Orthodontic brackets removal: morphological in vitro evaluation

Debonding procedure is a fundamental stage in the orthodontic treatment (1). Adhesive removal should lead to a complete polished enamel in order to prevent the plaque accumulation and enamel injures (2). Aim of this study is to evaluate in vitro by use of Scanning Electron Microscopy (SEM) the enamel surface after the bracket removal and the enamel polishing with four different techniques. Two groups of teeth, group A (n=12) and group B (n=12) were evaluated. The images were analyzed by the Image J software. After the debonding procedure the two groups were subcategorized in four groups (1A, 1B, 2A, 2B 3A, 3B and 4A, 4B, n.=3). The discriminant between the two main categories was the use of a magnification system (Group A) during the polishing stages. From the qualitative and quantitative images analysis the most conservative technique resulted to be the use of tungsten carbide bur, followed by the final polishing using the soft-polisher tip for composites. In group A, the percentage of the residual adhesive resulted 8% and the damages on the enamel surface showed to be 7%. In group B the percentage of the residual adhesive resulted 35% and the damages on the enamel surface showed to be 15%. This analysis showed how the use of a magnification system aids in significant way during the debonding procedures in the enamel surfaces’ preservation.The authors are grateful to Dr. M. Gianmatteo and to Dr. E. Nazaj, University of L’Aquila, for their help in the sampling and microscopy procedures

Evaluation of changes in postoperative sequelae in implant surgery after the administration of the association of bromelain and escin: a pilot study

The purpose of this pilot study was to evaluate the possible effect of two natural enzymes, bromelain and escin (test), in the treatment of post-operative sequelae after open flap implant placement in the posterior area compared with painkiller medications (control). Fourteen patients were enrolled and randomly assigned to test and control groups. Bromelain and escin were administered in the test group, and a placebo was administered in the control group. Oedema, pain, and trismus were evaluated at the baseline, 2 and 7 days after surgery. Trismus was assessed using an analogue method; oedema was assessed using analogue and digital methods, while pain was reported using a numerical rating scale (NRS). Descriptive analysis and not paired-test were performed. The analogue data for oedema for the test and control groups was 10.73 ± 0.77 cm and 10.67 ± 0.74 cm (p-value baseline–7 days = 0.1004) at 7 days post-surgery. The digital analysis showed at 7 days post-surgery 0.41 ± 0.24 mm for the test group and 0.56 ± 0.52 mm for the control group (p-value baseline–7 days = 0.3140). Pain (NRS 0–10) was higher for the test group at each time point. Trismus was accentuated in the test group at each time point after the surgery. Statistically significant differences were found for the analogue oedema evaluation between baseline and day 2, for trismus in both baseline and day 2 and baseline and day 7 comparison, and for paracetamol tablets intake at day 2. Further observations of more patients are needed

Effect of Light-Sources and Thicknesses of Composite Onlays on Micro-Hardness of Luting Composites

The aim of this study was to compare three different light-curing-units (LCUs) and determine their effectiveness in the adhesive cementation of indirect composite restorations when a light-curing resin cement is used. Two resin composites were selected: Enamel Plus HRI (Micerium) and AURA (SDI). Three thicknesses (3 mm, 4 mm and 5 mm) were produced and applied as overlays and underlays for each resin composite. A standardized composite layer was placed between underlay and overlay surfaces. Light curing of the resin-based luting composites was attained through the overlay filters using LCUs for different exposure times. All specimens were allocated to experimental groups according to the overlay thickness, curing unit and curing time. Vickers Hardness (VH) notches were carried out on each specimen. Data were statistically evaluated. The curing unit, curing time and overlay thickness were significant factors capable of influencing VH values. The results showed significantly decreased VH values with increasing specimen thickness (p < 0.05). Significant differences in VH values were found amongst the LCUs for the various exposure times (p < 0.05). According to the results, a time of cure shorter than 80 s (with a conventional quartz–tungsten–halogen LCU) or shorter than 40 s (with a high-power light-emitting diode (LED) LCU) is not recommended. The only subgroup achieving clinically acceptable VH values after a short 20 s curing time included the 3 mm-thick overlays made out of the AURA composite, when the high-power LED LCU unit was used (VH 51.0). Composite thickness has an intense effect on polymerization. In clinical practice, light-cured resin cements may result in insufficient polymerization for high thickness and inadequate times. High-intensity curing lights can attain the sufficient polymerization of resin cements through overlays in a significantly shorter time than conventional halogen light

Microtensile Bond Strength of Etch-and-Rinse Adhesives in Different Hydroabrasion Conditionings

The aim of the present study was to in vitro evaluate the effect of dentin conditioning with hydroabrasion on the microtensile bond strengths of three adhesive systems, compared to the standard etch-and-rinse technique. Sixty extracted human third molars were collected, and their midcoronal occlusal dentin was used for the microtensile bond strength test. Teeth were randomly assigned to three groups according to the adhesive system used: ExciTE F DSC, ENA Bond, and Scotchbond Universal. Specimens from each group were further divided into four subgroups: control specimens were treated with standard adhesive procedures; hydroabraded (HA) specimens were subjected to preventive hydroabrasion with three different intensity levels. After bonding procedures, composite crowns were incrementally built up. After thermocycling, specimens were subsequently sectioned into 1 × 1 mm sticks, and microtensile bond strengths were measured. Data were statistically analyzed. Failure mode analysis was performed. There were no significant differences in terms of bond strength between standard adhesion protocols and adhesion with HA preconditionings. On the other hand, the type of adhesive used had a significant effect on the tensile bond strength. Subgroups treated with hydroabrasion at higher intensity showed a slightly increased frequency of cohesive fractures. In conclusion, hydroabrasion can be used for dentin cavity preparation or finishing, since it does not seem to affect the bonding effectiveness

Application of Ozone Therapy in Paediatric Dentistry

The therapeutic use of ozone has been suggested for a long time in general dentistry and paediatric dentistry for its antimicrobial, virucidal, disinfectant, and biocompatible properties. Ozone has also anti-inflammatory, analgesic, and immunostimulant properties, and it promotes tissue regeneration. Dental treatment in children is often complex and ozone could support the clinician to enhance the approach and prognosis with young patients, non-cooperant children, or special needs patients. The efficiency of ozone will certainly increase if studies continue to show positive outcomes in a growing number of dental paediatric conditions. This review explores the recent literature of ozone therapy in paediatric dentistry and suggests fields of application for future randomized controlled trials (RCTs)

Low-Level Laser Therapy for the Treatment of Oral Mucositis Induced by Hematopoietic Stem Cell Transplantation: A Systematic Review with Meta-Analysis

Oral mucositis is a common and debilitating side effect induced by stem cell transplantation that is experienced by cancer patients undergoing chemotherapy or radiation therapy. This condition involves inflammation and ulceration of the oral mucosa, leading to pain, difficulty with eating and speaking, and an increased risk of infections. Mucositis not only compromises the quality of life for cancer patients, but also affects treatment outcomes and may necessitate dose reductions or treatment delays. This scientific article provides a comprehensive overview of mucositis. The purpose of this literature review with a meta-analysis is to evaluate the efficacy of laser therapy in treating post-transplant mucositis. Materials and methods: A search of the literature from 3 May 2023 was carried out on three online databases, PubMed, Scopus, and Web of Science. Only studies that treated patients with laser therapy were considered; only studies with the placebo-treated control group were considered. Review Manager version 5.2.8 (Cochrane Collaboration) was used for the pooled analysis. We measured the std. mean difference between the two groups (laser and placebo). Results: There were 230 papers included in this review. Two hundred twenty-seven were excluded. Furthermore, a manual search was performed. After the search phase, three articles were considered in the study. The overall effect showed differences in the degree of mucositis in the laser-treated patients compared with the placebo group. The meta-analysis shows a reduction in the degree of mucositis in the patients treated with laser therapy (std. mean difference −1.34 [−1.98; −0.98]; C.I. 95%). Conclusions: The application of laser therapy results in decreased severity of oral mucositis from radiation and chemotherapy. Our study shows that the application of low-level laser therapy in the treatment of transplant mucositis has excellent efficacy in relieving the symptoms and severity of mucositis

Flexural Properties of Three Novel 3D-Printed Dental Resins Compared to Other Resin-Based Restorative Materials

To evaluate the flexural strength and flexural modulus of three recently introduced 3D-Printed resins and compare them with the flexural properties of other well known, already commercialized, and extensively used resin based dental materials. Three 3D-printed dental resins, a fiber-reinforced epoxy resin, a heat-cured bis-acrylate-based composite resin, two conventional CAD/CAM PMMA, and a graphene-reinforced CAD/CAM PMMA, were selected for this study. Ten prismatic-shaped specimens (2 × 2 × 25 mm) were fabricated for each material (n = 10). All specimens underwent a three-point bending test using a universal testing machine and were loaded until fracture. Flexural strength (MPa) and flexural modulus (MPa) mean values were calculated and compared using the on ranks One-Way ANOVA test. Scanning electron microscope analysis of the 3D-printed resins was performed. Significantly different flexural properties were recorded among the tested materials. The fiber-reinforced epoxy resin exhibited the highest flexural strength (418.0 MPa) while, among the 3D-printed resins, the best flexural strength was achieved by Irix-Max (135.0 MPa). Irix-Plus and Temporis led to the lowest mean flexural strength values (103.9 MPa and 101.3 MPa, respectively) of all the CAD/CAM milled materials, except for the conventional PMMA by Sintodent (88.9 MPa). The fiber-reinforced epoxy resin also showed the highest flexural modulus (14,672.2 MPa), followed by the heat-cured bis-acrylate composite (10,010.1 MPa). All 3D-printed resins had a higher flexural modulus than the conventional PMMA materials. CAD/CAM fiber-reinforced epoxy resin excels in flexural strength, with Irix-Max showing promising flexural properties, which could encourage its use for permanent restorations. Caution is needed with Irix-Plus and Temporis due to their lower flexural strength compared to other traditional materials

Rationale and design of the CV-PREVITAL study: an Italian multiple cohort randomised controlled trial investigating innovative digital strategies in primary cardiovascular prevention

Introduction Prevention of cardiovascular disease (CVD) is of key importance in reducing morbidity, disability and mortality worldwide. Observational studies suggest that digital health interventions can be an effective strategy to reduce cardiovascular (CV) risk. However, evidence from large randomised clinical trials is lacking.Methods and analysis The CV-PREVITAL study is a multicentre, prospective, randomised, controlled, open-label interventional trial designed to compare the effectiveness of an educational and motivational mobile health (mHealth) intervention versus usual care in reducing CV risk. The intervention aims at improving diet, physical activity, sleep quality, psycho-behavioural aspects, as well as promoting smoking cessation and adherence to pharmacological treatment for CV risk factors. The trial aims to enrol approximately 80 000 subjects without overt CVDs referring to general practitioners’ offices, community pharmacies or clinics of Scientific Institute for Research, Hospitalization and Health Care (Italian acronym IRCCS) affiliated with the Italian Cardiology Network. All participants are evaluated at baseline and after 12 months to assess the effectiveness of the intervention on short-term endpoints, namely improvement in CV risk score and reduction of major CV risk factors. Beyond the funded life of the study, a long-term (7 years) follow-up is also planned to assess the effectiveness of the intervention on the incidence of major adverse CV events. A series of ancillary studies designed to evaluate the effect of the mHealth intervention on additional risk biomarkers are also performed.Ethics and dissemination This study received ethics approval from the ethics committee of the coordinating centre (Monzino Cardiology Center; R1256/20-CCM 1319) and from all other relevant IRBs and ethics committees. Findings are disseminated through scientific meetings and peer-reviewed journals and via social media. Partners are informed about the study’s course and findings through regular meetings.Trial registration number NCT05339841