Dental Community Research Articles

Medication‐Related Osteonecrosis of the Jaw Caused by Drugs With Antiangiogenic Effects—What Should the Clinician Be Aware of and What Course of Treatment Can Be Applied? A Systematic Review of Case Series and Case Reports

ABSTRACTObjectiveThis systematic review aimed to summarise the most common drugs with antiangiogenic effects associated with MRONJ, the diseases that patients can present and discuss the appropriate course of treatment.Materials and MethodsPubMed, Web of Science, Scopus and Embase were screened for case reports up to February 2024. Two independent reviewers selected the articles in a two‐step selection, screening 1.327 articles. The final sample was composed of 32 articles.ResultsMost of the patients were male with a mean age of 58 years. Although the majority of patients had cancer, 20% were treated with drugs with antiangiogenic effects for other diseases. The lesions occurred mainly in the posterior mandible, with dental extraction associated in more than half of the cases. Antibiotic treatment was employed in most cases with amoxicillin and clavulanic acid, usually associated with 0.12% chlorhexidine or a 0.2% oral rinse. Bevacizumab was the medication most associated with the lesions (40%).ConclusionThe dental community needs to be aware of the new drugs that can cause MRONJ through antiangiogenic effects, given that new medications are being reported every day.

Diagnosis of Cowden Syndrome as an Example of Dentist-Physician Communication: Report of a Case

Background: The mouth is the mirror of the body and can manifest signs of underlying health issues. The oral soft and hard tissues are physically linked to the rest of the body. Therefore, the role of dentists is much greater than the dental setup. Many physicians consider dentistry as a purely practical occupation and not scientific. In recent years, the relationship between oral and systemic disease has become a leading research issue. Interventional studies focused on the relationship between dental treatment and its effect on certain systemic condition. In this regard, the aim of this study is to introduce a case of Cowden Syndrome (CS) which was first diagnosed according to their oral manifestations by a dentist. Case report: A 37-year-old woman was referred to the Department of Oral Medicine, Shahid Beheshti University of Medical Sciences complaining of aesthetic problems. Intra-oral examinations showed grooves and papillomatosis. Examination of the oral cavity showed a high- arched palate, hypoplasia of the maxilla and jaw. According to the patient’s oral presentation, we asked for a consultation with gastroenterologist, gynecologist and endocrinologist. Finally, based on clinical and paraclinical findings, the clinicians put the final diagnosis of CS. Discussion: According to the review of literature, less than 500 cases have been reported worldwide, many of which have been diagnosed by dental surgeons, or oral pathology and medicine specialists by recognition of mucocutaneous lesions. There is a close association of CS with the development of several malignant neoplasms. This point emphasizes the importance of the early recognition of these lesions, which facilitates an early diagnosis of CS. Oral lesions can be the first sign of the disease, because they develop in 90 to 99% of cases. The diagnosis of CS in this case was made based on criteria proposed by the International Cowden Syndrome Consortium. Conclusion: Since the patients can have a variety of clinical manifestations, the diagnosis can be mistaken and delayed. Therefore, it seems that there is a need for awareness of this entity in the dental community.

Prevalence of Gamer’s Mark on the wrists of dental students in Mumbai: A multicentric study

Repeated friction between the wrist and the mouse pad leads to the development of a lesion on the wrist of the operator known as the ‘Gamer’s mark’. In the context of the rapid development of digital technology and increased dependence of dental students and professionals on the same, the present study aimed to analyze the prevalence of Gamer’s mark among dental students in the city of Mumbai. The present cross-sectional study was on 1412 dental students in four different institutions in Mumbai using a five-point questionnaire comprising questions relevant to the characteristics of gaming history and the presence of the lesion on the wrist. The responses were recorded in an Excel sheet and subjected to data analysis. The prevalence of the lesion across the full cohort was found to be 0.5%. Of the 103 participants reporting a history of gaming, 66.99% (n=69) had the lesion on either of their hands which comprised 50 males and 19 females. There was a statistically significant difference noted (p<0.05) wherein a higher number of males (p=0.02) as well as females (p=0.04) had the lesion as compared to those that did not (p<0.05) The correlation between the duration of the Gamer’s Mark lesion and the intensity of gaming underscores the need for awareness and preventive strategies in the dental community. As dentistry continues to embrace digitalization, it is imperative to address the potential health implications associated with prolonged computer usage.

Establishing the VR-haptic thinkers group: Insights and progress in dental training technologies

In today’s fast-paced, digitalized world, dental educators and professionals alike need to try and stay up to date on current learning methods to provide the best possible education to the new generations of students. VR-haptic training allows educators to guide students in performing dental exercises within a digital environment using input methods with tactile force feedback features. This can reduce the mental burden of students due to fear of failure, as material losses are no longer a factor. Additionally, students can practice in their own time and pace, outside of teaching hours. Despite being digital, this mode of teaching has been shown to enable skill transfer to the real world, affording educators more flexibility with how to teach their students both before and during traditional methods of practical dental education. To help support the embracement of this new technology, a global VR-Haptic Thinkers Consortium was established in early 2024 and is now formed of 36 partner universities, institutions, and industrial companies. The second VR-Haptic Thinkers Meetup, held in mid-2024, was given the theme of “VR-Haptic Dentistry, Pedagogy, and Curriculum Evolution”. The theme of the meetup was timely as in recent years dental educators have all faced many challenges in education and research and have had to deal with rapid changes in supportive VR-haptic education. A robust program was featured to engage with the dental community members who are curious about the new technological advancements in dental education.

Differences in dental management depending on the dentist’s years of practice

Purpose: This study was conducted to understand the environment of dental clinics based on dental management survey data and, in particular, to analyze the management status according to the dentist’s years of practice to prepare basic data for the dentists’ year of practice gap and improvement of the dental business.Methods: We surveyed members of the Korean Dental Association on subjective difficulties in management and the rate of change in sales, operating expenses, and operating profits, and analyzed the results.Results: As a result, there were clear differences in the difficulties of dental management and sales patterns depending on the dentist's years of practice.Conclusions: At a time when dental operations are becoming more diverse, there is a need to find ways to improve through dental management research. In addition, through future research on differences between generations of dentists, it will be necessary to understand each other's positions and communicate smoothly to resolve difficulties within the dental community.

Ontology and Bruxism: Do We Have Enough Information?

The idea of classifying and defining bruxism according to ontological principles may be interesting, but currently we just do not have enough information to label in a black or white manner the many facets of bruxism. In an era in which general knowledge on bruxism by the dental communities is surely in need of improvement, efforts to clarify the road map tracked by the current panelists who drafted the definition should be appraised carefully. The recent introduction of a standardized multidimensional evaluation system (i.e., Standardized Tool for the Assessment of Bruxism [STAB]) and a screening instrument for bruxism (i.e., BruxScreen) should be viewed as the starting points to enter a new era in the discipline of bruxism, in which non-hierarchical and non-preconceived approaches are used to collect data. Artificial intelligence strategies to mine data gathered with the above instruments might help building predictive models along the etiology-status-consequences trajectory, as recently suggested in a model for awake bruxism metrics. Until then, proposals to adopt ontological principles to classify bruxism will be merely based on speculations rather than on facts.

Knowledge of Dentist of Hyderabad regarding Dental treatment of pregnant patients.

Objective: To evaluate the knowledge of dentists of Hyderabad about treatment protocols of pregnant patient.Methodology: This cross-sectional descriptive study was conducted from November 2023 to December 2023 in Hyderabad in collaboration with faculty of community dentistry, Liaquat University of Medical & Health Sciences Jamshoro. 200 dentists were contacted to participate in the study.Results: According to our study dentists revealed that antibiotic amoxicillin was used in pregnant patients were 56% penicillin 9.4% and clindamycin 23.3%. According to dentists’ knowledge safest trimester for dental treatment is 2nd trimester. Regarding restoration most of the dentist revealed that glass ionomer cement is the best for pregnant patients.Conclusion: We conclude that there is general lack of knowledge in dentist of Hyderabad regarding dental treatment of pregnant patients. Seminars, educational programs regarding dental treatment of pregnant patients should be arranged so that our dentist must update their knowledge. There is great need of adding guidelines in dental curriculum in order to reduce the risk of any mishap. Key words: KAP, Dentist problem, Pregnant ladies. Hyderabad.

GREEN DENTISTRY: A SUSTAINABLE FUTURE FOR ORAL HEALTH CARE

The dental public health profession, like many others, is becoming increasingly aware of its environmental impact and the urgent need to adopt more sustainable practices. Green dentistry, also known as eco-friendly dentistry, is a growing movement that focuses on reducing waste, conserving energy, and minimizing pollution while maintaining high standards of patient care. By integrating environmentally conscious choices into daily practices—such as using digital technologies, reducing water consumption, and choosing biodegradable or recyclable materials—dentists can significantly contribute to environmental preservation without compromising the quality of their services. One of the core tenets of green dentistry is the shift towards digital dentistry. Traditional methods of record-keeping and patient management involve a considerable amount of paper and plastic waste. By adopting digital x-rays, patient records, and appointment scheduling systems, dental practices can dramatically reduce their paper use, lower radiation exposure, and decrease the need for disposable materials. Additionally, using energy-efficient equipment and eco-friendly sterilization techniques can help reduce the carbon footprint of dental offices, aligning with global sustainability goals. As the dental community moves towards greener practices, there is an opportunity for education and advocacy in dental public health. Dental schools and professional organizations play a crucial role in promoting awareness of sustainable practices among both practitioners and patients. By fostering a culture of environmental responsibility within the field, we not only contribute to a healthier planet but also inspire the next generation of dentists to prioritize sustainability in their professional lives. Green dentistry represents a vital step towards a more sustainable future for both the profession and the world at large.

Trustworthy Artificial Intelligence in Dentistry: Learnings from the EU AI Act

Artificial intelligence systems (AISs) gain relevance in dentistry, encompassing diagnostics, treatment planning, patient management, and therapy. However, questions about the generalizability, fairness, and transparency of these systems remain. Regulatory and governance bodies worldwide are aiming to address these questions using various frameworks. On March 13, 2024, members of the European Parliament approved the Artificial Intelligence Act (AIA), which emphasizes trustworthiness and human-centeredness as relevant aspects to regulate AISs beyond safety and efficacy. This review presents the AIA and similar regulatory and governance efforts in other jurisdictions and lays out that regulations such as the AIA are part of a complex ecosystem of interdependent and interwoven legal requirements and standards. Current efforts to regulate dental AISs require active input from the dental community, with participation of dental research, education, providers, and patients being relevant to shape the future of dental AISs.

Genomic analysis of conjugative and chromosomally integrated mobile genetic elements in oral streptococci.

This study aimed to investigate the diversity of conjugative and chromosomally integrated mobile genetic elements (cciMGEs) within six oral streptococci species. cciMGEs, including integrative and conjugative elements (ICEs) and integrative and mobilizable elements (IMEs), are stably maintained on the host cell chromosome; however, under certain conditions, they are able to excise, form extrachromosomal circles, and transfer via a conjugation apparatus. Many cciMGEs encode "cargo" functions that aid survival in new niches and evolve new antimicrobial resistance or virulence properties, whereas others have been shown to influence host bacterial physiology. Here, using a workflow employing preexisting bioinformatics tools, we analyzed 551 genomes for the presence of cciMGEs across six common health- and disease-associated oral streptococci. We identified 486 cciMGEs, 173 of which were ICEs and 233 of which were IMEs. The cciMGEs were diverse in size, cargo genes, and relaxase types. We identified several novel relaxase proteins and a widespread IME carrying a small multidrug resistance transporter. Additionally, we provide evidence that several of the bioinformatically predicted cciMGEs encoded within various Streptococcus mutans strains are capable of excision and circularization, a critical step for cciMGE conjugative transfer. These findings highlight the significance and potential impact of MGEs in shaping the genetic landscape, pathogenicity, and antimicrobial resistance profiles of the oral microbiota.IMPORTANCEOral streptococci are important players in the oral microbiome, influencing both health and disease states within dental bacterial communities. Evolutionary adaptation, shaped in a major part by the horizontal transfer of genes, is essential for their survival in the oral cavity and within new environments. Conjugation is a significant driver of horizontal gene transfer; however, there is limited information regarding this process in oral bacteria. This study utilizes publicly available genome sequences to identify conjugative and chromosomally integrated mobile genetic elements (cciMGEs) across several species of oral streptococci and presents the preliminary characterization of these elements. Our findings significantly enhance our understanding of the mobile genomic landscape of oral streptococci critical for human health, with valuable insights into how cciMGEs might influence the survival and pathogenesis of these bacteria in the oral microbiome.

Evaluation of awareness, requirement, and clinical applications of guided endodontics among dental practitioners in North India – A cross-sectional study

ABSTRACT Aim: Guided endodontics (GE) represents a cutting-edge shift in dental practice, utilizing three-dimensional imaging to enhance treatment precision and safety in endodontics. Since its introduction in 2016, GE has shown promise in reducing complications by guiding dental procedures with minimal invasiveness. This study evaluates its acceptance and application among North India’s dental community, aiming to identify educational gaps and operational challenges. Methodology: An online survey, approved by ethical standards, was distributed to dental professionals in North India, collecting 265 responses on their familiarity, application, and training needs regarding GE. Results: Findings reveal a general awareness of GE among respondents, with a notable lack of specialized training. While GE’s benefits in various dental treatments were acknowledged, a significant interest in further training was expressed, underlining the necessity for enhanced educational programs. Conclusion: The research highlights a keen interest in GE among dentists, despite existing educational gaps. There is a clear call for integrating GE-focused training into dental curricula to equip practitioners with the skills needed for its effective use, potentially transforming patient care in endodontics.

A Bibliometric Analysis of the 100 Most-Cited Articles concerning Atraumatic Restorative Treatment.

The present study aimed to identify the 100 most-cited articles concerning Atraumatic Restorative Treatment (ART) through a bibliometric analysis. The search was conducted in the Web of Science database in December 2023. Scopus and Google Scholar were used to compare the number of citations. The following data were extracted from the articles: title, authors, number of citations, access type, institution, country, continent, year of publication, journal, keywords, study design, and theme. Collaborative networks were generated using the VOSviewer software. Google Trends was used to investigate the global popularity of "atraumatic restorative treatment" research. The 100 selected articles, published between 1996 and 2019, were cited 5,092 times, ranging from 21 to 239 citations. Caries Research (12%) and Community Dentistry and Oral Epidemiology (12%) published the highest number of articles. Clinical study (52%) was the most prevalent study design. The main theme addressed was restoration longevity (43%). Conventional high-viscosity glass ionomer was the most used restorative material (69%). The country with the highest number of articles was the Netherlands (33%) and Europe was the continent with most publications (38%). The Rabboud University of Nijmegen had the highest number of articles (25%). Frencken JE was the most prominent author (38%). The most common keyword was "atraumatic restorative treatment" (n=60). According to Google Trends, Tanzania was the country that searched the most about ART. The 100 most cited articles on ART were mainly composed of clinical studies focusing on the longevity of restorations and originated in Europe.

Omicron and periodontal health; a clinical exploration of gingivitis and periodontitis

Introduction: The COVID-19 pandemic has profoundly affected global health, with variants such as Omicron posing new challenges due to their increased transmissibility and potential to evade immunity. Periodontal diseases, which are highly prevalent worldwide, have been linked to various systemic conditions, including respiratory infections. Objectives: To determine how periodontal problems affect Omicron infection susceptibility, symptom severity, and outcome in individuals infected with this variety and discover oral microbiota biomarkers that indicate severe Omicron patients. Materials and Methods: To gather data, a quantitative descriptive study was instituted, utilizing a well-structured questionnaire comprising multiple-choice and Likert scale questions. The sample population, dentists in Erbil, was reached through email, followed by statistical analyses involving mean scores, standard deviations, and practices degree to interpret the data. Results: Results displayed a varied range of perceptions, with significant discrepancies highlighted through high standard deviations in specific responses, pointing to the necessity for homogenized guidelines or educational outreach. The overall mean score categorized the sentiment as ‘Medium,’ indicating a moderate level of consensus on the relationship between the Omicron variant and periodontal issues. Conclusion: This exploration unveils not only a nuanced understanding among the dentist community but also showcases domains where unanimity is deficient, calling for intensified research and educational efforts to harmonize perspectives in this pressing matter, especially amid the prevalence of the Omicron variant. The findings signify an imperative to foster aligned understandings through enhanced educational interventions in the dental community in Erbil, Kurdistan, Iraq, potentially steering towards a more cohesive approach in handling cases with pre-existing periodontal conditions amid the Omicron surge.

Awareness of Molar Incisor Hypomineralisation (MIH) and Hypomineralised Second Primary Molars (HSPMs) among Northern Italian Dentists: A Questionnaire Survey.

The purpose of this study was to assess the awareness of molar incisor hypomineralisation (MIH) and hypomineralised second primary molars (HSPMs) among dental practitioners in Northern Italy, and to gather data on the occurrence of these conditions in their paediatric patients. A cross-sectional study was conducted using a structured online questionnaire administered through Google Forms. The survey comprised 10 single-choice questions addressing the occurrence of MIH and HSPM in caries-free patients aged 6-9 years. A total of 315 dentists participated in the survey, yielding a response rate of 31.5%. The majority of respondents reported that 1-25% of their paediatric patients exhibited HSPMs. Among this group, 43.62% of respondents observed MIH in 1-25% of cases. The findings from this survey suggest a consistent perception of MIH and HSPMs among dental practitioners, aligning with known prevalence data and indicating recognition of these conditions within the dental community in Northern Italy.

Acceptance among the public of weight screening and interventions delivered by dental professionals: observational study.

The objective of this study was to explore the acceptability to the public of receiving weight screening and the offer of support to lose weight from dental teams. A cross-sectional survey was conducted with recruitment of adults from dental practices and community and hospital settings in England and the National Institute for Health and Care Research (NIHR) Be Part of Research initiative. A total of 3580 participants were recruited across 22 dental sites and the NIHR Be Part of Research initiative. Sixty percent (n = 2055/3430) of participants reported that they would be comfortable with their height and weight being measured at a dental appointment. Male participants and those of non-White race and ethnicity had significantly increased odds of accepting weight screening (odds ratio [OR]: 1.98, 95% CI: 1.66-2.36; OR: 2.07, 95% CI: 1.42-3.03). Fifty-seven percent (n = 1915/3375) of participants reported that it would be acceptable for their dental team to offer support to help with weight management. Male participants and those of non-White race and ethnicity had significantly increased odds of accepting support (OR: 1.79, 95% CI: 1.49-2.13; OR: 1.62, 95% CI: 1.11-2.37). The most accepted form of support was provision of information on local weight-management programs (n = 1989/2379, 83.6%). The public is largely receptive to receiving weight screening and the offer of weight interventions from dental teams. Feasibility studies to test the implementation of lifestyle weight interventions in dental settings are required.

Five years in the community dental service: clinicians' perspectives.

Introduction Community dentists in England treat patients classed as vulnerable. The services in which they operate have faced challenges, with these known to have affected clinicians. It is important to monitor and understand the workforce and the effect the healthcare landscape, and its changes, has on them and the service they provide.Aims To explore and describe the evolution of working conditions of community dental service (CDS) dentists in England.Materials and methods Data for a cohort of dentists working in the CDS in England between 2017 and 2022, collected via questionnaire, were statistically and thematically analysed and data compared.Results Motivation in clinicians working in the service has significantly fallen since 2017 and concerns were held over the service meeting patient need. CDS dentists have become increasingly satisfied with the care they provide, though workload and job stress increased. Satisfaction with job terms and conditions increased significantly, though job satisfaction, with high and low morale, decreased over the period of interest. Working conditions and motivation were described as deteriorating, alongside increasing satisfaction with job terms and conditions, and fewer dentists reporting low morale. Factors cited as contributing to lower job satisfaction and morale were staffing, workload and working conditions.Conclusions We suggest that despite the increased pressures on the CDS, little improvement has been made to working conditions. The working environment continues to erode for CDS dentists in England and patient service is being negatively affected. While dentists appear to have adapted to these conditions, it is imperative that attention is paid both to CDS dentists and the service and improvements made.

3D-printed Zirconia and Lithium Disilicate in Dentistry and Their Clinical Applications.

The review focuses on the progressive role of 3D-printing in dentistry, particularly emphasizing the use of zirconia-based and lithium disilicate (LS2) -based ceramic materials. Celebrated for their biocompatibility and esthetic resemblance to natural teeth, these materials have shown promising results with high success rates. Digital light processing (DLP) and stereolithography (SLA) have been noted for producing superior 3D-printed ceramic products. Despite facing challenges such as surface defects, mechanical strength limitations, and esthetic inconsistencies, active research is dedicated to refining the quality and esthetics of 3D-printed zirconia-based and LS2-based ceramics. The review acknowledges the need to mitigate the steep costs of this manufacturing form and recognizes the current shortfall in clinician and technician awareness of these advanced techniques. Addressing these issues through focused research on improving surface quality, dimensional accuracy, and mechanical properties of 3D-printed dental prostheses is crucial, as is enhancing the dental community's understanding and acceptance of this innovative technology.

Promoting Equitable Access to Language Services in Oral Health: A Report from the Field

Summary: Providing equitable, patient-centered oral health care requires the dental community to address the cultural and linguistic needs and preferences of patients and their communities. This report describes our three-part demonstration project, providing an innovative framework and interprofessional approach to enhance language access in oral health care.

Knowledge and Awareness of the orthodontic triage and its uses among dental healthcare professionals – a cross-sectional study

IntroductionIn orthodontics, the triage system is used to assess the preadolescents to rule out interventions needed earlier and to assess the nature of orthodontic problems as complex or moderate. The objective of this study was to determine the knowledge and awareness of orthodontic triage and its uses among dental healthcare professionals (DHCP).Materials and methodsA triage awareness questionnaire (TAQ) was formulated and validated as reliable by a panel of five orthodontic specialists which was then circulated online among 400 DHCP. The questionnaire consisted of nine sections that assessed the current knowledge and usage of orthodontic triage among the dental community. Frequencies and percentages were reported for all categorical variables. Chi-square was used to assess the association among the variables.ResultsThe response rate was 28.2% with the majority of participants being general dentists. Regarding the knowledge and use of triage, 40% of DHCP were only familiar with the word “orthodontic triage” while being unaware of how it works and 79% denied using orthodontic triage. Regarding the management of anomalies, 42% of DHCP preferred extraction as the management of supernumerary teeth (p = 0.013). Practitioners belonging to private setups performed visual inspection in growing patients for assessment of their facial features (p = 0.012). Clinicians with more than one year of experience referred young patients to orthodontic specialists for the management of crossbite (p = 0.024). Younger clinicians (25–35 years) with more than one year of experience referred adult patients to orthodontists for correction of their unesthetic smile (p = 0.013).ConclusionsThis paper provides foundational data for the development of future policies and protocols supporting structured, evidence-based approaches to patient management via use of orthodontic triage. This study underscores the importance of targeted educational interventions to enhance understanding and implementation of orthodontic triage principles in clinical practice. Further probing is necessary to discern the disparity between understanding the orthodontic triage and effective employment of its components among practicing dental healthcare professionals.

Trends of burning mouth syndrome: a bibliometric study.

This study utilizes bibliometric analysis to map the current research landscape and forecast emerging trends within the domain of Burning Mouth Syndrome (BMS). A comprehensive review of literature related to BMS was conducted, drawing from the Web of Science Core Collection (WoSCC) from 2008 to 2023. The analysis included both publication types "Article" and "Review Article." Advanced quantitative techniques and visual analytics tools, including CiteSpace, VOSviewer, Tableau, and the Map Equation online platform were utilized to analyze the academic publications within this domain. Our analysis incorporated 497 articles on BMS. The data exhibit a progressive increase in the annual volume of publications from 2008 to 2023. In terms of geographic and institutional contributions, the United States of America (with 80 publications) and Nihon University (with 26 publications) emerged as leading entities in BMS research, while the Netherlands and England were identified as central to international collaboration efforts. Prominent researchers in this field include Adamo Daniela (18 publications) and Sun Andy (16 publications). Furthermore, the most cited works were authored by Jääskeläinen SK. An examination of the journals in which these articles were published showed a dominance of dental journals, highlighting significant interest and research efforts in BMS within the dental research community. The steady growth in BMS research signifies the formation of a robust core of researchers and demonstrates the maturation of the field. Despite this progress, the findings highlight a notable deficiency in cross-institutional and cross-regional collaborative efforts. Keyword cluster analysis has revealed "management" as a persistently relevant theme, with "pain modulation" emerging as the current focal interest. Additionally, "blood profile," "pernicious anemia," and "folate" have been identified as prospective areas of growing interest, suggesting important directions for future investigations. This bibliometric analysis reveals the research landscape of BMS, aiming to highlight potential collaborative opportunities and define future research directions. These insights are invaluable for guiding subsequent investigations and carving new paths in the exploration of BMS.