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This study aimed to evaluate the influence of the frequency of rhythmic masticatory muscle activity per hour (RMMA/h) scored by polysomnography (PSG) recordings on sleep-related factors and orofacial pain symptoms.According to RMMA/h frequency, participants were assigned either to the control group (i.e., CRMMA, n = 40); or the case group according to high (i.e., HRMMA, n = 12) or low (LRMMA, n = 28) RMMA/h frequency. Fisher's exact (nominal variables), One-way Analysis of Variance followed by post-hoc Tukey (continuous variables) and Poisson Regression tests were used to calculate orofacial pain symptoms and sleep-related breathing, behavior, and architecture differences between controls versus cases at a significance level of 5%.The CRMMA differed from HRMMA and LRMMA subgroups considering orofacial pain, self-reported tooth clenching or grinding, obstructive sleep apnea (OSA), snoring, and most variables considering sleep architecture (P ≤ 0.05). Multivariate adjusted Poisson regression analysis revealed that bruxers, regardless of RMMA/h frequency, presented a significantly higher prevalence rate (PR) related to orofacial pain (PR 1.68; P = 0.025) and self-reported behavior (PR 1.71; P = 0.012).Significant differences in N1, N2 and N3 stages, arousals, arousal per hour, and sleep onset latency variables were found comparing bruxer with high or low RMMA/h frequency. Compared to controls, bruxers presented higher PR related to headache and self-reported tooth clenching or grinding.

Objective: To evaluate the self-reported SB prevalence and explore associated risk factors in puerperal women who had given birth in Rio Grande, Southern Brazil. Methods: A single, standardized questionnaire was given within the 48 h postpartum period. Self-reported SB was the main outcome investigated. Chi-square test was used to compare proportions, and Poisson regression with robust variance adjustment was used in the multivariate analysis. Results: A total of 2225 women were included. Only 79 (3.6%) of these reported clenching or grinding their teeth during sleep. Adjusted analysis showed that the higher education level of the mothers (PR = 3.07; 95% CI 1.49–6.28; P = 0.006); living with three or more persons in the household (PR = 0.54; 95% CI 0.34–0.84; P = 0.007); medication intake during pregnancy (PR = 1.68; 95% CI 1.09–2.58; P = 0.017); smoking (PR = 1.93; 1.16–3.23; P = 0.024), or ever smoked (PR = 1.82; 95% CI 0.85–3.90; P = 0.024); severe anxiety (PR = 1.36; 95% CI 0.61–3.02; P = 0.005); and headache upon waking (PR = 4.19; 95% CI 1.95–9.00; P < 0.001) were significantly associated with self-reported SB. Conclusion for Practice: Our data pointed towards new factors in a specific group of women that may be relevant for preventing sleep-related behaviors in the pregnancy–puerperal cycle. The higher levels of education, medication intake, smoking or even smoked, severe anxiety, the higher the probability of puerperal woman to self-report SB. The nighttime tooth clenching strongly increased headache upon waking.

This study aimed to compare differences between complete denture conditions self-rated by older adult wearers and clinically exanimated by a professional based on standardised aesthetics and functional criteria.Complete denture clinical examination was based on the functional (stability, retention, occlusion and articulation, vertical dimension of occlusion) and aesthetics criteria. Data on self-rated complete denture conditions were measured using the Patient's Denture Assessment (PDA) questionnaire based on standardised aesthetic and functional criteria (n = 122). Prevalence rates of clinical and self-rated complete denture condition, sensitivity, specificity, positive and negative predictive values, and absolute and relative bias were calculated.The highest sensitivity (66.7% [95% CI 55.3-76.7]) was obtained for aesthetic criterion, whereas occlusion revealed the lowest sensitivity (14.9% [95% CI 6.2-28.3]). Stability had the highest specificity (91.3% [95% CI 72.0-98.9]) and aesthetics the lowest (21.4% [95% CI 8.3-41.0]). Stability also yielded the highest positive predictive value (83.3% [95% CI 51.6-97.9]), and vertical dimension of occlusion the lowest (26.3% [95% CI 9.1-51.2]). The vertical dimension of occlusion yielded the highest negative predictive value (71.2% [95% CI 58.7-81.7]). Self-rated data underestimated the complete denture condition in 6.5% compared with clinical examinations when the aesthetic criterion was excluded from the analysis and 7.6% when added.Older adult wearers better identified the condition of their complete denture when the aesthetic criterion was excluded from examination. In contrast, considering functional criteria (retention, stability, occlusion and vertical dimension of occlusion), self-rated complete denture conditions underestimated clinical examination.Using standardised aesthetic criteria in epidemiological studies for assessing complete denture conditions self-rated by wearers could avoid underestimating or overestimating the information regarding the use or need for dental prostheses.

This systematic review compared minimally and invasive surgical procedures to manage arthrogenous temporomandibular joint (TMJ).The review included clinical trials assessing surgical procedures of arthrogenous temporomandibular disorder (TMD) management by carrying out comparisons within the same surgical procedure (pre- and post-treatment) as well as between different surgical procedures. Meta-analyses were conducted only for similar comparison reporting the same outcome measures, visual analog scale (VAS) values to evaluate pain and maximum incisal opening (MIO) values.Of the 1,015 studies identified by the search strategy, 26 were selected for full-text reading, and 19 were included in the review. Of these, 16 studies were included in the meta-analysis and 3 in the qualitative analysis. The VAS scores showed significantly lower values after discectomies (p 0.001) and discoplasties (p 0.001) in the within-group comparison. Moreover, significantly lower VAS scores and higher MIO values were observed after discectomy compared to arthroscopy, eminectomy, and discoplasty (p 0.05).The findings of this systematic review suggest that although significantly lower VAS scores and higher MIO values were observed after discectomy, the currently available scientific evidence is unclear, and the use of invasive surgical procedures should not be implemented as an efficient first-line treatment option for arthrogenous TMD management.VAS and MIO outcomes could be insufficient to describe the success or failure of open surgical procedures like discectomy and discoplasty.

This systematic review investigated the hypothesis that preheated resin composites (RCs) used as luting agents improve the mechanical properties, physicochemical performance, and color of indirect ceramic restorations.Literature search was performed in three databases (Medline/PubMed, Scopus, and Web of Science) and in the grey literature (OpenGrey, ProQuest, and Catalog of ThesesDissertations from CAPES). Eligibility criteria included only studies comparing at least one preheated RC used as a luting agent with resin cements.Data regarding the mechanical properties, physicochemical characteristics, and color were analyzed qualitatively, and the microtensile bond strength and film thickness were also evaluated by meta-analysis. The search strategy identified 3894 papers, and 28 were full-text screened. Seven studies were included in the review, and 5 were included in the meta-analysis. No significant difference was found for microtensile bond strength (P = 0.14). Preheated RCs showed significantly higher film thickness than resin cements (P = 0.001).Overall, the use of preheated RCs as luting agents offers similar to poorer performance than using resin cements for bonding indirect restorations.Despite the claim that preheated RC could be used as a luting agent, further studies should investigate the effect of clinically unacceptable film thickness.

This study aimed to evaluate the prevalence of probable sleep bruxism (SB) in children aged 7-8 years and its association with sleep pattern and the time spent using devices with a screen.A cross-sectional study was conducted with children from Pelotas, Brazil (n = 556). Parents/caregivers were interviewed and provided demographic/socioeconomic information, children's daily screen time, nighttime tooth grinding or clenching, sleep duration and answered the Biological Rhythms Interview for Assessment in Neuropsychiatry for Kids (BRIAN-K-sleep domain). Probable SB was determined based on a positive clinical inspection with/without a positive parental/caregiver's reports of tooth clenching or grinding. Hierarchical Poisson regression was performed.The prevalence of probable SB was 15.83% (n = 88). There was no difference in the probable SB prevalence according to the daily screen time (p = 0.744), and low family socioeconomic status was associated with higher SB prevalence (Prevalence Ratio [PR] = 1.95; 95% Confidence Interval [95% CI]: 1.21-3.17; p = 0.006). Higher scores in the sleep domain of the BRIAN-K scale were associated with probable SB [PR = 1.07; 95% CI: 1.01-1.30; p = 0.013].Difficulties in maintaining sleep and low family socioeconomic status were associated with probable SB in schoolchildren, while screen time spent using devices with a screen was not associated.

Background: Studies addressing the training-induced neuroplasticity and interrelationships of the lip, masseter, and tongue motor representations in the human motor cortex using single syllable repetition are lacking. Objective: This study investigated the impact of a repeated training in a novel PaTaKa diadochokinetic (DDK) orofacial motor task (OMT) on corticomotor control of the lips, masseter, and tongue muscles in young healthy participants. Methods: A total of 22 young healthy volunteers performed 3 consecutive days of training in an OMT. Transcranial magnetic stimulation was applied to elicit motor evoked potentials (MEPs) from the lip, masseter, tongue, and first dorsal interosseous (FDI, internal control) muscles. MEPs were assessed by stimulus–response curves and corticomotor mapping at baseline and after OMT. The DDK rate from PaTaKa single syllable repetition and numeric rating scale (NRS) scores were also obtained at baseline and immediately after each OMT. Repeated-measures analysis of variance was used to detect differences at a significance level of 5%. Results: There was a significant effect of OMT and stimulus intensity on the lips, masseter, and tongue MEPs compared to baseline (p .05). OMT increased corticomotor topographic maps area (p

This in vitro study evaluated the effects of preheating, ultrasound application, and composite resin luting agent composition on the optical characteristics of feldspar ceramic laminates. The hypothesis was that the optical properties of the ceramic-luting agent-substrate unit would be affected by the composition of the luting material and use of ultrasound. Preheated restorative composite resins Charisma, IPS Empress Direct, and Filtek Z350 were used, with unheated RelyX Veneer resin cement serving as the control. The response variables for the physical properties of the materials were degree of conversion (n = 3 per material) and viscosity (n = 3 per material). Seven groups were generated based on the tested luting agent and the use of ultrasound. Color parameters were evaluated with a spectrophotometer at 3 timepoints (before luting [baseline], 24 hours after luting, and 1 month after luting), and color change was calculated according to the Commission Internationale de l'Eclairage (CIE) CIEDE 2000 formula and translucency parameters. The statistical significance of color change and viscosity was measured using 2-way analysis of variance (ANOVA), while the degree of conversion was measured using 1-way ANOVA. For translucency parameters, ANOVA on ranks and post hoc Duncan multiple range tests were performed. The control group showed the highest degree of conversion, while Filtek Z350 showed the highest viscosity. Statistically significant differences in color change between luting material groups were found under most conditions (P0.001), but there was no difference in translucency parameters between the luting materials (P = 0.446). Overall, the use of preheated composite resins as luting agents offers similar to poorer performance than conventional resin cement.

Cleft lip and/or cleft palate defects often result in a functional deficiency in the patient’s chewing, speech ability, and aesthetic appearance, usually demanding multidisciplinary effort for addressing the aesthetic and functional patient’s requirements. This clinical report describes the planned oral rehabilitation of a 46-year-old woman with unilateral cleft lip defect based on the patient’s peculiarities and age. Due to limitations concerning bone grafts and implant procedures, as well as orthodontic treatment, the prosthodontic rehabilitation using the metal-ceramic fixed partial denture was chosen. The treatment adequately reestablished the aesthetic and functional activities, positively impacting the patient’s quality of life.

This cross-sectional observational study with 24 patients evaluated differences in bite force (BF) and masticatory performance (MP) between conventional complete denture (CCD) and implant mandibular overdenture (IMO) users and the correlation between these variables. The BF test was performed bilaterally with an occlusal force device. During the MP test, patients were asked to chew Optocal particles for 40 cycles. The Shapiro Wilk test was employed to verify the normality of the data, the student t test to identify differences between groups, and Pearson’s correlation to investigate interrelationships between variables. A multiple linear regression was subsequently performed via the stepwise method. P values ≤0.05 were considered statistically significant. Unlike IMO users, CCD users presented a significant difference (25.6%) in BF between the dominant and non-dominant chewing side (p=0.04). IMO users presented significantly higher BF (p=0.01) without presenting a dominant side (p=0.38), and also performed significantly better for the following MP parameters: MPX50 values decreased by 27.25% in IMO users (p=0.01), MPB decreased by 48.38% (p=0.01), and ME 5.6 decreased by 53.25% (p=0.02), while ME2.8 increased by 151.57% (p=0.01). The BF and MPX50 in the IMO wearers group were negatively correlated (-0.57; p=0.05); this correlation coefficient was the only parameter included in the multivariate regression model. IMO users have higher BF and better masticatory performance than CCD users, especially in terms of chewed particles size reduction. MP is correlated with a higher BF in IMO users through better particle trituration. Resumo Este estudo observacional transversal com 24 participantes teve como objetivo avaliar as diferenças na força de mordida (FM) e na PM (performance mastigatória) entre usuários de prótese total convencional (PTC) e de overdenture mandibular (OM) e a correlação entre essas variáveis. O teste de FM foi realizado bilateralmente com um dispositivo de força oclusal. Durante o teste de PM, os pacientes foram solicitados a mastigar uma porção padronizada de Optocal por 40 ciclos mastigatórios. O teste de Shapiro Wilk foi empregado para verificar a normalidade dos dados, o teste T de Student para identificar diferenças entre os grupos e os coeficientes de correlação de Pearson para investigar inter-relações entre variáveis. Uma regressão linear múltipla foi realizada pelo método stepwise. Valores de p≤0,05 foram considerados estatisticamente significantes. Diferentemente dos usuários de OM, os usuários de PTC apresentaram uma diferença significativa (34%) na FM entre o lado dominante e o não dominante (p=0,04). Os usuários de OM apresentaram FM significativamente maior (p=0,01) sem apresentar um lado dominante (p=0,38) e obtiveram PM significativamente melhor nos seguintes parâmetros: os valores de PMX50 diminuíram 27,25% (p=0,01), PMB diminuiu em 48,38% (p=0,01), e EM 5.6 diminuiu 53,25% (p=0,02), enquanto EM2.8 aumentou 151,57% (p=0,01). A FM e PMX50 no grupo de usuários da IMO foram negativamente correlacionados (-0,57;p=0,05); esse coeficiente de correlação foi o único parâmetro incluído no modelo de regressão multivariada. Os usuários da OM possuem maior FM e melhor performance mastigatória do que os usuários de PTC, observados principalmente na redução do tamanho das partículas mastigadas. A PM está correlacionada com um maior FM nos usuários da OM através de uma melhor trituração de partículas.

Background A number of theories associate emotional factors with the triggering of sleep bruxism (SB). Few studies have used validated instruments to assess psychological characteristics and SB in children. In this study, the authors aimed to assess the prevalence of parent-reported SB in children and its association with social, emotional, and behavioral problems. Methods The authors conducted a cross-sectional study with a school-based sample at 20 public schools in Brazil. Parents or caregivers provided information related to tooth-grinding sounds during sleep and about children’s social, emotional, and behavioral problems by using the Strength and Difficulties Questionnaire. Analyses were carried out considering each subscale of the Strength and Difficulties Questionnaire and the total score. The authors estimated prevalence ratios by using a Poisson regression model. Statistical inferences were based on 95% confidence intervals. Results A total of 556 children aged 8 years were included. Prevalence of SB was 30.83%. Results of an adjusted analysis showed a significant association of SB with higher scores on total difficulties (overall score) (P Conclusions Parental reports of emotional and behavioral problems were associated with a higher prevalence of SB in schoolchildren. Practical Implications This study’s results contribute to those of previous investigations about the association between psychological characteristics and SB. Interdisciplinary research involving dentistry and psychology may improve the understanding of bruxism.

BACKGROUND AND OBJECTIVE: Few studies estimated the joint effect of implant design (length and diameter), peri-implant, and occlusal variables on early marginal bone loss. The monitoring of these factors during the first year after implant loading may be effective in preventing early implant failure. This prospective longitudinal study aimed to identify early-predictors of marginal bone loss around morse-tapered connection implants 12 months after implant loading.METHODS: Participants (n = 33) received 109 morse taper implants inserted subcrestally (diameter: 3.5 to 5 mm, length: 6 to 15 mm) loaded with single crowns. Implants were radiographically examined at the implant placement (baseline) and 12 months after prosthetic loading. Implant, peri-implant, and occlusal-related independent variables were analyzed by decision tree analysis. Mixed-effects multilevel analysis was used to estimate adjusted predictive values of marginal bone loss based on the early-predictors identified in decision tree analysis.RESULTS: Higher marginal bone loss was observed at mesial (mean of 0.87 mm; ranged from 0.5 to 1.19) than at distal sites (mean of 0.73 mm; ranged from 0.4 to 1.12 mm). The predictive model revealed of the largest marginal bone loss in association with cement-retained prostheses, a platform diameter of 3.5 mm, papilla sizes up to 2 mm, keratinized mucosa width inferior to 3 mm, implant lengths above 8.5 mm, inadequate occlusal relations, presence of bleeding on probing and deep peri-implant pocket.CONCLUSION: As implant dimensions, peri-implant and occlusal-related factors were associated with early marginal bone loss around morse taper implant, intervention in these factors might prevent early marginal bone loss.

This study investigated the effect of ultrasound application when luting ceramic using two preheated composites that show distinct responses to preheating at 69°C: Filtek Z100 and Z350XT. RelyX Veneer was the control. Feldspar disks were luted using the resin-based luting agents (RBLAs), and ultrasound was tested. Biaxial flexure strength (σ

This scoping review aimed to identify the signs and symptoms of temporomandibular joint (TMJ) involvement in individuals with ankylosing spondylitis (AS).Systematic literature searches were performed on PubMed, Embase, and Web of Science databases (up to April 2022). Studies with signs and symptoms of temporomandibular joint disorder (TMD) in adults with AS were included. TMJ outcomes were extracted and analyzed qualitatively.From 527 potentially eligible studies, 22 were included. A total of 4309 individuals with AS were evaluated, aged between 18 and 80 years, being males approximately 65% of the sample. Signs and symptoms of pain, tenderness to palpation on TMJ and masticatory muscles, joint noises (i.e., clicking or crepitus), limited mouth opening, disc displacement, and radiographic changes were often observed.The available evidence shows that different signs and symptoms of TMD co-occur with AS disease, with a higher prevalence of TMD observed in individuals with AS than in individuals without AS. Indeed, it seems that individuals suffering from AS disease have an increased risk of developing TMD.

This study aimed to systematically review the literature to identify clinical studies assessing neuroplasticity changes induced by or associated with bruxism or a tooth-clenching task using neurophysiological techniques. Searches were performed in five electronic databases (PubMed, EMBASE, Scopus, Web of Science, and Google Scholar) in April 2020. This review included clinical studies using neurophysiological techniques to assess neuroplasticity changes in healthy participants before and after a tooth-clenching task or comparing bruxers and non-bruxers. The quality assessment was performed with the Joanna Briggs Institute tool and Grading of Recommendations Assessment, Development, and Evaluation. Meta-analyses were conducted with studies reporting similar comparisons regarding masseter motor evoked potential amplitude and signal change outcomes. Of 151 articles identified in the searches, nine were included, and five proceeded to meta-analysis. Included studies presented moderate to very low methodological quality. From these included studies, eight evaluated bruxers and non-bruxers, of which five of them observed brain activity differences between groups, and three found no differences. Even so, all studies have suggested distinct difference in the central excitability between bruxers and non-bruxers, the meta-analysis revealed no statistically significant differences (P > 0.05). It appears that bruxism seems, indeed, to be associated with distinct differences in the neural pathways related to the control of the jaw-closing muscles, but that considerable variability in terms of classification of bruxism and assessment of neuroplasticity hamper a definite conclusion. Future research projects should take these concerns into consideration in order to further the understanding of bruxism physiology and pathophysiology.

OBJETIVO: Averiguar o impacto de fatores socioeconômicos e psicossociais na qualidade de vida de pacientes oncológicos.MÉTODOS: 100 indivíduos aceitaram participar do estudo no periódo de agosto/2015 a fevereiro/2016. Foram aplicados questionários para coleta de dados socioeconômicos, qualidade de vida(WHOQOL-bref), senso de coerência (SOC), autopercepção de felicidade e ansiedade e depressão (HADS).Foi utilizado o teste ANOVA para associação dos dados sociodemográficos com os sitios do tumores e os domínios do WHOQOL-bref além dos outros itens estudados.RESULTADOS: A amostra foi composta por 57 homens e 43 mulheres, com idade média de 59,11 anos. Entre todos os domínios do WHOQOL-bref (físico, psicológico, relações sociais e meio ambiente), a renda familiar baixa e o câncer de cabeça e pescoço influenciaram para pior percepção de qualidade de vida. No domínio psicológico e meio ambiente, o sexo masculino (p=0,04) demonstrou pior qualidade de vida. Os indivíduos idosos (60-82 anos, p=0,008) e solteiros ou divorciados (p=0,0008) apresentaram pior qualidade de vida no domínio social. O baixo do senso de coerência revelou pior percepção de qualidade de vida em todos os domínios do WHOQOL(p

Introduction This cross-sectional study evaluated the influence of endodontic filling material, cervical limit of root filling, and tooth location on the color variation (∆E00 ) from 1 to 60 months of follow-up. Materials and methods Color records were obtained from 70 participants who received 83 endodontic treatments. CIEL*a*b* color coordinates were measured on the homologous tooth, which was considered as baseline, and on endodontic treated teeth with a spectrophotometer. ∆E00 was calculated by the CIEDE2000 method at three conditions (condition 1: homologous tooth vs endodontically treated tooth after ≤1 month; condition 2: homologous tooth vs endodontically treated tooth after >1-12 months; condition 3: homologous tooth vs endodontically treated tooth after >12 months up to 5 years) for each variable. The zinc oxide and eugenol mineral trioxide aggregate or resin-based filling materials, dental cervix or ≥2 mm in the apical direction cervical limit of root filling and anterior or posterior tooth location were considered in the comparisons. Confidence intervals for the means (95% CI) were calculated, ∆E00 values and CIEL*a*b* individual color coordinates were compared for each pair of variables using the Student t test or Welch test (α = .05). Results Greater ∆E00 values were generally observed in the condition 3 for cervical limit (∆E00 = 10.7), use of zinc oxide and eugenol and mineral trioxide aggregate-based filling materials (∆E00 = 10.7), and anterior teeth (∆E00 = 12.4). Only in the condition 1, the ∆E00 values of the filling materials did not show statistical differences (P = .198). Conclusions Higher ∆E00 values were yielded from zinc oxide and eugenol and mineral trioxide aggregate-based filling materials, anterior teeth, and dental cervix cervical limit of root filling. Clinical significance Tooth discoloration yielded by endodontic materials and procedures is a challenge to clinical practice resulting in aesthetic problems and discomfort to both patient and professional, especially when it occurs in anterior teeth.

This in vitro study evaluated the influence of feldspathic ceramic thickness on the properties of light- and dual-cured resin cements. For each cement (RelyX Veneer, Allcem Veneer, RelyX Ultimate, and Allcem Dual), three ceramic specimens were prepared, with seven thicknesses for each (0.5, 1.0, 1.5, 2.0, 2.5, 3.0, and 3.5 mm). The degree of conversion, Vickers microhardness, irradiance power, color variation (ΔE00 ), and translucency parameters were assessed. Microhardness and irradiance power were analyzed using analysis of variance (ANOVA) with post hoc Tukey's test, while ΔE00 , translucency parameters, and degree of conversion were analyzed using ANOVA of ranks with post hoc Duncan's Multiple Range Test. The relationship between each of the dependent variables (degree of conversion, ΔE00 , and translucency parameter tests) and the specimen thickness was described using linear regression for each of the four resin cements. The significance level for all analyses was set at 5%. RelyX Ultimate yielded the lowest degree of conversion values among all resin cements. Allcem Veneer produced the lowest microhardness values, without statistical differences between thicknesses, of up to 1 mm. Allcem Dual produced the highest ΔE00 and translucency parameter values. Feldspathic ceramic thickness influenced the mechanical properties of resin cements and optical aspects of the restorative set.

Statement of problem An occlusal device is frequently recommended for patients with bruxism to protect implant-supported restorations and prevent marginal bone loss. Scientific evidence to support this treatment is lacking. Purpose The purpose of this 3-dimensional (3D) finite element study was to evaluate the influence of an acrylic resin occlusal device, implant length, and insertion depth on stress distribution with functional and parafunctional loadings. Material and methods Computer-aided design software was used to construct 8 models. The models were composed of a mandibular bone section including the second premolar and first and second molars. Insertion depths (bone level and 2 mm subcrestal) were simulated at the first molar. Three natural antagonist maxillary teeth and the placement or not of an occlusal device were simulated. Functional (200-N axial and 10-N oblique) and parafunctional (1000-N axial and 25-N oblique) forces were applied. Finite element analysis (FEA) was used to determine the maximum principal stress for the cortical and trabecular bone and von Mises for implant and prosthetic abutment. Results Stress concentration was observed at the abutment-implant and the implant-bone interfaces. Occlusal device placement changed the pattern of stress distribution and reduced stress levels from parafunctional loading in all structures, except in the trabecular bone. Implants with subcrestal insertion depths had reduced stress at the implant-abutment interface and cortical bone around the implant abutment, while the stress increased in the bone in contact with the implant. Conclusions Parafunctional loading increased the stress levels in all structures when compared with functional loading. An occlusal device resulted in the lowest stress levels at the abutment and implant and the most favorable stress distribution between the cortical and trabecular bone. Under parafunctional loading, an occlusal device was more effective in reducing stress distribution for longer implants inserted at bone level. Subcrestally, implant insertion yielded the most favorable biomechanical conditions at the abutment-implant interface and at the coronal surface of the cortical bone, mainly when there was no occlusal device.

Purpose This retrospective cohort study in an asymptomatic nonpatient population evaluated the prevalence of specific morphologic changes usually associated with the presence of degenerative joint diseases (DJD) using cone beam computed tomography (CBCT) and examined the associations between DJD and age, sex, and number of teeth present. Materials and methods CBCT images (268 TMJs) of 134 asymptomatic patients were studied. Patient data were obtained from clinical records, and calibrated examiners interpreted the CBCT images. The presence or absence of traditional radiographic signs of DJD (erosion, generalized sclerosis, osteophytes, and subchondral cysts) in the condyle and articular eminence of each TMJ were evaluated. The data were submitted to bivariate (chi-square and Fisher exact tests) and multivariate (Poisson regression) analyses (α = .05). Results The sample was primarily composed of men (52.24%) and individuals aged ≥ 61 years (55.64%); 61.94% were partially edentulous with ≤ 12 teeth in the oral cavity. The most common DJD diagnoses were mandibular condyle osteophytes (30.22%) and erosion (12.69%), followed by articular eminence erosion (8.58%) and mandibular condyle subchondral cysts (7.09%). The bivariate analysis showed a statistically significant association between women and subchondral cysts (P = .007), between edentulous individuals and subchondral cysts (P = .008), and between individuals with ≤ 12 teeth and mandibular condyle erosion (P = .005). In the adjusted Poisson regression analysis, a significant association was found between DJD and gender (P = .015). Conclusion Despite the limitations of this study, the results show a high prevalence of morphologic changes usually associated with the presence of DJD in asymptomatic subjects. Osseous TMJ abnormalities were most present in women, individuals with a lower number of teeth, and older individuals.

PURPOSE This randomized clinical trial assessed how surface roughness (Ra) in resilient liners was affected by soft tissue health conditions and time-related aspects in patients with complete dentures. METHODS Specimens of acrylic resin (control) and denture liners (silicone-based or acrylic resin-based) were inserted into the dentures of patients with and without denture stomatitis (n = 30). Ra was evaluated before denture insertion and after 7, 14, and 21 days of prosthesis wearing. Data were analyzed using three-way analysis of variance and Student-Newman-Keuls test. RESULTS Patients with stomatitis showed a higher Ra (P < .001), while all liners presented rougher surfaces after 14 days of clinical service, irrespective of the soft tissue health condition. CONCLUSION Ra of the tested denture liners was increased in patients with denture stomatitis. It is presumed that a longer wearing period will result in rougher surfaces.

SUMMARY Objective: To evaluate the masking ability and translucency of monolithic and bilayer CAD-CAM ceramic structures. Methods: Discs of high translucency (HT) and low translucency (LT) lithium disilicate–based ceramic (IPS e.max CAD) with different thicknesses (0.7, 1, 1.5, and 2 mm) were evaluated as a monolithic structure or combined (bilayer) with a 0.5-mm-thick zirconia framework (IPS e.max ZirCAD). The masking ability and translucency were calculated based on CIE L*a*b* color coordinates measured with a spectrophotometer (SP60, X-Rite). The translucency parameter (TP) was calculated using color coordinates measured over standard white-and-black backgrounds. The masking ability was calculated by CIEDE2000 color difference metric (ΔE00) for each specimen measured over a tooth-colored substrate (shade A2) compared to three darker backgrounds (shade C4 and two metal substrates). Confidence intervals (CI) for the means (95% CI) were calculated for TP and ΔE00. The Pearson correlation between ΔE00 and TP was investigated for monolithic and bilayer structures over all backgrounds. Results: The thinner the lithium disilicate layer, the greater the translucency and the higher the ΔE00 values. The effect of ceramic thickness on both translucency and masking ability was more pronounced for the monolithic structures. In addition, monolayers always presented a greater color variation than their bilayer counterparts. The metallic background produced greater ΔE00 than the C4-shaded substrate. Conclusion: Monolithic veneers were able to mask C4-shaded background but did not mask metallic backgrounds. Bilayer structures showed greater shade masking ability than monolithic structures.

Purpose: This cross-sectional study aimed to evaluate the association of demographic and clinical characteristics, Sense of Coherence (SOC), clinical conditions (number of teeth, and use of and need for dental prostheses), and Oral Health-Related Quality of Life (OHRQoL); and if the SOC modifies the relationship of clinical conditions and OHRQoL in a sample of elders. Methods: Trained dentists assessed the participants’ oral health and conducted interviews (n = 110). Information on sociodemographic conditions (sex; age at time of data collection; educational level; household income), SOC, and OHRQoL were investigated. Clinical data included use of and need for dental prostheses; number of decayed, missing, and filled teeth; and number of teeth (categorized by median). OHRQoL was measured using the Oral Health Impact Profile (OHIP-14). Effect modification between SOC and each clinical oral condition on OHRQoL was tested in regression models. Results: The findings of the present study showed that individuals with high SOC presented better OHRQoL, even after adjustment for sociodemographic and clinical conditions. Conclusion: SOC modifies the effect in the association between OHIP-14 scores and clinical conditions, and could be a protective factor in adverse conditions.

The aim of this randomized clinical trial was to compare the occurrence and intensity of postoperative pain and analgesic intake after root canal treatment, using different root canal sealers. Sixty single-rooted teeth diagnosed with asymptomatic necrosis and apical periodontitis were randomly assigned to 3 experimental groups (n=20), according to the root canal sealer: AH Plus, Endofill or MTA Fillapex. Endodontic treatment was performed in two sessions, and calcium hydroxide was used as the intracanal dressing. Patients were instructed to record pain intensity as none, slight, moderate and severe. Scores from 1 to 4 were attributed to each level of pain after 24 h, 48 h and 7 days. The need for analgesic intake was also recorded. Differences in the incidence of postoperative pain and the need for an analgesic were analyzed using the chi-square test. Differences in pain intensity after treatment were analyzed using the ordinal (linear) chi-square test. No significant differences were detected among the groups in terms of either incidence or intensity of postoperative pain, or need for analgesic intake, at any timepoint (p>0.05). No pain was reported after 7 days. AH Plus, Endofill and MTA Fillapex used for filling root canals resulted in the same rate of postoperative pain and need for analgesic medication.

Objective This cross-sectional clinical study evaluated the associations between sociodemographic, occupational, clinical conditions, psychological and sleep quality variables on definite sleep bruxism (SB). Methods All records obtained from adults (aged 20–60 years) and the elderly (aged >60 years) who had undergone polysomnography (PSG) at a private medical outpatients’ clinic from July 2017 to February 2018 were reviewed. Data from a questionnaire, based on the criteria of the American Academy of Sleep Medicine (AASM), were also gathered. Definite SB data pattern distribution was analyzed, and multivariate Poisson regression with robust variance was used to assess the associations between definite SB diagnosis, determined via PSG recordings, and the independent variables. A significance level of 5% was adopted. Results A total of 240 individuals were included in the study and the SB prevalence was 7.08% (n = 17). The adjusted Poisson regression analysis revealed association between definitive SB and individuals with respiratory allergy (PR = 3.63; 95% CI:1.01–13; P = 0.047) and restless sleep (PR = 2.97; 95% CI:1.04–8.50; P = 0.042). Conclusion This study found associations between definite SB and clinical conditions (respiratory allergy) and sleep behavior (restless sleep). Knowledge regarding factors associated with definite SB can contribute to decision making in the clinical setting and management strategies involving a multidisciplinary approach.

The aim of the present study was to perform a critical reflection about intervention options for bruxism reduction in children and adolescents. Search was conducted based on the PICO-structured question: "What are the intervention options to reduce bruxism in children/adolescents?". No language, year, or study design restrictions were imposed. Studies reporting interventions to reduce bruxism in children ( 10) and adolescents (10 to 19 years old) were included. Reviews and letters to editors were not included. From 2723 records, 17 papers were included. Included studies were primarily randomized clinical trials performed in Brazil (35.3%) and using different criteria for the diagnosis of bruxism. Reduction in self-reported bruxism and headaches associated with bruxism were observed in studies that used medications (hydroxyzine/trazodone/flurazepam), occlusal splints, orthodontic interventions, and psychological and physical therapy interventions. Reduction in Rhythmic Masticatory Muscle Activity was observed with the use of the occlusal splint and in orthodontic interventions. Alternative treatments (medicinal extracts such as Melissa officinalis-L) have shown inconclusive results.Conclusions: Several intervention options are available to inhibit or reduce bruxism activity. The respective indication, contraindications, and side effects of each treatment option must be assessed individually and carefully, taking into account that bruxism is not considered a disorder in otherwise healthy individuals.What is known• Biological and psychological factors have been strongly correlated to the development of bruxism• Bruxism prevalence ranging from 6 to 50% in childrenWhat is new• Reduction in self-reported bruxism and headaches associated with bruxism were observed in studies that used medication (Hydroxyzine/ Trazodone/ Flurazepam), occlusal splints, orthodontic interventions, psychological, and physical therapy interventions• A reduction in Rhythmic Masticatory Muscle Activity was observed with the use of the occlusal splint and orthodontic interventions. Alternative treatments (medicinal extracts such as Melissa officinalis L) show inconclusive results in respect of the reduction in bruxism.

This randomized clinical trial evaluated the influence of the type of intraradicular posts (glass fiber post or cast metal post) in the success of endodontic treatment in teeth that received single metal-ceramic restoration. The sample consisted of adult patients, who presented for the first time seeking routine dental care at the dental school over a period of 5 years. Seventy-six out of ninety-six teeth that received endodontic treatment and intraradicular post were analyzed, randomly distributed in two groups – glass fiber post (n=38), and cast metal post (n=38). The quality of the endodontic treatment was radiographically evaluated, and the apical status was assessed using the periapical index (PAI). Statistical Analyses were performed to a significance level of 5%. Descriptive analyses were used to characterize the teeth and survival curves were created using the Kaplan–Meier method. The success rate of endodontic treatment was 90.8% (n=69) including glass fiber post and cast post. When appropriate endodontic treatment was performed is possible to conclude that the success of endodontic treated teeth that received posts was not related to the post type. Este ensayo clínico aleatorizado evaluó la influencia del tipo de postes intrarradiculares (postes de fibra de vidrio o postes de metal fundido) en el éxito del tratamiento de endodoncia en los dientes que recibieron restauración de metal-cerámica simple. La muestra estuvo conformada por pacientes adultos, quienes acudieron por primera vez buscando atención odontológica de rutina en la facultad de odontología durante un período de 5 años. Se analizaron setenta y seis de los noventa y seis dientes que recibieron tratamiento endodóntico y poste intrarradicular, que consistieron en dos grupos: poste de fibra de vidrio (n = 38) y poste de yeso (n = 38). La calidad del tratamiento endodóntico se evaluó radiográficamente y el estado apical se evaluó mediante el índice periapical (PAI). Los análisis estadísticos se realizaron a un nivel de significancia del 5%. Se utilizaron análisis descriptivos para caracterizar los dientes y se crearon curvas de supervivencia mediante el método de Kaplan-Meier. La tasa de éxito del tratamiento endodóntico fue del 90,8% (n = 69), incluidos los postes de fibra de vidrio y los postes de yeso. Cuando se realizó el tratamiento de endodoncia adecuado, es posible concluir que el éxito de los dientes tratados con endodoncia que recibieron postes no estuvo relacionado con el tipo de postes. Este ensaio clínico randomizado avaliou a influência do tipo de pino intrarradicular (pino de fibra de vidro ou pino de metálico-fundido) no sucesso do tratamento endodôntico em dentes que receberam restauração metalocerâmica. A amostra foi composta por pacientes adultos, que se apresentaram pela primeira vez em busca de atendimento odontológico de rotina na faculdade de odontologia durante um período de 5 anos. Foram analisados ​​setenta e seis dos noventa e seis dentes que receberam tratamento endodôntico e pino intrarradicular, aleatoriamente distribuídos em dois grupos - pino de fibra de vidro (n = 38) e pino metálico-fundido (n = 38). A qualidade do tratamento endodôntico foi avaliada radiograficamente e o estado apical foi avaliado pelo índice periapical (PAI). As análises estatísticas foram realizadas a um nível de significância de 5%. Análises descritivas foram utilizadas para caracterizar os dentes e as curvas de sobrevivência foram criadas usando o método de Kaplan-Meier. A taxa de sucesso do tratamento endodôntico foi de 90,8% (n = 69) incluindo pino de fibra de vidro e pino metálico-fundido. Concluindo, quando foi realizado o tratamento endodôntico adequado, o sucesso da terapia endodôntica não teve relação com tipo de pino intraradicular.

Direct and indirect techniques are used for intracanal impression and fabrication of cast metal posts. However, whether those techniques affect the accuracy of cast metal posts is unknown.The purpose of this randomized clinical trial was to evaluate the accuracy of cast metal posts depending on tooth position and impression technique.Endodontically treated teeth (anterior or posterior) planned to receive cast metal posts and complete crowns were randomized according to impression technique (direct or indirect). Impressions were made by 2 operators, and time for the impression was recorded. All impressions and cast metal posts were photographed to assess any possible differences between techniques in length of the cast metal post.All cast metal posts were shorter than the impressions. The mean reduction for the metal posts was 2.3% for direct in anterior teeth, 5.7% for direct in posterior teeth, 6.3% for indirect in anterior teeth, and 7.2% for indirect in posterior teeth (all P.05). Statistically significant differences were found between time of technique and tooth position (P=.031), with the direct technique more time consuming than the indirect technique (P.001) for both tooth positions. For the indirect technique, the impression times for both tooth groups were similar (P=.459).Both of the intracanal impression techniques resulted in cast posts that were shorter than the impressed post space. The discrepancy was greatest for the indirect technique. Nevertheless, all posts were considered clinically acceptable and were cemented.

This study evaluated the association between the diagnosis of sleep bruxism (SB), scored by way of polysomnographic (PSG) recordings, clinical conditions and sleep architecture.A case-control study was conducted. All records from adults who had undergone polysomnography (PSG) recordings at a private medical outpatient clinic between January 2015 and December 2017 were reviewed. The sample included 58 bruxers (case group) and 58 non-bruxers (control group), identified based on the PSG recording and matched by sex and age.Obese individuals had significantly lower chance (OR 0.18; 95 % CI: 0.05-0.62; P = 0.005) of an SB diagnosis than individuals with normal BMI. Alcohol consumption significantly increased (OR 2.74; 95 % CI: 1.11-6.78; P = 0.029) and OSA decreased the chances (OR 0.55; 95 % CI: 0.23-1.30; P = 0.173) of an SB diagnosis. Bruxers had a significantly shorter wake time after sleep onset (WASO) (p = 0.002). As far as non-rapid eye movement (NREM) is concerned, the duration of stage N1 was statistically shorter (p = 0.034) and the duration of stage N3 was statistically longer (p = 0.001) in bruxers. Arousals (p = 0.013), arousals per hour (p = 0.009), respiratory disturbance index (RDI) values (p0.0005) and the apnoea-hypopnea index (AHI) (p = 0.002) were all lower in bruxers than in non-bruxers.The results of this study support a significant association between SB diagnosis, BMI and alcohol consumption. SB modified the sleep architecture as statistically significant differences were found between bruxers and non-bruxers for WASO, NREM stage N1 and N3, arousals, arousals per hour, RDI and AHI.

Objective This study aimed to evaluate whether sense of coherence (SOC) mediates the association between temporomandibular disorders (TMD) and oral health-related quality of life (OHRQoL) and general quality of life (QoL) in Brazilian elders. Methods Informations on sociodemographic, psychological, and presence or absence of temporomandibular disorders (TMD) were collected by trained dentists among non-institutionalized elders (n = 110). OHRQoL was measured with the Oral Health Impact Profile (OHIP-14) and QoL using the WHOQOL-BREF. Structural equation modeling (SEM) was used to estimate the standardized direct effect of TMD on OHRQoL and on QoL, and the indirect effect mediated by SOC. Results Temporomandibular disorders had no direct effect on OHRQoL (coef. -0.10), whereas indirect effect mediated by SOC was noted (coef. 0.35). Regarding QoL, the indirect effect of TMD, mediated by SOC, on QoL (coef. 0.58) was higher than the direct effect (coef. 0.34). Conclusion Sense of coherence mediated the effect of TMD on oral and general quality of life among elders.

The influence of inorganic filler content of resin-based luting agents (RBLAs) on color change (ΔE00), CIEL*a*b* (individual color coordinates), and translucency parameters (TP) of simulated ceramic laminate veneer (CLV) was investigated. RBLAs with low, intermediate, and high inorganic filler content (55%, 65%, and 75% mass fractions, respectively) were prepared. Feldspar ceramic (Vitablocs Mark II) specimens (1.2 mm × 0.8 mm, A1C shade) were bonded to simulated composite resin substrates (1.6 mm × 1.2 mm, A2D shade) using three experimental and a commercial (RelyX Veneer) RBLA (translucent shade). The ΔE00 was calculated by CIEDE2000 color difference metric under three conditions (before, immediately after, and 24 h after luting). The TP was calculated using CIEL*a*b* color coordinates measured over white and black backgrounds. Surface morphology of the RBLAs was analyzed. One-way and two-way analyses of variance with a post-hoc Tukey’s test were used respectively to calculate TP, CIEL*a*b* coordinates, and ΔE00 (α= 0.05). Overall, the tested RBLAs presented clinically visible ∆E00 values under the three conditions evaluated. For all RBLAs, higher ∆E00 values were observed between measurements obtained before and immediately after luting. Different inorganic filler content did not significantly increase the opacity of the ceramic-luting agents-resin composite set. The variation in inorganic filler content did not influence significantly the TP of simulated CLV; although all of the experimental RBLAs tested yielded ∆E00 above the perceptibility threshold. The L*, a*, and b* individual color coordinates were cementation-dependent.

This study evaluated the effect of the accelerated artificial aging (AAA) on feldspar ceramic strength and the reinforcing effect promoted by adhesive cementation with resin luting agent. One hundred twenty feldspar ceramic disks were obtained. Sixty disks were acid-etched, silanized, and coated with an experimental resin luting agent simulating the adhesive luting procedures. Four groups were created (n=30): uncoated ceramic (control group), uncoated ceramic submitted to AAA, ceramic coated with resin luting agent, and coated ceramic submitted to AAA. Biaxial flexural testing with ball-on-ring setup was carried out. Biaxial flexural strength (s bf , MPa), characteristic strength (s 0 , MPa), and Weibull modulus (m) were calculated for axial positions z=0 (ceramic surface) and z=−t2 (luting agent surface). Data of s bf at positions z=0 and z=-t2 were separately submitted to statistical analyses (a=0.05). The uncoated ceramic submitted to AAA had no significant difference in s bf and s 0 compared with the control group. Resin coating of the ceramic increased s bf and s 0 at z=0. The AAA increased the s bf and s 0 for the resin-coated ceramic specimens at z=0 and also the s 0 at axial position z=-t2. The structural reliability at z=0 and z=-t2 was not influenced by the variables tested. In conclusion, resin coating improved the mechanical strength of the feldspar ceramic. The AAA procedure was not effective in aging the uncoated or resin-coated feldspar ceramic specimens. Resumo Este estudo avaliou o efeito do envelhecimento artificial acelerado (EAA) na resistência da cerâmica feldspática e o reforço promovido pela cimentação adesiva com cimento resinoso. Cento e vinte discos de cerâmica feldspática foram obtidos. Sessenta discos foram condicionados com ácido, silanizados, e recobertos com um cimento resinoso experimental simulando os procedimentos de cimentação adesiva. Quatro grupos foram criados (n=30): cerâmica sem recobrimento (grupo controle), cerâmica sem recobrimento submetida ao EAA, cerâmica recoberta com cimento resinoso, cerâmica recoberta com cimento resinoso submetida ao EAA. O teste de resistência à flexão biaxial foi realizado utilizando o dispositivo pistão-anel. Resistência à flexão biaxial (s fb , MPa), resistência característica (s 0 , MPa), e módulo de Weibull (m) foram calculados para as posições axiais z=0 (superfície da cerâmica) e z=−t2 (superfície do cimento). Os dados de s fb em z=0 e z=−t2 foram submetidos a análises estatísticas separadamente (a=0,05). A cerâmica não recoberta submetida ao EAA não teve diferença significante na s fb e s 0 comparada com o grupo controle. O recobrimento com cimento resinoso da cerâmica aumentou a s fb e s 0 em z=0. O EAA aumentou a s fb e s 0 para os espécimes de cerâmica recobertos com cimento resinoso em z=0 e também a s 0 em z=−t2. A confiabilidade em z=0 e z=−t2 não foi influenciada pelas variáveis testadas. Concluindo, o recobrimento com cimento resinoso melhorou a resistência mecânica da cerâmica feldspática. O procedimento de EAA não foi efetivo em envelhecer os espécimes de cerâmica feldspática recobertos ou não com cimento resinoso.

This study evaluated the masking ability of different porcelain thicknesses and combination of enamel and/or dentin porcelain layers over simulated background dental substrates with higher (A2) and lower (C4) color values. Combination of the enamel (E) and dentin (D) monolayer porcelain disks with different thicknesses (0.5 mm, 0.8 mm, and 1 mm) resulted in the following bilayer groups (n=10): D1E1, D1E0.8; D1E0.5; D0.8E0.8; D0.8E0.5, and D0.5E0.5. CIELAB color coordinates were measured with a spectrophotometer. The translucency parameter of mono and bilayer specimens and the masking ability estimated by color variation (ΔE*ab) of bilayer specimens over simulated dental substrates were evaluated. Linear regression analysis was used to investigate the relationships translucency parameter × ΔE*, translucency parameter × porcelain thickness, and ΔE* × porcelain thickness. Data were analyzed statistically (α= 0.05). Thinner porcelain disks were associated with higher translucency. Porcelain monolayers were considerably more translucent than bilayers (enamel + dentin). Dentin porcelain was less translucent than enamel porcelain with same thickness. ΔE* was always lower when measured over A2 background. Higher ΔE* was observed for the C4 background, indicating poorer masking ability. Increased ΔE* was significantly associated with increased translucency for both backgrounds. Decreased translucency and ΔE* were associated with increased total porcelain thickness or increased dentin thickness for both backgrounds. In conclusion, increased porcelain thickness (particularly increased dentin layer) and increased porcelain opacity resulted in better masking ability of the dental backgrounds.

Aim To assess differences in the oral diseases/conditions between adults and older adults. Methods A cross-sectional study was carried out with all adults and older adults in Luzerna, South Brazil (n = 569). Clinical data included use of and need for dental prostheses; number of decayed, missing and filled teeth; and temporomandibular disorder. Differences between adults and older adults were evaluated using χ2-tests. Associations between independent variables and the use of and need for dental prostheses were determined using Poisson regression analyses (P

The type of resin-based luting agent might influence the color stability of ceramic veneers.The purpose of this study was to investigate the effects of resin-based agents and aging on the color stability of ceramic veneers bonded to enamel.Ceramic disks were cemented to bovine enamel disks with 4 resin-based luting agents (n=10): dual-polymerizing cement (RelyX ARC), light-polymerizing cement (RelyX Veneer), flowable composite resin (Filtek Z350 Flow), or composite resin preheated for 30 minutes at 60°C (Filtek Z350 XT). CIE L*, a*, and b* color coordinates were measured 24 hours after cementation (baseline) with a color spectrophotometer and reevaluated after 10,000 and 20,000 thermal cycles. Color variation was calculated by using CIELab (ΔE*(ab)) and CIEDE2000 (ΔE00) methods. Then 95% confidence intervals were calculated for color variation means between baseline and 10,000 thermal cycles and between 10,000 and 20,000 thermal cycles. The 95% confidence intervals were also calculated for the means of individual color coordinates (L*, a*, and b*).The dual-polymerizing cement had the highest color variation among all luting agents. No significant differences were found in color variation among the light-polymerizing materials. All agents showed ΔE*(ab)3.46 and ΔE002.25 after 20,000 thermal cycles. Variations in L*, a*, and b* coordinates were material dependent. The dual-polymerizing agent was yellowish and reddish after aging.The dual-polymerizing cement had higher color variation than the light-polymerized materials when used for bonding ceramic veneers to enamel. Flowable and preheated composite resins had similar color stability to that of light-polymerizing resin-based cement.

Purpose: This study evaluated the pretreatment influence of occlusal splints and relines on mandibular movements (MM) and vertical dimension of occlusion (VDO) in longstanding complete denture wearers. Materials and Methods: A total of 30 volunteers were randomly assigned to three groups (n = 10): control (C), relining of old denture (RD), and occlusal splints (OS). Individual extent of MM was assessed via intraoral Gothic arch tracings and the VDO using posed frontal images taken at three time points. Results: The OS group showed statistically significant differences when compared with the other groups (P < .05). Conclusion: Both MM and VDO were significantly improved by use of occlusal splints pretreatment.

Statement of problem Clinical evidence on the best chemical protocol for the disinfection and removal of biofilm from complete dentures is lacking. Purpose The purpose of this crossover randomized clinical trial was to assess the effectiveness of various chemical hygiene clinical protocols in reducing the microbial viability of biofilm formed on complete dentures. Material and methods In this triple-blind (participants, dentist, and outcome evaluator) study, complete denture wearers without candidiasis were randomly divided into 4 groups (n=40) according to the chemical hygiene protocol: water (placebo), 0.5% sodium hypochlorite solution, 0.12% chlorhexidine gluconate solution, and 5% sodium bicarbonate solution. The biofilm formed on the palate intaglio and denture teeth was collected and assessed in each experimental phase for quantitative microbial viability at the seventh and 14th day after using the chemical protocol. Results Two participants were lost. Data were analyzed by MANOVA and Tukey HSD tests. Soaking dentures was not effective in decreasing Candida albicans, C. non-albicans, and lactobacillus counts. The use of sodium hypochlorite and chlorhexidine decreased total microorganisms and Streptococcus mutans counts for both palate and teeth compared with water and sodium bicarbonate. The intaglio of the dentures always presented higher microbial counts than did the denture teeth. Conclusions The use of sodium hypochlorite and chlorhexidine and mechanical cleansing with a toothbrush decreased microbial viability in healthy complete denture wearers.

Objectives: A systematic review and meta-analysis of diagnostic test accuracy studies was conducted to assess if the radiomorphometric indexes observed in panoramic radiographies could estimate reduced bone mineral density (BMD) similarly to standard technique the bone densitometry (dual energy X-ray absorptiometry) in females older than 30 years. Methods: A systematic search in four databases was conducted until January 2019. Two evaluators performed data extraction and evaluation of risk of bias independently, and agreement was achieved by consensus. Data were synthesized on a subgroup meta-analysis with a random effect model and the hierarchical summary receiver-operating characteristic curve was used to calculate pooled estimates of studies. Results: Thirty three studies were included and 12 different radiomorphometric indexes identified, including Mandibular Cortical Index (MCI). The final number of cases pooled for the analysis was 5266 females.The MCI for BMD loss (osteopenia) presented values of sensitivity 0.81 [95% confidence interval (CI), 0.78–0.84] and specificity 0.48 (95% CI, 0.45–0.50), while for osteoporosis sensitivity 0.35 (95% CI, 0.30–0.40) and specificity 0.88 (95% CI, 0.86–0.90). The mandibular cortical width presented values of sensitivity 0.58 (95% CI, 0.40–0.73), specificity 0.73 (95% CI, 0.60–0.83) for osteopenia, while for osteoporosis sensitivity 0.57 (95% CI, 0.36–0.76) and specificity 0.83 (95% CI, 0.68–0.92). Due to the high sensitivity, MCI presented a potential value as a screening tool for initial BMD loss (osteopenia), once tests presenting high sensitivity are described as rarely missing subjects with the disease. To the other hand, MCI to osteoporosis and Mandibular Cortical Width for both conditions are not recommended because presented specificity higher than sensitivity. Conclusion: The MCI can be recommended as a feasible tool to screen initial BMD loss (osteopenia) in females above 30 years old using panoramic radiography exams.

Self-adhesive resin cements are gaining increasing popularity in dentistry because they simplify the cementation protocol by eliminating the etching, priming, and bonding steps. Due to the scarce literature on the clinical performance of glass fiber posts luted using different adhesive strategies, clinicians have difficulty in selecting the most appropriate resin cement system. This Critical Appraisal will review in vitro and clinical studies regarding the luting of fiber posts with self-adhesive materials.

Objective This randomized controlled trial compared the survival of glass fibre and cast metal dental posts used to restore endodontically treated teeth with no remaining coronal wall. Methods Fifty-four participants (45 women) and 72 teeth were evaluated during a follow-up period of up to 3 years. Teeth were randomly allocated to the glass-fibre and cast-metal post groups. All teeth were restored with single metal-ceramic crowns. Survival probabilities were analyzed using Kaplan–Meier statistics (p ≤ 0.05). Results The 3-year recall rate was 92.3% and the survival rates of glass fibre and cast metal posts were similar (97.1% and 91.9%, respectively; p = 0.682). Four failures were observed: two glass fibre posts in a premolar and anterior tooth debonded, one glass fibre post in a premolar debonded in association with root fracture, and one root fracture occurred in a molar with a cast metal post. Conclusions Glass fibre and cast metal posts showed similar clinical performance in teeth with no remaining coronal wall after 3 years. Clinical Significance Posts are used to restore most endodontically treated teeth with no remaining coronal wall. This randomized controlled trial, one of few to compare glass fibre and cast metal posts in such teeth, showed that post type did not significantly influence the survival of restorations. These results can help dentists respond to the important question of how best to rehabilitate endodontically treated teeth with no remaining coronal wall.