Correction to: Effect of Er:YAG laser etching on topography, microstructure, compressive strength, and bond strength of a universal adhesive to calcium silicate cements Figure 2 was incorrect in the original published version of this article. Correct figure in presented here. The original article has been corrected.

Prevalence of undiagnosed diabetes and pre-diabetes in chronic periodontitis patients assessed by an HbA1c chairside screening protocol Abstract Objectives The objective of the present study was to implement a chairside diabetes screening strategy for the identification of undiagnosed hyperglycaemia in periodontal patients. Materials and methods Measurement of HbA1c was performed in patients (n = 139) diagnosed with periodontal disease to determine possible unknown hyperglycaemia. Patients fulfilled the criteria for screening according to the questionnaire by the Centers for Disease Control and Prevention (CDC). The Cobas® b101 in vitro diagnostic system was used for the measurement of glycosylated haemoglobin (HbA1c) in capillary blood. Body mass index (BMI) and waist circumference were also measured to determine splanchnic obesity. Periodontal parameters were assessed with an automated probe and included probing depth, clinical attachment loss, bleeding on probing and presence/absence of plaque. Results Most patients had moderate periodontitis. Almost 25% of the subjects tested were found to have unknown hyperglycaemia while 80.5% of them had splanchnic obesity. A significant association was found between HbA1c and BMI (Mann–Whitney test; p = 0.0021) as well as between HbA1c and waist circumference (Spearman rho test; p = 0.0007). No differences were observed regarding periodontal parameters between subjects exhibiting HbA1c ≥ 5.7% and those with HbA1c < 5.7% (Mann–Whitney test; p > 0.05) although those with HbA1c ≥ 5.7% displayed higher proportions of sites with clinical attachment loss > 5 mm (z test with Bonferroni corrections; p < 0.05). Conclusions Periodontal patients, especially those with a bigger than normal BMI and waist circumference, are a target group worth screening for diabetes. Clinical relevance The dental practitioner can contribute significantly to the worldwide effort of health care professionals in diabetes screening and referring for early diagnosis of the disease.

Differences between palpation and static/dynamic tests to diagnose painful temporomandibular disorders in patients with Lyme disease Abstract Objectives The aim was to determine the frequency of Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD)-based pain diagnoses and dynamic/static tests-based pain diagnoses, and to assess the agreement of palpation tests with static/dynamic tests. Materials and methods Eighty-six (N = 86) adult patients with Lyme disease (mean age 57.0 ± 14.3 years; male/female ratio was 42/44) were examined according to techniques described in the RDC/TMD. Additionally, dynamic/static tests were performed. For RDC/TMD-based pain diagnoses and dynamic/static tests-based pain diagnoses, descriptive frequencies were calculated. Differences between the frequency of palpation-based diagnoses and of dynamic/static-based diagnoses as well as the agreement between pain diagnoses established with the two diagnostic approaches were assessed. Results RDC/TMD-based pain diagnoses were made in 61 patients for myofascial pain and in 11 patients for arthralgia and/or osteoarthritis. Based on dynamic/static tests, mainly myogenous pain was diagnosed in 6 patients, and a mainly arthrogenous pain in 5. The agreement of palpation tests with static/dynamic tests in Lyme disease population was poor. Conclusion A high prevalence of TMD symptoms was found in patients with Lyme disease. The results suggest that using palpation tests alone could overestimate primary TMDs when comorbid conditions are present. Clinical relevance: Dynamic/static tests should be used as part of the routine TMD assessment. In case of Lyme disease as the actual cause of the facial pain, while the dentist might be suspecting TMD when dynamic/static TMD tests are negative, referral to an appropriate specialist for the diagnosis and treatment of Lyme disease needs to be made.

Characterization of circulating DNA in plasma of patients after allogeneic bone grafting Abstract Objectives Cell-free DNA (cfDNA) harboring mutations has been found in patients with diseases. Experimental studies have shown that cfDNA can be transmitted, leading to transformations in the host. In the present study, we evaluated whether bone allograft material contains cfDNA and whether this foreign cfDNA can be released into the patient’s blood circulation. Materials and methods Plasma samples were collected preoperatively and postoperatively on the same day, at 5 weeks, and 4 months from 25 women who received bone allograft material (test group) from male donors and from 10 women who were treated with autologous graft (control group, only pre- and postoperative samples were collected). DNA was quantified and characterized in bone material and plasma samples by quantitative PCR with primers specific for glyceraldehyde-3-phosphate dehydrogenase (GAPDH) and Y chromosome and gel electrophoresis. DNA in bone material was digested by different concentrations of DNase I. Results We detected between 1 and 1.8 μg cfDNA fragments at a length around 601 base pairs (bp) and smaller in each 100 mg allograft. Treatment of the allograft with DNase I completely degraded the longer but not the shorter DNA 90-bp fragments. Y-DNA was not detected in the patients’ bloodstream at any time during the treatment and follow-up, but elevated levels of circulating cfDNA could be measured immediately postoperatively. Conclusions Our results suggest that a transmission of DNA from allografts used for alveolar ridge reconstruction in humans is unlikely. The observed increase in circulating cfDNA in allograft and autograft patients immediately postoperatively may be elicited by the surgical procedure. Clinical relevance The results support the safety of allograft materials. The results suggest that human allograft materials seem not to release DNA into the blood since we did not measure Y-DNA with our technique.

Association of oral mucosa hyperpigmentation with imatinib mesylate use: a cross-sectional study and a systematic literature review Abstract Objectives To assess the association between oral mucosa hyperpigmentation in patients with leukemia and imatinib mesylate use. Additionally, we compared our data to those obtained from a systematic review. Materials and methods A cross-sectional study was conducted with 74 patients undergoing treatment with imatinib mesylate. Sociodemographic characteristics, oral mucosa alterations, and medical history were evaluated. Oral hyperpigmentation was scored. The use of imatinib mesylate and hydroxyurea was evaluated. Association between oral hyperpigmentation and imatinib mesylate was assessed. A systematic review was also conducted to retrieve case reports or case series of patients with oral hyperpigmentation associated with imatinib mesylate. Results Among the 74 participants, 41 were male (55.4%) and 33 were female (44.6%). Participants’ mean age was 49.3 years. Sixty-six (89.2%) patients developed hyperpigmented lesions in the hard palate mucosa. In multivariate analysis, patients who had used imatinib mesylate for > 72 months had a hyperpigmentation score 1.62 times higher than those who had used this medication during a shorter period. Patients who had used hydroxyurea for > 30 days had a hyperpigmentation score 1.43 times higher than those who had used this medication during a shorter period. The systematic review retrieved 20 clinical cases of patients undergoing imatinib mesylate treatment and exhibiting oral hyperpigmentation. Conclusions The development of oral hyperpigmentation is associated with imatinib mesylate use. Hydroxyurea seems to increment such an association. Clinical relevance To assist providers in the differential diagnosis of hyperpigmented lesions associated with imatinib mesylate, as well as in the clinical management of such lesions.

The German version of Early Childhood Oral Health Impact Scale (ECOHIS-G): translation, reliability, and validity Abstract Objectives The aims of this study were to develop a German version of the Early Childhood Oral Health Impact Scale (ECOHIS), a measure of oral health-related quality of life in pre-school-age children, and to assess the instrument’s reliability and validity. Methods The original English version of the ECOHIS questionnaire was translated into German (ECOHIS-G) by a forward-backward translation method. A total of 336 children aged 0 to 5 years and their caregivers who were recruited at the Department of Paediatric Dentistry in Vienna, Austria, participated in this study. The caregivers completed the ECOHIS-G and their children were clinically examined for the presence of dental caries and plaque accumulation. Reliability of ECOHIS was investigated in a subsample of 59 subjects after 3 weeks. Results Questionnaire summary score test-retest reliability was 0.81 (intraclass correlation coefficient, 95% confidence interval (CI) ranging from 0.68 to 0.89) and internal consistency was 0.83 (Cronbach’s alpha, lower limit of the 95% CI 0.80). Validity of the ECOHIS-G questionnaire was supported by correlation coefficients with global ratings of oral health of − 0.42 (95% CI − 0.45 to − 0.35) and overall well-being of − 0.29 (95% CI − 0.34 to − 0.22) which met the expectations. Mean ECOHIS-G scores were statistically significantly higher in children with caries compared with caries-free children. Conclusions The German version of the ECHOHIS was found to be reliable and valid in children aged 0 to 5 years. Clinical relevance These findings enable assessments of oral health-related quality of life in German-speaking pre-school children.

Comparative evaluation of SPECT/CT and CBCT in patients with mandibular osteomyelitis and osteonecrosis Abstract Objectives Therapy of osteomyelitis and osteonecrosis very often requires surgery. Proper preoperative radiological evaluation of a lesion’s localization and extent is a key in planning surgical bone resection. This study aims to assess the differences between single-photon emission computed tomography and cone beam computed tomography when detecting an osteomyelitis/osteonecrosis lesion as well as the lesion’s qualitative parameters, extent, and localization. Material and methods Identification of candidates was performed retrospectively following a search for patients with histologically or clinically confirmed osteomyelitis or osteonecrosis. They were matched with a list of patients whose disease extent and localization had been evaluated using single-photon emission computed tomography and cone beam computed tomography in the context of clinical investigations. Subsequently, two experienced examiners for each imaging technique separately performed de novo readings. Detection rate, localization, extent, and qualitative parameters of a lesion were then compared. Results Twenty-one patients with mandibular osteomyelitis and osteonecrotic lesions were included. Cone beam computed tomography detected more lesions than single-photon emission computed tomography (25 vs. 23; 100% vs. 92%). Cone beam computed tomography showed significantly greater depth, area, and volume, whereas length and width did not differ statistically between the two groups. Conclusion Both single-photon emission computed tomography and cone beam computed tomography could sensitively detect osteomyelitis/osteonecrosis lesions. Only single-photon emission computed tomography showed metabolic changes, whereas cone beam computed tomography seemed to display anatomic morphological reactions more accurately. The selection of the most adequate three-dimensional imaging and the correct interpretation of preoperative imaging remains challenging for clinicians. Clinical relevance In daily clinical practice, three-dimensional imaging is an important tool for evaluation of osteomyelitis/osteonecrosis lesions. In this context, clinicians should be aware of differences between single-photon emission computed tomography and cone beam computed tomography when detecting and assessing an osteomyelitis/osteonecrosis lesion, especially if a surgical bone resection is planned.

Calcium phosphates as fillers for methacrylate-based sealer Abstract Objectives The aim of this study was to evaluate the mineral deposition, push-out bond strength, radiopacity, the degree of conversion, film thickness, flow, calcium ion release, and pH of experimental endodontic sealers containing hydroxyapatite (HAp), aflfa-ticalcium phosphate (α-TCP), or octacalcium phosphate (OCP) particles. Materials and methods Fifty single straight root human premolars were instrumented and divided into five groups (n = 10). Experimental endodontic sealers were formulated by 70 wt% urethane dimethacrylate (UDMA), 15 wt% of glycerol-1,3-dimethacrylate (GDMA), 15 wt% of ethoxylated bisphenol A glycol dimethacrylate (BISEMA), camphorquinone (CQ), N,N-dihydroxyethyl-para-toluidine (DHEPT), and benzoyl-peroxide. 10 wt% of each HAp, α-TCP, or OCP were added to the resin and its properties were assessed. Results After 7 days, the degree of conversion ranged from 44.69% (GOCP) to 50.74% (Gcontrol) and no statistical difference were observed (p < 0.05). GAHplus showed the highest push-out bond strength 4.91 (± 2.38) MPa at 28 days of analysis (p < 0.05). Film thickness and pH were not statistically different (p > 0.05). Statically lower values of flow were found for GHAp, GOCP, and Gα-TCP (p < 0.05). Calcium deposition values were higher for GHAp at 28 days. Conclusions Bond strength, degree of conversion, and film thickness of endodontic sealers with phosphates showed similar results compared with AHplus, but displayed higher amounts of Ca2+ release. Clinical relevance Phosphate fillers improve the performance of endodontic sealers after 28 days of simulated body fluid.

The critical bond strength of orthodontic brackets bonded to dental glass–ceramics Abstract Objectives To evaluate the critical bond strength (σ) of ceramic and metal brackets to a lithium disilicate-based glass–ceramic. Materials and methods Two hundred and forty ceramic specimens (IPS e-max CAD) were randomly distributed in 12 experimental groups (n = 20). Two ceramic brackets (monocrystalline, BCm; and polycrystalline, BCp) and a metal bracket (BM) were bonded to glass–ceramic specimens after one of the following surface treatments: HF—hydrofluoric acid applied for 60 s; S—silane applied for 3 min; HFS—HF followed by S; and MDP—application of an adhesive containing a phosphate monomer (MDP). All brackets were bonded to the treated glass–ceramic using a resin cement, stored in 37 °C water for 48 h before shear bond strength testing. Optical (OM) and scanning electron (SEM) microscopies were used for fractographic analysis. Data was statistically analyzed using Kruskal–Wallis and Student–Newman–Keuls (α = 0.05). Results BCm bonded to glass–ceramic treated with either HFS or HF showed the highest median σ values, respectively, 10.5 MPa and 8.5 MPa. In contrast, the BCp bonded to glass–ceramic treated with MDP showed the lowest median σ value (0.8 MPa), which was not statistically different from other MDP-treated groups. Conclusions The failure mode was governed by the glass–ceramic surface treatment, not by the bracket type. Quantitative (σ values) and qualitative (fracture mode) data suggested a minimum of 5 MPa for brackets bonded to glass–ceramic, which is the lower critical limit bond strength for a comprehensive orthodontic treatment. Clinical relevance Bonding brackets to glass–ceramic requires micromechanical retention.

Effect of fracture orientation on detection accuracy of vertical root fractures in non-endodontically treated teeth using cone beam computed tomography Abstract Objectives This study aimed to investigate the effect of fracture orientation on the detection accuracy of vertical root fractures (VRFs) in non-endodontically treated teeth using four different cone beam computed tomography (CBCT) units. Materials and methods Thirty eight out of 148 extracted human permanent teeth were chosen randomly, and VRFs were artificially induced to result in 20 mesiodistally and 18 buccolingually oriented root fractures. The fracture width was subsequently measured. All the teeth were scanned with four CBCT units. CBCT images were evaluated independently by two observers. Area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were calculated for each observer and fracture orientation. The AUC between the two fracture orientations was compared using Z test. Results The mean fracture width was 140 μm (standard deviation 26.8 μm). A statistically significant difference was found between the mesiodistal and buccolingual VRFs for the AUC from the CBCT unit 3D Accuitomo 170 (p = 0.02). There were no statistically significant differences between the mesiodistal and buccolingual VRFs for AUCs from the CBCT units NewTom VGi (p = 0.21), ProMax 3D Mid (p = 0.23), and i-CAT FLX (p = 0.21). Conclusion Fracture orientations of teeth with VRFs in non-endodontically treated teeth may play a role in the detection accuracy of CBCT images, but this effect seems to be dependent on the CBCT unit used. Clinical relevance Although for most of the CBCT units tested, the fracture orientation of VRF in non-endodontically treated teeth seems not to play a role for the diagnosis, clinical data is needed to further assess the impact of different devices on VRF detection.