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1.

Objective

The objective of the present in vitro study was to evaluate the influence of endodontic irrigation systems on the removal of smear layer and ion diffusion of calcium hydroxide through dentinal tubules in root external resorption models.

Materials and methods

Forty single-rooted teeth were divided into four groups (G1, G2, G3, and G4) according to the irrigation regimens: G1, saline solution; G2, 10% sodium hypochlorite with ultrasonic irrigation; G3, 14% EDTA with ultrasonic irrigation; G4, 14% EDTA with ultrasonic irrigation → 10% sodium hypochlorite with ultrasonic irrigation. Ultrasonic irrigation lasted 45 seconds and all the roots were irrigated with 2 mL of saline solution. In experiment 1, the samples were observed on the root canal wall using scanning electron microscope and the percentage of opened dentinal tubules (POD) was calculated. Experiment 2 evaluated the diffusion of calcium ions through dentinal tubules.

Results

In the middle region of root canals, the mean POD values were 0.11, 5.02, 82.17 and 96.72 in G1, G2, G3, and G4, respectively. In the apical region of root canals, the mean POD values were 0.06, 0.43, 4.41, and 12.70 in G1, G2, G3, and G4, respectively. The diffusion of calcium ions in G4 was significantly high in all groups.

Conclusion

This study demonstrated that a combination of EDTA and sodium hypochlorite with ultrasonic irrigation was most effective in removing the smear layer and ion diffusion from the root canal to the surrounding media.  相似文献   

2.

Objective

To evaluate the quality of life in patients with moderate or large cranial bone defects before and after late cranioplasty.

Methods

Authors performed a prospective clinical trial including all consecutive patients that filled inclusion criteria during a period of 1 year. All patients answered the quality of life SF-36 questionnaire in 5 different times. Besides authors gathered information about the primary trauma and demographic characteristics.

Results

A total of 70 consecutive patients were admitted to the hospital during the study period, and 62 were included in the project. Cranioplasty statistically improved patients' quality of life in all 8 domains after a 24 months follow-up.

Conclusion

Cranioplasty has a significant impact over the quality of life in brain trauma victims who survived the primary trauma and harbor a large cranial bone defect.  相似文献   

3.

Statement of problem

Identifying factors that affect the clinical outcomes of implant therapy is important.

Purpose

The purpose of this retrospective study was to determine whether implant location was a factor affecting the complication and failure rates of single-tooth implant-supported restorations in a predoctoral setting.

Material and methods

The charts of 431 patients treated with a surgically placed dental implant and restored with a single crown in the predoctoral clinic were analyzed. Data on implant location, type of complication (surgical or prosthetic), and type of failure were collected and analyzed according to implant location using the Fisher Exact Test and Mantel-Haenszel Exact Chi Square Test analysis (α=.05).

Results

The charts revealed 158 complications (68 surgical and 90 prosthetic) in 110 patients, and 3.9% of the implants failed. No statistically significant difference was found between the number of surgical complications or prosthetic complications in the maxilla and the mandible (P=.469).

Conclusions

Jaw location (maxilla compared with mandible) of the implant had no statistically significant impact on the incidence of surgically or prosthetically related complications. No statistically significant difference was found in overall implant failures, surgical failures, and prosthetic failures between maxillary and mandibular implants.  相似文献   

4.

Objectives

Present and overview the clinical finding, management and arthroscopic study of Synovial Chondromatosis (SC) cases in Temporomandibular Joint (TMJ) treated by our team.

Study design

During year 2008–2018, 16 TMJ SC cases were treated and reviewed. The clinical manifestations, radiographic data, arthroscopic study and pathologic findings were recorded and analyzed.

Results

Average age of first visit was 32.68. The ratio of male/female was 2/14, right/left was 7/9. The most common symptoms were pain, continuous crepitus and limited mouth opening (LMO). All cases were examined by computed tomography (CT) and magnetic resonance imaging (MRI) preoperative and proved by pathology postoperative. The diagnostic rates of CT and MRI were 12.5% and 93.75% respectively. 1 case could not be detected by both, but by arthroscopy. Particles in all cases occurred in the upper joint cavity and were all removed by arthroscopic technique. No recurrence was found after 3 years follow-up.

Conclusions

MRI and arthroscopic technique could be the first choice in the diagnosis and treatment of SC. Most cases were in stage 3 of the disease at the first visit. Low recurrence rate may be attributed to the improvement of intra-articular environment after surgery. Larger sample sizes are needed for further study.  相似文献   

5.

Background

Promoting the directional attachment of gingiva to the dental implant leads to the formation of tight connective tissue which acts as a seal against the penetration of oral bacteria. Such a directional growth is mostly governed by the surface texture.

Material and methods

In this study, three different methods, mechanical structuring, chemical etching and laser treatment, have been explored for their applicability in promoting cellular attachment and alignment of human primary gingival fibroblasts (HGFIBs).

Results

The effectiveness of mechanical structuring was shown as a simple and a cost-effective method to create patterns to align HGIFIBs.

Conclusion

Combining mechanical structuring with chemical etching enhanced both cellular attachment and the cellular alignment.  相似文献   

6.

Background

Several significant issues on clinical trials reporting the effect of arginine-containing dental products have been addressed in systematic reviews and meta-analyses identifying the need for high-quality randomized clinical trials. A further methodological analysis of the given systematic reviews with meta-analysis on arginine products might provide information for future high-quality randomized clinical trials and current clinical practice.

Objective(s)

The objective was to perform a meta-epidemiological assessment of meta-analyses reporting the anticaries effect of arginine-containing formulations.

Methods

The data on risk-of-bias assessment, effect size measure, dispersion of estimated precision, and follow-up period were summarized for the meta-epidemiological review analysis.

Results

Studies with larger magnitude of effect sizes might present with unclear random sequence generation and unclear allocation concealment representing the selection bias. There was a significant strong negative correlation between the follow-up time and dispersion of precision estimates (rs = ?0.79, P = .034).

Conclusion

Results show that clinical trials on arginine dental products have methodological shortcomings. Both the selection bias and follow-up period influence the effect size magnitude and subsequent precision dispersion during evidence synthesis in clinical trials on arginine-containing dental products.  相似文献   

7.

Purpose

This systematic review aimed at assessing the effects of PRGF in new bone formation, soft tissue healing and post-operative pain and swelling in sites that underwent ridge preservation, ridge augmentation and maxillary sinus augmentation procedures.

Materials and methods

A comprehensive literature search employing seven databases was conducted by two independent reviewers. Only randomized and non-randomized controlled clinical trials using PRGF alone or in combination with bone grafting materials were selected.

Results

Overall, 919 studies were identified, of which a total of 8 articles were included in the qualitative analysis. Two of the selected studies reported on ridge preservation, one on ridge augmentation and five on maxillary sinus augmentation. Positive results were recorded for soft tissue healing and post-operative pain and swelling following these procedures. However, outcomes of PRGF on new bone formation post extraction and on maxillary sinus augmentation when combined with other biomaterials were conflicting. Meta-analysis could not be conducted for any variables due to the heterogeneity of selected studies.

Conclusion

Limited evidence exists on the effects of PRGF in different intraoral bone grafting procedures, with some benefit reported on soft tissue healing and post-operative symptomatology. As this platelet concentrate is commonly used in clinical practice, further research is needed to fully assess its clinical indications and effectiveness.  相似文献   

8.

Background

Silver diamine fluoride (SDF) is used topically to prevent or arrest caries. The authors' aim was to characterize the kinetics of silver and fluoride after topical application of SDF.

Methods

Sixteen adults participated in a pharmacokinetics study after the application of 38% SDF to 5 teeth (approximately 50 microliters, estimated 4-11 milligrams per participant). Serum and urine samples were collected over 24 hours after application and were analyzed for silver and fluoride.

Results

Silver serum peak was 0.67 (standard deviation [SD], 0.49) nanograms per milliliter; median time to peak was 3 hours. The estimated elimination half-life of silver was 46 (SD, 26) hours. No silver was recovered in urine. Baseline fluoride serum levels ranged from less than 10 through 50 ng/mL (< 0.01-0.05 parts per million) and fluctuated around baseline after SDF. The 24-hour urinary fluoride was 1.29 (SD, 0.81) mg.

Conclusions

SDF was well tolerated in this study, and no adverse events related to SDF were reported.

Practical Implications

This clinical study confirmed that topical application of 38% SDF, in growing use in the United States, is safe and well tolerated in healthy adults.  相似文献   

9.

Statement of problem

A palatogram aids prosthodontists and speech pathologists in evaluating the precise prosthetic treatment needed and the effectiveness of such treatment to improve speech intelligibility. Powder is commonly used to visualize tongue-palate contact, where wetted areas of powder in the oral cavity reveal such contact during palatography. However, discomfort and the risk of aspiration are among the shortcomings of this method, and an improved method is needed.

Purpose

The purpose of this in vitro study was to examine the feasibility of a new method of palatography that uses airborne-particle–abraded acrylic resin so that wet areas can be easily distinguished from dry areas.

Material and methods

Seventy-two specimens of heat-polymerized acrylic resin were prepared in 6 different resin colors. After the specimens had been airborne-particle abraded, CIELab color values for each specimen were measured using a colorimeter under dry and wet conditions and recorded. Color difference (ΔE) was then computed, and a paired Student t test, 1-way analysis of variance, and multiple comparison using the Tukey post hoc analysis were applied (α=.05).

Results

A significant color difference was found between the 2 conditions in all acrylic resin specimens examined. Mean ΔE ranged from 5.58 to 6.76.

Conclusions

The results indicated that an airborne-particle–abraded acrylic resin surface can show color differences made by wetting on palatograms.  相似文献   

10.

Background

Specialty-based practice is a fundamental component of US medicine and dentistry, yet the recognition of new dental specialties has markedly diminished in the past 50 years while medical specialization has flourished.

Methods

This article reviews the history of specialty development while focusing on the underlying scientific, educational, and cultural changes in both professions. The process of dental specialty recognition is also examined.

Results

The current dental specialty recognition process provides a set of criteria aspiring specialties need to fulfill at the time of application, yet the relationship between the criteria and the sequence for attaining them is undefined. Scientific development and evidence-based practice have grown to become the cornerstone of contemporary health care specialization.

Conclusions

A new paradigm for specialty and subspecialty development in dentistry is needed. A model is presented herein that recognizes scientific development as the basis for specialization and describes a formal, sequenced process for the development of emerging specialties and subspecialties.

Practical Implications

This new paradigm for dental specialty recognition builds on the current criteria for specialization while encouraging cross-disciplinary interaction and nurturing the development of emerging specialties and subspecialties in dentistry. Doing so will allow dentistry to maintain its lead role in the maintenance of oral health and oral disease treatment in the US population.  相似文献   

11.

Background

This study was undertaken to quantify how the Great Recession impacted the demand for general oral health care and orthodontic care in the United States. The authors conducted an analysis to help dentists anticipate changes in demand for care during future economic downturns.

Methods

The authors analyzed Medical Expenditure Panel Survey data for the period 2003 through 2015. Data plotting for the various factors considered showed patient demand before, during, and after the Great Recession, including an indication of postrecession recovery. Statistical significance across time was determined using a χ2 test. The point estimates and statistical inferences took into account the complex survey design of the Medical Expenditure Panel Survey.

Results

General dentist visits declined slowly and steadily during the Great Recession, reaching a low of 38.4% in 2010, and have not shown significant signs of recovery. Orthodontic visits also declined to an all-time low of 2.5% in 2010, although they have somewhat recovered. Out-of-pocket expenditures were lower in 2015 than in 2003 for general dental and orthodontic care.

Conclusion

The effects of the Great Recession resulted in a decrease in the demand for oral health care, differing for general oral health care and orthodontic care.

Practical Implications

These findings, especially in combination with leading indicators for economic downturns, will allow dentists to better plan and use strategies for maintaining practice stability during periods of reduced demand for care.  相似文献   

12.

Statement of problem

A recent trend has been to reduce the procedural complexity of complete denture fabrication. Whether the clinical remount step is necessary is unclear.

Purpose

The purpose of this systematic review was to assess the relevance of the clinical remount procedure on complete denture outcomes.

Material and methods

Five electronic databases were searched through to May 2018. The terms “denture*”, “dental prosthes*”, “equilibrat*”, and “remount*” were chosen. The titles and abstracts were screened, and those which met the inclusion criteria were selected for full-text assessment. Studies that only performed the laboratory remount or were not randomized controlled studies were excluded.

Results

After duplicate removal, the database search strategy resulted in a total of 226 potential studies. After the titles and abstracts had been screened and the inclusion and exclusion criteria applied, 10 studies were retrieved for full-text assessment. Four randomized controlled clinical studies were included in the systematic review. A meta-analysis could not be performed because of variation in outcome measures after the clinical remount.

Conclusions

A clinical remount for complete dentures is recommended on delivery to reduce clinically observed areas of discomfort and reduce the number of recall appointments. The development of a reliable and valid patient satisfaction questionnaire is necessary to determine conclusively whether the clinical remount also improves patient-perceived satisfaction and mastication.  相似文献   

13.

Purpose

The incidence of positional head deformation has increased during the last decades. Helmet therapy has been proved to be a reliable method for the treatment of nonsynostotic skull deformities. Until today, a simple classification to differentiate between different head shapes has not been established.

Materials and methods

We suggest a classification system to group patients with plagiocephaly, brachycephaly, and a combination of both, using two simple values: cranial vault asymmetry (CVA), and cephalic index (CI). We further analyzed a study population of 1050 children treated with molding helmets to identify prognostic variables for better outcome within our proposed classification.

Results

In all, 736 patients were male (70.10%) and 314 patients were female (29.90%). Mean improvement of cranial vault asymmetry index (CVAI) ranged from 2.94% to 7.08% (CVA 0.37 cm–0.86 cm) in subgroups of patients defined by classification and severity of deformation. In patients with brachycephaly, CI improved from 4.17% to 8.22%. Duration of therapy differed from 21 weeks to 24 weeks. Children aged 6 months or less showed greater improvement and shorter duration of therapy compared to older patients. In addition to early onset of therapy, classification and severity of deformation were significantly associated with a reduction of the deformation under therapy. There were distinct differences in outcomes between different head shapes.

Conclusion

Helmet therapy should be initiated early. Our analysis suggests that the proposed classification correctly identifies patients whose deformation is reduced under therapy.

Level of evidence

III.  相似文献   

14.

Statement of problem

The accuracy of digital scanners is acceptable for scanning a complete dental arch. However, whether that accuracy is sufficient for only 1 tooth within the dental scan of a complete dental arch is unclear.

Purpose

The purpose of this in vitro study was to evaluate and compare the accuracy of 4 intraoral scanners on a complete dental arch and on prepared teeth digitally isolated from the digital scan in terms of trueness and precision.

Material and methods

A model of a complete dental arch with tooth preparations was scanned 40 times with each of the 4 digital scanners. Their accuracy was evaluated by using 3-dimensional (3D) software to compare the test models with a highly accurate reference model. The data were digitally processed to isolate the prepared teeth and evaluate them in the same way. The data were statistically analyzed using the Levene test and the Tamhane's T2 test (α=.05).

Results

In scans of a complete dental arch, the True Definition scanner had the best accuracy values, followed by TRIOS, iTero, and Omnicam. For prepared teeth isolated from the dental arch, both True Definition and TRIOS had the best values, followed by iTero and Omnicam.

Conclusions

In both long-span scans of the complete dental arch and isolated prepared teeth, the True Definition scanner had the greatest accuracy, closely followed by TRIOS.  相似文献   

15.
16.

Statement of problem

Electron backscatter radiation from dental materials can contribute to soft tissue injury in patients undergoing head and neck radiation therapy.

Purpose

The dose enhancement from the materials used for prosthodontic restoration of the dentition has not been well quantified. This study reports the magnitude of backscatter dose from the contemporary dental materials lithium disilicate and zirconia as compared with high-noble alloy and investigates the role of a spacer material in mitigating this effect.

Material and methods

Three flat slabs of dental materials high-noble alloy, lithium disilicate, and zirconia with thicknesses of 1.5 and 3 mm were irradiated with 6-MV photons from a clinical linear accelerator. Measurements were made using a thin-window parallel-plate ionization chamber placed at 0, 1, 3, and 5 mm from the material. One millimeter of poly(methyl methacrylate) or thermoplastic material was used to cover the dental material and measure the effect on the adjacent dose enhancement.

Results

Dose enhancements between 8% and 50% were recorded adjacent to the dental restoration materials. The largest enhancements occurred for the material of the highest density, the high-noble alloy. Dose enhancement was substantially lower for lithium disilicate (8%) and zirconia (30%). The thickness of the restoration material did not significantly affect dose enhancement. The dose enhancement decreased with distance from the material, dropping to <10% for all materials at 3 mm.

Conclusions

Contemporary dental restorations enhance the backscatter dose. The presence of dental restorations may warrant the use of a stent to create separation from these materials as this can mitigate the effect.  相似文献   

17.

Purpose

Successful implant therapy is based on fast, safe, and predictable osseointegration. Several surface modifications have been introduced to improve the bone-to-implant interaction. This in vivo study evaluates the impact of plasma surface conditioning on early wound healing and osseointegration.

Materials and methods

A total of 16 dental implants with a sand-blasted and acid-etched surface were conditioned with cold atmospheric plasma prior to insertion in the frontal bone of four miniature pigs. Sequential fluorescence labeling was administered to label bone metabolism, and after 8 weeks, bone blocks were harvested for radiological, histological, and histomorphometrical evaluation.

Results

The plasma conditioning had no impact on the morphology of the implant surface. The bone-to-implant contact ratio was 90.4% and 86.5%, the interthread bone density 72.5% and 63.4%, and the periimplant bone density 60.5% and 61.1%, in the plasma conditioned group and control group, respectively. Concentric bands of fluorescence enrichment indicated a chronological and homogenous mineralization of newly formed bone. No unwanted periimplant side effects were detected.

Conclusion

The increased parameters for osseointegration in this in vivo study merit further investigation in prospective clinical trials.  相似文献   

18.

Background

This study aimed to determine the psychometric properties of the English-language version of the Orofacial Esthetic Scale (OES-E) in a population of dental patients.

Methods

In this cross-sectional study, 1,784 English-speaking, adult dental patients (mean age, 56.7 [standard deviation, 15.8] years; 60.0% women) were included. The 8-item OES-E was used to assess orofacial appearance. Dimensionality of the OES was investigated through an analysis of the items’ correlation matrix, a parallel analysis, and an exploratory factor analysis. Convergent validity was determined by means of several correlations between the OES and items of the Oral Health Impact Profile measuring orofacial appearance. Reliability of the OES was assessed as the instrument’s internal consistency by means of computing Cronbach α and average interitem correlation.

Results

All analyses for dimensionality revealed that the OES is sufficiently represented by a single factor. Convergent validity was supported by means of the correlations of the OES summary score with the other measures of the construct with Pearson product moment and Spearman rank correlation coefficients of the expected size and direction. Cronbach α (lower boundary of 95% confidence interval, 0.94) and average interitem correlation (0.70) revealed that the scale’s internal consistency was excellent.

Conclusion

This study found that the OES-E has sufficient psychometric properties to characterize dental patient’s global assessment of orofacial appearance.

Practical Implications

The brevity and the easy application make the OES a pragmatic tool to clinically appraise the important construct of orofacial appearance in dental patients.  相似文献   

19.
20.

Background

Research has identified significant gaps in preventive oral health care among certain subpopulations of US children. The authors of this study sought to estimate children’s preventive oral health care use and oral health and investigate associations with child, family, and health care characteristics.

Methods

Data for this observational, cross-sectional study came from the 2016 National Survey of Children’s Health. Children aged 2 through 17 years were included (n = 46,100). Caregiver-reported measures were preventive dental visits, prophylaxis, toothbrushing or oral health care instructions, fluoride, sealants, fair or poor condition of the teeth, and problems with carious teeth or caries. Univariate, bivariate, and multivariable logistic regression analyses were conducted.

Results

As reported by parents or caregivers, 8 in 10 children had a preventive dental visit in the past year but lower rates of specific services: 75% prophylaxis, 46% fluoride, 44% instructions, and 21% sealants. In addition, 12% had carious teeth or caries and 6% had fair or poor condition of the teeth. In adjusted analyses, young children (aged 2-5 years), children with no health insurance, and those from lower-income and lower-educated households had decreased likelihood of a preventive dental visit as well as specific preventive services. Children with preventive health care visits and a personal physician or nurse had increased likelihood of receiving preventive oral health care.

Conclusions

Preventive oral health services are lagging among young children and children from lower socioeconomic backgrounds. Further studies are needed to identify interventions that encourage use of specific preventive services.

Practical Implications

Dentists should work with caregivers and primary care providers to promote preventive oral health care, especially among young children and those from lower socioeconomic backgrounds.  相似文献   

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