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Experimental Dental Research—New Concepts for Future Patient Needs: Part II

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dentistry, Oral Surgery and Oral Medicine".

Deadline for manuscript submissions: closed (25 April 2024) | Viewed by 9457

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Special Issue Editor

Prof. Dr. Matthias Karl

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Universitätsklinikum des Saarlandes und Medizinische Fakultät, Universität des Saarlandes, 66421 Homburg, Germany
Interests: biomechanics of dental implants; strategies for disinfection; attachment systems for removable dental prostheses
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Despite all the difficulties and problems we had to face during the pandemic, it triggered considerable advances, not only in everyday life but also in dentistry. We have all become familiar with virtual meetings and congresses and dentistry has shown to the other medical specialties that we know how to deal with critical situations and adapted hygiene measures. At dental schools, we managed to continue educating our future colleagues for whom it has become normal to live and work under circumstances that we, the older generation, could not have imagined previously. On the research side, the lockdown periods provided some extra time to reconsider concepts and to envision novel research projects.

As such, I am delighted that MDPI was again willing to provide a forum for presenting new concepts in all fields of dentistry and to follow up on the previous Special Issue in this field. Please be encouraged to present even the most provoking ideas and early-on concepts to solve our future patients' needs.

Prof. Dr. Matthias Karl
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

preclinical research
new concepts
operative dentistry
prosthodontics
oral surgery

Published Papers (7 papers)

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Research

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13 pages, 2561 KiB

Open AccessArticle

Attachment of Respiratory Pathogens and Candida to Denture Base Materials—A Pilot Study

by Anne Schmutzler, Catalina Suzana Stingu, Elena Günther, Reinhold Lang, Florian Fuchs, Andreas Koenig, Angelika Rauch and Sebastian Hahnel

J. Clin. Med. 2023, 12(19), 6127; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12196127 - 22 Sep 2023

Cited by 1 | Viewed by 610

Abstract

Denture prostheses are an ideal and extensive reservoir for microorganisms to attach to their surfaces. The aim of the study was to elucidate interactions between materials for the fabrication of denture bases and the attachment of microorganisms, focusing on respiratory pathogens and Candida species. Specimens (6 mm × 1 mm) with a standardized surface roughness (Sa = 0.1 µm) were prepared from heat-pressed polymethyl methacrylate (PMMA), CAD/CAM-processed PMMA, and CAD/CAM-processed polyether ether ketone (PEEK). The specimens were randomly placed in the vestibular areas of complete upper dentures in seven patients and were removed either after 24 h without any oral hygiene measures or after a period of four weeks. The microorganisms adherent to the surface of the specimens were cultivated and subsequently analyzed using mass spectrometry (MALDI-TOF). The means and standard deviations were calculated, and the data were analyzed using a two-way analysis of variance (ANOVA) and Tukey post-hoc test where appropriate (α = 0.05). There was a significant increase (p ≤ 0.004) in the total bacterial counts (CFU/mL) between the first (24 h) and the second (four weeks) measurements. Regarding quantitative microbiological analyses, no significant differences between the various materials were identified. Respiratory microorganisms were detected in all samples at both measurement time points, with a large variance between different patients. Only after four weeks, Candida species were identified on all materials but not in all participants. Candida species and respiratory microorganisms accumulate on various denture base resins. While no significant differences were identified between the materials, there was a tendency towards a more pronounced accumulation of microorganisms on conventionally processed PMMA. Full article

(This article belongs to the Special Issue Experimental Dental Research—New Concepts for Future Patient Needs: Part II)

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Graphical abstract

8 pages, 2135 KiB

Open AccessCommunication

Aging and Fracture Resistance of Implant-Supported Molar Crowns with a CAD/CAM Resin Composite Veneer Structure

by Angelika Rauch, Wendy Heinzmann, Martin Rosentritt, Sebastian Hahnel, Michael Benno Schmidt, Florian Fuchs and Andreas Koenig

J. Clin. Med. 2023, 12(18), 5997; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12185997 - 15 Sep 2023

Cited by 1 | Viewed by 644

Abstract

Chipping of implant-supported molar crowns (iSCs) is a frequently reported complication. This study aimed to investigate the in-vitro aging and fracture resistance of iSCs with a CAD/CAM resin composite veneer structure fabricated with the Rapid Layer Technology (RLT) approach. Eight iSCs per group were fabricated by using two different CAD/CAM resin composites (Shofu Block HC: SH; Grandio blocs: GB) for veneer structures, and zirconia (ZrO₂), polyetheretherketone (PEEK), and cobalt–chromium (CoCr; control) as framework materials. The surfaces to be bonded were sandblasted, cleaned in an ultrasonic bath, and a coupling agent was applied. A self-adhesive resin luting composite was used to adhesively lute the veneer structures to the frameworks. The crowns were semi-permanently cemented to the abutments. After storage in deionized water, iSCs were loaded in a chewing simulator (TCML, 10,000 thermal cycles 5 °C to 55 °C for 20 s, 1.2 million, loading force 50 N). Four ZrO₂ and one CoCr crown did not survive the TCML. The fracture force was determined after 24 h storage in deionized water and yielded values of ≥974 N. Lowest fracture forces were yielded in the PEEK-SH group in comparison to CoCr or ZrO₂ groups (p ≤ 0.031). For identical framework materials, no significant influence of the veneering material was observed. All PEEK-GB frameworks fractured, and chipping occurred for ZrO₂-SH and all CoCr frameworks. PEEK-SH and ZrO₂-GB presented both chipping and framework fractures. Within the limitations of this in-vitro study, the RLT with a CAD/CAM resin composite veneer structure might be a promising approach to veneer iSCs. Yet, the choice of the CAD/CAM resin composite and of the framework material determine the fracture resistance. Full article

(This article belongs to the Special Issue Experimental Dental Research—New Concepts for Future Patient Needs: Part II)

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13 pages, 5343 KiB

Open AccessArticle

Oral Sequelae after Head and Neck Radiotherapy: RCT Comparing 3D-Printed Tissue Retraction Devices with Conventional Dental Splints

by Christopher Herpel, Thomas Held, Christos Labis, Leo Christ, Kristin Lang, Sebastian Regnery, Tanja Eichkorn, Adriane Lentz-Hommertgen, Cornelia Jaekel, Julius Moratin, Karl Semmelmayer, Tracy Thecla Moutsis, Karim Plath, Oliver Ristow, Christian Freudlsperger, Sebastian Adeberg, Jürgen Debus, Peter Rammelsberg and Franz Sebastian Schwindling

J. Clin. Med. 2023, 12(8), 2789; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12082789 - 09 Apr 2023

Viewed by 1615

Abstract

Objectives: To evaluate oral sequelae after head and neck radiotherapy (RT) when using two different types of intraoral appliances. Thermoplastic dental splints (active control) protect against backscattered radiation from dental structures. Semi-individualized, 3D-printed tissue retraction devices (TRDs, study group) additionally spare healthy tissue from irradiation. Materials and Methods: A total of 29 patients with head and neck cancer were enrolled in a randomized controlled pilot trial and allocated to receive TRDs (n = 15) or conventional splints (n = 14). Saliva quality and quantity (Saliva-Check, GC), taste perception (Taste strips, Burghart-Messtechnik), and oral disability (JFLS-8, OHIP-14, maximum mouth opening) were recorded before and 3 months after RT start. Radiotherapy target volume, modality, total dose, fractionation, and imaging guidance were case-dependent. To evaluate intra-group developments between baseline and follow-up, nonparametric Wilcoxon tests were performed. Mann-Whitney-U tests were applied for inter-group comparisons. Results: At follow-up, taste perception was unimpaired (median difference in the total score; TRDs: 0, control: 0). No significant changes were found regarding oral disability. Saliva quantity (stimulated flow) was significantly reduced with conventional splints (median −4 mL, p = 0.016), while it decreased insignificantly with TRDs (median −2 mL, p = 0.07). Follow-up was attended by 9/15 study group participants (control 13/14). Inter-group comparisons showed no significant differences but a tendency towards a better outcome for disability and saliva quality in the intervention group. Conclusion: Due to the small cohort size and the heterogeneity of the sample, the results must be interpreted with reservation. Further research must confirm the positive trends of TRD application. Negative side-effects of TRD application seem improbable. Full article

(This article belongs to the Special Issue Experimental Dental Research—New Concepts for Future Patient Needs: Part II)

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15 pages, 1511 KiB

Open AccessArticle

Factors Associated with Esthetic Outcomes of Flapless Immediate Placed and Loaded Implants in the Maxillary Incisor Region—Three-Year Results of a Prospective Case Series

by Edith Groenendijk, Tristan Ariaan Staas, Ewald Maria Bronkhorst, Gerry Max Raghoebar and Gert Jacobus Meijer

J. Clin. Med. 2023, 12(7), 2625; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12072625 - 31 Mar 2023

Cited by 1 | Viewed by 1911

Abstract

Flapless immediate implant placement and provisionalization (FIIPP) is often associated with an increased risk of buccal soft-tissue recession. This study aims to assess the 3-year esthetic outcome. In 100 consecutive patients, one maxillary incisor, with or without a pre-extraction buccal bone defect (≤5 mm), was replaced by an implant installed in a maximal palatal position (buccal gap ≥2 mm). The created gaps were filled with bovine bone substitute. Patient satisfaction (PS), pink esthetic scores (PES/modPES), and white esthetic score (WES) were calculated at different time points. A multilevel regression analysis (MRA) was performed to analyze which factors may be associated with the esthetics. After three years, PS scored 8.9 ± 0.84 on a scale of 10 (n = 83), and the soft-tissue esthetics were high (PES = 12.2; modPES = 8.5), as was the WES (8.2), showing no decrease from one year. Buccal bone defect size and smoking could not be associated with the soft-tissue outcome; however, implant location, gap size, and emergence profiles could. Performing FIIPP, the final crown (WES) scored highest when it was cemented, the soft tissue (PES/modPES) in central-incisor positions, and all (WES/PES/modPES) with concave emergence profiles. Full article

(This article belongs to the Special Issue Experimental Dental Research—New Concepts for Future Patient Needs: Part II)

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10 pages, 1751 KiB

Open AccessArticle

Oral Cell Lysates Reduce the Inflammatory Response of Activated Macrophages

by Layla Panahipour, Azarakhsh Oladzad Abbasabadi and Reinhard Gruber

J. Clin. Med. 2023, 12(4), 1701; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12041701 - 20 Feb 2023

Cited by 2 | Viewed by 956

Abstract

Necrotic cell damage occurs as a consequence of invasive dental procedures. Loss of membrane integrity being the hallmark of necrotic cells leads to the release of cytoplasmic and membranous components. Macrophages are predestined to respond to lysates originating from necrotic cells. Here, we implement necrotic lysates from human gingival fibroblasts, HSC2, and TR146 oral epithelial cell lines, and RAW264.7 macrophage cell lines to be tested for their potential to modulate the inflammatory response of macrophages. To this aim, necrotic cell lysates were prepared by sonication or freezing/thawing of the respective cell suspension. Necrotic cell lysates were tested for their potential to modulate the lipopolysaccharide (LPS)-induced expression of inflammatory cytokines using RAW264.7 macrophages as a bioassay. We show here that all necrotic cell lysates, independent of the origin and the preparation way, reduced the expression of IL1 and IL6 in LPS-induced RAW264.7 macrophages, most obviously shown for TR146 cells. This finding was supported in a bioassay when macrophages were exposed to poly (I:C) HMW, an agonist of TLR-3. Consistently, all necrotic lysates from gingival fibroblasts, HSC2, TR146, and RAW264.7 cells reduced the nuclear translocation of p65 in LPS-exposed macrophages. This screening approach supports the overall concept that necrotic cell lysates can modulate the inflammatory capacity of macrophages. Full article

(This article belongs to the Special Issue Experimental Dental Research—New Concepts for Future Patient Needs: Part II)

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15 pages, 2529 KiB

Open AccessArticle

Implant-Supported Overdentures: Current Status and Preclinical Testing of a Novel Attachment System

by Frank Wendler, Lisa Diehl, Pejman Shayanfard and Matthias Karl

J. Clin. Med. 2023, 12(3), 1012; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12031012 - 28 Jan 2023

Cited by 1 | Viewed by 1678

Abstract

Numerous attachment systems exist for implant-supported overdentures, with each having specific limitations in terms of retention, cost, wear, maintenance and cleanability. A retrospective analysis of patients restored with implant-supported overdentures using bars, telescopic crowns and Locator-type attachments was performed and the patients were interviewed. An in vitro strain gauge study compared telescopic crowns, Locator-type attachments and a novel flexible attachment system employing a shape memory alloy (NiTi) with respect to peri-implant strain development during insertion, loading and removal of an overdenture. A significantly lower number of attachment-related complications was observed in bars as compared to telescopic crowns (p = 0.00007) and Locator-type attachments (p = 0.00000), respectively. Greater overall patient satisfaction was noted in bar-retained restorations while Locator-type attachments led to lower levels of satisfaction regarding prosthesis retention. In vitro, telescopic crowns caused maximum strain development during prosthesis insertion and loading, while during removal this was observed in Locators with white retentive inserts. NiTi attachments caused significantly lower strain development during insertion as compared to telescopic crowns (p = 0.027). During loading, NiTi attachments caused significantly lower strain development than Locators with blue retentive inserts (p = 0.039). During removal, NiTi attachments caused significantly less strain development as compared to Locators with white retentive inserts (p = 0.027). Positional discrepancies between male and female attachment parts affected the retention and reaction force between both components, which may be minimized by using the novel NiTi attachment system. This may be beneficial in terms of component wear and implant loading. Full article

(This article belongs to the Special Issue Experimental Dental Research—New Concepts for Future Patient Needs: Part II)

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Review

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16 pages, 1080 KiB

Open AccessReview

Validation of Digital Impressions’ Accuracy Obtained Using Intraoral and Extraoral Scanners: A Systematic Review

by Naisargi Shah, Mrinmyaee Thakur, Shruti Gill, Omkar Shetty, Nasser M. Alqahtani, Mohammed A. Al-Qarni, Saeed M. Alqahtani, Mohamed Fadul A. Elagib and Saurabh Chaturvedi

J. Clin. Med. 2023, 12(18), 5833; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12185833 - 08 Sep 2023

Viewed by 1270

Abstract

Background: At present, the evidence regarding digital impressions’ accuracy recorded by using digital scanners is lacking. This systematic review aimed to evaluate whether the type of scanning (intraoral/extraoral) affects the Accuracy of Digital Impressions. Method: Two independent reviewers performed a systematic search in the database both electronically and manually (PubMed, Ebsco HOST, the Cochrane Library, and Google Scholar) for articles published from 1 January 2010 to 1 December 2022. This study was registered with the International Prospective Register of Systematic Reviews (PROSPERO CRD42020188765) and followed the PRISMA statement. The question in focus was as follows: Does the type of scanning (intraoral or extraoral) affect the accuracy of digital impression? Results: A total of 449 papers were obtained by searching electronically and manually. In total, 15 complete-text papers qualified for assessment based on eligibility criteria. After reading the full-text articles, five studies were excluded. Ten studies were selected for the qualitative analysis. The qualitative data reported that the accuracy of both types of scanners (intraoral and extraoral) lies within the range of clinical acceptability. Nevertheless, the intraoral scanners seem to be more accurate when compared to the extraoral scanners for a partial arch situation. Conclusions: Scanning type affects the accuracy of the digital impression. Various factors influence the scanning ability. Intraoral scanners seem to be more accurate compared to extraoral scanners for a partial arch situation. More studies comparing the accuracy of the intraoral scanner and extraoral scanner for a complete arch scan and in an in vivo study setting are needed. Full article

(This article belongs to the Special Issue Experimental Dental Research—New Concepts for Future Patient Needs: Part II)

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