-two single-root canal teeth were included in this in vitro study. After decoronation, the root canals were prepared with master apical file #30, and to shape the coronal part, #1-3 Gates-Glidden drills were used. The specimens were divided into four experimental groups (n = 18) and two control groups (n = 5). In all groups except the negative control group, CH was applied to the root canal system, and the access cavity was temporarily restored with zinc oxide eugenol. The samples were incubated for 1 week at a temperature of 37°C and a humidity level of 100%. For CH removal, the experimental groups received different irrigation regimens and file types: group 1: hand K-file + 5.25% sodium hypochlorite, group 2: XP-Endo Finisher rotary file + 5.25% sodium hypochlorite, group 3: hand K-file + 0.12% CHX, and group 4: XP-Endo Finisher rotary file + 0.12% CHX. CH was not removed from the positive control group. The root canals were then longitudinally sectioned, and the remaining CH in the apical, middle, and coronal thirds was quantified using a stereomicroscope. Statistical analysis was performed using one-way and two-way ANOVA and the Kruskal-Wallis test (P < 0.05). Results:The XP-Endo Finisher rotary file and CHX irrigation resulted in significantly higher residual CH in the apical third (P < 0.05). Conversely, the lowest mean residual CH was observed in the coronal third with hand K-file and sodium hypochlorite irrigation (P < 0.05). Sodium hypochlorite exhibited superior effectiveness in CH removal compared to CHX (P < 0.05). Conclusion:There was no discernible advantage of using XP-Endo Finisher over hand K-file for the removal of CH. However, sodium hypochlorite proved to be more effective than CHX in achieving CH removal.
Background:The infrazygomatic crest (IZC) is a commonly used extra-alveolar site for orthodontic miniscrew placement because of its favorable anatomical position and relatively dense cortical bone. However, variations in bone thickness, insertion height, and angulation can influence the stability and success of miniscrew placement. To systematically evaluate and synthesize the available evidence on the infrazygomatic crest region to determine the most suitable site, insertion height, and angulation for orthodontic miniscrew placement. Materials and Methods:A systematic search was conducted across PubMed, Embase, Web of Science, Scopus, the Cochrane Library, and grey literature sources including Google Scholar and OpenGrey for studies published up to March 2023. Studies assessing cortical bone thickness and anatomical characteristics of the IZC relevant to miniscrew placement were included. Thirteen studies met the inclusion criteria for qualitative synthesis, and nine studies providing quantitative data were included in the meta-analysis. Mean values and standard deviations of bone thickness and insertion height along the distobuccal root of the maxillary first molar at 70° angulation were extracted. Forest plots were generated to compare findings across studies. Risk of bias was assessed using the Quality Assessment of Measurement Accuracy Studies (QUAMAS) tool. Results:Among the included studies, most reported adequate bone thickness in the region buccal to the maxillary first molar. Meta-analysis indicated that sufficient bone thickness is generally observed when miniscrews are inserted at an angulation of approximately 60°-70°. The optimal insertion height was commonly reported between 10 and 15 mm above the occlusal plane, where greater cortical bone thickness was observed. Increasing insertion angulation and decreasing insertion height were associated with improved bone engagement and primary stability. Conclusion:The current evidence suggests that the region buccal to the maxillary first molar in the infrazygomatic crest is the most favorable site for orthodontic miniscrew placement. An insertion angle of approximately 60°-70° and a height of 10-15 mm above the occlusal plane appear to provide optimal bone thickness and stability.
Background:The present study aimed to evaluate endocrown and inlay as retainers of fixed partial denture (FPD) and to compare the effect of restoration design, ceramic type, and connector size on stress distribution using finite element analysis. Materials and Methods:Cone-beam computed tomography of the patient was selected and entered into Catia v5-21 software for modeling. Then, FPD was designed to replace the second premolar. Three restoration materials including lithium disilicate (LDS), zirconia reinforced lithium silicate (ZLS) and Zirconia (Zr) and three connector size including 4×4, 3×4, 3×3 mm, and in terms of preparation design as both retainer endocrown (EE), both inlay (II), first premolar inlay and first molar endocrown (IE), and first premolar endocrown and molar inlay (EI). Finally, the mechanical information was entered into the Ansys software (ANSYS Inc.). Then the mesh sub-regions were defined. Finally, a force of 300 Newton was applied vertically and at an oblique. Then, the maximum stress level and its location were compared and examined among the different study groups, and finally, the data were assessed. Results:The minimum stress level was observed in the EI-LDS with 3 × 4 connector size under vertical loading (55.1 MPa), and the highest stress level was observed in the IE-Zr with 3 × 4 connector dimension under oblique loading (558.8 Mpa). The lowest strain (0.5) was observed in the EI-Zr with 4 mm × 4 mm connector size under vertical loading. Conversely, the highest strain (4.1) was seen in the EE-LDS with a 4 mm × 3 mm connector under oblique loading. Conclusion:Partial ceramic restorations may serve as effective conservative alternatives to conventional full crowns as retainers for posterior FPDs.
Background:The incorporation of digital techniques has gained popularity in the fabrication of fixed dental prostheses (FDPs) over the last decade; however, limited evidence exists regarding the marginal and internal fit when using conventional versus digital impression techniques. This systematic review and meta-analysis aimed to compare the marginal and internal fit of tooth-supported multi-unit FDPs produced from conventional and digital impressions. Materials and Methods:A comprehensive search was conducted in electronic databases, including Cochrane Library, PubMed, and Scopus. A meta-analysis was conducted using the standardized mean differences (SMDs) to quantify the effect sizes. Results:Fourteen studies, three randomized controlled trials (RCTs) and 11 in vitro were included in the review, all complying with the inclusion criteria. The meta-analysis revealed that multi-unit FDPs fabricated using digital impressions generally exhibited improved marginal and internal fit compared with those produced using conventional impressions. In the RCT subgroup, digital impressions showed a trend toward improved marginal fit (SMD: -0.25; 95% confidence interval [CI]: -0.64-0.14) and statistically significant improvement for internal fit (SMD: -0.15; 95% CI: -0.55 to -0.24). In contrast, in vitro studies demonstrated statistically significant superiority of digital impressions for both marginal fit (SMD: -0.81; 95% CI: -1.06, -0.56) and internal fit (SMD: -0.52; 95% CI: -0.79 to -0.24). Conclusion:Although digitalized impressions demonstrated statistically superior marginal and internal fit compared with conventional impressions, the observed differences should be interpreted with caution. Most outcomes remained within clinically acceptable limits. Among the intraoral scanners, the Trios system showed a trend toward improved marginal fit.
Background:Low-intensity pulsed ultrasound (LIPUS) has gained recognition as a noninvasive, Food and Drug Administration-approved therapeutic modality with diverse clinical applications, including in orthodontics. This review aims to summarize the benefits and mechanisms of LIPUS in various aspects of orthodontic care. Materials and Methods:A comprehensive literature search was conducted across multiple databases (Web of Science, PubMed, Embase, and Cochrane Library), focusing on randomized controlled trials, clinical studies, and experimental research from 2004 to 2024. Results:LIPUS has been shown to significantly accelerate orthodontic tooth movement, reduce treatment duration by up to 49%, and improve patient compliance. It works by enhancing bone remodeling, stimulating osteoblast and osteoclast activity, and increasing the expression of bone-forming and resorptive proteins. LIPUS also addresses orthodontically induced inflammatory root resorption, promoting the repair of cementum and reducing root damage through mechanisms involving osteoprotegerin and receptor activator of nuclear factor kappa-ligand signaling. Furthermore, LIPUS is effective in alleviating pain associated with orthodontic treatments by promoting tissue healing and reducing inflammation. In orthognathic surgery, LIPUS accelerates bone regeneration and tissue recovery, improving outcomes such as reduced swelling and enhanced bone healing. The application of LIPUS also supports the stability of miniscrews, a critical factor in orthodontic anchorage, by increasing bone-screw contact and reducing screw mobility. In addition, LIPUS enhances the effectiveness of functional orthopedic treatments in growing patients with skeletal malocclusions, promoting mandibular growth and improving treatment outcomes. Conclusion:Overall, LIPUS proves to be a promising adjunct in orthodontics, with wide-ranging benefits including accelerated tooth movement, reduced root resorption, pain relief, and improved surgical recovery, making it an effective tool in contemporary orthodontic practice.
Background:Oral cancer (OC) and oral potentially malignant disorders (OPMDs) remain major global public health challenges, particularly in low-and middle-income countries. Although early detection substantially improves prognosis, limited healthcare infrastructure restricts timely diagnosis. Artificial intelligence (AI) enabled, mobile phone-based diagnostic systems offer a promising, accessible solution, and multiple systematic reviews have demonstrated their potential. However, uncertainty persists regarding the comparative performance of AI models across diverse real-world settings. Aim:An umbrella review was aimed at evaluating the comparative performance of different AI models in detecting OC and OPMD. Materials and Methods:This research identified six systematic reviews from databases such as Medline (via PubMed), Web of Science, Scopus, and EMBASE through October 2024 which were checked at the title, abstract, and full-text levels. The risk of bias (ROB) was then assessed using the Joanna Briggs Institute's ROB assessment tool. Results:Across included reviews, pooled sensitivity and specificity for AI-based detection ranged from 88% to 92%, with reported diagnostic odds ratios ranging from 114 to 2549, indicating strong discriminatory performance. Deep learning architectures such as EfficientNet and ResNet consistently demonstrated high diagnostic accuracy, while hybrid approaches (e.g., MLSO + SVM) showed promising performance in selected analyses. However, substantial heterogeneity was observed across studies (I 2 often >85%), reflecting variability in populations, image acquisition protocols, and model architectures. Conclusion:Deep learning models like EfficientNet and ResNet are favored in clinical diagnostics for their exceptional performance and adaptability. Hybrid approaches, such as MLSO + SVM, also show great potential by combining the strengths of traditional and modern methods effectively.
Background: Since the 1960s, silicone has been the material of choice for maxillofacial prostheses due to its biocompatibility and favorable mechanical properties. However, reduced strength, color instability, and susceptibility to ultraviolet and oxygen degradation limit its longevity. Nanoparticles such as titanium dioxide (TiO2), zinc oxide (ZnO), SiO2, and ZrO2, have been introduced to enhance silicone’s resistance to environmental stress, abrasion, and photodegradation. Materials and Methods: This systematic review assessed the influence of nanoparticles on the properties of maxillofacial silicones. A literature search was conducted in PubMed, Scopus, Web of Science, Cochrane, and Google Scholar. Eligible studies included systematic reviews and meta-analyses published in the past decade, focusing on the effect of nanoparticles on the mechanical and physical performance of silicones. Data were analyzed according to nanoparticle type and reported outcomes. Results: Six categories of nanoparticles were identified across the reviewed studies. The most frequently examined were TiO2, ZnO, SiO2, and ZrO2, while others included ZrSiO4, TiSiO4, Ag-Zn Zeolite, and Al2O3. Findings demonstrated improvements in tensile strength, hardness, flexibility, compressive resistance, and color stability. Nanoparticles also enhanced resistance to aging and environmental changes, while some (e.g., Ag-Zn Zeolite) provided antimicrobial effects. Conclusion: Incorporating nanoparticles into maxillofacial silicones considerably enhances their mechanical, physical, and biological properties.
Background: Assessment of budding and grading of oral squamous cell carcinoma (OSCC) establishes the prerequisite for its management as the first step toward personalized management. The inclusion of depth of invasion (DOI) and its regional metastasis provides a holistic approach to the treatment of this devastating lesion. Materials and Methods: The present study is a descriptive analytical study of 80 diagnosed cases of OSCC. Only OSCC cases with both preoperative and corresponding postoperative tissue sections, along with relevant clinical information, were included in the study. Results: The budding and depth (BD) score demonstrated strong predictive accuracy for lymph node metastasis (LNM), with a sensitivity of 83.3% and specificity of 70.0%. The positive predictive value was 76.9%, whereas the negative predictive value was 77.8%. The 95% confidence interval ranged from 0.65 to 0.85, underscoring the reliability of this predictive model. These findings highlight the BD score as a valuable tool for anticipating LNM. Correlation analysis revealed significant relationships between BD scores and several clinical parameters. The budding score showed a moderate correlation with tumor size (r = 0.45) and lymph node involvement (r = 0.60), both statistically significant at P < 0.05. Similarly, the DOI exhibited significant correlations with tumor size (r = 0.55) and lymph node involvement (r = 0.65). Chi-square test employed to calculate P value. P <0.05 was considered statistically significant. Conclusion: The results indicate a strong correlation between higher BD scores and greater lymph node involvement, as well as deeper tumor invasion, pointing to more aggressive tumor characteristics, proving it to be an effective tool for clinical prognosis.
Background: Exposure to chemical substances is one of the occupational hazards among dentists. Therefore, this study aimed to investigate the changes in chemical exposure and control measures in general dental offices in Isfahan city, Iran, from 2001 to 2023. Materials and Methods: This study was performed with a repeated cross-sectional design. 184 offices were surveyed in 2001 and 250 offices in 2003. Data were collected by a researcher-made checklist. This tool has four parts, including questions related to demographic characteristics, questions related to the time period of exposure, questions related to exposure type and its consequences, and questions related to control measures. Results: The results showed that although the use of some chemicals has increased or remained unchanged, the use of most chemicals, such as resin-based dental restorative materials, acid etch materials, latex, dental plaster, common disinfectants, and hand hygiene products, has decreased in 2023 compared to 2001 (P < 0.028). Moreover, the results indicated that professional control measures, including education, personal protective equipment, engineering control, and several measures, have significantly improved in 2023 compared to those in 2001 (P < 0.001). Conclusion: These findings highlight the importance of improving workplace conditions, implementing control measures, and applying less hazardous materials in dental offices.
Background: Laser therapy with fluoride-containing material, such as casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), is a new technique for caries prevention. The purpose of this study is to investigate the effect of CPP-ACP, fluoride varnish (FV), and diode laser (DL) on the microhardness of enamel. Materials and Methods: This in vitro study involved 18 extracted human premolar teeth. The teeth were split into buccal and lingual halves. Baseline microhardness was measured using the Vickers hardness test before any intervention. The samples were randomly divided into seven groups (n = 5): (1) the GC Tooth Mousse (GCTM) group, (2) the MI Paste Plus (MIPP) group, (3) the DL group, (4) the FV group, (5) the DL + GCTM group, (6) the DL + MIPP group, and (7) the DL + FV group. The samples were then stored in artificial saliva for 1 h, immersed in demineralizing solution for 3 h, and in remineralizing solution for 21 h, repeated over 12 days. Finally, the samples remained in the remineralizing solution for an additional 2 days. The final microhardness was measured on day 14. Mean and standard deviation values summarized the data, with paired t-tests and analysis of covariance used to compare the groups’ microhardness before and after treatment. Data were analyzed using SPSS version 22, with a significance level set at < 0.05. Results: The mean microhardness of all teeth was significantly changed after the intervention (P < 0.05). The FV (11.09%) and FV + DL (9.89%) groups had a minimum reduction in microhardness, while the GCTM group (38.2%) showed a maximum reduction. DL irradiation before using remineralizing agents increased microhardness in the GCTM + DL and FV + DL groups. However, a decrease in the microhardness of the MIPP + DL group was observed after DL irradiation. No significant difference was observed in the mean microhardness of the DL + GCTM, DL + MIPP, and DL + FV groups compared to the GCTM, MIPP, and FV groups, respectively. Conclusion: Using DL along with FV or GCTM can have a synergic effect on the amount of microhardness. Although this effect was not observed in the DL + MIPP group, FV has a positive effect on tooth microhardness.
Background:Oral lichen planus (OLP) is a chronic mucocutaneous inflammatory disease that is somewhat frequently manifested in various clinical forms: reticular OLP (ROLP) and erosive OLP (EOLP), and some cases are associated with dysplasia. Higher risk of malignant transformation has been linked to dysplastic alterations in OLP. Glucose transporter protein (GLUT1) is a transmembrane glycoprotein associated with increased glucose metabolism and proliferation of cells. This study's objective was to analyze and compare the expression patterns of GLUT1 in EOLP, ROLP, and lichen planus-related dysplasia in an attempt to acquire improved knowledge of the molecular pathways that underlie the etiology and advancement of OLP. Materials and Methods:In this retrospective study, analysis of GLUT1 expression was done in 32 samples of OLP (16 for ROLP, 10 for EOLP, and 6 for OLP with dysplasia) with immunohistochemistry. Statistical analysis was performed using Pearson's Chi-square and F-tests, with significance set at P < 0.05. The immune GLUT-1 expression was evaluated semi-quantitatively and qualitatively at ×100 magnification. Results:The mean percentage of GLUT1-positive cells in ROLP (16.53 ± 11.72) was lower than that in EOLP and OLP with dysplasia. Among the three groups, there was a significant difference in terms of staining intensity, intracellular location, and extent of GLUT1 immunoexpression within the epithelium layers (0.000, 0.034, and 0.006, respectively). Conclusion:GLUT1 overexpression reflects increased glycolytic activity of proliferating cells in response to hypoxia and high energy requirements in EOLP and OLP-related dysplasia. GLUT1 expression may predict the malignant potential of OLP toward oral squamous cell carcinoma.
Background:The use of natural plant extracts to combat pathogenic bacteria offers a promising approach to preventing microbial resistance. This study explores the synergistic antimicrobial effects of Salvadora persica, propolis, and clove extracts against Candida albicans and Streptococcus mutans. Materials and Methods:This was an in vitro experimental study designed to evaluate the antimicrobial activity and synergistic interactions of ethanol extracts of S. persica, clove, and propolis against S. mutans and C. albicans using agar dilution and checkerboard assays. The chemical composition of the extracts was analyzed using Soxhlet and accelerated solvent extraction methods, followed by gas chromatography-mass spectrometry analysis. Results:The minimum inhibitory concentration values for S. persica, clove, and propolis against S. mutans were 4.5 mg/ml, 9 mg/ml, and 2.2 mg/ml, respectively, and for C. albicans, 4.5 mg/ml for S. persica and clove, and 1.1 mg/ml for propolis. Combinations of these extracts demonstrated synergistic effects with fractional inhibitory concentration indexes ranging from 0.3 to 1.5 against both pathogens. Conclusion:These results suggest that combining plant extracts with propolis may offer an effective strategy for treating oral infections. Given the role of S. mutans in dental caries, these findings support the potential use of these natural compounds in preventive and therapeutic dental applications.
Background:The aim of this laboratory study was to investigate the immediate and delayed effects of silver diamine fluoride (SDF) on the microshear bond strength (μSBS) of two types of sixth-generation self-etch and universal etch-and-rinse (ER) adhesives to sound dentin (SD) and Caries-Affected Dentin (CD). Materials and Methods:In this experimental study, 120 human third molars were selected, half of which had occlusal caries. First, the occlusal enamel was removed, and SD and CD surrounded by SD were exposed. The samples were divided into three groups. In the first group, SDF was not used; in the second group, SDF was applied, and in the third group, after applying SDF, the samples were incubated in artificial saliva for 1 month. The sixth-generation self-etch adhesive was used in half of the samples, and the universal ER adhesive was used in the other half. The μSBS of the samples was measured, and the strength and type of failure were investigated. The data were analyzed using three-way analysis of variance (α = 0.05). Results:The highest mean shear bond strength was observed in the SD without SDF and Clearfil Liner Bond (LB), and the lowest mean shear bond strength was observed in the CD, LB, and Aged SDF. The bond strength was lower in the CD than in the SD (P < 0.001). In CD, SDF caused a slight increase in the immediate μSBS, which was not significant in any of the bonding systems. Bond strength in the SD with Aged SDF was significantly higher in All Bond (AB) Universal than in LB (P = 0.03). Conclusion:Applying SDF to SD, regardless of the type of bond, decreases the bond strength, while it increases the bond strength of CD. If SDF is used in SD, it is better to use AB and ER bonding systems.
Background:The aim of this study was to assess oral health status and prosthetic needs of elderly populations in Almaty, Kazakhstan, and identify gaps in geriatric dental care. Materials and Methods:In cross-sectional and retrospective analyses a total of 708 adults aged 45 + were examined using the World Health Organisation-recommended methods. Participants were grouped by age, diagnosis, and treatment. Prosthetic status and needs were evaluated, including crowns, bridges, partial/complete dentures, and edentulism. Data were analyzed using SPSS version 22.0 (USA). Pearson's correlation coefficient and Kruskal-Wallis analysis of variance were applied to assess associations between variables, with statistical significance set at P < 0.05. This study employed a mixed design that combined cross-sectional and retrospective analyses. It involved both sociological surveys and clinical dental examinations to assess prosthetic needs and oral health status. Results:Edentulism was common (41.9% complete, 38.8% partial). Over half (52.1%) used prostheses, mainly removable dentures, yet 42.6% were dissatisfied. Barriers included financial hardship (68.3%), limited access, and disability, with women, older adults, and low-income groups most affected. Preventive care gaps were evident: 28.4% required urgent care, and 64.3% lacked emergency records. Conclusion:Affordable, accessible, and high-quality dental services are urgently needed for Kazakhstan's elderly. Findings support the development of targeted policies and future research to enhance geriatric oral health and promote healthy aging.
This review examines self-injurious behavior (SIB) in individuals with attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD), focusing on teeth autoextraction, a rare occurrence in this group. The study centers around an 11-year-old girl who, as a new patient, was missing two teeth and later extracted two more. It analyzes documented SIB cases, particularly teeth autoextraction in ADHD and OCD contexts. Few documented cases show teeth autoextraction in ADHD and OCD individuals, highlighting a lesser-known form of SIB. Early recognition and multidisciplinary management are vital to address this behavior. Identifying autoextraction in ADHD and OCD patients is crucial for dental and healthcare professionals. Collaborative care can prevent SIB escalation and provide holistic support for these individuals.
Background:There is a growing need for adjunctive periodontal therapies that effectively reduce inflammation, halt disease progression, and enhance tissue regeneration. This study evaluated the clinical efficacy of locally delivered Vitamin D3 gel as an adjunct to nonsurgical periodontal therapy in patients with periodontitis. Materials and Methods:A randomized controlled split-mouth trial was conducted in 30 patients with Stage II-III periodontitis and bilateral pockets. Test sites received scaling and root planing (SRP) with locally delivered Vitamin D3 gel, while control sites received SRP with placebo gel. Clinical parameters - plaque index, gingival index (GI), sulcus bleeding index (SBI), width of keratinized tissue (WKT), probing pocket depth (PPD), and clinical attachment level - were recorded at baseline, 3 months, and 6 months. Intragroup changes across time points were analyzed using the analysis of variance, and intergroup comparisons were performed using the paired t-test, with significance set at 0.05. Results:Significant intragroup PPD reductions were observed in both groups at 6 months (Test: 4.75 ± 0.72-3.2 ± 0.62 mm; Control: 5.0 ± 0.73-2.7 ± 0.47 mm; P < 0.05). Intergroup differences were nonsignificant at baseline and 3 months (P > 0.05). At 6 months, the test group demonstrated significantly greater improvements in GI (t = 3.13, P = 0.005), SBI (t = 4.77, P = 0.000), WKT (t = 2.60, P = 0.017), and PPD (t = 3.25, P = 0.004), indicating superior clinical outcomes. Conclusion:Local delivery of Vitamin D3 gel resulted in significant reductions in PPD and GI, suggesting a promising adjunctive approach to periodontal therapy by simultaneously targeting inflammation, infection control, and tissue regeneration.
Dentinogenic ghost cell tumor (DGCT) is a rare odontogenic neoplasm, representing a solid variant of the calcifying odontogenic cyst (COC), accounting for 2%-14% of all COCs and <0.5% of odontogenic tumors. Its unique histological and clinical characteristics, coupled with its potential for local invasiveness, underscore the necessity for accurate diagnosis and management. This article reports two cases of DGCT Case 1involves a 13-year-old boy presented with the absence of permanent teeth 4 and 5. Radiographic examinations revealed a mixed radiolucent-radiopaque lesion in the left mandible associated with the impacted permanent teeth. The lesion exhibited well-defined borders and significant calcifications. Microscopic analysis revealed islands of odontogenic epithelium with features resembling ameloblasts, numerous ghost cells, and areas of dystrophic calcification, confirming the diagnosis of DGCT. Case 2 involves A 67-year-old male presented with an exophytic lesion on the left side of the mandibular alveolar mucosa. On pathologic examination, the sample revealed features that led to the diagnosis of a peripheral DGCT. In the first case, given the lesion's size and location, a surgical excision was performed using an intraoral approach under general anesthesia, including a margin of healthy tissue. Short-term follow-ups were conducted every 3 months, and no recurrence was noted after 6 months. In the second case, an excision biopsy and short-term follow-up were conducted. This case highlights the clinical presentation, radiographic features, and histopathological characteristics of two cases of DGCT, emphasizing the importance of surgical intervention and regular follow-up in managing this rare neoplasm. Enhanced awareness and understanding of DGCT are essential for timely diagnosis and effective treatment, particularly in pediatric patients presenting with dental abnormalities.
Background: The use of tooth-colored restorations, particularly composite resins, in the treatment of primary teeth has become increasingly common. The durability and clinical success of these restorations largely depend on the adhesive system and its application protocol. Therefore, this study aimed to systematically review the literature comparing the shear bond strength of sixth-generation self-etch adhesives with that of fourth-generation etch-and-rinse adhesives in primary teeth. Materials and Methods: A comprehensive search was conducted in PubMed, Scopus, and Cochrane databases using relevant keywords. Out of 162 initially identified studies, 72 in-vitro studies comparing the shear bond strength of sixth- and fourth-generation adhesives on human primary teeth were screened.After assessing eligibility based on study objectives, population, sample selection, participation rate, available variables, data collection methods, statistical analyses, and results, five studies underwent full-text analysis. Ultimately, four studies met the inclusion criteria for this systematic review. Results: No statistically significant differences were observed in the shear bond strength between the two adhesive systems. However, minor variations were noted. Moreover, none of the included studies evaluated the long-term performance of these adhesives. Conclusion: Despite the high heterogeneity and risk of bias among the included studies, the evidence suggests that fourth-generation adhesives may exhibit slightly better shear bond strength compared to sixth-generation self-etch systems in laboratory settings. Nonetheless, due to reduced application time and technique sensitivity, self-etch systems may be preferable for pediatric patients.
