Principles Of Dentistry Research Articles

Interdisciplinary Delphi study by PROSEC North America: Recommendations on single indirect restorations made from ceramic and nonmetallic biomaterials for posterior teeth.

This article puts forward consensus recommendations from PROSEC North America regarding single indirect restorations made from ceramic and nonmetallic biomaterials in posterior teeth. The consensus process involved a multidisciplinary panel and three consensus workshops. A systematic literature review was conducted across five databases to gather evidence. The recommendations, informed by findings from systematic reviews and formulated based on a two-phase e-Delphi survey, emphasize a comprehensive treatment strategy that includes noninvasive measures alongside restorative interventions for managing dental caries and tooth wear. The recommendations advocate for selecting between direct and indirect restorations on a case-by-case basis, favoring inlays and onlays over crowns to align with minimally invasive dentistry principles. The recommendations highlight the critical role of selecting restorative biomaterials based on clinical performance, esthetic properties, and adherence to manufacturer guidelines. They emphasize the importance of precision in restorative procedures, including tooth preparation, impression taking, contamination control, and luting. Regular follow-up and maintenance tailored to individual patient needs are crucial for the longevity of ceramic and nonmetallic restorations. These PROSEC recommendations provide a framework for dental practitioners to deliver high-quality restorative care, advocating for personalized treatment planning and minimally invasive approaches to optimize oral health outcomes. The PROSEC North America recommendations highlight the importance of minimally invasive techniques in posterior tooth restorations using ceramic and non-metallic biomaterials. These principles prioritize tooth structure conservation and personalized treatment planning, essential for enhancing clinical outcomes and long-term oral health.

Knowledge of and Attitude Toward Preventive Care Among Iraqi Dentists and Senior Dental Students: A Cross-Sectional Study.

Acquiring knowledge and maintaining a positive mindset are essential for dental care providers to offer optimal dental services. Dental professionals are expected to follow preventive dentistry principles to ensure the best oral health maintenance for their patients, as prevention is a key component of public health initiatives. This study aims to assess the knowledge and attitudes toward preventive dental care among Iraqi dentists and senior dental students. A cross-sectional study, conducted from June to August 2023, involved 876 Iraqi dentists and 587 senior dental students in Baghdad, utilizing a physically paper-based self-administered questionnaire. Participants' level of knowledge was assessed based on a 5-point Likert scale to 12 statements on preventive dental care. Their attitudes were inquired by selecting one option from a 7-point Likert scale on four pairs of bipolar adjectives describing preventive dentistry. Higher scores were considered more accurate knowledge and more positive attitudes. Statistical evaluation included the Chi-square test and regression analysis. In total, data from 841 dentists and 567 students were analyzed (response rate: 96%). Around 90% of dentists (N=745) and students (N=502) acknowledged the impact of sugar, sealant, and water fluoridation on dental caries, but about 80% of dentists (N=662) and students (N=446)undervalued the role of fluoridated toothpaste. Women (OR=1.4, 95% CI: 1.02-2.1) and dentists, within one year of their graduation (OR=1.9, 95% CI: 1.1-3.5), exhibited higher levels of knowledge. More favorable attitudes towards preventive dentistry were associated with a higher level of knowledge among dentists (OR=1.6, 95% CI: 1.2-2.3). Regarding dental students, those from private dental schools showed higher scores of knowledge than their counterparts from public schools (OR=2.1, 95% CI: 1.3-3.4). The majority of participants held the belief that preventive dentistry is beneficial for the community but just about 60% of dentists (N=477) and students (N=300)exhibited a positive attitude toward the economic advantages of preventive dentistry for dentists, as well as the ease of engaging in preventive dental practices. The dentists and dental students in this study demonstrated satisfactory knowledge and a favorable attitude toward most aspects of preventive dentistry. However, deficiencies were noted in certain areas, such as the application of topical fluoride for preventing dental caries, as well as a substantial proportion of individuals who lacked a positive perspective on the economic benefits of preventive dentistry. Hence, there is a clear need for educational interventions during their undergraduate training and postgraduate continuing education to enhance their knowledge levels and cultivate a more positive attitude towards preventive dentistry.

Knowledge, Attitude and Practice of Green Dentistry among Dental Professionals in Saudi Arabia: A Cross-sectional Study

Introduction: Green dentistry is an evolving practice that focuses on sustainability, prevention, and a minimally invasive, patient-centric approach. It aims to preserve the environment by reducing the ecological footprint of dental practices. The most common waste products used in dental practice are amalgams from restorative materials, radiographic chemicals, plastic/paper barriers, and disinfectant solutions, all of which can adversely affect the environment and human health. Aim of Study: Despite these pressing concerns, awareness and implementation of green dentistry among dental professionals in Saudi Arabia are lacking. This knowledge gap is particularly maximum among graduates and postgraduates, who possess limited understanding of green dentistry principles. The aim of this study was to assess the knowledge of green dentistry concepts and practices among dental professionals and identify the barriers and facilitators for promoting sustainable dental practice in the country. Materials and Methods: This cross-sectional, questionnaire-based study conducted among 190 dental practitioners in the Kingdom of Saudi Arabia; the questionnaire was distributed online. Results: Among the 190 respondents, the majority were male practitioners (72%), with most of them holding master’s degrees (39.5%) and working as specialists (47%). The overall awareness of green dentistry was higher, and most dentists followed eco-friendly practices and proper waste disposal methods. Conclusion: Green dentistry is a multidisciplinary approach that emphasizes efficient resource practice within dental offices, thereby reducing the impact of dental practice on the environment through the adoption of eco-friendly practices.

Penggunaan Gigi Tiruan pada Lansia dengan Obstructive Sleep Apnea

A person who has reached the elderly stage will have an experienced degenerative process that causes several disorders. Changes in the masticatory function due to the loss of the remaining teeth can cause a transformation not only in the mastication system but also in the upper airway system of respiration. This is due to orofacial deformation, tongue retraction while in the resting position, occlusal vertical dimension changes, and a decrease in facial height. Obstructive Sleep Apnea (OSA) is a sleep breathing disorder with 17 % prevalence rate in adults and increases up to 49% in the elderly stage. A complete denture can be a rehabilitative treatment option for the elderly OSA patient. Wearing dentures during sleep is against the principles of dentistry because it can cause the tongue to be positioned posteriorly. However, people, mostly women, still wears denture while sleeping. This might further increase the obstruction of upper airway system.

Uncommon Restoration on Nonvital Premolar with Porcelain Inlay: A Case Report with Five-year Follow-up

Introduction: In fixed prosthodontics, the old paradigm on endodontically treated teeth leads to more fragilization due to the architectural preparation needed for a full coverage crown. Endodontically treated premolars with class II defects are common in daily practice. When only one proximal surface is affected, direct adhesive restorations are the most used. The use of porcelain inlay is quite uncommon in this situation despite its advantages. Case Presentation: This article illustrates a clinical case of a 31-year-old female with healthy teeth except for the non-vital first maxillary premolar, presenting a class II mesio-occlusal cavity. The occlusion exam revealed functional anterior guidance and canine guidance on both sides during lateral mandibular translation. Based on mini-invasive dentistry principles, the decision was to restore the nonvital bicuspid with a porcelain inlay. Although scientific literature did not report restoration of the premolars with a ceramic inlay in clinical practice, this option was retained. The realization of a porcelain inlay was described step by step. A follow-up up to 5 years was done. Results: The iatrogenic tooth fragilization was avoided by a mini-invasive approach. At the end of this follow-up period, there was no complication or complaint. The patient was satisfied with the final result. Conclusion: Porcelain inlay seems to be a good option to restore the occluso-proximal cavity on nonvital premolars in a context of a favourable occlusion. Porcelain inlay is respectful of the principles of minimally invasive dentistry and allows to achieve the objectives of function, aesthetics and biocompatibility. However, clinical studies should be conducted to investigate the longevity of porcelain inlay on ETPs.

Assessment of knowledge, attitude, and behavior related to children's oral health in pediatricians and students in the pediatric field in Iran: a cross-sectional study.

Pediatricians have an important role to play in motivating and instructing parents on oral health in children. The aim of this study was to assess knowledge of, attitude to, and behavior regarding oral health care in children among pediatricians and students in the pediatric field in Iran. This cross-sectional study included all students in the pediatric field (those who had started a residency or fellowship) and practicing pediatricians in provincial centers and universities (61 setting centers) throughout Iran in the course of 2021. Participants completed an online questionnaire assessing details of the parameters of knowledge of, attitude to, and behavior toward oral health for each individual. A convenience sampling technique was used to gather the study sample. All data were coded for each of the parameters. The data were analyzed by one-way ANOVA (Analysis of Variance)/Tukey and Pearson's correlation tests and path analysis. Out of 582 participants who visited the website, a total of 217 completed the entire questionnaire (participation rate of 37.2%). On the attitude parameter, 84.8% of participants scored above 75% of the possible attainable score, while only 37.9% and 48.1% of them had adequate knowledge and behavior for the possible score, respectively. Specialists had a higher mean score on behavior and knowledge than residents (P=0.001). There was a significant correlation between the scores on attitude and behavior (r=0.42, P<0.001), attitude and knowledge (r=0.19, P=0.005), and behavior and knowledge (r=0.25, P<0.001). Nearly all of the participants, 216 (99.5%), felt the need for the principles of dentistry to be included in the curriculum. Pediatricians showed a favorable attitude to oral health, but their knowledge of and behavior in the field was inadequate. Improvement of pediatricians' interest and performance in oral health in children should be encouraged through the inclusion of these parameters in the curriculum for students of the pediatric field. Implementing training programs for practical pediatricians or incorporating independent theoretical and clinical courses offered by pediatric dentists in dental school departments into the field curriculum of the students in the pediatric field is recommended.

Dentists' awareness and knowledge of evidence- based dentistry principles, methods and practices: a systematic review.

Introduction As an attempt to provide supporting evidence for the formulation of future educational strategies on knowledge translation, this systematic review assessed and synthesised the available evidence related to the dentists' awareness, perceived and actual knowledge of evidence-based dentistry (EBD) principles, methods and practices.Methods Primary studies that considered dentists' reports collected from interviews, questionnaires, or conversation sessions were selected. Studies enrolling students, dental hygienists, or other health professionals were not included. Reviews, editorials, letters, study protocols, articles presenting knowledge translation strategies and initiatives, examples of EBD approaches to specific clinical questions, and guidelines focused on EBD implementation were also excluded. Cochrane, Embase, PubMed, Scopus and Web of Science databases were searched. Grey literature was partially covered by the Google Scholar search and the reference lists of the pre-selected studies. The study search was concluded in February 2021. Descriptive data of the selected studies were synthesised, and the risk of bias was assessed according to the National Institutes of Health Quality Assessment Tool for observational cohort and cross-sectional studies.Results Twenty-one articles were included. High percentages of dentists were aware of EBD. Variable proportions of professionals declared to have some understanding of EBD, although few presented actual knowledge of principles, methods and practices.Discussion Methodologically, most studies presented limitations regarding sample representativity, participation rates, detailing of the outcome measures, and validation of the assessment tools. Additionally, extensive overall ranges of responses were often observed across the studies, possibly as a result of heterogeneity across samples and assessment tools. The authors thus suggest developing valid questionnaires including all dimensions (awareness, perceived knowledge and actual knowledge) within an assessment tool. This would contribute to establishing knowledge translation strategies to overcome specific gaps in EBD knowledge.

Evolution of Impression Tray and Materials- A Literature Review

Dentistry, as a specialty is thought to have begun around 3000 B.C. The study of dental history consistently reveals each age's indebtedness to its immediate and distant predecessors. Nowhere has this been more strikingly revealed than in the field of prosthetic dentistry, dependent as it has been upon material and mechanical development and invention. Dentistry like the allied arts and sciences took full advantage of mechanical developments of the last twenty centuries. During this period applied mechanics was recognized as an essential supplement to biological principles of dentistry. Dentistry got established as a science and industrial development had a definite impact on dentistry. This article thus explains in depth the development of impression trays and materials.

Intraarticular injections of platelet rich plasma and plasma rich in growth factors with arthrocenthesis or arthroscopy in the treatment of temporomandibular joint disorders: A systematic review

Intra-articular platelet rich plasma injections [PRP] or platelet rich growth factors [PRGF] injections have been used as therapeutic treatment options for patients with temporomandibular joint disorder [TMD] in recent years. The purpose of this paper is to evaluate the level of the available scientific evidence in the current literature on the benefits of applying PRP or PRGF injections to patients with TMD simultaneously or after arthrocentesis or arthroscopy to reduce post-operative pain and improve temporomandibular joint function. This systematic review was conducted according to PRISMA criteria and an electronic database search was carried out in the PubMed, Scopus and Cochrane databases during May 2021. The patients in the study group were injected with intra-articular PRP or PRGF simultaneously or after arthrocentesis or arthroscopy while the patients in the control group had arthrocentesis or arthroscopy without an intra-articular injection or received an injection of hyaluronic acid or Ringer's lactate solution. Eight randomised controlled clinical trials were selected. The PRP and PRGF intra-articular injections demonstrated significant differences in terms of pain reduction in three studies and improved mandibular function in two. The treatment with PRP or PRGF intra-articular injections demonstrated slightly better clinical results but of little significance in comparison with the control group. Evidence of their effectiveness is crucial to establish them as non-invasive treatments and as an affordable option for treating some types of TMDs. In accordance with Evidence-based dentistry principles, this review has been assigned a C recommendation.

Ergonomic Evaluation of Senior Undergraduate Students and Effect of Instruction Regarding Ergonomic Principles on It

Background and objective: Musculoskeletal disorders in dentists due to abnormal postures may result in economic and health problems. To prevent these problems, the working posture of dental students should be assessed and corrected in dental procedures. This study was undertaken to assess the effect of instruction regarding ergonomic principles on them by using the Rapid Entire Body Assessment (REBA) method. Material and methods: The posture of 117 students was assessed by REBA before and after of the "Ergonomic principles in dentistry" course. The sample size was selected based on previous studies on this issue. REBA scores were assessed by SPSS software using Friedman-test. Results: The statistical analysis of data gathered from this study showed that the ergonomic structure had a significant effect only in the group of right-handed females (P=0.046). In other groups, no significant change was observed (P>0.05). There was no significant change before and after instruction in REBA classifications (negligible, low risk, medium risk, high risk, very high risk) (P>0.05). There was no relation between the types of positions and REBA score (P>0.05). Conclusion: Ergonomic instruction can significantly decrease musculoskeletal disorders in female dentists who use their right-hand to work. In the other groups, however, the absolute amount of danger became better, but this change was not statistically significant.

Modern Operative Dentistry Principles for Clinical Practice

Modern Operative Dentistry Principles for Clinical Practice

From dental science to clinical practice: Knowledge translation and evidence-based dentistry principles

It has been claimed that in order to decrease the gap between what we know and what we do, research findings must be translated from knowledge to action. Such practices better enable dentists to make evidence-based decisions instead of personal ideas and judgments. To this end, this literature review aims to revisit the concepts of knowledge translation and evidence-based dentistry (EBD) and depict their role and influence within dental education. It addresses some possible strategies to facilitate knowledge translation (KT), encourage dental students to use EBD principles, and to encourage dental educators to create an environment in which students become self-directed learners. It concludes with a call to develop up-to-date and efficient online platforms that could grant dentists better access to EBD sources in order to more efficiently translate research evidence into the clinic.

When is enough, enough?

Mrs Kim is a cheerful 63-year-old who has been agreeable to any treatment plan you have proposed. Her initial presentation was complex. Her maxillary left canine was extracted in adolescence; consequently, there was a significant maxillary-to-facial midline discrepancy of 4 mm. Bilateral fixed bridges have replaced the absent mandibular first molars. The patient had mild bimaxillary protrusion, with facial convexity that only slightly exceeds ethnic norms. Despite Mrs Kim's lip incompetence, few would have considered her unattractive. To add to the treatment complexity, there was 50% generalized crestal bone loss that preexisted her treatment course, but her periodontist considered her status to be stable. Also of note is her long-term use of oral bisphosphonates to treat osteoporosis. You elected to initiate her treatment without extractions. As treatment progressed, you gave Mrs Kim thorough autonomy by discussing the option of premolar extractions to coordinate her midlines and provide incisor retraction. Her consistent response was, “Whatever you think, doctor. I truly trust you.” But at today's debonding appointment, you feel a bit disturbed. Although she proclaimed her delight with the treatment result, her maxillary midline remains conspicuously deviated to the left and mild protrusion remains. She appreciates the excellent alignment your therapy has provided and confirms her commitment to long-term retention to maintain her result. Is there justification for your own dissatisfaction with her treatment outcome? After all, from a dental health perspective, you've successfully managed a periodontally susceptible patient who is on prolonged bisphosphonate therapy—both of which had the potential to increase the risk and complexity of treatment. And an extraction strategy would have involved replacement of both mandibular fixed bridges—a costly endeavor that she is not prepared to face. Mrs Kim is happy with the result. You had been forthright by repeatedly explaining the shortcomings of the nonextraction plan. How much information about her treatment result should you tell her without undermining her satisfaction? Are you obligated to offer any explanation of her treatment's shortcomings to fulfill your ethical responsibility? Should her less-than-perfect outcome remain as an emotional burden to you—especially since she has been such a conscientious patient? The relationship between a patient and the doctor is one of fiduciary responsibility, comprising trust that the commitment between the doctor and the patient will be upheld.1Rule J. Veatch R.M. Autonomy and informed consent.in: Bywaters L. Harmon L. Ethical principles in dentistry. 2nd ed. Quintessence, Chicago2004: 142Google Scholar By definition, this involves fidelity, but the ethical principles of veracity, beneficence, and nonmaleficence also pertain. As one component of the fiduciary relationship, the patient expects that the doctor will deliver a level of care to the best of his or her ability and be truthful regarding all aspects of treatment. Yet “truth” can often involve not only what is said, but also what is unsaid. Omission of selected details of a treatment result can be misleading or deprive patients of certain aspects of their status that may have future pertinence. For example, is explaining a posttreatment marginal ridge discrepancy between the mandibular first and second molars relevant to a patient? Is your inability to fully correct a unilateral Class II molar relationship or a 60% overbite pertinent? Such a distinction between the relevant and the irrelevant, or the trivial and the consequential, can form a fine line indeed. Mrs Kim knows nothing about the instability of proclined incisors and is unconcerned about her facial-to-maxillary midline discrepancy. She is delighted that her 2 mandibular fixed bridges do not need to be replaced. And her periodontist is pleased with her recent examination and charting results, confirming that her condition has remained stable despite her 2-year treatment course. Since you have fully disclosed her present status and its shortcomings—and she accepts both—have you fulfilled your ethical duty to maintain your fiduciary responsibility? Perhaps. But at the very least, your obligation to participate in her long-term maintenance will follow you for years to come.

Esthetic and Functional Recovery of Extensively Decayed Posterior Teeth Through Conservative Treatment

The case exemplifies the combination of two important principles in dentistry: 1) the maintenance of pulp vitality by the partial excavation of the contaminated dentin followed by the application of a biomaterial; and 2) esthetic and functional recovery based on biological restoration. Tooth vitality was confirmed two months after pulp treatment and restoration was accomplished with a fragment of a tooth extracted from another individual. This method is easy to perform and offers esthetic, functional, emotional and social benefits to the patient.

Minimum intervention dentistry principles and objectives

Minimum intervention dentistry (MID) is the modern medical approach to the management of caries, utilizing caries risk assessment, and focusing on the early prevention and interception of disease. Moving the focus away from the restoration of teeth allows the dentist to achieve maximum intervention, with minimal invasive treatments. The four core principles of MID can be considered to be: (1) Recognition - early identification and assessment of potential caries risk factors through lifestyle analysis, saliva testing and using plaque diagnostic tests; (2) Reduction - to eliminate or minimize caries risk factors by altering diet and lifestyle habits and increasing the pH of the oral environment; (3) Regeneration - to arrest and reverse incipient lesions, using appropriate topical agents including fluorides and casein phosphopeptides-amorphous calcium phosphates (CPP-ACP); (4) Repair - when cavitation is present and surgical intervention is required, conservative caries removal is carried out to maximize the repair potential of the tooth and retain tooth structure. Bioactive materials are used to restore the tooth and promote internal healing of the dentine. Effective implementation of MID involves integrating each of these four elements into patient assessment and treatment planning. This review paper discusses the key principles of MID as a philosophy of patient care, and the practical objectives which flow into individual patient care.

Preparing Faculty Members for Significant Curricular Revisions in a School of Dental Medicine

Resistance to change is expected, especially when change involves and impacts many stakeholders. During the past year, the Curriculum Committee at the University of Pittsburgh School of Dental Medicine has been preparing the dental school for a major curricular revision of its predoctoral program. This article describes how a faculty retreat was designed to gain support for and involvement in this reform process. In particular, it examines the results of a faculty survey that was used to shape the retreat and was developed to determine the faculty's perceived knowledge about instructional design, barriers to innovations in teaching, and the influence of student evaluations and evidence-based dentistry principles on faculty teaching. Having identified strengths and weaknesses and areas of concern among faculty members through the survey, the Curriculum Committee was able to prepare a retreat that addressed faculty needs while simultaneously advancing the movement towards curriculum reform.

An evidence‐based assessment of the clinical guidelines for replanted avulsed teeth. Part II: prescription of systemic antibiotics

Current clinical guidelines recommend prescribing systemic antibiotic therapy (SAT) for patients having an avulsed permanent tooth replanted. The principles of evidence-based dentistry can be used to assess whether this is the best approach based on currently-available evidence. The objective of this study was to use the principles of evidence-based dentistry to answer the PICO question: (P) for a replanted avulsed permanent tooth, (I) is prescribing SAT, (C) compared with not prescribing SAT, (O) associated with an increased likelihood of successful periodontal healing after tooth replantation? A literature search was performed across four internet databases (Ovid Medline, Cochrane Library, PubMed, ISI Web of Science), for relevant citations (n = 35 702). Limiting citations to those in English and removing duplicates produced a set of titles (n = 14 742) that were sieved according to evidence-based dentistry principles. Relevant titles were selected for abstract assessment (n = 782), identifying papers for examination (n = 74). Inclusion criteria were applied and three papers (326 total teeth) met the final criteria for meta-analysis. Meta-analyses found no statistically significant difference between prescribing or not prescribing antibiotics for acceptable periodontal healing without progressive root resorption (common odds ratio = 0.90, SE = 0.29, 95% confidence intervals = 0.51-1.58). The evidence for an association between prescribing SAT and an increased likelihood of acceptable periodontal healing outcome is inconclusive. This investigation of antibiotic use as defined in the clinical guidelines indicates there is inconclusive clinical evidence from studies of replanted avulsed human teeth to either contradict or support the guideline. Pending future research to the contrary, dentists are recommended to follow current guidelines in prescribing SAT when replanting avulsed teeth.

Strategic Extraction: Comparison of Traditional and Implant Therapies

According to the evidence-based dentistry principles, the superior treatment options should be pursued. As endosseous dental implants gain greater acceptance, the critical question is whether a tooth with a questionable prognosis should be managed conservatively in a traditional fashion or extracted in preparation for a dental implant. The evidence regarding this issue will be examined in this paper as the outcomes for various treatments are compared.

Dentist-patient relationship and quality care 2. Trust

The public in general and individual patients in particular have a high level of trust in the dental profession. As trust is an important moral value and a demand in health care, a better understanding of the multidimensional nature of trust and its impact on the efficiency and quality of care is of utmost importance. The core values and principles of dentistry serve to maintain the professional status and the associated trust in the profession and thus are of particular concern to the individual dentist and to organised dentistry.

Basic ethical principles in dentistry

Ethical principles in medical profession originate from ancient times when Hippocrates has established basic principles of doctor?s ethics. Those are universal ethical principles, being actual till nowadays, but supplemented with new requirements. In this paper underlined were basic ethical principles for all dentists mandatory to follow.