Dentistry 3000

The role of different factors in the development of cleft lip, palate, or both

2023-11-13T15:01:23-05:00

Background: Cleft lip and cleft palate refer to congenital malformations characterized by fissures or divisions in the upper lip, the palatal region of the mouth, or both. Cleft lip and cleft palate occur due to incomplete closure of face tissues during fetal development.

Objective: To identify the primary elements that could contribute to the occurrence of cleft lip and palate.

Subjects and methods: The sample included 1080 patients distributed between cleft lip only, cleft palate only, and cleft lip and palate. Parents of participants answered questions related to their medical and exposure history. Subjects were seen over 13 years, from 1 January 2010 to 31 December 2022. Participants came to our hospital with ages from a few hours to 3 months.

Results: The distribution of cleft types in the sample was as follows: 11.6% had cleft lip alone, 29.5% had cleft palate exclusively, and 57.3% had both cleft lip and palate. The most significant number of patients, 28%, were found to be first-born individuals. The majority of dads who exhibited patience were aged 30 years or older, accounting for 65% of the sample. Among these individuals, 8.6% had a concurrent systemic ailment, while 40% were identified as smokers. Most moms were between the age range of 16 to 30 years (65.4%). Incorporate additional factors into the analysis, including the presence of familial cleft history and psychiatric disorders.

Conclusion: We found a high frequency of consanguinity between the parents maternal psychology factors such as fear, hearing bad news or hearing loud sounds like gunshots (prevalent during civilian war in Iraq between 2010-2014 years) among parents of children born with cleft lip and palate.

Mandible Reconstruction with 3D Printed Models

2023-07-19T11:40:51-04:00

Background: When surgeons operate under general anesthesia, length of surgery, not only its outcome, matters. In maxillofacial surgery we can reduce the time in reconstructive surgery by using presurgical bended plates in presurgically designed 3D models.

Method: The study measured the mean time to bend the plates preoperatively on a printed three-dimensional model and the capability of the plates to adapt well on the mandible intraoperatively in cases of mandibular reconstruction after partial resection of the mandible due to pathology, such as benign aggressive tumors.

Results and conclusions: The mean time to bend the plates preoperatively was 17 minutes, with rapid adaptation during surgery. This is important in minimizing the time that the wound is exposed to the environment and minimizes the trauma to the surrounding soft tissues. Multiple checks of the plate if bended at time of surgery can increase trauma to the surrounding soft tissues.

The study supports the recommendation of the use of the preoperatively corrected and printed 3D models to prebend the plates pre-operatively. This step should be included as a routine workflow in elective cases, since it is not be possible in cases of emergency or urgency.

Prevalence of dehiscence and fenestration in Iraqi population: CBCT-based analysis

2023-11-03T17:48:09-04:00

Objective: This study utilized the cone-beam computed tomography (CBCT) to investigate the prevalence of lower and upper jaw fenestration and dehiscence in individuals with normal patterns, with a particular focus on central incisors to first molars on the two sides.

Materials and Methods: An analysis was conducted on a cohort of 415 patients treated from January 2022 to December 2022 in the periodontal departments of Baghdad, Sulemania, Basra, and Najaf. There was a total of 174 males and 241 females that had Class I characteristics with normal anterior region patterns. The study focused on the occurrence of fenestration and dehiscence in the dentated area of both the right and left sides. These occurrences were subjected to statistical analysis.

Results: Dehiscence has been seen in 4.89% of the assessed mandibular teeth, whereas fenestration was observed in 0.73% of the same teeth. Dehiscences were seen in 9.78% of the examined cases in the upper jaw, while fenestrations were discovered in 5.13% of the cases. These findings indicate a significant difference in the frequency of these conditions between the upper and lower jaws.

Conclusion: The occurrence of dehiscence in both jaws was found to be greater than the occurrence of fenestration. The observed patterns suggested that these findings are more possibly to be attributed to physiological instead of pathological factors.

Evaluating Child Behavior and Preference Toward NumBee and Traditional Syringe (a Randomized Clinical Trial)

2023-09-16T08:31:13-04:00

BACKGROUND: Local anesthetics are the gold standard for pain control in dentistry. Most patients still view the “needle” as a source of anxiety and disruptive behavior rather than relief. The patient’s cooperation and comfort level will increase with the administration of painless local anesthetic injection using appropriate technique. The purpose of this study was to assess the patient cooperation and behavior after receiving local anesthesia injection and to compare patients’ acceptance and preference of needleless NumBee anesthetic delivery device to conventional dental syringe.

MATERIALS AND METHODS: 30 non-fearful 6-8-year-olds who had never been to the dentist were selected for the study using a split-mouth design. They underwent a simple class I restoration on both mandibular permanent first molar teeth in two separated dental visits. The Frankl behavior rating scale was used to assess patient behavior following injection. Patients expressed their preference and acceptance of the used syringes by answering a questionnaire.

RESULTS: After injection by either method, 25 patients had Frankl behavior rating score of 4. Patients that had a negative response with the traditional method, showed a score of 2, following NumBee injection (p=0.035).

CONCLUSION: Patients accepted both methods, and NumBee may induce less fear, with minimum stinging and unpleasant taste.

Association of Dental Caries with Different ABO Blood Groups

2023-08-25T12:54:52-04:00

BACKGROUND: ABO blood type affects general and oral health, as salivary physiochemical features are different among various blood kinds. Thus, these may affect the dental caries severity. This work studied the caries experience prevalence in individuals displaying various blood types. This work tested the association between ABO blood group and dental caries. Also, this work evaluated which ABO groups are associated with a higher vulnerability to dental caries.

MATERIALS AND METHODS: Sixty Tikrit University students were randomly selected and were put into four groups based on blood type, and dental caries experience was diagnosed and scored based on the index of Decay Missing Filling Teeth and Surfaces (WHO, 2013). This index scores caries lesions by severity.

RESULTS: The blood type O was the most frequent (37%), followed by B, A, and AB types. Caries experience (DMFS and DMFT) was statistically significantly higher among the B blood group (P<0.05).

CONCLUSION: ABO blood group was associated with dental caries disease.

Comparative evaluation of Indocyanine Green and 810nm Diode Laser Assisted Antimicrobial Photodynamic Therapy with 810nm Diode Laser Assisted New Attachment Procedure as adjuncts to Scaling and Root Planning in Supportive Periodontal Therapy: A Randomized Controlled Split-Mouth Clinical Trial

2023-04-04T16:25:30-04:00

BACKGROUND: Minimally invasive nonsurgical management of recurrent periodontal pockets remains the most viable option during supportive periodontal therapy (SPT), but with inconclusive results. The purpose of this study is to evaluate and compare the adjunctive use of Indocyanine green (ICG) and 810nm Diode laser assisted photodynamic therapy (IG-PDT) with 810nm Diode laser assisted new attachment procedure (LANAP) in the management of persistent pockets in SPT.

MATERIALS AND METHODS: This single blinded randomized controlled split mouth clinical trial included 20 participants with at least two adjacent teeth with PPD ≥5mm and Clinical attachment level (CAL) ≥3mm in the contralateral quadrants. IG-PDT group received application of 5mg/ml solution of ICG for one minute followed by 810±10nm diode laser with 1W power density. LANAP group received 810±10nm diode laser application at 3W power density with 100ms and 650ms pulse duration at two consecutive passes. Clinical parameters i.e., Plaque index (PI), Gingival index (GI), PPD, CAL gain were recorded at baseline, 3 and 6 months. Landry’s Healing index was assessed on the 7^th day and 1 month postoperatively. Patient comfort was assessed using Visual Analog Scale (VAS) immediate post-operatively.

RESULTS: Student t test and repeated measures of ANOVA were used for statistical analysis. Both site level and patient level assessments of clinical parameters showed improvement in clinical parameters in both groups. However, IG-PDT group showed significantly greater improvements in PPD (<0.001) and CAL (<0.001) at 3 and 6 months evaluation. IG-PDT showed better healing (P-0.03) at 7^th post-operative day. However, LANAP showed less discomfort (2.40±0.50) compared to IG-PDT group (3.20±0.61).

CONCLUSION: IG-PDT is shown to provide better clinical outcomes compared to LANAP in management of patients under SPT.

Effect of Potassium Iodide and Glutathione on Color Change and Remineralization Potential Induced by Silver Diamine Fluoride Application

2023-02-20T04:50:01-05:00

Purpose: To evaluate the effect of applying potassium-iodide (KI) and glutathione (GSH) on silver-diamine fluoride (SDF) induced tooth discoloration as well as their effect on its remineralization potential.

Methods: To examine color change, cervical dentinal demineralized cavities were performed mesially and distally in 16 human premolars. Glass-ionomer restoration (GIC) was applied and allocated to four groups I-IV according to the following pre-treatments: No pre-treatment, SDF, SDF+KI, SDF+20%(wt) GSH. Spectrophotometric evaluation of samples at time intervals: 1,7 and 14 days of GIC application. To examine the effect of remineralization, 21 bovine dentin blocks were divided into groups I-III: SDF, SDF + KI, and SDF + GSH. Vickers microhardness was measured, before and after demineralization and after 7 days of treatment.

Results: Spectrophotometric results after 14 days for groups I-IV were:1.29±0.18, 12.24±0.19, 2.19±0.32 and 4.76±0.19 respectively. Groups III and IV showed significant reduction in ΔE compared with group II, although they showed significant increase in ΔE compared with group I (p<0.001). KI showed better management of color changes than GSH. The microhardness test results after treatment application to demineralized dentin for Groups I-III were: 30.81±20.87, 30.59±16.42, 24.69±13.21, respectively. All groups showed significantly increased microhardness of demineralized dentin (P ≤ 0.05), which was comparable to that of Group I.

Conclusion: Application of KI and GSH after SDF significantly minimized color changes without affecting the remineralizing effect of SDF.