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AIM: To analyze the scientific production related to the use of botulinum toxin (BTX-A) in the management of bruxism and evaluate its scope, impact, networks, and new research trends. MATERIALS AND METHODS: A descriptive and retrospective study of publications indexed in Scopus from January 2018 to May 2024 was conducted. The bibliometric indicators evaluated were a number of publications, citations, h-index, SCImago Journal Rank 2022, CiteScore 2022, Lotka's Law, Bradford's Law, and keyword co-occurrence analysis. Data were processed using SciVal and VOSviewer. RESULTS: We obtained 98 publications, including original articles, reviews, and other types of documents. Among the most productive authors, most were from South Korea and Turkey. Wonkwang University (South Korea) had the highest number of publications, while Baylor College of Medicine (USA) had the highest impact with 66.5 citations per publication. Toxins had the highest number of publications and the best Cite Score in 2022. Six main topics related to BTX-A in bruxism were identified, highlighting "reviews," "electromyography" and "controlled clinical trials". CONCLUSIONS: The use of BTX-A for the treatment of bruxism has generated increasing interest and scientific output in recent years, especially in South Korea and Brazil. However, there is a disparity in the productivity of authors, with most authors presenting only one publication. CLINICAL SIGNIFICANCE: This study highlights the need for further research and collaborations to optimize clinical practice and better understand the efficacy and management of BTX-A for treating bruxism. How to cite this article: Villanueva-García M, Ruck-Sanchez N, Tinedo-López PL, et al. Bibliometric Analysis of Botulinum Toxin and Bruxism: Impact, Visualization, and Collaborative Networks. J Contemp Dent Pract 2024;25(6):599-604.

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Introducción: Las recesiones gingivales son afecciones de las encías, que son muy frecuentes y podrían provocar repercusiones estéticas, hipersensibilidad dentinaria y tener más tendencia a la formación de lesiones cervicales. Es necesario recubrir la superficie radicular mediante técnicas regenerativas periodontales. Objetivo: Comparar la cantidad de recubrimiento radicular, la profundidad al sondaje y el nivel de inserción clínica, empleando las técnicas de colgajo de reposición coronal, con y sin injerto de tejido conectivo, en pacientes con recesiones gingivales Miller I y II. Métodos: Se incluyeron un total de 16 pacientes con recesiones gingivales Miller clase I y II, de los cuales se seleccionaron 50 piezas dentarias tratadas quirúrgicamente para cubrir las recesiones. Se utilizaron las técnicas de colgajo de reposición coronal, con y sin injerto de tejido conectivo. Las mediciones clínicas fueron comparadas al inicio y a los tres meses posoperatorios. Resultados: Al tercer mes poscirugía los resultados del recubrimiento radicular, profundidad al sondaje y el nivel de inserción clínica para la técnica colgajo de reposición coronal con injerto de tejido conectivo, fueron 0,96 ± 1,33; 0,87 ± 0,63; 1,83 ± 1,7 y para la técnica colgajo de reposición coronal fueron 1,44 ± 1,19; 1,04 ± 0,52; 2,48 ± 1,48, respectivamente. Al comparar el recubrimiento radicular intergrupo no se encontraron diferencias significativas (p = 0,11). Sin embargo, al comparar la profundidad al sondaje intergrupo (p = 0,04), el nivel de inserción clínica intergrupo (p = 0,001) y todas las mediciones clínicas intragrupo (p = 0,001), se encontraron diferencias significativas. Conclusiones: La técnica de colgajo de reposición coronal, con y sin injerto de tejido conectivo, demostró diferencias significativas en la profundidad al sondaje y el nivel de inserción clínica en recesiones gingivales Miller I y II. No se alcanzaron diferencias significativas para el recubrimiento radicular en ambas técnicas a los 3 meses de seguimiento(AU)

Introduction: Gingival recession is a very common gum condition which may result in aesthetic alterations and dentin hypersensitivity, and increase the probability of cervical lesions. It is necessary to cover the root surface using periodontal regeneration techniques. Objective: Compare the amount of root coverage, probing depth and clinical insertion level, using coronally repositioned flap techniques with and without connective tissue graft in patients with Miller I and II gingival recessions. Methods: A total 16 patients with Miller class I and II gingival recessions were included in the study, from whom 50 teeth were selected which had been treated surgically to cover the recessions. The techniques used were coronally repositioned flap with and without connective tissue graft. Clinical measurements were compared at the start of the postoperative period and three months later. Results: Three months after surgery, root coverage, probing depth and clinical insertion level were 0.96 ± 1.33; 0.87 ± 0.63; 1.83 ± 1.7, respectively, for coronally repositioned flap with connective tissue graft, and 1.44 ± 1.19; 1.04 ± 0.52; 2.48 ± 1.48, respectively, for coronally repositioned flap. Root coverage intergroup comparison did not find any significant differences (p = 0.11). However, intergroup comparison of probing depth (p = 0.04) and clinical insertion level (p = 0.001), and all the intragroup clinical measurements (p = 0.001) did find significant differences. Conclusions: Coronally repositioned flap technique with and without connective tissue graft showed significant differences in terms of probing depth and clinical insertion level in Miller I and II gingival recessions. At three months' follow-up, no root coverage significant differences were observed for either technique(AU)

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Resumen: El objetivo de este estudio fue evaluar la prevalencia y distribución de cálculos pulpares en un grupo de adultos peruanos mediante tomografía de haz cónico (CBCT). Materiales y métodos: Se analizaron 67 tomografías de haz cónico seleccionadas aleatoriamente de un centro tomográfico en Lima, Perú. Fueron evaluadas 1263 imágenes de piezas dentarias mediante el tomógrafo Point 3D Combi 500 S. El análisis de las imágenes se realizó con el software Real Scan y todas las piezas dentarias fueron evaluadas en las vistas sagital, axial y coronal. Todas las medidas fueron sometidas a prueba de chi cuadrado. (p<0.05). Resultados: De un total de 67 pacientes, un 83,58% presentaron calcificaciones y de 1263 piezas dentarias, un 30.8% a través de la CBCT. La prevalencia de calcificaciones fue mayor en el sexo femenino que masculino. Los molares maxilares y mandibulares fueron los grupos de dientes con mayor frecuencia de cálculos pulpares. Se encontró significancia entre los cálculos pulpares y el género, rango de edad, tipo y estado de pieza dentaria. Conclusiones: La primera molar maxilar tuvo mayor prevalencia de calcificaciones pulpares que la mandibular. La presencia de caries aumentó la posibilidad de aparición de estas calcificaciones, específicamente en maxilar. La CBCT podría ser una herramienta sensible para detectar cálculos pulpares. El conocimiento de la distribución de cálculos pulpares puede ayudar a los dentistas en el tratamiento clínico de endodoncia.

Abstract: The aim of this study was to evaluate the prevalence and distribution of pulp stones in a group of Peruvian adults using cone beam tomography (CBCT). Materials and methods: 60 randomly selected CBCT from a tomographic center in Lima, Peru were analyzed. A total of 1263 images of teeth using the Point 3D Combi 500 S tomograph were evaluated. Images analysis was performed with Real Scan software and all teeth were evaluated in sagittal, axial and coronal views. All measurements were subjected to a chi square test. (p<0.05). Results: Of the 1263 teeth, 30.8% presented pulp calcifications through the CBCT. The prevalence of calcifications was higher in women than in men. The maxillary and mandibular molars were the groups of teeth with the highest frequency of pulp stones. There was significance between the pulp stones and the gender, age range, type and state of the tooth. Conclusions: The maxillary first molars had a higher prevalence of pulp calcifications than the mandibular ones. The presence of caries increased the possibility of the appearance of these calcifications, specifically in the maxillary teeth. CBCT could be a sensitive tool to detect pulp stones. Knowledge of the distribution of pulp stones can help dentists in the clinical treatment of endodontics.

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En los últimos años, se ha incrementado el porcentaje de colocación de implantes dentales y, con ello, también la mayor presencia de eventos adversos, por lo que las complicaciones no son infrecuentes. La gran mayoría de recomendaciones para la reducción de complicaciones asociadas con la colocación de implantes dentales están analizadas desde el punto de vista de sus causas directas, juzgando la técnica o al individuo, pero no al sistema en conjunto, cuando este constituye la etiología real de las complicaciones. Recientemente, se ha empezado a considerar más importante la inclusión de los factores humanos y la conciencia de la situación en la comprensión de las complicaciones en implantología oral. Esto ha permitido analizar de manera global tanto al individuo como a su entorno, y aportar soluciones basadas en la prevención. Sin embargo, el conocimiento y la utilización de estos aspectos en implantología oral están aún en vías de popularización, por lo que el objetivo del presente artículo es difundir el enfoque de los factores humanos y la conciencia de la situación en la prevención de complicaciones y en la reducción de riesgos en los procedimientos de colocación de implantes dentales. (AU)

In recent years, the percentage of dental implant placement has increased, and the presence of adverse events and complications are not uncommon. The vast majority of recommendations for reducing complications associated with dental implant placement are analyzed from the point of view of their direct causes, evaluating the technique and/or the individual, but not the system as a whole, being this the actual etiology of complications. The inclusion of human factors and situation awareness has recently gained increasing importance in oral implantology complications and has allowed global analysis of both the individual and the environment, providing solutions based on prevention. However, knowledge and use of these aspects in oral implantology are still in the process of popularization, and therefore, the objective of this article was to describe the human factors involved and situation awareness for preventing complications and reducing the risks associated with dental implant placement procedures. (AU)

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OBJECTIVE: To review the historical and current periodontal phenotype classifications evaluating methods and characteristics. Moreover, to identify and classify the methods based on periodontal phenotype components. OVERVIEW: Several gingival morphology studies have been frequently associated with different terms used causing confusion among the readers. In 2017, the World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions recommended to adopt the term "periodontal phenotype". This term comprises two terms, gingival phenotype (gingival thickness and keratinized tissue width) and bone morphotype (buccal bone plate thickness). Furthermore, gingival morphology has been categorized on "thin-scalloped", "thick-scalloped" and "thick-flat" considering the periodontal biotype. However, by definition, the term phenotype is preferred over biotype. Periodontal phenotype can be evaluated through clinical or radiographic assessments and may be divided into invasive/non-invasive (for gingival thickness), static/functional (for keratinized tissue width), and bi/tridimensional (for buccal bone plate thickness) methods. CONCLUSIONS: "Thin-scalloped," "thick-scalloped," and "thick-flat" periodontal biotypes were identified. These three periodontal biotypes have been considered in the World Workshop but the term periodontal phenotype is recommended. Periodontal phenotype is the combination of the gingival phenotype and the bone morphotype. There are specific methods for periodontal phenotype evaluation. CLINICAL SIGNIFICANCE: The term periodontal phenotype is currently recommended for future investigations about gingival phenotype and bone morphotype. "Thin-scalloped," "thick-scalloped," and "thick-flat" periodontal phenotypes can be evaluated through specific methods for gingival thickness, keratinized tissue width, and buccal bone plate thickness evaluation.

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In recent years, the percentage of dental implant placement has increased, and the presence of adverse events and complications are not uncommon. The vast majority of recommendations for reducing complications associated with dental implant placement are analyzed from the point of view of their direct causes, evaluating the technique and/or the individual, but not the system as a whole, being this the actual etiology of complications. The inclusion of human factors and situation awareness has recently gained increasing importance in oral implantology complications and has allowed global analysis of both the individual and the environment, providing solutions based on prevention. However, knowledge and use of these aspects in oral implantology are still in the process of popularization, and therefore, the objective of this article was to describe the human factors involved and situation awareness for preventing complications and reducing the risks associated with dental implant placement procedures.

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Resumen: Objetivo: El propósito de este estudio fue evaluar la influencia de los niveles de pH de tres geles de blanqueamiento de consultorio en la rugosidad superficial del esmalte bovino, después del protocolo del blanqueamiento. Materiales y métodos: Se obtuvo 36 muestras de esmalte bovino, las cuales fueron cortadas y divididas en tres grupos (n=15): peróxido de hidrógeno 40% (Opalescence Boost 40%), peróxido de hidrógeno 35% (Whiteness HP AutoMixx) y peróxido de hidrógeno 35% (Whiteness HP Blue), recibiendo una aplicación de 40 minutos de blanqueamiento. Los valores del promedio del pH fueron determinados utilizando un pHmetro durante la aplicación inicial y final del gel. Un rugosímetro fue utilizado para evaluar la rugosidad superficial (Ra) antes y después del blanqueamiento. Los datos fueron analizados con la prueba de Friedmann y wilcoxon (diferencia entre grupos); la prueba Kruskall Wallis y U de mann (diferencia en cada grupo), así como prueba de Pearson o Spearman para la correlación. Resultados: Hay un aumento en los valores del pH del inicio al final del blanqueamiento en todos los grupos, excepto para el grupo peróxido de hidrógeno 35% (Whiteness HP Automixx). Para los resultados de rugosidad superficial existe un aumento en todos los grupos. No se encontró correlación entre niveles de pH de los geles blanqueadores y la rugosidad superficial del esmalte después del blanqueamiento. Conclusiones: Los geles blanqueadores de peróxido de hidrógeno con altas concentraciones que presenten un pH alto o bajo podrían causar alteraciones de la superficie del esmalte dental, como el aumento en la rugosidad superficial.

Abstract: Objective: The purpose of this study was to evaluate the influence of the pH levels of three in-office bleaching gels on the surface roughness of bovine enamel, after the bleaching protocol. Materials and methods: 36 samples of bovine enamel were obtained, which were cut and divided into three groups (n=12): 40%hydrogen peroxide (Opalescence Boost40%), 35% hydrogen peroxide (Whiteness HP AutoMixx) and 35% hydrogen peroxide (Whiteness HP Blue), receiving a 40-minute application of bleaching. The average pH values were determined using a pH meter during the initial and final application of the gel. A roughness meter was used to assess surface roughness (Ra) before and after bleaching. Data were analyzed with the Friedmann and wilcoxon test (difference between groups); the Kruskall Wallis and U Mann test (difference in each group), as well as Pearson or Spearman test for correlation. Results: There is an increase in pH values from the beginning to the end of bleaching in all groups, except for the 35% hydrogen peroxide group (Whiteness HP Automixx). For surface roughness results there is an increase in all groups. No correlation was found between pH values of the bleaching gels and the surface roughness of the enamel after bleaching. Conclusions: Hydrogen peroxide bleaching gels with high concentrations that have a high or low pH could cause alterations in the surface of the tooth enamel, such as increase in surface roughness.

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OBJECTIVE: Cone beam computed tomography (CBCT) images can be useful for estimating cervical vertebrae maturity (CVM). The aim of this study was to evaluate the reliability of cephalograms derived from CBCT versus lateral cephalograms (LC) to estimate the CVM in a Peruvian population. MATERIAL AND METHODS: The sample evaluated consisted of 40 cephalograms derived from CBCT and 40 LC images from individuals aged 10-19 years. One trained and calibrated observer (Kappa scores≥0.90) interpreted the CBCT and LC images twice. Intra-observer reliability of each maturation stage on CBCT sagittal slices and LC images were analysed using the weighted kappa statistics (α=0.05). Comparison of CVM stages between CBCT slices and LC images were analysed by the Spearman rank correlation coefficient, p<0.05. RESULTS: The weighted kappa test showed almost perfect intra-observer agreement for the CVM stages using the CBCT sagittal slices (0.873). Considering the LC images, the weighted kappa test showed almost perfect intra-observer agreement too (0.937). In both intra-observer agreement, the difference was limited to one maturation stage of the CVM method. The first and second intra-observer agreement for the CVM stages between the CBCT sagittal slices and LC images were almost perfect (0.937 and 0.874). High correlation values at the first (0.975) and second (0.976) intra-observer agreement for the CVM stages between CBCT sagittal slices and LC images were also found. CONCLUSION: CBCT is a reliable method for CVM assessment and can be used as an alternative method for this purpose. The orthodontists might use the CBCT scans as a valuable tool for CVM method estimation.

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AIM: The purpose of this study was to evaluate the MD (marginal discrepancy) on the calcinable copings in abutments for cemented prostheses with three luting agents. METHODS: Sixty-four analogs of CeraOne-type abutments (NACONIH code, Titanium Fix Implant Sytem SP, Brazil) were divided into four groups (n = 16). The copings were cast and placed on the CeraOne abutment analogs and cemented with eugenol-free zinc oxide (EfZO) (n = 16), with glass ionomer (GI) (n = 16), and with zinc phosphate (ZP) (n = 16), and as a control group, there were CeraOne plastic copings (NACOC code, Titanium Fix Implant Sytem SP, Brazil) (n = 16) which were not cemented with any material. After 24 hours, the MD of the four groups was measured. MD was evaluated using a stereoscopic microscope (Leica EZ4 W, Leica Microsystems, Germany) with an increase of ×100. MD was measured at four predetermined and equidistant sites with respect to the marginal line of the cast adaptation. The measurement was made from the distance between the free edge of the cast cylinder and the margin of preparation of the titanium abutment, with a level of statistical significance of p < 0.05. RESULTS: Of the three fixing agents, the ZP was found to have the highest MD (53.59 ± 14.21 µm); however, the lowest MD (41.72 ± 9.10 µm) was found in the GI group. These differences are statistically significant at p < 0.001. CONCLUSIONS: In summary, according to our results, it was found that ZP cement showed the highest MD after cementation, followed by the glass ionomer, while EfZO showed the lowest MD.

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RESUMEN Objetivo: Evaluar la influencia de las perforaciones corticales en regeneración ósea guiada (ROG) mediante resultados de histomorfometría obtenidos de estudios humanos y animales. Revisión de la literatura actual: Se realizó una búsqueda electrónica de estudios en humanos y animales en bases de datos PubMed, Cochrane Library, SciELO y Google Scholar desde 1980 hasta mayo del 2017. Se utilizó la siguiente estrategia de búsqueda: ((decortication of bone) OR (bone decortication) OR (alveolar decortication) OR (decortication) OR (decortications) OR (cortical perforation of bone) OR (cortical bone perforation) OR (cortical perforation) OR (cortical perforations) OR (intramarrow penetration) OR (marrow penetration)) AND ((guided bone regeneration) OR (guided bone augmentation) OR (bone augmentation) OR (osseous repair) OR (graft integration)). Discusión y conclusión: Se identificaron 65 artículos y sólo se seleccionaron 8. Cuatro estudios en animales mostraron influencia estadísticamente significativa al realizar perforaciones corticales. En 3 estudios en animales y en un estudio en humanos esta diferencia no fue estadísticamente significativa. Sin embargo, al realizar perforaciones existió mayor número de vasos sanguíneos y mayor formación ósea sin reacciones inflamatorias resaltantes ni impactos negativos. Las perforaciones corticales muestran beneficios en etapas tempranas de cicatrización influyendo significativamente en la angiogénesis incrementando la cantidad de hueso neoformado.

ABSTRACT Objective: To evaluate the influence of cortical perforations on guided bone regeneration (ROG) by histomorphometry results obtained from human and animal studies. Review of current literature: An electronic search of trials in humans and animals with histomorphometric evaluations was carried out in the PubMed, Cochrane Library, SciELO and Google Scholar databases from 1980 to May 2017. The following search strategy was used: ((decortication of bone) OR (bone decortication) OR (alveolar decortication) OR (decortication) OR (decortications) OR (cortical perforation of bone) OR (cortical bone perforation) OR (cortical perforation) OR (cortical perforations) OR (intramarrow penetration) OR (marrow penetration)) AND ((guided bone regeneration) OR (guided bone augmentation) OR (bone augmentation) OR (osseous repair) OR (graft integration)). Discussion and conclusion: Sixty five articles were identified and only 8 were selected. Four studies in animals showed statistically significant influence when performing cortical perforations. In 3 studies in animals and in 1 human study this difference was not statistically significant. However, when drilling, a greater number of blood vessels and a greater bone formation without inflammatory reactions or negative impacts were recorded. Cortical perforations show benefits in early stages of healing, influencing significantly in the angiogenesis, increasing the amount of neoformed bone.

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Las perforaciones corticales, penetraciones intramedulares o decorticaciones se realizan a menudo como parte del procedimiento de regeneración ósea guiada (ROG). Su sustento biológico se basa en que mejorarían la angiogénesis y proporcionarían una vía hacia el hueso esponjoso rico en vasos sanguíneos. También se consideran como un "noxious stimuli" (estímulo nocivo) que iniciaría el fenómeno regional acelerado con una respuesta local exuberante facilitando la cicatrización ósea normal. Además, mejorarían la unión o enlace físico entre el injerto óseo y el lecho receptor asegurando estabilidad y fusión de los bloques óseos. Sin embargo, se nos presentan algunas interrogantes relacionadas a su fundamento, a los términos que las describen, a los tamaños, a su cantidad y disposición, al instrumental adecuado para realizarlas y al confort del paciente. (AU)

Cortical perforations, intramedullary penetrations or decortications are often performed as part of the guided bone regeneration (GBR) procedure. Their biological basis is that they would improve angiogenesis, providing a pathway to the medullar bone rich of blood vessels. In addition, cortical perforations would be consider as a "noxious stimuli" that initiate the accelerated regional phenomenon with an exuberant local response facilitating normal bone healing. Moreover, they would improve the physical bonding between the bone graft and the recipient bed ensuring stability and fusion of the bone blocks. However, there are some questions related to its foundation, terms to describe them, their sizes, quantity and disposition, the appropriate instruments to perform them and the comfort of the patient. (AU)

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