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Dent. J., Volume 9, Issue 8 (August 2021) – 16 articles

Cover Story (view full-size image): Inadequate polymerization of bulk–fill composites was associated with more biofilm accumulation and surface topography changes. Overall, non-optimally performed curing reduced the amount of energy received by the bulk-fill, which led to a reduced degree of conversion, more biofilm formation, and higher surface roughness. In addition, the improper light-curing of bulk–fill composites compromises their physicochemical and biological properties, leading to inferior clinical performance and reduced restorative treatment longevity. View this paper.
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Article
Abrasion Behaviour of Different Charcoal Toothpastes When Using Electric Toothbrushes
Dent. J. 2021, 9(8), 97; https://0-doi-org.brum.beds.ac.uk/10.3390/dj9080097 - 20 Aug 2021
Viewed by 391
Abstract
Objectives: The purpose of this in vitro study was to compare the abrasion behaviour of different charcoal toothpastes when brushing with electric toothbrushes on human enamel. Materials and Methods: A self-designed brushing machine was built using six commercially available electric toothbrushes in abrasion [...] Read more.
Objectives: The purpose of this in vitro study was to compare the abrasion behaviour of different charcoal toothpastes when brushing with electric toothbrushes on human enamel. Materials and Methods: A self-designed brushing machine was built using six commercially available electric toothbrushes in abrasion chambers. Each chamber was constantly supplied with a toothpaste–water mix. Pieces of human enamel, which were embedded in PMMA, were brushed for 4 h. Before and after brushing, profilometer measurements were performed in order to determine the substance loss due to brushing. Results: The following calculated mean removal values (mean ± SD) were found: (4.6 ± 0.6) µm (Group C: Splat Blackwood), (3.2 ± 0.9) µm (Group D: Curaprox Black is White), (2.3 ± 0.7) µm (Group B: Sensodyne Pro Schmelz), (1.7 ± 0.6) µm (Group A: Water), (1.4 ± 0.6) µm (Group E: Prokudent Black Brilliant). A post hoc Tukey HSD test (p = 0.05) showed that the results for Group A/B/E, Group B/D and Group C each lie within subsets that differ statistically significantly from the other subsets. Conclusions: Within the limitations of this in vitro study, it can be stated that some charcoal toothpastes lead to significantly higher abrasion on human enamel, when brushing with electric brushes. Clinical Relevance: As low-abrasion toothpaste is generally advisable, and some charcoal toothpastes should be viewed critically with regard to their abrasive properties. Full article
(This article belongs to the Special Issue Feature Papers in Dentistry Journal in 2021)
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Article
Biomedical Courses Should Also Be Designed for Dental Students: The Perceptions of Dental Students
Dent. J. 2021, 9(8), 96; https://0-doi-org.brum.beds.ac.uk/10.3390/dj9080096 - 16 Aug 2021
Viewed by 585
Abstract
Introduction: It can be challenging integrating biomedical sciences into dentistry programs. The aim was to examine students’ perceptions of how joint biomedical courses with medical students and courses tailored for dental students supported their clinical studies. Materials and methods: The target group was [...] Read more.
Introduction: It can be challenging integrating biomedical sciences into dentistry programs. The aim was to examine students’ perceptions of how joint biomedical courses with medical students and courses tailored for dental students supported their clinical studies. Materials and methods: The target group was clinical phase dental students. Cross-sectional survey data were collected using a questionnaire, which consisted of questions covering biomedical and clinical study content and learning methods. Results: A total of 110 (82%) students completed the survey. Students had difficulty recognising the relevance of joint biomedical courses for clinical work, but when the link was clear, their interest in the content increased. The closer the respondents were to graduation, the less relevance they expressed the biomedical sciences had. Almost all students (95%) wanted more dental content for the early study years. Discussion: The student perspective provides valuable information for the development of biomedical courses. Students should be offered customised courses that include dental content and perspectives on clinical work, whenever suitable to the didactic content of the basic science course. Our study shows that the dental perspective needs greater integration with the biomedical content. This also supports interprofessional learning and appreciation for the other field’s contribution to human health. Full article
(This article belongs to the Special Issue Dental Education)
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Review
Effect of Polishing Systems on the Surface Roughness of Nano-Hybrid and Nano-Filling Composite Resins: A Systematic Review
Dent. J. 2021, 9(8), 95; https://0-doi-org.brum.beds.ac.uk/10.3390/dj9080095 - 12 Aug 2021
Viewed by 507
Abstract
Background: The polishing of surface roughness is an important characteristic of composite resins and is directly related to the longevity of the restoration and patient comfort. Different polishing systems utilize different protocols, as reported in the literature. This systematic review (SR) aimed to [...] Read more.
Background: The polishing of surface roughness is an important characteristic of composite resins and is directly related to the longevity of the restoration and patient comfort. Different polishing systems utilize different protocols, as reported in the literature. This systematic review (SR) aimed to synthesize and analyze the available scientific evidence about the effect of polishing systems on the surface roughness of nano-hybrid and nano-filling composite resins. Methods: The study protocol of this SR was registered at the International Prospective Register of Systematic Reviews -PROSPERO- (CRD4201705653). A search was conducted in PubMed-Medline, Scopus, LILACS, EMBASE, for the period 2007–2020. Quality appraisal and a descriptive analysis of the papers that met the inclusion criteria were conducted. Results: 18 records were included. Seven polishing systems (PS) of one step were found, seven PS of two steps, eight PS of three steps, three PS of four steps, and four PS of five steps. Polishing protocols (PP) varied, with application times ranging from 10 s to 60 s with speeds between 10,000 and 30,000 RPM. Regarding composition, the aluminum oxide was one of the most important components used to achieve a smooth surface. Conclusions: Multistep polishing systems were the most effective (i.e., Astropol and Sof-Lex Discs). Full article
(This article belongs to the Special Issue Dental Materials and Their Clinical Applications)
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Article
Evaluating Classification Consistency of Oral Lesion Images for Use in an Image Classification Teaching Tool
Dent. J. 2021, 9(8), 94; https://0-doi-org.brum.beds.ac.uk/10.3390/dj9080094 - 12 Aug 2021
Viewed by 407
Abstract
A web-based image classification tool (DiLearn) was developed to facilitate active learning in the oral health profession. Students engage with oral lesion images using swipe gestures to classify each image into pre-determined categories (e.g., left for refer and right for no intervention). To [...] Read more.
A web-based image classification tool (DiLearn) was developed to facilitate active learning in the oral health profession. Students engage with oral lesion images using swipe gestures to classify each image into pre-determined categories (e.g., left for refer and right for no intervention). To assemble the training modules and to provide feedback to students, DiLearn requires each oral lesion image to be classified, with various features displayed in the image. The collection of accurate meta-information is a crucial step for enabling the self-directed active learning approach taken in DiLearn. The purpose of this study is to evaluate the classification consistency of features in oral lesion images by experts and students for use in the learning tool. Twenty oral lesion images from DiLearn’s image bank were classified by three oral lesion experts and two senior dental hygiene students using the same rubric containing eight features. Classification agreement among and between raters were evaluated using Fleiss’ and Cohen’s Kappa. Classification agreement among the three experts ranged from identical (Fleiss’ Kappa = 1) for “clinical action”, to slight agreement for “border regularity” (Fleiss’ Kappa = 0.136), with the majority of categories having fair to moderate agreement (Fleiss’ Kappa = 0.332–0.545). Inclusion of the two student raters with the experts yielded fair to moderate overall classification agreement (Fleiss’ Kappa = 0.224–0.554), with the exception of “morphology”. The feature of clinical action could be accurately classified, while other anatomical features indirectly related to diagnosis had a lower classification consistency. The findings suggest that one oral lesion expert or two student raters can provide fairly consistent meta-information for selected categories of features implicated in the creation of image classification tasks in DiLearn. Full article
(This article belongs to the Special Issue Dental Education)
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Article
Education Regarding and Adherence to Recommended Nutrition Guidelines among Dental Students
Dent. J. 2021, 9(8), 93; https://0-doi-org.brum.beds.ac.uk/10.3390/dj9080093 - 09 Aug 2021
Viewed by 447
Abstract
The Dietary Guidelines for Americans (DGA) were developed to reduce or prevent many types of chronic illness, including cancer, heart disease and diabetes. Healthcare provider recommendations may be influenced by understanding of and adherence to the DGA, which may be incorporated into provider [...] Read more.
The Dietary Guidelines for Americans (DGA) were developed to reduce or prevent many types of chronic illness, including cancer, heart disease and diabetes. Healthcare provider recommendations may be influenced by understanding of and adherence to the DGA, which may be incorporated into provider training, medical and dental clinical curricula—although few studies have evaluated adherence to the DGA among dental students. This approved retrospective study of voluntary student responses from a first-year dental school nutrition course included a short dietary and exercise survey administered as part of the DGA learning module. A total of N = 299 students completed the voluntary nutrition survey, yielding a response rate of 91.4%. Daily fruit and vegetable intake, dairy and whole grain servings among UNLV-SDM students were significantly lower than the DGA recommendations but higher than U.S. averages for 18–30-year-olds—although neither group met DGA recommendations. This study represents one of the first to evaluate the dietary intake of U.S. dental students for comparison with the DGA for positive health behaviors. These data demonstrate a lack of adherence to the DGA among highly educated dental students and the need for the curricular inclusion of diet and nutrition into the dental school curriculum. Full article
(This article belongs to the Special Issue Dental Education)
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Article
Hardness of Resin Cements Polymerized through Glass-Ceramic Veneers
Dent. J. 2021, 9(8), 92; https://0-doi-org.brum.beds.ac.uk/10.3390/dj9080092 - 09 Aug 2021
Viewed by 438
Abstract
(1) Background: The aim of this study is to evaluate the hardness of resin cements polymerized through ceramic disks under different process factors (ceramic type and thickness, light-polymerization units and polymerization time); (2) Method: Three types of ceramic blocks were used (IPS e.max [...] Read more.
(1) Background: The aim of this study is to evaluate the hardness of resin cements polymerized through ceramic disks under different process factors (ceramic type and thickness, light-polymerization units and polymerization time); (2) Method: Three types of ceramic blocks were used (IPS e.max CAD; Celtra Duo; VITABLOCS). Ceramic disks measuring 0.5 mm, 1.0 mm and 1.5 mm were cut from commercial blocks. Two resin cements (Rely X Veneer and Variolink Esthetic) were polymerized through the ceramic specimens using distinct light-polymerization units (Deep-cure; Blue-phase) and time intervals (10 and 20 s). Hardness of cement specimens was measured using microhardness tester with a Knoop indenter. Data were statistically analyzed using factorial ANOVA (α = 5%); (3) Results: Mean microhardness of Rely X Veneer cement was significantly higher than that of Variolink Esthetic. Deep-cure resulted in higher mean microhardness values compared to Blue-phase at 0.5- and 1-mm specimen thicknesses. Moreover, a direct correlation was found between polymerization time and hardness of resin cement; (4) Conclusions: Surface hardness was affected by resin cement type and ceramic thickness, and not affected by ceramic types, within evaluated conditions. Increasing light-polymerization time significantly increased the hardness of the cement. Full article
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Article
Early Clinical Experience and Mentoring of Young Dental Students—A Qualitative Study
Dent. J. 2021, 9(8), 91; https://0-doi-org.brum.beds.ac.uk/10.3390/dj9080091 - 06 Aug 2021
Viewed by 393
Abstract
The literature reports that student transition between preclinical and clinical dental education can be traumatic and stressful for many reasons. Early clinical experience has been reported to provide some relief. In this qualitative study, twelve final year dental students were interviewed about their [...] Read more.
The literature reports that student transition between preclinical and clinical dental education can be traumatic and stressful for many reasons. Early clinical experience has been reported to provide some relief. In this qualitative study, twelve final year dental students were interviewed about their perceptions and experiences with a mentee/mentor (FOAL) program in Aarhus, Denmark, to see if it (1) counteracted stress perceptions from preclinical education to the clinic, (2) inspired professionalism and a sense of study relevance, (3) helped in learning to reflect on competencies and attitudes, (4) helped with clinical social perspectives (communication/contact), (5) helped with motivation to learn and (6) helped to reaffirm one’s professional study choice. Using qualitative description methods with purposeful sampling, data from interviews were collected, transcribed, analyzed and validated with a short questionnaire. The FOAL program, today, has several benefits for mentees, including partially helping in the preclinic to clinic transition and the increased insight into mentors’ clinical tasks and communication with patients. Informants described that FOAL also contributed positively to both mentee and mentor students’ learning motivation, collaborative skills and professional attitudes. Challenges were lack of organization/planning, not enough clinical hours, lack of clinical knowledge and persistent stress levels at the clinical transition. These issues are already being considered in the curriculum reform currently in progress and are also relevant to other dental curricula internationally. Full article
(This article belongs to the Special Issue Dental Education)
Perspective
Benefits of Using Fluorescence Induced Theragnosis in Fixed Orthodontic Therapy: Status, Technology and Future Trends
Dent. J. 2021, 9(8), 90; https://0-doi-org.brum.beds.ac.uk/10.3390/dj9080090 - 05 Aug 2021
Viewed by 499
Abstract
Dental biofilm is often found to be the source of bacteria that releases toxins, peptides, lipopolysaccharides as well as organic acids, which lead to gingival inflammation and tooth caries. Further, the persistent plaque may result in the continued destruction of the surrounding soft [...] Read more.
Dental biofilm is often found to be the source of bacteria that releases toxins, peptides, lipopolysaccharides as well as organic acids, which lead to gingival inflammation and tooth caries. Further, the persistent plaque may result in the continued destruction of the surrounding soft and hard tissues. During fixed orthodontic therapy, arch-wires, brackets, and elastic modules have been shown to be sites of significant plaque accumulation, making it difficult for a patient to maintain proper oral hygiene. The problem most dentists face is that they cannot visualize this biofilm completely to be able to carry out efficient plaque removal. Visual assessment is, to date, the most common method for plaque visualization, and various indexes have been demonstrated to be sufficient for quantification of the amount of plaque present. However, the problem is that visual assessments are inconsistent, operator dependent and often subjective, which can lead to inconsistency in results. Fluorescence is one such method that can be explored for its use in effective plaque identification and removal. Literature has it that dentists and patients find it particularly useful for monitoring oral hygiene status during treatment. Fluorescence has the capability of offering clinical orthodontists and researchers a new method of detection of demineralization during orthodontic treatment, furthermore, for efficient removal of orthodontic adhesive cements, fluorescent light may be used in conjunction with high-speed burs to deliver fast, less time consuming, and safer results. The benefit of direct visual treatment using fluorescence enhanced theragnosis is that the patient receives controlled and guided therapy. It has multiple benefits, such as early diagnosis of caries, biofilm identification, and even helps to achieve improved treatment outcomes by better resin selection for esthetic procedures. Full article
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Article
Behavior of Children during Dental Care with Rubber Dam Isolation: A Randomized Controlled Study
Dent. J. 2021, 9(8), 89; https://0-doi-org.brum.beds.ac.uk/10.3390/dj9080089 - 04 Aug 2021
Viewed by 517
Abstract
Background: The establishment of the dental dam improves dentist working conditions and patient protection. The purpose of this study was to analyze the behavior of the child during dental care with or without a dam. Methods: In this interventional randomized study, 51 patients [...] Read more.
Background: The establishment of the dental dam improves dentist working conditions and patient protection. The purpose of this study was to analyze the behavior of the child during dental care with or without a dam. Methods: In this interventional randomized study, 51 patients are divided into two groups, one with a rubber dam and the other with cotton roll isolation. Their behavior was observed during the treatment of temporary molars. The duration of the treatment, the patient’s feeling with a visual analogue scale (VAS), the behavior (B) of the child measured with a hetero-evaluation scale (modified Venham scale) and the cardiac frequency (CF) were measured. Results: The group treated with a rubber dam has a significant decrease in the various stress parameters that have been identified (B, p value = 0.034; CF, p value = 0.015). Subgroups of patients with and without nitrous oxide sedation were compared and similar results were obtained. Conclusions: Isolation with a rubber dam reduces child’s stress during dental care. Although it is slightly more time-consuming and training is necessary for a quick and effective placement, it allows dentists to perform dental care in the best possible conditions, while reducing dental anxiety in young patients. Full article
(This article belongs to the Special Issue Oral Health Care in Paediatric Dentistry)
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Review
Cariogenic Biofilms: Development, Properties, and Biomimetic Preventive Agents
Dent. J. 2021, 9(8), 88; https://0-doi-org.brum.beds.ac.uk/10.3390/dj9080088 - 03 Aug 2021
Viewed by 572
Abstract
Oral biofilms will build up within minutes after cleaning of the dental hard tissues. While the application of remineralizing agents is a well-known approach to prevent dental caries, modern oral care products offer also additional active agents to maintain oral health. Human saliva [...] Read more.
Oral biofilms will build up within minutes after cleaning of the dental hard tissues. While the application of remineralizing agents is a well-known approach to prevent dental caries, modern oral care products offer also additional active agents to maintain oral health. Human saliva contains many different organic and inorganic compounds that help to buffer organic acids produced by cariogenic microorganisms. However, most oral care products only contain remineralizing agents. To improve the benefit of those products, further active ingredients are needed. Books, review articles, and original research papers were included in this narrative review. Putting all these data together, we give an overview of oral biofilms and active compounds used in modern oral care products to interact with them. The special focus is on inorganic compounds and their interaction with oral biofilms. While organic compounds have several limitations (e.g., cell toxicity), inorganic compounds based on calcium and/or phosphate (e.g., sodium bicarbonate, hydroxyapatite, calcium carbonate) offer several advantages when used in oral care products. Calcium release can inhibit demineralization, and the release of hydroxide and phosphate ions might help in the buffering of acids. Therefore, the focus of this review is to summarize the scientific background of further active ingredients that can be used for oral care formulations. Full article
(This article belongs to the Special Issue Feature Papers in Dentistry Journal in 2021)
Article
Accuracy of Guided Surgery and Real-Time Navigation in Temporomandibular Joint Replacement Surgery
Dent. J. 2021, 9(8), 87; https://0-doi-org.brum.beds.ac.uk/10.3390/dj9080087 - 02 Aug 2021
Viewed by 490
Abstract
Background: Sophisticated guided surgery has not been implemented into total joint replacement-surgery (TJR) of the temporomandibular joint (TMJ) so far. Design and in-house manufacturing of a new advanced drilling guide with vector and length control for a typical TJR fossa component are described [...] Read more.
Background: Sophisticated guided surgery has not been implemented into total joint replacement-surgery (TJR) of the temporomandibular joint (TMJ) so far. Design and in-house manufacturing of a new advanced drilling guide with vector and length control for a typical TJR fossa component are described in this in vitro study, and its accuracy/utilization was evaluated and compared with those of intraoperative real-time navigation and already available standard drilling guides. Methods: Skull base segmentations of five CT-datasets from different patients were used to design drilling guides with vector and length control according to virtual surgical planning (VSP) for the TJR of the TMJ. Stereolithographic models of the skull bases were printed three times for each case. Three groups were formed to compare our newly designed advanced drilling guide with a standard drilling guide and drill-tracking by real-time navigation. The deviation of screw head position, screw length and vector in the lateral skull base have been evaluated (n = 72). Results: There was no difference in the screw head position between all three groups. The deviation of vector and length was significantly lower with the use of the advanced drilling guide compared with standard guide and navigation. However, no benefit in terms of accuracy on the lateral skull base by the use of real-time navigation could be observed. Conclusion: Since guided surgery is standard in implant dentistry and other CMF reconstructions, this new approach can be introduced into clinical practice soon, in order to increase accuracy and patient safety. Full article
(This article belongs to the Special Issue 3D Printing in Dentistry)
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Article
The New Normalcy in Dentistry after the COVID-19 Pandemic: An Italian Cross-Sectional Survey
Dent. J. 2021, 9(8), 86; https://0-doi-org.brum.beds.ac.uk/10.3390/dj9080086 - 31 Jul 2021
Viewed by 682
Abstract
Background: After the first lockdown, Italian dentists resumed their practice while handling several challenges. Reducing contagion risk by complying with the stringent measures recommended by the Italian Ministry of Health for dental activity while also balancing patient needs was a difficult task. This [...] Read more.
Background: After the first lockdown, Italian dentists resumed their practice while handling several challenges. Reducing contagion risk by complying with the stringent measures recommended by the Italian Ministry of Health for dental activity while also balancing patient needs was a difficult task. This work aims to understand the procedures that were adopted in the second phase of the COVID-19 pandemic (5 May–30 September 2020) and the dentists’ expectations and concerns about returning to normalcy. Methods: A national survey with 38 questions was conducted from November 2020 to January 2021 and comparisons were performed among the five main Italian geographic areas. Results: Located mainly in northwest Italy, 1028 dentists were included in the survey. About 83% of the Italian dentists fully restarted their activities after the lockdown. The resumption was significantly marked in North Italy and the Center than in the South (p < 0.01). Over 80% adopted the recommended precautional guidelines, modifying them according to the specific dental treatment executed. Fifty percent of dentists were confident in returning to normalcy after the COVID-19 crisis. Many precautions adopted during the pandemic will be continued, especially in South Italy and the Islands (p < 0.01). Conclusions: Italian dentists reported excellent autonomous organizational skills and the maintaining of high-quality precautions during the reopening phase. Full article
(This article belongs to the Special Issue Feature Papers in Dentistry Journal in 2021)
Systematic Review
Medication-Related Osteonecrosis of the Jaws Initiated by Zoledronic Acid and Potential Pathophysiology
Dent. J. 2021, 9(8), 85; https://0-doi-org.brum.beds.ac.uk/10.3390/dj9080085 - 30 Jul 2021
Viewed by 444
Abstract
The aim of this systematic review is to present an up-to-date review of available publications investigating the cellular mechanisms initiating the development of medication-related osteonecrosis of the jaw caused by zoledronic acid. Electronic searches of MEDLINE/PubMed and Scopus were conducted on the 3 [...] Read more.
The aim of this systematic review is to present an up-to-date review of available publications investigating the cellular mechanisms initiating the development of medication-related osteonecrosis of the jaw caused by zoledronic acid. Electronic searches of MEDLINE/PubMed and Scopus were conducted on the 3 June 2019. A total of 804 publications were identified, of which 11 met the inclusion criteria and were, therefore, included in this study. All the included studies were in vitro studies investigating various human cells. The current review found that zoledronic acid in various concentrations increased apoptosis and decreased migration and proliferation of epithelial cells, fibroblasts, osteoblasts, endothelial cells and dental pulp stem cells, which can affect local tissue homeostasis. The consequences of zoledronic acid were found to be both time- and dose-dependent. The pathophysiology of medication-related osteonecrosis of the jaw is likely a multifactorial process involving prolonged wound healing, chronic inflammation and altered bone remodelling following the administration of zoledronic acid. Further research is needed to identify the exact pathophysiology to optimise management and treatment. Full article
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Systematic Review
Adjuvant Effect of Titanium Brushes in Peri-Implant Surgical Treatment: A Systematic Review
Dent. J. 2021, 9(8), 84; https://0-doi-org.brum.beds.ac.uk/10.3390/dj9080084 - 30 Jul 2021
Viewed by 419
Abstract
Background: the prognosis of peri-implant surgery can be affected by poor decontamination of the implant surface, which could be improved with the use of titanium brushes. The objectives of this systematic review were to evaluate the effectiveness of titanium brushes in the decontamination [...] Read more.
Background: the prognosis of peri-implant surgery can be affected by poor decontamination of the implant surface, which could be improved with the use of titanium brushes. The objectives of this systematic review were to evaluate the effectiveness of titanium brushes in the decontamination of the implant surface in terms of plaque index, probing depth, bleeding on probing and bone loss/gain; as well as its effectiveness according to the type of peri-implant bone defect. Methods: an electronic search was carried out in the PubMed, Scopus, Cochrane and Embase databases, as well as a manual search. The search strategy included four keywords: “Peri-implantitis”, “Periimplantitis”, “Implant Surface Decontamination” and “Titanium Brush”. Randomized controlled studies published in the last 10 years were included and systematic reviews, in vitro studies and animal studies were excluded. Results: 142 references were found, from which only four articles met the inclusion criteria. All of the studies included in the present review reported beneficial results in terms of probing depth, gingival index and radiographic bone loss and gain after implant surface decontamination adjuvated by titanium brushes. Conclusions: titanium rotary brushes show improvements in the evolution and prognosis of peri-implant surgery, although more long-term studies are needed to draw more solid conclusions. Full article
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Article
Improper Light Curing of Bulkfill Composite Drives Surface Changes and Increases S. mutans Biofilm Growth as a Pathway for Higher Risk of Recurrent Caries around Restorations
Dent. J. 2021, 9(8), 83; https://0-doi-org.brum.beds.ac.uk/10.3390/dj9080083 - 30 Jul 2021
Viewed by 481
Abstract
How dentists cure a resin-based material has deleterious effects on the material’s properties and its interaction with surrounding dental tissues. Biofilm accumulation has been implicated in the pathogenesis of carious lesions around dental restorations, with its composition manifesting expressed dysbiosis in patients suffering [...] Read more.
How dentists cure a resin-based material has deleterious effects on the material’s properties and its interaction with surrounding dental tissues. Biofilm accumulation has been implicated in the pathogenesis of carious lesions around dental restorations, with its composition manifesting expressed dysbiosis in patients suffering from dental caries. To evaluate the influence of varying radiant exposure on the degree of conversion (DC%), Streptococcus mutans biofilm growth, and surface roughness of bulk-fill composites under different light-curing conditions. Two light-curing units (LCU) at 600 and 1000 mW/cm2 were used to simulate curing conditions with different angulations (∢20° and ∢35°) or 2 mm-distance displacements of the LCU tip. The radiant exposure (RE) was assessed, and the composites were analyzed for DC%. Biofilm formation was induced over the bulk-fill composites and analyzed via colony-forming units counting and scanning electron microscopy (SEM). The surface roughness was analyzed via a profilometer and SEM after biofilm formation. Curing conditions with different angulation or displacement decreased RE compared to the “optimal condition”. The moderately (∢35°) angulated LCU tip and low (600 mW/cm2) radiant emittance significantly reduced the DC% (p < 0.05). The difference in DC% between the top and bottom of the composites ranged from 8 to 11% for 600 mW/cm2 and 10 to 20% for 1000 mW/cm2. Greater S. mutans biofilm and surface changes were found in composites with non-optimal RE delivery (e.g., tip displacement and angulation) (p < 0.05). Inadequate polymerization of bulk-fill composites was associated with more biofilm accumulation and surface topography changes. Overall, non-optimally performed curing procedures reduced the amount of delivered RE, which led to low DC%, more biofilm formation, and higher surface roughness. The improper light-curing of bulk-fill composites compromises their physicochemical and biological properties, which could lead to inferior clinical performance and reduced restorative treatments’ longevity. Full article
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Article
Sinus Mucosa Thickness Changes and Ostium Involvement after Maxillary Sinus Floor Elevation in Sinus with Septa. A Cone Beam Computed Tomography Study
Dent. J. 2021, 9(8), 82; https://0-doi-org.brum.beds.ac.uk/10.3390/dj9080082 - 21 Jul 2021
Cited by 1 | Viewed by 561
Abstract
Background: A thickening of the sinus mucosa is observed after sinus floor augmentation. The objective of this retrospective study was to evaluate the influence of the presence of septa in the dimensional variation and ostium involvement over time of the Schneiderian mucosa after [...] Read more.
Background: A thickening of the sinus mucosa is observed after sinus floor augmentation. The objective of this retrospective study was to evaluate the influence of the presence of septa in the dimensional variation and ostium involvement over time of the Schneiderian mucosa after sinus floor augmentation. Materials and Methods: Fifteen sinuses with septa (septa group) and 15 without (control group) were selected. CBCTs taken before surgery, and were analyzed after 1 week and after 9 months. Schneiderian membrane thickness changes over time and involvement of the ostium were evaluated. Results: Four perforations occurred in the septa group and none in the control group. After 1 week of healing, the sinus mucosa thickness increased in height by 5.7 mm and 7.1 mm in the septa and control groups, respectively. In this period, the patency of the ostium decreased in both groups, and three infundibula were obstructed in the septa group, and five in the control group. The mucosa was thicker and the edema was closer to the ostium in the control compared to in the septa group. After 9 months of healing, the dimensions regressed to normal pattern and no obstruction of the infundibula were observed. No statistically significant differences were found between septa and control groups. Conclusions: after one week of healing, the sinus mucosa increased in dimensions in both septa and control groups. However, the sinus mucosa presented a tendency of being thicker and closer to the ostium, resulting in a higher number of infundibula obstructions, in the control group compared to in the septa group. After 9 months, the sinus mucosa regressed to normal dimensions and no obstructions of the infundibula were observed in any group. Full article
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