Comparison of the Efficacy of Three Different Bone Regeneration Materials: An Animal Study

An Up-to-Date Review of Materials Science Advances in Bone Grafting for Oral and Maxillofacial Pathology

Bone grafting in oral and maxillofacial surgery has evolved significantly due to developments in materials science, offering innovative alternatives for the repair of bone defects. A few grafts are currently used in clinical settings, including autografts, xenografts, and allografts. However, despite their benefits, they have some challenges, such as limited availability, the possibility of disease transmission, and lack of personalization for the defect. Synthetic bone grafts have gained attention since they have the potential to overcome these limitations. Moreover, new technologies like nanotechnology, 3D printing, and 3D bioprinting have allowed the incorporation of molecules or substances within grafts to aid in bone repair. The addition of different moieties, such as growth factors, stem cells, and nanomaterials, has been reported to help mimic the natural bone healing process more closely, promoting faster and more complete regeneration. In this regard, this review explores the currently available bone grafts, the possibility of incorporating substances and molecules into their composition to accelerate and improve bone regeneration, and advanced graft manufacturing techniques. Furthermore, the presented current clinical applications and success stories for novel bone grafts emphasize the future potential of synthetic grafts and biomaterial innovations in improving patient outcomes in oral and maxillofacial surgery.

Innovative Alveolar Ridge Preservation Surgical Technique with Immediate Dental Implant Placement: A Retrospective Case Report of 1-Year Follow-Up

Following tooth extraction, the alveolar ridge undergoes morphological and dimensional changes, including a clot formation that is gradually replaced by granulation tissue. Studies indicate that both horizontal and vertical ridge dimensions decrease after extraction; however, these changes can be mitigated through grafting with biomaterials and barrier membranes. Alveolar ridge preservation (ARP) techniques are employed to counteract bone resorption postextraction, encompassing periosteal inhibition and modified periosteal inhibition (MPI) techniques. The Degidi clot chamber technique offers a means to achieve biomaterial-free extraction sockets, promoting healing and osteointegration. This study aims to present the first rehabilitation of a postextraction dental implant in the maxilla using an innovative ARP procedure via a MPI technique. The technique does not involve autologous or heterologous grafting materials; instead, a cortical lamina and a customized screw are used in conjunction with the blood clot. The primary objective is to protect the vestibular cortical bone from preosteoclastic aggression, which can trigger bone resorption. The technique employs a 0.5-mm cortical lamina to mechanically shield the vestibular cortical bone, preventing vestibular cortical bone resorption and increasing its thickness without the need for biomaterial insertion, relying on the blood clot. The effectiveness of the technique was assessed through a 12-month postimplantation cone-beam computed tomography scan, revealing a 0.5-mm increase. Although based on a single case, the 1-year follow-up results are promising, and further studies are warranted to validate the technique's efficacy.

The Effect of Mixed Polymethylmethacrylate and Hydroxyapatite on Viability of Stem Cell from Human Exfoliated Deciduous Teeth and Osteoblast

OBJECTIVES

 Stem cell from human exfoliated deciduous teeth (SHED) has great potential for bone tissue engineering and cell therapy for regenerative medicine. It has been combined with biomaterials such as mixed of polymethylmethacrylate (PMMA) and hydroxyapatite (HA) as candidates for synthetic bone graft biomaterial. The aim of this study was to analyze the toxicity test of mixed PMMA-HA scaffold seeded with SHED and osteoblast in vitro.

MATERIALS AND METHODS

 SHED was isolated from the pulp of noncarious deciduous teeth and osteoblast cells were cultured, and exposed to PMMA-HA scaffolds with three concentration groups: 20/80, 30/70, and 40/60 for 24 hours. Cytotoxicity test was performed by MTT assay to cell viability.

STATISTICAL ANALYSIS

 Data were analyzed using IBM SPSS Statistics 25, one-way analysis of variance followed by least significant difference test, considering the level of significance p-value less than 0.05 RESULTS:  The percentage of SHED's viability was best in the PMMA-HA group with concentrations of 20/80, followed by 30/70, and 40/60 with 87.03, 75.33, and 65.79%, respectively. The percentage of osteoblast cell's viability was best in the PMMA-HA group with concentrations of 20/80, followed by 30/70, and 40/60 with 123.6, 108.36, and 93.48%, respectively.

CONCLUSIONS

 Mixed PMMA-HA was not toxic for the SHED and osteoblast. This characteristic is the initial requirement to be proposed as an alternative material for healing alveolar bone defects. In vivo animal research is mandatory to confirm the use of PMMA-HA on the alveolar defect model.

Prevalence and Association between Primary Stability and Bone Quality in Implants Placed in Edentulous Dental Arches: A Retrospective Analysis

Immediate function has become an accepted treatment modality for fixed restorations in completely edentulous jaws. The dental implants have gained immense popularity. A secure implant primary stability is positively associated with a successful implant integration and long term successful clinical outcome. The main aim of this study was to find the association between primary stability and bone density in implants placed in maxilla and mandible. A total of 1263 patients who had undergone implant placement from March 2020-March 2021 in Saveetha Dental College and Hospitals, Chennai, India were chosen for the study. The primary stability and bone density of these patients were collected from the hospital records. The collected data was compiled, reviewed, tabulated in Microsoft Excel sheet and entered in SPSS software for statistical analysis. In the present study, the patient aged between 28 and 37 years had undergone more implant placement (31%) with male predilection (53%). The most commonly associated primary stability was found to be 30-40 Ncm (51.37%) predominantly with D2 type of bone density (52.69%). A Chi-squared statistical test was done for primary stability and bone density and the P was found to be 0.00 (Chi-squared P < 0.05, statistically significant). The most predominant bone density was D2 associated with primary stability of 30-40 Ncm. The association between bone density and primary stability was found to be statistically significant. The present study shows a strong relationship between bone density and primary implant stability.

Association of Age, Gender, and Site of Implant Placement: An Institution-Based Retrospective Study

Tooth loss is an undesirable condition that leads to functional, esthetic and social damage, having an impact on an individual's quality of life. Dental implants are man-made tooth root replacements that are increasingly used to replace a missing tooth. It is important to gather demographic data in order to take precautions before the possible failures. Hence the objective of this study was to retrospectively determine the association between age, gender, and site of implant placement in patients reporting to a private dental institution. This study was carried out from the data obtained from the case records of 1281 patients who had undergone implant therapy. Chi-square test was applied to see associations of gender, age and implant site. The results show that a maximum number of 348 implants (27.7%) were placed in patients aged between 41-50 years. The patient pool consisted of 705 (55%) females and 576 (45%) males. A maximum of 228 implants (17.80%) were placed in region 46 and 224 implants (17.49%) in region 36. Only 2 implants (0.2%) were placed in region 41. There was a positive association between age, gender and site of implant. In those aged 20-30 years, 20.53% of implants were placed, 26.23% in 31-40 years, 27.1% in 41-50 years, 17.95% in 51-60 years and 8.11% in 61-70 years of age. In male, a maximum of 124 implants (54.4%) were placed in region 46 and only 1 implant (50%) in region 41. In females, region 36 had a maximum of 110 implants (49.1%), and the least number of implants were placed in regions 31 and 41. In this study, it can be concluded that general factors such as age and gender had a significant effect on the site of implant placement.

Determination of the Sterilization Dose of Gamma-Ray Irradiation for Polyvinyl Alcohol-Collagen-Chitosan Composite Membrane as a Material for Periodontal Regenerative Surgery

OBJECTIVE

 Membrane sterility is very necessary considering its function as an implant material. Therefore, this research aims to determine the dose of gamma-ray irradiation for the sterilization of polyvinyl alcohol (PVA)-collagen-chitosan composite membranes used as regenerative surgery materials.

MATERIALS AND METHODS

 A total of 100 pieces of the composite membranes were prepared in a size of 2.0 × 1.5 cm by mixing 7.5% PVA, 3% collagen, and 2% chitosan using the film casting method in three batches. Furthermore, the bioburden test was performed to determine the initial microbial count in the sample by following ISO 11737-1. The results were used to ascertain the dose of gamma-ray irradiation on the sample according to ISO 11137-2. The dose verification test was then performed at the sterility assurance level 10-6.

RESULTS

 The average result of the bioburden test from three batches was 6.6 colony forming unit; hence, the verification dose was 4.8 kGy. In the verification dose test, since there was only one contaminated sample, the sterility dose test was continued.

CONCLUSION

 The sterile gamma-ray irradiation dose for PVA-collagen-chitosan composite membrane was 17.1 kGy.

Use of 3D-printed polylactic acid/bioceramic composite scaffolds for bone tissue engineering in preclinical in vivo studies: A systematic review

3D-printed composite scaffolds have emerged as an alternative to deal with existing limitations when facing bone reconstruction. The aim of the study was to systematically review the feasibility of using PLA/bioceramic composite scaffolds manufactured by 3D-printing technologies as bone grafting materials in preclinical in vivo studies. Electronic databases were searched using specific search terms, and thirteen manuscripts were selected after screening. The synthesis of the scaffolds was carried out using mainly extrusion-based techniques. Likewise, hydroxyapatite was the most used bioceramic for synthesizing composites with a PLA matrix. Among the selected studies, seven were conducted in rats and six in rabbits, but the high variability that exists regarding the experimental process made it difficult to compare them. Regarding the results, PLA/Bioceramic composite scaffolds have shown to be biocompatible and mechanically resistant. Preclinical studies elucidated the ability of the scaffolds to be used as bone grafts, allowing bone growing without adverse reactions. In conclusion, PLA/Bioceramics scaffolds have been demonstrated to be a promising alternative for treating bone defects. Nevertheless, more care should be taken when designing and performing in vivo trials, since the lack of standardization of the processes, which prevents the comparison of the results and reduces the quality of the information. STATEMENT OF SIGNIFICANCE: 3D-printed polylactic acid/bioceramic composite scaffolds have emerged as an alternative to deal with existing limitations when facing bone reconstruction. Since preclinical in vivo studies with animal models represent a mandatory step for clinical translation, the present manuscript analyzed and discussed not only those aspects related to the selection of the bioceramic material, the synthesis of the implants and their characterization. But provides a new approach to understand how the design and perform of clinical trials, as well as the selection of the analysis methods, may affect the obtained results, by covering authors' knowledgebase from veterinary medicine to biomaterial science. Thus, this study aims to systematically review the feasibility of using polylactic acid/bioceramic scaffolds as grafting materials in preclinical trials.

A Bibliometric Study on the Top 101 Most-Cited Articles of Dental Journals of the Middle East/North Africa Countries From 2011 to 2021

Introduction: This retrospective descriptive study evaluated the Scopus-indexed dental journals and their most-cited documents affiliated with the Middle East and North Africa (MENA) countries from 2011 to 2021. Methods: Dental journals affiliated with MENA countries, their bibliometric indicators (SJR, CiteScore, SNIP, and H-index), and the 101 most cited articles of the considered journals were extracted and studied through descriptive statistics. In addition, the "citation per year" of each top 101 articles was calculated. Spearman's rho test was used for pairwise comparisons of the correlation coefficient values between each two of the considered bibliometric indicators. Results: The number of citations of the 101 most-cited papers ranged from 35 to 203. The mean (SD) citations of studied articles were 61.33 (37.58) and the median was 46. Furthermore, CiteScore had the highest significant correlation with SJR (r=0.828, P˂0.001). Moreover, the citation per year of the top 101 documents had no significant relationship with any of the journals' bibliometric indicators. Conclusion: Because journal performance and citation rate are multi-dimensional concepts, a single metric cannot express them thoroughly despite correlations between indices. "European Journal of Dentistry" from Turkey, "Saudi Dental Journal" from Saudi Arabia, and "Iranian Endodontic Journal" and "Journal of Lasers in Medical Sciences" both from Iran had the highest ranks in the SCImago portal and the highest scores in bibliometric indices amongst the MENA dental journals.

Evaluation of Implant and Prosthesis Survival Rates Based on Crestal Bone Loss

A dental implant mimics the tooth and restores its function. It has flourished as a replacement of missing natural teeth that has a success rate over 90% over the years. However, this root-form implant has also been associated with some complications after its application. Crestal bone loss, one of the biggest challenges in dental implant placement, occurs around the dental implant neck within a few months post-loading. The aim of this study was to determine survival rates and to measure crestal bone changes after placement of a single crown prosthesis. Data collection was done in a private dental university setting. Data from approximately 296 cases were retrieved after analyzing 86,000 case sheets. The following parameters were evaluated based on dental records: age, sex, implant placement area, implant diameter and length, and presence or absence of exudate. Crestal bone loss was assessed radiographically. Excel tabulation and SPSS version 23 were used for data analysis. Chi-square testing was done to correlate various parameters used in this study. Incipient crestal bone loss was commonly observed. It was seen that the association between crestal bone loss and exudate was statistically significant (Chi-square, p < 0.05). Within the limits of this study, incipient crestal bone loss was observed in most dental implants irrespective of bone density, implant length, implant diameter, and implant placement area.

T-scans in implant procedures

T scans are a breakthrough in technology which allows the user to accurately analyze the occlusion of a patient with minimal to zero errors. They are used during prosthodontic rehabilitation to map out the patient's occlusion to plan for replacements. Such a high advancement in technology has a backdraw. The cost of the equipment is a concern for simple dental practitioners. There are no large scale studies using T scans in determining the occlusion. Therefore, it is of interest to analyze the use of T scans in determining the percentage of contact in patients with dental implants. This retrospective analysis was done at the Saveetha University hospital set up where patients undergoing prosthesis fabrication for implants were included. Details like their age, gender and the percentage of contact of the implant and percentage of contact on the adjacent tooth were recorded. These details were tabulated and imported to IBM SPSS version 23 for statistical analysis. Chi square test was used to analyze comparable variables. 22 patients were analyzed, the mean percentage of contact of implants was found to be 7.45±;9.01 and the mean percentage of contact of adjacent teeth was found to be 10.14±6.7. Thus, T scan is an efficient method in recording the dynamic occlusal contacts of a patient. The use of T scan reveals data pertaining to individual tooth but in the present study there is no statistical significance in terms of exact values comparing implant contact to adjacent tooth contact. Further studies are needed with relation to timing and contact surface of implant prosthesis.

Knowledge, attitude, and practice survey on the use of stamp technique for the management of Class I caries in molars among undergraduate students in dental schools

Stamp technique is a recently developed technique that involves of creating an index which records the occlusal anatomy of posterior teeth before cavity preparation. This technique is beneficial in cases where the caries is involving the occlusal surface with little or no damage to the occlusal anatomy or the marginal ridges. The aim of the study is to assess the knowledge and practice on the use of stamp technique for the management of Class 1 caries in molars among undergraduate students. A questionnaire-based study was conducted among 100 dental students in Saveetha Dental College. The questionnaire contained 17 questions that were circulated through Google Forms and received dichotomous responses. The data were collected as an ordinal variable and the collected data were analyzed using SPSS software, and Chi-square test and descriptive analysis were done. This study shows that almost 37% of the respondents were interns and final-year students, 62% of them felt carving would be easier to attain the proper occlusal morphology, 55% of them prefer both flowable and packable composites, and 63% felt stamp technique would be technique sensitive. There was a significant association between the year of study and difficulties faced in occlusal stamp technique (P = 0.014 < 0.05). Undergraduate students were moderately aware of the stamp technique in composite restorations. More detailed knowledge on composite finishing and polishing should be emphasized in the undergraduate curriculum.

Knowledge and awareness of forensic dentistry course among undergraduates

Forensic odontology is an expanding field within the domain of forensic sciences, where dental knowledge is applied in identification of individuals through analysis of the dental-related records. The study goal was to determine if undergraduate students were aware of the forensic dentistry course. A cross-sectional survey was initiated about the need for forensic courses in UG program. Nearly 100 students participated in this survey, data have been collected, and graph has been plotted. Data have been collected with the help of SPSS software; data have been analyzed and plotted as graph. One hundred students responded the survey; only limited people's opinions have been collected. The result varies among the students; 58% knows about the importance of forensic odontology in dentistry using Chi-square value, P = 0.09. The majority of students, who replied to this poll, had some understanding and awareness of forensic odontology in dentistry, but they need to learn more about how it is practiced.

Practice management in undergraduate dental program: The need among dental students

The objective of this study is to assess the opinion of dental students regarding the necessity for a practice management (PM) course in their curriculum. To determine the necessity of a PM course in dental programs, a series of questions was developed and given to 100 dental students. Dental students were asked a series of questions about the necessity of this course, and responses were gathered. The questionnaire included time management, patient management, teamwork, leadership quality, and other requirements of the course. According to the results, dentistry students desired that the PM curriculum cover subjects such as teamwork, confidence, the value of the PM course, time management, patient management abilities, leadership qualities, and others. Most of the responses obtained from the students agreed that the PM curriculum must be taught with the course for better management. The development of any course should be based on the need and opinion of the students who pursue the course of dentistry. Thus, this study evaluates the need for a PM course in an undergraduate (UG) dental program.

Accuracy of multiple implant impressions using different combinations of impression materials using closed tray technique: An in vitro study

Decision for precision! The first stage in creating an accurate, passively fitting prosthesis is to replicate the intraoral relationship of implants using impression methods. The technique and the impression material utilized are the key elements that influence the accuracy of the implant imprint. The goal of this study was to assess the accuracy of the described implant impression technique using various impression materials, as well as to look into the clinical aspects that influence implant impression accuracy. Two holes (4.3 mm × 10 mm) were drilled in a U-shaped study plastic model representing the partially edentulous maxilla, and the appropriate Nobel Biocare Replace select implants were implanted. Closed tray copings were placed for the relevant implants, and closed tray impressions were taken with several impression materials (PVS-1) Dentsply, medium-bodied, and 2) Regular setting-Zhermack Elite HD+). To assess passive fit accuracy, a jig trial and RVG IOPA were used. Stereomicroscopy was used to evaluate the precision of the implant and analog interface from two perspectives: buccal and lingual. On the buccal aspect, Group 1 had a mean value of 13703.29, whereas Group 2 had a mean value of 11395.58. On the lingual aspect, Group 1's mean value was 8415.61, whereas Group 2's was 9192.01. In the closed tray technique, no statistically significant differences between different imprint materials were found. There was no significant difference in the accuracy of closed tray implant impression techniques with different impression materials, according to the findings.

Need for practice management in undergraduate dental program - A cross sectional survey among the dentists

Advancement in technology, enhancement of knowledge, elevated expectations from the patients regarding the quality of treatment, and economic factors are emerging as challenges to dentists, which demand emerging dentists to have skills on patient management and leadership through an improved curriculum. The aim of the present study was to conduct a survey among dentists regarding the need for practice management in undergraduate dental program. A total of 100 dentists from Chennai were involved in the study. They were made to answer 15 questions which were circulated online. The obtained data were statistically analyzed using SPSS software. It is evident that the majority of the dentists emphasize on including practice management courses in the undergraduate dental program as it may be helpful for the budding dentists in their future private practices. It can be concluded that the opinion of the dentists is strong and beneficial and should be considered.

Comparative analysis of weld strength of nickel-chromium and cobalt-chromium base metal alloys when submitted to tungsten inert gas welding

Long span base metal alloy fixed prosthesis and partial dental prosthesis frameworks most often require welding for better fit and adaptation. The type of metal alloys used and its effect on the weld strength of the prosthesis have to be investigated. The aim of the study is to comparatively analyze the weld strength of nickel-chromium (Ni-Cr) and cobalt-chromium (Co-Cr) base metal alloys when subjected to tungsten inert gas (TIG) welding. 10 nickel- and cobalt-based specimens were obtained by casting of castable resin patterns of dimension 25 mm × 3 mm × 1 mm. Welding of the samples was carried out using the Lampert PuK 2 welding equipment, and a three-point bend test using a universal testing machine was carried out to evaluate the weld strength of the specimens. Statistical analysis was carried out using the SPSS software version 23. Higher weld strength was observed in the Co-Cr alloy (mean = 898 MPa) than in the Ni-Cr alloy (mean = 690 MPa), when submitted to TIG welding (P < 0.05). TIG welding could be a better alternative for joining base metal alloys for long span edentulous cases, and cobalt-based alloys could be better alternatives to nickel-based alloys that usually tend to cause hypersensitivity reactions.

Dentists' Preference toward Fixed Versus Removable Implant Prosthesis on Edentulous Jaws to Improve Quality of Life

Implants that can be used in the prosthetic rehabilitation of full and partial edentulous patients are now frequently used due to advances in dentistry. The aim of the study is to find the prevalence of implant supported fixed vs. removable prosthesis and associated quality of life evaluation. A cross-sectional, descriptive study was conducted in an institution, on randomly selected individuals. The study group consisted of adult patients who attended the outpatient Department of Prosthodontics from June 2019-March 2020. Eighty-six thousand (86,000) case sheets were evaluated and Chi-square test, independent t-test and frequency analysis were used to explore the relationship between two variables. Out of the patients, 76.5% preferred fixed prosthesis while 23.5% chose removable prosthesis. Females preferred fixed prosthesis over removable. The young-old age group had more removable prosthesis compared to the middle- and elderly age group. Patients with implant supported fixed dental prosthesis had a better quality of life compared with patients with implant supported overdentures. Esthetic and functional rehabilitation is a preferred option females generally care more about their teeth and looks so wanted more fixed options. The young-old age group preferred removable prosthesis over fixed prosthesis. Patients with implant supported fixed dental prosthesis have a better quality of life compared with patients with implant supported overdentures.

Synthetic materials in craniofacial regenerative medicine: A comprehensive overview

The state-of-the-art approach to regenerating different tissues and organs is tissue engineering which includes the three parts of stem cells (SCs), scaffolds, and growth factors. Cellular behaviors such as propagation, differentiation, and assembling the extracellular matrix (ECM) are influenced by the cell's microenvironment. Imitating the cell's natural environment, such as scaffolds, is vital to create appropriate tissue. Craniofacial tissue engineering refers to regenerating tissues found in the brain and the face parts such as bone, muscle, and artery. More biocompatible and biodegradable scaffolds are more commensurate with tissue remodeling and more appropriate for cell culture, signaling, and adhesion. Synthetic materials play significant roles and have become more prevalent in medical applications. They have also been used in different forms for producing a microenvironment as ECM for cells. Synthetic scaffolds may be comprised of polymers, bioceramics, or hybrids of natural/synthetic materials. Synthetic scaffolds have produced ECM-like materials that can properly mimic and regulate the tissue microenvironment's physical, mechanical, chemical, and biological properties, manage adherence of biomolecules and adjust the material's degradability. The present review article is focused on synthetic materials used in craniofacial tissue engineering in recent decades.

Knowledge and awareness on neurolept anesthesia among dental students

N20 omission or addition to the combination of an opioid and neuroleptic is referred to as neuroleptanalgesia and neuroleptanesthesia, respectively. Conscious sedation is the result of this evolution. The requirement for high-quality anesthesia that is also related with speedier recovery, improved comfort, and lower costs all support the concept of neuroleptanesthesia. A set of eight questions was formulated and circulated among the undergraduate and postgraduate students of Saveetha Dental College. Responses were collected and the data were entered into MS Excel sheet and transferred to SPSS for the analysis. Results were made into graphs and interpreted. In the present study, among the students who took part in the study, 36.3% of the students were postgraduates and 63.7% of them were undergraduates. About 45.2% of the students were not aware and 54.8% of the students were aware that neuroleptanalgesia refers to the combination of a potent sedative analgesic agent and a tranquillizer. Many of the students were not aware of what neuroleptic esthetic is and how it evolved. The current study showed that most students did not have enough knowledge about neurolept anesthesia. However, dentists should make efforts to improve knowledge, awareness of neurolept anesthesia for further advancement, and the need for high-quality anesthesia.

Awareness and knowledge of oral manifestations in cardiovascular diseases among the general public

Cardiovascular diseases (CVDs) are disorders affecting the heart and blood vessels. Periodontal problems, bleeding gums, dry mouth, and gingival hyperplasia are common oral manifestations seen in cardiovascular-related problems. To assess the extent of awareness and knowledge, the general public has toward the oral manifestation related to that of CVDs. A questionnaire was distributed among the general public in relation to that of the extent of awareness and knowledge of oral manifestations with regard to CVD. A total of 161 responses were collected from the survey. The collected data were compiled and analyzed by the SPSS software; the Pearson Chi-square test was done where P < 0.05 was considered statistically significant. The study showed that 65.22% of the population is aware of the types of CVD. About 59.63% of the population do not know that periodontal problems lead to cardiovascular problems. About 39.75% have vague knowledge about the maintenance of poor oral health causing cardiovascular problems. The study concluded that the general public is not much aware of the oral manifestations related to that of CVDs.

Average time in between appointments for multivisit pulpectomy in patients reported to a university dental hospital

Complete removal of the infected coronal and radicular pulp tissue along with obturation of the canal space with suitable medication is defined as pulpectomy. The most common indication for pulpectomy is a tooth with irreversible pulpitis which shows symptoms of nocturnal pain and abscess. To determine the average time in appointments for multivisit pulpectomy in patients reported to a university dental hospital. It is planned as a retrospective analysis of the case records of patients who were treated as two visit pulpectomy procedures in a university dental hospital, India. The study concluded that in the majority of the situations the average time in between appointments for multivisit pulpectomy was found to be within 1 week.

Knowledge, awareness, and practice survey on conventional radiographic methods and processing among dental students

X-rays are electromagnetic waves produced by an X-ray machine and are used to observe the internal structures of patients. The X-rays pass through the body before being detected by the detector file or a digital detector behind the patient. To analyze the knowledge, awareness, and practice on conventional radiographic method and processing among the dental students. A well-framed questionnaire consisting of 10 questions were prepared and distributed among 100 dental professionals and students through the online Google forms link. The data were collected, tabulated in Excel sheets, and analyzed using the SPSS software. The Chi-square test was used to assess the P value. Sixty-five percentage of the participants are aware of conventional radiographic methods and 35% are not aware. The Chi-square test was done giving a P = 0.001 (<0.05), which is statistically significant. The dental students as compared to the other specialties have adequate and efficient knowledge and are aware of the conventional radiographic methods and its processing.

Effect of brushing simulation on the surface roughness of soft-tissue liners: An in vitro study

Soft denture liners evenly distribute functional loads over denture-bearing tissues. The liners aid in more evenly distributing the pressures of mastication to the underlying tissues by absorbing some of the masticatory forces. The study aimed to evaluate the brushing simulation influence on the surface roughness property of soft-tissue liners. A total of eight samples of Avue brand soft-tissue liners with the composition of varnish base and varnish catalyst were suspended into a standard template extracted and numbered sequentially and surface roughness was calculated using a stylus profilometer. A total of 30,000 cycles brushing were done, where the first group samples were brushed with Colgate toothpaste and the second group brushed with Dabur Red toothpaste using a toothbrush simulator (ZM3.8 SD Mechatronik). The data of both pre- and postbrushing values were recorded manually and statistically uploaded on SPSS software version 22 and values were represented in clustered bar graph forms. The significance value of Ra was 0.321. The significance value of Rq was 0.211. The significance value of Rz was 0.354, hence statistically, insignificant. In the present study, the surface roughness of soft-tissue liners is reduced to a minimal extent after brushing simulation.

Novel Approaches and Biomaterials for Bone Tissue Engineering: A Focus on Silk Fibroin

Bone tissue engineering (BTE) represents a multidisciplinary research field involving many aspects of biology, engineering, material science, clinical medicine and genetics to create biological substitutes to promote bone regeneration. The definition of the most appropriate biomaterials and structures for BTE is still a challenge for researchers, aiming at simultaneously combining different features such as tissue generation properties, biocompatibility, porosity and mechanical strength. In this scenario, among the biomaterials for BTE, silk fibroin represents a valuable option for the development of functional devices because of its unique biological properties and the multiple chances of processing. This review article aims at providing the reader with a general overview of the most recent progresses in bone tissue engineering in terms of approaches and materials with a special focus on silk fibroin and the related mechanisms involved in bone regeneration, and presenting interesting results obtained by different research groups, which assessed the great potential of this protein for bone tissue engineering.

Biomimetic Mineralization on 3D Printed PLA Scaffolds: On the Response of Human Primary Osteoblasts Spheroids and In Vivo Implantation

This study aimed to assess the response of 3D printed polylactic acid (PLA) scaffolds biomimetically coated with apatite on human primary osteoblast (HOb) spheroids and evaluate the biological response to its association with Bone Morphogenetic Protein 2 (rhBMP-2) in rat calvaria. PLA scaffolds were produced via 3D printing, soaked in simulated body fluid (SBF) solution to promote apatite deposition, and characterized by physical-chemical, morphological, and mechanical properties. PLA-CaP scaffolds with interconnected porous and mechanical properties suitable for bone repairing were produced with reproducibility. The in vitro biological response was assessed with human primary osteoblast spheroids. Increased cell adhesion and the rise of in vitro release of growth factors (Platelet-Derived Growth Factor (PDGF), Basic Fibroblast Growth Factor (bFGF), Vascular Endothelial Growth Factor (VEGF) was observed for PLA-CaP scaffolds, when pre-treated with fetal bovine serum (FBS). This pre-treatment with FBS was done in a way to enhance the adsorption of serum proteins, increasing the number of bioactive sites on the surface of scaffolds, and to partially mimic in vivo interactions. The in vivo analysis was conducted through the implantation of 3D printed PLA scaffolds either alone, coated with apatite (PLA-CaP) or PLA-CaP loaded with rhBMP-2 on critical-sized defects (8 mm) of rat calvaria. PLA-CaP+rhBMP2 presented higher values of newly formed bone (NFB) than other groups at all in vivo experimental periods (p < 0.05), attaining 44.85% of NFB after six months. These findings indicated two new potential candidates as alternatives to autogenous bone grafts for long-term treatment: (i) 3D-printed PLA-CaP scaffold associated with spheroids, since it can reduce the time of repair in situ by expression of biomolecules and growth factors; and (ii) 3D-printed PLA-CaP functionalized rhBMP2 scaffold, a biocompatible, bioactive biomaterial, with osteoconductivity and osteoinductivity.

An Innovative Meta-Systematic Review into the Landscape of Literature and the Concluding Evidence on the Quality of Life of Patients Using Two Implant Supported Mandibular Complete Denture Prosthesis

Aim:

The aim of this systematic review is to analyze the existing evidence on the quality of life of patients completely edentulous in the mandible.

Materials and Methods:

A search questionnaire was formulated using population intervention comparison outcome (PICO) analysis, and a comprehensive search was initiated in PubMed Central, Medline, Cochrane, and Google Scholar databases for the related topics. Manuscripts published till December 2019 were included in this review. Out of the 63 articles obtained from searching all databases, 27 studies were excluded based on the title and abstract. Out of the remaining 36 studies, 12 were excluded based on the inclusion and exclusion criteria of our interest and 24 were included on the basis of core data.

Results:

One review author identified randomized trials meeting inclusion criteria for this review. Two review authors extracted data and assessed study quality. The oral health-related quality of life in completely edentulous mandibular patients wearing implant-supported overdentures was better when compared to conventional tissue-supported complete denture, and a minimum two implant-supported mandibular complete denture has sufficient improvement in oral health-related quality of life.

Conclusion:

There are about more than 170 reviews and clinical trials that have been published in support of the same for the past two decades. Thus, the clinicians may not be tempted in placing additional implants in well-formed mandibular edentulous ridges. To enhance the understanding of mandibular implant overdenture treatment, clinicians must scrutinize the existing evidence and formulate a protocol by striking a balance between efficient and evidence based treatment.