Odovtos - International Journal of Dental Sciences

Alignment Efficiency of Two Archwires in Adolescents with Moderate to Severe Crowding

Ivette Sáenz — Wed, 30 Apr 2025 00:00:00 -0600

There is no consensus in clinical orthodontics on which aligning arch wire should be used at the initial stage of treatment. This randomized clinical trial evaluated the efficiency of multistranded Nitinol (Supercable) aligning arch-wire versus a standard arch-wire (Nitinol) in the first stage of orthodontic treatment in adolescents with severe crowding. Forty patients ages 12 to 17 with an Irregularity Index as proposed by Little between 5 to 17 mm were selected. Vinyl polysiloxane impressions (VPS) were taken before treatment (T1) at 6 weeks (T2) and 12 weeks (T3). Roth prescription .022 x .028 Edgewise brackets were bonded using light cure adhesive to the six anterior teeth of each dental arch and bands were placed on all first molars. Subjects were paired by gender and Irregularity Index into two groups of 20 each and assigned either to the control group (Nitinol) or the experimental archwire (Supercable). The predictor variables in this study were the type of archwire, type of dental arch and the time intervals. The outcome variable was the Irregularity Index score. The Irregularity Index was measured using 3D digital study models (e-models) and GeoDigm software from the VPS impressions taken at T1, T2 and T3. The data was analyzed with both a Two and Three-way Analysis of Variance (p≤0.05) to identify differences in the alignment of the maxillary and mandibular teeth and to determine differences between the two archwires. The Two and Three way ANOVA showed that there was a statistically significant difference (p≤0.05) in the alignment capabilities between the maxilla and the mandible. However, there was no evidence of a statistically significant difference (p=0.301) between NiTi and Supercable archwires at any time interval.

Influence of Periodontitis on Th17/Treg Percentages in Patients with Rheumatoid Arthritis

Wed, 30 Apr 2025 00:00:00 -0600

Th17/Treg cells and P. gingivalis have been implicated in rheumatoid arthritis (RA) and periodontitis (PE). The aim was to determine and compare Th17/Treg cells and the influence of P. gingivalis on this cell population in healthy subjects (HS) and patients with PE, RA, and PE/RA. The number of copies of P. gingivalis was performed by real-time PCR and flow cytometry was used to analyze Th17/Treg cells. In this study, PE in patients with RA increased the number of DNA copies of P. gingivalis, increasing the percentages of Th17 cells, as well as the number and regulation of Treg cells. Periodontitis influences the immune system, increasing the percentage of pro-inflammatory cells in patients with rheumatoid arthritis, which may could influence the inflammatory condition of this population.

Implant Survival Rate and Prosthetic Complications of Full-arch Implant-supported Fixed Prostheses In Edentulous Upper Jaws: A Cohort Study

Wed, 30 Apr 2025 00:00:00 -0600

Full-arch implant-supported fixed dental prostheses, an implant-supported prosthesis, which the patient must carefully manage in home oral hygiene procedures, is the fixed alternative to a mucosal-supported or implant-anchored prosthesis. Clinically, the execution of this rehabilitation requires four implants for the lower jaw and six implants for the upper jaw. The aim of the present study is to verify the survival-rate of implants for implant-fixed prostheses in the edentulous upper jaw. This retrospective study was carried out on patients who received an upper full-arch fixed prostheses on six implants for rehabilitation. A total of 36 patients were included and evaluated from a clinical and radiographical point of view. The follow-up period in which the data were collected on the upper full-arch is between 60 and 84 months. A total of 232 implants were inserted and monitored in this period. Clinical and radiographic evaluations were carried out on all 232 implants, with constant re-evaluation. The total implant survival rate is 93.1%, a value which is similar to previous studies already published on the topic. There were few prosthetic complications, mainly the fracture of anterior prosthetic teeth. Most of these full-arch, which as antagonist had another previously made full-arch implant-supported fixed dental prostheses or overdenture on four or overdenture on two implants, achieves good results in this study at 84 months.

Effects of Periodontal Treatment on CRP and Other Cellular Markers in Blood

Gisella Rojas González — Wed, 30 Apr 2025 00:00:00 -0600

Periodontitis is a chronic inflammatory disease that affects public health worldwide. It has been related to microorganisms that trigger an inflammatory response that, in turn, produces a deterioration of the teeth’s supporting tissue. In recent years, studies have shown some similarity and association between periodontitis and atherosclerotic cardiovascular disease. The serum increases in C-reactive protein (CRP), fibrinogen, alpha-1 antitrypsin, moderate increase in leukocytes, increase in sedimentation rate and Von Willebrand factor antigen make it likely that there is a relationship between periodontal disease and other systemic conditions, specifically atherosclerotic disease. This study seeks to establish if there is any relationship between these values after phase II periodontal treatment in patients with periodontitis at the Faculty of Dentistry of the University of Costa Rica. The initial values are found in a previous publication (1). In this second stage, the sample was reduced to 14 patients, of whom 57% presented metabolic compromise such as rheumatoid arthritis, arterial hypertension and diabetes mellitus, and 50% decreased PCR levels. As for the mean level of the total sample, in both stages of the study, PCR increased from 2.72 (SD: 2.25) to 5.36 (SD: 9.68). Of the patients who received periodontal treatment, 21.4% had low PCR levels (<1 mg/L), 50% medium (1-3 mg/L) and 28.6% high (>3 mg/L). There was no statistically significant difference in any of the variables analyzed for cholesterol, triglycerides and fibrinogen. Of the total number of patients in whom carotid ultrasound was performed, 52.4% were diagnosed as healthy, 33.3% had bulbar myointimal hyperplasia and 14.3% had atheromatous plaques. One of the participants died of myocardial infarction. This study does not conclude that there is a relationship between periodontal disease and cellular markers, which are also found in atheromatous disease, but it can be affirmed that there is a probability that periodontal disease contributes to affect the metabolic condition of the patient.

Morphometric analysis of the infraorbital groove, canal, and foramen on computed tomography scans of an Iranian population

Wed, 30 Apr 2025 00:00:00 -0600

This study morphometrically assessed the infraorbital groove (IOG), canal (IOC) and foramen (IOF) on computed tomography (CT) scans of an Iranian population. This cross-sectional study evaluated the CT scans of 126 patients presenting to a hospital in Qazvin city, Iran during 2020-2022, who were selected by convenience sampling. An oral and maxillofacial surgeon and an oral and maxillofacial radiologist identified the relevant anatomical landmarks and the measurements were made by a trained senior dental student. Data were analyzed by independent t-test, and Pearson’s correlation test (alpha=0.05). The mean IOC length was 9.86±1.34 mm, the mean IOG length was 12.78±1.57 mm, the mean IOC-IOG angle was 136.78±6.90 degrees, the mean IOC-vertical plane angle was 26.92±5.74 degrees, the mean IOC-horizontal plane angle was 58.54±6.18 degrees, the mean horizontal distance between the IOF and the sagittal plane passing through the supraorbital notch (SON) was 4.85±0.98 mm, the mean horizontal distance between the IOF and the sagittal plane passing through the midline was 23.04±2.90 mm, the mean vertical distance between the IOF and infraorbital rim (IOR) was 9.22±1.45 mm, the mean distance between the IOF and anterior nasal spine (ANS) was 27.63±10.99 mm, the mean angle between the IOF and ANS was 33.52±5.46 degrees, and the mean soft tissue thickness over the IOF was 10.60±2.04 mm. No significant difference was found in the parameters based on age (P>0.05). IOF-midline and IOF-IOR distances were significantly greater in males than females (P<0.05). No other significant differences were found based on gender (P>0.05). According to the results, the IOF-midline and IOF-IOR distances were significantly greater in Iranian males than females. The obtained results regarding the position of IOC, IOF, and IOG on CT scans of the Iranian study population can help maximize the success of related clinical procedures.

The Effect of Platelet-Rich Fibrin and Low-Level Laser Therapy Associated with Simplified Papilla Preservation Flaps in the Management of Supra-Alveolar Periodontal Defects

Wed, 30 Apr 2025 00:00:00 -0600

The current study aimed to evaluate and compare the effect of Platelet Rich Fibrin (PRF) and Low-Level Laser Therapy (LLLT) on the clinical outcomes when supraalveolar defects were accessed with Simplified Papilla Preservation Flap (SPPF). Forty-five patients presenting with supra-alveolar defects were allocated into three study groups with 15 patients in each group. SPPF approach was performed in each group with the addition of PRF and LLLT in the test groups. In all the study groups, a significant reduction in pocket depth was observed (P<0.001) at 6 months after therapy. The Relative Attachment Gain was significantly higher in the PRF Group (P<0.001) and in the Control Group (P=0.02) at six months compared to baseline. The study groups failed to show significant differences between them when clinical parameters were compared at six months.

Effect Of 0.2% Chlorhexidine Gel in the Management of Postoperative Pain After Pre-Prosthetic Surgery: Pilot Study

Wed, 30 Apr 2025 00:00:00 -0600

Pre-prosthetic surgical procedures such as clinical crown lengthening (CLS), can cause pain, discomfort, and postoperative inflammation; causing the need of the prescription of medications such as analgesic, anti-inflammatories and in certain cases systemic antibiotics. However, prolonged and indiscriminate use of these medications often leads to adverse effects on general health. Thus, the ideal to treat locally pain and inflammation, and to prevent local infection is promising. The objective of this preliminary study was to evaluate the controlled use of a local chlorhexidine gel (CHXg) immediately place after pre-prosthetic periodontal surgery to manage postoperative pain using a customized whitening trays. A randomized controlled double-blind parallel-group clinical pilot trial was conducted. A sample of 10 patients aged 18 to 60 years, requiring a crown lengthening procedure was selected. Two groups (Group A: 0.2% CHXg vs Group B: placebo gel). Pain scores were evaluated by using a visual analog scale (VAS), and side effects and poswas 3.32 for Group A and 4.85 for Group B (p=0.05), with results showing no statistically significant difference. Few studies have assessed the effect and influence of 0.2% CHX gel on postoperative pain control. Some reports suggest that intra-alveolar use of CHX gel is more effective than administering 10 mg of ketorolac alone. In this study, there were no statistically significant differences, indicating that the use of 0.2% CHX gel applied after pre-prosthetic surgery may not significantly reduce postoperative pain.

Evolution of Regulatory Governance for Human Research in Costa Rica

Karol Ramírez — Wed, 30 Apr 2025 00:00:00 -0600

Regulatory governance of human research derives from historical abuses of people participating in health related and non-health relates studies. Costa Rica was no exception and nowadays counts with a Regulatory Law of Biomedical Research (Law 9234) that guarantees the protection of research participants’ human rights. The aim of this narrative review is to overview the gradual development and state of the art of protections and oversight of research with humans in Costa Rica. A recapitulation of why regulatory governance for biomedical human research was enacted in 2014 will be discussed. Even so, there is no legal requirement in Costa Rica, as in other developing nations, for non-health related protocols with human participants, to undergo the scrutiny of research boards. Nonetheless, even before Law 9234 was passed, the University of Costa Rica made efforts to compel compliance with research ethics when studying humans. Therefore, another objective is to review the current ethical guidelines dictated by the University of Costa Rica and Scientifical Ethics Committee of the University of Costa Rica to conduct responsible human research. The University of Costa Rica’s institutional regulatory framework on human research, can serve as a model to other national and international institutions from developing nations, where ethical assessment of sociocultural research is relatively neglected, compared to the review of biomedical and clinical studies.

Does the Application of Anti-Erosive Substances on Eroded Dentin Affect Bond Strength? A Systematic Review

Wed, 30 Apr 2025 00:00:00 -0600

This systematic review evaluated whether using anti-erosive agents as a pretreatment of eroded dentin before bonding with resin composite affects the bond strength. A search was conducted by two reviewers in the PubMed, Embase, Scopus, Web of Science, and Science Direct databases in January 2023. Articles that employed artificially eroded human dentin and performed treatment prior to adhesion with anti-erosive substances were eligible. A validated tool with 12 items regarding in vitro studies was used to assess the risk of bias in the selected articles, obtaining a final score for each study. Four in vitro studies were included in this systematic review. Most studies used the microtensile bond strength test; most failures were adhesive or mixed. No tested substance negatively affected the bond strength to eroded dentin. Sodium fluoride (NaF), tin-containing fluoride (Sn/F) and silver diamine fluoride (Ag(NH₃)₂F) have been proven not to interfere with or improve bond strength to eroded dentin.

Intratubular Penetration Depth of Ultrasound Activated Bioceramic Sealant Cements at the Dentin-Radicular Cement Interface

Wed, 30 Apr 2025 00:00:00 -0600

To evaluate the intratubular penetration depth of ultrasound-activated bioceramic sealant cements into root dentin, specifically at the dentin-cement interface. This in vitro experimental study was conducted with samples that were randomly divided based on the type of sealer used and whether ultrasound activation was applied prior to obturation. This resulted in four experimental groups (n=40). Groups A1 and B1 utilized the Eighteeth Ultra X ultrasonic activator with a blue tip #20 featuring a 2% taper at low power for activation, while groups A2 and B2 did not employ any form of activation. The symbol (+) denotes groups with ultrasonic activation, while (-) represents groups without ultrasonic activation. In the middle third, it was observed that BioC Sealer (+) had a mean sealing value of 0.66±0.17, while MTA Fillapex (+) showed a mean value of 0.38±0.07. It was found that BioC Sealer (-) had a mean sealing value of 0.24±0.04 in the middle third, while MTA Fillapex (-) showed a mean value of 0.16±0.04. These differences were not statistically significant (p=0.569). In the apical third, the BioC Sealer (-) presented a mean sealing value of 0.44±0.17, while the MTA Fillapex (-) obtained a mean value of 0.30±0.04. However, this difference did not reach statistical significance (p=0.0745), suggesting that both materials can provide a similar seal in the apical third. The results suggest that both BioC Sealer and MTA Fillapex provide a comparable seal in the middle and apical thirds of the root canal system, however, this was not statistically significant. This indicates their potential efficacy in both endodontic sealing procedures.

Tooth Tissue Loss in Locating Mesiobuccal Canal during Selective Retreatment using Dynamic Navigation System: An In vitro Study

Wed, 30 Apr 2025 00:00:00 -0600

Selective root canal retreatment has demonstrated positive success, but the process is challenging because imprecision compromises the tooth's structural durability. As there is a lack of literature on selective retreatment using DNS, this in-vitro study was designed for comparative evaluation of tooth tissue loss and time taken in locating mesiobuccal (MB)canal using the dynamic navigation system (DNS; Navident, ClaroNav, Toronto, ON, Canada ) to the freehand (FH) method. The null hypothesis was that both methods would have similar tooth tissue loss and time required for the procedure. Twenty root canal-treated human mandibular molar teeth were mounted on Navident manikin. Using the Navident programme, the drilling path and depth were virtually designed using cone-beam computed tomographic (CBCT) scans. A minimal access cavity for locating the MB root was prepared with dynamic navigation in the DNS group and with freehand in the FH group. Volumetric tooth tissue loss was evaluated with the help of postoperative CBCT and On-demand software. Statistical analysis was done with an independent-sample T Test (p<0.05). The time taken for the procedure was recorded with a stopwatch. The tooth tissue loss was significantly less with the DNS group (35.83 mm³) compared to the FH group (52.84 mm³) with a P value of 0.001. The time taken for the DNS group was less with the DNS group (29.00 seconds) compared to the FH group (53.60 seconds) with statistical significance with a P value of 0.001. The DNS resulted in minimal tooth tissue loss with a shorter time compared to the FH group. This technique can be practised for predictable selective retreatment in endodontics.

Secondary Analysis of Public Metagenomic Data Identifies Periodontal Pathogens in the Oral but Not Gut Microbiome

Adriana Jaramillo-Echeverry, Nelson Rivera-Franco, Beatriz Parra-Patiño — Wed, 30 Apr 2025 00:00:00 -0600

The oral microbiome, particularly periodontopathogens, may influence the gut microbiome. The aim of this study was to assess the correspondence, diversity, and abundance of periodontopathogenic bacteria in oral and fecal samples from healthy adults. Secondary analyses of 12 public sequences from 6 healthy women, matched by anatomical site (gut and oral cavity), were performed using 16S rRNA-based metagenomics. The sequences were obtained from the BioProject PRJNA834584, published by the Chinese University of Hong Kong, with data generated via Illumina MiSeq. The Shaman application, which relies on Vsearch and DESeq2 for R, along with the Silva database, facilitated the determination of differential abundance and diversity at the species and genus levels between anatomical sites. After dereplication and removal of singletons and chimeras, 352 OTUs were identified. Taxonomic assignment resulted in 148 genera and 80 species, corresponding to 88.64% and 25.85% of annotations, respectively. The dendrogram displayed two distinct clusters separating oral and faecal samples, and principal coordinate analysis accounted for 53.7% of the variance by anatomical site (Permanova test, p=0.003). The Shannon diversity index was 2.14 (95% CI: 1.55-2.73) for fecal samples and 2.28 (2.03-2.53) for oral samples. The Simpson index was 0.70 (0.53-0.88) for faecal samples and 0.82 (0.76-0.88) for oral samples. Periodontopathogenic bacteria were found exclusively in oral samples, with variations in frequency. No periodontopathogenic species were detected in fecal samples. The human microbiome from two different niches in healthy adults shows distinct bacterial compositions between the oral cavity and the gut, with Bacteroides predominating in faecal samples and Streptococcus in oral samples. Greater richness was observed in faecal samples. Both microbiomes exhibited high bacterial diversity, with no significant differences.

Influence of the Cavity-Depth/light Tip-Material Distance on the Degree of Conversion and Physical Properties of a Nanohybrid Resin Composite Employing the Incremental Technique

Javier F. Roque Trujillo, Fabián Murillo-Gómez — Wed, 30 Apr 2025 00:00:00 -0600

Evaluate the influence of different cavity depth and consequent light-tip/material distance, on the degree of conversion, biaxial flexural strength and microhardness of a nanohybrid resin-composite (top/bottom), employing the incremental technique. Quadrangular samples (4x4mm) with thickness variations (cavity-depth simulation: 2, 4, and 6 mm; n=10) were made using a nanohybrid resin-composite (Forma, A3, Ultradent) employing the incremental technique. Vickers Microhardness and degree of conversion were assessed on top/bottom surfaces. Biaxial flexural strength was tested on resin-composite discs (8.5mm diameter, 2mm thick) using 3D-printed molds (vertically stacked). Microhardness and Degree of conversion data were analyzed employing 2-way/ANOVA, Biaxial flexural strength with 1-way/ANOVA.For microhardness, “distance” factor plus “surface/distance” interaction resulted statistically significant (p<0.05). The 2 mm group, followed by the 4 mm group, showed the highest results (99.41±52.23 and 84.1±15.74 VHN), while the 6 mm group had the lowest (68.60±18.69 VHN), with lower values observed on the bottom surfaces for the latter group only. Biaxial flexural strength data showed no significant differences among groups. Degree of conversion was significantly higher at the top surfaces compared to the bottom surfaces (top: 47.74±9.67%; bottom: 21.93±8.57%). At 2 and 4 mm distance, polymerization quality remained adequate (top/bottom surfaces). A 6 mm distance produced lower quality polymerization, mainly on the bottom surfaces. In such scenario, an additional photopolymerization cycle may be desirable. The current outcomes may be related only to the conditions (RBC, distances and LCU) employed in this study.

Orthodontic Management of Palatally Displaced Maxillary Canine with Bracket Modification Approach: A Case Report

Tri Minh Doan, Chau Tran Bao Vu — Wed, 30 Apr 2025 00:00:00 -0600

The maxillary permanent canine is known to be susceptible to displacement due to its long and complex journey from initial formation to its eventual placement in the occlusal position. This report presents a case of a 15-year-old female patient with a palatally positioned left maxillary canine. A fixed orthodontic approach using 0.022-slot brackets with MBT prescriptions was employed. During treatment, an open-coil spring and a power chain were utilized to reposition the canine within the dental arch. Additionally, a bracket originally designed for the upper left central incisor was rotated 180° to accommodate the displaced canine. When engaged with a 0.019 × 0.025-inch stainless steel wire, the modified bracket approach effectively provided the desired labial root torque. The modified bracket selection approach successfully delivered the intended labial root torque.

Strategy to Promote Scientific Publications in Dental Students

Jorge H. Wilches-Visbal, Midian C. Castillo-Pedraza — Wed, 30 Apr 2025 00:00:00 -0600

The Role of the Endodontist in Palliative Care

José Pablo Meneses Guzmán — Wed, 30 Apr 2025 00:00:00 -0600

This article addresses the crucial role of the endodontist in Palliative Care, focusing on the oral health of individuals with advanced diseases or a limited life expectancy. It highlights the importance of early detection of subclinical pathologies and the prevention of oral complications that can impact the patient's quality of life (1). The endodontist, as part of a multidisciplinary team, contributes to the planning of non-invasive treatments and the improvement of patient well-being (2). Additionally, the article underscores the need for academic training in Palliative Care for endodontists, as well as the importance of communication with other professionals responsible for each case. It also discusses the necessary precautions for patients undergoing bisphosphonate treatment and the importance of conducting detailed diagnoses before performing surgical procedures (5).