Dentistry Research Articles

Unintentionally Retained Elevator Blade Left for 8 Years Causes Mild Chronic Pain.

Fracture of surgical instruments in dental practice is not usually reported in the literature. Management involves searching for and retrieving the fragment to avoid issues such as infection, swallowing, or aspiration. Although foreign bodies may not cause symptoms for years, some can cause chronic pain. The authors describe herein the unusual case of an unintentionally retained broken elevator blade left for 8 years before being found during an orthodontic evaluation. Panoramic radiography revealed a foreign body in the alveolar bone of the right mandibular third molar that was causing mild chronic pain. The patient was unaware whether routine radiographic examination had revealed its presence. Cone-beam computer tomography was performed to identify the position of the blade fragment, and surgery was performed to retrieve it. The mild chronic pain disappeared after removal. It is advisable to use high-quality surgical instruments and to perform routine checkups before and after surgery.

COVID-19 pandemic: mental health (distress as depression) in orthodontists

ABSTRACT Objectives For health professionals, pandemic conditions impacted all societal aspects, including economic, wellness, and mental health. This study analysed sociodemographic factors, post-traumatic stress disorder symptoms (PTSD), and depression levels caused by the coronavirus disease 2019 (COVID-19) pandemic in orthodontists. Materials and Methods A sociodemographic questionnaire, the Impact of Event Scale (IES), and the Patient Health Questionnaire (PHQ-9) were used. Following data collection, multiple statistical analyses were applied: scores were compared using the Mann-Whitney and Kruskal-Wallis tests, followed by Dunnett's multiple comparisons. The association between variables was verified using Chi-square or likelihood ratio tests. Multiple logistic regression models were estimated after bivariate logistic regression tests (p < 0.10). The final models using the Stepwise backward selection method were assessed for variables at 5%. Results Of the respondents, 69.3% were women, and their mental health questionnaire scores were significantly higher (p < 0.001). The IES avoidance and PHQ-9 scores were statistically different between the age groups (p = 0.040 and p < 0.001, respectively). Subjective distress was associated with years of practice, monthly income, fear of contracting COVID-19 during dental care, transmitting COVID-19 to patients, and thinking about the future (p < 0.05). Depression was significantly associated with orthodontic practice type, self-confidence in providing dental care, pandemic impact on dental practice, remote care, monthly income, changes in financial expenses, fear of contracting COVID-19 and thinking about the future (p < 0.05). Conclusion Over half of the orthodontists experienced moderate-to-severe mental distress, and the same number suffered from mild-to-severe depression during the pandemic. Registration: Ethics and Research Committee (CEP) of the Faculty of Dentistry of the University of São Paulo (FOUSP): CAAE: 34223720.1.0000.0075 Protocol: 4.191.353

Research on the Application of Additive Manufacturing Technology in the Digital Field of Oral Medicine

In recent years, additive manufacturing technology has developed rapidly in oral healthcare. Especially in the application of preoperative models, navigationtemplates, denture and orthodontic device manufacturing, the accuracy of surgery has been improved, treatment time has been shortened, and good restoration effects have been achieved. Oral medicine is considered one of the most promising fields for future additive manufacturing technology, and its application in oral medicine will become an inevitable trend.

Validity of the Oral Hygiene Ability Instrument (OHAI).

To evaluate the validity of the newly developed Oral Hygiene Ability Instrument (OHAI), created to assess the cause of any inability of older adults to perform oral hygiene, and to revise the instrument based on the results. Good oral hygiene is among the most important prophylactic measures for oral health. This applies especially to older adults, among whom risk factors and physical and cognitive barriers are more common and can hamper oral hygiene. The OHAI contains (I) an interview, (II) clinical examination, (III) observation of oral hygiene activities and a summarising part. In the study, 149 older adults in three groups participated: stroke, cognitive disorder and general dental patients. Inclusion criteria were to be ≥65 years old, have at least one tooth and to manage oral hygiene without assistance. For criterion validity, sensitivity and specificity were calculated using eight reference instruments. To determine construct validity, we used known group validity, factor analysis and Rasch analysis. The criterion and construct validity of the OHAI were found to be acceptable to good. In the stroke group, balance and fine motor skills were assessed to affect oral hygiene most; in the cognitive disorder group, it was balance, coordination, spatial ability and cognitive functions. Analyses revealed that one item had no added value and that some response options were not optimal. The OHAI proved to be valid for the group it is intended for, with only minor revisions needed, resulting in a 32-item instrument. The OHAI could be a valuable person-centred tool in prophylactic work with older adults with failing oral hygiene.

Use of the Water flosser to control dental biofilm: An integrative literature review

Water flosser oral irrigators have been used as a means to control oral biofilm, but there are still doubts as to the indication and effectiveness of these devices as a single or adjuvant means for oral hygiene. Thus, the present study aimed to perform an integrative literature review in the databases to investigate the importance of Water Flosser in the disintegration of dental biofilm and its best indication of clinical use. We defined the sample selection considering a period of 15 years prior to September 2023, accessing online databases such as Periódicos da Capes, SciElo, Web of Science, SCOPUS and PubMed. We used terms related to the literature, such as "Water Flosser", "Oral Irrigator", "Water Flosser and Biofilm", "Biofilm", "Mechanical Control of Biofilm" and "Gingivitis and Water Flosser". The most recent studies have shown beneficial results in controlling inflammation and biofilm comparable to brushing and flossing techniques. However, the results should be carefully analyzed, as these studies were published by only one group of researchers and a conflict of interest was found. On the other hand, these devices can improve the patient's interest in biofilm control, improving their compliance and consequently the maintenance of oral health.

Comparison between patients rehabilitated with full-arch fixed implant-supported prostheses and complete denture regarding well-being, self-esteem and quality of life

Objective: To evaluate and compare satisfaction and OHRQoL in patients using complete dentures or full-arch fixed implant-supported prostheses. Material and Methods: 200 patients were divided into two groups: 1) Test group (TG): patients rehabilitated with lower full-arch fixed implant-supported prosthesis; and 2) Control group - (CG): patients using complete dentures. Patients had Oral Health-related Quality of Life (OHRQoL) assessed through 4 validated questionnaires: 1) Oral Health Impact Profile (OHIP-14); 2) Rosenberg Self-Esteem Scale (RSS); 3) Orthognathic Quality of Life Questionnaire (OQLQ); and 4) Short Form Health Survey (SF-8). Statistical analysis was done by using the Wilcoxon test, considering a level of significance of 5%. Results: The results demonstrated that the TG presented better results (p&lt;0.001) than the CG in relation to OHIP-14 (9.0±2.36 and 21.0+3.17, respectively), including functional limitation, physical pain, physical and psychological disability, and social and physical disability. Moreover, TG presents better outcomes than CG for RSS (35.0+2.31 and 31.0+2.31, respectively) and OQLQ (16.0+3.19 and 27.5+3.22, respectively), but without difference (p = 0.79) for SF-8 (83.1+6.64 and 83.1+8.16, respectively). Conclusion: Patients with lower full-arch fixed implant-supported prostheses, compared to patients using complete dentures, present a better perception regarding their general well-being, higher self-esteem and quality of life.

Predoctoral US dental school applicants and first-time, first-year enrollees, 2023 Entering Class.

This article aims to provide an overview of the characteristics of applicants and first-time, first-year enrolled predoctoral oral health students in the 2023 Entering Class, while highlighting trends over the past decade. The study employs a descriptive analysis of predoctoral US dental school application data sourced from the ADEA Associated American Dental Schools Application Service (ADEA AADSAS®) and Texas Medical and Dental Schools Application Services (TMDSAS) portals. Between 2013 and 2023, the number of first-time, first-year enrollees increased by 14%. Applicant numbers rebounded post-COVID pandemic and were 0.5% higher in 2023 compared to 2019. The proportion of female predoctoral applicants and first-time, first-year enrollees each increased by 11 percentage points over the last decade. Racial and ethnic diversity among first-time, first-year enrollees improved, particularly among Hispanic or Latino and Black or African American students, with both groups increasing by 51% between 2013 and 2023. There has been a steady increase in first-time, first-year enrollees, reflecting growth in the number of US-trained predoctoral oral health professionals. Applicant numbers have rebounded from the impact of COVID-19 pandemic. The increase in the share of female dental school applicants and first-time, first-year enrollees has brought the gender distribution in predoctoral oral health programs more closely in line with that of postsecondary education. While progress has been made in terms of increased representation of historically underrepresented racial and ethnic (HURE) groups, much work remains to achieve greater representation.

Systemic Statin Use and Pulp Chamber Calcification: A Pilot Retrospective Case Control Study Using Cone-Beam Computed Tomography.

This pilot retrospective case-control study questioned whether systemic statin use causes pulp calcification using cone-beam computed tomography images from the patients prescribed oral statins and comparing those of healthy individuals. CBCT scans of 54 patients, including 27 age- and sex-matched patients for the study and control groups, were analysed using Mimics Innovation Suite software. The study included patients using statins regularly for at least 1 year. Only intact teeth with opposing teeth were selected for the study group and matched with the control group. Dental crown and pulp chamber volumes were calculated and proportioned. The data were analysed with chi-square and Shapiro-Wilk tests to assess normal distribution, followed by Mann-Whitney U test if necessary. Statistical analysis showed no difference between the study and control groups (p = 0.505). Statin use duration did not cause statistically significant difference in terms of the reduction of pulp chamber volume (p = 0.141). Within the limitations of the study, systemic statin use did not cause dental pulp calcification. The results suggest, oral administration of the statin drugs is not an unfavourable condition for dental practice. Further studies with larger numbers of patients are needed to support this conclusion.

Effectiveness of behavioural therapy and inhalational sedation in reducing dental anxiety among patients attending dental clinics - a systematic review and meta-analysis

Effectiveness of behavioural therapy and inhalational sedation in reducing dental anxiety among patients attending dental clinics - a systematic review and meta-analysis

Pediatric pharmacogenetics: profiling CYP2C8 polymorphisms at King Abdulaziz University Dental Clinic.

Ibuprofen, a widely used non-steroidal anti-inflammatory (NSAID) for managing pain and inflammation in pediatric patients, is metabolized by the CYP2C8 enzyme. Studies suggest that the CYP2C8*2, *3, and *4 variations of the CYP2C8 gene diminish ibuprofen metabolism, increasing the risk of adverse reactions. The aim of this study was to determine the frequency of the CYP2C8*2, *3, and *4 alleles and genotypes in a pediatric population attending the King Abdulaziz University dental clinic and compare our findings to those of other populations. A cross-sectional study was conducted with 140 healthy Saudi children ages 6-12. Saliva samples were collected using Oragene™ DNA Sample Collection Kits and analyzed for polymorphisms using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The study identified that CYP2C8*2 AA, AT, and TT genotypes occurred at frequencies of 87.86 %, 9.29 %, and 2.86 %, respectively. For CYP2C8*3, AA, AG, and GG genotypes were found in 87.14 , 8.75, and 4.29 % of subjects, respectively. The CYP2C8*4 allele was less frequent, with CC and CG genotypes at 97.86 % and 2.14 %, respectively, and the GG genotype was absent. Allele frequencies for CYP2C8*2, *3, and *4 were 7.5 %, 8.57 %, and 1.07 %, respectively. Our findings reveal that the allelic frequencies for the CYP2C8 polymorphisms in the Saudi pediatric cohort are substantially elevated compared to those reported in other Asian populations. This suggests Saudis may experience more varied drug responses, especially for medications that undergo metabolism by the CYP2C8 enzyme, like ibuprofen.

Prevalence of Prescribing Macrolides and Aminoglycosides Among Dentists in Aden, Yemen. A cross-sectional Survey

This study assessed the understanding of dentists regarding the appropriate prescription of aminoglycosides and macrolides in Aden, Yemen. We carried out a cross-sectional study, enlisting a total of 150 licensed dentists from both public and commercial dental clinics. The data was gathered throughout the period of October to December 2023. Out of the 150 participants, 57% were men, and 47% had less than 5 years of experience. According to the poll, a large majority of dentists, 72%, use macrolides on a regular basis in their practice. In addition, azithromycin was the most commonly prescribed macrolide, accounting for 18% of total prescriptions. By comparison, aminoglycosides account for only 21% of all prescriptions, and neomycin is quite rare. 13% of persons with penicillin allergies were administered streptomycin, underscoring the necessity for safer alternatives. Dentists typically follow the prescribed time frame of 3-5 days to ensure the appropriate administration of macrolides. The findings indicated that individuals should get instruction on the proper utilization of aminoglycosides and macrolides, be provided with comprehensive information to enable them to make well-informed decisions on their treatment alternatives, and be obligated to adhere to guidelines grounded in empirical evidence from real-life scenarios. Effective antibiotic stewardship practices in Yemeni dentistry require collaboration among dentists, microbiologists, and public health officials. It is recommended to undertake additional research to expand the study's scope and include observational studies and interviews with dentists.

Oral health status, self-perceptions, and risk awareness among young adult users of electronic cigarettes in Pakistan.

The use of electronic cigarettes (ECs) has surged globally, particularly among young individuals. This study aimed to assess the perceptions of vaping-related oral health risks, clinical oral health status, and self-perceived dental and periodontal conditions among young adult users of ECs in Pakistan. A cross-sectional study was conducted from June 2023 to March 2024, recruiting 142 young users of ECs. Intraoral examinations assessed Decayed, Missing, and Filled Teeth (DMFT) index, Oral Hygiene Index Simplified (OHI-S), Gingival Bleeding Index (GBI), Plaque Index (PI), and dental stain. Data on sociodemographic characteristics, oral health behaviors, vaping habits, and perceptions of impact of vaping on oral health were gathered through a self-administered questionnaire. Associations between EC use and various oral health variables were analyzed using the chi-squared and Fisher's exact tests. Mean DMFT was 5.66 (SD=2.20). Poor oral hygiene (29.6%) and severe dental staining were prevalent. Most participants (76.1%) brushed once daily, while only 34.5% attended regular dental check-ups. Gingival bleeding and plaque accumulation were observed in 47.2% and 35.3% of participants. Around 66% reported daily EC use, with 80.3% initiating vaping before the age of 18 years. Most common reason for vaping was perception that ECs are safer than traditional smoking (31.7%). Participants' perceptions of vaping-related oral health risks were relatively low, with 45% associating vaping with tooth decay, 48% with gum disease, and 58.5% with tooth staining. Tooth brushing frequency, vaping frequency (per day), and time since vaping started, were significantly associated with oral clinical indicators (p<0.05). The education level was the only variable significantly associated with vaping-related risk perception (p<0.05). The study reveals that oral health awareness among young vapers is low, with many starting EC use at a young age and exhibiting poor oral health behaviors. Misconceptions about the safety of ECs compared to conventional cigarettes may contribute to increased vaping.

Odontogenic Infections: Management in Ambulatory Care Settings for Nurse Practitioners

Dental insurance and access to care need substantial improvement in the United States, given their current inadequacies that contribute to suboptimal oral and physical health outcomes and escalate national health care expenditures. The disparities in access to dental care exacerbate oral health disparities across socioeconomic lines. With their broad reach and comprehensive approach to health care, nurse practitioners are uniquely positioned to play a pivotal role in enhancing oral health outcomes. They can effectively integrate preventive measures and early intervention strategies for conditions such as odontogenic infections, thereby reducing emergency department visits and improving overall patient health. This clinical feature critically examines evidence-based practices for the presentation, diagnosis, and management of odontogenic infections within primary care settings. Disseminating this knowledge aims to empower nurse practitioners to deliver timely and effective care, ultimately fostering more significant equity and accessibility in dental health services nationwide.

The critical intersection of mental health and oral health in severe mental disorders.

To highlight the critical need for integrated healthcare approaches for individuals with severe mental disorders and poor oral health. Review and discussion of factors contributing to elevated DMFT (decayed, missing, and filled primary teeth) indices in individuals with severe mental disorders. Higher DMFT indices are reported in individuals with schizophrenia and bipolar disorder due to medication side effects, cognitive impairments, and socio-economic challenges. Emphasis on the necessity of combining mental and dental health services through regular dental check-ups, specialized education programs, and professional collaboration. Integrated healthcare strategies are essential to improve overall patient care and well-being for those with severe mental disorders.

Nanoemulsion and nanoemulgel-based carriers as advanced delivery tools for the treatment of oral diseases.

Oral diseases rank among the most widespread ailments worldwide posing significant global health and economic challenges affecting around 3.5billion people, impacting the quality of life for affected individuals. Dental caries, periodontal disease, bacterial and fungal infections, tooth loss and oral malignancies are among the most prevalent global clinical disorders contributing to oral health burden. Traditional treatments for oral diseases often face challenges such as poor drug bioavailability, breakdown of medication in saliva, inconsistent antibiotic levels at the site of periodontal infection as well as higher side effects. However, the emergence of nanoemulgel (NEG) as an innovative drug delivery system offers promising solutions where NEG combines the advantages of both nanoemulsions (NEs) and hydrogels providing improved drug solubility, stability, and targeted delivery. Due to their minuscule size and ability to control drug release, NEGs hold promise for improving treatment of oral diseases, where versatility of these delivery systems makes them suitable for various applications, including topical delivery in dentistry. This review concisely outlines the anatomy of the oral environment and investigates the therapeutic potential of NE-based gels in oral disorder treatment. It thoroughly examines the challenges of drug delivery in the oral cavity and proposes strategies to improve therapeutic efficacy, drawing attention to previous research reports for comparison. Through comprehensive analysis, the review highlights the promising role of NEGs as a novel therapeutic approach for oral health management via research advancements and their clinical translation. Additionally, it provides valuable insights into future research directions and development opportunities in this area.

Oral health and the next pandemic: A call to action

Oral health and the next pandemic: A call to action

English

Introduction: Addressing the health problems of prison inmates is a major challenge for public administrations, which are responsible for guaranteeing the necessary services to deal with them. It is therefore essential to know which are the chronic pathologies that affect them most frequently, what impact they have on the oral cavity and what type of treatments are required. The aim of this study is to shed further light on these questions. Material and method: Articles in PubMed on chronic and oral pathologies and treatment needs were reviewed. Results: The most prevalent chronic pathologies are heart disease, chronic respiratory disease, diabetes and cancer. Anxiety and depression are also highly prevalent among the prison population, along with the consumption of tobacco, alcohol and drugs of abuse. They are responsible for the appearance of caries and periodontal diseases, the treatment of which should be carried out in the prison environment. Conclusions: The level of dental care among the prison population is very low. Therefore, it is necessary to implement preventive and therapeutic measures among inmates to improve their oral health and, consequently, their general health.

Perspectives from program directors on the selection process for Saudi periodontics residency programs: a cross-sectional study.

Applying to periodontics programs in Saudi Arabia holds significant importance for both applicants and periodontics program directors. As of today, there has been no investigation into how periodontics program directors (PDs) identify and select potential candidates for their programs. The aim of this study is to assess the factors taken into consideration during the selection process for periodontics programs by PDs in Saudi Arabia. In this cross-sectional study, an electronic survey was sent out to Periodontics PDs of the Saudi Commission for Health Specialties (SCFHS) in Saudi Arabia. Variables of interest included the Grade Point Average (GPA), Saudi Dental License Exam (SDLE), research, interview, service and electives, letter of recommendation, and other miscellaneous factors. A degree of importance scale was used to measure the significance of each factor for PDs. This study surveyed 16 PDs with a response rate of 72.7%. The majority of PDs were from the Central and Western Regions. Approximately 56% of the PDs were affiliated with universities. The study identified, from the perspective of PDs, that the most important factors were the reputation and performance of the applicant during clinics or interactions with staff, followed by general research experience. Additionally, interview performance was rated equally with SDLE score and GPA, as well as factors such as undertaking periodontics elective rotations during internship and working in the same department. Regardless of the region or number of years of experience, all PDs considered the most significant factor to be the reputation and performance of the applicant during clinics or interactions with staff. This study sheds light on the factors perceived by program directors in Saudi Arabia that influence the selection process for applicants to periodontics programs. By understanding these factors, dental graduate students can better customize their applications and experiences to meet the expectations of admission committees.

Exploring Dentists’ Preferences in Selecting Adhesive Systems: A Survey Analysis

Dental adhesives play a crucial role in modern dentistry by enabling the bonding of diverse restorative materials to tooth surfaces. These systems have evolved through seven generations, each characterized by unique chemical compositions and application techniques. The advancements in dental adhesives have significantly impacted restorative dentistry by preserving tooth structure, enhancing aesthetics, and ultimately improving patient outcomes and treatment options. The choice of adhesive system depends on various factors, including the clinical scenario, material compatibility, and dentist preference. Ongoing advancements in adhesive technology continue to enhance treatment outcomes and streamline procedures for dental practitioners. The development of universal adhesives capable of functioning in both etch-and-rinse and self-etch modes has further simplified clinical protocols. This study is an observational cross-sectional study conducted among Romanian dentists. A questionnaire was distributed via email to Romanian dentists, encompassing seven questions that explored the predominant use of etch-and-rinse or self-etch adhesive systems, preferred adhesive types, and commonly encountered challenges in direct restorations. Statistical analyses were conducted using DATAtab version (2024). The study highlighted the varying preferences among Romanian dentists in selecting suitable adhesive agents. Etch-and-rinse (ER) techniques predominated in direct restorations, with universal adhesives being the most frequently used. Further investigation is warranted to delve into the preferences of Romanian dentists regarding the utilization of self-etch (SE), etch-and-rinse (ER), and universal adhesives (UAs).

Assessing the Effect of Toothpastes on Enamel Surface Roughness Using a Custom-Designed and Fabricated Toothbrush Simulator Device for Evaluation.

The primary objective of this study is to emphasize the importance of maintaining optimal oral health through regular toothbrushing practices. To achieve this objective, a custom-designed electromechanical toothbrush simulator device was developed. This innovative tool enables researchers to investigate the impact of abrasive-based whitening toothpastes on enamel surface roughness compared to brushing without toothpaste. The device design is composed of multiple systems, including mechanical, motorization, and toothpaste irrigation components. The device incorporates various components, including mechanical, motorization, and toothpaste irrigation systems. Specifically, the mechanical aspect comprises fabricated metal parts, 3D printed elements, and a load cell for measuring brushing force. The motorization section integrates a microcontroller and a stepper motor, allowing for the adjustment of brushing cycles and speed. Furthermore, the toothpaste irrigation system employs a pump with adjustable speed, along with a toothpaste canister and a waste receptacle. By providing a controlled environment for evaluating the effects of different toothpaste formulations on enamel integrity, this simulator device contributes significantly to advancements in oral care research and product development.