Dental Assessment Research Articles

Universal scoring system for assessing speech function in patients with cleft palate at the stages of surgical treatment

To develop a universal system for assessing the speech function in patients with congenital palatal cleft in the postoperative period. A universal system for assessing the speech function for patients with a palatal cleft can be applied both after the primary operation of uranoplasty and for patients diagnosed with velopharyngeal insufficiency (VPI). The patient's speech is assessed according to the following criteria: defects in the pronunciation of consonants by place of articulation: labial, labiodental, lingual-dental, lingual-palatal, lingual-alveolar; speech breathing; tongue position; directed air stream; voicing disorders; The patient's is also evaluated for the following findings: hypernasality (reflected speech); hypernasality (spontaneous speech); hyponasality; pharyngeal reflex; audible nasal emission/turbulence; facial grimaces; speech intelligibility. The speech therapy and dental assessments are added to obtain a value characterizing the patient's condition: from 0 to 10 scoring indicates than only speech therapy correction is needed; from 11 to 18 - the decision on the necessity of surgical treatment is made by the surgeon together with the speech therapist, from 18 to 25 - surgical treatment is necessary with subsequent sessions with a speech therapist. With the help of this questionnaire, the operating surgeon can more accurately and objectively assess in dynamics the result of the surgical treatment, regardless of the results of speech therapy treatment in the postoperative period. The creation of this scoring system for speech assessment is aimed at objectivizing the results of uranoplasty and speech-improving operations. It allows the surgeon to compare the effectiveness of different surgical methods. The universal scoring system for assessing the state of speech function can be applied in the diagnosis of a patient with a palatal cleft both after the primary operation on the palate and after corrective surgical interventions. It allows monitoring progress and identifying dynamics in surgical and speech therapy treatment.

Accuracy of different dental age assessment methods to determine chronological age among children with special needs.

This study aimed to validate the accuracy of dental age (DA) based on the dental development of permanent teeth in children with special needs using Demirjian, Willems, and London Atlas methods and to correlate the dental and chronological age (CA) of children with special needs in Malaysia. The panoramic radiographic images belonging to children with special needs from the two teaching dental hospitals in Malaysia aged between 5 and 16 years were included in the study. The evaluation was performed by two observers using three methods (London Atlas, Demirjian, and Willems methods) to estimate the accurate DA. The outcome was determined by comparing the mean of the DA and CA. A total of 52 panoramic radiographs were available for the analysis. The London Atlas and Demirjian methods overestimated the DA with a mean of 0.05 and 0.20 years, respectively, while the Willems method underestimated by 0.19 years. The London Atlas method was highly precise and accurate, while Demirjian and Willems methods were the least precise and accurate. The London Atlas method of DA estimation is highly accurate and valid for children with special needs in the Malaysian population, followed by the Willems and Demirjian methods.

Evaluation of blue and red two-tone colored staining solution for dental plaque imaging using an intraoral scanner.

We first reported that intraoral imaging with a color-imaging intraoral scanner could evaluate stained plaques and contribute to oral hygiene instructions. In this study, we aimed to evaluate the effects of red and blue staining on dental hygiene assessment with an intraoral scanner using plaque control record values and plaque-stained areas. Fifteen patients (six males and nine females, aged 25-85 years) were included in this study. The patients' teeth were stained with a two-tone (blue and red) dental plaque staining solution, and images of their teeth were recorded with an intraoral scanner and a digital camera. The plaque control record was measured by direct viewing, as usual, and on a monitor using intraoral scanner image. In addition, the plaque deposition area was measured using images obtained using an intraoral scanner and images taken by a digital camera. Most parts were stained red and blue dental plaque staining was also observed. Plaque control record values tended to be higher in the intraoral scanner evaluation than in the direct evaluation. The plaque-stained area was larger in intraoral scanner images than in camera images. It is possible to use a two-tone plaque-staining solution for oral health evaluation using an intraoral scanner. In the future, we need to investigate cases of blue-stained plaques. Key words:Intraoral scanner, oral hygiene, dental plaque, preventive dentistry.

Dental Cavity Grading: Comparing Algorithm Reliability and Agreement with Expert Evaluation.

The current study introduces a novel, algorithm-based software developed to objectively evaluate dental cavity preparations. The software aims to provide an alternative or complement to traditional, subjective assessment methods used in operative dentistry education. The software was tested on cavity preparations carried out by 70 participants on artificial molar teeth. These cavities were also independently assessed by an experienced academic panel. The software, using 3D imaging, calculated cavity dimensions and assigned an error score based on deviation from ideal measurements. Statistical analyses included sensitivity, specificity, positive predictive value, negative predictive value, Cohen's kappa, the intraclass correlation coefficient (ICC3k), Spearman's rho, Kendall's tau correlation coefficients, and a confusion matrix. The software demonstrated a high degree of accuracy and agreement with the panel assessments. The average software and panel scores were 64.1 and 60.91, respectively. Sensitivity (0.98) was high, specificity (0.55) was moderate, and the ICC3k value (0.857) indicated a strong agreement between the software and the panel. Further, Spearman's rho (0.73) and Kendall's tau (0.56) suggested a strong correlation between the two grading methods. The results support the algorithm-based software as a valid and reliable tool for dental cavity preparation assessments. The software's potential use in dental education is promising, though future research is necessary to validate and optimize this technology for wider application.

Review of age assessment methods of children and adolescents by teeth X-rays

Interest in the topic of age assessment for forensic medical identification of personality has not decreased for over the past decade. Establishing an exact age have a critical importance for law enforcement authorities, for example in case of wrongdoing by illegal migrants without identity documents. The search and systemic analysis of published researches devoted to age assessment by dental status in children and adolescents with subsequent updating of the directions of development in this scientific subject theme and the possibility of their realization in practice in the Russian Federation were carried out in order to have an objective concept of used methods of dental status assessment in the world practice.

Exploring Unexpected Maxillary Sinus Abnormalities in Dental CBCT Scans

Background: Incidental maxillary sinus pathologies refer to unexpected findings of abnormalities within the maxillary sinuses discovered during routine dental imaging examinations. Objective: To determine the frequency of incidental maxillary sinus pathologies in dental patients on cone-beam computed tomographic (CBCT). Study Design: Cross sectional study. Settings: Department of Dentistry Multan Medical and Dental College, Multan Pakistan. Duration: From August 2022 to January 2023. Methods: This study included 132 adult patients presenting with cone-beam computed tomographic (CBCT) images for dental assessment. Exclusion criteria comprised maxillofacial trauma, previous surgery, or congenital anomalies. Patient demographics and radiographic findings were recorded, with two radiologists independently assessing CBCT images for incidental maxillary sinus pathologies. Descriptive statistics and subgroup analyses were performed in SPSS. Results: The mean age was 46.3±10.2 years. In gender distribution, 60 patients (45.5%) were male, while 72 patients (54.5%) were females. The overall prevalence of incidental maxillary sinus pathologies was present in 75 cases, accounting for 56.81% of the total. Among the pathologic findings, mucous retention cysts were the most common, present in 35 patients (63.6%), followed by polyps in 15 patients (27.3%), sinusitis in 10 patients (18.2%), and anatomical variations in 20 patients (36.4%). Conclusion: The study identified an overall prevalence of incidental maxillary sinus pathologies in 56.81% of the dental patient population, emphasizing the importance of comprehensive evaluation during routine dental assessments.

Integration of a dental hygienist into the interprofessional long-term care team.

To address poor oral health of residents in long-term care homes (LTCH), this study explored the process of integrating an educational resource and a dental hygienist on the interprofessional care team. This convergent mixed-methods study took place at a 472-bed LTCH in Toronto, Canada from February to August 2018. Nurses employed at the LTCH participated in the study. During the study period, a dental hygienist was integrated into an interprofessional LTCH team. Nurses completed an online eLearning module about using the Oral Health Assessment Tool (OHAT) when referring residents' oral health concerns to a. Pre/post knowledge quizzes, module feedback and satisfaction surveys were administered. A retrospective chart review examined OHAT use and compared nurse and dental hygienist oral health assessments. Two cycles of semi-structured interviews with five nurses explored experiences with the eLearning module, OHAT and integration of the dental hygienist into the team. Nurses scored well on the knowledge quizzes and reported comfort in using the OHAT to refer oral concerns to a dental hygienist; however, actual use was minimal. oral health issues were under-reported by nurses on the Resident Assessment Instrument-Minimum Data Set (RAI-MDS); the dental hygienist reported significantly more debris, teeth lost and carious teeth (all P < 0.0001). Qualitative analysis indicated that the nurses valued dental hygienist integration into the team. Using knowledge mobilisation practices, a new oral health referral tool was developed. This study highlights the feasibility and desirability of an oral health eLearning module, practical assessment tools and participation of a dental hygienist on the LTCH interprofessional care team.

Automated Detection of Dental Caries from Oral Images using Deep Convolutional Neural Networks

The urgent demand for accurate and efficient diagnostic methods to combat oral diseases, particularly dental caries, has led to the exploration of advanced techniques. Dental caries, caused by bacterial activities that weaken tooth enamel, can result in severe cavities and infections if not promptly treated. Despite existing imaging techniques, consistent and early diagnoses remain challenging. Traditional approaches, such as visual and tactile examinations, are prone to variations in expertise, necessitating more objective diagnostic tools. This study leverages deep learning to propose an explainable methodology for automated dental caries detection in images. Utilizing pre-trained convolutional neural networks (CNNs) including VGG-16, VGG-19, DenseNet-121, and Inception V3, we investigate different models and preprocessing techniques, such as histogram equalization and Sobel edge detection, to enhance the detection process. Our comprehensive experiments on a dataset of 884 oral images demonstrate the efficacy of the proposed approach in achieving accurate caries detection. Notably, the VGG-16 model achieves the best accuracy of 98.3% using the stochastic gradient descent (SGD) optimizer with Nesterov’s momentum. This research contributes to the field by introducing an interpretable deep learning-based solution for automated dental caries detection, enhancing diagnostic accuracy, and offering potential insights for dental health assessment.

Remote assessment of dental records by using intraoral scan-based digital three-dimensional models in an elderly patient population - an exploratory study.

To assess the agreement rates of dental records derived from intraoral scan-based digital three-dimensional models (3DM) and 3DM + panoramic radiographs (3DM+PAN-X) compared to clinical findings. Based on the 3DM/3DM+PAN-X of 50 patients undergoing supportive periodontal therapy (SPT), ten remote raters (inexperienced in using IOS or 3DM) assessed for each site of the dental scheme (32 sites) whether a tooth was missing (M), filled (F), restoration- and caries-free (H), replaced by an implant (I) or decayed (D). Remote records were compared to the clinical reference record of each patient at tooth-level. The clinical records were assessed by an experienced dentist who supplemented the clinical findings with information from available radiographs and the patient records to define the clinical reference record. The agreement-rates for 3DM/3DM+PAN-X at tooth-level are: M: 93%/94%, F: 84%/88%, H: 92%/92%, I: 65%/96%, D: 29%/29%. The overall agreement-rate is 88% for the 3DM-based dental records (14093 of 16000 entries true) and 91% for 3DM+PAN-X (14499 of 16000 entries true). Using 3DM for dental record assessment, posterior teeth had higher odds of correct findings compared to anterior teeth (upper jaw OR=2.34, lower jaw OR=1.27). The remote detection of healthy, missing and filled teeth and implants by raters inexperienced in using IOS or 3DM shows a high agreement-rate with the clinical findings. The additional evaluation of PAN-X increased the agreement-rate significantly for implants. Thus, the remote assessment of dental records using 3DM+PAN-X has a high accuracy when applied in SPT-patients with low caries activity.

Use of oral nutritional supplements in irradiated patients with head and neck cancer.

Malnutrition is common among patients with head and neck cancer (HNC) and associated with poorer outcomes. Oral nutritional supplements (ONS) are often prescribed, with concerns raised about their cariogenicity. This study examined ONS use and caries experience in patients with HNC 12 months post-diagnosis. Fifty-four patients with HNC referred for pre-radiotherapy dental assessment were recruited. Data collected included: age, gender, residential postcode, smoking, alcohol use, HNC characteristics, dental history, oral hygiene habits, dietary advice and ONS use. Data was collected at diagnosis, during radiotherapy and 6 weeks, three, six- and 12-monthspost-treatment completion. Fifty-one subjects completed the study. 76.5% of the participants used ONS for an average of 13.8 weeks. Caries developed in 22.9% of ONS users and 11.1% of non-users (p = 0.6585). The mean overall duration of ONS use was 18.7 weeks for the caries group and 8.5 weeks for the caries-free group (p = 0.1507). Lack of collaboration and disconnection was noted between dietary advice given by dieticians and dentists. ONS use is common among patients with HNC. Larger studies are needed to establish the reasons for caries development and impacts of ONS use on oral health. Importance of multidisciplinary management of malnutrition is highlighted.

Caries Detection in Primary Teeth Using Intraoral Scanners Featuring Fluorescence: Protocol for a Diagnostic Agreement Study.

Digital methods that enable early caries identification can streamline data collection in research and optimize dental examinations for young children. Intraoral scanners are devices used for creating 3D models of teeth in dentistry and are being rapidly adopted into clinical workflows. Integrating fluorescence technology into scanner hardware can support early caries detection. However, the performance of caries detection methods using 3D models featuring color and fluorescence in primary teeth is unknown. This study aims to assess the diagnostic agreement between visual examination (VE), on-screen assessment of 3D models in approximate natural colors with and without fluorescence, and application of an automated caries scoring system to the 3D models with fluorescence for caries detection in primary teeth. The study sample will be drawn from eligible participants in a randomized controlled trial at the Royal Children's Hospital, Melbourne, Australia, where a dental assessment was conducted, including VE using the International Caries Detection and Assessment System (ICDAS) and intraoral scan using the TRIOS 4 (3Shape TRIOS A/S). Participant clinical records will be collected, and all records meeting eligibility criteria will be subject to an on-screen assessment of 3D models by 4 dental practitioners. First, all primary tooth surfaces will be examined for caries based on 3D geometry and color, using a merged ICDAS index. Second, the on-screen assessment of 3D models will include fluorescence, where caries will be classified using a merged ICDAS index that has been modified to incorporate fluorescence criteria. After 4 weeks, all examiners will repeat the on-screen assessment for all 3D models. Finally, an automated caries scoring system will be used to classify caries on primary occlusal surfaces. The agreement in the total number of caries detected per person between methods will be assessed using a Bland-Altman analysis and intraclass correlation coefficients. At a tooth surface level, agreement between methods will be estimated using multilevel models to account for the clustering of dental data. Automated caries scoring of 3D models was completed as of October 2023, with the publication of results expected by July 2024. On-screen assessment has commenced, with the expected completion of scoring and data analysis by March 2024. Results will be disseminated by the end of 2024. The study outcomes may inform new practices that use digital models to facilitate dental assessments. Novel approaches that enable remote dental examination without compromising the accuracy of VE have wide applications in the research environment, clinical practice, and the provision of teledentistry. Australian New Zealand Clinical Trials Registry ACTRN12622001237774; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384632. DERR1-10.2196/51578.

Bony Congenital Nasolacrimal Duct Obstruction: A Novel Phenotype of Aplasia of Lacrimal and Major Salivary Glands

PurposeAplasia of lacrimal and salivary gland (ALSG) is a syndromic disorder characterized by aplasia of lacrimal and salivary systems. Reported ophthalmic manifestations of ALSG include aplasia of lacrimal glands, punctal agenesis, lacrimal sac mucocele and membranous congenital nasolacrimal duct obstruction (CNLDO). Bony CNLDO, a rare cause of congenital epiphora, has not been associated with any syndromic disorder. This study investigated the relationship between genetic mutations and bony CNLDO in three Chinese families with ALSG. DesignSingle-center observational case study. ParticipantsThree Chinese families with bony CNLDO including 7 affected and 9 healthy family members. MethodsSlit-lamp ophthalmic examination, comprehensive physical examination, orbital Computed Tomography (CT), cervicofacial Magnetic Resonance Imaging (MRI), audiometry and whole exome sequencing on periphery blood were performed. Variants were cross-referenced with 1000 control genomes and various population databases. Pathologic variants were identified using bioinformatic tools. Main Outcome MeasuresClinical examination, diagnostic imaging, whole exome sequencing and bioinformatic analysis findings. ResultsAffected patients had decreased tear production on Schimer I Test and reduced tear break-up time. Bony CNLDO was observed on computed tomography, showing unilateral or bilateral bony termination at the middle or terminal segment of the nasolacrimal canal. Cervicofacial MRI showed aplasia or absence of lacrimal, parotid and submandibular glands. Physical examination revealed normal ears, digits and facial morphology. Audiometry and dental assessment were conducted on the pediatric patients and yielded normal results. The clinical characteristic of patients aligned with diagnosis of ALSG. Genomic analysis revealed three novel heterozygous missense mutations of Fgf10 gene: c.316T>C, c.327C>G, c.332T>G. The inheritance pattern was autosomal dominant with variable penetrance. These variants were not observed in 1000 control chromosomes and population databases. These variant positions were also shown to be highly conversed across various animal species. Mutated genes and proteins were predicted as “deleterious” with most computational models with a few suggesting they may be “benign”. ConclusionsBony CNLDO was identified as a novel phenotype of ALSG implicated by missense mutations of highly conserved residues in the Fgf10 gene. These cases broadened our knowledge of Fgf10-related phenotypes and prompt clinicians to consider syndromic associations in patients with bony CNLDO.

Estimation of Dental Age by Mandibular Third Molar Through Digital Orthopantomogram Using Modified Demirjian Method In South Indian Population Visiting A Dental College- A Retrospective Study

Aim: The aim of this study was to evaluate the applicability of Demirjian’s method for dental age assessment in a group of South Indian population and to develop an age-predictive equation suitable for the studied group. Subjects and methods: In this retrospective, blind, cross-sectional study, 120 Digital Orthopantomograms were selected from the archived medical files of patients attending Dental College and evaluated to estimate dental age. Results: Age was over estimated for almost all of the studied subjects with an accuracy range from 0.18 to 1.19 years for males and from 0.08 to 0.87 years for females, with the exception of two age subgroups Conclusion: Demirjian’s method is very useful and suitable for the South Indian population. The development of a prediction equation and the introduction of adaptable conversion tables to transform the maturity score into a dental age for the South Indian population with population-specific samples may be suitable alternatives.

Dental age assessment in the living: a comparison of two common stage classifications for assessing radiographic visibility of the root canals in mandibular third molars.

After dentition is complete, degenerative tooth characteristics can be used for dental age assessment. Radiological assessment of the visibility of the root canals of the mandibular third molars in dental panoramic radiographs (DPRs) is known to be one such suitable feature. Essentially, two different stage classifications are available for evaluating the visibility of the root canals of mandibular third molars in the DPR. The aim of this study was to determine if one method outperforms the other. Therefore, the 2010 method of Olze et al. was directly compared to the 2017 method of Lucas et al. in the 2020 modification of Al Qattan et al. To this end, 233 DPRs from 116 females and 117 males aged 20.0 to 40.9 years were evaluated by three independent experienced examiners. In addition, one examiner ran two independent evaluations. Correlation between age and stage was investigated, and the inter- and intra-rater reliability was estimated for both methods. Correlation between age and stage was higher with the Olze method (Spearman rho 0.388 [95% CI 0.309, 0.462], males and 0.283 [95% CI 0.216, 0.357], females) than the Lucas method (0.212 [95% CI 0.141, 0.284], males and 0.265 [95% CI 0.193, 0.340], females). The intra-rater repeatability of the Olze method (Krippendorff's α = 0.576 [95% CI 0.508, 0.644], males and α = 0.592 [95% CI 0.523, 0.661], females) was greater than that for the Lucas method (intra-rater α = 0.422 [95% CI 0.382, 0.502], males and α = 0.516 [95% CI 0.523, 0.661], females). Inter-rater reproducibility was also greater for the Olze method (α = 0.542 [95% CI 0.463, 0.620], males and α = 0.533 [95% CI 0.451, 0.615], females) compared to the Lucas method (α = 0.374 [95% CI 0.304, 0.443], males and α = 0.432 [95% CI 0.359, 0.505], females). The method of Olze et al. was found to present marginal advantages to the Lucas et al. method across all examinations and may be a more appropriate method for application in future studies.

Do we need to improve the general oral health of our population to reduce the risk of Infective Endocarditis?

Abstract Background Emphasis is placed on the link between oral health and Infective Endocarditis (IE), particularly around odontogenic infections and specific dental procedures. The Adult Dental Health Survey in 2009 showed 45% of adults in the UK required dental intervention typically associated with developing IE. Antibiotic prophylaxis in this context is not without controversy. With gum and periodontic disease endemic, is the modern issue one of generalised poor oral health as a risk factor for IE? Purpose To determine the impact of oral health on risk and outcome in IE. Terminology SDCEP published dental guidelines of when to consider AP against IE for dental procedures. It identifies dental procedures that can cause transient bacteraemia. Methodology Data were collected from October 2020-Januaury 2023 in 123 patients with confirmed IE at a central London cardiac surgical centre. Patients had a focussed dental assessment with history, intraoral examination and dental panoramic radiograph to determine the risk and extent of oral disease. Results Average age was 54.2years. 77/123 (63%) had native IE (NVE) and 46 (37%) prosthetic (PVE). 17 (37%) cultured oral organisms from blood (Table 1); 8 (47%) of these organisms are associated with active dental disease (decay, periodontal disease, dental infection). Organisms can be found in Table 2. However, 93/123 (76%) had oral caries requiring dental treatment, irrespective of typical portal of entry for that organism. The proposed dental treatment posed a high risk for causing IE in 70%. 93/123 (76%) needed further dental treatment within six months rendering only 12% of patients orally stable. Oral organisms were seen more frequently in NVE (41/77) vs PVE (17/46). There was no difference in the incidence of dental disease requiring treatment (77% NVE vs 74% PVE). Whilst 27% of PVE had had recent (within 4 months) dental treatment compared to 73% NVE, only 1 PVE patient grew an oral commensal compared to 82% of NVE patients. Conclusion Prevention of IE is key to reducing the morbidity and mortality of this disease. We see oral commensals causing IE in 47%, with only 12% of this modern IE cohort dentally stable. Despite this, there was no difference in rates of dental disease requiring invasive treatment when stratified by oral vs non-oral organisms. A robust public health strategy is required to reduce the risk of oral disease driving IE.

Postoperative Oral Care Pathways Are Not Required at the Time of Buccal Mucosa Harvest

Purpose: For patients undergoing urethroplasty with buccal mucosa grafting, the impact of oral care pathways on infection and pain control remains unstudied. We hypothesize that the elimination of dietary restrictions and mouthwash regimens from the oral care pathway would not alter the rate of donor site complications. Materials and Methods: One hundred urethroplasty cases using buccal mucosa were retrospectively reviewed for donor site and perineal wound complications. No preoperative or intraoperative antibiotic oral cleanses were used in any case. Records were categorized by use of postoperative dietary restrictions and mouthwash regimens. Graft harvest size, preexisting oral issues, baseline comorbidities, dental assessments, perioperative antibiotics, and postoperative pain control regimens were accounted for. Results: Forty patients were included in the oral care pathway and 60 in the nonoral care pathway. Baseline demographics, dental assessment, and graft harvest details were similar between groups. There were no cases of graft site infection, with a median follow-up of 226 days. All graft site issues resolved in 3 to 4 weeks or less. Perineal wound infections for oral care pathway 2 (5%), and no oral care pathway 4 (6.7%), P = .6. Urinary tract infections for oral care pathway 7 (17.5%), and no oral care pathway 2 (3.3%), P = .027. Conclusions: Postoperative oral complications remain low without the use of oral cleanses, dietary restrictions, or mouthwash regimens. Routine use of donor site care pathways is likely unnecessary in this patient population.

Automatic performance assessment in Virtual Reality medical simulators: A model based on procedure trajectories and machine learning

Virtual Reality (VR) simulators for medical training helps students develop the sensorimotor skills required to perform specific procedures. However, as a training resource, a VR simulator usually lacks the capacity to assess the user’s performance automatically and provide feedback. The main objective of this study is to develop a model to automatically assess performance in VR medical simulators, based on the medical instrument trajectories and machine learning. We designed a model to use the data collected in medical VR simulators and defined two different labeling systems: by level of expertise or by a dental instructor assessment. We calculated 98 features related to the participant’s performance and combined three different feature selection/fusion algorithms with five classifiers. The SVM algorithm accomplished the best results overall, with an accuracy of 0.77, specificity of 0.60 and sensitivity of 0.94 using the labeling by the dental instructor’s assessment. Overall, the results for the performance assessment were promising and the model can be trained for similar VR medical simulators that collects trajectory data through a haptic device.

Evaluation of oral biotics’ effectiveness for home oral care

Relevance. The incidence of oral mucosal diseases is nowadays increasing. Inflammatory periodontal diseases are common in dental practice and occupy second place worldwide among oral diseases.Purpose. The study aimed to analyze ‘Denta Balance’, an oral synbiotic complex, and ‘Lesnoy balsam’, a mouthwash, as home care products treating inflammatory periodontal diseases and halitosis.Material and methods. The study included 40 patients aged 18 to 28 y.o., of which 10 were males (25%) and 30 females (75%). They randomly formed two groups. The age in Group 1 was 23.0 ± 2.5 years and in Group 2 – 24.0 ± 3.2 years. In all patients, we assessed the Fedorov-Volodkina hygiene index and papilla bleeding index (PBI, Saxer &amp; Mühlemann, 1975) before and after oral care product use. All patients formed two groups, 20 patients in each group. The fi group used a spray and powder for oral administration containing synbiotic complex; Group 2 used a natural-phytoncide mouthwash as an oral care product. Besides dental status assessment, we conducted a survey where we collected dental history. The main survey criteria were tooth sensitivity, halitosis, dry mouth, tenderness around the gums, bleeding on brushing, eating or spontaneous bleeding. We also asked the patients to assess the one-month effect of synbiotic-complex products and natural-phytoncide mouthwash.Results. The use of products showed a positive effect in both groups, i.e., tenderness around the gums, tooth sensitivity, and halitosis disappeared; bleeding on brushing and spontaneous bleeding significantly decreased; the gum colour returned to normal. The dental status index assessment confirmed the effectiveness of the treatment: the hygiene index insignificantly improved after the treatment; periodontal indices changed for the better.Conclusion. The study noticed a positive effect of Denta balance, a spray with a probiotic for bleeding gums, and Denta balance FRESHeffect, a probiotic for fresh breath, included in the protocol of inflammatory periodontal disease and halitosis treatment.

Oral health in patients with different sites of head and neck squamous cell carcinoma is not different.

Oral health might not only act as risk factor for head and neck squamous cell carcinoma (HNSCC), but might also have a predictive value for the patients' survival. Currently, information on the effect of oral health on survival of patients with different sites of HNSCC is lacking. This single-center retrospective study aimed to compare oral health in patients with different sites of HNSCC and to analyse whether oral health is associated with survival in the different subsets of HNSCC patients. Dental records of HNSCC patients referred for dental assessment prior to radio(chemo)therapy were included. Patient-related parameters (age at time of diagnosis, sex, tobacco exposure, alcohol consumption, HPV status), treatment data (primary treatment, intent), performance status, tumor demographics (anatomical site, TNM staging), and oral health parameters (DMFT, periodontal health, teeth with/without root canal treatment and with/without periodontitis apicalis) were obtained. Oral health parameters were compared between different anatomical sites. Survival of all HNSCC patients and of individual subsets was assessed using Kaplan-Meier statistics, and the effect of tumor demographics, patient-related parameters, and oral health on survival was analysed by cox regression analyses (α = 5%). 371 patients with HNSCC (oral: n = 86, oropharyngeal: n = 174, hypopharyngeal: n = 59, laryngeal: n = 15, other: n = 37) were included. Oral health parameters did not differ between subsets (padj.≥0.199). Five-year cumulative survival of HNSCC patients amounted to 78.6%. Only for HNSCC originating in the oral cavity and oropharynx, survival was associated with the treatment intent (p = 0.015) or performance status (p = 0.007) in the multivariable analyses, respectively. Within the limitations of this study, oral health was not different between different subsets and had no significant effect on survival of HNSCC patients.

Evaluation of the Accuracy of Demirjian's Method for Dental Age Estimation in Northern Sudanese Children and Adolescents

A variety of methods have been used worldwide in dental age assessment in the living. However, since dental development varies between populations, population-specific studies are necessary. This study aimed at investigating the accuracy of age estimation using developing teeth from panoramic radiographs according to the method devised by Demirjian and colleagues in a sample of Northern Sudanese children and adolescents (2) Methods: A total sample of 917 X-Rays from patients aged between 6-16 years of age was available, but only 527 were suitable (265 boys, 272 girls). (3) Results: The mean difference between chronological and dental age for Northern Sudanese boys, ranged between (–0.389 to +0.571) while, for the Northern Sudanese girls, the mean difference ranged between (–0.056 to+0.732); (4) Conclusions: The results showed that the Demirjian's method did not accurately predict age in this Northern Sudanese population. Standards were produced to convert the maturity scores calculated by Demirjian's method to a new dental age assessment for Northern-Sudanese population