Bioactive Dental Materials: The Current Status

The field of dental materials has undergone a significant evolution in recent years [...

Cone-Beam Computed Tomography and the Related Scientific Evidence

Cone-beam computed tomography (CBCT) is the most common three-dimensional (3D) imaging technique used in dentistry [...

Surface electromyography in the assessment of masticatory muscle activity in patients with pain-related temporomandibular disorders: a systematic review

BackgroundTemporomandibular disorders (TMD) are a set of painful conditions affecting the orofacial region that are prevalent and constitute the most frequent type of non-dental pain complaint in the maxillofacial area. Pain-related TMD (TMD-P) is characterized by ongoing pain in the masticatory muscles, the temporomandibular joint, or surrounding structures. Due to the multiple factors that contribute to the development of this condition, it can be challenging to accurately diagnose. One of the useful method for assessing patients with TMD-P is surface electromyography (sEMG). The aim of this systematic review was to provide a comprehensive overview of the current scientific literature on the evaluation of masticatory muscle activity (MMA) in individuals diagnosed with TMD-P, through the utilization of sEMG.MethodsTo gather relevant information, electronic databases such as PubMed, Web of Science, Scopus, and Embase were searched using specific keywords including: “pain” AND (“temporomandibular disorder*” OR “temporomandibular dysfunction*”) AND “surface electromyography” AND “masticatory muscle activity.” The inclusion criteria were studies assessing MMA in patients with TMD-P using sEMG. The Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies was utilized to evaluate the quality of the studies that were included in the review.ResultsThe search strategy identified 450 potential articles. Fourteen papers met the inclusion criteria. Global quality rating for significant part of the articles was weak. Most studies showed greater sEMG activity of the masseter (MM) and temporal anterior (TA) muscles at rest in TMD-P subjects than in the asymptomatic controls, while the MM and TA muscles were less active in the pain-related TMD group compared to the non-TMD group during maximal voluntary clenching (MVC).ConclusionThere were differences in MMA in the TMD-pain population compared to a healthy control group during various tasks. The diagnostic efficacy of surface electromyography in assessing individuals with TMD-P remains unclear

Direct Esthetic Composite Restorations in Anterior Teeth: Managing Symmetry Strategies

A novel procedure for symmetric and consistent layer thickness management in esthetic direct restoration of anterior teeth is presented. For the purpose of obtaining a satisfactory final outcome of an esthetic direct restoration, it is crucial to standardize either margin preparation design and dentin and enamel layer thickness. Leaving too much space for the final translucent layer may lead in fact to “low value—gray” restorations if not correctly managed. The most common tool used to check layer thickness is the sagittal silicone index, which is reliable but involves planning; therefore, it requires two stages appointments. In this clinical case, a novel procedure is used to prepare, to model and to check thickness of composite shades in a single appointment, thus providing a symmetric esthetic outcome. A healthy 21-year-old woman referred to our dental office for the esthetic rehabilitation of both maxillary central incisors. The correct composite bilateral and symmetric layer thickness management provided a predictable esthetic outcome of the restorations. The main objective of this case presentation is to describe a novel technique that is able to save chair-time and dental laboratory costs during direct restorations in anterior teeth

Oral Health and Teledentistry Interest during the COVID-19 Pandemic

Background: The COVID-19 pandemic outbreak has significantly changed access to dental treatments. Methods: The data related to oral health and teledentistry topics were collected from the open database Google Trends. The analyzed material was collected from 19 June 2016 to 6 June 2021 among anonymous search engine users. The following expressions were analyzed: “dental care”, “emergency dental care”, “oral health”, ”periodontitis”, “teledentistry”, “is it safe to go to the dentist”, and “COVID-19” and ”PPE dentist”. Results: During the first lockdown in 2020, a significant increase in “emergency dental care” phrase queries was detected, with a simultaneous decrease in regular “dental care” questions, as well as a peak in the queries for “periodontitis” preceded by lower interest in “oral health.” The number of searches stated for “teledentistry” increased during the time of the pandemic 5 times and for and “PPE dentist” 30 times. The risk of visiting the dental studio was seen in almost 40 times increase in the query “is it safe to go to the dentist.” Conclusions: The COVID-19 imprinted a stigma on oral health care. In this difficult epidemiological situation, teledentistry might become a helpful solution

The “Pre-Finishing” Approach in Direct Anterior Restorations. A Case Series

n esthetic restorations of anterior teeth the clinician has to manage several aspects in order to have a predictable outcome. A deep knowledge of the anatomy as well as the adhesive procedures and the optical properties of resin-based composites are mandatory to achieve esthetic results. Contemporary restorative materials present either several shades and different translucency properties and therefore they are able to mimic teeth’s optical behavior thus providing a natural aspect to anterior restorations. The wrong thickness of different composite layers may provide unpleasant results such as low value (grayish) restorations that often requires reintervention. A precise step-by-step procedure is therefore mandatory to provide the proper shade at the correct place. There is therefore the need of some corrections and adjustments during the layer procedure in order to avoid errors in shade positioning that could affect final result. The authors present a case series (six clinical cases) treated with the proposed technique with up to five years follow-up

Morphometric Analysis of the Mandibular Canal, Anterior Loop, and Mental Foramen: A Cone-Beam Computed Tomography Evaluation

This study investigated the cone-beam computed tomography (CBCT)-based features of the mandibular canal, mental foramen, anterior loop, and accessory mental foramina with respect to age and sex. A total of 306 CBCT mandibular images were included in this retrospective study to measure the mandibular canal location and extension, the mental foramen position, the presence of the anterior loop, and the accessory mental foramina. The measurements were obtained in sagittal, coronal, and axial views. Descriptive statistics are presented. Sex-related differences, correlations, and comparisons were calculated using SPSS at 5% significance level. The mandibular canal was located more coronal and medial in male patients. The majority of cases had the mental foramen located just apical to the mandibular second premolar with a mean height of 2.94 mm and a mean length of 3.28 mm. Age affected the size of the mental foramen. The mental canal in all cases tended to show a coronal direction. Mesial extension of the anterior loop was found in 66.01% of the images while accessory mental foramina were detected in 2.6%. The complexity of the mandibular canal, mental foramen, anterior loop, and accessory mental foramina among Sudanese patients with respect to age and sex was confirmed

Application of Fractal Analysis in Detecting Trabecular Bone Changes in Periapical Radiograph of Patients with Periodontitis

Evaluation of detailed features of the supporting bone is an important step in diagnosis and treatment planning for teeth with clinical attachment loss. Fractal analysis can be used as a method for evaluating the complexity of trabecular bone structures. The aim of this study was to evaluate the trabecular bone changes in periapical radiographs of patients with different stages of periodontitis using fractal analysis. Methods. This comparative cross-sectional study was performed on patients with and without clinical attachment loss in mandibular first molars. Teeth with clinical attachment loss were divided into mild, moderate, and severe periodontitis groups. Digital periapical radiographs were obtained from the mandibular first molars using the same exposure parameters. DICOM file of the radiographs was exported to ImageJ software for fractal analysis. Three regions of interest (ROIs) were considered in each radiograph: two proximal ROIs mesial and distal to the mandibular first molar and one apical ROI. Fractal dimension (FD) values were calculated using the fractal box counting approach. Statistical analysis was performed using the chi-square test, Mann–Whitney test, intraclass correlation coefficient, and ANOVA (α = 0.05). Results. FD values were significantly different between moderate and severe periodontitis and healthy periodontal bone (P0.05). Conclusion. Fractal analysis is a useful tool for evaluation of bone alterations in moderate and severe periodontitis, but was not able to detect the most initial radiographic bone signs of mild periodontitis

Predictive Periodontitis: The Most Promising Salivary Biomarkers for Early Diagnosis of Periodontitis

The primary cause of tooth loss in the industrialized world is periodontitis, a bacterial anaerobic infection whose pathogenesis is characterized by composite immune response. At present, the diagnose of periodontitis is made by a complete status check of the patient’s periodontal health; full-mouth plaque score, full-mouth bleeding score, probing depth, clinical attachment level, bleeding on probing, recessions, mobility, and migration are evaluated in order to provides a clear picture of the periodontal conditions of a single patient. Chair-side diagnostic tests based on whole saliva could be routinely used by periodontists for a very early diagnosis of periodontitis, monitoring, prognosis, and management of periodontal patients by biomarker detection, whose diagnostic validity is related to sensitivity and specificity. Recent paper reviews and meta-analyses have focused on five promising host derived biomarkers as candidate for early diagnosis of periodontitis: MMP-8 (Metalloproteinase-8), MIP-1α (Macrophage inflammatory protein-1 alpha), IL-1 β (Interleukin-1 beta), IL-6 (Interleukin-6), and HB (Hemoglobin), and their combinations. Chair-side Lab-on-a-chip (LOC) technology may soon become an important part of efforts to detect such biomarkers in saliva medium to improve worldwide periodontal health in developed nations as well as in underserved communities and poor countries. Their applications in preventive and predictive medicine is now fundamental, and is aimed at the early detection of risk factors or the presence or evolution of the disease, and in personalized medicine, which aims to identify tailor-made treatments for individual patients. The aim of the present paper is to be informative about host derived periodontal biomarkers and, in particular, we intend to report information about the most important immune response derived biomarkers and Hemoglobin as candidates to be routinely utilized in order to obtain a chair-side early diagnosis of periodontal disease

Human Periapical Cysts-Mesenchymal Stem Cells Cultured with Allogenic Human Serum are a "clinical-grade" construct alternative to bovine fetal serum and indicated in the regeneration of endo-periodontal tissues

Aim: Our research investigated the use of human serum (HS) as a safe and clinical-grade culture medium, using a new cell-model: hPCy-MSCs. This article is aimed to concretely applicate the concept of "waste-based regenerative dentistry" to translate it in future endo-periodontal applications. Methodology: HPCy-MSCs were cultured in 2 different mediums, both containing α-MEM: the 1st with 10% FBS (Control group), and the 2nd with 10% human serum (Test group).Cell proliferation and stemness assays, gene expression, immunophenotypic analysis and osteogenic differentiation were performed to verify our hypothesis. cDNA samples were amplified with qPCR.Experiments were performed in triplicate and analysed with statistical software. Results: The hPCy-MSCs cultivated in a medium with HS were morphologically similar to those cultivated with FBS, and showed a significantly higher proliferation rate. Von Kossa's staining revealed that osteoblasts from hPCy-MSCs in HS implemented with osteogenic induction factors, showed a better osteogenic activity, also confirmed by a significant upregulation of osteopotin (OPN) and matrix extracellular phosphoglycoprotein (MEPE). Conclusions: HPCy-MSCs cultivated in HS showed phenotypic stability and a clear regenerative binding, thus, suggesting these two components as a clinically-grade construct for future endo-periodontal therapies. Riassunto: Obiettivi: La nostra ricerca ha analizzato l'utilizzo del siero umano (HS) come mezzo di coltura sicuro e "clinical-grade", per uso clinico, utilizzando un nuovo modello cellulare: le hPC-MSCs. Questo articolo ha lo scopo di applicare concretamente il concetto di "odontoiatria rigenerativa basata sui rifiuti biologici", al fine di tradurlo in future applicazioni endo-periodontali. Materiali e metodi: Le HPCy-MSCs sono state coltivate in 2 mezzi di coltura diversi, entrambi contenenti α-MEM: il primo con 10% di FBS (gruppo di controllo) e il secondo con il 10% di siero umano (gruppo di test).Sono stati eseguiti saggi di proliferazione cellulare e di staminalità, espressione genica, analisi immunofenotipica e differenziamento osteogenico per verificare la nostra ipotesi di partenza. Campioni di cDNA sono stati amplificati con qPCR.Gli esperimenti sono stati eseguiti in triplicato e analizzati con software statistici. Risultati: Le hPC-MSC coltivate in un terreno con HS erano morfologicamente simili a quelle coltivate con FBS e mostravano un tasso di proliferazione significativamente più alto. La colorazione di Von Kossa ha rivelato che gli osteoblasti da hPC-MSC coltivate in HS implementato con fattori di induzione osteogenica hanno mostrato una migliore attività osteogenica, confermata anche da una significativa up-regolazione di osteopotina (OPN) e fosfoglicoproteina della matrice extracellulare (MEPE). Conclusioni: Le HPCy-MSC coltivate in HS hanno mostrato stabilità fenotipica e un chiaro atteggiamento rigenerativo, suggerendo quindi questo protocollo come un approccio clinicamente valido per le future terapie endo-periodontali. Keywords: Regenerative medicine, Stem cells, Osteogenesis, Human periapical cyst-MSCs, Translational research, Parole chiave: Medicina rigenerativa, Cellule staminali, Osteogenesi, Human periapical cyst-MSCs, Ricerca traslazional