Biocompatibility of 3D-Printed Dental Resins: A Systematic Review.

BACKGROUND: The biocompatibility of 3D-printed dental resins has become a critical concern in modern dentistry due to the increasing utilization of additive manufacturing (AM) techniques in dental applications. These resins serve as essential materials for fabricating dental prostheses, orthodontic devices, and various dental components. As the clinical adoption of 3D printing in dentistry grows, it is imperative to comprehensively assess the biocompatibility of these materials to ensure patient safety and dental treatment efficacy. This systematic review aimed to evaluate the existing body of literature on the biocompatibility of 3D-printed dental resins, thereby providing valuable insights into the potential biological risks associated with their use. METHODS: The search strategy to identify relevant papers was implemented across PubMed/MEDLINE, Scopus, Web of Science, Embase, Cochrane Library, CINAHL, and Google Scholar to identify relevant studies. Study selection was not limited to any particular timeframe of publishing. The revised CONSORT criteria were used to ascertain the authenticity and dependability of the review's outcomes. Comprehensive screening and eligibility assessment processes were conducted to select studies meeting predefined criteria. Biocompatibility-related parameters, including toxicity, mechanical properties, cell viability, and other relevant outcomes, were analyzed across selected studies using a standardized variable extraction protocol. RESULTS: A total of 9 studies were included in the systematic review. The findings encompassed various aspects of biocompatibility assessment, including material composition, mechanical properties, cell viability, and cytotoxicity. Some studies revealed significant improvements in flexural strength and cell viability with specific resin formulations, demonstrating their potential for enhanced clinical utility. Conversely, certain resins exhibited cytotoxicity, while others displayed promising biocompatibility profiles. CONCLUSION: As per the assessed findings, material composition, post-processing techniques, and manufacturing methods emerged as critical factors influencing biocompatibility outcomes. While some resins exhibited favorable biocompatibility profiles, others raised concerns due to cytotoxicity. These findings emphasize the need for careful consideration when selecting and implementing 3D-printed dental resins, with a focus on materials engineering and comprehensive biocompatibility testing. Further research is warranted to elucidate the long-term biocompatibility and clinical implications of these materials.

Periapical healing outcome following non-surgical endodontic intervention among diabetic patients: A systematic review conducted according to PRISMA guidelines and the Cochrane handbook for systematic reviews of interventions.

Background: Periapical diseases are common dental conditions that require non-surgical endodontic intervention (NEI) for successful treatment. However, the impact of diabetes mellitus (DM) on the periapical healing (PH) outcome in diabetic patients remains somewhat unclear. This review aimed to evaluate the PH outcome following endodontic intervention among DM-afflicted individuals. Methods: A comprehensive search was conducted across multiple electronic databases to identify relevant studies. Specifically, a set of selection criteria was applied to select studies that assessed PH outcomes in individuals with DM who underwent different treatment protocols. Data extraction and quality assessment were performed following predetermined protocols. The risk of bias (RoB) 2 assessment tool evaluated the quality of the included studies. Results: A total of 11 studies met the inclusion criteria and were included in the investigation. Four studies showed a higher incidence of apical periodontitis in diabetic individuals compared to controls, and five studies reported reduced healing and success rates in this group. Overall, nine studies have shown that DM has a negative impact on periapical outcomes. This suggests that DM is an important factor in the prognosis of endodontic intervention. The assessment tools used were PAI, PR, SC, and FD analysis. RoB-2 assessed the included studies as having a moderate RoB. Conclusion: This review provides compelling evidence that DM patients experienced a noticeable negative impact on PH outcomes compared to the control population. These findings highlight the importance of considering the diabetic status of patients when assessing the prognosis of periapical diseases and planning interventions for NEI. Further research is needed to validate these results and explore potential mechanisms underlying the observed associations.

Addressing Oral Health Disparities of a Tribal Population Through a Combined Implementation of Focus Group Discussion, Mobile Technology Networking, and Creating a Supportive Environment: A Prospective Study.

BACKGROUND AND OBJECTIVE:  Oral health disparities generally exist among tribal populations, prompting creative solutions to tackle these challenges. By using a combined implementation strategy of including focus group discussion (FGD), mobile technology networking (MTN), and creating a supportive environment, this study aims to assess and bring positive changes in oral health in these populations. METHODS: The current study employed a mixed-method approach on a sample of 100 tribal volunteers. Qualitative assessment included FGD conducted regularly for three months based on themes such as oral hygiene habits, access to oral health, technology in oral health, the relationship of oral health to general health, and the role of diet in oral health. Quantitative evaluation included recording of the oral hygiene index-simplified and gingival index to measure gingival status. Messages on oral health were routinely posted to mobile phones to reinforce oral health education. Appropriate use of indigenous oral hygiene aids (neem and datun) was also taught during the discussion session. Clinical examinations were compared before and after FGD. Data were analyzed using IBM SPSS Statistics for Windows, Version 25 (Released 2017; IBM Corp., Armonk, New York, United States). A paired 't' test was used to find significant differences in gingival status at p<0.05. RESULTS: The FGD sessions deduced observations such as limited access to dental care, inadequate oral hygiene practices such as usage of neem sticks and twigs, and lack of oral health awareness. The implementation of MTN facilitated the dissemination of oral health information and enhanced communication between community members and healthcare providers. The gingival index score significantly improved from pre-FGD to post-FGD with a mean difference of 0.41700 significant at p=0.000. Oral hygiene of the target population shifted from "Fair" oral hygiene status to "Good" oral hygiene status. CONCLUSION: The combined implementation of FGD, MTN, and creation of a supportive environment demonstrated promising results in addressing oral health disparities among the tribal population. The interventions led to improved gingival status and better utilization of oral hygiene practices. These findings highlight the importance of tailored interventions, community engagement, and mobile technology in addressing oral health disparities in tribal populations. Ongoing support, sustainability, and further research are necessary to ensure the long-term impact and effectiveness of these interventions.

A Systematic Review and Meta-Analysis on Oral Health Disparities Among the Indigenous Paediatric Population.

There is a knowledge gap in the literature regarding oral health disparities (OHD) in minority and indigenous (IG) paediatric cohorts that needs to be addressed. Disparities in oral health among children are a pressing concern, highlighting inequities in access to dental care and meeting needs. The current systematic review aims to provide a comprehensive synthesis of the prevailing understanding of OHD in the minority and IG strata. A meticulous search strategy was formulated by a team of reviewers to identify pertinent studies from databases of PubMed, MEDLINE, Scopus, Google Scholar and EMBASE. Data extraction and article selection strictly adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Newcastle-Ottawa Scale (NOS) was employed to evaluate the methodological quality of the studies included. Review Manager version 5.4 was used to synthesise quantitative data. A total of five cross-sectional studies were included in the final analysis. The findings consistently demonstrated the existence of racial and socioeconomic disparities in oral health across varying age groups and geographical locations in the defined population. Significant disparities in oral health outcomes were observed between IG and non-IG populations, with IG and minority groups exhibiting a heightened vulnerability to oral health challenges. Through a meta-analysis of the compiled data, a statistically significant association was established between children (being a member of a minority group) and unmet oral health needs. Socioeconomic status (SES) and maternal education were factors that showed a significant impact on oral health disparity. All studies were graded to be of the low-risk category based on the NOS risk of bias tool. This review successfully identified several influential factors contributing to oral health disparities, such as cultural practices, dietary patterns and access to oral healthcare services. Additionally, discernible differences in oral health status were evident between IG and non-IG children, with IG children enduring a greater burden of oral health difficulties. These findings underscore the imperative for targeted interventions and policy measures aimed at addressing the specific oral health needs of minority and IG paediatric populations, with the overarching goal of mitigating the existing disparities.

The Predominance of Tobacco Propensities and Tobacco-Related Oral Lesions in Textile Mill Workers of Bhopal: A Cross-Sectional Study.

INTRODUCTION: Low wages, long work hours, and stressful working conditions predominantly affect the oral and general health of industrial workers, which in turn result in their tobacco consumption. This cross-sectional study examined the prevalence of tobacco use and its associated oral lesions among textile mill workers in Bhopal, India. Oral cancer and premalignant lesions are significantly increased by smoking and chewing tobacco. The study's objective was to assess and record the prevalence of oral mucosal lesions linked to tobacco use in different age groups among Bhopal textile industry workers. METHODOLOGY: A cross-sectional study was conducted among 583 textile mill workers. Data were collected using a questionnaire and the WHO Oral Health Assessment Form 2013. IBM SPSS Statistics for Windows, Version 29 (Released 2022; IBM Corp., Armonk, New York, United States) was used for the statistical analysis. Variables were compared using the mean, percentage, and standard deviation. The chi-square test and Fisher's exact test were used to compare the distribution of gender, tobacco habits, and oral mucosal lesions in different age groups. RESULTS: Males made up 69.1% of the workforce. A clear male preference was noted (P ≤ 0.001). About 64.7% of the workers did not have any tobacco-related habits, 20.8% used smokeless tobacco, 7.9% used a smoking form of tobacco, and 6.7% used both. Older age groups, 31-45 and >46 years old, had a higher proportion of users of smokeless tobacco (P ≤ 0.001). The most commonly reported oral mucosal lesions were ulcerative conditions in 6.9%, followed by oral submucous fibrosis (OSMF), keratotic lesions, and leukoplakia in 5.0%, 4.1%, and 3.6% of the study population, respectively. Leukoplakia and OSMF were prevalent in the 31-45-year age group, while ulcerative lesions were more prevalent in the 18-30-year age group (P ≤ 0.001). CONCLUSION: Workers at textile mills were more likely to use a smokeless form of tobacco. Older age groups had higher rates of smokeless tobacco use as compared to smoking, which was more prevalent in the younger age group. Oral mucosal lesions in older age groups frequently include OSMF and leukoplakia. The main reasons for engaging in the tobacco use habit were stress and a lack of awareness. Oral hygiene was a neglected entity among workers.

Management protocols of chronic Orofacial Pain: A Systematic Review.

Objective: Chronic orofacial pain (CP) is a persistent and debilitating condition that affects the face, mouth, and jaw and can have a significant impact on an individual's quality of life by posing problems to eat, speak, and perform everyday activities. By the means of this narrative review, we aim to assess different types of management modalities that exist to combat chronic orofacial pain. Design: Various databases were explored with MeSH keywords of chronic orofacial pain, orofacial pain, and interventions and treatment protocols for eligible articles. After an extensive literature search, it was ascertained that this review identified four major categories of treatment modalities for the management of chronic orofacial pain, namely pharmacological management, psychological management, lifestyle interventions-based management, and current stimulation-based management. Results: Of the four categories discussed, although pharmacological intervention offered the most immediate relief-especially from orofacial pain that was of a sudden, stab-like in nature-psychological management demonstrated a remarkable ability to reduce/alleviate the more serious aspect of chronic orofacial pain and was deemed better in comparison to the rest. Lifestyle-based techniques and current stimulation-based management were of limited use since they tended to focus more on the causal and not the symptomatic aspect of orofacial pain. Conclusions: Many patients with persistent orofacial discomfort can experience notable improvements in their symptoms and general well-being by all the treatment modalities evaluated.

Impact of temporomandibular disorders on oral health-related quality of life: A systematic review and meta-analysis.

BACKGROUND: The management of temporomandibular disorders (TMDs) requires a comprehensive approach that considers multiple factors, including the impact of oral health-related quality of life (OHRQoL). Through this investigation we aim to assess the impact of OHRQoL played in a TMD-afflicted individual. METHODS: Using keywords relevant to our research, such as "Oral health related quality of life," "Oral hygiene," "Temporomandibular joint" and "Temporomandibular disorders," a comprehensive search across multiple online databases was carried out, yielding a total of 632 studies at the preliminary stage of the review. Modified New Castle Ottawa scale was used to assess the quality of studies included. RESULTS: Eight studies were included in the review, out of which six were eligible for further meta-analysis. The studies included in this review employed various OHRQoL measures, including the Oral Health Impact Profile-14 (OHIP-14), the Short-Form 36 Health Survey (SF-36) and the OHIP- 49. All the studies demonstrated significant effect of TMDs on the OHRQoL of the target population under study. CONCLUSION: The impact of OHRQoL on the management of TMD was deemed to be significant. The comprehensive management of TMD should consider the impact of the condition on the individual's daily life and incorporate interventions that address both the physical and psychological aspects of the condition. By improving OqL, individuals with TMD can experience improved overall well-being and quality of life.

Mechanical failures of dental implants and supported prostheses: A systematic review.

Purpose: Though, mechanical dental implant and supported prosthesis failures are considered significant, a comprehensive evaluation is lacking. A systematic review analyzing different aspects related to such failures was therefore done. Methods: - Electronic search was carried out in PubMed/MEDLINE and Cochrane Library for articles published between 1981 and 2021. Articles were selected using predefined criteria. Data extraction was based on mechanical complications associated with dental implants, prosthetic implant failures, survival rate of implants, mechanical failure of implants placed in the maxilla and mandible, and mechanical complications associated with implant supported over dentures. Quality of included studies was assessed. Meta-analysis for heterogenicity testing, publication bias and implant failure assessment was conducted using MedCalc® Statistical Software version 19.7. Results: - Eighteen retrospective and prospective studies were included following PRISMA guidelines. Mechanical complications were more in the initial 9 years but reduced later. Abutment screw loosening was one of the more common mechanical complications (16.21%). Maxillary implant failure was greater compared to mandibular implant failure with an odds ratio of 4.66 (95% CI -3.21- 6.75). Failure of implant supported overdentures due to mechanical complications were 3% in the fixed effect, and 2.9% in the random effect model (P < 0.05). The overall prevalence of mechanical failure was between 5.6% and 7.7% (P < 0.05). Conclusion: Mechanical failures of implant and supported prosthesis have similar prevalence to biological and esthetic failures, and therefore need to be given due credence. Identifying specific factors contributing to such failures can help reduce incidence.

Accuracy of marginal fit of an implant-supported framework fabricated by 3D printing versus subtractive manufacturing technique: A systematic review and meta-analysis.

STATEMENT OF PROBLEM: Evidence comparing additive 3-dimensional printing (3DP) with subtractive milling for implant-supported frameworks is lacking. PURPOSE: The purpose of this systematic review and meta-analysis was to compare the marginal fit and accuracy of complete arch implant-supported frameworks (CA), implant-retained fixed partial dentures (IRFPDs), single implant crowns (SICs), and interim implant-retained restorations (IIRRs) by using additive manufacturing (AM) and subtractive manufacturing (SM) methods. MATERIAL AND METHODS: An electronic search was performed in PubMed, ScienceDirect, Google Scholar, and the Cochrane Library for articles published up to August 2020. The authors acquired the data and evaluated the articles, and the final selection of articles was made according to the inclusion and exclusion criteria. The Methodological Index for Non-Randomized Studies (MINORS) scale was used to evaluate the quality of the included studies. Heterogeneity was evaluated, and meta-analyses with subgroup analyses were performed in the selected studies. RESULTS: The database search resulted in 960 articles. After removing duplicate articles (410 studies), the titles and abstracts were screened in detail, and 10 in vitro studies were selected for qualitative analysis and 9 for quantitative analysis according to the eligibility criteria. Subgroup analyses were performed to compare the 3DP versus the SM technique for different types of implant-supported frameworks (IRFPDs, SICs, IIRRs, and CA). In the IRFPDs analysis, the marginal fit accuracy of the 3DP systems was higher than that with the subtractive manufacturing method (P<.001). In the subgroup analysis of SIC frameworks (P=.55) and CA (P=.67) frameworks, no significant difference was observed in the assessed techniques. CONCLUSIONS: The marginal fit of implant-supported frameworks manufactured by AM or SM methods is in the clinically acceptable range.

Assessment of Parental Perceptions of Socio-Psychological Factors, Unmet Dental Needs, and Barriers to Utilise Oral Health Care in Autistic Children.

INTRODUCTION:  Parents' participation is crucial in the dental health intervention of children with autism spectrum disorder (ASD). Parenting children with ASD is extremely stressful and challenging. Parents and other caregivers have a responsibility to care for and raise children with ASD. Parental perception of the condition, situational adaptation, and attitude towards the issue are significant indicators of how they will respond and eventually adapt to it. METHODOLOGY: A comparative, descriptive study was done on parents of 154 autistic children and 235 normal children. An 11-variable questionnaire eliciting various details of socio-psychological factors affecting the utilisation of oral health care was designed and validated. The questionnaire also included parameters regarding barriers to accessing dental services. The dental caries and oral hygiene status of all children were examined using the Basic Oral Health Survey 2013 proforma. Chi-square and independent t-tests were applied to find significant differences between the groups. RESULTS: A greater number of male children (61.0%) were observed among autistic children. Parental perception regarding socio-psychological concerns with raising an autistic child showed significant differences for all variables between the groups except for assistance in the child's task with 90.2% as against 55% of the parents with non-autistic children. Parents of autistic children were more receptive to the idea of focus group discussion. Decayed teeth were significantly found to be higher in autistic cohorts (2.554 ± 1.616 versus 1.779 ± 1.841). Oral hygiene status was also statistically significant amongst autism-affected children than those who were not at p =0.000. CONCLUSION: The present study explored various socio-psychological factors of parental perception of autistic children. A better outcome can be suggested when parents gained awareness regarding various strategies and treatment options available for their child's oral health. Furthermore, dental health can be improved by bringing in certain environmental modifications in which the autistic child is groomed.

Evaluation of Crestal Bone Loss in Flap vs Flapless Implant Placement Technique: An In Vivo Comparative Study.

AIMS: The aims of the study were to assess the technique with-flap and flapless implant placement and to compare crestal bone heights around the implant in flapless and conventional flap technique using digital radiovisiograph, in 3 and 6 months after the surgery. MATERIALS AND METHODS: A total of 20 implants were placed by flap and flapless implant technique; each patient received two implants, except for two patients who received four implants. A radiovisiograph was taken at implant placement, as well as 3- and 6-month intervals. Crestal bone level was compared between flapless and flap during these intervals and compared between intervals for each group. RESULTS: On evaluating the distribution, it was found to be asymmetric and hence lacked normality (K-S = 0.382; p <0.001). On mesial side, bone loss values in group I ranged from 0.40 to 1.10 units with a mean value of 0.71 and a standard deviation of 0.26 units. The median value was 0.70. On evaluating the data for normality, it was found to be symmetric and normal (K-S = 0.166; p = 0.200). CONCLUSION: This study concluded that there are not any significant differences in the crestal bone with both flap and flapless techniques. Comparatively, the flapless approach showed a lesser crestal bone height reduction, which was statistically significant. CLINICAL SIGNIFICANCE: Implant dentistry is nonetheless behind when advances are concerned, we have seen the inclination toward minimal invasive implant techniques to yield better esthetic as well as improved results, thus taking care of patients' discomfort.

Evidence-based effectiveness of herbal treatment modality for recurrent aphthous ulcers - A systematic review and meta-analysis.

Recurrent Apthous Ulcers (RAU) has affected mankind through time immemorial. It is the most commonly prevalent oral mucosal lesion manifesting as painful ulcers involving non - keratinised oral mucosa. This review was done to assess herbal intervention in RAU patients for outcomes of ulcer size and pain intensity. Literature search of published articles in Medline, Scopus, Ovid and Journal of Web upto August 2020 were reviewed for the pre-described outcomes. Revman 5.4 software was used for study analysis. Total 9 articles were finally chosen for qualitative analysis. Meta analytic comparison demonstrated the ulcer reduction (CI = -2.22 to - 0.09; p <0.001) and pain intensity (CI = -4.60 to - 0.08; p <0.001) was reduced in the herbal group as compared to the controls. A definite evidence of herbal intervention was noted in alleviating RAU signs and symptoms.

Primary Failure of Eruption: A Cause of Posterior Open Bite.

Primary eruption failure is a poorly understood condition in which the teeth fail to erupt in oral cavity in absence of any local or systemic factors. First and second molars are most commonly affected but one or more number of teeth, primary or permanent can be partially or completely affected. The orthodontic or surgical methods to get such teeth in occlusion have failed miserably. The early diagnosis of primary eruption failure (PEF) will allow the dentist to accurately rehabilitate the patient without wasting any time on treatments which are bound to fail. HOW TO CITE THIS ARTICLE: Shivakumar GC, Srivastava A, et al. Primary Failure of Eruption: A Cause of Posterior Open Bite. Int J Clin Pediatr Dent 2019;12(4):360-361.

Body Mass Index and Dental Caries: A Systematic Review.

INTRODUCTION: This review was undertaken to analyze the relationship between body mass index (BMI) and dental caries with the available literature evidence. MATERIALS AND METHODS: The articles were searched from Medline/PubMed and Journal of Web published between 2005 and 2016. RESULTS: Out of the 146 references obtained, 16 articles in English language were read in full, which fulfilled the inclusion criteria after assessing by Down and Black criteria. CONCLUSION: No consensus was reached in the relationship between BMI and dental caries in the present review due to varied associationsHow to cite this article: Shivakumar S, Srivastava A, Shivakumar GC. Body Mass Index and Dental Caries: A Systematic Review. Int J Clin Pediatr Dent 2018;11(3):228-232.

A comparative study to evaluate the efficacy of lycopene and curcumin in oral submucous fibrosis patients: A randomized clinical trial.

BACKGROUND: : Oral submucous fibrosis (OSMF) is a most prevalent potentially malignant disorder associated with betel quid chewing frequently observed in the Indian population. The present study conducted is much of a keen interest because there is much new information, both in the press and the medical literature, about the benefits of fresh fruits and vegetables and antioxidants (such as lycopene and curcumin) for both prevention and treatment of diseases. As clinicians, we often prescribe medications with significant adverse effects, and certainly, if armed with evidence to support using such antioxidants as safer therapeutic alternatives for treatment of OSMF. AIMS AND OBJECTIVE: The aim of the study was to compare and evaluate the efficacy of lycopene and curcumin given orally in clinically diagnosed OSMF patients. MATERIALS AND METHODS: Sixty patients were divided randomly into two groups Group A and Group B. After fulfilling the eligibility criteria, sixty patients were randomly allotted based on fishbowl method into thirty each. This technique eliminated the selection bias arising in the study. Group A individuals were treated with 4 mg of lycopene and Group B individuals were given 300 mg of curcumin thrice daily for 3 months. Both the groups were assessed in terms of mouth opening and burning sensation. The statistical analysis was done using SPSS Version 16.0 statistical Analysis Software. RESULTS: In Group A, the initial burning sensation was 65.83 ± 3.98%, and in Group B, it was 62.33 ± 5.22% (visual analog scale). After 3 months, there was complete cessation of burning sensation in both the groups. Burning sensation between the groups was statistically nonsignificant (P > 0.05). In Group A, mean mouth opening at baseline (1st visit) observed was 3.17 ± 0.08 cm which improved to 3.52 ± 0.07 cm after 3 months of the treatment period. In Group B, mean mouth opening at baseline (1st visit) observed was 3.32 ± 0.07 cm which improved to 3.52 ± 0.08 cm after 3 months of the treatment period. On comparing intergroup, the difference was statistically nonsignificant (P > 0.05). However, on comparing intergroup, average percent change in mean mouth opening from 1st visit to subsequent time intervals across the time period was found to be statistically significant (P < 0.05). Group A showed 11.1 ± 1.0% improvement in mean mouth opening and Group B showed 6.2 ± 0.4% improvement in the mean mouth opening from the 1st visit till the posttreatment period. The change in the mean mouth opening from 1st visit till posttreatment in Group A was 0.35 ± 0.14, and in Group B, it was 0.20 ± 0.09. CONCLUSION: Lycopene showed better results than curcumin in improving mouth opening; both the drugs were equally effective in decreasing burning sensation in OSMF patients.