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Objective: To assess the clinical performance of monolithic screw-retained implant-supported zirconia crowns (MSI) bonded or mechanically retained on prefabricated Ti-bases using a complete digital workflow., Methods: A retrospective analysis was conducted on patients who underwent single dental implant procedures between January 2017 and May 2018. Inclusion criteria were: patients over 18 years of age; implants placed in posterior sites; MSI on prefabricated Ti-base realized by using a complete digital workflow; a minimum follow-up period of 2 years. Cemented crowns and fixed dental prosthesis were excluded. Mechanical complications included: fracture of Ti-base; loss of retention; loosening of Ti-base screws. Technical complications included: fracture and debonding of monolithic zirconia. Biological complication was set strictly at a probing pocket depth of 5 mm and bleeding on probing or pus secretion., Results: A total of 144 dental implants placed in 127 patients were included, 73 with a fully tapered implant system (BLX) and 71 with a conical connection system (Nobel Parallel CC). Of the 73 BLX implants, 4 experienced loosening of the Ti-base screw, while 3 Nobel Parallel CC implants experienced the same problem. In addition, 4 fractures of the Ti-base and 6 fractures of the inner surface of the monolithic zirconia were observed in the Nobel Parallel CC implants. Cumulative survival was 100 % for bonded crowns and 85 % for mechanically retained crowns. Radiographic evaluation revealed a mean CBL of 0.12 mm for the BLX and 0.13 mm for the Nobel Parallel CC implants with no statistically significant differences between the Ti-base types. There was no evidence of bleeding on probing or pus secretion. All probing pocket depths were <3 mm., Conclusion: The use of a prefabricated Ti-base remains a clinically acceptable choice, however, MSIs bonded to prefabricated Ti-bases had fewer mechanical and technical complications than the MSI mechanically retained to a prefabricated Ti-base., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Statement of Problem: Additive manufacturing (AM) technology is emerging as an innovative approach in the dental field. In recent years, manufacturers have introduced 3-dimensionally printed composite resins (3D-CRs) that are specifically designed for the AM of definitive prostheses; however, the mechanical and surface properties of these materials require investigation., Purpose: The purpose of this in vitro study was to assess and compare the mechanical and surface properties of 2 commercially available 3D-CRs for definitive restoration after artificial aging., Material and Methods: Saremco print Crowntec; Saremco Dental AG and Varseo Smile Crown Plus; Bego GmbH were printed with a layer thickness of 50 µm at a 90-degree angle. A total of 20 bar-shaped specimens (25×2×2 mm) were produced from each material to measure the flexural strength (σf) and elastic modulus (E) using a 3-point bend test, and 5 disk-shaped specimens (Ø15×3 mm) from each material were used to measure the surface microhardness using a microhardness test. Half of the specimens were tested under dry conditions, while the other half were immersed in distilled water for 30 days. Five disk-shaped specimens (Ø15×3 mm) from each material were used to evaluate surface roughness before and after undergoing toothbrushing simulations. Additionally, 5 disk-shaped specimens (Ø15×1 mm) were used to assess water sorption (w sp ) and solubility (w sl ) over 28 days. Statistical analyses were conducted using the Wilcoxon matched-pairs signed-rank test (1-tailed) with 90% power (α=.05)., Results: The mean ±standard deviation flexural strength values were 123.4 ±8.7 MPa for Saremco print Crowntec and 109.9 ±15.8 MPa for Varseo Smile Crown Plus. After aging, these values were 97.5 ±15.2 MPa for Saremco print Crowntec and 94.2 ±11.7 MPa for Varseo Smile Crown Plus. The mean Vickers hardness values were 33.2 ±0.8 N/mm 2 for Saremco print Crowntec and 31.5 ±0.6 N/mm 2 for Varseo Smile Crown Plus. After aging, the mean values were 31.7 ±0.9 N/mm 2 for Saremco print Crowntec and 29.6 ±1.0 N/mm 2 for Varseo Smile Crown Plus. The mean modulus of elasticity was 4.2 ±0.3 GPa for Saremco print Crowntec and 3.82 ±0.2 GPa for Varseo Smile Crown Plus. After 21 days, the mean sorption values were 11.52 ±0.6 mg/mm 3 for Saremco print Crowntec and 12.43 ±0.4 mg/mm 3 for Varseo Smile Crown Plus. After 28 days, the mean solubility values were 1.36 ±0.4 mg/mm 3 for Saremco print Crowntec and 0.98 ±0.3 mg/mm 3 for Varseo Smile Crown Plus. Significant differences were found between the 2 3D-CRs in flexural strength in the dry state (P=.03), in Young modulus after 30 days of water immersion (P=.023), and in Vickers hardness in the dry state (P=.01) and after 30 days of water immersion (P=.018)., Conclusions: Both 3D-CRs provided good in vitro performance and the mechanical properties required for long-term clinical application. Artificial aging decreased the flexural strength of both 3D-CRs., (Copyright © 2024 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Background: Teeth bleaching is a common practice performed by dental hygienists and dentists to correct aesthetic problems due to dental discoloration. Patients' opinions on this procedure may be different according to their personal experiences, expectations and individual sensitivities. The aim of this study is to assess the degree of satisfaction and related sensitivity of patients to professional and home bleaching treatment., Methods: A questionnaire consisting of 12 multiple-choice questions was submitted to 625 subjects among general population. These were related to: 1) patient's age and whether the patient is a smoker; 2) personal satisfaction; and 3) post-treatment tooth sensitivity. Descriptive analyses of all variables in the questionnaire were performed, and statistical analyses between variables were carried out by Chi-square test and Fisher's Exact test., Results: Of the people surveyed, 66% performed home bleaching, while the remaining performed the treatment in a dental office. Thirty-three percent of patients had previously undergone teeth bleaching and the 95.7% stated that they were satisfied with the treatment. Of these, only 36.4% reported experiencing postoperative hypersensitivity. Most patients (91.3%) received professional scaling before undergoing bleaching treatment., Conclusions: Patient satisfaction with tooth whitening treatment can vary from patient to patient and represents a strong indicator of treatment efficacy and suitability. A proper communication, careful management and individualized patient assessment are key to maximizing satisfaction and ensuring a positive and fulfilling patient experience.

Dental decay is a prevalent bacterial disease affecting a significant percentage of children globally. In paediatric dentistry, various materials are available for restoring deciduous teeth, addressing both functional and aesthetic concerns. However, paediatric dentists encounter challenges related to patient compliance, limited working time, and material handling. This study aims to observe the survival rate of bulk-fill composite restorations in paediatric patients over a five-year follow-up. A total of 198 patients aged 0 to 12 years underwent 673 class II restorations on deciduous first molars (1M) and second molars (2M). All restorations were conducted performed by 1 Pediatric DDS resident students from the Paediatric Dentistry Department (Padova University), utilizing using different isolation techniques. Bulk-fill composite restorations were evaluated over a five-year follow-up, and data were collected by a single investigator. After five years, 177 patients and 611 restorations were assessed. The retention rate was higher in primary second molars than in first molars, with fewer marginal dyschromies and less formation of secondary caries. The overall failure rate was higher in primary first molars and primary lower second molars. Bulk-fill composites demonstrated significantly positive performance in terms of retention, maintenance, and marginal dyschromies. Bulk-fill composites are promising materials of choice in paediatric dentistry due to their easy handling and favorable properties. Further research is necessary to compare high and low viscosity bulk-fill composites and assess the impact of different variables on restoration success., Competing Interests: The authors declare no conflict of interest., (©2024 The Author(s). Published by MRE Press.)

Introduction: Tobacco smoke is a major health risk factor for smokers but also for non-smokers due to passive smoking. These risks come from conventional cigarette smoke but also from aerosol produced by electronic cigarettes and heated tobacco products (HTPs). The aim of this study was to investigate population knowledge about the adverse effects of passive smoking from traditional cigarettes, electronic cigarettes, and HTPs., Methods: Between February and October 2023, 504 subjects among the general population responded to a questionnaire with 8 questions in Italian, via a link to the Google Forms platform. The questions related to the oral health effects of active and passive smoking. Descriptive analyses of all variables in the questionnaire were performed, and statistical analyses between variables were carried out using the chi-squared test and Fisher's exact test., Results: A large subset of individuals interviewed stated that active smoking is harmful to health and consider active smoking more damaging compared with passive smoking (86.3%). The majority believed that passive smoking of cigarettes is more harmful to oral health than passive smoking of HTPs (79.4%) or electronic cigarettes (e-cigarettes) (84.9%)., Conclusions: Results suggest that most people in this study had good knowledge about the adverse effects of active or passive smoking on health; however, knowledge regarding e-cigarettes and HTPs was poor and confused. These results reveal the complexity of perceptions regarding different types of smoking and the need for further research to fully understand the risks associated with each type of passive smoking., Competing Interests: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported., (© 2024 Ludovichetti F. S. et al.)

Objectives: To assess the diagnostic ability in detecting oral lesions among dentists, dental hygienists, dentistry students, oral hygiene students, and non-healthcare subjects., Materials and Methods: Participants were invited to classify 30 images of oral lesions in "benign" or "suspected malignant" only based on the visual appearance of the lesion. Diagnostic accuracy was assessed by calculating sensitivity and specificity with 95% confidence intervals and stratified by population group and image features (color, shape, and size of the lesions)., Results: A total of 16,590 examinations by 553 subjects were analyzed. Overall sensitivity and specificity were 57% (95% confidence interval 56%-58%) and 64% (95% confidence interval 63%-65%). Diagnostic accuracy varied among population groups, with experienced dentists showing the lowest sensitivity (52%) and the highest specificity (71%). Red lesions, flat lesions, and large lesions had the lowest sensitivity (42%, 36%, 57%) but the highest specificity (70%, 75%, 76%)., Conclusions: We found worrying low ability to detect suspected malignant oral lesions by both healthcare workers and non-healthcare subjects. Lesion-specific characteristics may lead to differences in recognition. Specific courses and more adequate teaching methods should be proposed to increase identification of oral lesions., (© 2023 The Authors. Oral Diseases published by Wiley Periodicals LLC.)

Background/Objectives: Advancements in oral imaging technology are continually shaping the landscape of dental diagnosis and treatment planning. Among these, photon-counting computed tomography (PCCT), introduced in 2021, has emerged as a promising, high-quality oral technology. Dental imaging typically requires a resolution beyond the standard CT systems achievable with the specialized cone-beam CT. PCCT can offer up to 100 µm resolution, improve soft-tissue contrast, and provide faster scanning times, which are crucial for detailed dental diagnosis and treatment planning. Using semiconductor detectors, PCCT produces sharper images and can potentially reduce the number of scans required, thereby decreasing patient radiation exposure. This review aimed to explore the potential benefits of PCCT in dental imaging. Methods: This review analyzed the literature on PCCT in dental imaging from January 2010 to February 2024, sourced from PubMed, Scopus, and Web of Science databases, focusing on high-resolution, patient safety, and diagnostic efficiency in dental structure assessment. We included English-language articles, case studies, letters, observational studies, and randomized controlled trials while excluding duplicates and studies unrelated to PCCT's application in dental imaging. Results: Studies have highlighted the superiority of PCCT in reducing artifacts, which are often problematic, compared to conventional CBCT and traditional CT scans, due to metallic dental implants, particularly when used with virtual monoenergetic imaging and iterative metal artifact reduction, thereby improving implant imaging. This review acknowledges limitations, such as the potential for overlooking other advanced imaging technologies, a narrow study timeframe, the lack of real-world clinical application data in this field, and costs. Conclusions: PCCT represents a promising advancement in dental imaging, offering high-resolution visuals, enhanced contrast, and rapid scanning with reduced radiation exposure.

The problem of antibiotic resistance is becoming increasingly serious worldwide due to uncontrolled prescription. Dentists are among the groups that prescribe the most antibiotics, often to delay urgent treatment. The purpose of the present study is to investigate the prescribing protocols adopted by dentists for prophylaxis and antibiotic therapy in major clinical surgical indications., Methods: A ten-question survey was administered to a group of Italian dentists. The participants were asked about their preferences for antibiotic administration for the prevention of infective endocarditis, the administration of antibiotics to patients allergic to penicillin, the insertion of implants, and the extraction of third molars. The retrieved data were screened and analyzed., Results: A total of 298 surveys were filled out. The most-prescribed antibiotic was amoxicillin or amoxicillin with clavulanic acid or macrolides for allergic patients. The administration of two grams of amoxicillin one hour before surgery was the most widely used prescriptive protocol for prophylaxis. International guidelines on antibiotic prophylaxis for infective endocarditis were only partially followed. The most heterogeneous results emerged for prophylaxis associated with dental implants or provided prior to surgical third-molar extraction., Conclusions: The present study shows widespread antibiotic prescriptive heterogeneity among the sample of dentists analyzed, especially in conditions where international guidelines are lacking. An evidence-based consensus on prescriptive modalities in dentistry would be desirable in the near future.

Background: The COVID-19 pandemic has significantly impacted various sectors, including healthcare. The dental profession has faced unprecedented challenges in providing care while minimizing the risk of transmission. The aim of the study is to assess how patient's perception of hygiene in the dental field has changed since COVID-19. In detail, it has been analyzed patient's attention to hygiene and how in his opinion the dental practice changed its procedures after COVID-19., Methods: A questionnaire consisting of 10 multiple-choice questions was submitted to 509 subjects, patients of several dental practices. These were related to: 1) change in their perception of hygiene after COVID-19; 2) how the office they usually go to has changed and what hygiene standards it has adopted; 3) vaccination against COVID-19. Descriptive analyses of all variables in the questionnaire were performed, and statistical analyses between variables were carried out by Chi-square test and Fisher's Exact Test., Results: Most patients (75.8%) stated that they had changed their perception of hygiene after the onset of COVID-19. They reported that they had experienced changes in hygiene procedures at their usual dental practice (70.7%), including rinsing with chlorhexidine mouthwash, continuous air and water disinfection and use of personal protective equipment (PPE). Vaccination of practitioners was considered to be important by 73.5% of participants., Conclusions: In the present study it was analyzed how emergence of the new Coronavirus has considerably changed the perception of patient hygiene within the dental practice. As a result of the awareness implemented to prevent virus transmission, patients are paying more attention to hygiene and preventive procedures to protect their health.

Objectives: To evaluate the clinical performance of monolithic zirconia restorations with feather-edge margins fabricated by digital impressions., Materials and Methods: All participants that present monolithic zirconia restorations with feather-edge margins realized with digital workflow were evaluated during scheduled periodontal maintenance between February and September 2022 according to predetermined inclusion criteria. Clinical performance was assessed using the modified USPHS and periodontal parameters. Overall survival was calculated for monolithic zirconia restorations. Technical and biologic complications were reported. Descriptive statistical analysis and life-table analyses were performed for all data., Results: A total of 1472 monolithic zirconia FDPs (1279 on abutments and 193 on pontics) placed in 1189 patients (982 males and 490 females) from February 2017 to September 2020 were analyzed. The mean follow-up was 44 months (range 36-61 months), and the overall survival rate was 98.5%. There were 931 single crowns, 96 were 3-unit FDPs, 33 were 4-unit FDPs, 11 were 5-unit FDPs, and 6-unit FDPs. Three single crowns had irreparable cracks, and 6 single crowns and one 4-unit FDP were fractured. One 3-unit FDP failed due to tooth fracture and 5 single crowns failed due to endodontic failure. The loss of retention was noted in 25 monolithic zirconia FDPs and hypersensitivity in 44 single crowns. Biologic complications were uncommon., Conclusions: Based on the results and its limitations, the monolithic zirconia FPDs and digital impressions represent a favorable prosthetic treatment similar to that reported with other margin designs CLINICAL RELEVANCE: Monolithic zirconia restorations on vertical-margin abutments fabricated using a digital workflow demonstrate excellent clinical performance. The digital clinical workflow without the use of a cast means a reduction in costs, steps, and operating time., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective:  Over a billion people in the world live with some form of disability and this figure is destined to grow due to the increase in life expectancy. As consequence, the caregiver is taking on an increasingly important role that gains relevance also in the field of oral-dental prevention, being able to promptly identify needs for medical treatment. In some cases, however, the caregiver can be an obstacle to consider in case of a lack of adequate knowledge and commitment. The aim of this study is to evaluate the caregiver level of oral education comparing family members and health workers dedicated to people with disabilities knowledge., Materials and Methods:  Anonymous questionnaires were distributed in five disability service centers and filled alternatively by family members of patients with disability and disability service centers health workers., Results:  Two-hundred fifty questionnaires were collected, of which 100 were filled in by family members and 150 by health workers. Data were analyzed by applying the chi-squared (X2) independence test and the pairwise method for missing data., Conclusion:  Family members oral education appears better in terms of brushing frequency, toothbrush replacement, and number of dental visits., Competing Interests: None declared., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).)

Background: Different methods are used for the analysis of marginal and internal fit of partial crowns, but not all of them are applicable for in vivo studies. The aim of this review is to search the available methods, described in the current literature, to assess marginal and internal fit in partial crowns., Methods: an electronic search was performed on Pubmed and Web of Science databases to find studies published from 1 January 2017 up to 2 March 2023, following PRISMA guidelines and Cochrane handbook for systematic reviews. The search strategy applied was: "(marginal) AND (fit OR gap OR adaptation OR discrepancy) AND (inlay OR onlay OR partial crown)". In vitro studies which evaluated marginal and internal fit on CAD CAM or 3D printed partial crowns were included in this review. Quality of the studies was assessed by using Quality Assessment Tool For In Vitro Studies (QUIN tool)., Results: 22 studies were included. Among conventional methods, direct view with microscope, indirect view on resin replicas, and silicone replica technique (SRT) were used. Considering new digital methods, micro-CT, SRT 3D and triple scan technique (TST) were applied., Conclusions: Among 2D methods, direct view technique is the most used marginal fit analysis. For a more comprehensive evaluation, a 3D digital analysis is suggested. SRT and indirect view are the only 2D methods available for in vivo analysis. A protocol for the application of TST for assessment in vivo is now available, but no studies are reported in literature yet.

Background: Bleeding disorders can be divided into three categories: congenital coagulation disorders (CCDs), antiplatelet-induced bleeding disorders (APBDs) and anticoagulant-induced bleeding disorders (ACBDs). Implant placement can be challenging in these kinds of patients. The aim of this study is to provide evidence on implant surgery in patients with bleeding disorders and to generate some practical recommendations for clinicians., Material and Methods: Pubmed/MEDLINE, Scopus, Web of Science and Cochrane Library databases were screened. The latest search was performed in July 2022. Case reports, case series, cohort studies, cross-sectional studies, case control studies, reviews, consensus reports, surveys and animal studies were included in the analysis., Results: Seventeen articles on CCDs were found, fourteen on APBDs and twenty-six on ACBDs. Most of these articles were case reports or case series. Patients with CCDs can be treated after the infusion of the missing coagulation factor. Patients with APBDs can be treated without withdrawing the therapy. Patients with ACBDs should be treated depending on the anticoagulative medication., Conclusion: Despite the low level of evidence, dental implants can be safely placed in patients with bleeding disorders. However, careful preoperative evaluation and the adoption of local and post-operative bleeding control measures are mandatory.

Objective:   The aim of this study is to evaluate whether the treatment of ECC, performed in a single-session dental treatment under general anesthesia, can affect the quality of life of pediatric patients. It was assessed whether risks and discomforts involved in SSGA are outweighed by its effectiveness and reliability in improving oral health-related quality of life., Materials and Methods:  The quality of life that was assessed in this prospective study was oral health-related quality of life (OHRQL). Pediatric patients aged between 3 and 6 years with ECC undergoing dental treatment in SSGA were asked to fill in the Early Childhood Oral Health Impact Scale (ECOHIS) form both before and 1 month after the intervention. The data obtained were then statistically elaborated and analyzed to evaluate the actual significance of the differences found between the values before and after treatment and between the two sexes., Results:  Mean ECOHIS score before treatment was 30.58, following a large decrease after treatment, with a mean score of 2.94. Most parameters show a significant improvement between pre- and post-SSGA treatments, mainly those related to oral-dental pain, daytime irritability, and impact on family environment. Average ECOHIS scores for males and females are 31.72 and 29.76 before treatment and 3.55 and 2.52 1 month after treatment, respectively, showing no statistically significant differences., Conclusion:  The dental treatment of young children under SSGA is associated with considerable improvement in their OHRQL. It can be considered an effective and reliable way of managing cases that cannot be dealt with by alternative methods., Competing Interests: None declared., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).)

Introduction: Third molar surgery can cause post-operative complications to the patient due to the presence of a wound from the incision. This study aimed to compare marginal flap with para-marginal flap on postoperative complications by the measurements on pre and post-surgical plaque index (PI), bleeding on probing (BoP), maximum opening of the mouth (MOM), pain perception (PP) and post-surgical tumefaction (PT)., Methods: In this double-blind randomized clinical trial, 40 patients were recruited and randomly allocated in two groups. In Group 1, third molar extraction was carried out after a marginal flap design was performed, while in Group 2 a para-marginal flap was performed. Plaque index, bleeding on probing, maximum mouth opening, and distal probing were assessed right before and one week after surgery, while post-operative pain perception and post-operative swelling were accounted one week following surgery., Results: Statistically significant differences were reported between treatment groups, as the para-marginal flap led to better outcomes for all the measured indexes., Conclusions: The para-marginal flap design may decrease the occurrence of post-operative complications and discomforts after mandibular third molar surgery, compared to marginal flap design.

Background: Dental caries still represents a major public health problem, as it is the most widespread noncommunicable disease. The enamel of deciduous teeth is less resistant than permanent dentition and for this reason demineralization, and consequent caries formation, progresses more rapidly. The purpose of this study is to investigate the correlation between the incidence of caries and intake of sugary drinks in pediatric patients., Methods: The study included 526 subjects (295 males, 231 females) between the ages of 2 and 15 years old. Several variables were examined, including: gender, age, separate values of the decay missing filled teeth (DMFT) epidemiological index (for both deciduous and permanent dentition), quantity and quality of sugary drinks taken daily, daily brushing frequency, parental nationality and socio-economic status. A multivariate analysis conducted (using a simple linear regression model) to verify the association between soft drink consumption and DMF, including a series of confounding variables (namely, sex, brushing frequency and parents' nationality)., Results: From the results of the statistical analysis of the variables examined, a correlation between the incidence of caries in children aged between 2 and 14 years and brushing frequency, consumption of sugary drinks and parents' nationality was found., Conclusions: It is important to raise awareness and properly inform patients and healthcare colleagues about the importance of oral health. Taking good care of our oral health represents part of implementation of the lifestyle and the quality of life of the future generations.

Background: Dental calculus is the result of dental plaque mineralization, originating from the tooth-associated bacterial biofilm. Recent evidence revealed that the dental calculus microbiome has a more complex composition than previously considered, including an unstructured mix of both aerobes and anaerobes bacteria. Actually, we lack information about the influence of host lifestyle factors, such as diet and health on this highly biodiverse ecosystem. Here, we provide a pilot study investigating dental calculus microbial biodiversity and its relation with the host diet., Methods: We collected 40 dental calculus samples during routine dental inspection; deoxyribonucleic acid was extracted and analyzed through 16S amplicon sequencing, while dietary information was retrieved through a questionnaire. Associations between diet and oral bacteria taxonomy and functional pathways were statistically tested., Results: Overall, microbiome composition was dominated by 10 phyla and 39 bacterial genera, which were differently distributed among samples. Cluster analysis revealed four main groups based on the taxonomic profile and two groups based on functional pathways. Each taxonomic cluster was dominated by different microbial biomarkers: Streptococcus, Rothia, Tannerella, Lautropia, and Fusobacterium. Bacteria genera and pathways were also associated with specific dietary elements, especially vegetable and fruit intake suggesting an overall effect of diet on dental calculus microbiome., Conclusions: The present study demonstrates that there exists an inter-variability in the microbial composition of dental calculus among individuals of a rather homogeneous population. Furthermore, the observed biodiversity and microbial functions can find an association with specific dietary habits, such as a high-fiber diet or a protein-rich diet., (© 2022 The Authors. Molecular Oral Microbiology published by John Wiley & Sons Ltd.)

Background: Oral mucositis (OM) is one of the most debilitating side effects of chemotherapy. Among the current methods used in OM management, the feasibility of high power laser therapy (HPLT) has been proposed but not fully evaluated., Aim: The aim of this study was to evaluate the efficacy of HPLT in the treatment of OM in paediatric patients., Design: Fourteen oncohematological paediatric patients treated with chemotherapy and/or hematopoietic stem cell transplantation and affected by OM at different grades were enrolled in this study. All patients were treated with a class IV laser device in four sessions for four consecutive days, OM was evaluated with the WHO-OTS scale. The perception of pain was assessed by the visual analog scale. Photographs of and information about lesions and patient questionnaires were taken and collected, respectively. Descriptive analyses and the Wilcoxon signed-rank test (nonparametric test) were used, with a statistical significance of α = .05., Results: After a week into the treatment, 57% of patients were completely healed, whereas the whole cohort experienced a drastic decrease in pain, from an average value of 5.8-1.1 (p = .0016). The average number of injuries per patient decreased from 7.4 to 3.1 (p = .008)., Conclusion: High power laser therapy appears to be a safe and efficacious method for managing OM. It reduces pain and severity of oral cavity injuries. Further studies are needed to determine the optimal parameters useful in OM treatment and to evaluate the relative effectiveness of HPLT to other treatments like LLLT., (© 2023 The Authors. International Journal of Paediatric Dentistry published by BSPD, IAPD and John Wiley & Sons Ltd.)

Statement of Problem: The choice of retention type of an implant-supported fixed dental prosthesis (FDP) becomes critical when the dental implant is not placed in a prosthetically ideal location. In recent years, computer-aided design and computer-aided manufacturing (CAD-CAM) technology has enabled the correction of the location of screw access hole depending on the clinical needs of the patient. However, how FPDs with angulated screw channels (ASCs) perform clinically is unclear., Purpose: The purpose of this prospective clinical study was to evaluate the mechanical complications and crestal bone loss (CBL) when posterior monolithic zirconia implant-supported FDPs with an ASC are used., Material and Methods: Participants (N=37) with a missing single posterior tooth or multiple teeth, sufficient bone height, and an implant site without infection were included. Each participant received parallel-walled implants (Nobel Parallel CC) of 7-, 8.5-, or 10-mm length by using a 1-stage approach. After 4 months of healing, a conventional impression was made, and a digital workflow was followed. Monolithic zirconia restorations (Katana ML) were milled, stained, and mechanically attached to a titanium base (NobelProcera ASC abutment). CBL was measured from radiographs at 6, 12, 24, and 36 months after the placement of the prosthesis. Implant and prosthetic characteristics including implant diameter, implant length, screw channel angle (angle≤15 degrees versus angle>16 degrees), prosthetic type (single crown versus multiple-unit FDP), and antagonist dentition (natural versus prosthesis) were also recorded. A generalized linear mixed model with a log link was estimated to assess the independent predictors of CBL among the angles of ASC-retained definitive restorations and the clinically relevant variables (α=.05)., Results: Thirty-seven participants received 51 implants, and the median follow-up period was 30 months (interquartile range: 22-36). Two single-crown implants failed within the first 12 months of delivery. The implant and restoration survival rate was 96% at 36 months. Screw loosening was recorded in 2 study participants. After a follow-up of 36 months, the mean ±standard deviation CBL value was 0.15 ±0.14 mm with an increase over time (P<.001). The effect of the angle of ASC, implant diameter, implant length, prosthetic type, and antagonist on the CBL was not statistically significant (P>.05)., Conclusions: CBL was not associated with the angle of ASC, implant diameter, implant length, prosthetic type, or antagonist when posterior monolithic zirconia implant-supported FDPs with ASCs were used. Screw loosening in 2 situations was the only mechanical complication during the first 3 years of service., (Copyright © 2021 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Purpose: To investigate and assess the differences in crestal bone loss (CBL) between wide-diameter, external-hexagon-connection implants restored with platform-switching (PS) and platform-matching (PM) restorations with a follow-up of 10 years. Materials and Methods: This study retrospectively analyzed the updated and enlarged dataset of a 5-year prospective clinical study at 10-year follow-up. The data concerns 182 healthy adult subjects treated in a private dental practice who received a single wide-diameter implant with an external hexagon connection in the molar area, restored with either a PS restoration (test) or PM restoration (control). The amount of CBL was radiographically measured at each annual follow-up, as well as after 5 and 10 years of implant loading. In evaluating the association between the two types of abutments and bone loss (including change over time), a linear mixed effects model was run for longitudinal data. Results: Implants connected with PS restorations exhibited significantly lower reduction (0.25 mm) in CBL than those joined to PM restorations ( P < .001; 95% CI from 0.22 to 0.29). However, both groups presented a higher increase in bone loss during the first year (0.58 mm in PS and 0.83 mm in PM) and a linear increment thereafter until the 10-year follow-up (0.046 mm/year; P < .001; 95% CI from .042 to .049). Conclusion: Notwithstanding the limitations of this study, it can be concluded that after 10 years of follow-up, the implant with a wide diameter and external-hexagon connection restored with a PS abutment seems to be more effective in reducing bone loss compared with the PM abutment.

The relationship between periodontitis and such systemic disorders as diabetes, cardiovascular disease and obesity has been extensively investigated. There is less scientific evidence available, however, regarding the influence of systemic diseases on the risk of late failure of dental implant rehabilitation due to peri-implantitis. The aim of the present study was to review the literature on the role of several common systemic disorders (diabetes, obesity, cardiovascular disease, hypertension and osteoporosis) in the onset of peri-implantitis. A database search initially yielded 2787 studies of potential interest published up to 1 March 2022 (993 in PubMed; 908 in Web of Science; and 886 in Scopus). After removing 1190 duplicate articles and checking the titles, abstracts and full texts for relevance, 70 articles were selected for the present analysis. Only cohort, case-control studies and clinical case series were considered. Most of the literature concludes for no association between diabetes, cardiovascular disease, hypertension or osteoporosis and the risk of peri-implantitis. On the other hand, almost all the studies that investigated obesity as a risk factor for implant rehabilitation found a positive association between the two. Further longitudinal studies are needed to better understand the effects of systemic diseases on rehabilitation with dental implants.

Background: Caries is a multifactorial degenerative disease, and it is the most common chronic disease during childhood. Few studies have assessed the effects of breastfeeding and bottle feeding on children's dental caries, also taking into account the duration of both options. We investigated whether the infant feeding duration and feeding methods (breast, bottle or both) are risk factors for dental caries in childhood., Methods: Our study included 210 children from 2 to 6 years old and it was carried out in the Department of Pediatric Dentistry of Borgo Cavalli (Treviso, Italy). The average number of decayed, missing, and filled primary tooth surfaces (DMFT) were investigated by analyzing the medical histories. Data collection was conducted from September 2021 to July 2022. Data analysis was performed using the statistical program R (R Foundation for Statistical Computing, Vienna, Austria). First, an analysis was performed to verify the database using a graph. We used the negative Poisson and Binomial count model for the data. Next, the verification of which covariables were significant was performed, finally the conclusions were obtained., Results: By dividing the population according to the type of feeding, we saw that most of the children participating in the study had between 3 and 7 cavities. By analyzing the length of feeding, we saw that the average duration was between 10 and 20 months. Due to the P values, we concluded that the total duration of feeding variable was not significant in explaining the event of interest and, therefore, only the variable type of feeding (artificial and natural) was significant because the P value was below the 5% significance level. Finally, we concluded that natural type breastfeeding increases the average amount of caries by 1.29 times, or 29% more than artificial feeding., Conclusions: Compared to bottle-feeding, breastfeeding increases the risk of caries at an early age; however, there is no correlation between duration and occurrence of caries. Meanwhile, considering health benefits, dental professionals should not discourage breastfeeding; as a matter of fact, promoting breastfeeding has many benefits for infants and mothers, provided that it is associated with proper oral hygiene.

Pregnancy is a critical time for a woman since it involves a series of changes in the body due to hormonal fluctuations and changes that can also influence the oral cavity and can lead to certain pathologies, such as carious lesions. Furthermore, it has been demonstrated over the years that having poor dental health during pregnancy might have a significant impact on the child's oral health. The aim of the study is to analyze the level of knowledge and information of mothers on the importance of oral health care before, during, and after pregnancy as a preventive factor for the future oral health of the child. A questionnaire of 13 multiple choice questions was formulated and delivered from 24 February 2022 to 13 July 2022, aimed at women with at least one child. The Department of Pediatric Dentistry of the Borgo Cavalli Clinic in Treviso and the Maxillofacial Surgery Department of Santa Maria di Ca' Foncello Hospital in Treviso were the data collection centers. Crosstabs with dependency variables were used to statistically analyze the results. The study cohort consists of 411 women, whose responses showed that the majority did not have dental visits before and during pregnancy, which is why 74% of the whole sample did not request or receive information from professionals. Most mothers knew that they had to cleanse their child's mouth and, among them, those who responded more correctly, that is, who started before the eruption of the teeth, had received instructions from professionals. However, the low frequency of mothers performing dental checks during pregnancy did not allow mothers to become aware of the possibility of transmitting the carious lesions to their child, as conscious mothers represent 21%. Education from dentist and dental hygienists, gynecologists, and pediatricians is essential since they have an impact on mothers' habits and behaviors and ensure favorable oral health for both the mother and the child.

Biobanks are not-for-profit services for the collection, processing, storage and distribution of biological samples and data for research and diagnostic purposes. In dentistry, biological materials and data obtained from questionnaires investigating oral conditions can be stored and used for large-scale studies on oral and systemic diseases. To give some examples: gene expression microarrays obtained on biobanked specimens were used in the identification of genetic alterations in oral cancer; efforts to identify genetic mechanisms behind dental caries have been based on an integrative analysis of transcriptome-wide associations and messenger RNA expression. One of the largest studies on facial pain was conducted using Biobank data. Cryopreservation of dental pulp stem cells is a common practice in tooth biobanks. With the exception of teeth and pulp, also leftover oral soft and hard tissues may represent a source of healthy samples that has rarely been exploited as yet. While biobanks are increasingly attracting the attention of the scientific community and becoming economically sustainable, a systematic approach to this resource in dentistry seems to be lacking. This review illustrates the applications of biobanking in dentistry, describing biobanked pathological and healthy samples and data, and discussing future developments., (© 2021 The Authors.)

Background: Dental erosion is an irreversible condition of loss of teeth hard tissues caused by intrinsic or extrinsic acids attack, without bacterial involvement. Common soft drinks have an acid pH and they release hydrogen ions and act as chelating agents, dissolving teeth mineral component. The aim of the study was to investigate the correlation between the consumption of soft drinks in children and the degree of dental erosion., Methods: A questionnaire of 15 multiple choice questions was addressed to the parents of the 231 children needing different dental treatments. Responses were compared with the level of dental erosion of their child, that was clinically investigated using the Basic Erosive Wear Examination (BEWE) index., Results: About 26.8% of subjects fall into a high-risk category of dental erosion while 24.2% in a low risk level. Socioeconomic status and oral hygiene habits are able to affect the degree of dental erosion. Toothpastes containing fluoride have not proved effective in preventing this phenomenon and no significant correlations were found between the type of toothbrush used and its frequency of use., Conclusions: It is necessary to apply preventive measures such as information on the processes and causes of erosion, instruction about right home oral hygiene maneuvers and the possible use of specific products, to avoid the development of problems related to severe dental wear.

The present review aimed to assess the possible relationship between occlusal overload and peri-implant bone loss. In accordance with the PRISMA guidelines, the MEDLINE, Scopus, and Cochrane databases were searched from January 1985 up to and including December 2021. The search strategy applied was: (dental OR oral) AND implants AND (overload OR excessive load OR occlusal wear) AND (bone loss OR peri-implantitis OR failure). Clinical studies that reported quantitative analysis of occlusal loads through digital contacts and/or occlusal wear were included. The studies were screened for eligibility by two independent reviewers. The quality of the included studies was assessed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. In total, 492 studies were identified in the search during the initial screening. Of those, 84 were subjected to full-text evaluation, and 7 fulfilled the inclusion criteria (4 cohort studies, 2 cross-sectional, and 1 case-control). Only one study used a digital device to assess excessive occlusal forces. Four out of seven studies reported a positive correlation between the overload and the crestal bone loss. All of the included studies had moderate to serious overall risk of bias, according to the ROBINS-I tool. In conclusion, the reported data relating the occlusal analysis to the peri-implant bone level seem to reveal an association, which must be further investigated using new digital tools that can help to standardize the methodology., Competing Interests: The authors declare no conflict of interest.

Purpose: To compare the flexural properties and the adhesion of Lactobacillus salivarius (LS), Streptococcus mutans (SM), and Candida albicans (CA) on heat-polymerized (CV), CAD-CAM milled (CAD), or 3D-printed (3D) Poly (methylmethacrylate) (PMMA)., Methods: Ultimate Flexural Strength (UFS), Flexural Strain (FS) (%) at Flexural Strength, and Flexural Modulus (FM) of specimens (65.0×10.0×3.3 mm) from each PMMA group (n=6) were calculated by using the 3-point bending test. The surface roughness profiles (R) were measured before and after polishing with a contact profilometer. LS, SM, and CA adhesion on PMMA specimens (n=18) (10 mm in diameter, 3 mm in height) was assessed after 90 minutes and 16 hours by using scanning electron microscopy. The Kruskal-Wallis test with post hoc analysis was performed to compare the groups (alpha=0.05)., Results: Mean UFS values were 80.79±7.64 MPa for CV, 110.23±5.03 MPa for CAD, and 87.34±6.39 MPa for 3D. Mean FS values were 4.37±1.04% for CV, 4.71±0.62% for CAD, and 6.19±0.13 % for 3D. Mean FM values were 2542±301 MPa for CV, 3435±346 MPa for CAD, and 2371±197 MPa for 3D. CAD had the lowest average R value (0.29±0.16 µm) before polishing, and bacterial adhesion after 90 minutes of incubation. R value and microbial adhesion were not different amongst groups after polishing and 16 hours of incubation, respectively., Conclusion: The CAD group displayed the best flexural properties, except for FS, the lowest roughness before polishing and bacterial adhesion after 90 minutes of incubation. All tested PMMAs had similar surface roughness after polishing, and microbial adhesion after 16 hours of incubation.

(1) Objective: To evaluate and compare the depth of cure (DOC) of two bulk-fill flowable composites (Filtek Bulk Fill Flowable Restorative and Tetric EvoFlow Bulk Fill), two conventional flowable composites (Filtek Supreme XTE Flowable Restorative and G-ænial Flo X) and one high-strength universal injectable composite (G-ænial Universal Injectable). (2) Methods: specimens were placed in a stainless-steel mold with an orifice of 4 mm in diameter and 10 mm in depth and light-cured for 20 s using a light emitting diode (LED) light-curing unit (LCU) with an irradiance of 1000 mW/cm2; depth of cure was assessed using the ISO 4049 scrape technique, and the absolute length of the specimen of cured composite was measured in millimeters with a digital caliper. The same procedure was repeated with 14 samples for each material under investigation, for a total number of 70 test bodies. Material roughness and hardness results were also investigated using, respectively, a 3D laser confocal microscope (LEXT OLS 4100; Olympus) at ×5 magnification and a Vickers diamond indenter (Vickers microhardness tester, Shimadzu®, Kyoto, Japan) under 10-N load and a 30 s dwell time. SEM images at 3000 and 9000 magnification were collected in order to study the materials’ filler content. Statistical analysis were performed by a commercial statistical software package (SPSS) and data were analyzed using multiple comparison Dunnett’s test. (3) Results: The average DOC of both bulk-fill composites was more than 4 mm, as a range of 3.91 and 4.53 mm with an average value of 4.24 and 4.12 mm, while that of the conventional flowable composites was much lower, as a range of 2.47 and 2.90 mm with an average value of 2.58 and 2.84 mm; DOC of the high-strength injectable composite was greater than the one of traditional composites, but not to the level of bulk-fill materials, as a range of 2.82 and 3.01 mm with an average value of 3.02 mm. Statistical analysis revealed significant differences (p-values < 0.05) in the depth of cure between bulk fill flowable composites and other composites, while there was no difference (p-values > 0.05) between the materials of the same type. (4) Conclusions: Bulk-fill flowable composites showed significantly higher depth of cure values than both traditional flowable composites and high-strength injectable composites.

Purpose: To describe the possible adverse effects of sodium hypochlorite (NaOCl) solutions, high-concentration alcohol solutions, and povidone-iodine products, which are indicated for disinfection of inanimate surfaces against human coronavirus of the severe acute respiratory syndrome (SARS-CoV), on prosthesis materials, including zirconia, lithium disilicate, and acrylic resin., Materials and Methods: A systematic literature research for articles published between January 2010 and February 2020 was conducted in Scopus, PubMed/Medline, Web of Science, Embase, and Science Direct using a combination of the following MeSH/Emtree terms and keywords: sodium hypochlorite, alcohol, ethanol, povidone-iodine, dental ceramic, zirconia, lithium disilicate, and acrylic resin., Results: A total of 538 studies were identified in the search during initial screening, of which 44 were subject to full-text evaluation, and 24 fulfilled the inclusion criteria. Seven articles on zirconia and lithium disilicate investigated the effect of NaOCl (0.5% and 1%), 96% isopropanol, and 80% ethanol on bond strength after saliva contamination. The remaining articles evaluated color alteration, surface roughness modifications, decrease in flexural strength, and bonding strength of all cleaning agents on acrylic resin., Conclusion: NaOCl (1%) solution for 1 minute is recommended to reduce SARS-CoV infectivity and to minimize the risk of cross-contamination through prosthetic materials. The increase in surface roughness and color alteration were recorded using 1% NaOCl on acrylic resin, but this increase was not clinically significant. A decrease in bonding strength was determined after using 1% NaOCl, 96% isopropanol, and 80% ethanol solutions on lithium disilicate. Silanization before the try-in procedure and the application of the second layer of silane after cleaning methods are recommended to improve the bonding strength.

Background: The purpose of this review is to describe the possible effect of toothbrushing on surface roughness of resin-contained CAD/CAM materials., Methods: Systematic literature search for articles published in peer-reviewed journals between January 2000 and February 2020 has been conducted, which evaluated the effect of brushing on surface roughness of resin-contained CAD/CAM dental materials. The research was conducted in Scopus, PubMed/Medline, Web of Science, Embase, and Science Direct using a combination of the following MeSH/Emtree terms: "brushing", "resin-based", "dental", "CAD/CAM", and "surface roughness"., Results: A total of 249 articles were found in the search during initial screening. Fifty-five articles were selected for the full-text evaluation after the steps of reading of abstract/title and remotion of duplicate. Only six articles fulfilled the inclusion criteria. The Cohen's Kappa agreement test showed an index of 0.91 for full-text., Discussion: Four of five selected articles identified an increase of surface roughness on resin-contained CAD/CAM materials after toothbrushing. Although all the articles examined used different toothpastes with no homogeneous relative dentine abrasivity (RDA) and cycles of brushing, the findings are about the same. The possible reason is attributable to the compositions of the resin-contained CAD/CAM materials., Conclusions: The surface roughness of most resin-contained CAD/CAM materials was affected by artificial toothbrushing. Correct knowledge of the composition of the dental material and toothpastes is fundamental to avoid an increase of surface roughness on prosthetic rehabilitation.

Various signaling molecular pathways are involved in odontogenesis to promote cellular replication and differentiation. Tooth formation is controlled mainly by epithelial-mesenchymal interactions. The aim of this work was to investigate how cellular replication and differentiation ensue during the formation of the murine first molar in postnatal ages until eruption, focusing on morphogenesis, odontoblast differentiation and cellular replication. Wild-type CD1 mice were examined from birth to weaning. Morphogenesis and interaction between developing epithelial and mesenchymal tissues were evaluated in hematoxylin-eosin and Gomori trichome stained sections. Immunohistochemistry for nestin, which mediates the differentiation of odontoblasts, especially their polarization and elongation, showed that this intermediate filament was apparent already at postnatal day P1 in the apical region of odontoblasts and progressed apically from cusp tips, while it was not present in epithelial tissues. The expression of nuclear antigen Ki-67 highlighted dividing cells in both epithelial and mesenchymal tissues at P1, while one week later they were restricted to the cementoenamel junction, guiding root elongation. The link between odontoblast maturation and cellular replication in the different tooth tissues is essential to understand the development of tooth shape and dimension, to outline mechanisms of tooth morphogenesis and possibly eruption.

A method is described for minimizing errors in positioning a surgical template during the insertion of implants immediately after extraction and the placement of interim prostheses with immediate loading. The technique, called sequential template immediate loading (STIL), uses modular templates to fix pins before extracting the teeth, thus giving a reliable position for the subsequent templates for inserting the implant and placing the interim prosthesis., (Copyright © 2020 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

The aim of this review was to assess efficacy and acceptance of aesthetic zirconia crowns (ZCs) compared to the traditionally employed stainless steel crowns (SSCs) for primary teeth restoration. A comprehensive literature search was completed for the relevant keywords in Scopus and Medline databases. Resulting article abstracts and full texts were screened to determine final inclusion. Eighteen articles were included from the initial search. There is still little evidence to support the use of one type of crowns over another for primary teeth, in particularly for ZCs, lately introduced in pediatric restoration. The gold standard for restoring decayed primary teeth is still represented by SSCs, despite the growing importance of the aesthetic issue related to their use. Aesthetic ZCs resulted in having adequate properties to be employed for the treatment of decayed primary teeth, such as mechanical resistance, limited plaque adhesion, wear behavior and natural appearance. There is still a paucity of literature clinically evaluating the efficacy of ZCs for primary teeth restoration, but they can be considered a promising alternative to SSCs. This field of research has to be more deeply explored to improve dental care in children affected by early childhood caries.

Objective: Breastfeeding plays a key role in the development of the baby, in addition to the benefits to the mother and this dyad. Among the possible difficulties in this process, we have ankyloglossia. Some professionals opt for the frenotomy, although the literature is controversial. This paper aims to present how the literature provides subsidies for health professionals' decision and action in the intersection of the themes: breastfeeding, ankyloglossia, and frenotomy., Materials and Methods: The research on the platforms SciELO and PubMed used the terms: "ankyloglossia," "frenotomy," and "lingual frenulum" and the same ones associated with "breastfeeding." A specific inclusion and exclusion criteria were applied and validated by the American Speech-Language-Hearing Association to reduce any bias in the analysis. In the end, 16 papers were included and, by thematic equivalence, divided into two domains: association between lingual frenulum alteration and breastfeeding and between frenotomy and breastfeeding., Results: The literature does not assure that the frenotomy is the "standard conduct" to be adopted in cases of difficulty in breastfeeding and ankyloglossia., Conclusion: Further studies are needed on the different types of ankyloglossia and their direct influence on the sucking function and lactation difficulties.

Today periodontal health is considered as an integral part of systemic health itself and no longer as a single factor. The literature recognizes that the presence of periodontal disease can represent a risk factor for numerous systemic conditions such as heart disease and diabetes. In recent years, we have witnessed a progressive interest regarding the influence exerted by this condition on reproduction, as well as the possible repercussions on conception possibilities. Upon analyzing a limited number of studies available for the correlation between periodontal disease and female infertility, it could be inferred that this condition can be equated to the presence of a real outbreak of infection and therefore exert its influence, not only through bacterial translocation in the bloodstream, causing the systemic dissemination of pathogens, but also through the production of cytokines and immunoglobulins by inflammatory mediators. This situation limits bacterial growth, but it could cause damage to the fetus, to the reproductive system, and could hinder conception attempts. Although further research is needed to better clarify the mechanism underlying the possible correlation between periodontal disease and female infertility, the present article aims to review all the available literature on this topic., Lay Summary: In recent years, interest regarding the influence of gum disease on conception has increased. Since serious gum disease (periodontitis) can be compared to an outbreak of infection, studies suggest that the bacteria that mediate inflammation do not remain confined only to the gum tissue, but can enter the bloodstream and spread, thus spreading the infection and having a whole-body effect. This situation could cause damage to the developing baby, to the reproductive system and could hinder conception attempts. Constant maintenance of oral health is definitely necessary. It is important for the professionals involved (gynecologists, obstetricians, dentists, etc.) to communicate and collaborate on these issues. Dentists could advise on the correct hygienic maintenance not only to pregnant women, but also to those who are planning a pregnancy in order to avoid the occurrence of unfavorable conditions., Competing Interests: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported., (© 2021 The authors.)

Purpose: Reconstructing the occlusal morphology of posterior teeth in definitive dental prosthesis can be challenging. The use of the correlation technique enables replication of the information and occlusal anatomy of interim dental prostheses to the definitive ones. The purpose of this controlled clinical trial was to compare the static and dynamic contacts (SDC) of monolithic zirconia crowns designed with correlation and library techniques., Material and Methods: Twenty-four patients were included in the study for a total of 28 molars. For each abutment tooth, an interim crown was fabricated and two digital scans, with and without the interim crown in place were made. Two single crowns were designed using correlation and library techniques. Fifty-six monolithic zirconia crowns were milled. The interim and definitive crowns were evaluated intraorally for SDC by using a 24-μm-thick blue articulating foil. After removing the interim and definite crowns, extraoral photographs were taken to calculate the SDC area using software (ImageJ) and analyzed by the Kruskal-Wallis test., Results: The average and ± standard deviation (SD) of area of the occlusal marks on interim crowns was 32.27 ± 3.45 mm 2 . Definitive crowns designed by using the correlation technique had an area of 31.01 ± 3.73 mm 2 ; the area in the library technique was 36.85 ± 5.78 mm 2 . No statistically significant difference was found (p = 0.091) between the occlusal mark areas of the interim and definitive crowns designed by using the correlation technique. Whereas, there were significant differences between the areas of occlusal marks of the interim and definitive crowns designed by using the library technique, and between the areas of occlusal marks of definitive crowns designed by using the correlation and library techniques (p < 0.001)., Conclusion: The average area of the SDC of monolithic zirconia crowns designed by using the correlation technique was similar to that of interim crowns. The library technique was less effective when replicating the SDC compared to the correlation technique., (© 2020 by the American College of Prosthodontists.)

(1) Background: Multiple myeloma is a rare cancer that primarily affects the bone marrow. Osteoclasts are responsible for increased bone resorption and, therefore, bone destruction. Bisphosphonates are a class of drugs that can slow down bone resorption by reducing the number and action of osteoclasts. Intravenous injections of bisphosphonates (generally Zoledronic Acid) are administered to patients affected by Multiple Myeloma, but BRONJ is described as a serious side effect. This 5-year retrospective study aims to evaluate the efficacy of appropriate dental treatment protocols prior to initiating bisphosphonate therapy to prevent the development of BRONJ. (2) Methods: A total of 99 patients with symptomatic multiple myeloma were involved in this study (41-90 years, mean age 65 years, standard deviation 5 years). The data relating to the visits were tracked using a specific server and consulting the clinical reports. The AAOMS (American Association of Oral and Maxillofacial Surgeons) position was applied for both diagnosis and treatment. A total of 79 patients were examined before the administration of bisphosphonates (group A) and 20 after (group B). (3) Results: The entire sample required dental treatment: 23.2% underwent restorative therapy, 8% endodontic treatments, 44.4% tooth extractions. Periodontal disease was present in 41.4% of the patients. No osteonecrosis was observed in the first group, whereas BRONJ was found in five patients of the second one (25%) and two patients (10%) showed osteosclerotic areas under investigation [OR 0.026 (CI 0.0027 to 0.2454)]. (4) Conclusions: In the literature, there are no precise data about the prevalence of BRONJ. Despite the limitation of the present study, we point out that dental treatment before the treatment with intravenous bisphosphonates can help in reducing the incidence of BRONJ and good dental status is necessary for BRONJ prevention.

Statement of Problem: The marginal gap and ceramic bond strength of metal-ceramic restorations are important for success. However, studies evaluating the marginal gap and ceramic bond strength of fixed partial dentures (FPDs) produced with 3D printing technologies such as selective laser melting (SLM) are scarce., Purpose: The purpose of this in vitro study was to investigate the marginal gap of cobalt-chromium (Co-Cr) alloy frameworks produced by SLM technology before and after ceramic firing. Additionally, the metal-ceramic bond strength was evaluated with the Schwickerath crack-initiation test according to the International Standards Organization (ISO) 9693-1:2012., Material and Methods: Conventional impressions were made, and the definitive cast of a patient requiring a 4-unit FPD was scanned. After designing the FPD, the files were sent to a service center for the fabrication of a metal master model, 80 Co-Cr frameworks, and 80 flat specimens (25×3×0.5 mm) with SLM technology. The marginal gap between frameworks and the abutment tooth of the metal master model was nondestructively measured by using an optical coordinate-measuring machine. A total of 80 sets, consisting of 1 framework and 1 flat specimen, were sent to 80 dental laboratory technicians for ceramic firing. Detailed instructions for correct manipulation of the framework and flat specimen were provided. The marginal gap was remeasured, and the 3-point bend test was used to evaluate metal-ceramic bond strength., Results: Only 28 of the 80 dental technicians returned the specimens within a prespecified time and/or in adequate condition. The mean ±standard deviation marginal gap of the framework before ceramic firing was 25 ±9 μm and 34 ±12 μm after firing. The difference was statistically significant (P=.001). The mean ±standard deviation 3-point bend strength was 33 ±9 MPa., Conclusions: Ceramic firing affected the marginal gap; however, all Co-Cr frameworks had a marginal gap lower than 120 μm, which is reported to be a clinically acceptable limit. Most of the specimens (80%) had a metal-ceramic bond strength value higher than the 25-MPa ISO 9693 requirement. Five of 28 dental laboratory technicians were not able to comply with ceramic firing instructions., (Copyright © 2019 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

The transfer of extraoral and intraoral clinical information into the virtual environment is necessary to optimize prosthetic treatment planning. The purpose of this article was to describe a digital workflow designed to superimpose the different 3D files obtained with an intraoral scanner, a cone bean computed tomography (CBCT) device, and a facial scanner and their clinical application with the Digital bite device., (Copyright © 2019 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Background: In patients with fixed orthodontic treatment, good oral hygiene management is important to prevent complications such as caries, enamel demineralization, white spots, gingivitis, gingival hyperplasia and periodontitis. The aim of this experimental study is to compare the plaque and gingival indexes in patients with labial or lingual appliances., Methods: Twenty patients with a mean age of 27±-4.95 years were selected; ten patients (eight females and two males) between 17 and 39 years were fitted with a labial appliance while ten patients (nine females and one male) between 16 e 36 years were fitted with a lingual appliance. The dental hygienist made an evaluation using the plaque index and the gingival index, motivated and instructed the patients with labial and lingual devices to perform correct home oral hygiene. The timepoint were the following: T0 before the bonding, T1 one month after the bonding, T2 three months after the bonding, T3 six months after the bonding., Results: In the vestibular appliance at T0, the plaque index is significantly lower than the lingual device, but the bleeding index is significantly higher. Moreover, in both treatments, an increase in the parameters from T0 to T1, T2 and T3 was confirmed, and in the latter a linear increase trend both in the plaque index and in the gingival index can be observed., Conclusions: The plaque and bleeding index increase gradually from T0 to T3, but there is no significant difference between the vestibular and lingual appliances.

Purpose: Compare the accuracy of intraoral digital impression in full-arch implant-supported fixed dental prosthesis acquired with eight different intraoral scanner (Ios)., Methods: A polymethyl methacrylate acrylic model of an edentulous mandible with six scan-abutment was used as a master model and its dimensions measured with a coordinate measuring machine. Eight different Ios were used to generate digital impression: True Definition, Trios, Cerec Omnicam, 3D progress, CS3500, CS3600, Planmeca Emelard and Dental Wings. Fifteen digital impressions were made. A software called "Scan-abut" was developed to analyse and compare the digital impression with the master model, obtaining the scanning accuracy. The three-dimensional (3D) position and distance analysis were performed., Results: Mean value of the 3D position analysis showed that the True Definition (31 μm ± 8 μm) and Trios (32 μm ± 5 μm) have the best performance of the group. The Cerec Omnicam (71 μm ± 55 μm), CS3600 (61 μm ± 14 μm) have an average performance. The CS3500 (107 μm ± 28 μm) and Planmeca Emelard (101 μm ± 38 μm) present a middle-low performance, while the 3D progress (344 μm ± 121 μm) and Dental Wings (148 μm ± 64 μm) show the low performance. The 3D distance analysis showed a good linear relationship between the errors and scan-abutment distance only with the True Definition and CS3600., Conclusions: Not all scanners are suitable for digital impression in full-arch implant-supported fixed dental prosthesis and the weight of the output files is independent from the accuracy of the Ios., (Copyright © 2019 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.)

Purpose: To evaluate the influence of the crown-to-implant ratio (CI) on marginal bone loss (MBL) around short dental implants placed in the posterior mandible., Materials and Methods: All patients treated with short implants (7 mm length) in the posterior mandible between 1994 and 2003 at the Dental Clinic of the Department of Neuroscience of the University of Padua (Italy) were retrospectively included in the analysis. MBL and clinical CI (cCI) were measured on the radiographs. Implant characteristics including implant diameter, prosthetic type, retention mode, antagonist type, veneering material, and implant surfaces were retrieved from local medical records. A generalized linear mixed model was estimated to identify the predictors of MBL., Results: A total of 108 dental implants placed in 51 patients were included in the analysis. Mean follow-up was 16 years (range: 11 to 20 years). Mean cCI was 2.21 (SD = 0.31) with a mean crown height of 10.86 mm (SD = 0.99). Mean MBL was 1.42 mm (SD = 0.38). At multivariable analysis, cCI ≥ 2 was associated with higher MBL (regression coefficient: 0.27; 95% CI: 0.15 to 0.40), while implant characteristics, follow-up, and site were not associated with MBL. The effect of a cCI ≥ 2 was estimated in an increase of 0.28 mm in MBL (95% CI: 0.14 to 0.43 mm)., Conclusion: Higher cCI was associated with greater MBL of implant-supported fixed dental prostheses in short dental implants placed in the posterior mandible, while implant characteristics, follow-up, and site were not associated with MBL. However, the increase of 0.28 mm of MBL in patients with a cCI ≥ 2 may be not clinically relevant.

This study evaluated the arthritogenic effect of lipopolysaccharide (LPS) in a mouse model of periodontal disease. Periodontitis was induced in wild-type CD1 mice by nine LPS injections (10 or 50 ng) into the maxillary mucosa. Untreated mice or injected with LPS at the tail were used as controls. Two weeks after final inoculation, mice were sacrificed to collect blood, maxilla, and paw samples. Development and progression of periodontitis and arthritis were monitored using clinical assessment, micro-computed tomography (micro-CT), ultrasound (US), and histological analysis. CXCL1, IL-1β, IL-6, TNF-α, and anti-citrullinated peptide antibodies (ACPA) serum levels were determined by enzyme immunoassay. Ankle swelling and inflammation manifested after the 5th periodontal injection of 50 ng of LPS and progressed until the end of experiments. Periodontal injection of 10 ng of LPS and LPS tail injection did not induce paw changes. Therefore, the subsequent assessments were conducted only in mice periodontally injected with 50 ng of LPS. Maxillary micro-CT and histological analysis showed that LPS-induced alveolar bone resorption and vascular proliferation in periodontal tissue, but not inflammation. US and histology revealed increased joint space, leukocyte infiltration, synovial proliferation, and mild cartilage and bone destruction in the paws of mice orally injected. Cytokines and ACPA showed a trend towards an increase in LPS mice. This study shows that arthritis and periodontal disease can co-occur in wild-type mice after periodontal injection of LPS at optimal dose. Our model may be useful to improve the understanding of the mechanisms linking periodontitis and arthritis.

Coatings incorporating nanoparticles of molybdenum and tungsten disulfide (MoS 2 and WS 2 )-known for their lubricating properties-are applied to orthodontic stainless steel wires to verify if there is an improvement in terms of tribological properties during the sliding of the wire along the bracket. To simulate in vitro sliding of the wire along the bracket and evaluate friction 0.019 × 0.025 inches orthodontic stainless steel (SS) wires were subjected to the application, by electrodeposition, of Ni, Ni + MoS 2 , and Ni + WS 2 . The samples produced were analyzed with scanning electron microscopy and assessment of resistance to bending. Thirty-two test conditions have been analyzed, arising from the combination of four types of coatings (SS bare wires and strings with three types of coating), two types of self-ligating bracket (Damon Q, Ormco and In-Ovation R, GAC International), two bracket-wire angles (0° and 5°), two environments (dry and wet). Analyses carried out on the samples show acceptable coatings incorporating MoS 2 and WS 2 and a resistance of coatings after a minimum bending. In "dry conditions" a statistically significant decrease in friction occurs for wires coated with MoS 2 and WS 2 if associated with the In-Ovation bracket. In "wet conditions" this decrease is observed only in isolated test conditions. Analysis of the wires after sliding tests show little wear of the applied coatings. Nanoparticles are acceptable and similar in their behavior. Improvements in terms of friction are obtained pairing coatings incorporating MoS 2 and WS 2 with the In-Ovation bracket in dry conditions.

Objectives: A cross-sectional study was performed to assess the association between possible sleep bruxism (SB) and awake bruxism (AB) with sleep characteristics and chronotype (i.e. circadian cycle preference)., Methods: One-hundred-nineteen young adults filled out a self-reported questionnaire to assess SB and AB, a questionnaire about daily life aspects, as well as the Morningness-Eveningness Questionnaire (MEQ) to profile chronotype., Results: The frequency of self-reported SB and AB was 25.2% and 37.0%, respectively. Both SB and AB were significantly more frequent in females than males. Most participants had an intermediate chronotype profile (n = 85; 71.4%). Neither SB (p = 0.556) nor AB (p = 0.334) were associated with chronotype. Nightmares were more prevalent among individuals with possible SB (38.3%). Difficulty concentrating in daily activities was more frequently reported among individuals with AB (51.9%)., Conclusion: There was no association between possible SB and AB or the chronotype profiles among Italian dental students.