Dent. J., Volume 10, Issue 7 (July 2022) – 24 articles

Background: Children suffer from various oral and periodontal diseases. Dental caries is one of the most prevalent oral diseases among children in the world. This study was conducted to identify the prevalence and risk factors of dental caries in children in Mymensingh, Bangladesh. Methods: A cross-sectional study was conducted on 362 pediatric patients who attended the Dental Unit of Mymensingh Medical College from March to September 2019. The sample size was calculated using a statistical formula and the children were selected using a systematic random sampling technique. Children and their guardians were interviewed and data were recorded using a structured questionnaire. Risk factors were analyzed using multivariate logistic regression. Results: The overall prevalence of dental caries was 82.7%. The prevalence of caries was significantly higher in aged children (8–10 years) and also in rural, low-income, and illiterate families. Seven significant risk factors were identified that included residence in the rural area (OR: 7.31 [1.73–30.83]), a parental income of BDT ≤ 20,000 per month (OR: 4.75 [1.49–15.05]), reduced duration (≤1 min) of teeth cleaning (OR: 18.54 [2.05–168.17]), teeth cleaning before breakfast (OR: 93.30 [10.95–795.32]), the spoon-feeding method (OR: 12.57 [2.09–75.61]), long-term (37–48 months) breastfeeding (OR: 212.53 [8.69–5195.25]), and family oral problem (OR: 8.20 [2.57–26.16]). Conclusions: The prevalence of dental caries among the children in Mymensingh is very high and was associated with residence in rural areas, parental income, reduced duration of teeth cleaning, teeth cleaning before breakfast, the spoon-feeding method, long-term breastfeeding, and family oral problems. Full article

Objectives: Oral lichen planus (OLP) is an inflammatory disease. Bioelectrical impedance analysis (BIA) is a method for assessing tissue composition. Based on a combination of reactance and resistance data, a phase angle is calculated that may range from 90° to 0°, and that correlates with body cell mass. There is evidence to suggest that neoplastic tissue has a lower phase angle than normal tissue. The aim of the present experimental study was to establish whether OLP patients have a different tissue phase angle from healthy controls. Materials and Methods: Bioelectrical impedance measurements were obtained for the buccal mucosa, tongue, hard palate and upper anterior gums using an ad hoc device in a sample of 57 consecutive patients with OLP and 60 healthy controls, and their phase angles were calculated. Results: The mean resistance, reactance, and phase angle of the hard palate and gums were higher in the OLP group than in the controls, and the differences were statically significant. The resistance and reactance recorded for the adherent gingiva and hard palate were always higher in the OLP group (p = 0.044; p = 0.020; p = 0.054), and so was the phase angle for the adherent gingiva. No statistically significant differences emerged for the other areas of the oral cavity (p < 0.05). Conclusion: These findings confirm differences between the bioelectrical impedance of OLP lesions and that of healthy oral tissues. Clinical relevance: Bioelectrical impedance analysis could be useful in the diagnosis of OLP. Full article

Aim: This study sets out to explore the relationship between craniofacial morphology and obstructive sleep apnea (OSA) severity, assessing the relative contribution of obesity, calculated using BMI. Methods: A sample of 30 adult patients (20 males; 10 females), mean age = 54(±76) years, with a polysomnography-confirmed diagnosis of OSA, i.e., with an apnea-hypopnea index (AHI) of over 5 events/h, was recruited and underwent cephalometric evaluation. Sleep parameters, namely AHI, AHI supine, oxygen desaturation index (ODI), and mean oxygen saturation [Mean SaO2%], were assessed. Correlation analysis between 13 cephalometric features and AHI was performed using a Pearson test. The sample was split into three groups based on AHI score (mild = 10 < AHI < 15; moderate = 15 < AHI < 30; severe = AHI > 30), and ANOVA was performed to compare the means of cephalometric features. In addition, the sample was split into two groups according to BMI (normal weight = BMI < 25; overweight = BMI > 25). Correlation analysis between cephalometric features and AHI was performed for each group using a Pearson test. Results: The average polysomnographic values were AHI = 29.08(±16); AHI supine = 43.45(±21); ODI = 23.98(±21); mean SaO2(%) = 93.12(±2). Posterior facial height (PFH) was significantly lower in the severe OSA group than in patients with moderate OSA (p = 0.05). In the normal-weight group, negative correlations of the PFH and SNA angle with AHI (r = −0.36; r = −0.25, respectively), and positive correlations of the FMA angle and MP-H distance with AHI (r = 0.29; r = 0.20, respectively), were found. In the overweight group, negative correlations of AO-BO distance, SPAS (upper posterior airway space) and PAS (posterior airway space) with AHI (r = −0.30; r = −0.28; r = −0.24, respectively), and positive correlations of AFH (anterior facial height) and the FMA angle with AHI (r = 0.32; r = 0.25, respectively), emerged. Conclusions: PFH seems to be related to the aggravation of OSA. In normal-weight subjects, hard tissue-related factors have a greater impact on OSA severity, whereas in overweight subjects, the impact of fat tissue is greater. Full article

This review aims to discuss and illustrate various uses of cantilevers to solve multiple clinical issues and prove their versatility. Cantilevers are commonly used in the segmented arch technique, and they can be designed to solve various clinical problems with highly predictable results. Its design and shape can modify the various combinations of vertical and horizontal forces. The novel trend is to combine cantilevers with skeletal anchorage. Cantilevers offer a very simple and statically determined force system. The advantage is the control over side effects, which normally occur on the anchor teeth and the occlusion. The disadvantages include possible side effects on the anchorage unit, when the anchorage is poorly controlled. The review highlights the clear benefits of cantilever use in complex corrections of single teeth, segments, and entire arch with a diminished effect on the dentition, also with the use of skeletal anchorage. With their simple and easily tailored design, these springs can be called an orthodontic multi-tool. Full article

Sinus floor elevation is a surgical procedure that allows for the insertion of the implant in the posterior region of the maxilla in case of insufficient volume of native bone. Several studies have reported a high success rate, and this has helped to spread this surgical procedure around the world. The subject has been extensively studied and this could lead researchers to think that no new scientific evidence can be provided. However, new ideas and discoveries show that research never reaches a conclusion, and that new information can be added all the time. This collection aimed to provide new evidence that could be added to daily clinical work and to provide new ideas for future research. Full article

There is empirical evidence of an association between periodontitis and coronary heart disease (CHD). However, it is uncertain whether periodontal treatment in CHD patients might lead to reduced healthcare costs. This study aims to assess the association between periodontal treatment and healthcare costs in newly diagnosed CHD patients. Data from 21,263 adults who were continuously insured between 2011 and 2016 and who were newly diagnosed with CHD in 2013 were selected from a German claims database. The study population was differentiated by the utilization of periodontal treatment. The average treatment effect (ATE) of periodontal treatment on healthcare costs (total, inpatient, outpatient, drugs) was investigated using weighted Poisson regression models conditional on covariates and is shown as a ratio (of geometric means). Periodontal treatment was documented for 4.7% of the persons in the study population. Newly diagnosed CHD patients showed an ATE of 0.98 for total healthcare cost (95% CI 0.90–1.06), 0.79 for inpatient costs (95% CI 0.61–1.04), and 0.95 for drug costs (95% CI 0.87–1.04). A statistically significant 7% increase in outpatient costs was shown (95% CI 1.01–1.13). Despite a lack of statistical significance in most cases, the study provides evidence of a meaningful decrease in inpatient costs after periodontal treatment. Further studies are needed. Full article

Gingival recessions (GR) are often associated with the presence of non-carious cervical lesions (NCCL). The latter result in the disappearance of the cement–enamel junction (CEJ), with consequent difficulties both in measuring the recession itself and in performing root coverage techniques. The restoration of cervical lesions is consequently an important aspect in the treatment of GR, with the re-establishment of a “new” CEJ. This pilot study aimed to verify whether restorative therapy alone, with the execution of a restoration that mimics the convexity of the natural CEJ and thanks to a slight horizontal over-contour, can stabilize a clot in the intrasulcular site and consequently is able to change the position of the gingival margin in a coronal direction. In periodontally healthy patients, with a non-thin gingival phenotype, 10 GR-associated NCCL restorations were performed using a protocol inspired by concepts of prosthetic conditioning, with a progressively reduced convexity (“coronally dynamic restoration”) and de-epithelialization of the gingival sulcus. We observed that 70% of the treated teeth showed a reduction in crown length after 15 days (−0.267 mm), without an increase in probing depth. While considering the limitations of the sample and the need to evaluate the different parameters that can affect the result, the coronally dynamic restoration of NCCL with GR was able to influence the position of the gingival margin in a coronal direction. Full article

Background: The COVID-19 pandemic caused all universities in Malaysia to switch to online learning, including for dental education. The effect of this switch has yet to be assessed. Thus, this study aimed to assess International Islamic University Malaysia (IIUM) dental students’ perspectives on the implementation of online learning during the COVID-19 pandemic and its impact on academic performance. Methods: Cross-sectional and retrospective methods were used. The handling, didactic benefits, motivation, and challenges of online learning were assessed via an online questionnaire, and academic performance was assessed by comparing professional exam scores pre- and post-online learning. Results: Among the 249 IIUM dental student respondents, a positive response was recorded for the management of online learning, despite a few challenges in the area of didactic benefits and motivation. A significant improvement (p-value < 0.05) was observed in examination scores in oral biology, microbiology, and pharmacology, while dental material and GMGS showed declines in performance. Other subjects showed no significant difference (p-value > 0.05) in mean scores before and after online learning. Conclusion: Generally, students had a positive response towards online learning management, despite facing some challenges. Based on the analysis of examination results, only two subjects in Year 2 and Year 3 were negatively affected by online learning during the pandemic. Full article

Background: The estimation of an individual’s age is a fundamental component of forensic odontology. Literary reports found that the efficiency of Cameriere methodology for age estimation varied among many population groups. Therefore, this study aimed to determine the applicability of the Cameriere methods to a select South African population of the KwaZulu-Natal (KZN) province. Materials and Methods: This cross-sectional retrospective study was conducted on 840 digital panoramic radiographs that met the inclusion criteria. Dental maturity was determined through the morphometric analysis of the seven left permanent mandibular and maxillary teeth in accordance with Cameriere et al. (2006). Moreover, the dental age was also calculated using the South African Black Bayesian formulae of the Cameriere method by Angelakopoulos et al. (2019). The paired sample t-test or Wilcoxon’s signed rank test assessed the significant difference between the chronological age and estimated dental age for the various formulae. A p-value < 0.05 was considered to be statistically significant. Results: The Cameriere et al. (2006) Italian formula and the South African Black Bayesian formulae of the Cameriere method by Angelakopoulos et al. (2019) underestimated and overestimated age in the South African Black and Indian population groups of the KZN province, respectively. Therefore, the authors generated a novel population-specific regression formulae (including and excluding third molars) using “step-wise regression analysis” and a “best-fit model” for the South African Black and Indian population groups of KZN. Conclusion: This study recommends that the population-specific formulae generated in this study be utilized in the KZN population to improve the accuracy of dental age estimation within this region. Full article

The purpose of this study is to evaluate the effects of nanocrystal cellulose (NCC) from bamboo on the flexural strength of heat-cured acrylic resin. A total of 35 specimens (3.3 mm × 10 mm × 64 mm) were prepared and the specimens were divided into five groups of seven specimens each. Group 1 used conventional acrylic resin that was prepared based on the instructions of the manufacturer (0%). The filled NCC from bamboo fiber in four concentrations (0.25, 0.5, 1, and 2% w/w) was used in the four-reinforcing resin workpiece groups. The specimens were loaded until failure occurred on a three-point bending test machine. One-way analysis of variance and Dunnett’s multiple comparison test at a 95% confidence level were used to determine the statistical differences in the flexural strength among the five groups. The results found that the average flexural strength of five specimen groups (0, 0.25, 0.5, 1, and 2% w/w) were 60.11 ± 2.4, 60.75 ± 2.18, 66.50 ± 5.08, 56.04 ± 0.31, and 48.05 ± 2.61 MPa, respectively. The flexural strength of 0.5 mg% w/w NCC-reinforced acrylic resin was significantly higher than the control group (p < 0.01). The reinforced NCC from bamboo fiber to acrylic resin improved the flexural strength properties. Full article

Individuals with orofacial clefting (OFC) have a higher prevalence of tooth agenesis (TA) overall. Neither the precise etiology of TA, nor whether TA occurs in patterns that differ by gender or cleft type is yet known. This meta-analysis aims to identify the spectrum of tooth agenesis patterns in subjects with non-syndromic OFC and controls using the Tooth Agenesis Code (TAC) program. An indexed search of databases (PubMed, EMBASE, and CINAHL) along with cross-referencing and hand searches were completed from May to June 2019 and re-run in February 2022. Additionally, unpublished TAC data from 914 individuals with OFC and 932 controls were included. TAC pattern frequencies per study were analyzed using a random effects meta-analysis model. A thorough review of 45 records retrieved resulted in 4 articles meeting eligibility criteria, comprising 2182 subjects with OFC and 3171 controls. No TA (0.0.0.0) was seen in 51% of OFC cases and 97% of controls. TAC patterns 0.2.0.0, 2.0.0.0, and 2.2.0.0 indicating uni- or bi-lateral missing upper laterals, and 16.0.0.0 indicating missing upper right second premolar, were more common in subjects with OFC. Subjects with OFC have unique TA patterns and defining these patterns will help increase our understanding of the complex etiology underlying TA. Full article

Dental Implants are a popular treatment option for tooth replacement, with documented long-term success and survival rates of more than 95% over a period of 10 years. However, incorporating dental implantology into an undergraduate dental curriculum has issues associated. Therefore, the aim of this research was to examine and evaluate current undergraduate dental implantology education in the UK, investigate the amount of time allocated to this subject and analyse the barriers that are currently impeding the development of the programmes. An online questionnaire hosted by Online Surveys was designed, piloted, and sent to 16 dental schools providing undergraduate education in the UK. Ethical approval was gained from The University of Salford to conduct the study. Out of the 16 dental schools contacted, eight questionnaire responses were received, hence a response rate of 50% was achieved. The hours dedicated to the implant teaching programme varied from 3 h to 25 h, with a mean average of 11 h. It was identified from the results that no teaching of dental implantology was conducted in year 2; 12% of the schools responded that the subject was taught in year 1, 37% in year 3, 75% in year 4 and 50% in year 5. The methods used to deliver the programme were mainly lecture-based teaching, with only one dental school allowing students to place implants on patients. The main barriers to progression of the programme were financial (75%), followed by time limitations imposed by the curriculum (37%) and liability insurance (37%). However, there appears to be a consensus that further training beyond bachelor’s degree level is required to teach implantology effectively. Full article

Aim: The present paper aims to systematize data concerning the prevalence and risk of dental erosion (DE) in adult patients with gastroesophageal reflux disease (GERD) compared to controls. Materials and methods: Core electronic databases, i.e., MEDLINE/PubMed, EMBASE, Cochrane, Google Scholar, and the Russian Science Citation Index (RSCI), were searched for studies assessing the prevalence and risk of DE in adult GERD patients with publication dates ranging from 1 January 1985 to 20 January 2022. Publications with detailed descriptive statistics (the total sample size of patients with GERD, the total sample size of controls (if available), the number of patients with DE in the sample of GERD patients, the number of patients with DE in the controls (if available)) were selected for the final analysis. Results: The final analysis included 28 studies involving 4379 people (2309 GERD patients and 2070 control subjects). The pooled prevalence of DE was 51.524% (95 CI: 39.742–63.221) in GERD patients and 21.351% (95 CI: 9.234–36.807) in controls. An association was found between the presence of DE and GERD using the random-effects model (OR 5.000, 95% CI: 2.995–8.345; I² = 79.78%) compared with controls. When analyzing studies that only used validated instrumental methods for diagnosing GERD, alongside validated DE criteria (studies that did not specify the methodologies used were excluded), a significant association between the presence of DE and GERD was revealed (OR 5.586, 95% CI: 2.311–13.503; I² = 85.14%). Conclusion: The meta-analysis demonstrated that DE is quite often associated with GERD and is observed in about half of patients with this extremely common disease of the upper gastrointestinal tract. Full article

Suturing is an essential skill in dentistry and not one easily acquired. The COVID-19 pandemic prompted a change to the use of Thiel cadavers and online resources with the aim of improving skill acquisition using the best model available. This study investigated the utility of the Thiel cadaver for teaching suturing skills and the potential impact of the lockdown. Fifty-seven year 4 students attended a teaching session. Student views on this teaching were explored via a questionnaire survey and qualitative data collected from a focus group. Data were analysed using an inductive approach. The response rate was 53% (30 students) for the questionnaire with 9 students participating in the focus group. Independent feedback was provided by two members of the teaching staff. Online video resources were very well received by the students with 97% agreeing that it was useful preparation. Ninety percent (90%) thought that the cadaveric model was suitable for this teaching and realistic. Positive emergent themes from the focus group centred on the use of the cadaveric model and the positive and relaxed teaching and learning environment. Staff perceived this model as superior to previously used models. There were no reported negative pandemic impacts and the cadaver model was well received. Full article

Background: Providing regional anesthesia skills shaping remains relevant nowadays. A number of studies show that dentists have difficulties with these working independently. The study aim is the comparative analysis of the results of mandibular anesthesia (IANB) manual-skills shaping among dentists on plastic models and cadavers. Methods: In total, 999 participants were training in the skills of mandibular anesthesia from 2017 to 2021. The participants were divided in a random way into two groups: 700 participants were trained on plastic models, and 299 were trained on the cadaver material. After a lecture on the clinical and anatomical guidelines for IANB, a demonstration of the technique was provided, with subsequent testing of the injection technique. Satisfaction with the aspects of the training was assessed using the Likert scale. Results: the analysis of average values showed that participants from the group in which the manual skills were practiced on cadavers were more satisfied with the main aspects of the training, according to the sum of the main criteria of the modified scale. Conclusions: The important advantages of cadaver educational technology are that the sensations of tissue resistance are identical to natural ones, the individuality of each object, and the possibility of the visual study of the anesthesia technique, by dissection of the needle course and the location of the anesthetic depot. Full article

The purpose of the present study was to examine the impact of scanning strategy on trueness and precision of the impression acquired from an intraoral scanner. Fifteen complete-arch, mandibular, post-orthodontic treatment casts were scanned with a laboratory scanner (Identica SE 3D, Medit) as the gold standard, and with an intraoral scanner (i500 Medit) following three different paths of the scanning head over the arch (scanning strategies A, B, and C). The hand scans were performed twice by one examiner and repeated by a second examiner, resulting in 180 triangular mesh surfaces (digital casts). The meshes were superimposed on the gold standards using the Viewbox 4 software. The closest distances between the meshes were computed and trueness and precision were evaluated using a General Linear Model. An interaction was found among the examiner and strategy. The accuracy of complete-arch impressions was affected by the scanning strategy; the manufacturer’s recommended strategy (A) was statistically significantly better (p < 0.05) than B and C, which were similar. An average accuracy below 50 μm, which is clinically acceptable in most orthodontic procedures, was achieved with all the examined scanning strategies. Full article

Background: In Finland, the development of oral health in young, 19- to 21-year-old males regarding restorative treatment need seems to have slowed down according to cross-sectional conscript studies between 1976 and 2011. At the individual level, the mean number of decayed teeth (DT > 0) has also steadily continued to decline. In Finland, military service is mandatory, and around 85% of males complete it. The aim of this cross-sectional study was to investigate the oral health status of young men at the beginning of the 2020s. Methods: The data were collected in July 2021 in the eight biggest Finnish Defence force garrisons by ten calibrated dentists serving in the ranks. The inclusion criteria for this study were a year of birth between 2000 and 2002 and male gender (n = 508). Third molars were included. Restorative treatment need was evaluated using ICDAS scoring. The study was designed according to the STROBE guidelines. Results: Mean DT value was 1.13 when third molars were included and 1.03 when they were excluded. Mean DMFT value was 3.23 and 2.98, respectively. The proportion of conscripts with DT > 0 was 36.4% and 34.8%, respectively. The prevalence of caries was concentrated among a small number of conscripts. Most (76.5%) had BEWE (basic erosive wear examination) of 0–2. Conscripts in the moderate and severe ETW (erosive tooth wear) groups (BEWE 3–13) comprised 23.5% of the cohort. None of the conscripts fell into the most severe group (BEWE 14–18). Conclusions: The oral health of conscripts has improved over the last ten years, and restorative treatment need has decreased significantly. Compared to previous studies, restorative treatment need was concentrated on an even smaller proportion of conscripts. Full article

Dry socket is one of the postoperative complications of tooth extraction. It is the partial or total loss of the post-extraction blood clot, resulting in severe pain that usually starts one to five days postoperatively, with clinical evidence of exposed alveolar bone, necrotic debris, halitosis, and tenderness on examination. The purpose of our systematic review was to answer the question “Is there a relationship between smoking and dry socket?”. After meeting the inclusion and exclusion criteria, eleven studies were included in this systematic review (according to the PRISMA statement guidelines). Based on a meta-analysis, tobacco smokers had a more than three-fold increase in the odds of dry socket after tooth extraction. Overall, the combined incidence of dry socket in smokers was found to be about 13.2% and in non-smokers about 3.8%. Despite the heterogeneity of the included studies (different types of teeth extracted, different age groups), cigarette smoking was related to an increased risk of dry socket after tooth extraction. Full article

Periodontal disease is a complex disease that involves an imbalance between the oral microbiota and an individual’s inflammatory response. Moreover, the inflammatory response contributes to further imbalance; if left untreated, periodontal disease may result in tooth loss. Vitamin D is intricately involved in the regulation of calcium–phosphate homeostasis and bone mineral metabolism; considering that periodontal surgery usually includes regenerative therapy, adequate vitamin D and calcium levels are essential. The benefits of vitamin D and calcium supplementation have been demonstrated in situations where deficiency is associated with adverse outcomes, such as periodontal disease and maternal health. However, knowledge and attitudes about supplementation, as well as the actual levels of supplementation, vary greatly in the general population; they also differ between men and women. The aim of this review is to discuss how vitamin D and calcium supplementation affect oral and periodontal health, especially in women. Additionally, this review provides suggestions for public health strategies regarding vitamin D and calcium supplementation, as well as the effects of both types of supplementation on maternal oral health. Full article

The aim of this cross-sectional study was to evaluate the status of laser use and training in the U.S. and Canadian graduate periodontology programs. A survey questionnaire was sent electronically to 55 periodontology program directors in North America. The questions focused on laser implementation, types of lasers used, for which procedures lasers were used, and level of education/clinical training provided to residents. Data were analyzed using descriptive statistics and Fisher’s exact test. Twenty-two directors responded (40%). Most programs (86%) used lasers and 89% used a diode laser. Laser treatment was the most used for periimplantitis (84%). Fifteen programs (79%) provided didactic and clinical training, with 47% programs giving 4–12 h of didactic training. In 53% of programs, residents completed 4 to10 procedures. Only 29% of programs had residents who had received a certification in lasers, with most (80%) programs requiring between 1–9 cases for certification. Of the participants not providing laser training, the major barrier was indicated as being “expense”, with 68.7% reporting plans to implement laser education. Conclusions: Most graduate periodontics programs were providing laser training and treatment. There was great variability regarding the training methods, specifically in number of dedicated laser courses, time allocated for laser training, and prerequisites for laser certification. Full article

It is common for women to undergo orthodontic treatment during pregnancy, especially through the use of fixed orthodontic devices. In changing the oral microbiome profile, it is crucial to increase the immune responses of pregnant women using fixed orthodontics; however, changes in the microbiomes of pregnant women with orthodontic appliances can be adjusted. Therefore, we aimed to conduct research on the oral cavity microbiome profiles, specifically IL-6 and TNF-α, of pregnant women using fixed orthodontic appliances. We proposed an observational analysis of 30 third-trimester pregnant women. OHI-S was recorded, saliva collection was performed using the passive drool method for IL-6 and TNF-α, and analysis and mucosal swabs were used to determine the oral microbiome profile. Kruskal–Wallis and post hoc Bonferroni tests were used to identify any significant differences with values of p < 0.05. Of these pregnant women, those with orthodontic appliances developed 10 types of bacteria at similar levels (>80%) from the genera Streptococcus, Lactobacillus, and Veillonella. There was no difference between the oral microbiomes of the control group and the pregnant women with a history of orthodontic appliance use. While the level of TNF-α in the women with orthodontic appliances was higher compared with the control group who had never used orthodontic appliances (p < 0.05), there was no difference in the IL-6 levels. The IL-6 and microbiome profile produced normal results, so the use of orthodontic appliances during pregnancy should be allowed with conditions. Pregnant women with orthodontic appliances must keep the oral cavity clean and their appliances well-maintained to avoid oral problems. Full article

Objective: We aimed to evaluate the failure resistance of different lengths of mini dental implants from the same manufacturer, and to assess their failure following overloading. Materials and Methods: According to the ISO 14801, 15 mini dental implants 2.4 mm in diameter, with lengths of 8.5 mm, 10 mm, or 13 mm, were subjected to compression loading until failure using a universal testing machine. The mean load-to-failure values for each length of the mini dental implants were calculated and analysed using SPSS^®, via one-way ANOVA (p < 0.05). Results: The mean load to failure for mini dental implants was 329 N (SD 6.23), 326 N (SD 5.95), and 325 N (SD 6.99) for the 13 mm, 10 mm, and 8.5 mm implants, respectively. A comparison of means showed no significant difference between the groups (p = 0.70). The tested mini dental implants exhibited bending failure modes below the first thread. Conclusion: Under high compressive loading testing, there was no effect of the length on the failure of the mini dental implants following overloading. Moreover, all tested mini dental implants with different lengths showed the same failure mode and distortion location. Full article

Recently, tissue-level implants with a convergent collar have been introduced. While different studies have investigated the outcomes of this implant design in the rehabilitation of single teeth, its use in full-arch rehabilitation has yet to be investigated. The present case report describes the clinical outcomes of a full-arch immediate loading rehabilitation using tissue-level implants, with and without using implant-abutment units, with 2 years of follow-up. A female patient with mandibular terminal dentition and a high level of bone resorption (distal areas with a few millimeters of residual bone in the vertical dimension and both distal and anterior areas with narrow crestal bone in the horizontal dimension) was seen at the C.I.R Dental School, Turin, Italy. The patient was seeking to be rehabilitated with fixed prosthodontics, and she was found eligible for an immediate loading implant full-arch rehabilitation. Four implants were inserted in the same appointment. The two anterior implants were inserted straight and connected directly to the prosthesis (no abutments); the two distal implants were tilted in order to avoid the alveolar nerve and connected to two 30° angulated abutments. Two years post-implant placement, all of the implants were successfully integrated, resulting in an implant survival rate of 100%. The peri-implant soft tissues were stable at all the implant sites. No differences were highlighted between those implants with and without abutments. Within the limitations of the present clinical report, implant full-arch rehabilitations with tissue-level implants both with and without implant-abutment units showed optimal outcomes after two years of follow-up. Further research is encouraged to confirm whether this implant design may be a valid alternative to traditional implants in this type of rehabilitation, with or without implant-abutment units. Full article

The aim of this study was to evaluate the color stability of esthetic ceramic brackets and adhesive samples after immersion in most commonly consumed beverages. A hundred ceramic brackets from five different manufacturers (Forestadent^®, G&H^®, GC, DynaFlex^®, and American Orthodontics) and 120 samples of adhesives (3M™Transbond™ XT and American Orthodontics BracePaste^® color change adhesive and BracePaste^® adhesive) were immersed into four different solutions: coffee, Coca-Cola^®, the vitamin drink Cedevita^®, and artificial saliva (control group). The samples were kept in an incubator at 37 °C. Color readings were evaluated before (T0), at 24 h (T1), 72 h (T3), 7 days (T4), and 14 days (T5) after initial immersion using a spectrophotometer according to the L*a*b* color scale. All the examined brackets showed a statistically significant difference in discoloration (p = 0.001). 20/40™ Brackets (American Orthodontics) showed the best color stability, while the greatest color modification was recognized in QuicKlear^® III (Forestadent^®) brackets. Regarding adhesives, the greatest staining was observed in the BracePaste^® color change adhesive and the least in the Transbond™ XT samples. In conclusion, color change occurs in all solutions, including control groups, and coffee has the greatest impact on color stability. Full article