Aims: Dental caries remain a major public health issue, primarily caused by cariogenic bacteria such as Streptococcus mutans, Lactobacillus salivarius, and Enterococcus faecalis. Glass ionomer cements (GICs) are commonly used in restorative dentistry because of fluoride release and biocompatibility, while recent modifications incorporating nanomaterials aim to enhance their antibacterial property. This study evaluated the antibacterial efficacy of conventional and nano-modified GICs of Fuji IX (GC Japan), Fuji II LC Capsule (GC Japan), and nano hydroxyapatite-silica GIC (nanoHA-Silica-GIC) against S. mutans, L. salivarius, and E. faecalis using agar diffusion assay. Materials and methods: Meuller-Hinton blood agar (MHA) was used for bacterial growth, and inhibition zones were measured at 1, 3, 5, and 7 days. Statistical significance was assessed through one-way ANOVA and Kruskal-Wallis tests, with the threshold for significance set at (P < 0.05). All materials demonstrated antibacterial activity against the tested microorganisms. Results: No difference (P > 0.05) was observed between Fuji IX and nanoHA-Silica-GIC. However, Fuji II LC showed the largest inhibition zones at all time intervals, with measurable differences (P < 0.05). Conclusion: Within the study’s limitationof agar diffusion assay, nanoHA-Silica-GIC demonstrated antibacterial efficacy comparable to Fuji IX, while Fuji II LC produced larger inhibition zones against S. mutans, L. salivarius, and E. faecalis, which antibacterial efficacy possibly influenced by material diffusibility.
Introduction: Pregnancy is a dynamic state of physiological changes that significantly impact maternal health. During this period, hormonal fluctuations and dietary shifts alter the oral ecosystem, increasing the proliferation of pathogenic bacteria such as Streptococcus mutans. This biological environment increases the risk of caries, requiring rigorous medical and dental supervision to prevent complications that could affect both the mother and the developing baby. Objective: To evaluate Streptococcus mutans bacterial load and salivary pH as predictive indicators of caries risk in pregnant patients. Materials and Methods: 63 pregnant women were selected, and the salivary pH was measured, a saliva sample was collected for later analysis. All the saliva samples were processed using the CRT Bacteria® methodology and the number of CFU were obtained. The caries risk was determined by the number of CFU and salivary pH. Results were sent to each pregnant woman for them to know their caries risk. Results: In the saliva samples processed, 90% of the participants exhibited a high caries risk, with Streptococcus mutans counts exceeding (>10^5 CFU/ml) while only 10% presented a low risk (<10^5 CFU/ml). Salivary pH testing revealed that the majority of the sample (73%) maintained a pH of 6, followed by 15% with a neutral pH of 7, and 12% presenting a more acidic environment with a pH of 5. Conclusion: Elevated Streptococcus mutans counts and acidic salivary pH during pregnancy significantly correlate with increased caries susceptibility.
Periodontal diseases are among the most prevalent chronic inflammatory conditions worldwide and represent a significant public health burden. Increasing evidence suggests that periodontal pathogenesis is driven by microbial dysbiosis and host inflammatory dysregulation rather than by isolated pathogens. Within this ecological framework, probiotics have emerged as a potential strategy for modulating the oral microbiome and promoting microbial homeostasis. This short communication discusses current evidence regarding the potential preventive role of probiotics in periodontal health, focusing on biological mechanisms, clinical findings, and implications for preventive medicine. Clinical studies suggest that probiotic supplementation may influence inflammatory periodontal parameters and microbial composition. For example, randomized clinical trials have reported reductions in bleeding on probing ranging from approximately 10% to 30%, as well as modest decreases in probing depth (~0.3-0.6 mm) when probiotics are used as adjuncts to mechanical therapy. However, heterogeneity in probiotic strains, dosage regimens, and treatment protocols limit definitive conclusions. Although probiotics cannot yet be routinely recommended for periodontal prevention, microbiome-modulating approaches represent a promising direction for preventive oral health strategies. Further well-designed studies with standardized methodologies are required to clarify their preventive potential.
Objective: To determine the incidence and characteristics of zygomatic orbital fractures. Methods: This retrospective study analyzed 103 patients treated for zygomatic orbital fractures at King Abdullah University Hospital from January 2017 to December 2020. Patient records and radiographs were evaluated for demographics, injury causes, fracture patterns, and treatment modalities. Data analysis included descriptive statistics and Chi-Square tests, with p<0.05 considered significant. Results: Road traffic accidents (RTA) were the primary cause of zygomatic orbital fractures, accounting for 54.37% of cases. Open reduction and internal fixation (ORIF) were the predominant treatment method, used in 81.6% of patients. The study identified 179 fractures in 103 patients, with a male-to-female ratio of 3:1. Patients aged 21-30 years were most affected (36.9%), followed by those aged 31-40 years (23.3%). Conclusion: The incidence and etiology of zygomatic orbital fractures reflect community trauma patterns, with RTA being the predominant cause. These findings highlight the need for targeted prevention strategies and specialized treatment protocols for zygomatic orbital fractures.
This case report details the diagnosis and management of peri-implantitis in the esthetic zone of a 68-year-old male patient. The patient presented with clinical signs of inflammation and radiographic evidence of bone loss around a 30-year-old implant-supported crown. The treatment plan was executed in three phases: initial removal of the pathogenic biofilm and cemented crown, surgical correction of hard tissue deformities using guided bone regeneration (GBR), and the fabrication of a new screw-retained zirconium crown. The comprehensive approach, incorporating pharmacological, surgical, and prosthetic interventions, resulted in the successful restoration of the implant site with optimal esthetic and functional outcomes. This report highlights the importance of a perio-prosthetic management approach for peri-implantitis.
The cemento-enamel junction (CEJ) is essential to the morphology of the dental alveolar process as the tooth emerges into the oral environment. The aesthetic outcomes of implant-supported restorations (ISRs) in the anterior maxilla are closely linked to this bone morphology. Furthermore, the soft tissue gingiva that covers the bone is influenced by the dental-alveolar architecture, particularly in terms of preserving papillary structures. Existing literature has noted challenges associated with papilla loss and the formation of "black triangles" when implants are placed, especially during the remodeling phase of the alveolar process, which must adapt to accommodate a dental implant designed quite differently from the natural tooth it replaces. This article investigates the role of the cemento-enamel junction (CEJ) in the dental-alveolar architecture of maxillary anterior teeth and its influence on the aesthetic outcomes of implant-supported restorations (ISRs). The study aims to provide insights that can enhance decision-making in implant placement and restorative outcomes.
The knowledge about the envelope of function and its influence on the TMJ and lifelong incisal tooth wear is essential when treating your patients holistically. It is furthermore very easily corrected with aligners.
Purpose: To evaluate the fracture resistance of zirconia surveyed crowns with different rest seat designs. Materials and methods: Forty surveyed crowns (n = 20 / group) were made with different rest seats as follows: group 1; zirconia-based material with narrow media-occlusal rest seat; group 2; zirconia-based material with wide media-occlusal rest seat. Then 3M RelyX Luting Cement was used to bond the printed crowns to resin dies. Using Instron 5569 Universal, compression force was applied to the crowns until fractured, and then fracture resistance at maximum load was recorded. Statistical analysis was conducted using the Wilcoxon signed-rank test (α = 0.05) in SPSS (IBM, Armonk, NY, USA). Results: There was nostatistically significant difference in fracture resistance for both groups. Conclusion: Different designs of rest seats CAD/ CAM surveyed crowns can be used; however more research is necessary to measure clinical outcomes.
Aim: This study aimed to analyse the gene expression profile of inflammation- and fibrosis-related targets in drug-induced gingival enlargement (DIGE) in subjects with periodontitis. Materials and Methods: Forty-four patients were divided into four groups: N (control), P (periodontitis), A (periodontitis undertaken amlodipine), and G (DIGE with periodontitis). Periodontal flap surgery was performed at least 6 months after therapeutic intervention and gingival tissue samples were subjected to histomorphometric analysis. Results: None had DIGE grades 2-3 after initial therapy. Compared to controls, inflammatory and fibrosis markers cluster of differentiation 68, matrix metalloproteinase (MMP) 12, A disintegrin and metalloprotease (ADAM) 17, connective tissue growth factor, and cathepsin L were pronounced in DIGE patients; SIRT1 was higher in non-responders. Conclusion: The importance of proper dental plaque management for the treatment of DIGE with periodontitis Elevated SIRT1 may indicate antifibrotic properties.
Aim: Compare the quality of the completion of the cases through dental models attended by the residents of the Orthodontics postgraduate of Universidad Autonoma of Nuevo Leon. The residents did not know the criteria measured by the American Board of Orthodontics (ABO) in its phase III and the residents who did understand these criteria, in addition to knowing if the residents met a minimum of 4 criteria. Materials and Methods: Dental models from the Orthodontics postgraduate archive were used; 98 models in total were analyzed and divided into two groups. Group 1 consisted of residents who did not know the criteria that would be measured, of which 49 models were taken. The other, group 2 did know the requirements; another 49 models were taken. They were evaluated by the same examiner using a millimeter caliper authorized by the American Board of Orthodontics, seven of the eight criteria reviewed by the ABO were examined; these were alignment, marginal ridges, buccolingual inclination, occlusal relationship, occlusal contacts, overjet, and contacts interproximal. A comparison between groups was performed using the Mann-Whitney test, and the result was p=0.05. Results: No significant differences were found between the two groups. However, the criterion with the lowest negative score or the least failed was interproximal contacts, followed by occlusal contact, marginal ridges, occlusal relationship, overjet, alignment, and buccolingual inclination. Conclusions: It was concluded that the residents completed the cases the same way whether or not they knew the criteria required by the Board.
Amyloidosis is a disease characterized by the accumulation of extracellular amyloid protein in many different tissues and organs, with localized or systemic symptoms. It can be acquired or inherited. Amyloid can accumulate in the liver, spleen, kidney, heart, nerves and blood vessels and cause different clinical syndromes such as cardiomyopathy, hepatomegaly, proteinuria, macroglossia, ecchymoses, neuropathy, renal failure, hypertension, autonomic dysfunctions and corneal abnormalities. In this case report, we present a 73-year-old male patient who presented to our clinic with dysphagia due to macroglossia for 2 years and had no other symptoms.
The type of implant and the method of implantation are believed to have a significant influence on primary failure. The aim of this retrospective study was to determine the reliability of osseointegration of BioniQ implants (LASAK s.r.o., Czech Republic) based on the rate of primary failure and to analyze the causes of failure in detail. The primary failure rate of BioniQ implants was 2.35% of all implants and 0.6% when augmentation procedures are excluded. This represents a result, which is in agreement with the data found in current published literature.
There is a paucity of information regarding the administration of Target Controlled Infusion (TCI) sedation to American Society of Anesthesiology (ASA) class 3 and 4 patients for maxillofacial procedures. We report a selection of ASA 3 and ASA 4 patients who recently underwent dental extractions by maxillofacial surgeons and were managed under TCI propofol sedation in mainstream hospital settings. The utilisation of effective TCI propofol sedation, accompanied by an ultra short-acting narcotic (either alfentanil or remifentanil) given immediately prior to the administration of local anaesthetic (LA) by the surgeon, permits the avoidance of higher risk general anesthesia and its associated complications within this more infirm patient group. Effective use of TCI sedation in ASA 3 and ASA 4 maxillofacial patients requires the provision of skills routinely employed for sedation in healthy patients, with the appropriate dosage modifications necessitated by age and associated patient co-morbidities. Properly administered in a hospital setting, TCI sedation with propofol accompanied with an ultra-short acting narcotic is safe and effective.
Odontogenic keratocyst was first mentioned in the literature by Mikulicz in 1876, and described by Philipsen in 1956. These cysts are developmental odontogenic cysts arising from dental laminate remnants. Generally, these cysts can be seen in the second or third decade of life, in both mandibular and maxillary jaws; but most often they are localized in the mandibular jaw. A 23-year-old male patient who came to our clinic complaining of swelling in the lower jaw and did not have a systemic disease had a radiolucent lesion measuring about 4 * 2 cm in the mandible and lateral tooth area in the maxilla. Enucleation of radiolucent lesions which are localized in maxillary and mandibular jaws was performed. Both lesions were sent to the pathology laboratory for detailed examination. Extraction of the impacted right mandibular canine was made. According to the pathology report, a diagnosis of odontogenic keratocyst was made to both lesions. In this case keratocysts were seen as multiocular, and it was suspected that there could be Gorlin Goltz syndrome. According to the medical genetic report of the patient, who does not have any systemic diseases, Multilocular Odontogenic Keratocysts could not be associated with Gorlin Goltz syndrome.
Background: Obesity in Mexico is an alarming problem that has been increasing in recent decades. Dietary factors make this pathology more incidents at younger ages and it is closely related to oral health. This study aims to know the association between the need and presence of prosthesis with the type of obesity in a Mexican population in the state of Yucatan. Objectives: This study explores the relationship between obesity and oral health in the adult population of the Yucatan state in Mexico. Methods: The research was carried out in July 2021 in Merida, Yucatán (Mexico). The sample was made up of 114 people, whose ages were between 15 and 81 years old. The data analysis focused on factors such as obesity type, gender distribution, and oral health status. Results: A notable absence of dental prostheses is perceived in over 80% of participants, suggesting a potential impact on mastication and dietary choices. A direct correlation between obesity type and the need for dental prostheses is identified, with a higher prevalence in individuals with higher body mass indices. This underscores the potential interplay between oral health, obesity, and dietary habits. Conclusions: This research contributes to a growing body of evidence emphasizing the importance of optimal oral health in facilitating efficient mastication and digestion. Further studies are needed on the need for preventive measures alongside treatment in promoting oral health awareness within the community
In modern times, patients have a preference for fast treatment options and fixed restorations, particularly when compared to older patients. The field of fixed reconstructions on implants has witnessed significant advancements, providing a diverse array of treatment options for various situations. However, despite the numerous aesthetic and functional benefits, there is currently a lack of well-defined clinical guidelines regarding the ideal number of implants, loading type, and reconstruction methods. Although there are some existing recommendations, it is crucial to consider the influence of micro/macroscopic factors when determining treatment plans and surgical approaches for each unique case. In this specific case report, we describe the rehabilitation of the upper jaw of a 36-year-old patient. The treatment plan was devised with the objective of not only addressing the patient's immediate needs but also considering potential future requirements in the lower jaw. Special attention was given to the patient's existing dentition and possible risk factors. Furthermore, the plan included the utilization of a 3Shape intraoral scanner (Trios 3) device to digitally capture the impression phase. Additionally, careful consideration was given to the patient's current dentition and possible risk factors. Despite the widespread use of intraoral scanners in dental practice, their role remains somewhat limited due to insufficient significant results and the uncertainty that may arise when using them during surgical procedures. However, in this specific case report, the Trios 3Shape scanner showcased a high level of accuracy, resulting in streamlined workflow and reduced work time. Overall, the outcomes were satisfactory for both the patient and the dental team involved.
Objectives: Several dental surgical procedures use disposable and reusable instruments. This study aimed to compare the clinical performance of new and reused microblades to perform dental surgery. Methods: The clinical performance of the microblade was evaluated by the cutting capacity during root coverage modified tunnel surgery. The surgery involved cutting the initial portion of the sulcus in the mandible of ex-vivo pigs. After each surgery, the microblades were cleaned, sterilized, and the surface was analysed by scanning electron microscopy and surface roughness measurement. The surface roughness parameters (Ra, Rq, PV, the number of peaks, the number of valleys, and the density of the peaks and valleys, respectively) were determined by a 3D optical profilerugosimeter. Results: Clinical results showed that in the first, second, and third uses, the forces applied to the microblade to perform the soft tissue flaps were similar. During the fourth surgery, there was a need to increase the force on to microblade to perform the dissection. In a visual inspection of the microblade, no differences were observed in the surface morphologies after any uses. Scanning electron microscopy (SEM) analysis showed that the number of grooves increased as the number of reuses increased. The surface roughness parameters increased after each use. Conclusions: Based on the clinical results, it is possible to conclude that it is feasible to sterilize and reuse microblades a maximum of three times. Visual inspection proved to be an inadequate procedure to identify surface damage and impairment of instrument performance. Clinical Significance: Visual inspection and scanning electron microscopy analysis are inadequate procedures to identify surface damage and impairment of surgical cutting instrument performance. It is advisable to efficiently use the same instrument a maximum of 3 times.
Background and aims: The host immune response is altered by a series of physiological and pathological factors such as age, gender, inflammation, surgery, and medications. This study was conducted to evaluate differences in salivary IgA (S-IgA) levels in individuals who underwent dental implant surgery and compare them to individuals who were not exposed to dental treatments. S-IgA levels were determined at least 3 months after implant installation. Methods: A total of 60 healthy individuals were included in the study; 30 participants received implant treatment (Implant Group) and were compared with 30 participants with no implant treatment as controls (Control Group). 1.5 ml of unstimulated saliva was obtained for all participants. The quantitative enzyme-linked immunosorbent assay (ELISA) technique was used for the measurement of salivary IgA levels. Results: The age range of the participants in the implant group was 38-62 years, with a mean age of 47.9 years; 18 (60%) were males and 12 (40%) were females. The age range of the study's controls was 38-59 years, with a mean age ± SD of 45.2 ± 5.2 years for 18 (60%) males and 12 (40%) females. The mean number of implants was 2.7 ± 0.83, and the mean period after implant placement was 19.2 ± 8.2 months. A low sIgA level (< 250 μg/mL) was present in 10% of implant patients, but not in any cases in the control group. In contrast, only 6.7% of implant patients had this amount at a level greater than 351 μg/mL, compared to 53.3% in the control group. The mean ± SD for cases was 302.7 ± 36.8 g/mL versus 370.8 ± 59.2 μg/mL for controls, indicating that all normal distribution values were significantly lower in the implant patient group compared to higher values in healthy controls. Males had higher normal values across the board in both groups (cases and controls). Male dental implant patients' mean and standard deviation (312.2 ± 38.3 vs. 408.2 ± 42.2 µg/ml) showed a statistically significant decrease. Female dental implant patients' mean and standard deviation (287.3 30.6 vs. 314.7 ± 27.6 µg/ml) showed a statistically significant decrease. Overall, there was a significant decrease in the mean ±SD of dental implant patients (302.7 ± 36.8 µg/ml) versus the rising level in the total healthy control group (370.8 ± 36.8 µg/ml). The observed averages of sIgA for the presence of peri-implant mucositis in the two independent samples (yes, no) differed significantly by 60.7, with a 95% confidence interval of 41.1-80.3, and this finding is very significant (p<0.0001). Conclusion: Salivary immunoglobulin A level values were significantly lower statistically in implant patients compared to the control group. The results, however, showed that there is a connection between lower sIgA levels in saliva and the development of pre-implant mucositis, meaning that low sIgA levels are risk factors for peri-implant mucositis or that peri-implant mucositis causes lower sIgA levels to be produced in mouth saliva.
