Odovtos - International Journal of Dental Sciences
Odovtos – International Journal of Dental Sciences (Odovtos-Int J Dent Sc) is the official scientific publication of the Faculty of Dentistry, University of Costa Rica. The main objective of this peer-reviewed journal is to disseminate original and transcendental knowledge in the field of dentistry and its specialties. Odovtos-Int J Dent Sc primary readership consists of dentists, dental educators, academics, dental students, researchers, health professionals and general public interested in expanding their knowledge in the area. Our journal consider unpublished and original manuscripts in ENGLISH with a prominent focus on critical and innovative data, promoting major clinical, academic and scientific research, based on International Committee of Medical Journal Editors (ICMJE) recommendations. Odovtos - Int J Dent Sc offers Online-First publication, allowing frequent dissemination of its content. You can access our Journal Normalized Citation Impact and Citation Impact in InCites-Clarivate: Incites - Clarivate Citation Impact 2025 JCR Impact Factor list of Clarivate Analytics: 0.9 Qualis 3 SCOPUS WHY SUBMIT YOUR PAPER TO OUR JOURNAL? Odovtos – International Journal of Dental Sciences compromises to disseminate their contents worldwide, through collaborations with several Dental Schools, online databases, index and repositories, website, social media, among others. All submitted manuscripts are peer-reviewed based solely on the criteria of quality, innovation and pertinence. The pre-publication process is brief due to online submission. Moreover, Odovtos-Int. J. Dent. Sc. is an Online-First Journal, which allows frequent publication in Internet according to Open Access Initiative, favoring the diffusion of its content. Journal indexed: ODOVTOS is indexed in Clarivate Analytics with a 2025 JCR Impact Factor list of Clarivate Analytics: 0.9 <a href="https://www.scimagojr.com/journalsearch.php?q=21101088429&tip=sid&clean=0#:~:text=%3Ca%20href%3D%22https%3A//www.scimagojr.com/journalsearch.php%3Fq%3D21101088429%26amp%3Btip%3Dsid%26amp%3Bexact%3Dno%22%20title%3D%22SCImago%20Journal%20%26amp%3B%20Country%20Rank%22%3E%3Cimg%20border%3D%220%22%20src%3D%22https%3A//www.scimagojr.com/journal_img.php%3Fid%3D21101088429%22%20alt%3D%22SCImago%20Journal%20%26amp%3B%20Country%20Rank%22%20%20/%3E%3C/a%3E"> Our journal is also indexed in: Scopus SCIELO REDALYC LATINDEX LILACS DIALNET ESCI-CLARIVATE ANALYTICS REDIB PERIODICA ICJME MIAR ROAD BIBLAT EUROPUB EBSCO PROQUEST ULRICHS COPAC PKP INDEX JOURNAL TOCS DRJI DAIJ J-GATE INDEX COPERNICUS
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Machine Learning-Based Risk Stratification Models Incorporating Systemic Health Factors for Identification of Clinically Significant Periodontitis
To develop and internally validate machine learning–based risk stratification models integrating periodontal and systemic health variables to identify patients with clinically significant (moderate-severe) periodontitis, and to evaluate their discrimination, calibration, interpretability, and potential adjunctive clinical utility. An observational analytical study was conducted using clinical, radiographic, and systemic health data from 268 systemically compromised patients. Multiple supervised machine learning algorithms, including logistic regression, random forest, and gradient boosting, were developed to classify periodontal disease status as a binary diagnostic outcome. Internal validation was performed using repeated cross-validation and an independent test dataset. Diagnostic performance was assessed using area under the receiver operating characteristic curve (AUC-ROC), accuracy, sensitivity, specificity, and Brier score. Calibration plots and decision curve analysis were used to evaluate reliability and potential clinical utility. Model interpretability was assessed using Shapley Additive Explanations (SHAP). Moderate to severe periodontitis was identified in 49.3% of patients. Among the evaluated models, the gradient boosting classifier demonstrated the highest diagnostic performance, with an AUC-ROC of 0.89, accuracy of 83.5%, sensitivity of 82.4%, specificity of 84.7%, and a Brier score of 0.13. Incorporation of systemic health variables improved diagnostic discrimination compared with models using periodontal variables alone. Explainable AI analysis identified clinical attachment loss, probing pocket depth, and duration of diabetes mellitus as key diagnostic contributors. Artificial intelligence-based diagnostic classification models integrating periodontal and systemic health data demonstrated high diagnostic accuracy, reliable calibration, and favourable clinical utility in identifying moderate to severe periodontitis among systemically compromised patients. These models may serve as adjunctive diagnostic decision support tools in periodontal care; however, external validation in independent populations is required before clinical implementation.
Artificial intelligence; Periodontitis; Systemic diseases; Machine learning; Clinical decision support; Explainable AI.
Copyright (c) 2026 Vishnu Priya Veeraraghavan, Ravikanth Manyam, Aysha Jebin A., Sanjana Sharma, Santosh R. Patil. https://creativecommons.org/licenses/by-nc-sa/4.0
Changes in Irradiance and Polymerization Efficiency According to the Operating Cycle of Light-Curing Units
Curing lights are indispensable devices in restorative dentistry, as they provide the necessary energy for resinous materials to achieve adequate mechanical, chemical, and physical properties. However, their performance depends not only on the irradiance reported by the manufacturer but also on the stability of the emission throughout usage cycles. Therefore, the objective of this study was to establish, based on current literature, how usage cycles modify the irradiance of curing lights and how this variation affects polymerization efficiency. The results showed that as the battery discharges or usage cycles accumulate, irradiance and dose decrease, leading to a reduction in the effective energy received by the restorative material and compromising the conversion rate, especially in wireless and low-cost lights. It is concluded that the stability of irradiance across cycles should be considered a critical factor for achieving adequate curing. Periodic monitoring of the lamps is a fundamental measure to preserve the quality and longevity of the restorations.
Photopolymerization; Composite resins; Irradiance; Light-curing units; Use cycles.
Copyright (c) 2026 Paulo C. Camargo-Melendez, Jorge H. Wilches-Visbal. https://creativecommons.org/licenses/by-nc-sa/4.0
Obstructive Sleep Apnea: A Case Report and Literature Review
Obstructive sleep apnea (OSA) is a sleep disorder caused by upper airway obstruction during sleep, leading to airflow interruption. Despite its increasing prevalence, OSA remains largely underdiagnosed. This literature review and case report aims to update the dental community on the diagnosis and management of OSA while presenting the case of a patient treated with a multidisciplinary approach including surgical intervention. We report the case of a 27-year-old patient with a chief complaint of respiratory impairment, snoring, and unaesthetic chin projection, associated with daytime sleepiness, headaches, severe snoring, fatigue, and extreme exhaustion. The patient presented with a BMI of 32 kg/m², a class II dentofacial deformity, mandibular retrognathism, and moderate OSA (apnea-hypopnea index: 22), and was treated with maxillomandibular advancement (MMA) with counterclockwise rotation of the occlusal plane, genioplasty and lifestyle modifications. The intervention resulted in a reduction of the Apnea-Hypopnea Index to 0.5 events/hour and a favorable esthetic and functional outcome. Long-term weight management remains crucial to prevent recurrence, while annual follow-up ensures appropriate monitoring. This case supports existing evidence on the benefits of surgical correction in appropriately selected patients and highlights the importance of multidisciplinary management in OSA treatment.
Obstructive sleep apnea; Orthognatic surgery; Maxillomandibular advancement; Le Fort type I osteotomy; Counterclockwise rotation; Bilateral sagittal split osteotomy; Case report.
Copyright (c) 2026 Mauricio E. Muñoz-Pereira, Valeria Martínez-Archer. https://creativecommons.org/licenses/by-nc-sa/4.0
GO-Sr-Se Multi-Doped Nanohydroxyapatite Synergistically Promotes BMSCs Osteogenic Differentiation, and Antibacterial Efficacy: In Vitro Study
Nanohydroxyapatite (nHA) is one of the most widely used bone-substitution materials in biomedical applications. Some clinical scenarios involving extensive bone loss and bony infections may require further development of therapeutic modalities to enhance material characteristics. Doping nHA with some metal ions can improve its physical and biological properties and address its limitations. Therefore, the ongoing study aims to examine the role of doped nanohydroxyapatite with graphene oxide (GO), strontium (Sr), and selenium (Se) ions (GO-Sr-Se-doped nHA) formulation as a potential bone substitution material on bone marrow stem cells (BMSCs). Within this study, nHA and GO-Sr-Se-doped nHA were synthesized by the microwave-assisted sol-gel technique. BMSCs were isolated from rats and treated with these two types of nanoparticles. Their effect on BMSCs’ osteogenic potential was evaluated by alkaline phosphatase (ALP) activity, and calcium mineralization was assessed by Alizarin Red S (ARS). Antibacterial activity against both Staphylococcus aureus and Escherichia coli was also assessed through the agar diffusion method. GO-Sr-Se-nHA supplementation of the culture medium significantly increased both ALP enzyme production (P<0.05) and calcium mineral deposition (P<0.05) and significantly inhibited the growth of both Escherichia coli and Staphylococcus aureus (P<0.05). Our results indicated that GO-Sr-Se-nHA doped nanoparticles could enhance BMSCs osteogenic differentiation, with potent antibacterial activity if compared to plain nHA, making them a suitable candidate for treating bone defects and their use in future bone regenerative applications.
Hydroxyapatite; Nanoparticles; Strontium; Selenium; Bone marrow; Stem cells.
Copyright (c) 2026 Mariam Salah Ibrahim Hassan, Galal ElDeen Mosaad Sadek, Ahmed Wael Abouzeid, Radwa Hamed Hegazy, Sara El Moshy. https://creativecommons.org/licenses/by-nc-sa/4.0
Dimensional Accuracy of Additively Manufactured Dental Models Compared with Conventional Gypsum Casts Across Different Measurement Spans: An In Vitro Study
Accurate dental models are critical for achieving predictable outcomes in prosthodontics; however, the transition from conventional to digital workflows raises concerns regarding dimensional reliability across different clinical scenarios. This in vitro study evaluated the dimensional accuracy of conventional gypsum casts and additively manufactured dental models using standardized linear measurements derived from a metal master reference model, with particular emphasis on span-dependent behavior. Twenty definitive models were divided into 2 groups (n=10): gypsum casts obtained from addition silicone impressions and resin models fabricated through intraoral scanning followed by LCD-based 3-dimensional printing. Ten predefined linear distances were measured using a digital Vernier caliper (±0.01 mm), and deviations were calculated relative to the reference model. Statistical analysis included Shapiro–Wilk testing and independent t tests or Mann–Whitney U tests (α=.05). Gypsum casts demonstrated significantly smaller deviations in localized measurements (0.05-0.12 mm) compared with additively manufactured models (0.22-0.44 mm) (P< .05). For inter-point distances, both workflows showed comparable performance in selected spans, whereas differences became evident in longer transverse measurements. No significant differences were observed in diagonal dimensions. Dimensional discrepancies were not uniformly distributed, indicating that measurement span influences accuracy outcomes. Within the limitations of this study, gypsum casts remain more precise for short-span measurements, while additively manufactured models provide comparable accuracy over broader distances. Both workflows produced deviations within clinically acceptable ranges, supporting the use of additively manufactured models as a reliable alternative in digital prosthodontic workflows, particularly when full-arch spatial relationships are prioritized.
Models, Dental; Printing, Three-Dimensional; Imaging, Three-Dimensional; Computer-Aided Design; Dental Impression Materials; Prosthodontics.
Copyright (c) 2026 Leonard Walter Huamani Diaz, Henry Flores Concha, Jorge Yóplac Hung, Liliana Tumbalobos Carhuas, Consuelo Marroquín-Soto, César-Augusto Padilla-Avalos. https://creativecommons.org/licenses/by-nc-sa/4.0
Use of Remote Intervention Tools for the Assessment of Oral Alterations in the Context of Oral Cancer Prevention: A Scoping Review
To map the use of remote digital intervention tools for the identification of oral lesions suspected of malignancy, describing outcomes, user and professional acceptance, and contributions to the early diagnosis of oral cancer. The review followed the PRISMA-ScR guidelines and searches were conducted in PubMed, Scopus, Embase, LILACS, Web of Science, and grey literature, without restrictions on publication date, geography or language. Articles that helped to answer the question “How can remote intervention tools contribute to the evaluation of oral alterations in the context of oral cancer prevention?” were considered eligible for inclusion. Two independent reviewers (MEM and MLR) performed the articles selection and data extraction. A total of 230 records were identified; of these, 18 met the inclusion criteria. Most interventions were asynchronous, were based on mobile applications and digital platforms, and usually focused on communication between professionals. The majority of studies reported good diagnostic accuracy, a reduction in unnecessary referrals, and feasibility in resource-limited settings. According to this review, most remote intervention tools are based on asynchronous interaction among professionals, with diagnostic accuracy as the main outcome. The results are satisfactory and good agreement with in-person clinical examination is observed. When well structured, digital tools represent promising strategies to expand the reach of preventive actions and promote the early diagnosis of oral cancer.
Early detection; Oral cancer; Prevention; Remote consultation; Telehealth; Teledentistry.
Copyright (c) 2026 Maria Eduarda Merlin, Maria Laura Rosse, Alan Grupioni Lourenço, Ana Carolina Fragoso Motta. https://creativecommons.org/licenses/by-nc-sa/4.0
Impact of Endodontic Obturation Technique on the Adhesive Interface Between Fiber Post Cementation System Using Universal Adhesive and Radicular Dentin
This study evaluated the incidence of residues on dentin after endodontic obturation using warm vertical condensation (WC), cold single cone (SC), and lateral condensation (LC) techniques, as well as their effect on push-out bond strength and adhesive failure mode of a fiber post cementation system using a universal adhesive (Ambar Universal Plus APS). Sixty roots underwent chemo-mechanical preparation and were distributed into three groups (n=20) according to the obturation technique. Post space preparation was performed after 7 days. Thirty roots (n=10 per group) were subjected to scanning electron microscopy analysis to assess the incidence of residues on dentin. In the remaining thirty roots, fiber posts were cemented using the universal adhesive with a conventional resin cement and subsequently subjected to the push-out test. All analyses were conducted at the cervical, middle, and apical thirds of the post space. Data were analyzed considering the factors “obturation technique” and “root canal third,” with a significance level set at 5%. The WC technique showed the lowest incidence of residues on dentin and the highest push-out bond strength values, regardless of the root canal third evaluated (P<0.05), whereas SC and LC demonstrated similar results for both analyses (P>0.05). The warm vertical condensation technique improved the adhesive performance of fiber post cementation using a universal adhesive, likely due to reduced residual obturation materials on radicular dentin, independent of the root canal third, while cold single cone and lateral condensation techniques exhibited comparable behavior.
Adhesion; Endodontics; Root Canal; Fiber Post.
Copyright (c) 2026 Antonia Patricia Oliveira Barros, Jesús Aranda Rojas López, Joatan Lucas de Sousa Gomes Costa, Wilfredo Gustavo Escalante-Otárola, Gabriela Mariana Castro-Núñez, Milton Carlos Kuga. https://creativecommons.org/licenses/by-nc-sa/4.0
Biocompatibility and Elemental Characterization of Bioceramic Root Canal Sealers vs Resin Sealer AH Plus
Root canal sealers must be biocompatible with periapical tissues and exhibit adequate physicochemical properties. This study aimed to characterize and evaluate the biocompatibility of two commercially available bioceramic root canal sealers (NeoSEALER Flo and AH Plus Bioceramic Sealer) and one epoxy-amine resin–based sealer (AH Plus). Surface morphology was analyzed by scanning electron microscopy (SEM), chemical composition by Fourier Transform Infrared Spectroscopy (FTIR), and radiopacity according to ISO 6876 specifications. Biocompatibility was assessed using human gingival fibroblasts (hGFs) through WST-1 cell proliferation assay after 24 and 48 h. All sealers demonstrated adequate cytocompatibility, with no cytotoxic effects observed. AH Plus showed significantly higher cell proliferation at 24 h, while AH Plus Bioceramic exhibited increased proliferation at 48 h. SEM analysis revealed distinct surface topographies among materials, with AH Plus presenting a more homogeneous surface and bioceramic sealers showing granular and porous structures. FTIR confirmed the characteristic chemical composition of each material. All sealers met ISO radiopacity requirements, with AH Plus exhibiting the highest radiopacity. All evaluated sealers demonstrated suitable biological and physicochemical properties.
Root canal sealers; Biocompatibility; Human gingival fibroblasts; Characterization.
Copyright (c) 2026 Eduardo Adrián Sánchez Barajas, Alejandra Rodríguez Hidalgo, Marine Ortiz Magdaleno, Rafael Álvarez-Chimal, Amaury Pozos-Guillén, Febe Carolina Vázquez Vázquez. https://creativecommons.org/licenses/by-nc-sa/4.0
Mobile Health Apps for Oral Cancer-A Scoping Review of User Experience
Mobile health (mHealth) applications have become a tool for enhancing awareness, facilitating early detection, aiding diagnosis, and supporting treatment follow-up. However, the sustainability and effectiveness of these applications depend on user experience (UX) influencing adoption, engagement, and trust. A comprehensive, independent search was conducted in 3 databases (PubMed-Medline, Scopus, Embase) and 2 additional sources (ScienceDirect and Google scholar) from inception till 10th September 2025, adhering to Preferred Reporting Items for Systematic Reviews and Meta-analysis: Extension for Scoping Reviews checklist. Study designs such as experimental, quasi-experimental, cohort, case-control, and cross-sectional assessing users of all ages their experiences towards oral cancer based mobile applications were included. Experiences were assessed in terms of adoption, acceptance, usability, feasibility and satisfaction. Two independent reviewers screened the articles with 0.89 agreement rate as per Cohen’s kappa. Rayyan AI software was used for screening. Narrative evidence synthesis approach was used to present the extracted data. The initial search identified 693 studies, of which 7 met inclusion criteria. Across studies, usability, feasibility, acceptance, adoption, and satisfaction were reported positively among healthcare professionals, patients, and community participants. Usability and feasibility were higher among applications with offline functionality or stable internet connectivity and digital literacy. Acceptance and adoption were high across user groups, although medicolegal concerns were reported by professionals. Satisfaction was associated with internet connectivity and gender, with higher ratings among men. Professionals prioritized clinical utility and documentation, whereas non-clinical users focused on ease of use and health awareness. mHealth applications for oral cancer are generally well received across user groups with a positive user experience. Future research should prioritize usability assessments using standardized tools. Tailoring app design to address the priorities of all user groups will improve user experience, which will be key to driving adoption and sustained use.
Oral cancer; Mobile health applications; Digital health; Health behavior; Technology acceptance; Patient satisfaction.
Copyright (c) 2026 Elakeya Udhaya, Dilip Kumar, Sapna Negi, Ankita Mathur, Toufiq Noor, Vini Mehta. https://creativecommons.org/licenses/by-nc-sa/4.0
Halitosis: Basic Principles About its Origin and Treatment Narrative Review
Halitosis is the presence of an unpleasant smell that emanates from the oral cavity. The etiology of halitosis is multifactorial, existing non oral, oral and extraoral causes. The volatile sulphur compounds (VSC): hydrogen sulfide and methyl mercaptan are the prominent elements of malodour. Intraorally there is a significant correlation between VSC concentrations and periodontopathogenic bacteria. In patients with no gum disease the halitosis is originated mainly in the dorsal surface of the tongue, so cleaning or brushing it is an effective method to prevent or decrease halitosis. There are multiple chemical options for the treatment of the malodour that will depend on the origin and severity of it. This article reviews the origin and mechanical and chemical treatments that are available.
Copyright (c) 2018 Odovtos - International Journal of Dental Sciences https://creativecommons.org/licenses/by-nc-sa/4.0
Complex-Compound Odontoma: A Rare Clinical Presentation
Odontomas can be detected as complex or compound variants and they rarely show the histologic characteristics of both types together. The tumor commonly associated with malocclusion, eruption disturbances and pathological anomalies, but they seldom cause bony expansion. Early detection and management of odontoma with multidisciplinary approach pose an important role to prevent disturbances associated with this common odontogenic tumor. Here we report a rare case of an odontoma which show the features of both complex and compound types and also cause bony expansion, eruption failure in an 8-year-old boy.
Radiographic Evaluation of the Presence/Agenesis of Third Molars in a Mexican Child Population
In the human being, third molar is the tooth that exhibits more variants during its embryologic development, usually causing diverse anomalies and discomfort when erupting to the oral cavity. It has been pointed out that the prevalence of third molar agenesis is between 9 to 37%. The aim of the present comparative cross-sectional study was to radiographically assess the presence/absence of third molar germs (G3M) in a sample of pediatric patients of Mexican origin. A total of 513 panoramic radiographs were analyzed from patients attending the Pediatric Dentistry Postgraduate Program ( San Luis Potosí University, México), during the years 2011 to 2017. Inclusion criteria were patients between 7 and 18 years old, any gender; children with antecedents of a third molar extraction, previous orthodontic treatment, or with an associated congenital or systemic condition were excluded. Total prevalence G3M agenesis was calculated. Then, statistical comparisons of agenesia proportions per dental quadrant, gender, and age group were performed. 245 panoramic radiographs corresponded to the female gender, while 268 belonged to the male gender. The total prevalence of G3M agenesia was estimated in nearly 56%, and the 7-8 years old group exhibited the highest proportion; however, when this age group was excluded from the analysis, such prevalence decreased to 27.3%. Both mandibular quadrants showed higher proportions of G3M agenesia. There were no significant differences between genders. The total prevalence reported in the present study was found to be well above regarding the international parameters. It is quite possible that lack of radiographic visualization of G3M had been inaccurate in some cases due to the common absence of calcification traces from those teeth during early ages (7-8 years old). The adjusted analysis provided a prevalence value more in line with the recognized standards in the dental literature.
Remineralizing Effect of Xilitol, Juniperus Communis and Camellia Sinensis Added to a Toothpaste: An In Vitro Study
The aim of this study was to explore the remineralizing effect of toothpastes based on Xilitol, Camellia Sinensis and Juniperus Communis. An in vitro experimental study was carried out in an 18 human premolars sample, which were treated with one of the 3 evaluated toothpastes and a control fluoride one. The atomic percentages of Ca and P were evaluated by Energy Dispersive X-ray Spectroscopy (EDS). In addition, the enamel surface of treated teeth was visualized by Scanning Electron Microscopy (SEM). The evaluations were carried out in three stages: pre-treatment, after an artificial demineralization process and after the treatment with the toothpastes. In the statistical analysis, the one-way ANOVA and Pearson correlation tests were used. Xilitol and Juniperus Communis showed the greatest gain of P ions compared to the control group (p<0.01). As for Ca, the group treated with xylitol-based toothpaste showed more ion gain compared with the control group (p<0.01). In the Pearson correlation test between Ca and P, statistically significant correlations were observed in all groups (p<0.01), ranging between r=0.7413 (Xylitol Group) and r=0.9510 (Control Group). We concluded that Xylitol paste showed the highest remineralizing property, both in the EDS analysis and in the SEM images.
Rogelio J. Scougall-Vilchis DDS, MSc, PhD
Management of a Child with Reactive Attachment Disorder in the Dental Clinical Setting: A Case Report
Reactive attachment disorder (RAD) is an early childhood mental health disease characterized by impaired social interactions and communication abilities, and neurological deficits in the child’s developing brain. This disorder can significantly affect the pediatric patient’s behavior in the dental setting. An uncooperative 9-year-old Mexican girl, who was residing in a temporary home, was referred by a general dental practitioner to the Postgraduate Pediatric Dental Clinic with her caretaker, requesting dental examination and treatment. The patient presented with a previous diagnosis of RAD with intellectual/social disability. With the psychiatrist’s guidance, an exhaustive oral prophylaxis was carried out in the initial appointments, followed by diverse restorative treatments under the continuous application of behavioral management techniques. These restorative procedures included resin restorations and pit-fissure sealants, under local anesthesia and rubber-dam isolation, on the first four permanent molars. The entire treatment was completed in six weeks. The patient and her caretaker were provided with detailed educational and motivational strategies for improving the patient´s oral hygiene, and they also received nutritional advice. For control reviews and the reinforcement of preventive habits, future appointments were carefully scheduled. An interdisciplinary pediatric collaboration between the dentist, nurse, and psychiatrist was fundamental for improving the patient’s oral health and general welfare.
Childhood reactive attachment disorder; Dental management; Pediatric psychiatric disorders
Copyright (c) 2019 Arturo Garrocho-Rangel DDS, PhD, Hilda Romero-Huízar DDS, Socorro Ruiz-Rodríguez DDS, MS, Nadia P. Campos-Lara DDS, Fernando Pozos-Guillén MD, Amaury Pozos-Guillen DDS, PhD (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
A Fiberglass and Resin Post Technique Combined with Fragment Collage of an Upper Central Incisor: Multidisciplinary Treatment
The clinical treatment of anterior tooth fractures requires specialized knowledge, technical skill, and a degree of artistic sense to ensure successful treatment. Herein, we describe the reattachment of an original tooth fragment with endodontic involvement via the utilization of a micro-hybrid composite resin and an aesthetic fiberglass post.
Juan Carlos Ramírez Barrantes DDS, MSD, PhD
Impact of Two Distinct Dental Anesthesia Simulation Models on the Perception of Learning by Students
We evaluated an infiltration anesthesia simulation model (IAM) and a conduction anesthesia simulation model (CAM) on the perception of learning by Mexican dental students. Our aim was to compare the perception of learning by dental students trained with two distinct dental anesthesia simulation model (DASM) with dental students who were not trained with a DASM. 3 groups participated in the study: G1 (N=12 students) learned to block the mental nerve (BMN) by participating in a theoretical lecture (stage 1) and a clinical demonstration (stage 2); G2 (N=12 students) learned the BMN by participating in the stage 1, stage 2, and training with the CAM; G3 (N=12 students) learned the BMN by participating in the stage 1, stage 2, and training with the IAM. The groups performed the BMN in a clinical exercise. Working-time of all participants was timed. Perception of learning for all participants was evaluated with a 5-point Likert Scale. The results showed that statistically significant differences were found between score of G1 and score of G2 and score of G3 (P<0.05). No statistically significant differences were found between scores of G2 and scores of G3. G1, G2 and G3 showed an average working-time of 12:42 minutes, 9.75 minutes and 8:03 minutes, respectively (P<0.05). We concluded that the IAM and CAM showed a positive impact on the perception of learning, and the students trained with the IAM showed a shorter working time compared with the students trained with the CAM.
Dental anesthesia simulation model; Dental education; Simulation based learning; Perception of learning; Likert scale.
Bernardino I. Cerda-Cristerna DDS, MSc, PhD
Copyright (c) 2019 Jadith Merino-Parra DDS, Ricardo E. Madrazo-Meneses DDS, Takashi Komabayashi DDS, MSc, PhD, Bernardino I. Cerda-Cristerna DDS, MSc, PhD (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Knowledge of Parents about Bruxism in their Children
Objective: Bruxism is a jaw muscle activity disorder characterized by clenching or grinding of the teeth and can be seen in both children and adults. The purpose of this study is to evaluate the parental knowledge about bruxism in children. Methods: A cross-sectional study was conducted with 265 parents whose children were attended at University of Mersin pediatric dentistry and oral and maxillofacial surgery clinics. Children’s ages varied from 6 months to 16 years old. A 20-questioned questionnaire was used to collect the data. IBM SPSS Statistics 22 for statistical analysis (SPSS IBM, Turkey) program was used for the analysis. Results: A total of 265 parents (159 were female and 106 were male) participated in the study. The majority of the parents were between the ages of 31-40 (60.8%). The rate of clenching and grinding of teeth during sleep (21.5%) was higher than the rate when they were awake (7.2%). The ratio of the parents seeking treatment for their children because of this harmful habit was very low (3.8%). The majortiy of parents (37.7%) reported that they seek help from dentists. The participants believed that bruxism was associated with dental problems (33.6%) and emotional factors (32.8%). A significant difference was found between the educational background of the parents and the ability to define bruxism. Conclusion: Parents had inadequate knowledge about bruxism in children and this was mostly related to the educational background of the parents.
Bruxism; Parents; Knowledge; Awareness; Child; Surveys; Questionnaires
Copyright (c) 2019 Secil Calıskan DDS, PhD, Ebru Delikan DDS, MDs, Ayse Ozcan-Kucuk DDS, MDs (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Effect of Polishing Systems on Fluoride Release and Surface Roughness of Different Restorative Materials
Secondary caries is an important factor in the replacement of the restorations, and it is thought that fluoride-releasing materials may prevent this problem. Furthermore, the fluoride release of the materials may be increased by polishing process. Available knowledge about the effect of polishing systems (PS) on the fluoride release of materials is limited. Therefore, this study was conducted to evaluate the effect of PS on the fluoride release of fluoride-containing materials. Restorative materials were divided into 6 groups: Fuji IX GP, Fuji II, Dyract XP, Beautifil II, Beautifil-Bulk, and Filtek Ultimate. Each group was also divided into four subgroups: Mylar strip, Sof-Lex Discs, Sof-Lex Diamond, and OneGloss. Fluoride release was determined using a fluoride ion-selective electrode. Surface roughness was evaluated with a profilometer. Two-way repeated measure and one-way ANOVA tests were used for statistical analysis. The initial rapid fluoride release was observed only in Fuji IX. The PS increased the fluoride release of Fuji IX and Fuji II and Dyract XP materials while reducing the fluoride release of resin-based materials. The highest surface roughness values were obtained with OneGloss. Further, a significant relationship between fluoride release and surface roughness was found. The polishing provides an increase in fluoride release, especially in glass-ionomer-based materials. This article revealed that there is a relationship between fluoride release and surface roughness. Proper PS must be chosen according to the material to provide the best clinical benefits in terms of fluoride release and surface roughness.
Compomers; Composite resins; Dental materials; Fluorides; Glass ionomer cements.
Copyright (c) 2019 Soner Şişmanoğlu DDS, PhD, Burak Gümüştaş DDS, PhD, Zuhal Yıldırım-Bilmez DDS, PhD (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
In Vitro Effect of Temperature on Dentin Bond Strength of Universal Adhesive Systems
The aim of this study was to evaluate the shear bond strength (SBS) of two universal adhesives (Universal Single Bond and All Bond Universal) and a two-step self-etch adhesive system (Clearfil SE Bond) to dentine at various temperatures. Materials and Methods: One hundred and twenty dentin specimens were divided randomly to 12 groups, according to adhesive systems (Universal Single Bond and All Bond Universal, Clearfil SE Bond) and temperature ( 4ºC, 20 ºC, 36ºC, 55ºC) used. Dentin specimens were prepared (n :10, adhesives were applied, and composite cylinders were polymerized. Statistical analysis of the SBS data was performed using Two-way analysis of variance (ANOVA) and Tukey’s Honestly Significant Differences post-hoc test. Results: The Clearfil SE Bond was shown to have higher SBS than the universal adhesives at all temperatures; however, there was no statistically significant difference (P>0.05). In both groups, the lowest SBS values were observed in the samples at 4°C while the highest SBS values were observed in the samples at 55°C. In this case, there was a statistically significant difference (P<0.05). Conclusions: The results suggest that the effectiveness of an adhesive may increase if it is preheated at 36°C or above before use instead of being used immediately after removal from the refrigerator or at room temperature.
Shear bond strength; Universal adhesive systems; Preheating.
Copyright (c) 2019 Serdar Akarsu DDS, PhD, Sultan Aktuğ Karademir DDS (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Surgical Complications Associated to Maxillary Sinus Floor Elevation in Implantology
Maxillary sinus floor elevation has been extensively documented as a safe and predictable procedure for gaining vertical bone height in the atrophic posterior maxilla. Even though, complications have been reported, which can potentially jeopardize the outcome of the regeneration and implant therapy. Therefore, the purpose of this literature review is to present, debate and analyze the different complications that can occur during a sinus floor elevation.
Maxillary Sinus; Sinus Floor; Sinus Floor Augmentation; Membrane; Septum.
Copyright (c) 2019 Deisy E. Quispe Damián DDS, MSc, Carmen T. Castro-Ruiz DDS, MSc, Gerardo Mendoza Azpur DDS, MSc (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Bruxism in Children and Adolescents: A Review of the Literature
Bruxism is defined as a repetitive activity of the chewing muscles characterized by clenching or grinding of the teeth and/or by striking and swinging the jaw. It is of multifactorial etiology and it is considered that there is a physiological bruxism necessary for the development of the face of children. These two aspects complicate the diagnosis that is fundamentally based on a questionnaire to the parents and on the clinical examination of the child. When the physiological wear does not differentiate in time from the parafunctional wear, it has negative consequences in the child that alter their quality of life, requiring an adequate multidisciplinary management. Considering that it is necessary to know the fundamental characteristics of bruxism in children and adolescents, the objective of this review article is to update its circadian manifestations, classifications, prevalence, etiology, risk factors, diagnosis and treatment that will serve the dentist for the early identification and treatment.
Bruxism; Sleep bruxism; Grinding; Children; Adolescent
Copyright (c) 2020 Viviana Abigail Alvarez-Gastañaga, Mercedes Carolina Baldeón-López, Violeta Malpartida-Carrillo CD, Mg, Esp (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Effect of Light Curing Modes on the Color Stability of a Nanohybrid Composite Immersed in Different Beverages
Aim: Sufficient polymerization remains as crucial for composites to prevent discoloration. Both LEDs and halogen units are used for polymerization and different curing modes are improved to overcome inadequate polymerization. This in vitro study investigated staining susceptibility of a nano-hybrid resin composite light-cured in different modes and immersed in different staining media. Methods: Disc-shaped specimens were prepared from nano-hybrid resin composite (Filtek Z550) and light-cured according to following modes: Halojen (GI), LED standard (GII), LED pulse (GIII) or LED ramp (GIV). Half of the specimens of each group (n=7) were stored in one of the staining media (red wine or coffee) for 10 min/day during experimental period. Measurements were performed using spectrophotometer according to CIEL*a*b system at baseline and on 7, 28 and 56 days. Colour differences (∆E) between groups were submitted to statistical analysis. Results: Regarding 7-day evaluation, colour change values of specimens immersed in coffee revealed no remarkable difference among curing modes (p>0.05); whereas specimens in GIV were significantly less stained compared to specimens in GII and GIII when immersed in red wine. Regarding 56-days of evaluation, specimens of GIV showed statistically significant colour change in red wine compared to other groups. However specimens in GI revealed the least staining after 56-days of coffee immersion, and this result was statistically different from LED groups. Conclusion: This study suggest that light-curing mode influences the staining susceptibility of the tested composite. Composites polymerized with halogen unit showed lower staining than all LED modes. Despite novel light sources, halogen units may still used reliably at clinics.
Composite resin; LED units; Halogen units; Light curing modes; Color stability; Polymerization
Copyright (c) 2020 Gunce Ozan PhD, Hande Sar Sancakli DDS, Murat Tiryaki PhD, Isil Bayrak PhD (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Effects of Different Storage Conditions on Mechanical Properties of CAD/CAM Restorative Materials
The aim of this study was to evaluate mechanical properties of six new-generation all-ceramic materials for CAD/CAM (Lava Ultimate [LU], VITA Mark II [VM], InCoris TZI [IC], IPS e.max CAD [EM], VITA Suprinity [VS], IPS Empress CAD [EC]) and two different provisional restoration CAD/CAM materials (Telio CAD [TC], Vita CAD-Temp [VC]) after different storage conditions. 36 bar-shaped samples of 4 mm in width and 14 mm in length with 1.2 mm thicknesses were prepared from each material group (N=288). The specimens from each material were kept under three different storage conditions (n=12): under dry conditions at room temperature; 37°C distilled water for 7 days; and 37°C distilled water for 7 days followed by 10,000 thermal cycles. All specimens were subjected to a 3-point flexural test with a crosshead speed of 1.0 mm/min. The specimens were loaded until failure. Twelve fractured specimens after the flexural test from each group were used for the Vickers hardness test (under 300 gf of loading in 15 seconds). The flexural modulus, flexural strength and Vickers hardness values were separately analyzed with two-way analysis of variance, Tukey’s multiple comparison tests at a significance level of p<0.05. There were statistically significant differences between materials and storage conditions according to flexural modulus, flexural strength and Vickers hardness values (p<0.05). The flexural strength, flexural modulus and Vickers hardness values of LU, VC, TC, VS and IC decreased after water storage followed by thermal cycling (p<0.05). The mechanical properties of provisional restoration CAD/CAM materials had showed a significantly decrease after water storage followed by thermal cycles but their mechanical properties were acceptable for fabrication of provisional restorations. The mechanical properties of VM, EC and EM were not affected by different storage conditions whereas IC and VS were affected.
Copyright (c) 2020 Ayşe Atay DDS, PhD, Elçin Sağirkaya DDS, PhD (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Functional Rehabilitation with an Onlay Ceramic Adhesive Restoration: Case Report
The objective of this article was to analyze the indications for the proper selection of Onlay adhesive ceramic restorations, providing a step-by-step clinical protocol. Biomechanical principles based on morphological considerations and geometric terms must be present for the careful preparation of Onlay-type cavities. Concepts about cavitary preparations are discussed under essential conditions in the preservation of healthy dental tissue, without compromising the functional and aesthetic results over time. The author's suggestion is to respect and follow in a timely manner each of the steps applied in this restorative clinical protocol, to improve the final outcome of the restoration.
Esthetic; Adhesive systems; Composite resins; Minimally invasive restorations.
Copyright (c) 2020 Juan Carlos Ramírez Barrantes DDS, MSD, PhD (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Ex Vivo Evaluation of a Restoration Protocol for Teeth with Simulated Incomplete Rhizogenesis
The use of phosphate buffered saline (PBS) as an intracanal medication triggers a biomineralization process within mineral trioxide aggregate (MTA) apical plugs during the apexification process in teeth with incomplete rhizogenesis. However, no consensus is available in the literature regarding a restorative protocol for this type of treatment. Thus, the objective of this study was to use scanning electron microscopy (SEM) to evaluate the processes of biomineralization and adhesion in a restorative protocol for teeth with simulated incomplete rhizogenesis. Methodology: Root sections with a thickness of 2mm and cavities with a diameter of 2mm were used. The sections were randomly prepared and filled with the following materials: Group 1 (n=12), ProRoot MTA; and Group 2 (n=12): MTA Exp. Subsequently, the samples were immersed in PBS for 35 days. Every 5 days, the PBS was replaced, and the precipitates were collected, dried, and weighed. Two samples from each group were analyzed by SEM. Moreover, 24 single-rooted teeth were standardized, incomplete rhizogenesis was simulated, and 5-mm-long apical plugs were created with Pro Root MTA. As an intracanal medication, PBS was used for different periods of time: Group 1:48 h; Group 2:7 days; and Group 3:15 days. Then, fiberglass posts were cemented with the REBILDA® Post System. The samples were prepared and analyzed by SEM. Results: ProRoot MTA and MTA Exp effectively promoted the formation of carbonated apatite precipitates and biomineralization with dentin. ProRoot MTA yielded more carbonated apatite precipitates compared to MTA Exp (p=0.0536). The use of PBS as an intracanal medication for 7 and 15 days promoted intratubular mineralization (MIT), and treatment for 15 days was more effective (p < 0.05). The REBILDA® Post System effectively promoted the microimbrication of the adhesive system and the formation of resinous tags with lateral adhesive branches. Conclusion: Apexification with MTA associated with the use of PBS as an intracanal medication for 15 days, in addition to the use of the REBILDA® Post System, seems to be a feasible restorative protocol.
Adhesion; Apexification; Apical plug; Biomineralization; Mineral trioxide aggregate.
Copyright (c) 2020 Cristina Retana-Lobo DDS, MSD, Jessie Reyes-Carmona DDS, MSD, PhD (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Is Burning Mouth Syndrome Based on a Physiological Mechanism which Resembles that of Neuropathic Pain?
Burning mouth syndrome (BMS) is a chronic intraoral pain state that has been described as burning pain, tingling or numbness in the oral mucosa, in the absence of any organic disease. Most often affecting the tongue, anterior palate, and/or lips. The diagnosis of primary BMS is purely clinical and based on patients’ description of typical subjective symptoms as well on the exclusion of any systemic or local factors that may give rise to secondary burning pain sensations within the oral mucosa. Relevant studies links BMS to a peripheral neuropathy and BMS patients have revealed distinct abnormalities within the trigeminofacial large and small fiber systems and the trigeminal brainstem complex. Therefore, treatment approach should involve a multidisciplinary character similar to the treatment for neuropathic pain including factors that might also play a role on the BMS etiology and pathophysiology.
Burning mouth syndrome; Neuropathic pain; Pathophysiology.
Copyright (c) 2020 Marisol Reyes Sevilla DDS (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Assessment of the Flexion Force of TMA and Elgiloy Intrusion Arches to Different Lengths of Activation. An In Vitro Study
The present study analyzed the utilitary arch of Ricketts made with TMA and Elgiloy alloys, evaluating the forces that each one presented at different activation lengths. METHODS: A total of 30 arches (15 per alloy) 17x25 caliber were assessed. An acrylic model that simulated the jaw was used with tubes welded to the bands located on the first molars where the arches were attached and brackets were bonded to the lower incisors. The Ricketts arches had a total length of 100 mm and were activated in their distal branch, obtaining the lengths of 5, 10 and 15 mm measured from the slot of the anterior brackets in the midline. A Digital Universal Testing Machine CMT-5L was used to measure the bending force and the statistical analysis was carried out with the Student's T and Mann-Whitney U test. RESULTS: The TMA alloys had a significantly lower strength in each of the activations 5, 10, 15 mm (13,53; 31,61 and 42,01grams respectively) compared to Elgiloy (31.41; 62,61 y 93,00 grams respectively). While increasing the activation length, the flexural forces increased significantly for both alloys. CONCLUSION: The suggested forces for the intrusion of lower incisors were reached by the Elgiloy arches.
Dental intrusion; Alloys; Flexural resistance.
Copyright (c) 2020 Francis Kelvin Ramos Lara DDS, Teresa Evaristo-Chiyong DDS, MSc, PhD (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Sexual Dimorphism Via Palatal Vault Morphometric Analysis on A Sample Peruvian Population
Objective: Determine sexual dimorphism precision via palatal vault morphometric analysis in craniums sourced from the Laboratorio de Investigación Forense del Equipo Forense Especializado (EFE) de Ayacucho del Ministerio Público - Perú. Materials and Methods: Cross-sectional design consisting of a sample of 43 skulls with pre-established biological gender, (24 males and 19 females). Sexual dimorphism was established by means of the method proposed by Meera Jacob and co., based on palatal width and length measurements, after which the palatal index was calculated, establishing the method’s precision and accuracy. The inferential analysis was made with a level of significance of 5% through the T student test, Shapiro Wilk and Pearson’s coefficient. Results: Palatal width had a mean of 3.43 (+0.31cm) for males and 3.62 (+0.25) for females and in palatal length a mean of 5.07 (+0.44) cm. for males and 4.79 (+0.41) cm. for females is established; on palatal index, 100% of the male skulls correspond to hard narrow palate and on females 73.7% to narrow, 21% to intermediate and 5.3% to wide. Furthermore, it was determined that there were statistically significant differences between width and length of palatal vault for both genders, and a discriminating analysis formula was proposed. Conclusion: Morphometric analyses of palatal vaults establish an 83.72% precision on the estimation of sexual dimorphism.
Sexual dimorphism; Palatal vaults; Morphometric analysis.
Copyright (c) 2020 Karen J. Escalante-Flórez DDS, Daniel G. Suárez-Ponce DDS, MSc, PhD, Ymelda W. Velezmoro-Montes DDS, MSc (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Impact on Quality of Life of Oral Diseases Related to Stress
It has been suggested that oral mucosa diseases related to stress have a negative impact on the quality of life. However, the information regarding which aspects are the most affected is inconclusive. The objective was to compare the quality of life associated with oral health in two groups: Cases formed by 21 patients coming from a teaching clinic, suffering oral lichen planus, recurrent aphthous stomatitis, and burning mouth syndrome; Control formed by 42 healthy subjects matched for age and gender. Oral Health Impact Profile questionnaire was applied. Statistical analysis showed that group Cases has worse quality of life (p 0.03) than the one of controls, specifically on psychological discomfort (p 0.027), physical disability (p 0.004); and handicap dimensions (p 0.002; RM 5.63 IC1.58-20.80). It was concluded that patients suffering oral mucosa disease related to stress showed poor quality of life.
Oral lichen planus; Recurrent aphthous stomatitis; Burning mouth syndrome; Anxiety; OHIP-49.
María C. Villanueva-Vilchis DDS, MSc, PhD
Copyright (c) 2020 Diana I. Rivera-Reza DDS, María C. Villanueva-Vilchis DDS, MSc, PhD, Luis A. Gaitán-Cepeda DDS, MSc, PhD (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Detection of Oral Entamoeba Gingivalis and Trichomonas Tenax in Adult Quilombola Population with Periodontal Disease
The objective was to analyze the periodontal condition severity and the occurrence of pathogenic microorganisms in the oral cavity of an adult population of an Afrodescent Community of northeastern Brazil. This is an observational and cross-sectional study performed through an oral clinical examination, using a standardized clinical record. For the subjects with periodontal disease, the bacterial biofilm was collected in a Petri dish containing 0.9% physiological solution to detect the presence of microorganisms Entamoeba gingivalis and Trichomonas tenax, and later observed under an optical microscope. Statistical analysis was performed by calculating the prevalence of periodontal disease and the frequency of the protozoa in the bacterial biofilm. Statistical significance of the relationships researched was verified by Fisher's exact test. It was evaluated 29 subjects pertaining to the Quilombola Patioba community, aged 35 to 44 years. The results showed that among the adults of the community, there was a high prevalence of periodontal disease (75.86%), being higher in the 1st and 6th sextants of the Community Periodontal Index (CPI). E. gingivalis positivity occurred in most sextants affected by gingivitis, while in the condition of periodontitis, this microorganism was not present in the 3rd, 4th and 6th sextants. In all sextants affected by periodontal disease, T. Tenax was observed when associated with gingivitis. It is worth mentioning the begging of the elaboration of health policies, social and professional commitment that foster a greater promotion of oral health and quality of life for the quilombolas of northeastern Brazil.
Epidemiology; Dental health surveys; African continental ancestry group; Antigens, Protozoan; Periodontitis.
Cristiane Costa da Cunha Oliveira DDS, PhD
Copyright (c) 2020 Jamille Alves Araújo Rosa MsC, Matheus dos Santos Fernandez, Igor Soares Vieira PhD, Rubens Riscala Madi PhD, Cláudia Moura de Melo PhD, Cristiane Costa da Cunha Oliveira DDS, PhD (Author) https://creativecommons.org/licenses/by-nc-sa/4.0