Micro-Computed Tomography Applications in Dentistry

Micro-computed tomography (MCT) encompasses two primary scanning options: ex-vivo and in-vivo imaging. Ex-vivo scanning involves the examination of extracted teeth or dental specimens, allowing for detailed analyses of the microarchitecture of mineralized tissue. By analyzing the microarchitecture of dental tissues, MCT can provide valuable information about bone density, porosity, and microstructural changes, contributing to a better understanding of disease progression and treatment outcomes. Moreover, MCT facilitates the quantification of dental parameters, such as bone volume, trabecular thickness, and connectivity density, which are crucial for evaluating the efficacy of dental interventions. This present study aims to comprehensively review and explore the applications of MCT in dentistry and highlight its potential in advancing research and clinical practice. The results depicted that the quantitative approach of MCT enhances the precision and reliability of dental research. Researchers and clinicians can make evidence-based decisions regarding treatment strategies and patient management, relying on quantifiable data provided by MCT. The applications of MCT in dentistry extend beyond research, with potential clinical implications in fields such as dental implantology and endodontics. MCT is expected to play an increasingly significant role in enhancing our understanding of dental pathologies, improving treatment outcomes, and ultimately, benefiting patient care in the field of dentistry.

Comparison of Self-Perception of Esthetics and Orthodontic Treatment Needs among Dental and Non-Dental Students with Assessment by Orthodontist

Objectives: The present study was conducted to compare the self-perception of esthetics and wish for seeking orthodontic treatment among dental and non-dental students. The realistic orthodontic treatment needs were confirmed by expert orthodontist. Methods: A cross-sectional study was conducted among 255 male students (Dental—75, Medical—93 and Pharmacy—87 students). The questionnaire included 20 items covering dental esthetics self-perception (10 questions), self-confidence and psychological impact (5 questions), and the need for seeking orthodontic treatment (5 questions) on a five-point Likert scale. The realistic orthodontic treatment needs were confirmed by photographs using aesthetic component of IOTN and clinical examination for the participants and analysis of jaw models using Dental aesthetic index (DAI). Kruskal-Wallis ANOVA was used to check the significant difference between groups. Results: The overall average esthetic self-perception score for total sample was 3.83. The overall average psychological impact score for the whole sample was 2.67. The total percentage of participants who either agree or strongly agree with the question related to their perception of need for seeking orthodontic treatment was 70%. According to the assessment of orthodontic needs using AC-IOTN, 19.8% required definitive treatment. According to the assessment of orthodontic treatment needs based on DAI, 20.3% and 9.9% needed highly desirable (DAI 31 - 35) and definite need of treatment (DAI ≥ 36) respectively. Conclusion: It can be concluded that there was no difference between the esthetic perception of dental and non-dental students. The self-perception for seeking orthodontic treatment was over-reported by participants compared to real requirement as assessed by orthodontic specialist. Dental esthetics has no psychological impact on academic performance and self-confidence as perceived by study participants.

General Considerations for the Practice of Pediatric Dentistry in the Period of COVID-19 Pandemic: A Review

Context: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) has been identified in December 2019. Since then, it has been spreading around the world and has caused a pandemic. Strict safety protocols should be followed to resume dental treatments. Evidence Acquisition: A comprehensive search was conducted on PubMed, Scopus, Medline and google scholar databases using the MeSH words of COVID-19, SARS-COV-2, Dentistry, and Child from December 2019 until July 2020. Results: Among COVID-19 patients, asymptomatic patients still are considered to be serious carriers of the COVID-19 which can play a key role in transmission of the virus. Children are reported to be less than 2 percent of the infected population and are considered as serious potential carriers. Telemedicine can take a key part in educating parents regarding this matter. Chronic and rare diseases such as Kawasaki Disease (KD) might show acute and more frequent symptoms amongst COVID-19 patients. Salivary testing can be a convenient chairside way for COVID-19 and it has been shown to be effective in identifying critically ill patients. Dry mouth and amblygeustia have been reported to be the oral symptoms of the COVID-19. Conclusions: Dentists must make tough decisions in prioritizing patient’s needs in the period of pandemic. They should frequently get updated as the situation is fluid and the protocols might change.

History of Dentistry from the Period of the Ottoman Empire to the Republican Period

The Ottoman-Turkish medicine and dentistry was born and developed in the lands of Anatolia. The most mature period of the Islamic medicine was in the Ottoman Empire on the lands of Anatolia. While inheriting the Turkish-Islamic science and culture structure and the ancient age and Old Greek science, it was integrated with the medicine philosophy here. In the 13th and 15th centuries, in Ottomans, the development of the dentistry was on the issues of the dental diseases and periodontology. In the 14th and 15th centuries, it was observed in the medicine books of the Turkish physician writers that they were also dealing with the child dentistry as issues. That the dental medicine took place in the works of art written between the 15th and 19th century shows the existence of the surgeons realizing the tooth extraction. With the opening of the first dentist school in the year of 1909, the training of dentistry started. In this study, the issue of the development and training of the dentistry in the Ottomans among the 13th-19th centuries were dealt with the outlines. Also, the first examples and fundamental works of art of the dentistry literature from the Ottoman Empire to the Republican period will be told shortly.

Use and Attitudes towards Teleconsultation in Dentistry

An electronic (web-based) questionnaire was devised to find out the extent of teleconsultation and e-mail use for patient-provided communications in dentistry. This project was carried out in 2011 inthe health care district of South-Ostrobothnia, in South-Western Finland.The questionnaire was sent by e-mail to all 120 regional dentists, to which 76 replies were obtained (response rate 63%). The responses indicated a surprisingly positive attitude towards teleconsultation. A clear majority of 91% indicated that it could bring additional benefits to the current consultation methods.This study revealed that a slight majority of dentists in the region use e-mail for patient communication and 53% used e-mail for consultation. Approximately 10% use videoconferencing for consultation.The study also revealed that the majority of those who do not yet use electronic consultation are willing to try them out in the future. Security issues are a concern for many dentists. Practically all respondents wish for written instructions on the use of electronic consultation.

Gingival-derived mesenchymal stem cells:An endless resource for regenerative dentistry

The gingiva, the masticatory portion of the oral mucosa, is excised and discarded frequently during routine dental treatments and following tooth extraction, dental crown lengthening, gingivectomy and periodontal surgeries. Subsequent to excision, healing eventually happens in a short time period after gingival surgery. Clinically, the gingival tissue can be collected very easily and, in the laboratory, it is also very easy to isolate gingival-derived mesenchymal stem cells (GMSCs) from this discarded gingival tissue. GMSCs, a stem cell population within the lamina propria of the gingival tissue, can be isolated from attached and free gingiva, inflamed gingival tissu-es, and from hyperplastic gingiva. Comparatively, they constitute more attractive alternatives to other dental-derived mesenchymal stem cells due to the availability and accessibility of gingival tissues. They have unique immunomodulatory functions and well-documented self-renewal and multipotent differentiation properties. They display positive signals for Stro-1, Oct-4 and SSEA-4 pluripotency-associated markers, with some co-expre-ssing Oct4/Stro-1 or Oct-4/SSEA-4. They should be considered as the best stem cell source for cell-based therapies and regenerative dentistry. The clinical use of GMSCs for regenerative dentistry represents an attrac-tive therapeutic modality. However, numerous biological and technical challenges need to be addressed prior to considering transplantation approaches of GMSCs as clinically realistic therapies for humans.

Pathways of fear and anxiety in dentistry: A review

The aim of this article was to analyze the theories underpinning dental fear, anxiety and phobias. To be included, articles must have been published between the years of 1949 and 2013 concerning fears and phobias within dentistry and/or psychiatry. Of 200 articles originally under review, 140 were included and reviewed by the authors.Five specific pathways relating to dental fear and anxiety were identified; Cognitive Conditioning, Informative, Visual Vicarious, Verbal Threat, and Parental. Eight currently accepted management techniques across all dental disciplines for dental fear and anxiety were identified. Further research is required to identify clinical diagnosis and treatment for fears originating from different pathways.

Platelet preparations in dentistry:How? Why? Where? When?

The aim of this article is to review the outcomes of platelet preparations in dentistry. A structured electronic search discovered 348 articles, which described the use of autologous platelet concentrates with a relevance to clinical dentistry. Among these articles, 220 articles investigated platelet rich plasma, 99 investigated platelet rich fibrin, 22 investigated plasma rich in growth factors and 7 investigated the use of concentrated growth factors. Several studies reported beneficial treament outcomes in terms of enhanced bone and soft tissue regeneration.

Dentistry-ProConsult软件辅助石膏牙造模在口腔教学中的应用

背景:在口腔医学教学实践中,牙列的正常形态及咬合关系一直是教学的难点,但牙齿的咬合界面及功能耦联关系复杂,不易掌握,一直以来也是临床教学的难点和重点。目的:探索Dentistry-ProConsult 软件辅助石膏牙造模在口腔教学中的应用效果。方法:将44 名空军军医大学五年制口腔医学专业本科四年级学员随机分为2 组,对照组(n=21)在传统教学模式下学习不同类型牙齿的解剖结构和咬合关系及雕刻蜡牙,无任何功能软件的应用;试验组(n=23)在Dentistry-ProConsult 软件辅助石膏牙造模口腔教学模式下学习不同类型牙齿的解剖结构和咬合关系,通过Dentistry-ProConsult 软件辅助石膏牙造模口腔教学,带教教师可主动引导学生通过三维模型从不同层次和角度理解牙齿的正常形态及复杂的咬合关系,在此基础上结合3D 打印模型,让学员在石膏模具中逐一雕刻正常牙齿形态。学期末对学员的笔试成绩及操作成绩进行统计学分析。结果与结论:①试验组理论成绩高于对照组[(85.6±12.4),(79.3±15.7)分,t=6.735,P < 0.05],操作考试成绩高于对照组[(88.2±10.6),(82.5±14.5)分,t=7.182,P < 0.05];②问卷调查显示,试验组学员对于该课程的教学满意程度评分优于对照组[(87.5±8.7),(79.7±10.1)分,t=8.531,P < 0.05];③结果表明,Dentistry-ProConsult 软件辅助石膏牙造模教学方法显著提高了学员的理论及实践成绩,同时提高了学员的课堂满意度。

A Palladium Based Alloy for Prosthetic Dentistry: Structure and Properties

Using the results of physical and chemical researches and mechanical tests of the Pd-Au-Cu-Sn system alloys, a new palladium-based alloy has been chosen and studied in detail. It has a higher plasticity and a lower hardness than the Palladent alloy, widely used in prosthetic dentistry: its hardness is lower than 300 MPa, and its specific elongation is 10%~14 %. At the same time, such important practical characteristics of the alloys as the strength of adhesion to ceramics and thermal expansion coefficient are almost similar.

Oral care offerings in populations of Ferlo (Senegal): The contribution of traditional dentistry

The aim of this study was to examine whether the offering of traditional treatments can constitute a positive contribution to integrate in an oral public health care settings. Method: This was a cross-sectional study involving 300 people living in the area of Ferlo in East Central Senegal. Selected individuals must be residents of the area over the age of 15 years. Cluster sampling was used as a recruitment method. Data collected concerned the type of oral health care used whether modern or traditional, the periodontal condition (plaque, gingival and bleeding index, attachment loss, pocket depth and CPITN). Dental status was evaluated by DMFT. The data were analyzed with R software and the Student’s t test was used to compare the averages of indices in both groups at the threshold of 5%. A co-variance analysis was allowed in order to determine associations between some indices and therapy type in multivariate approach. Results: Averages of dental and periodontal indices were globally higher in people using modern therapies. DMFT, CPITN and gingival index increased significantly when the type of therapy was modern after adjustment on the plaque index and age. Conclusion: The traditional dentistry could constitute a positive contribution to a public health care, especially in a context of developing country. However, this practice should be guided and validated by a research-based evidence to allow better use of the therapeutic processes, and promote the health of populations.

Self-Assembled Monolayers (SAMs): Which Perspectives in Implant Dentistry?

Self-assembled monolayers (SAMs) are ordered organic films formed by adsorption of an active organic coating on a solid surface. Their formation provides an alternative, highly innovative, to current traditional chemical treatments of the titanium surfaces. For this reason the structural phases, the formation and the growth of SAMs is described from a surface science point of view. Particulars are given to SAMs on titanium concerning surface morphology, chemical composition and affinity of specific head group for Ti surfaces (silanes, siloxane, phosphonates and phosphates). Preparation, coating methodologies, limitations and techniques used for the characterization of SAMs are reported. For their physicochemical characteristics and micro-nano scale features some perspectives of using SAMs in biomedical application are outlined.

Transformation and Prospects of Dentistry Innovations in China

The burden of dental diseases is increasing in the Chinese population.However,the development of the dental industry falls behind the average development level of medical industry in China.The emergence of digital dental technologies has created significant opportunities for the development of the dental industry in China.This article explores the innovative development background of the Chinese dental industry,describes the current innovation status in Chinese medical colleges and enterprises,highlights key problems faced by the nation,enterprises,and hospitals,proposes solutions to these issues,and puts forwards a new concept of building an open and collaborative service system,a transformation path,and a whole-chain support system for innovations in dentistry.

Medicine in the future-with subspecialists in medullary neurology and brain dentistry

The solitary tract nucleus of the medulla with its limited watershed vascular capacity may occasionally be the focus of transient ischemia caused by the increased metabolic demands associated with frequent and intense neuronal stimulation from other organs and other parts of the brain. Case reports have suggested that these ischemic changes may sometimes result in the initiation of intense autonomic discharges, which can occasionally be fatal. Therapeutic interventions for the medulla oblongata are hamperedby its limited accessibility. Systemically administered pharmaceuticals may have some usefulness in future years. Previous experience with vagus nerve stimulation in the treatment of epilepsy suggests that it may have some usefulness in stabilizing medullary autonomic discharges. Computerized electronic stimulation of other cranial nerves may be helpful as well, especially the chorda tympani nerve, and may be most easily accomplished from implanted dental appliances, especially molar modules, transmitting signals via secondary transmitters procedurally placed on cranial nerves. Future technology may enable wireless signaling from the implanted dental appliance to the secondary transmitter placed at the nerve site. By the year 2050 subspecialists in medullary neurology and brain dentistry may use computerized electronic stimulation of cranial nerves to prevent sudden unexpected death and treat "chest pain from the brain".

Use of dentomaxillofacial cone beam computed tomography in dentistry

Cone-beam computed tomography(CBCT) was developed and introduced specifically for dento-maxillofacial imaging. CBCT possesses a number of advantages over medical CT in clinical practice, such as lower effective radiation doses, lower costs, fewer space requirements,easier image acquisition, and interactive display modes such as mutiplanar reconstruction that are applicable to maxillofacial imaging. However, the disadvantages of CBCT include higher doses than two-dimensional imaging; the inability to accurately represent the internal structure of soft tissues and soft-tissue lesions; a limited correlation with Hounsfield Units for standardized quantification of bone density; and the presence of various types of image artifacts, mainly those produced by metal restorations. CBCT is now commonly used for a variety of purposes in oral implantology, dentomaxillofacial surgery, image-guided surgical procedures, endodontics, periodontics and orthodontics. CBCT applications provide obvious benefits in the assessment of dentomaxillofacial region, however; it should be used only in correct indications considering the necessity and the potential hazards of the examination.

Aging and Geriatric Dentistry

Five theories shed lights on the potential mechanisms of aging:somatic mutations,telomere loss,mitochondrial defects,and accumulation of altered proteins inside proteasomes.The existence of a program of aging is not yet identified,but overlaps with a program for risks of death.On the other hand,organisms are programmed for survival,which ultimately fails.This failure results in aging,notabily,focusing on alterations of specific genes.Irregular examinations,dysfunctions,insufficient use of fluoride,and removable partial dentures,are favoring the formation of caries and periodontal pathologies.Oral lesions are due to local trauma,related gingival recession,and formation of pockets.They are associated to insufficient removal of food/plaque.Epithelial thinning,and reduction of extracellular matrix components,lead to plications and foldings of the mucosal surface,and subsequently to bacterial colonization.Geriatric dentistry(or gerodontology)is an increasing field of dentistry,mostly associated with the growing percentage of patients over 80+years.

CAD/CAN APPLICATION IN DENTISTRY: A PRESENTATION OF THE DURET SYSTEM

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Empathy Levels of Dentistry Students in Peru and Argentina

Objectives: To compare the empathy of students in two faculties of Dentistry in Peru and Argentina, three factors were considered: universities, academic year and gender. Material and Methods: Empathy matrices in Dentistry students were measured using the Jefferson Scale of Empathy, culturally validated in Peru and Argentina. Empathy data were compared among and within the faculties tested using a three-factor analysis of variance (model III), a Duncan test, and a discriminant analysis. The level of significance used was less than 0.05. Results: We found that differences existed between the students tested. The comparison between the levels of empathy in the studied factors and the presence of unexplained variance showed that empathy was able to differentiate populations. Conclusions: The results indicate variability in the empathy values associated with the factors studied. The discriminant test confirms the differences between faculties revealed by the data matrix resulting from the JSE. These differences are possibly due to the effect of educational and social factors.

数字化口内扫描技术专家共识

数字化口内扫描是近年口腔数字化技术的研究热点,成为口腔正畸、修复、种植的重要技术。数字化口内扫描的精确度和数据资料采集拼接的准确性是保证数字印模成功和加工制作效果的关键;而扫描仪特性、成像原理以及操作者扫描方式、扫描对象、口腔组织特殊性、修复设计方案等均会影响数据采集的准确性。仍有诸多操作者对于如何鉴别不同修复设计的扫描策略、扫描轨迹、如何减少数字化扫描误差等认识不足,且目前国内外学者关于数字化口内扫描技术尚未形成统一标准与共识。为了更好地帮助操作者应对口内扫描中遇到的难题,提高数字化扫描质量,本文集合了参与专家的共同意见,通过对现有证据的归纳鉴别,阐述数字化口内扫描误差的原因与应对方法,掌握不同口腔印模需求下的扫描策略。本专家共识认为,基于影响数字化口内扫描精度及扫描图像重现效果受诸多因素的影响,采用正确的扫描轨迹可缩短临床操作时间,提高扫描的精确性,扫描轨迹主要包括E字法、分段法和S型法等。①进行固定义齿修复时,建议先扫描基牙及前后两个邻牙,再把基牙区域挖出洞型,最后在基牙预备完成后补扫洞型缺口处,既可满足临床实际需求,同时也能得到最可靠的精度。②全口无牙颌行全口义齿修复时,在牙槽嵴底黏膜组织设定标记点、一次性捕获前庭区域的图像、采用不同类型的扫描路径如“Z”形、“S”形、颊腭、腭颊路径、分段扫描牙弓等策略,可以减少扫描误差和改善图像拼接以及重叠的问题。③对于种植修复,当进行种植体支持的单冠修复与小跨度上部结构修复时,建议先预扫所需牙弓,再把基牙区域挖出洞型,最后安装好种植扫描杆后再补扫洞型缺口处;当进行骨水平种植体冠修复时,可通过改良的间接扫描方法,将扫描过程分为三步:首先在口内扫描临时修复体和相邻两个牙位的牙齿与牙龈组织,然后在种植体上安装标准扫描杆并扫描全牙弓,最后在口外扫描临时修复体,以获取种植体颈部穿龈轮廓的三维形态,从而增加种植体周软组织扫描的稳定性,提高扫描还原度;对于牙列缺失种植固定桥修复,黏膜具有活动度增加了扫描难度,扫描仪难以分辨形态大小相同的扫描杆,易造成图像叠加错误,可以通过更改扫描杆的几何形状改变光学曲率半径,获得更高的种植数字化印模精确度。共识认为,随着扫描牙弓的范围越大,数据拼接次数增加,扫描精度随之下降;尤其是行全口种植修复印模时,由于口内存在不稳定、不平整的黏膜形态,且无相对明显、固定的参照物,易增加图像拼接处理的难度,造成精度不足,针对此类进行修复设计时,应谨慎选择数字化口内扫描方式获取模型数据,在缺失牙大于5颗时不宜使用数字化印模。

中国口腔医学美学推动者: 深切怀念中国工程院邱蔚六院士

2024年5月24日,我国口腔医学界首位中国工程院院士邱蔚六教授在上海仙逝,巨擘陨落,英名千古。他在国内外口腔颌面外科、头颈肿瘤外科以及口腔颌面修复重建外科领域的卓越成就令世人敬仰,而他的雄韬伟略推动口腔医学美学发展贡献的故事却鲜为人知。