Dent. J., Volume 12, Issue 5 (May 2024) – 6 articles

Autotransplantation is a successful technique to replace compromised teeth. This study presents a computer-guided surgical approach for preparing the receiving socket for a mature mandibular third molar donor tooth with a wait-and-see approach instead of prophylactic endodontic treatment. A 42-year-old woman developed root resorption of tooth 3.7. Extraction of 3.7 and autotransplantation of 3.8 was planned, following a 6-week orthodontic phase for periodontal ligament activation and teeth mobilization. Due to the different root morphology between the compromised and donor teeth and the high mandibular bone density, the receiving socket preparation was performed using guided surgery templates. Two surgical splints were designed with a surgical planning software. Tooth 3.7 was extracted, the recipient site was guided-milled, and tooth 3.8 was transplanted into the new socket in approximately one second of extra-alveolar time. The rapidity of the extra-alveolar time facilitated complete healing without resorting to root canal treatment. Five-year radiological control does not show any periapical lesion or root resorption. The surgical procedure for tooth autotransplantation is fundamental: it must be as atraumatic as possible to preserve the periodontal ligament of the tooth and the receiving socket, and the dentist must minimize the extra-alveolar time. Guided surgery is a reliable solution to combine all these aspects. Full article

Complications such as peri-implantitis could ultimately affect the survival of a dental implant. The prevention and treatment of peri-implant diseases require managing bacterial biofilm and controlling environmental risks, including the presence of pro-inflammatory titanium (Ti) particles in the peri-implant niche. Objectives included the evaluation of the size and quantity of Ti particles released from moderately roughened Ti surfaces during common mechanical surface decontamination methods. One hundred and forty moderately roughened Ti discs were divided into seven groups (n = 20 per group); six groups received mechanical decontamination procedures (ultrasonic scaling (US) with a metal tip and poly-ether-ketone (PEEK) under low and medium power settings, air-polishing with erythritol powder, and Ti brush), and the control group underwent air–water spray using a dental triplex. The rinsing solution was collected for Ti mass analysis using inductively coupled plasma mass spectrometry (ICPMS), as well as for Ti particle size and count analysis under scanning electron microscopy (SEM) with energy-dispersive spectroscopy (EDS). US metal tip instrumentation generated 34.00 ± 12.54 μg and 34.44 ± 6.08 μg of Ti under low and medium power settings, respectively. This amount of Ti generation was significantly higher than other instrumentation methods. The mean Ti particle size of the US groups ranged from 0.89 ± 0.27 μm to 1.25 ± 0.24 μm. No statistically significant difference was found in the particle size among US groups and Ti brush group (1.05 ± 0.11 μm), except for US with the PEEK tip, where a significantly smaller mean particle diameter was found at the low power setting (0.89 ± 0.27 μm). Mechanical instrumentation can produce Ti particulates and modify the implant surfaces. US using a metal tip generated the highest amount of Ti with smaller Ti size particles compared to all other commonly used mechanical surface instrumentations. The EDS analysis confirmed Ti in PEEK US tips. It can be suggested that deterioration from the PEEK US tip and Ti brush, as observed under SEM, is an additional source of Ti release during Ti surface decontamination. Full article

The osteogenic differentiation process, by which bone marrow mesenchymal stem cells and osteoprogenitors transform into osteoblasts, is regulated by several growth factors, cytokines, and hormones. Plasma Rich in Growth Factors (PRGF) is a blood-derived preparation consisting of a plethora of bioactive molecules, also susceptible to containing epigenetic factors such as ncRNAs and EVs, that stimulates tissue regeneration. The aim of this study was to investigate the effect of the PRGF clot formulation on osteogenic differentiation. Firstly, osteoblast cells were isolated and characterised. The proliferation of bone cells cultured onto PRGF clots or treated with PRGF supernatant was determined. Moreover, the gene expression of Runx2 (ID: 860), SP7 (ID: 121340), and ALPL (ID: 249) was analysed by one-step real-time quantitative polymerase chain reaction (RT-qPCR). Additionally, alkaline phosphatase (ALPL) activity determination was performed. The highest proliferative effect was achieved by the PRGF supernatant in all the study periods analysed. Concerning gene expression, the logRGE of Runx2 increased significantly in osteoblasts cultured with PRGF formulations compared with the control group, while that of SP7 increased significantly in osteoblasts grown on the PRGF clots. On the other hand, despite the fact that the PRGF supernatant induced ALPL up-regulation, significantly higher enzyme activity was detected for the PRGF clots in comparison with the supernatant formulation. According to our results, contact with the PRGF clot could promote a more advanced phase in the osteogenic process, associated to higher levels of ALPL activity. Furthermore, the PRGF clot releasate stimulated a higher proliferation rate in addition to reduced SP7 expression in the cells located at a distant ubication, leading to a less mature osteoblast stage. Thus, the spatial relationship between the PRGF clot and the osteoprogenitors cells could be a factor that influences regenerative outcomes. Full article

Deproteinised bovine bone (DBB) is widely used as bone substitute in maxillary sinus floor augmentation (MSFA) surgery. No previous studies have shown the long-term volumetric changes in the augmented bone when using DBB. The selected patients had MFSA performed using a lateral window technique and a xenograft, alone or in combination with the patient’s autologous bone from the mandible. Cone beam computed tomography (CBCT) images were used to compare the volumetric changes in the augmented bone for patients over a period of 6 or more years. No significant bone reduction was seen in the augmented bone region when comparing MSFA after 7 months and 6 or more years after dental implantation. Full article

The integration of wireless sensors with artificial intelligence could represent a transformative approach in restorative dentistry, offering a sophisticated means to enhance diagnostic precision, treatment planning, and patient outcomes. This systematic review was conducted to pinpoint and assess the efficacy of wireless sensors in restorative dentistry. The search methodology followed the guidelines outlined by PRISMA and involved the utilization of prominent scientific databases. Following the final phase of evaluating eligibility, the systematic review included six papers. Five experiments were conducted in vitro, while one was a randomized clinical trial. The investigations focused on wireless sensors for cavity diagnosis, toothbrush forces, facial mask applications, and physiological parameter detection from dental implants. All wireless sensors demonstrated efficacy in achieving the objectives established by each study and showed the validity, accuracy, and reproducibility of this device. The investigations examined in this systematic review illustrate the potential of wireless sensors in restorative dentistry, especially in the areas of caries detection, dental implant systems, face masks, and power brushes. These technologies hold promise for enhancing patient outcomes and alleviating the workload of dental practitioners. Full article

This retrospective study compared Class II orthodontic non-extraction treatment using Carriere Motion Appliance (CMA) and Twin Block (TB) appliances. Methods: The treatment of 38 patients was assessed. Pre- and post-treatment cephalometric radiographs were analyzed to evaluate skeletal, dental, and soft tissue treatment outcomes and efficacy. Results: Both appliances effectively corrected the Class II molar relationship. When measured at the distal aspect of the first molar, TB achieved 4.22 mm, while CMA had a 2.55 mm correction. When measured in the mesial aspect, the CMA achieved a 3.9 mm correction. The changes in SNB and ANB were statistically significant only in the TB group. The CMA appliance demonstrated statistically significantly less protrusion of the mandibular incisors and less upper incisor retrusion without vertical changes compared to the TB appliance. The TB demonstrated statistically significant lower lip protrusion compared to the CMA. Conclusion: The CMA corrects Class II malocclusions only by exerting a dentoalveolar influence and does not demonstrate the added effects associated with TB, such as elongation of lower facial height (LFH) and less loss of lower anchorage. Nonetheless, the correction in the TB group comprised both dentoalveolar and skeletal components. The CMA promotes a multidirectional upper and lower molar movement, and despite our 2D cephalometric analysis, we were able to estimate the extent of upper molar derotation. Full article