Comparative study of anatomical features of primary and accessory maxillary ostia between patients with obstructive sleep apnea and healthy controls.

PURPOSE: The purpose of this study was to examine how the size and shape of the maxillary sinus and its ostia (the primary maxillary ostium and accessory maxillary ostium) relate to each other in patients with OSA using computed tomography (CT) scans. Additionally, the study aimed to explore whether or not obstructive sleep apnea (OSA) had an effect on these structures. METHODS: CT images of patients diagnosed with OSAS and healthy participants were evaluated to compare the patency, location, dimension, and presence of PMOs and AMOs using the Mann-Whitney U, Student t, and chi-square tests. Also, intragroup correlations were analyzed by Spearman's correlation test. RESULTS: Among 139 patients with OSA and healthy controls, there were significant variations in the average length (p = 0.001) and width (p = 0.008) of PMOs among the study groups. The mean maxillary sinus volume was significantly decreased in the OSA group (p = 0.001). A significant decrease in the maxillary sinus volume was observed in the OSA group (p = 0.001). In the OSA group, a significant correlation was observed between PMO obstruction and the presence of AMO (p = 0.004). The healthy group had significant correlations (r = 0.755, p = 0.000) between the vertical height and the distance between PMO and the maxillary sinus floor. Correlation analyses revealed positive, strong correlations between study variables such as the mean length and width of AMO and the vertical height of the maxillary sinus (r = 0.566, p = 0.000) in the OSA group. CONCLUSIONS: The current study indicated significant differences in sinus volume, PMO occlusion, and AMO-related dimensions between patients with OSA and healthy controls.

The effects of applying a novel cleaner on the bonding strength of zirconia surfaces.

This study evaluates how pre-treatment with an MDP-containing cleaning agent (Katana Cleaner, Kuraray) influences the micro-shear bond strength (µSBS) of saliva-contaminated zirconia when used with universal adhesive (UA) systems. Rectangular specimens (2 mm × 12 mm × 15 mm) were obtained (IPS, e.max ZirCAD, MO, B65L17, Ivoclar Vivadent) and divided into three groups; a non-contaminated group (control group)(CON), a contaminated and cleaned with isopropyl alcohol group(ISP), and lastly, a group contaminated and cleaned with an MDP-containing cleaning agent(KAC). Each group was then subdivided into three subgroups according to the UAs used (n = 12). Composite cylinders were prepared and bonded to each surface with Panavia V5 (Kuraray, Noritake Dental). A µSBS test was performed and the data were evaluated with the two-way analysis of variance (two-way ANOVA) and multiple comparisons test (α = 0.05). The highest µSBS values were obtained in the non-contaminated group (p < 0.001), regardless of UAs. All subgroups showed lower µSBS values after saliva contamination, but KAC resulted in significantly higher µSBS values than 99% isopropanol (p < 0.001). Overall, the lowest µSBS value was obtained with 99% isopropanol. The KAC-Clearfil UA subgroup resulted in statistically significantly higher µSBS values than the other UAs (p = 0.035 and 0.007), although all three UAs resulted in sufficient µSBS values. This study revealed that applying KAC followed by a UA containing phosphate monomers produces promising results for improving µSBS values of zirconia, greater than results using 99% isopropanol.Clinical relevance: An MDP-containing cleaning agent followed by a phosphate monomer containing a universal adhesive is a promising method to obtain acceptable bonds with saliva-contaminated zirconia ceramics.

Comparison of the efficacy of intra-articular injections of hyaluronic acid and lactoferrin in mono-iodoacetate-induced temporomandibular joint osteoarthritis: A histomorphometric, immunohistochemistry, and micro-computed tomography analysis.

OBJECTIVES: This study aims to evaluate the efficacy of high-molecular-weight hyaluronic acid (HMWHA) and lactoferrin (LF) injections on temporomandibular joint (TMJ) cartilage and subchondral bone in mono-iodoacetate (MIA)-induced temporomandibular joint osteoarthritis model in rats. MATERIALS AND METHODS: In this in vivo study, a total of 24 rats were divided into three groups as follows: saline group (Group 1), HMWHA group (Group 2), and LF group (Group 3) including eight rats in each group. The intra-articular injections were administered once a week for three weeks after osteoarthritis was induced. All animals were euthanized 28 days after induction of osteoarthritis, and TMJs were harvested for histomorphometric, immunohistochemical, and micro-computed tomography (CT) analysis. RESULTS: There was no significant difference between the HMWHA and LF groups in terms of the histomorphometric and immunohistochemical analysis results (p>0.05). According to the micro-CT analysis, the LF group had the highest mean bone volume fraction (74.9±0.5) and trabecular thickness (0.122±0.002), while the saline group had the lowest mean values (55.0±0.3 and 0.071±0.002, respectively) (p<0.001). There was no significant difference between the HMWHA and LF groups according to the micro-CT analysis (p>0.05). Both groups had better healing effects than the saline group in all analyses. CONCLUSION: Lactoferrin has a healing effect at least as much as HMWHA in MIA-induced TMJ osteoarthritis. We suggest that LF may be evaluated in future clinical studies as a promising agent in the treatment of osteoarthritis.

Two-year evaluation of porcelain laminate veneers using FDI criteria.

PURPOSE: The use of porcelain laminate veneers (PLVs) is a minimally invasive technique that is often used in restorative dentistry due to esthetic considerations. The aim of this study was to evaluate PLVs according to the Fédération Dentaire Internationale (FDI) World Dental Federation clinical criteria. MATERIALS AND METHODS: This clinical study included 11 patients (7 female and 4 male) who had been admitted to the Usak University Faculty of Dentistry between February 2019 and February 2021. Before taking part in the study, patients were informed about alternative treatment procedure options. A total of 30 PLVs were fabricated and cemented, and patients were evaluated according to the FDI criteria (with a follow-up after 2 years). RESULTS: Restorations were evaluated by two trained researchers. During the follow-up evaluation, no fractures or cracks were observed in any restoration. Further, 73% (n = 22) of the PLVs had perfect marginal adaptation and only 27% (n = 8) had small marginal fractures that could be removed by polishing. Moreover, 57% (n = 17) of the PLVs were evaluated as a good color match (no difference in shade and/or translucency), whereas 33% (n = 13) had only minor deviations. In periodontal examinations, 23% (n = 7) of the PLVs had no plaque, inflammation, or pockets, whereas 77% (n = 23) had minor plaque inflammation and no pocket development. CONCLUSIONS: As there were no fractures, fails, or need for removal of the restorations after 2 years, PLVs showed clinically satisfactory performance. The performance of PLVs can be considered highly favorable due to the minimally invasive and periodontally-compatible nature, with a good color match when carefully planned.

Effect of single-dose locally applied lactoferrin on autograft healing in peri-implant bone in rat models.

Immediate dental implant installation into fresh extraction sockets has become a common surgical technique and yields successful clinical results. In addition, complete contact may not be possible with this procedure cause of defects between the bone wall and the implant surface. Therefore, different graft materials have been used in the literature to increase the peri­implant bone volume. The aim of the present study was to evaluate the effect of single-dose and locally applied lactoferrin on autograft healing in peri­implant area and bone implant contact value. Twenty-four Sprague-Dawley rats were included in this study. Firstly, a trephine drill was used for creating a cylindrical bony defects (6.5 mm in diameter and 3 mm in depth) under sterile saline irrigation in the lateral side of the femur. Subsequently, implant beds -2.5 mm diameter and 6 mm depth - were prepared in the middle of each defect with special implant drills. All of the implants were installed and primary stability was achieved. Rats were randomly divided into 3 groups (n = 8 each): Group-1 had empty defects, Group-2 had defects filled with autograft, and Group-3 had defects filled with autograft and lactoferrin solution (100 µg/ml) combination. All of the rats were sacrificed at postoperative 4th week and samples were analyzed with micro-computed tomography, histomorphometry and immunohistochemistry respectively. It was found that Group 3 had the least area of fibrous tissue (6.75±0.83mm2) according to the other 2 groups (p<0.001). On the other hand, Group 3 had the highest osteoblast number (25.50±3.29), osteoclast number (21.25±1.03), newly formed bone area (20.50±1.30 mm2), total healing area (22.62±0.93 mm2), defect closure rate (80.37±1.40%), bone implant contact value (23.2%±0.6%), and percentage bone volume (18.2%±0.3%) (p<0.001). Matrix metalloproteinase-3 expression was found to be highest in Group 3 by immunohistochemistry analysis. In this study it was observed that the results of the different analysis techniques supported each other. According to these findings it can be stated that a single-dose and locally applied lactoferrin solution plays an important role in the autograft healing in peri­implant area and increasing bone implant contact value. These findings will shed light on further clinical studies of implant osseointegration.

Bond strength of metal brackets to feldspathic ceramic treated with different surface conditioning methods: an in vitro study.

PURPOSE: To compare MEP which is originally manufactured for increasing bond strength between organic resins and ceramic with conventional surface treatment methods in preparation of leucite-reinforced FC surfaces regarding shear bond strength (SBS) of stainless steel brackets and the mode of bond failure. MATERIALS AND METHODS: Forty specimens that were fabricated from FC material and glazed were randomly assigned to four surface conditioning methods: (1) CoJet Sand; (2) MEP; (3) HF acid etching followed by silane coupling agent; (4) Diamond bur followed by silane coupling agent. The SBS was determined using universal testing machine. Bond failure sites were classified according to Adhesive Remnant Index (ARI). RESULTS: No statistically significant difference (p less than 0.05) was found in SBS between the groups while significant intergroup differences were detected concerning ARI scores (p less than 0.001). Group 1 had ARI score 1 and 2 indicating mode of failure at the adhesive interface with greater percentage of the adhesive left on bracket base. The other groups had higher frequency of ARI score 3 and 2. The quantity of the ARI retained on the ceramic surface was highest in Group 3, followed by Group 4 and Group 2. CONCLUSION: MEP can be a suitable alternative for bonding metal brackets to FC surface.

Possible sleep and awake bruxism, chronotype profile and TMD symptoms among Turkish dental students.

It was hypothesized that an individual's chronotype profile has an effect on the performance of work or study tasks. Dental students have to cope with both academic and clinical workloads, and the latter requires extra concentration. The first aim was to evaluate the association of sleep bruxism (SB) and awake bruxism (AB) with sleep related items, temporomandibular disorder (TMD) complaints, and chronotype profile; the second aim was to evaluate the association between complaints of TMD and chronotype profile among dental students. The present cross-sectional descriptive study involved 218 dental students whose ages ranged between 18 and 30 years. In order to gather data, students were required to respond to a questionnaire, which aimed to evaluate possible SB and possible AB occurrence and demographics, sleep-related items and complaints of TMD. For the assessment of the chronotype profile, the morningness-eveningness questionnaire (MEQ) was used. The chi-square test, the Mann-Whitney U test, and t-test analyses were performed to evaluate the factors associated with SB, AB and chronotype profile. The frequency of self-reported SB was 25.2% and AB was 28.9%. The prevalence in the eveningness profile who reported possible AB was 45.3%, while it was 24.2% in intermediate individuals and 18.8% in the morningness profile. An association was also found between possible AB and eveningness chronotype profile (p = .009). No association was found between other temporomandibular joint (TMJ) pain and noise and chronotype profiles (p > .05). An association was found between possible AB and eveningness chronotype profile but no association was found between possible SB and chronotype profile. Moreover, complaint of TMD (face, head, neck pain) was observed particularly in students with an eveningness profile.

Effects of bruxism on temporomandibular joint internal derangement in patients with unilateral temporomandibular joint pain: The role of magnetic resonance imaging diagnostics.

Objective: This study compared temporomandibular joint (TMJ) magnetic resonance imaging (MRI) findings between bruxism and control groups with unilateral TMJ pain as well as the TMJ MRI findings for the painful and non-painful sides of individuals in the two groups.Methods: Clinical and MRI findings of patients seen at Usak University, Dentistry Faculty, Department of Oral and Maxillofacial Surgery for unilateral TMJ pain between 2017 and 2020 were analyzed. Bruxism was diagnosed based on clinical findings and patient history. The MRI variables were disc/condyle relationship (normal, disc displacement with reduction, or disc displacement without reduction), disc structure (normal and abnormal), condyle degeneration type (normal, moderate, or severe), and joint effusion (absent or present). Pain was recorded based on a visual analog scale (VAS) numbered between 0 and 10. Statistical analyses were performed using IBM SPSS. The data were distributed non-normally according to the results of Kolmogorov-Smirnov tests. The Mann-Whitney U test was used to compare age and VAS. Chi-square tests were used to compare categorical variables. Statistical significance was defined as p < 0.05Results: This study assessed the MRI records of 558 cases of TMJ pain. No significant differences in disc/condyle relation, disc structure, condyle structure, or effusion were observed between the control and bruxism groups (p > 0.05). However, a significant difference in TMJ MRI findings was observed between the painful and non-painful sides of each individual in the control and bruxism groups (p = 0.001, p < 0.001 and p = 0.004, p < 0.001, respectively).Conclusion: The results of this study established a relationship between the painful side for each patient and TMJ MRI findings. In particular, individuals with bruxism had a higher rate of TMJ internal derangement and effusion on the painful side.

Associations between self-reported bruxism, sleep quality, and psychological status among dental students in Turkey.

Objectives: To assess sleep quality among dental students and to identify psychological factors associated with self-reported sleep bruxism (SB).Methods: A total of 212 dentistry students from the Usak University Faculty of Dentistry participated in this study. A self-report questionnaire was administered to identify possible SB. The Depression, Anxiety, and Stress Scale (DASS-21) questionnaire was administered to evaluate psychological factors, and the Pittsburgh Sleep Questionnaire Index (PSQI) was used to evaluate sleep quality.Results: Possible SB was more frequently observed in females than in males. The mean DASS-21 score in those with possible SB was significantly higher than in those without SB (p< 0.001). The mean PSQI (total) score was also significantly higher in those with possible SB than in those without SB (5.0 ± 2.4) (p= 0.007).Conclusion:The findings revealed that psychological factors and sleep quality significantly affected the prevalence of self-reported SB among dental students.

Effect of cement color and tooth-shaded background on the final color of lithium disilicate and zirconia-reinforced lithium silicate ceramics: An in vitro study.

OBJECTIVE: To evaluate the translucency and effects of different cement colors on the final shade of lithium disilicate ceramics (LDS) and zirconia-reinforced lithium silicate ceramics (ZLS) over an A1 and A3 tooth-shaded background. MATERIALS AND METHODS: Eighty-eight rectangular-shaped specimens were sliced from LDS and ZLS blocks. The final thickness of the specimens was set at 0.8 ± 0.01 mm. Spectrophotometric measurements for the translucency were taken against black and white backgrounds. Composite resin tooth-shaded background disks were fabricated in two shades (A1 and A3), as were resin cement disks (opaque and translucent) (n = 11). Next, the ceramic specimens and tooth-shaded backgrounds were connected with glycerin, and baseline measurements were taken. These measurements were used as a reference. Then, the ceramic specimens, cement specimens, and tooth-shaded backgrounds were connected together with glycerin, and a second set of measurements was taken. The CIEDE2000 (ΔE00 ) color formula was used to calculate the translucency and color differences. A Mann-Whitney U test was also performed for the translucency, and a three-way ANOVA (analysis of variance) test was performed for the ΔE00 values (α = .05). RESULTS: The LDS and ZLS groups had similar translucency (P = .055). The ΔE00 values of the specimens were significantly affected by the cement color and tooth-shaded backgrounds in the LDS and ZLS groups (P < .05). Using the opaque cement color resulted in statistically significant differences against the light and dark (A1 and A3) tooth-shaded backgrounds in both the LDS and ZLS groups (P = .022 and P = .006). CONCLUSIONS: The material type did not affect the translucency or final color. However, the cement color did affect the final shade when thin ceramic restorations were used. CLINICAL SIGNIFICANCE: It should be noted that the cement color and tooth-shaded background used may change the final color of thin high translucency ceramic restorations that contain lithium disilicate and zirconia-reinforced lithium silicate.

Effect of porcelain firing and cementation on the marginal fit of implant-supported metal-ceramic restorations fabricated by additive or subtractive manufacturing methods.

STATEMENT OF PROBLEM: Adaptation between abutment and suprastructure plays a crucial role in the long-term success of implant-supported metal-ceramic crowns. Fabrication methods, the porcelain firing stage, and cementation techniques may affect the marginal adaptation between the crown and abutment. However, the information regarding this issue is sparse. PURPOSE: The purpose of this in vitro study was to compare marginal fit after the fabrication of cobalt-chromium alloy copings, porcelain firing, and cementation of metal-ceramic restorations that were fabricated with computer-aided design and computer-aided manufacturing (CAD-CAM) milling and direct metal laser sintering techniques. MATERIAL AND METHODS: Thirty straight tissue-level titanium abutments were screwed onto implant analogs. All specimens were embedded in acrylic resin and divided into 2 groups according to CAD-CAM milling and direct metal laser sintering fabrication of the metal coping. Fifteen cobalt-chromium implant-supported metal copings were fabricated by using the CAD-CAM milling technique and 15 by using the direct metal laser sintering technique. In both groups, marginal gap measurements between the cobalt-chromium copings and abutments were obtained before (T0) and after the placement of the ceramic veneer (T1) and after cementation (T2) by using a stereomicroscope with a magnification of ×40. The data were statistically evaluated by using 2-way ANOVA and the Tukey post hoc test (α=.05). A t test was used to determine whether there were significant differences between the fabrication techniques (α=.05). RESULTS: A significant difference in the fabrication stages was found in the direct metal laser sintering group. The direct metal laser sintering coping group and porcelain applied direct metal laser sintering group had a statistically lower marginal gap value than the cemented direct metal laser sintering group (P=.021, P=.038). The direct metal laser sintering coping group had a lower marginal gap value than the CAD-CAM milling coping group, although the difference was not statistically significant (P=.216). CONCLUSIONS: Porcelain firing and cementation increased the marginal gap between the crown and abutment. No statistically significant differences were found between the direct metal laser sintering and CAD-CAM milling techniques in terms of marginal fit.

Evaluation of the Marginal and Internal Fit of Implant-Supported Metal Copings Fabricated with 3 Different Techniques: An In Vitro Study.

PURPOSE: To compare the marginal and internal fit of cobalt-chromium (Co-Cr) alloy copings fabricated by with lost wax technique (LW), computer-aided design and computer-aided manufacturing (CAD/CAM), and direct metal laser sintering (DMLS). MATERIALS AND METHODS: Thirty-six tissue level, straight titanium abutments were screwed onto implant replicas. All specimens were embedded in acrylic resin and randomly divided into 3 subgroups according to the fabrication of metal coping: LW, CAD/CAM, and DMLS. In total, 36 (n = 12/group) Co-Cr implant-supported metal copings were prepared. Marginal, intermarginal, axial, and occlusal fits of each coping were measured using the silicone replica technique. The data were evaluated statistically using one-way ANOVA and Bonferioni post-hoc test (α = 0.05). RESULTS: The CAD/CAM group showed significantly lower marginal fit than the LW group and DMLS groups (p < 0.001). The marginal fit of the LW group was not significantly different from the DMLS group (p = 0.721). No significant difference found among the fabrication methods in terms of intermarginal fit (p = 0.913). The CAD/CAM group showed lower axial fit than the LW group (p = 0.026), but there was no statistical difference between the DMLS group and the LW (p = 0.999) and CAD/CAM groups (p = 0.247). No significant differences found among the fabrication methods in terms of occlusal fit (p = 0.158). CONCLUSIONS: The LW and DMLS groups showed better marginal fit compared to the CAD/CAM group; however, the CAD/CAM group was better than the LW group in terms of axial fit. All fabrication methods demonstrated similar intermarginal and occlusal fit.