Laser Er:YAG-Assisted Debonding May Be a Viable Alternative to the Conventional Method for Monocrystalline Ceramic Brackets.

In orthodontic practice, due to the increased interest among patients in smile aesthetics, different types of brackets are now being used, with those most frequently applied being ones made of polycrystalline and monocrystalline ceramic. The aim of this study was to evaluate the laser Er:YAG-assisted debonding technique compared to conventional methods for removing monocrystalline ceramic brackets from human teeth. The study sample included 60 vital teeth (frontals of the upper jaw) from 10 patients who had monocrystalline ceramic brackets and were in the final phase of orthodontic treatment. The debonding procedure was carried out following a split-mouth study design, using either the conventional technique or laser Er:YAG 2940 nm radiation. For each tooth, three variables were evaluated: the patient's sujective tooth sensitivity associated with the debonding, the time required for debonding, and pulp blood flow microdynamics after the debonding. Three evaluation instruments were used to assess and quantify the treatment effects: (i) the Wong-Baker FACES Pain Rating Scale for pain assessment; (ii) a digital stopwatch/timer to measure the time required to remove the bracket; and (iii) laser Doppler flowmetry (LDF) for recording the pulp blood flow evolution. The statistical analysis of the recorded data showed a statistically significant difference between the two debonding methods regarding the tooth sensitivity during the debonding and the time required for the procedure. The subjective tooth sensitivity was reduced from a mean ± standard deviation of 3.07 ± 1.46 to 0.47 ± 0.86 on the Wong-Baker FACES scale (Wilcoxon signed rank, p < 0.001). The necessary time for debonding was reduced by 0.697 ± 0.703 s per tooth (paired t-test, p < 0.001). There was no difference in the blood microdynamics between the two debonding techniques. According to the results of this study, the laser Er:YAG-assisted debonding technique may be a viable alternative to the conventional method for monocrystalline ceramic brackets.

Diagnostic Aspects of an Included Third Molar in an 88-Year-Old Patient: A Case Report and Literature Review.

Included third molars in elderly patients are quite rare in dental practice, and therefore easily misdiagnosed, because these teeth are usually extracted in youth. Additional challenges to correctly diagnosing such a dental condition, and its associated complications, arise from frequent co-morbidities in elderly patients, and from difficult communication with the patient. We report a case of an 88-year-old female patient, who presented in the dental emergency room complaining of a discomfort caused by the sharp edges of her lower incisors, and requesting their extraction; the final diagnosis, of suppurated pericoronitis at tooth 48, was concluded based on the clinical elements and X-ray examination.

The Effect of Changing the Toothbrush on the Marginal Gingiva Microcirculation in the Adolescent Population-A Laser Doppler Flowmetry Assessment.

It is well-known that proper tooth brushing has the effect of stimulating microcirculation in a healthy gingiva. The aim of this study was to evaluate the microcirculation dynamics at the level of healthy marginal gingiva in adolescents after changing their toothbrush. Three evaluation instruments were employed to assess and quantify the effects on the marginal gingiva: the periodontal probing depth (PD), gingival index (GI) and laser Doppler flowmetry (LDF). A total of 12 adolescents, aged between 15 and 20, were enrolled in the study, resulting in a total of 72 frontal upper teeth for PD and GI and 48 gingival interdental sites for LDF assessment. For each measurement, the pulp blood flow signal was recorded for 1 min and represented as a pulsatory signal. Data were collected in four moments: before the toothbrush changed and 24 h, 7 days and 14 days after. For the statistical analysis, the nonparametric Friedman test was applied for comparisons between more than two pair numeric series and for comparisons between two sets of pair values without Gaussian distribution, the Wilcoxon signed-rank test was applied. The paired t test was used for two sets of normally distributed paired values. The results showed that using a new toothbrush in the adolescent population with healthy gingiva can induce statistically significant increases in gingival blood flow, which remain at a high level even at two weeks. The GI also increases significantly at 7 days and 14 days, while the periodontal PD does not change significantly.