Dental Treatment Research Articles

Mechanisms of functional asymmetry of the face formation in patients with dysfunctional condition of temporomandibular joint

Objective. To give a detailed description of clinical manifestations, diagnosis and treatment of functional asymmetry of the face in patients with dysfunctional condition of temporomandibular joint (TMJ). Materials and methods. A complete examination of 34 (25 %) patients with symptomatic facial asymmetry of the 3rd type according to H.S. Hwang classification was carried out. The group consisted of 5 males (14,71 %) and 29 females (85,29 %). Screening protocol included standard dental care, cone beam computer tomography of both jaws and TMJ, MRI of TMJ with functional load. Results. 24 patients (70.59 %) completed complex dental treatment; 10 (29.41 %) people stopped treatment for various reasons and were excluded from further study. Complete restoration of facial symmetry was achieved in 21 people (87.5 %), partial restoration in 3 (12.5 %) patients. The height of the lower facial part and the synchrony of occlusal contacts were restored in all patients. Noise in the joint area persisted in 3 (8.8 %) cases, which is associated with arthrosis in the articular heads. In patients with unreducible dislocations, the intensity of the clicks decreased, and there was no pain at the end of treatment. It should be noted that all patients of this group refused subsequent surgical treatment. Conclusion. Functional asymmetry of the face results from multifactorial impact on the human organism and is multimorbid by nature. This condition is accompanied by complicated dental pathology, such as increased hard tooth tissues attrition, functional overload with traumatic nodes formation, disturbance of muscles and TMJ functions. It requires following diagnostic and treatment algorithm under the supervision of internal medicine specialists to correct sleep, postural stability, impaired psychoneurological status.

Rebuilding the Strength of Hypomineralized Enamel – An In-Depth Systematic Literature Review

Molar Incisor Hypomineralization (MIH) is a prevalent developmental enamel defect characterized by qualitative changes in the enamel of one or more first permanent molars, often accompanied by similar defects in the incisors. This condition leads to significant dental challenges, including soft, porous enamel, which is more susceptible to damage and caries than non-MIH teeth. The affected teeth exhibit lower mineral concentration, higher porosity, and altered mechanical properties, contributing to their increased vulnerability to decay and restoration failures. Research indicates that MIH-affected teeth often require more extensive dental treatments due to compromised structural integrity. The enamel defects associated with MIH manifest as well-demarcated opacities, which can lead to hypersensitivity and aesthetic concerns for patients, particularly children. However, there is hope in the form of various remineralization strategies that have been explored to address MIH's challenges. These strategies, including recent clinical trials, have demonstrated the efficacy of remineralization agents in restoring some of the lost enamel properties, which is crucial for managing MIH effectively. This potential for restoration through remineralization strategies offers a hopeful outlook for improving patient outcomes with MIH.

Validation of the Polish version of an Ageism Scale for Dental Students (ASDS-PL).

Ageism is one of the common forms of discrimination and prejudice. It has also been shown to be present in health professionals, including doctors, nurses, and medical students. The aim of this study was to translate the Ageism Scale For Dental Students (ASDS) into Polish, perform a culture adaptation, and conduct a preliminary validation analysis. The survey was administered to 202 third-, fourth-, and fifth-year students at the Jagiellonian University (No. 1072.6120.283.2020). Data were analyzed using principal components analysis (PCA) with an oblique, Promax rotation, and confirmatory factor analysis (CFA). Cronbach's alpha (α) was calculated to check the internal consistency reliability. Discriminant validity was analyzed using the Mann-Whitney and Kruskal-Wallis test. PCA produced a 10-item scale distributed into three factors, which explains 59.52% of the total variance. Factor 1 ("preconceived notions about dental treatment") contained four items (α=0.703), Factor 2 ("cost-benefit of providing care for older patients")-four items (α=0.660) and Factor 3 ("dentist-older patient interaction")-two items (α=0.662). CFA confirmed that the model is a good fit (RMSE=0.058, 90% CI from 0.014 to 0.092, CFI=0.950, and TLI=0.926). The discriminant validity showed statistically significant differences in factors or individual items related to the year of the study, gender, and having a history of living with an older person(s) or an older patient(s) treated. The validation of the ASDS conducted in Poland identified 10 items with sufficient validity and reliability.

Research progress in the clinical application of inhaled anesthetic sevoflurane.

Sevoflurane has been widely used in clinical anesthesia as an inhalation anesthetic. With the development of medicine, there have been several new applications in recent years, such as daytime surgery, labor analgesia, and combined nerve block for some surgeries. Moreover, as research progresses, it has been found that it not only has potential organ protection effects but can also be used to treat severe asthma and relieve the tracheal spasm state. In addition, local administration can effectively treat vascular ulcers. We briefly review the organ protective effect of sevoflurane, its application in dental treatment, asthma treatment, vascular ulcer treatment and some new progress in clinical application.

Transient bradycardia during local anaesthesia to the oral cavity under intravenous sedation and its associate factors: a prospective observational study

BackgroundLocal anaesthesia in dental procedures is generally safe, although the occurrence of transient bradycardia (TB) has occasionally been reported. TB is often associated with two reflexes, the trigeminal cardiac reflex (TCR) and the vasovagal reflex (VVR) and is characterised by a rapid decrease in heart rate (HR) and blood pressure (BP). The prevalence of TCR is considered low, and its predictors have not been thoroughly investigated, although an association with the gag reflex has been suggested in recent years.MethodsThis prospective study assessed TB occurrence during local anaesthesia and its potential associated factors. A comprehensive questionnaire was used to categorise discomforts during dental treatment, and various anxiety scales were used to measure patients’ anxiety levels. We investigated HR variability during local anaesthesia administration under sedation and the association between the incidence of TB and gag reflex. Subsequently, logistic regression analysis was performed to assess factors associated with TB occurrence.ResultsThe prospective analysis included 188 patients of 234 initial patients. The analysis revealed a high TB incidence rate of 41% during local anaesthesia administration under sedation. No severe hypotensive events occurred, indicating a relatively benign nature of TB during local anaesthesia. TB occurrence was significantly higher in the group of patients with the gag reflex. Further analysis revealed that both gag reflex and trait anxiety were significantly associated with TB occurrence, whereas dental phobia did not directly correlate with TB.ConclusionThis study highlights the prominent occurrence of TB during local anaesthesia in dental treatment, which is primarily attributed to TCR activation. The identification of gag reflex and trait anxiety as independent factors associated with TB development may pave the way for TB prevention measures. Further research is required to clarify the mechanisms of TCR and perform safer dental procedures under sedation. Future studies should also aim to elucidate the precise mechanisms underlying TB during local anaesthesia through direct measurements of neural activity. A better understanding of TB in dentistry is crucial for improving patient safety and optimising dental practice protocols.

Physician-dentist dual referral model concept for coordinated bone anabolic therapy

BackgroundBone anabolic drugs used for the pharmacologic treatment of osteoporosis have the potential to enhance alveolar bone regeneration to improve implant success. There are no US Food and Drug Administration–approved drugs indicated to improve oral bone density around teeth or implants. MethodsThe authors summarized expert opinions on a novel coordinated treatment approach leveraging the effects of systemic bone anabolic drugs to enhance dental implant therapy in patients with osteoporosis and a dual referral model for physicians and dentists to address the clinical needs of patients with osteoporosis from a comprehensive perspective of oral-systemic health. Interviews of key opinion leaders were conducted with a bone health specialist group consisting of specialists in orthopedic surgery, internal medicine, geriatrics, endocrinology, and clinical densitometry and a surgical dental specialist group consisting of periodontists and oral surgeons. ResultsOverall, both groups shared positive feedback on the idea of strategically timing administration of anabolic osteoporosis drugs with dental treatment. Both groups expressed interest in the dual referral model. ConclusionsThe feedback of key opinion leaders supported the coordinated bone anabolic therapy concept and identified a need for improved interdisciplinary collaboration, education, and communication to realize the synergies of physician-dentist clinical cooperation. Practical ImplicationsStrategic timing of osteoporosis therapy could improve skeletal bone health and reduce fracture risk while offering adjunctive dental benefits.

Assessing Personality Risks profile in Prosthodontics Patients: A Delphi-Driven Classification Approach.

This paper aims to identify specific personality traits that could potentially undermine the overall satisfaction of the patient with the prosthodontic treatment. A literature review was conducted to identify the personality traits (PT) relevant to patients requiring dental treatment. Later, a Delphi process was employed to classify the selected PT into risk levels to prosthodontic treatment satisfaction, ultimately leading to the development of a personality risk profile (PRP) proposal. The expert panel consisted of specialists with over ten years of practice. The Delphi process involved three rounds of evaluation and consensus building. Twenty-six PT associated with dental treatment satisfaction were identified. Following the three rounds of the Delphi method, a consensus was achieved, resulting in the classification of these PT into three PRP, as follows: Low Risk (cooperative, understanding, compliant, trusting, concerned about their health, willing, thankful, and responsible), Moderate Risk (Insecure, Over-informed, Demanding, Appearance-obsessed, and Pessimistic), and High Risk (mistrustful, skeptical, unwilling, defiant attitude, unrealistic expectations, neglectful, treatment resistant, patient refers negatively about other dentists, violent, irresponsible, idealise the dentist, and controller). This study identified and categorized PT that have the potential to adversely impact prosthodontics treatment satisfaction. Through this PRP proposal, dental professionals can recognize these patients before initiating prosthodontic interventions.

Dental treatment of a patient with cutis laxa syndrome

Dental treatment of a patient with cutis laxa syndrome

Influence of Osteoporosis on the Course of Apical Periodontitis.

Osteoporosis is a disease characterized by disruption of the bone microarchitecture. It is observed in both sexes, but to a greater extent in women. It affects the whole body, including the jaws. The main indicator of the presence of osteoporosis accepted by the World Health Organization is bone mineral density. The aim of this article is to find data on the influence of osteoporosis on apical periodontitis, to investigate how the intake of osteoporosis drugs affects apical periodontitis, and to establish various data that may be of benefit to the dental practitioner when treating patients with osteoporosis and apical periodontitis. Open-access publications are included. The presence of osteoporosis is important to the dentist. Apical periodontitis in these patients has a faster progression. They are characterized by inflammation and destruction of the tissues located around the tooth root. Osteoporosis has a destructive effect on bone tissue through different mechanisms: nuclear factor-κβ ligand and NLRP3/Caspase-1/IL-1β cascade. It is also associated with low estrogen levels. Various medications such as corticosteroids, bisphosphonates (alendronate, zoledronate (Zoledronic acid), calcitonin, raloxifene, and strontium used to treat osteoporosis can affect the course of apical periodontitis. When treating patients with periapical lesions, the dentist must take a proper medical history and general medical history. In cases of osteoporosis or taking bisphosphonates and other medications, consideration should be given to whether consultation with a specialist is necessary, what treatment approach would be most appropriate, and what the prognosis will be. Chronic diseases affect both the general state of the body and dental health. It has been found that in patients with osteoporosis, inflammation of the apical periodontium develops with faster bone resorption. Before starting dental treatment, it is important to specify the etiology of osteoporosis, the bone density of each patient, as well as the medications they are taking.

Reduction of Dental Anxiety in Children Using Virtual Reality: A Randomised Controlled Trial.

The aim of this research is examining the effectiveness of Virtual Reality (VR) in the reduction of dental anxiety in children with novel methods. The three arm parallel-group randomised clinical study was conducted in children aged 6-10 years. Pulpotomy procedure was performed on randomised 90 selected children (n=30 in each group; AG: group applied active distraction using VR glasses, PG: group applied passive distraction, i.e., watching cartoons on a screen mounted onto a dental unit, CG: control group). Before and after the procedure, children were administered Facial Pain Scale (FIS), Children's Fear Rating Scale (CFSS-DS) and Frankl Behaviour Rating Scale (FBRS). The pulse rate was measured to check the anxiety levels of all treated children at five different time points. Statistical significance was determined as p<0.05. VR has been found to positively contribute to the performance of children in adapting to dental treatment. The VR application aims to create positive attitude in children by providing them a safe atmosphere and becoming a useful tool in the dental profession.

Exacerbating orthodontic tooth movement in mice with salt-sensitive hypertension

Background/purposeOrthodontic tooth movement (OTM) is a critical aspect of dental treatment that requires the precise control of bone remodeling processes. Hypertension (HTN) can affect the effectiveness of OTM. Salt-sensitive hypertension (SSHTN) is of particular concern due to its detrimental effects on bone health, potentially altering orthodontic outcomes. This study aimed to investigate the effects of SSHTN on OTM using a mouse model. Materials and methodsMale mice were divided into a normal and an SSHTN group. The SSHTN model was generated by administering N(ω)-nitro-l-arginine methyl ester (l-NAME) followed by a high-salt diet. The OTM was performed using a nickel-titanium (Ni-Ti) closed-coil spring, and the tooth movement was measured after 12 days. Silicone imprinting was used to estimate the OTM distance. Osteoclast activity was assessed using tartrate-resistant acid phosphatase (TRAP) staining of decalcified maxillary sections. ResultsSSHTN mice exhibited significantly increased tooth movement compared to normal mice. This enhanced movement was associated with more osteoclasts in the SSHTN group than in the control group. These findings suggest that SSHTN increases OTM levels by promoting bone resorption. ConclusionSSHTN significantly affected OTM by enhancing osteoclast activity and increasing tooth movement. These results underscore the importance of considering hypertensive conditions in orthodontic treatment planning as they may require adjustments in force application to prevent potential adverse effects.

Retrospective evaluation of dental treatment under general anesthesia

Retrospective evaluation of dental treatment under general anesthesia

Assessment of Caries-Prevalence, Unmet Dental Treatment Needs and Barriers to Care as Perceived by Parents of Private and Government Aided-School Children of Gandhinagar-An Epidemiological Study

Assessment of Caries-Prevalence, Unmet Dental Treatment Needs and Barriers to Care as Perceived by Parents of Private and Government Aided-School Children of Gandhinagar-An Epidemiological Study

Association of oral hypofunction with aspiration pneumonia, fractures, and mortality in older Japanese adults.

In Japan's public health system, dentists can assess and intervene in oral hypofunction cases. However, the associations between oral hypofunction and health outcomes and costs remain unclear. This study aimed to identify these associations. This retrospective cohort study using a Japanese health insurance claims database included 45 916 individuals aged ≥65 years who underwent dental examinations for oral hypofunction. The primary outcomes were incidence rates of aspiration pneumonia, femoral or vertebral fractures and all-cause mortality. Secondary outcomes were annual medical and dental costs. We used competing risk regression and Cox models to estimate primary outcomes, and gamma regression models for secondary outcomes. The adjusted hazard ratios were 0.84 (95% CI 0.74-0.96) for the incidence of aspiration pneumonia, 1.11 (1.02-1.21) for the incidence of femoral or vertebral fractures and 1.27 (1.07-1.50) for all-cause mortality in individuals with oral hypofunction compared with those without. The adjusted relative risk was 1.05 (1.01-1.10) for annual medical costs and 0.94 (0.81-1.09) for annual dental costs in individuals with oral hypofunction compared with those without. Individuals with oral hypofunction were at increased risk of femoral or vertebral fractures and all-cause mortality, and they incurred significantly higher annual medical costs, compared with those without this condition. Notably, they showed a lower risk of aspiration pneumonia, suggesting potential benefits of dental intervention. Integrating dental care into medical strategies might be necessary to improve health outcomes and reduce healthcare costs for those with oral hypofunction. Geriatr Gerontol Int 2024; 24: 1053-1059.

A Retrospective Evaluation of Patients Who Had Den¬tal Treatments Under General Anesthesia

Aim: This retrospective study aimed to evaluate the demographic and operational data of uncooperative healthy individuals and individuals with special needs who underwent dental treatments under sedation and general anesthesia. Methods: Data of 458 patients with special needs and 77 healthy noncooperative patients who were examined at XXX University Faculty of Dentistry between January 2022 and May 2023 and underwent dental treatments under general anesthesia were examined retrospectively. Demographic data of the patients, American Society of Anesthesiologists (ASA) scores, mallampati (MP) scores, disability status, if they have systemic diseases, type of anesthesia (sedation/general anesthesia), anesthetic agents and analgesia used, operation duration and dental treatments, were evaluated. Results: The average age of 535 patients who received dental treatment was 13.5±9.9 years and 58.1% (n=311) of the patients were male and 41.9% (n=224) were female. According to ASA scores, the distribution was 15.7% ASA I, 77.6% ASA II, and 6.7% ASA III. While 14.4% of the patients were systemically healthy, 16.7% had epilepsy, 12.9% had cerebral palsy, 12.1% had mental retardation, and 7.1% had Down syndrome. Of 7.1% had various comorbidities such as cardiological problems. Sedation was applied to 7.3% (n=39) of the patients, and general anesthesia was applied to 92.7% (n=496). The average anesthesia duration was 74.5±34.6 minutes. While the average restorative treatment applied to the patients was calculated as 6.45±3.9, tooth extraction 5.25±4.3, fissure sealant 2.44±2.5, pulp treatment 1.62±0.9; Trauma splint was applied to 3 patients. Conclusions: While pre-anesthesia evaluation is very important in determining the risks in dental general anesthesia and sedation applications, the operating conditions and the general and oral health of the patients are effective in the dental treatment decision.

Study on Experiences with and Awareness of Swallowing Accidents during Dental Treatments among Domestic Dental Professionals

Objective: This study examined the causes of swallowing accidents experienced by dental professionals during dental treatment. In addition, an attempt was made to understand the awareness of swallowing accidents and identify factors influencing swallowing accident experiences. Methods: An online survey was conducted among 390 dental healthcare professionals to assess their experiences and perceptions of swallowing accidents. Quantitative analysis was performed on the collected data using statistical software. Frequency analysis, analysis of variance (ANOVA), and t-tests were used as analysis methods. Results: Swallowing accidents were prevalent among dental healthcare professionals (63.3%) and occurred most frequently in patients aged 41 to 60 years, with a higher incidence in men. Common foreign objects, including prostheses and extracted teeth, typically pass through the upper gastrointestinal tract. No significant difference was reported between the occupation and experience of dental workers and their perception of swallowing accidents. These findings indicate that awareness of the risk of swallowing accidents is not related to occupation or work experience. Conclusions: The substances and types of treatments that cause swallowing accidents vary. Therefore, the prevention of swallowing accidents occurring during dental treatment is important. In addition, increasing the awareness and education is necessary.

Modified Oral Health Assessment Tool (M-OHAT) for Residential Aged Care: A Co-Design Protocol

Background: Older adults in residential aged care facilities (RACFs) experience disproportionate levels of poor oral health relative to other groups in the general population, affecting their physical and mental wellbeing. The Oral Health Assessment Tool (OHAT) is a validated and widely used dental assessment tool; however, recent systematic reviews have identified shortcomings with respect to its measurement properties. Objective: The objective of this protocol is to provide a detailed overview of a multidisciplinary qualitative study that aims to (a) co-design and develop a modified OHAT for RACFs and (b) inform the development of an OHAT training package and implementation strategies. Methods: This study will utilize a co-design methodology with aged care residents, caregivers, staff members, and health professionals. The co-design workshops will: (1) investigate the barriers to and enablers of optimal oral healthcare in RACFs; and (2) co-design a modified version of the Oral Health Assessment Tool and a referral to treatment pathway that is appropriate for use in RACFs. The co-design workshops will facilitate group discussion and involve interactive activities using, for example, mind mapping and Sticky Notes. Qualitative data (transcripts and artefacts from co-design activities) will be analyzed in NVivo using an inductive codebook thematic analysis, specifically a template analysis. Conclusion: The findings of this study will inform a modified OHAT (M-OHAT), as well as future study phases regarding training and implementation strategies. It is expected that the M-OHAT will have enhanced usability and relevance to RACFs, facilitating the identification of poor oral health and timely referral to dental treatment.

Comparing the effectiveness of educational videos and booklets in enhancing knowledge about odontogenic infections and awareness about seeking dental treatment

Objective: Odontogenic infections are common but often disregarded due to a lack of awareness and knowledge about oral health. Effective health promotion through educational media can enhance understanding and encourage better oral hygiene practices. This study at Universitas Airlangga Academic Dental Hospital is conducted using visual and audiovisual media to educate patients, aiming to assess the efficacy of these media in increasing knowledge and awareness about odontogenic infections, ultimately promoting dental treatment-seeking behaviour. Material and Methods: One hundred eighty-two participants from the Universitas Airlangga Academic Dental Hospital completed the questionnaires to assess knowledge and awareness score increase using either videos or booklets. Results: The statistical test results using the non-parametric Wilcoxon test indicate that both methods influenced the knowledge and awareness scores. The Mann-Whitney test showed P=0.000, which means that the post-test scores of both methods were significantly different. Regarding N gain analysis, the increase in knowledge and awareness was higher when using booklets, with average scores of 2.5585 and 1.7457, compared to using videos, which resulted in increases of 0.3680 and 0.1683, respectively. Conclusion: Booklets were more effective than videos in increasing knowledge about odontogenic infections and awareness of seeking dental treatment.

Analyzing the Educational Needs of Dental Hygiene Students Using the Borich Needs Assessment and Locus for Focus Models

Objective: This study aimed to develop a standard for a practice-based curriculum that reflects the needs of dental hygiene students’ clinical practice education and to provide basic data that can contribute to improving dental hygienists’ competence in clinical practice. Methods: A survey of 132 dental hygiene students from selected universities was conducted. The Borich Needs Assessment model and The Locus for Focus models were used to evaluate the students’ educational needs for clinical practice content. Results: The highest level of present educational needs was for ‘fluoride application,’ while the greatest requirement was for ‘preparing surgical dental treatment’. Using The Locus for Focus model, 33 items in the first quadrant were identified as common to the Borich Needs Assessment priorities. These items include ‘dental insurance claims’, ‘patient reception’, ‘dental materials counseling’, ‘making a temporary crown’, ‘setting a temporary crown’, ‘document management’ and ‘prepare of dental emergencies’. Conclusions: The analysis of the clinical practice needs of dental hygiene students identified the needs for practice-oriented education. These findings suggest that future curriculum revisions should reflect not only the needs of students, but also the perspectives of educators and clinical dental hygienists.

Оптимизация стоматологического лечения пациентов с гемофилией

This work discusses the tactics of dental treatment of patients with hemophilia. Hemophilia is an inherited disease caused by a blood clotting disorder (factor VIII or IX deficiency). Patients with hemophilia represent a special category of patients, as they have an increased risk of bleeding from the oral mucosa. The purpose of the study was to review information on dental manifestations of hemophilia, determine the optimal algorithm and procedure for providing dental care to patients with this diagnosis. For this purpose, a search was carried out in the PubMed, Cyberleninka, eLIBRARY databases. Dental manipulations are carried out according to generally accepted methods with caution regarding injury to the mucous membrane. During treatment, it is necessary to use hemostatic agents additionally.