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Childhood malnutrition and hypo mineralized molar defects; a cross sectional study, Egypt

Background: Malnutrition is well-known to yield high morbidities and it has pre-eruptive and post-eruptive consequences. The objective of the study was to evaluate the prevalence of Hypomineralized Second Primary Molars (HSPM), Molar Incisor Hypomineralization (MIH) and dental caries in malnourished children, as well as addressing the relation between types of malnutrition and the dental morbidities. Methods: This is a cross sectional analytical study. A consecutive sample of 54 malnourished cases aged 5-10 years and presented to the Outpatient Clinic of Pediatric Dentistry Department, Faculty of Dentistry, Cairo University across 6 months period were examined for HSPM, MIH – using the European Academy of Pediatric Dentistry criteria – and dental Caries using def/ DMF indices. Outcomes were the presence or absence of MIH and HSPM and their levels measured as percentage as well as Caries Indices. Exposures were types of malnutrition and the socioeconomic status. Results : The mean age of study participants was 7.10 ± 1.34 years. HSPM and MIH were found in 47.2% and 45.2% of the study participants respectively, while dental caries was observed in 83% and 64.3% for primary and permanent teeth respectively. There was co-occurrence between HSPM and MIH in 39% of the cases. HSPM level was significantly different in various types of malnutrition. It showed significant difference between the stunted group (median HSPM of 14.2%) and the overweight or obese group (median HSPM of 0.0%) (P value 0.01). MIH level showed significant differences between the stunted group (median MIH of 19.4%) and overweight or obese group (median MIH of 0.0%) (p value 0.001), as well as between the stunted group (median MIH of 19.4%) and wasted group (median MIH of 0.0%) (p value 0.025). Conclusions : Malnourished children have high prevalence of dental abnormalities. HSPM could expect the presence of MIH.

By |2022-09-19T21:16:39+00:00January 1st, 2022|Other|

Prevalence of vitamin D inadequacy and bone turnover markers concerning bone mineral density in older persons.

Owing to the early tooth loss in a large population, the need for removable prosthodontic therapy has widely increased. Loss of teeth can occur due to trauma, periodontal disease, dental caries, and/or oral health negligence. The removable prosthesis is preferred over other teeth replacement methods owing to its cost-effectiveness. However, due to continuous alveolar bone resorption, relining of the removable prosthesis is needed regularly. We aimed to assess the prevalence of vitamin D deficiency and bone turnover marker concerning bone mineral density. Eighty complete denture wearers either in the maxilla or in the mandible or both constituted the study sample. Before the study, all subjects were explained the procedures of the study, and informed consent was obtained before proceeding with the study. Subjects were instructed to provide an early morning sample in a fasting state as serum osteocalcin (OCN) and C-terminal telopeptide (C-Tx) have diurnal variations. Blood samples were collected, and samples were ruled out for 25-OH vitamin D, serum OCN, and C-TX. To determine the association between frequency of relining and bone turnover marker, the collected data were subjected to statistical evaluation. Significant correlations were seen between bone C-Tx, turnover markers (p<0.001), and frequency of denture relining and osteocalcin (p<0.001). No statistically significant effect of gender, vitamin D levels, age, calcium levels, vitamin D supplements, and diabetes was seen on denture relining frequency. The present study concludes that an elevated level of the bone turnover markers such as OCN and C-Tx increases the frequency of relining.

By |2022-08-23T22:24:52+00:00January 1st, 2022|Other|

Vitamin D Deficiency and Early Implant Failure: Outcomes from a Pre-surgical Supplementation Program on Vitamin D Levels and Antioxidant Scores.

Purpose: Accumulating evidence has shown that vitamin D deficiency has been linked with an up to 300% increase in early implant failure. The aim of this study was to investigate a comprehensive pre-surgical dental support program (DentaMedica) on its ability to increase vitamin D and antioxidant levels prior to implant surgery.

Materials and methods: Twenty patients were enrolled in this study. To quantify vitamin D levels, two in-office vitamin D finger-prick tests (10-15 min in length) were compared to levels obtained from a standard laboratory blood test. An antioxidant testing device was also utilised to investigate the impact of this pre-surgical supplementation program on antioxidant scores 0 and 6 weeks post supplementation.

Results: It was first found that 65% of the population had an initial vitamin D deficiency (below 30 ug/ml). After supplementation, vitamin D levels increased from an average of 24.76 ng/ml to 50.11 ng/ml (ranging from 38 to 85.50 ng/ml). No statsitcally significant differences were observed between any of the 3 testing devices (2 in-office finger-prick tests and a standard blood sample). Initial antioxidant levels registered on the biophotonic unit averaged an antioxidant score of 27250 ± 10992.22. Following supplementation, an increase of 54% from baseline values (41950 ± 9276.31) was reported.

Conclusion: The results from this study show convincingly that the majority of the tested population was vitamin D deficient. It was further found that both in-office finger-prick devices demonstrated results comparable to standard lab scores (usually within an average 2-3 ng/ml). Following supplementation, all patients reached sufficient levels following this 4-6 week pre-surgical supplementation program specific to implant dentistry.

By |2022-08-23T20:42:43+00:00January 1st, 2022|Other|

Effects of desensitizing dentifrices on dentin tubule occlusion and resistance to erosive challenges.

Background: Many studies have demonstrated efficacy of casein phosphopeptide (CPP) containing products for dentin tubule occlusion for treatment of dentin sensitivity, but their effectiveness under dynamic erosive challenges remains to be elucidated. The purpose of the present study was to investigate the effectiveness of a desensitizing dentifrice containing CPP in occluding dentin tubules and resisting erosive challenges in comparison to that containing polyvinyl methyl ether/maleic acid (PVM/MA) copolymers.

Methods: A total of 33 dentin discs were prepared from coronal sections of human third molars and divided into 3 groups: a toothpaste containing CPP; a toothpaste containing PVM/MA and submicron silica; and a regular toothpaste (Controls). A soft-bristle toothbrush was used to brush the dentin discs with the dentifrices for 45 strokes in 30 s at a force of approximately 200 g. The brushing cycle was repeated after immersion of the dentin discs in artificial saliva overnight. The dentin discs were then challenged in orange juice for 10 min in an incubator rocking at 120 rpm. Three fields were randomly selected on each dentin disk surface to assess dentin tubule occlusions after each brushing cycle and after orange juice challenge with a 3D laser scanning microscope. Specimen cross sections were examined with a scanning electron microscope equipped with energy dispersive spectroscopy (SEM/EDS).

Results: After the first and second cycles of brushing, dentin tubules were occluded on average by 56.3% and 85.7% in CPP group, 66.2% and 88.1% in PVM/MA group, and 0.0 and 13.0% in the controls, respectively. There were no statistically significant differences in dentin tubule occlusions between the CPP and PVM/MA groups after two cycles of brushing (p>0.05). After dynamic erosive challenges with orange juice, 20.3% of the dentin tubules in the CPP group, 79.1% in the PVM/MA group and none in the control remained occluded (P<0.05). SEM/EDS imaging showed that dentin tubules were blocked with plugs containing dentifrice substances in CPP and PVM/MA groups after treatments, but none in the controls.

Conclusions: Desensitizing dentifrices containing CPP or PVM/MA could effectively occlude dentin tubules after two cycles of brushing. PVM/MA in combination with submicron silicon dioxide exhibited stronger resistance to dynamic erosive challenges by acidic beverages. Inorganic fillers that can enter dentin tubules and resist erosive challenges may be key for desensitizing dentifrices.

By |2022-08-28T21:04:17+00:00January 1st, 2022|Other|

Comparison of laser therapy and ozonated water on gingival inflammation in orthodontic patients with fixed appliances.

Background: There is an increased prevalence of oral ailments such as dental caries, gingivitis, and periodontitis when orthodontic therapy is administered. Poor oral hygiene in conjunction with the placement of fixed orthodontic appliances is considered a significant factor in raising accumulation of bacterial plaque and its associated inflammatory response.

Aim: The present study aimed to evaluate and compare laser therapy with subgingival irrigation using ozonated water on gingivitis in patients undergoing fixed orthodontic treatment and to ascertain the presence of the inflammatory marker monocyte chemoattractant protein (MCP-1) in gingival crevicular fluid (GCF).

Methods: This study was a double-blind clinical study in which a split-mouth design was applied in 30 subjects for 28 days that received fixed orthodontic therapy. In each subject, the upper right quadrant (control side) was irrigated with 0.01 mg/L ozonated water and the upper left quadrant (experimental side) was irradiated with a diode laser on day 0 (baseline) and day 7. The patients were recalled on days 7, 14, and 28 and clinical parameters were recorded at each visit. Biochemical evaluation of gingival inflammation with MCP-1 levels in GCF was obtained at the baseline (day 0) and on day 28.

Results: A statistically significant (p < 0.05) reduction of all clinical parameters and MCP-1 activity in GCF was observed on both sides. Low-level laser irradiation showed a significant reduction of clinical parameters and MCP-1 activity compared to subgingival ozone irrigation.

Conclusions: Laser therapy can be considered a more effective method than subgingival ozone irrigation in patients undergoing fixed orthodontic treatment as it showed a consistent improvement in gingival inflammation.

Relevance for patients: Fixed orthodontic appliances make oral hygiene maintenance difficult and results in gingivitis. Adjunctive oral hygiene procedures such as subgingival irrigation with ozonated water or laser irradiation are beneficial. The data from this study suggest that irrigation with ozonated water or laser irradiation reduces gingival inflammation, with laser therapy being more effective.

Can ozone or violet light improve the color change or physicochemical properties of hydrogen peroxide-bleached tooth?

This study investigated the bleaching effectiveness and the physicochemical effects on enamel of violet light and ozone, associate or not to hydrogen peroxide, compared to 35%-hydrogen peroxide. Enamel-dentin blocks from human molars were randomly allocated to receive one of the following bleaching protocols (n=15): (HP) 35%-hydrogen peroxide, (VL) violet light, (OZ) ozone, the association between hydrogen peroxide with ozone (OZ+HP) or violet light (VL+HP). All protocols were performed in two sessions with a 48h interval. Color (spectrophotometer) and mineral composition (Raman spectroscopy) were measured before and after the bleaching. Color changes were calculated by ΔEab, ΔE00, and whitening index (WI). The surface roughness was measured with an atomic force microscope. Data were analyzed by One-way or Two-way repeated measure ANOVA followed by the Tukey’s test (α = 0.05). The lowest color change values (either measured by WI, ΔEab, or ΔE00) were observed for VL and OZ used with no HP. Violet light associate with HP was unable to improve the color changes observed for the peroxide alone, in combination with OZ and HP, the highest color changes were verified. Regardless of bleaching protocol, the bleached enamel presented higher contents of PO4 and CO3 -2 than those observed at baseline. All bleaching protocols resulted in similar enamel surface roughness. Both the VL and the OZ caused reduced effects on the enamel color change when used alone. The ozone therapy improved the bleaching effect in the group that received the association of HP.

Biocompatibility in Dentistry: A Mini Review

The term “biocompatibility” has been gaining recognition, not only in medicine, but particularly in dentistry. It basically means, biocompatible materials should not have a negative impact on the recipient. Currently, there are literally thousands of different components that makeup the materials that are used in common dental procedures, with more being developed each year. Scientific literature is now reporting on the importance of using the most biocompatible material for the patient

By |2022-11-20T20:14:15+00:00January 1st, 2022|Other|

Concentrated growth factor regulates the macrophage-mediated immune response.

Concentrated growth factor (CGF) is a promising regenerative material that serves as a scaffold and adjunct growth factor for tissue engineering. The host immune response, particularly macrophage activity, plays a critical role in injury repair and tissue regeneration. However, the biological effect of CGF on the immune response is not clear. To enrich the theoretical groundwork for clinical application, the present study examined the immunoregulatory role of CGF in macrophage functional activities in vitro. The CGF scaffold appeared as a dense fibrin network with multiple embedded leukocytes and platelets, and it was biocompatible with macrophages. Concentrated bioactive factors in the CGF extract enhanced THP-1 monocyte recruitment and promoted the maturation of suspended monocytes into adherent macrophages. CGF extract also promoted THP-1 macrophage polarization toward the M2 phenotype with upregulated CD163 expression, as detected by cell morphology and surface marker expression. A cytokine antibody array showed that CGF extract exerted a regulatory effect on macrophage functional activities by reducing secretion of the inflammatory factor interleukin-1β while inducing expression of the chemokine regulated on activation, normal T cell expressed and secreted. Mechanistically, the AKT signaling pathway was activated, and an AKT inhibitor partially suppressed the immunomodulatory effect of CGF. Our findings reveal that CGF induces a favorable immune response mediated by macrophages, which represents a promising strategy for functional tissue regeneration.

By |2022-08-19T19:53:40+00:00January 1st, 2022|Other|

Titanium exposure and human health.

Historically, titanium (Ti) has maintained the reputation of being an inert and relatively biocompatible metal, suitable for use in both medical and dental prosthesis. There are many published articles supporting these views, but there is recent scientific evidence that Ti, or its corrosive by‐products, may cause harmful reactions in humans. It is important for all medical and dental professionals to understand the implications, complexities, and all potential pathways of exposure to this metal.

By |2022-11-20T19:10:32+00:00January 1st, 2022|Other|

Linking Dentistry and Chronic Inflammatory Autoimmune Diseases–Can Oral and Jawbone Stressors Affect Systemic Symptoms of Atopic Dermatitis?

 

Background: This case report demonstrates the value of ultrasound measurements, and immunological and toxicological diagnostics in addition to current x-ray imaging procedures to diagnose hidden oral and maxillofacial infections. Using a clear scheme shows the procedure of the authors’ steps. The positive impact on the patient’s dermatological clinical picture is shown. Functional regeneration using metal-free ceramic implants and autologous bone augmentation is demonstrated. After a healing period, a postoperative control took place.

Question: Are chronic inflammatory and chronic toxic stressors from the oral region affecting the patient’s state of health and dermatological symptoms?

Patients and methods: A 52 year old female suffering from neurodermatitis, who had been therapy-resistant for several years, was rehabilitated by oral surgery and prosthetics. Radiological examinations with orthopantomogram (OPG) and three-dimensional imaging (DVT/CBCT) were inconclusive for possible jawbone inflammatory sites. Immunological, toxicological diagnostics and trans-alveolar bone densitometry with ultrasound (TAU), were able to show immunological and toxicological stressors and areas of reduced bone density. Bone densitometry with ultrasound raised the suspicion of silent inflammations in the jawbone with potentially increased cytokine levels.

Results: For the patient incompatible materials, teeth with increased toxin exposure and surrounding softened, fatty, ischaemic bone was removed. Histologies and cytokine profiles were obtained. The resulting defects were functionally regenerated using ceramic implants and autologous augmentation. The cytokine profiles showed significantly elevated RANTES/CCL5, confirming the need for surgical intervention. The patient’s atopic dermatitis improved significantly in this case.

Summary: Individualized immunological and toxicological diagnostics and trans-alveolar bone density bone densitometry with ultrasound (TAU) identified immunological and toxicological stressors as well as reduced bone density with increased cytokine levels. A therapy-resistant neurodermatitis improved significantly after treatment.

Conclusion: This case report illustrates the need for patient-specific and individualized examinations that link dentistry more closely with other medical conditions in order to clarify possible interactions.

By |2022-07-12T18:00:51+00:00January 1st, 2022|Other|
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