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Effect of Psychological Stress on Salivary Cortisol and Periodontitis
Full text linkObjective: The progression of periodontitis, induced by polymicrobial dysbiosis, can be modified by systemic or environmental factorssuch as stress or anxiety that affect host response. This study evaluates the potential associations between psychosocial stress, salivarycortisol and periodontitis.Methods: In this cross-sectional study, 80 adult participants (41 males and 39 females) aged 20-45 years were included. Participantscompleted a stress self-assessment using a PSS scale questionnaire. Samples of saliva were collected for testing cortisol levels byELISA. The participants were then divided into four groups established on periodontal parameters (plaque index (PI), bleeding onprobing (BOP), probing pocket depth, and clinical attachment level), and stress levels: Group 1 (healthy periodontium without stress),Group 2 (periodontitis without stress), Group 3 (healthy periodontium with stress), and Group 4 (periodontitis with stress).Results: Statistically significant differences were observed between the values detected in the four experimental groups for PI, BI, PD,and CAL (p≤0.05). The highest means of cortisol level were revealed in the stressed healthy group and stressed with periodontitisgroup, at 39.7 and 40.5, respectively. Hence there were statistically significant differences overall across the four groups (p≤0.05).Conclusions: This study demonstrates that psychosocial stress is a risk factor for periodontal diseases, and in cortisol, as one of theelements that enhance periodontal damage, increases were recorded for all four clinical parameters, BI, PI, PD, CAL, which are usedas diagnostic tools for periodontitis
Effect of Smoking on Periodontal Status and Salivary Biomarkers Procalcitonin, C Reactive Protein and Matrixmetalloproteinase-8
Full text linkObjective: The study aimed to determine the salivary levels of C reactive Protein (CRP), Procalcitonin (PCT), andMatrixmetalloproteinase-8(MMP-8) in periodontitis patients and compare these levels between smokers and non-smokers.Methods: Eighty male subjects aged 25-60 years were chosen and divided into four groups, each comprising 20 individuals: group I:non-smokers without periodontitis, group II: smokers without periodontitis, group III: non-smokers with periodontitis, and group IV:smokers with periodontitis, based on their smoking habit and clinical periodontal parameters which included plaque index (PI%),bleeding index (BI%), pocket probing depth (PPD) and clinical attachment loss (CAL). To assess the salivary concentration, enzyme-linked immunosorbent assay (ELISA) was used for PCT, CRP, and MMP-8, IBM SPSS program version 22 was used for analysis,while ANOVA and Kruskal-Wallis test were used to compare the means and medians in normally distributed and non-normallydistributed variables, respectively.Results: There were significant variations in the clinical variables PI, BI, PPD, and CAL between the test and control groups (P 0.05).Furthermore, significant differences were detected in the levels of biomarkers PCT, CRP, and MMP-8 among the four groups. Also, asignificant difference was recorded between the levels of these biomarkers and smoking (P 0.05).Conclusions: The study found higher levels of salivary biomarkers in periodontitis and smoker individuals compared to non-periodontitis and non-smoker individuals
A Modified Naso-Alveolar Molding Device for Unilateral Cleft Lip and Palate
Full text linkAbstractObjective: Naso-alveolar-molding(NAM) is used to reshape the nasal cartilage and mold the maxillary alveolar arch before surgical cleft/lip repair. The study aimed to modify the conventional-NAM-device to lessen the severity of cleft lip/palate deformity and make the overall procedure simpler and beneficial, with fewer hospital recall visits.Methods: Sixty-six patients with unilateral cleft lip/palate were selected: 21 males and 12 females were fitted with a conventional-NAM-device, whereas 18 males and15 females were fitted with a modified-NAM-device. The inter-alveolar gap ranged between (14.5 and 13.5)mm. A presurgical-NAM-device was applied in the second week after the birth. Standardized parameters of cleft lip/palate were measured on the cast. Nostril width, columellar height, and columellar angle were measured on photographs. The number of recall visits was recorded. The modified device was similar to the conventional-NAM-device. However, the nasal stent was made of acrylic and separated from the plate. The thickness of the acrylic stent ranged from 10 to 3mm. The thicker and heavier acrylic was placed on the bigger arch side, and the thin part was placed on the small arch side.Results: A difference was observed between the conventional and modified device in the time taken to reduce the inter-alveolar-gap. Additionally, with the modified device there were fewer recall visits to the hospital. Furthermore, when the conventional NAM was compared with the modified device, the latter showed a significant improvement regarding the patients outcome (One-way-ANOVA or Kruskal-Wallis).Conclusions: The modified device is an effective and non-invasive device for accelerating the alignment of the alveolar segments to create the foundation upon which excellent lip/primary nasal surgery results can be achieved. This modification made the procedure more beneficial and simpler for the patient and parents. At the same time, recall visits were reduced by half when compared to those required for the conventional device
Influence of Immediate and Delayed Dentin Sealing on Bonding Strength of Lithium Disilicate Glass Ceramic An in vitro Study
Full text linkObjective: To investigate the influence of immediate and delayed dentin sealing technique on shear bonding strength (SBS) of thelithium disilicate glass-ceramic on tooth structure with different depths.Methods: The buccal surfaces of 40 maxillary first premolars were prepared with two different depths (1mm and 1.5 mm) and twodifferent timings for bonding (immediate and delayed dentin sealing). G1 (1 mm preparation) and G2 (1.5 mm preparation) weretreated with bonding (Tetric N-Bond Universal, Ivoclar,2021, Schaan/Liechtenstein) two weeks after preparation, before cementationto the ceramic block with delayed dentin sealing (DDS), while G3 (1 mm preparation) and G4 (1.5 mm preparation) were treatedimmediately after preparation with bonding and immediate dentin sealing (IDS). All specimens were stored in artificial saliva (Biotenedry mouth, GSK goupe, Canada) for two weeks at 24℃. Forty lithium disilicate glass-ceramic rectangular blocks (Rosetta SM)(HASSBIO, Korea) with dimensions of (2 mm height, 2mm width and 3 mm thickness) were prepared. After preparation of the toothsurfaces, all prepared blocks were cemented to the prepared teeth in groups GI and G2 with phosphoric acid 37% for 15 seconds, andall ceramic fitting surfaces were treated with 10% hydroflouric acid for 20 seconds and coupling agent monobond, then aging wasperformed for 5000 cycles in artificial saliva from 5-55 °C for all specimens. A universal test machine was used to test the shear bondstrength (SBS). The statistical analysis was done using a one-way ANOVA test followed by Tukey's post hoc test (p 0.05).Results: The result revealed that IDS and minimum preparation depth had significantly higher bonding strength than DDS. Bondingstrength in sequence was 15.50 ± 3.873 MPa in G3 and G4 8.25 ± 3.344 MPa, while for delayed dentin sealing the bonding strengthwas 7.75 ± 2.993 in G1 and 6.25 ± 2.125 MPa in G2.Conclusions: Teeth treated with IDS immediately after preparation showed significantly higher bonding strength than those treatedwith DDS for indirect ceramic restoration. Also, increase in the depth of the preparation toward the dentin led to a decrease in thebonding strength of the restoration
Evaluation of Flapless Approach for Dental Implantation: A Prospective Clinical Study
Full text linkbjective: The present study aims to evaluate the dental implant flapless technique as a successful treatment option for implant patients by assessing marginal bone loss after 3 months and post-operative pain.Methods: One hundred and twenty implants were placed in 40 patients. Two parameters were assessed post-operatively: marginal bone loss and pain; the difference in marginal bone loss (MBL) was measured based on an immediate post-operative OPG and another OPG taken three months after the surgery, and pain assessment was achieved using a 10-cm visual analog scale (VAS) post-operatively for five days. Descriptive and inferential statistics were used, and as most of the data were not normally distributed, Mann-Whitney test was used for comparing the groups.Results: The present study's findings demonstrate that the average marginal bone loss (MBL) around the implant at three months using the flapless technique was 0.2± 0.1 mm. No implants failed to osseointegrate. There was no statistical MBL significance between male and female patients or between upper and lower jaw. This study shows significantly reduced post-operative pain in the flapless implant placement technique.Conclusions: The flapless approach is predictable when patient selection, meticulous planning, and precise surgical protocols are followed
An In Vitro Comparative Study of Maxillary Denture Base Retention Between Conventional Fabrication and 3D Printed Techniques
Full text linkObjective: Many researchers have attempted to assess 3D printing as a manufacturing method to be used as an alternative for the conventional means. The current study aimed to determine the feasibility of 3D printed complete dentures in terms of retention.Methods: An edentulous maxillary model with an overlaying layer of mucosa was fabricated by 3D printing, using two different resins for the mucosa and model, which were then glued together to establish the final model. Afterwards, 8 single step putty and wash impressions were recorded with addition silicone. Each impression was scanned with a laboratory scanner. From each impression a stone cast was fabricated on which a conventional baseplate was constructed by heat polymerized PMMA with the pack and press technique. Meanwhile, from the 8 STL files of the scanned impressions, 8 baseplates were designed and printed with the denture base resin. Next, each of the 16 baseplates were connected to a loop at their center. Finally, the retentive value of all baseplates was measured by means of the universal testing machine. A statistical analysis was performed to evaluate the significance of retentive difference between the two groups.Results: The statistical analysis revealed that the printed dentures were significantly more retentive than the conventional, with a p-value of less than 0.029 and mean values of 15.0462 N and 12.05 N respectively.Conclusions: This study concluded that 3D printed complete dentures were significantly more retentive than the conventionally fabricated dentures
Effect of XP-Endo Finisher Rotary File on Removal of Smear Layer on the Root Canal Wall Using Different Rotary Files and Different Irrigants (An Ex- vivo Study)
Full text linkObjective: To evaluate the efficacy of XP- endo finisher (XPF) in removing the residual smear layer as a final step following the use of the One Curve and 2Shape files. Methods: Sixty extracted maxillary first molar teeth with (MB) root curvature within (10-25°) were selected, and only (MB) roots were used in this study. After that, the teeth were divided randomly according to the type of file used for canal preparation into two main groups (1 and 2). Then the main groups were divided into three subgroups (A, B, and C). In subgroups A1, B1, and C1, the 2Shape file was used for canal preparation; in subgroups A2, B2, and C2, the One Curve file was used. In subgroups A1 and A2, NaOCl was used during instrumentation and XPF to improve the residual smear layer removal with EDTA. In subgroups B1 and B2, NaOCl was used during instrumentation, and EDTA was used for 1 min to remove the residual smear layer. In subgroups C1 and C2, normal saline was used during instrumentation and with XPF. Then the roots were linearly sectioned into two parts. The coronal, middle, and apical thirds were quantified for the remaining smear layer under the scanning electron microscope (SEM). The Kruskal–Wallis- test and Mann- Whitney U test were used to measure the subgroups' differences. All tests were performed at the significant (p 0.05) level. Results: The subgroup C1 had the highest mean score and lowest efficiency in removing the residual smear layer. The result showed that the subgroup A2 exhibited the best residual smear layer removal effectiveness. Significant differences were observed between subgroups A1 and A2 (p 0.05). At the same time, there were significant differences between subgroups B1 and B2 (p 0.05), and subgroups A2 and B2 exhibited significant differences from C2 (p 0.05). Furthermore, significant differences were observed when subgroups C1 and C2 were compared to all the other subgroups (p 0.05). Conclusions: Using the One Curve file with NaOCl during instrumentation and using XPF to improve the residual smear layer removal with EDTA exhibited the best efficacy for removing the residual smear layer
Patient Satisfaction after Lip Enhancement Procedure by Facial Fillers in Sulaimani City
Full text linkObjective: The aim of this paper is to assess the level of patient satisfaction after receiving lip filler injections. It also attempts toinvestigate the association between the satisfaction level and various factors such as number of filler treatments, amount of fillerinjected and site of injection, among female patients in Sulaimani.Methods: A cross-sectional survey that used a questionnaire derived from the Global Aesthetic Improvement Scale, WHO quality oflife scale and convenience sampling was used to recruit patients attending cosmetic clinics to the study. Besides, descriptive analysisand chi-square methods were used to analyse the data.Results: 300 female patients participated in the study, with a mean age of 28.48 years. About 90% of the participants reportedimprovement after filler treatment, ranging from improved to very much improved . A statistically significant association was foundbetween patient satisfaction and number of filler treatments. Local side effects such as swelling and redness at the site of injection werecommon but they were mostly mild and did not last for an extended period.Conclusions: Although the satisfaction level is currently high, practitioners in the field need to pay more attention to this importantoutcome, since understanding the patients motivation and expectations before proceeding with the procedure is very important andcan contribute significantly to increasing patient satisfaction with the results
Clinical, Physiological, and Psychological Evaluation of Implant-Related Full Mouth Rehabilitation
Full text linkObjective: To assess patients' physiological and psychological aspects with full-mouth dental implantation. Methods: A cross-sectional observational study was conducted on 27 patients 30 years old who had full mouth dental implantation from the College of Dentistry Post Graduate Clinic, Shorsh Dental Teaching Center, and Researchers' Private Clinic from August 2021 to August 2022. Patients' feedback about the OHIP-14 questionnaire was assessed. Results: The mean±SD (standard deviation) age was 57.7±12.2 years, and male to female ratio was (1.1:1). Regarding their demographic characteristics, 33.3%, 44.4%, 37%, and 77.8% of patients were retired, had finished institute education, were unemployed, and were from Sulaymaniyah, respectively. In addition, 70.4%, 70.4%, 74.1%, 74.1, and 63% of patients irregularly visited the dentist, used toothbrushing once daily, did not use a mouth rinse, and had either Diabetes mellitus or hypertension or both, respectively. Meanwhile, 18.5%, 11.1%, 11.1%, and 3.7% of patients suffered from temporomandibular (TM) joint clicking, tenderness, limited mouth opening, and bad occlusion, respectively. Functional limitations and psychological disabilities were not well improved, but for other OHIP-14 questionnaire items only 3.7-7.4% of patients reported undesired outcomes. Conclusions: Patients with full-mouth dental implantation reported improvements regarding some items of the OHIP-14 questionnaire. However, in the current study, functional limitations and psychological disabilities were less improved than shown in the literature