Comparison of the Three-Dimensional Accuracy of Guided Apicoectomy Performed with a Drill or a Trephine: An In Vitro Study

Guided apicoectomy performed with 3D-printed polymer-based static surgical guides is an emerging trend in endodontic surgery. Static-guided apicoectomy is carried out with either a drill or a trephine. The aim of this in vitro study was to assess the accuracy of osteotomy and apicoectomy performed through a polymer guide, with both drill and trephine, and to compare the accuracy achievable with the two instruments. Six plaster models of a maxilla master model with extracted human maxillary teeth in polymethyl-methacrylate resin were used. The modeled osteotomies were performed in these. The master model was CBCT-scanned, and digital surgical plans were prepared, based on which the surgical guides were printed. The plans contained both drill and trephine apicoectomies. Digital three-dimensional position analysis was performed with dedicated algorithms. A total of 39 drill and 47 trephine osteotomies were analyzed. A statistically significant difference between the two instruments was found only in the global deviation of the distal endpoint, indicating lower deviation for the trephine procedure (1.53 mm vs. 1.31 mm, p = 0.038). Nevertheless, from a clinical perspective, this distinction is inconsequential. The results suggest that, for all practical purposes, the two approaches to apicoectomy allow the same level of accuracy

Factors Influencing Patient Satisfaction and Loyalty as Perceived by Dentists and Their Patients

Objective: This study aimed to identify the key aspects of patients’ dental care experience that influenced their self-perceived satisfaction and loyalty. Also examined was the agreement between patients and dentists regarding these factors. Methods: Questionnaires were administered to 1121 patients and 77 dentists, focusing on demographic information and 15 selected items related to the patients’ last dental visit. Descriptive and linear regression analyses were conducted. Results: The study included participants from 41 practices. Factors significantly influencing satisfaction and loyalty included location convenience, treatment quality, trust in dentists’ decisions, visit frequency satisfaction, clear treatment explanations, dentist’s interest in symptoms, patient-dental personnel attachment, and dentist’s knowledge of the patient and their medical records. While overall agreement between patients and dentists was high, some areas exhibited notable disagreement. Conclusions: The findings mostly align with existing literature, underscoring the importance of communication, trust, and a personal patient-dentist relationship in promoting satisfaction and loyalty. However, they also show that local, generally not reported factors might be at play, which necessitates dentists’ awareness and consideration of the local context for optimal outcomes

Az epidermolysis bullosa szájüregi tünetei és annak ellátása

The aim of this comprehensive article is to provide guidelines for the daily treatment of patients with epidermolysis bullosa, thus contributing to the attainment of their higher quality of life through the improvement of their oral health. Moreover, it is our intention to facilitate the cooperation among Hungarian general practitioners, dermatologists and dentists. Relying on recent research findings of the international literature, we intend to help general practitioners or dermatologists treating epidermolysis bullosa patients on a daily basis by identifying symptoms that require consulting an oral professional on the one hand, and to present the most important prevention strategies and further treatments advised for dentists on the other. Focusing on various aspects of dental treatment, we specify how a dentist can treat the patient without causing additional wounds or pain, and what kinds of therapy are justified by this approach

A COVID–19-vírusfertőzés klinikai felismerését szolgáló új információk és a fej-nyaki régióban dolgozó egészségügyi személyzet védekezésének lehetőségei

A feltételezhetően 2019 végén Kínából indult és világjárvánnyá vált koronavírus-betegség (COVID–19) az egészségügyi ellátórendszer minden szegmensét érinti világszerte, így hazánkban is. Mivel az egészségügyi személyzet számos egészségügyi ellátás során kapcsolatba kerülhet vírusfertőzöttekkel is, járvány idején elengedhetetlenül szükséges, hogy a különböző területen dolgozó hazai szakemberek is naprakész információt kapjanak a vírusról és a fertőzésnek a betegellátást befolyásoló aspektusairól, a javasolt intézkedésekről. A jelen közlemény egy irodalmi összefoglaló, melyben a szerzők a jelenleg elérhető, idevágó hivatkozásokat dolgozták fel, szem előtt tartva a klinikumi ellátás járványügyi vonatkozásait. A feldolgozott publikációk alapján kijelenthető, hogy az elsődlegesen a fej-nyak régiót érintő beavatkozások során, kiemelten a forgó eszköz használatát is igénylő intervenciók esetét, elengedhetetlenül szükséges a beavatkozáskor a helyiségben tartózkodó összes munkatárs teljes védelme, egyszer használatos teljes öltözékkel, szemüveggel és speciális maszkokkal. Ezen felszerelések cseréje és a rendelő tisztítása minden beavatkozás után meg kell, hogy történjen, és erre a teljes ellátóteamet oktatással előre fel kell készíteni. Annak érdekében, hogy megelőzhetők legyenek a kezelések alatti keresztfertőzések és a szakemberek fertőzései, elengedhetetlen a munka- egészségügyi és infekciókontroll-intézkedések szigorú betartása

Oral Health of Patients Undergoing Percutaneous Coronary Intervention—A Possible Link between Periodontal Disease and In-Stent Restenosis

Introduction: There is a well-documented association between coronary artery disease (CHD) and periodontal disease (PD) mediated by common inflammatory pathways. This association, however, has not been investigated extensively in the special context of in-stent restenosis. This study aimed to investigate the periodontal status of patients undergoing percutaneous coronary intervention (PCI) for restenotic lesions. Methods and Results: We enrolled 90 patients undergoing percutaneous coronary intervention and 90 age- and gender-matched healthy controls in the present study. All subjects received a full-mouth examination by a periodontist. Plaque index, periodontal status, and tooth loss were determined. The periodontal state was significantly worse (p < 0.0001) in the PCI group, and each periodontal stage increased the odds of belonging to the PCI group. This effect of PD was independent of diabetes mellitus, another strong risk factor for CAD. The PCI group was further divided into two subgroups: PCI for restenotic lesions (n = 39) and PCI for de novo lesions (n = 51). Baseline clinical and procedural characteristics were comparable between the two PCI subgroups. A significant (p < 0.001) association was found between the PCI subgroup and the severity of periodontal disease, with the incidence of severe PD reaching 64.1%. Conclusions: Patients undergoing PCI for in-stent restenosis exhibit more severe forms of periodontal disease not only as compared to healthy controls but also as compared to patients stented for de novo lesions. The potential causality between PD and restenosis must be studied in larger prospective studies. © 2023 by the authors

A case study of salivary microbiome in smokers and non-smokers in Hungary: analysis by shotgun metagenome sequencing

Objective To investigate the role of cigarette smoking in disease-development through altering the composition of the oral microbial community. Periodontitis and oral cancer are highly prevalent in Hungary; therefore, the salivary microbiome of smoker and non-smoker Hungarian adults was characterized. Methods Shotgun metagenome sequencing of salivary DNA samples from 22 individuals (11 non-smokers and 11 current smokers) was performed using the Ion Torrent PGMTM platform. Quality-filtered reads were analysed by both alignment-based sequence similarity searches and genome-centric binning. Results Prevotella, Veillonella and Streptococcus were the predominant genera in the saliva of both groups. Although the overall composition and diversity of the microbiota were similar, Prevotella was significantly more abundant in salivary samples of current smokers compared to non-smokers. Members of the genus Prevotella were implicated in the development of inflammatory diseases and oral cancer. The abundance of the genus Megasphaera also increased in current smokers, whereas the genera Neisseria, Oribacterium, Capnocytophaga and Porphyromonas were significantly reduced. The data generated by read-based taxonomic classification and genome-centric binning mutually validated the two distinct metagenomic approaches. Conclusion Smoking-associated dysbiosis of the salivary microbiome in current cigarette smokers, especially increased abundance of Prevotella and Megasphaera genera, may facilitate disease development