The impact of automated hippocampal volumetry on diagnostic confidence in patients with suspected Alzheimer's disease: an EADC study

INTRODUCTION: Hippocampal volume is a core biomarker of Alzheimer's disease (AD). However, its contribution over the standard diagnostic workup is unclear. METHODS: Three hundred fifty-six patients, under clinical evaluation for cognitive impairment, with suspected AD and Mini–Mental State Examination ≥20, were recruited across 17 European memory clinics. After the traditional diagnostic workup, diagnostic confidence of AD pathology (DCAD) was estimated by the physicians in charge. The latter were provided with the results of automated hippocampal volumetry in standardized format and DCAD was reassessed. RESULTS: An increment of one interquartile range in hippocampal volume was associated with a mean change of DCAD of −8.0% (95% credible interval: [−11.5, −5.0]). Automated hippocampal volumetry showed a statistically significant impact on DCAD beyond the contributions of neuropsychology, 18F-fluorodeoxyglucose positron emission tomography/single-photon emission computed tomography, and cerebrospinal fluid markers (−8.5, CrI: [−11.5, −5.6]; −14.1, CrI: [−19.3, −8.8]; −10.6, CrI: [−14.6, −6.1], respectively). DISCUSSION: There is a measurable effect of hippocampal volume on DCAD even when used on top of the traditional diagnostic workup

A clinical guideline for caries infiltration of proximal enamel lesions with resins

Objectives The purpose of the present study is to establish a guideline on the management of proximal enamel lesions with resin infiltration. Methods Each article in compliance with the inclusion criteria was evaluated by two independent authors, individually. The methodological quality assessment of the selected articles was conducted using SIGN checklists. Results A total of 15 in vivo studies, 12 systematic reviews and one economic evaluation fulfilled the selection criteria for in-depth analysis of the full text and quality assessment. Conclusions Infiltration of incipient enamel caries lesions is a clinically feasible and effective method for the treatment of interproximal lesions with high success rates, taking also into consideration the limitations of this systematic review. © 2018, Nature Publishing Group. All rights reserved

Digital selection of composite resin shade using cross polarized photography and a standardized white balance gray reference card

Purpose: The aim of the present case report was to describe, through a clinical case, a step-by-step technique, for the digital selection of composite resin shades using cross polarization and white balance employing a standardized reference card. Case Description: After intraoral impression, a digital diagnostic wax up was developed. A 3D printed cast was used to fabricate a lingual polyvinyl siloxane matrix. First a cross-polarized image of the contralateral central incisor was taken in RAW format, using a gray reference card. The digital image was manipulated using this card as a reference, to obtain reliable color values. The obtained color values, from the contralateral central incisor, were used in order to digitally find the closest combination of enamel and dentin shades between various composite systems. The values of a combination of shades of composite systems, was captured using cross-polarized images, with a gray reference card, after digital image manipulation of composite specimens, which have been created for this purpose. Conclusions: Digital evaluation and selection of composite resin system and shade, using a white balance reference card assisted by cross polarized photography, could help achieving more predictable outcomes using the stratification technique with composites. © 202

Efficacy of non-hydrogen peroxide mouthrinses on tooth whitening: An in vitro study

Objectives: To evaluate the tooth whitening efficacy of non-hydrogen peroxide containing mouthrinses. Methods: Forty incisors were randomly assigned into four groups. Four whitening mouthrinses, Oral-B 3D White Luxe/Procter & Gamble (WL), Listerine Advanced White/Johnson & Johnson (AW), Colgate Max White/Colgate (MW), and iWhite Whitening Mouthwash/Sylphar (iW), were used over a four-week period. Color changes of L*, a*, b*, ΔE*ab, and ΔE00, were recorded by a digital spectrophotometer (Spectroshade Micro/Mht), at baseline and intermediate week-intervals. Data were statistically analyzed using repeated measures ANOVA at α = 0.05. Results: The first-week mean change of L* was 0.76 and significantly different from the baseline for all solutions, without any further changes. Correspondingly, a* decreased by −0.36, while b* increased by 0.48, contributing to a color change of 1.15 ΔE*ab or 0.91 ΔE00. No differences were found among the solutions in respect to color-parameter changes (p > 0.05). Differences among time intervals were significant (p < 0.05) and mainly observed between the baseline and the following week-measurements. There was no statistically significant time-solution interaction (p > 0.05). Conclusions: Non-hydrogen peroxide whitening mouthrinses, slightly contribute to tooth whitening, by removing superficial staining, without any further tooth bleaching effect. Clinical significance: Non-hydrogen peroxide containing whitening mouthrinses, despite having a quick initial action, reach their ceiling relatively soon. Their effectiveness is barely perceptible and definitely inferior to other professional tooth bleaching methods. Thus, they can only be considered as a supplementary way of keeping teeth whiter, mainly by preventing recurrent tooth discoloration. © 2021 Wiley Periodicals LLC

Evidence provided for the use of oscillating instruments in restorative dentistry: A systematic review

Oscillating diamond instruments are considered gentle sources for the removal of demineralized tooth hard tissues and the preparation of cavity angles and margins needed in minimally invasive dentistry. However, there is a question if literature provides enough evidence for their efficacy in restorative dentistry procedures. A literature search until May 2016 was conducted, using PubMed, Scopus, and The Cochrane Central Register of Controlled Trials databases. The quality of the studies was assessed using the recommendation of the Oxford Centre for Evidence-based Medicine. Fifty-five studies were finally included in the study. Of which, 78.2% of them were laboratory studies and only 21.8% were clinical studies. The strength of recommendation was 5 for most of them and D their grade of evidence. Bond strength of adhesives on surfaces prepared with these instruments, effective caries removal and cutting characteristics of the oscillating instruments were the main targets of the studies. Conventional diamond, steel, and chemical vapor deposition diamond tips and systems based on abrasive slurry were the oscillating tips, used in different studies. The strength of recommendation and grade of evidence of the studies were low. Although these devices seem to be useful for many clinical situations, there is a need for more well-structured evidence-based studies with more widely accepted procedures and common devices, to have more meaningful results and conclusions of higher strength. © 2017 European Journal of Dentistry

Evaluation of dental explorer and visual inspection for the detection of residual caries among Greek dentists

Objectives: The objective of this study was to assess the effect of the operator's degree of clinical experience on the residual caries diagnosis through visual inspection and tactile sensation. Materials and Methods: The participants were asked about the years of their clinical practice, any further training concerning cariology, their familiarity with the minimal invasive philosophy, and the techniques that they use to remove dental caries and detect when to stop the removal of carious tissues. In addition, an in vitro diagnostic test was conducted. Carious teeth were excavated to a level selected in random. Teeth were examined by each participant individually. Initial examination was performed by visual inspection. Subsequently, a dental explorer was used concerning the potential need for further removal of dental tissues. A sample of 380 dentists and dental school students were selected for the purposes of this study. Results: Dental students presented statistically significant better sensitivity, than dentists from both age groups, during both visual inspection and tactile sensation of residual caries. Participants' ability to diagnose residual caries during cavity preparation was independent of their years of experience. Conclusions: During the removal of carious lesions, with the goal of limiting the sacrifice of healthy structures and the leftover of residual caries, clinicians should combine a selective removal technique and the attentive visual inspection, with at least one further diagnostic method, aside from the dental explorer. Tactile examination of residual caries solely with the dental explorer must be used with attention. © 2018 Journal of Conservative Dentistry | Published by Wolters Kluwer - Medknow

The Effects of Physical Exercise on Saliva Composition: A Comprehensive Review

Saliva consists of organic and inorganic constituents. During exercise, analysis of the saliva can provide valuable information regarding training stress, adaptation and exercise performance. The objective of the present article was to review the effect of physical exercise on saliva composition. The shift in the composition of the saliva, during and after a workout, reflects the benefits of exercise, its potential risks and the capability of the saliva to serve as a health indicator. The type and the frequency of training, the physical condition and the athletes’ general health influence the hormones, immunoglobulins and saliva enzymes. The correlation between saliva and physical exercise has to be further investigated and the available knowledge to be applied for the benefit of the athletes during sports activities. © 2022 by the authors. Licensee MDPI, Basel, Switzerland

Deep Margin Elevation: A Literature Review

A conservative approach for restoring deep proximal lesions is to apply an increment of composite resin over the preexisting cervical margin to relocate it coronally, the so-called “deep margin elevation” (DME). A literature search for research articles referring to DME published from January 1998 until November 2021 was conducted using MEDLINE (PubMed), Ovid, Scopus, Cochrane Library and Semantic Scholar databases applying preset inclusion and exclusion criteria. Elevation material and adhesive system employed for luting seem to be significant factors concerning the marginal adaptation of the restoration. This technique does not affect bond strength, fatigue behavior, fracture resistance, failure pattern or repairability. DME and subgingival restorations are compatible with periodontal health, given that they are well-polished and refined. The available literature is limited mainly to in vitro studies. Therefore, randomized clinical trials with extended follow-up periods are necessary to clarify all aspects of the technique and ascertain its validity in clinical practice. For the time being, DME should be applied with caution respecting three criteria: capability of field isolation, the perfect seal of the cervical margin provided by the matrix, and no invasion of the connective compartment of biological width. © 2022 by the authors. Licensee MDPI, Basel, Switzerland

Digitally designed reduction guide of to correct proclined anterior teeth: An aid before fabricating trial restorations

Restoring teeth with ceramic laminate veneers is most often an additive procedure. However, when proclined anterior teeth are being treated, a misfitting silicone matrix will lead to inaccurate trial restorations, affecting evaluation of the definitive esthetic result and leading to inaccurate definitive preparations. Using the digital technology, a 3-dimensionally printed reduction guide can be used to remove the proclined areas as the first step before trial restorations. Then, the trial restorations and made and then the definitive preparations made through them. © 2021 Editorial Council for the Journal of Prosthetic Dentistr