Provisional restorations represent an important phase during the rehabilitation process, knowledge of the mechanical properties of the available materials allows us to predict their clinical performance. At present, there is no systematic review, which supports the clinicians’ criteria, in the selection of a specific material over another for a particular clinical situation. The purpose of this systematic review and meta-analysis was to assess and compare the mechanical properties of dimethacrylates and monomethacrylates used in fabricating direct provisional restorations, in terms of flexural strength, fracture toughness and hardness. This review followed the PRISMA guidelines. The searches were conducted in PubMed, Embase, Web of Science, Scopus, the New York Academy of Medicine Grey Literature Report and were complemented by hand-searching, with no limitation of time or language up to January 10, 2017. Studies that assess and compare the mechanical properties of dimethacrylate- and monomethacrylate-based provisional restoration materials were selected. A quality assessment of full-text articles were performed according to modified ARRIVE and CONSORT criteria and modified Cochrane Collaboration’s tool for in vitro studies. Initially, 256 articles were identified. After removing the duplicates and applying the selection criteria, 24 articles were included in the qualitative synthesis and 7 were included in the quantitative synthesis (meta-analysis). It may be concluded that dimethacrylate-based provisional restorations presented better mechanical behavior than monomethacrylate-based ones in terms of flexural strength and hardness. Fracture toughness showed no significant differences. Within the monomethacrylate group, polymethylmethacrylate showed greater flexural strength than polyethylmethacrylate.
ObjectiveTo evaluate the psychosocial impact of malocclusion, determine its relationship with the severity of malocclusion, and assess the influence of gender and social class on this relationship in adolescents.MethodsA random sample of 627 Spanish adolescents aged 12 - 15 years underwent intraoral examinations by 3 calibrated examiners (intraexaminer and interexaminer kappa > 0.85) at their schools. Psychosocial impact was measured through a self-rated Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). The severity of malocclusion was measured by the Index of Orthodontic Treatment Need (IOTN). Gender and social class were also recorded.ResultsThe total PIDAQ score and those of its 4 subscales, social impact, psychological impact, aesthetic concern, and dental self-confidence, presented significant differences (p ≤ 0.05 by analysis of variance) and linear relationships with the IOTN grades (p ≤ 0.05 by linear regression). Stepwise linear regression models showed that the IOTN dental health component was a predictive variable of the total and subscale PIDAQ scores. Neither gender nor social class was an independent predictive variable of this relationship, except the linear model for psychological impact, where gender was a predictive variable. The occlusal conditions responsible for higher PIDAQ scores were increased overjet, impeded eruption, tooth displacement, and increased overbite.ConclusionsMalocclusion has a psychological impact in adolescents and this impact increases with the severity of malocclusion. Social class may not influence this association, but the psychological impact seems to be greater among girls.
The aim of this study was to examine the validity and reliability of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) as a tool for assessing the prevalence and level of burnout in dental students in Spanish universities. The survey was adapted from English to Spanish. A sample of 533 dental students from 15 Spanish universities and a control group of 188 medical students self-administered the survey online, using the Google Drive service. The test-retest reliability or reproducibility showed an Intraclass Correlation Coefficient of 0.95. The internal consistency of the survey was 0.922. Testing the construct validity showed two components with an eigenvalue greater than 1.5, which explained 51.2% of the total variance. Factor I (36.6% of the variance) comprised the items that estimated emotional exhaustion and depersonalization. Factor II (14.6% of the variance) contained the items that estimated personal accomplishment. The cut-off point for the existence of burnout achieved a sensitivity of 92.2%, a specificity of 92.1%, and an area under the curve of 0.96. Comparison of the total dental students sample and the control group of medical students showed significantly higher burnout levels for the dental students (50.3% vs. 40.4%). In this study, the MBI-HSS was found to be viable, valid, and reliable for measuring burnout in dental students. Since the study also found that the dental students suffered from high levels of this syndrome, these results suggest the need for preventive burnout control programs.
Objectives: The purpose of this study was to assess the validity and reliability of the Spanish version of PIDAQ for application in adolescents. Study Design: The questionnaire was translated, cross-culturally adapted and completed by 627 adolescents (366 12-year-olds and 261 15-year-olds). The adolescents were also examined by 4 examiners who had been calibrated against a gold standard and relative to each other (Kappa >0.85) in determining treatment need with the Dental Aesthetic Index (DAI) and the Index of Orthodontic Treatment Need (IOTN) DHC and AC components. Results: Cronbach´s alpha of the translated PIDAQ was 0.90. The 23 items of the questionnaire were divided into four domains that explained 60% of the variance. The test-retest reliability of the questionnaire was 0.93. Discriminant validity revealed a significant association between the scores for the questionnaire and its subscales or domains and those for the DAI, IOTN-DHC and IOTN-AC treatment need indices. Adolescents with orthodontic treatment need scored higher in the questionnaires. Conclusions: The results show that the Spanish version of PIDAQ has a very similar internal structure and psychometric properties to those of the original questionnaire and demonstrate its validity for use with Spanish adolescents. Key words:Orthodontics, epidemiology, quality of life, malocclusion.
Femtosecond laser has been proposed as a method for conditioning zirconia surfaces to boost bond strength. However, metallic or ceramic bracket bonding to femtosecond laser-treated zirconia surfaces has not been tested. This study compared the effects of four conditioning techniques, including femtosecond laser irradiation, on shear bond strength (SBS) of metallic and ceramic brackets to zirconia.Three hundred zirconia plates were divided into five groups: 1) control (C); 2) sandblasting (APA); 3) silica coating and silane (SC); 4) femtosecond laser (FS); 5) sandblasting followed by femtosecond laser (APA+SC). A thermal imaging camera measured temperature changes in the zirconia during irradiation. Each group was divided into 2 subgroups (metallic vs ceramic brackets). SBS was evaluated using a universal testing machine. The adhesive remnant index (ARI) was registered and surfaces were observed under SEM. Surface treatment and bracket type significantly affected the bracket-zirconia bond strength. SBS was significantly higher (p<0.001) for ceramic brackets in all groups (APA+FS > APA > FS > SC > control) than metallic brackets (APA+FS > FS > SC > APA > control). For metallic brackets, groups SC (5.99 ± 1.86 MPa), FS (6.72 ± 2.30 MPa) and APA+FS (7.22 ± 2.73 MPa) reported significantly higher bond strengths than other groups (p < 0.05). For ceramic brackets, the highest bond strength values were obtained in groups APA (25.01 ± 4.45 MPa), FS (23.18 ± 6.51 MPa) and APA+FS (29.22 ± 8.20 MPa).Femtosecond laser enhances bond strength of ceramic and metallic brackets to zirconia. Ceramic brackets provide significantly stronger adhesion than metallic brackets regardless of the surface treatment method.
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