Influence of prosthodontic rehabilitation and dietary advice on glycaemic control, nutritional status and oral health-related quality of life of older adults with type 2 diabetes.

OBJECTIVES: This prospective clinical study aimed to determine the influence of oral prosthodontic rehabilitation with partial removable dentures and simplified dietary advice on glycaemic control, nutritional status and oral health-related quality of life (OHRQoL) of older adults with type 2 diabetes. BACKGROUND: Individuals with tooth loss who did not wear complete or partial dentures are more likely to be at nutritional risk, suggesting that using dental prostheses would benefit the re-establishment of an adequate nutritional status and potentially improve quality of life. Nutritional therapy is essential for diabetes prevention, treatment and management, favouring glycaemic control. The literature provides little evidence on the contribution of partial removable dentures to improving diabetes control, nutritional profile and satisfaction in older adults, especially those with type 2 diabetes. MATERIALS AND METHODS: Older individuals diagnosed with type 2 diabetes mellitus, aged 60 years or older and needing oral rehabilitation with partial removable dentures were eligible for this prospective study. The primary outcome measure was glycaemic control, measured by glycated haemoglobin (HbA1c) levels. The Oral Health Impact Profile (OHIP-14) questionnaire and the Mini Nutritional Assessment short-form (MNA-SF) represented secondary outcome measures. These measures were assessed at baseline and 12 months of follow-up after prosthesis delivery, combined with simple dietary advice in pamphlet form. The data were analysed using the Wilcoxon matched-pairs test. RESULTS: Forty-four patients who met the inclusion criteria and required treatment with removable partial dentures were selected for this study, which was carried out for a year. During this period, seven participants declined to participate because they moved to another city. Hence, a final sample of 37 participants (16 men and 21 women, average age of 65.8 years, ranging from 60 to 83 years) were included in the study. No laboratory parameter (HbA1c levels) changed significantly during the investigation. The number of older adults at risk of malnutrition was significantly lower at 12 months than at baseline. Furthermore, nutritional status significantly improved 12 months after prosthodontic treatment combined with dietary advice, and the effect sizes were large. OHRQoL significantly improved after prosthodontic therapy combined with dietary advice. CONCLUSIONS: Prosthodontic treatment with partial dentures associated with simple dietary advice did not influence glycaemic control but improved the nutritional status and OHRQoL of older adults with type 2 diabetes.

Fifteen years of engine-driven nickel-titanium reciprocating instruments, what do we know so far? An umbrella review.

Numerous systematic reviews (SRs) have produced conflicting findings on engine-driven nickel-titanium reciprocating instruments (reciprocating instruments) since Yared's seminal study 15 years ago. This umbrella review analysed SRs examining the clinical and laboratory evidence regarding reciprocating instruments for root canal treatment. SRs that evaluated qualitatively and/or quantitatively the outcomes postoperative pain, oral health-related quality of life (OHRQoL), shaping ability, debris extrusion, microbial load, endotoxins reduction, cyclic fatigue, file fracture, dentinal cracks and root canal filling removal were included. The AMSTAR 2 tool was used to evaluate SRs quality, while the ROBIS tool to assess risk of bias (RoB). Forty SRs were included. The SRs revealed predominantly 'high' RoB and 'critically low' quality. Most focused on technical outcomes, exhibiting significant methodological and statistical heterogeneity. Findings suggest comparable efficacy between reciprocating and rotary instruments. However, due to the scarcity of high-quality evidence, future well-designed studies and reviews considering core outcome measures are needed.

Tooth color change after photodynamic therapy in endodontics: A systematic review.

BACKGROUND: A smile is considered one of the most important soft skills in social interaction. And discolored teeth may effect this. It is known that some photosensitizer agents (PS) used in photodynamic therapy (PDT) during root canal treatment could play a significant role in tooth color change, and thus the main objective of this systematic review is to address whether performing PDT can influence tooth color change and to synthesize the most effective methods to remove PS from the root canal system. METHODS: This study followed the PRISMA 2020 statement, and the protocol was registered at the Open Science Framework. Two blinded reviewers searched five databases up to November 20th, 2022: Web of Science, PubMed, Scopus, Embase, and the Cochrane Library. The eligibility criteria were studies that investigated tooth color change after PDT in endodontics. RESULTS: A total of 1695 studies were retrieved, and 7 were included in the qualitative analysis. All the included studies were in vitro evidence and investigated five different PS: methylene blue, toluidine blue O, malachite green, indocyanine green, and curcumin. Besides curcumin and indocyanine green, the remaining agents all caused tooth color change, and no method employed was effective in fully removing these PS from inside the root canal system CONCLUSIONS: Even though the findings showed that curcumin and indocyanine green did not influence tooth color change, the present evidence should be interpreted with caution since it is based on laboratory studies with questionable methods, and all efforts should be employed to avoid this undesirable side effect during clinical practice.

Bonding Efficacy of Universal Resin Adhesives to Zirconia Substrates: Systematic Review and Meta-Analysis.

PURPOSE: To provide an overview of the in-vitro bond strength of universal adhesives to zirconia and analyze whether these adhesives are a reliable alternative to conventional zirconia primers. MATERIALS AND METHODS: A systematic search was conducted in PubMed/Medline, Scopus, and ISI Web of Science databases up to August 2021. Investigations published in English, assessing resin-mediated bond to zirconia using universal adhesives compared to phosphate/silane-based primer or phosphate-based primer were included. After study selection and data extraction, risk of bias analysis was performed. Statistical analyses were performed using RevMan 5.4, with a random effects model, at a significance level of 0.05. RESULTS: In total, 23 studies were included for qualitative and quantitative analysis. Universal adhesives showed higher bond strengths than did phosphate-based primers (p < 0.00001) to aged zirconia without airborne alumina-particle abrasion. Similar results were observed when the zirconia surface was airborne-particle abraded at baseline and after dynamic aging (p < 0.0001). When universal adhesives and phosphate-silane based primers were compared, similar bond strengths (p ≥ 0.001) were observed after surface abrasion, regardless of storage condition. CONCLUSION: The results showed that universal adhesives generate higher bond strengths when compared to conventional zirconia primers.

Bioactivity Potential of Bioceramic-Based Root Canal Sealers: A Scoping Review.

INTRODUCTION: Bioceramic-based root canal sealers are novel materials with a bioactivity potential that stands out compared with conventional root canal sealers. However, the term bioactivity may be overused and is often misunderstood. Hence, the objective of this study was to synthesize and map key concepts related to the bioactivity analysis of bioceramic-based root canal sealers. METHODS: The present scoping review is reported in accordance with the PRISMA-ScR Statement and is registered in the Open Science Framework. Two blinded reviewers carried out a comprehensive search in six databases up to January 10th, 2022: MEDLINE, Scopus, Embase, Web of Science, Cochrane Library, and Lilacs/BBO. Eligibility was considered for in vitro and in vivo studies that evaluated the bioactivity potential of bioceramic-based root canal sealers. RESULTS: A total of 53 studies were included in the qualitative synthesis. In vitro bioactivity was evaluated through the mineralization potential, formation of carbonated apatite on the surface, and the gene expression related to proteins involved in the mineralization process. Meanwhile, for in vivo studies, staining techniques associated with immunohistochemical tests were mainly used to detect mineralization on the material-host tissue interface. CONCLUSIONS: According to the methodology used, the most prevalent methods to assess bioactivity in acellular form were the immersion of the material in Hank's balanced salt solution, followed by surface observation with scanning electron microscopy and energy dispersive X-ray. In cell cultures, the chosen method was usually Alizarin Red staining, followed by the evaluation of alkaline phosphatase enzymatic activity and the use of molecular biology tests.

Global research trends on photodynamic therapy in endodontics: A bibliometric analysis.

BACKGROUND: Photodynamic therapy (PDT) is an adjunctive treatment that aims to inactivate microorganisms through an oxidative reaction produced by irradiating a photosensitizing agent. The quest for improved root canal disinfection has sought supplementary methods when performing chemomechanical procedures. From this perspective, PDT protocols were proposed as an auxiliary approach in endodontics. Thus, the aim of this study was to investigate publication metrics and research trends related to this scope. METHODS: This review is reported in accordance with the PRISMA 2020 recommendations. Two blinded and independent reviewers systematically searched five electronic databases until December 2021. The acquired bibliometric parameters were analyzed through descriptive statistics and graphical mappings with VOSViewer software. RESULTS: The search retrieved 342 studies from 84 journals originating from 33 countries. About 85% of the included studies were published over the last decade. Most of the available evidence is laboratory-based (74.5%), and the main clinical outcomes evaluated were microbiological load reduction and postoperative pain. Mayram Pourhajibagher is the researcher with the most publications as the first author (n = 16). Tehran University of Medical Sciences carried out the highest number of studies (n = 29), and Photodiagnosis and Photodynamic Therapy is the journal that most published on the theme (n = 111). CONCLUSIONS: This bibliometric analysis mapped and discussed the scientific progress and publication metrics in PDT in endodontic research. Additionally, future perspectives were highlighted and should focus on discovering new photosensitizer agents, standardizing optimal photoactivation protocols, and conducting more clinical-oriented research.

Experimental resin-based dual-cured calcium aluminate and calcium titanate materials for vital pulp therapy.

This paper evaluates the physicochemical and biological properties of experimental resin-based dual-cured calcium aluminate (CA) and calcium titanate (CTi) materials for vital pulp therapy (VPT). The experimental dual-cured materials were obtained as two pastes: a) Bis-EMA 10, PEG 400, DHEPT, EDAB, camphorquinone, and butylated hydroxytoluene; and b) fluoride ytterbium, Bis-EMA 10, Bis-EMA 30, benzoyl peroxide, and butylated hydroxytoluene. The materials were divided into six groups based on the added calcium component: MTA (MTA®, Angelus); CLQ (Clinker-Fillapex®, Angelus); CA (calcined at ,1200°C in pastes a and b); CA800 (calcined at 800°C in paste a); CA1200 (calcined at 1,200°C in paste a); and CTi (paste a). The real-time degree of conversion and rate of polymerization (n = 3), diametral tensile strength (n = 10), hydrogen potential (n = 15), calcium ion release (n = 10), water sorption and solubility (n = 10), and cell viability (n = 6) were evaluated. One- and two-way ANOVA and Tukey's post hoc test were used in the analysis of the parametric data, and Kruskal-Wallis and Dunn's multiple tests were used to analyze the nonparametric data (α = 0.05). CLQ, CA800 and CA1200 had the highest diametral tensile strength. The water solubility of MTA was similar to that of CA800, CA1200 and CTi. CA800 and CA1200 resulted in cell viabilities similar to those of MTA and CLQ. The experimental dual-cured CA-based material that calcined at 800°C showed physicochemical and biological properties suitable for VPT, and similar to those of MTA.

Effect of an Intraorifice Barrier on Endodontically Treated Teeth: A Systematic Review and Meta-Analysis of In Vitro Studies.

The main cause of unsuccess in endodontically treated teeth (ETT) is due to bacterial recontamination. The placement of an intraorifice barrier (IOB) has been proposed for preventing this event in cases that the restoration is in an inadequate condition, enhancing the possibilities for predictable long-term success in endodontic therapy. Objectives. To evaluate through a systematic review and meta-analysis if it would be necessary to place an IOB in ETT. Materials and Methods. The present review is in accordance with the PRISMA 2020 Statement and is registered in the Open Science Framework. Two blinded reviewers carried out a comprehensive search in four databases up to July 10th, 2021: MEDLINE, Scopus, Embase, and Web of Science. Eligible studies were the ones which evaluated the use of an IOB in ETT in reducing microleakage with any material of choice and with any methods employed. Only in vitro studies published in English were included. Results. A total of thirty in vitro studies were included in the qualitative synthesis, and seven of those were included in the quantitative analyses evaluating the following materials: bioceramic cement, glass-ionomer cement (GIC), and resin-based composite (RBC). Most of the included studies placed an IOB at a 3 mm depth. Reduction in microleakage was observed when an IOB was placed, regardless of the material employed (p ≤ 0.01). Among the materials, GIC and RBC performed similarly (p > 0.05), with the bioceramic subgroup being statistically superior to the GIC subgroup (p ≤ 0.05). Conclusions. Although well-designed randomized clinical trials are required, the placement of an intraorifice barrier can significantly reduce microleakage in endodontically treated teeth, and the use of bioceramics as IOB seems to be the best available material for this purpose.

Experimental resin-based dual-cured calcium aluminate and calcium titanate materials for vital pulp therapy

Abstract: This paper evaluates the physicochemical and biological properties of experimental resin-based dual-cured calcium aluminate (CA) and calcium titanate (CTi) materials for vital pulp therapy (VPT). The experimental dual-cured materials were obtained as two pastes: a) Bis-EMA 10, PEG 400, DHEPT, EDAB, camphorquinone, and butylated hydroxytoluene; and b) fluoride ytterbium, Bis-EMA 10, Bis-EMA 30, benzoyl peroxide, and butylated hydroxytoluene. The materials were divided into six groups based on the added calcium component: MTA (MTA®, Angelus); CLQ (Clinker-Fillapex®, Angelus); CA (calcined at ,1200°C in pastes a and b); CA800 (calcined at 800°C in paste a); CA1200 (calcined at 1,200°C in paste a); and CTi (paste a). The real-time degree of conversion and rate of polymerization (n = 3), diametral tensile strength (n = 10), hydrogen potential (n = 15), calcium ion release (n = 10), water sorption and solubility (n = 10), and cell viability (n = 6) were evaluated. One- and two-way ANOVA and Tukey's post hoc test were used in the analysis of the parametric data, and Kruskal-Wallis and Dunn's multiple tests were used to analyze the nonparametric data (α = 0.05). CLQ, CA800 and CA1200 had the highest diametral tensile strength. The water solubility of MTA was similar to that of CA800, CA1200 and CTi. CA800 and CA1200 resulted in cell viabilities similar to those of MTA and CLQ. The experimental dual-cured CA-based material that calcined at 800°C showed physicochemical and biological properties suitable for VPT, and similar to those of MTA.

Salivary characteristics may be associated with burning mouth syndrome?

BACKGROUND: Burning mouth syndrome (BMS) it is characterized by burning and uncomfortable sensations with no clinical alterations or laboratory findings. The evaluation of the salivary characteristics of people with BMS can help the understanding of the pathogenesis of this condition. This case-control study aimed to trace the salivary profile of women with burning mouth syndrome (BMS). MATERIAL AND METHODS: 40 women with BMS and 40 control women were recruited. Unstimulated salivary flow rate (uSFR), pH, salivary cortisol levels, salivary viscosity, and oral health impact profile (OHIP-14 questioner) were determined. P< 0.05 was considered statistically significant. RESULTS: For uSFR, mean values obtained for BMS and for control group respectively were 0.35 and 0.61 mL/min; for pH, 7.23 and 7.34; for cortisol levels, 0.36 and 0.15 µg/dL; for viscosity values, 31.1 and 45.01 mPas and for OHIP-14 scores, 21.7 and 5.7. To uSFR, cortisol levels, viscosity values and OHIP-14 scores, differences were statistically significant. Salivary cortisol levels and OHIP-14 scores were correlated positively (rho = 0.624; p< 0.05). CONCLUSIONS: BMS women have lower uSFR and salivary viscosity and higher salivary cortisol levels that were associated with worse quality of life, compared with the control group. Key words:Xerostomia, Burning mouth syndrome, Viscosity.

Bonding Performance of Universal Adhesives: An Updated Systematic Review and Meta-Analysis.

PURPOSE: To evaluate through a systematic review and meta-analysis whether the immediate and long-term bonding performance of universal adhesives would be improved by prior acid etching. MATERIALS AND METHODS: Two reviewers performed a literature search up to April 2018 in eight databases: PubMed, Web of Science, Cochrane Library, SciELO, Scopus, LILACS, IBECS, and BBO. Only studies that evaluated the dentin or enamel bond strength of universal adhesives using a self-etch or etch-and-rinse strategy were included. Analyses were carried out using RevMan 5.3.5 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). A global analysis comparing self-etch or etch-and-rinse strategies and the influence of aging on bonding performance was performed with random-effects models at a significance level of p < 0.05. RESULTS: A total of 59 in vitro studies were included in the meta-analysis. The enamel bond strength of universal adhesives was improved by the etch-and-rinse approach (p < 0.05). In dentin, this effect was observed for ultra-mild and intermediately strong universal adhesives (p < 0.05). Irrespective of the strategy employed, intermediately strong adhesives showed a decrease in bond strength after all types of aging. This effect was also observed for ultra--mild universal adhesives used in the etch-and-rinse approach (p < 0.05). Mild universal adhesives showed bond strength stability in both strategies (p > 0.05). CONCLUSIONS: The in vitro evidence suggests that bonding performance of mild universal adhesives can be improved by using the selective enamel-etch strategy. Mild universal adhesives seem to be the more stable materials, in both etch-and-rinse or self-etch strategies.

Does laser therapy improve the wound healing process after tooth extraction? A systematic review.

Laser therapy could amplify the oral wound healing process by stimulating cell regeneration after injury, attenuating pain, and modulating the immune system. The purpose of this systematic review was to evaluate whether the application of laser therapy improved alveolar healing after tooth extractions. Eight electronic databases were screened: MedLine (PubMed), The Cochrane Library, Web of Science, Scopus, Lilacs, Ibecs, Scielo, and BBO. Three reviewers independently assessed the title and abstracts of potentially relevant studies. Only clinical trials and animal experiments that evaluated the wound healing effect of laser therapy after tooth extraction were included. A total of 16 studies fulfilled all criteria, thus 8 animal experiments and 8 clinical trials were included. Different types of laser were evaluated, such as CO2 , GaAlAs, Nd:YAG, Diode Laser, HeNe, and High-frequency Pulsed Diode Laser. Although HF, Diode and GaAs lasers were able to enhance wound healing process in clinical studies, four trials and one animal experiment showed no improvement in wound healing with laser therapy after tooth extractions. In general, the current available evidence in the literature showed that laser therapy improved the wound healing process, but these findings were limited to the type of laser applied and its specific settings. Further well-designed and randomized controlled trials are needed to support a benefit effect of using laser therapy after tooth extraction. PROSPERO registration number: CRD42014007509 (2014).

Efficacy of rhBMP-2 in Cleft Lip and Palate Defects: Systematic Review and Meta-analysis.

The aim of this study was to analyze the efficacy of using rhBMP-2 (recombinant human morphogenetic protein-2) in the treatment of patients with cleft lip and palate defects (CLPD). Seven databases were screened: PubMed (Medline), Lilacs, Ibecs, Web of Science, BBO, Scopus, and The Cochrane Library. Clinical trials that evaluated the use of bioactive treatment with rhBMP-2 in the treatment of patients with CLPD were included. Statistical analyses were performed by comparing the standardized mean difference of bone formation volume and bone filling percentage (p = 0.05). Ten studies compared the use of rhBMP-2 and iliac crest bone graft (ICBG). The global analysis for bone formation volume and bone filling percentage showed that bioactive materials were similar to ICBG with a standardized mean difference of respectively 0.07 (95% CI - 0.41 to 0.56) and 0.24 (95% CI - 0.32 to 0.80). The available literature suggested that use of rhBMP-2 presented similar bone formation results to those of ICBG in secondary alveolar bone grafting for patients with CLPD.

Piperonyl methacrylate: Copolymerizable coinitiator for adhesive compositions.

OBJECTIVES: This study describes the synthesis of piperonyl methacrylate (PipM) and evaluates its effect when used as coinitiator in the photoinitiated radical polymerization of experimental adhesive resins. METHODS: PipM was synthetized through an esterification reaction and characterized by FTIR and 1H NMR spectroscopy. Adhesive resins containing camphorquinone as photoinitiator and PipM or ethyl-4-dimethyl amine benzoate (EDAB) as coinitiators were formulated. Scotchbond Multipurpose (SBMP) adhesive was used as commercial reference. All materials were analyzed for polymerization kinetics, flexural strength, elastic modulus, water sorption/solubility, shear bond strength to bovine enamel and dentin, characterization of hybrid layer by scanning electron microscopy (SEM), microbiological direct contact test, and cytotoxicity. RESULTS: The adhesive with PipM presented higher degree of conversion and lower sorption/solubility when compared with other groups. Shear bond strength to enamel and dentin were similar for PipM and EDAB materials. The percentage of cellular viability was close to 100% and similar in the experimental groups and the commercial reference. CONCLUSIONS: PipM presented similar or superior performance to the tertiary amine used as control, representing a potential alternative coinitiator for photopolymerizable dental materials. CLINICAL SIGNIFICANCE: PipM could be potentially useful in the formulations of adhesive systems with enhanced chemical properties, which could mean improvement in the longevity of composite resin restorations.

Biological response to self-etch adhesive after partial caries removal in rats.

OBJECTIVES: The purposes of this study were to evaluate a model of slow caries progression and to investigate the performance of a self-etch adhesive system for partial caries removal. MATERIALS AND METHODS: Rat molars were infected with Streptococcus sobrinus 6715 culture. Different time points were analyzed: days 78, 85, and 95 (± 2). After this, the samples were processed for morphological analysis. Additionally, the first molars were restored with zinc oxide and eugenol (IRM™; Dentsply; Brazil) or adhesive system (Clearfil SE Bond™; Kuraray Medical; Japan) 78 days after caries induction. After, 3 or 15 days post-treatment, the animals were euthanized, and their mandibles were processed for morphological analysis, classified by means of scores, and submitted to statistical analysis. Subsequently, immunohistochemical analysis was performed for osteonectin (OSN) and transforming growth factor-ß1 (TGF-ß1) expression. RESULTS: According to the caries induction model used, on day 95 greater inflammatory infiltration (p < 0.001), and more extensive degradation of secondary/primary dentin were demonstrated than on day 78 (p < 0.05). Furthermore, the restorative materials presented similar performance (p > 0.05) and proved to be fundamental to control the carious lesion. The TGF-ß1 and OSN were shown to be active during the caries process. CONCLUSIONS: The slow caries lesion model was feasible for morphological analysis of the dentin-pulp complex. The self-etch adhesive system triggered no acute inflammatory infiltration or pulp necrosis, instead it seemed to stimulate early pulp repair. CLINICAL RELEVANCE: Clearfil SE Bond™ applied directly on caries-affected dentin did not predispose to pulp inflammation; instead, it appeared to provide early biological benefits.

Physical and Biological Properties of a High-Plasticity Tricalcium Silicate Cement.

INTRODUCTION: Mineral Trioxide Aggregate (MTA) is a tricalcium-based silicate, dicalcium silicate matrix. Despite its good biologic properties, some clinicians still claim to have difficulties in handling MTA after its preparation due to its sandy consistency. The aim of the present study was to evaluate the physicochemical properties and cytotoxicity of MTA Repair HP (Angelus, Londrina, PR, Brazil) compared with MTA Angelus (Angelus, Londrina, PR, Brazil). MATERIALS AND METHOD: The properties assessed were particle size, setting time, flow, film thickness, radiopacity, water solubility, compressive strength, and cytotoxicity. Statistical analysis was performed considering p < 0.05 as statistically significant. RESULTS: For radiopacity, water absorption and solubility MTA Repair HP were statistically similar to MTA Angelus. The MTA Angelus had statistically different film thickness values, higher than MTA Repair HP (p < 0.05). Besides, MTA Angelus showed a lower and statistically different compressive strength after 28 days than MTA Repair HP (p<0.05). Additionally, MTA Repair HP set more slowly (p < 0.05). Relative to cell viability, MTA Repair HP was statistically similar to MTA Angelus after 24 and 48 h in cell viability. CONCLUSIONS: The MTA Repair HP presented similar cell viability, lower film thickness, higher flow, setting time, and compressive strength values after 28 days than MTA Angelus. In general, the MTA Repair HP presented physicochemical and biological properties similar to the MTA Angelus.

Bioactive treatments in bone grafts for implant-based rehabilitation: Systematic review and meta-analysis.

BACKGROUND: The use of bioactive proteins, such as rhBMP-2, may improve bone regeneration in oral and maxillofacial surgery. PURPOSE: Analyze the effect of using bioactive proteins for bone regeneration in implant-based rehabilitation. MATERIALS AND METHODS: Seven databases were screened. Only clinical trials that evaluated the use of heterologous sources of bioactive proteins for bone formation prior to implant-based rehabilitation were included. Statistical analyses were carried out using a random-effects model by comparing the standardized mean difference between groups for bone formation, and risk ratio for implant survival (P ≤ .05). RESULTS: Seventeen studies were included in the qualitative analysis, and 16 in the meta-analysis. For sinus floor augmentation, bone grafts showed higher amounts of residual bone graft particles than bioactive treatments (P ≤ .05). While for alveolar ridge augmentation bioactive treatments showed a higher level of bone formation than control groups (P ≤ .05). At 3 years of follow-up, no statistically significant differences were observed for implant survival (P > .05). CONCLUSIONS: Bioactive proteins may improve bone formation in alveolar ridge augmentation, and reduce residual bone grafts in sinus floor augmentation. Further studies are needed to evaluate the long-term effect of using bioactive treatments for implant-based rehabilitation.

The Effect of Occlusal Splint Pretreatment on Mandibular Movements and Vertical Dimension of Occlusion in Long-Term Complete Denture Wearers.

PURPOSE: This study evaluated the pretreatment influence of occlusal splints and relines on mandibular movements (MM) and vertical dimension of occlusion (VDO) in longstanding complete denture wearers. MATERIALS AND METHODS: A total of 30 volunteers were randomly assigned to three groups (n = 10): control (C), relining of old denture (RD), and occlusal splints (OS). Individual extent of MM was assessed via intraoral Gothic arch tracings and the VDO using posed frontal images taken at three time points. RESULTS: The OS group showed statistically significant differences when compared with the other groups (P < .05). CONCLUSION: Both MM and VDO were significantly improved by use of occlusal splints pretreatment.

Should occlusal splints be a routine prescription for diagnosed bruxers undergoing implant therapy?

Despite the documented excellent clinical performance of dental implants, concerns linger regarding the best way to protect the restored dentition in patients with bruxism. This is because of the risk of occlusal overload that is reported to cause biological and biomechanical failures in the implant-prosthesis system. To better distribute occlusal loads to the rigid components of the prosthesis and to the interface between bone and implant during parafunctional movements, several dentists prescribe acrylic resin occlusal splints for nocturnal use by patients considered at risk. However, it is unclear whether this recommendation is based on scientific evidence or expert clinical opinion. This report reflects our effort to employ the systematic review protocol to assess whether there is scientific evidence to recommend an occlusal splint in bruxers after implant therapy.