Journal of Applied Cosmetology

Connective Tissue Attachment Invasion Frequency in Deep Interproximal Conservative Direct Restorations: a Preliminary Report of an Ongoing Cross-Sectional Study

2025-03-05T10:25:48+00:00

Deep interproximal direct restorations may be difficult to manage from a clinical point of view and potentially impinge on periodontal tissue stability. This study reports on connective attachment invasion frequency in deep interproximal conservative direct restorations. 124 sites of 38 consecutive patients in need of interproximal restorations were evaluated. Premolars and molars teeth without previous endodontic treatment with deep interproximal carious lesions involving ± 1mm of CEJ were considered. Periodontal and inflammatory parameters were recorded at each site (PPD, CAL, BOP, PI, KG). Under local anesthesia, crestal probing (MG - BC) and the distance from the apical margin of the preparation to the bone crest (PM - BC) were recorded. Clinical and radiographic quality control assessments were carried out upon completion of the restoration. The estimated connective attachment (CTA) dimension was calculated by subtracting periodontal probing depth (PPD) from crestal probing depth (SC). By comparing this value with the location of the restorative margin with respect to the gingival margin (MG), it was possible to determine whether or not the restoration was impinging on the connective tissue area. Only 3% of the restorations were found to be within the dimension of the CTA. If only subgingival margins were considered, the frequency of CTA violation would be 13.5%. This preliminary data from this ongoing study may help better define the indications for clinical crown lengthening procedures to avoid connective tissue attachment violation.

Role of the Dentist in the Management of Burning Mouth Syndrome: Preliminary Observational Study and Literature Review

2025-03-05T10:49:44+00:00

The aims of this observational study are the following: to identify diagnosis and treatment strategies for Burning Mouth Syndrome (BMS) according to current literature; to compare data collected in a sample of patients suffering from BMS with the data reported in the literature; to highlight the role of the dentist in the management of BMS. A sample of 10 consecutively treated patients was recruited to fulfill the research inquiries. All patients received a BMS diagnosis and underwent medical and psychological therapy. The patients were asked to evaluate their pain levels before and after treatment, filling in a Visual Analogic Scale and a Numerical Pain Rating Scale (NRS) to rate to what extent the treatment had been successful. A literature review was conducted on Pubmed and Cochrane using different keyword combinations. In the study group, 9/10 patients declared that the therapy gave satisfactory results. 4/10 patients reported benefit from the prescription of Clonazepam. Twelve articles were selected in the literature review. The review of literature presented in this work does not offer unequivocal evidence of Burning Mouth Syndrome diagnosis and treatment. Results obtained from the sample of 10 patients cannot be considered useful evidence to establish a clinical protocol.

Pain Management in Endodontics: a Narrative Review of Analgesic Use Preoperative, Intraoperative, and Postoperative

2025-03-06T09:27:54+00:00

Pain management in endodontics is a critical aspect of dental care, as the fear of endodontic pain often influences patient behavior and treatment outcomes. This narrative review examines the mechanisms, classification, and management strategies for pain associated with endodontic procedures, focusing on preoperative, intraoperative, and postoperative stages. Preoperative pain, often caused by irreversible pulpitis or periapical infections, is exacerbated by inflammatory mediators like prostaglandins, which lower pain thresholds and hinder anesthetic efficacy. Intraoperative pain arises from difficulties in achieving adequate anesthesia, particularly in cases of pulpitis, while postoperative pain, peaking within 24 hours, is linked to inflammatory responses in periapical tissues. A range of pharmacological options is discussed, including NSAIDs, paracetamol, corticosteroids, and opioids, alongside their mechanisms of action, efficacy, and side effects. NSAIDs remain the first-line treatment due to their anti-inflammatory and analgesic properties, with ibuprofen demonstrating rapid and effective pain relief. Corticosteroids are highlighted for their ability to enhance anesthetic success and reduce inflammation, particularly in severe cases. Opioids and gabapentinoids are reserved for more severe or neuropathic pain, with cautious use due to potential dependency risks. The aim of this review is to emphasize the importance of tailored analgesic strategies that address the specific pain phase, patient characteristics, and procedural requirements. This comprehensive approach not only alleviates pain but also enhances the overall effectiveness of endodontic treatment, ensuring better patient outcomes and satisfaction.

Interdental Papilla Regeneration with Hyaluronic Acid: a Narrative Review

2025-03-06T09:50:47+00:00

Peri-implantitis is a growing concern as dental implants become increasingly popular. This review paper aims to present the current understanding of peri-implant disease and provide insights into its management and prevention. The study followed PRISMA guidelines and conducted an extensive electronic search for relevant articles. Only systematic reviews published in Q1 and Q2 journals were considered. Eighteen systematic reviews have been selected from the 63 initial studies. The prevalence of peri-implantitis is estimated at around 19.53% of patients with implants and 12.53% of implants placed. Specific bacteria and MMP-8 levels have been associated with peri-implantitis, highlighting potential diagnostic markers. The review emphasized the need for consensus in research to accurately estimate the epidemiological parameters of peri-implantitis. Additionally, the adjunctive use of local antibiotics showed promising results in improving probing pocket depth and bleeding on probing compared to surgical treatment alone. Overall, this paper provides a comprehensive overview of the current knowledge on peri-implantitis and emphasizes the importance of precise diagnostic markers and effective treatment modalities.

Incidental Finding of Rare Developmental Anomalies in Children: a Case Series

2025-03-05T11:17:00+00:00

Dental developmental anomalies represent a family of variable conditions affecting tooth number, size, shape, position, and eruption. Often asymptomatic and discovered incidentally, these anomalies pose significant diagnostic and therapeutic challenges for dental practitioners. This case series presents six unusual dental anomalies observed during routine orthodontic evaluations. Cases include a horizontally impacted mandibular second molar associated with a third molar germ; a malformed maxillary second molar blocking the eruption of a third molar; fusion of a maxillary lateral incisor with a supernumerary tooth; double permanent maxillary canine inclusion caused by a supernumerary tooth; trauma-induced circular enamel hypoplasia following primary tooth trauma, and a lingually displaced supernumerary mandibular premolar. The findings underscore the importance of routine radiographic evaluations for early detection and highlight the need for interdisciplinary collaboration to manage these anomalies effectively. This paper aims to enhance awareness and provide practical insights for dental practitioners in diagnosing and treating such rare conditions.

Total Conometric Implant Prothesis Rehabilitation with Peek Secondary Caps: a Case Report

2025-03-06T08:14:50+00:00

This Case Report presents the rehabilitation of a 66-year-old female patient using a telescopic retention system with Polyetheretherketone (PEEK) secondary caps. The treatment utilized PEEK-based conometric retention for a partial upper-arch prosthesis. The report highlights the advantages and disadvantages of this approach compared to traditional retention systems. The patient's initial concerns about removability and aesthetic functionality were alleviated, and her satisfaction was underscored by significant improvements in her social activities and oral comfort. The case illustrates the feasibility of integrating PEEK into telescopic systems, addressing limitations of traditional materials and telescopic coupling while providing a cost-effective. Further clinical evaluation and research into surface modifications are essential to fully optimize this approach for long-term success.

Midline Tongue Splitting to Remove a Rare Acinic Cell Carcinoma of the Tongue Base: Surgical Technique and Case Report

2025-03-05T11:03:41+00:00

The aim of the present article is to describe a surgical technique to remove a rare type of oral carcinoma located at the base of the tongue. In this technical note, the authors describe how a tongue-based tumor can be achieved by a transoral approach through full-thickness tongue-splitting. In addition, the authors present a clinical case of remarkable rarity, both for the tumor histology and its unusual location, that permitted to apply the described technique. Pictures presented in the paper enrich the description of the surgical technique. A 77-year-old male was diagnosed with a neoplasm of considerable dimensions located at the level of the tongue base, very close to the median line. The patient was unaware of the neoplasm since no ulceration was present on the mucosal lining of the tongue, and only a negligible difficulty in swelling had appeared. In fact, he was diagnosed with the tongue tumor by chance: he fell over accidentally, broke his nose, and underwent a CT scan to verify whether facial bone fractures had occurred. Unexpectedly, CT imaging documented the presence of a mass measuring almost 7 cm in the axial plane and localized at the level of the tongue base. CT scan imaging suspected an adenocarcinoma of minor salivary glands. Nevertheless, a precise definition of the lesion couldn’t be determined, and the radiologist suggested performing an RMI. Magnetic Resonance concluded that the neoplasm was most likely an adenoid cystic lingual carcinoma. Considering the peculiar position of the neoplasm within the lingual body and considering that it appeared capsulated, the patient was offered to undergo surgical removal. The surgical technique applied in this case aimed at removing the tumor with the least invasive procedure to make the most of a natural route, the mouth, while avoiding far more challenging trans-cutaneous approaches. Full-thickness tongue splitting, with or without endoscopic magnification, is a suitable approach to achieve a well-defined, capsulated lesion of the tongue base; this technique allows complete neoplasm removal in a predictable and safe way.

Comparison of Plaque Removal Efficacy Between Sonic, Roto-Oscillating, and Manual Toothbrushes in Patients Undergoing Fixed Orthodontic Therapy: a Systematic Review

2025-03-06T08:46:54+00:00

Orthodontic treatment, especially fixed orthodontic treatment, increases the amount of plaque in the oral cavity due to the difficulty in brushing because of the presence of brackets. The aim of this systematic review was to compare different types of toothbrushes, that is, sonic, roto-oscillating, and manual, to determine the best method for removing plaque during treatment with fixed orthodontics. The review was conducted using the PubMed and Cochrane Library databases. The 2020 PRISMA guidelines were used for this study. Nine studies between 2013 and 2023 were included, two of which considered sonic toothbrushes in relation to others, and seven investigated roto-oscillating toothbrushes with other types. The aim of this study was to observe how plaque indices change based on the device used. Each study used a distinct method of instruction and follow-up. According to statistical data and plaque percentages, the best device appears to be a roto-oscillating toothbrush combined with an orthodontic brush head. However, it remains essential that patients, throughout the treatment, are motivated to have good oral hygiene at home and follow up to ensure the treatment is effective.

CBCT Evaluation of Upper Airway Volumetric Changes in Patients Treated with Hyrax-Type and McNamara-Type Rapid Maxillary Expanders

2025-03-06T10:25:01+00:00

The Rapid Maxillary Expander (RME) is an orthodontic-orthopedic appliance used to correct transverse maxillary deficiencies, often associated with chronic nasal airway obstruction. The aim of this study is to evaluate volumetric changes in the upper airway using CBCT and to compare any differences between the Hyrax and McNamara Rapid Maxillary Expanders. The study included 21 subjects (mean age: 9.71 years), 11 of whom were treated with the McNamara expander and 10 with the Hyrax expander. CBCT scans were performed before treatment (T0) and after device removal (T1). For each CBCT scan, Total Volume (TV), Retro-Palatal Volume (RPV), and Retro-Glossal Volume (RGV) were measured using ITK-Snap software. The data were statistically analyzed using the paired Student's t-test, while the unpaired Student's t-test was used to compare the two devices. A statistically significant increase was observed in Retro-Palatal Volume (1106 mm³, p = 0.0008) and Total Volume (3396 mm³, p = 0.013). No statistically significant changes were found in Retro-Glossal Volume (279 mm³, p = 0.08). Additionally, no significant differences emerged from the volumetric comparison between the two groups of expanders. CBCT has proven to be a valid and precise method for calculating airway volume. The statistically significant increases in Retro-Palatal Volume (RPV) and Total Volume (TV) suggest a potential reduction in upper airway resistance, which may benefit patients with oral respiratory issues. The lack of significant volumetric differences between the two devices indicates that both expanders have similar effects on the upper airways. Further studies are needed to assess the long-term stability of these airway changes.