Dental Status Research Articles

Interdisciplinary CBT treatment for patients with odontophobia and dental anxiety related to psychological trauma experiences: a case series

BackgroundWhile cognitive-behavioural therapy (CBT) is a well-established treatment for odontophobia, research is sparse regarding its effect on patients with dental anxiety related to psychological trauma experiences. This study aimed to evaluate changes in symptoms and acceptability of interdisciplinary Torture, Abuse, and Dental Anxiety (TADA) team treatment for patients with odontophobia or dental anxiety. We also wanted to describe the sample’s oral health status. The TADA teams offer targeted anxiety treatment and adapted dental treatment using a CBT approach.MethodsThe study used a naturalistic, case series design and included 20 consecutively referred outpatients at a public TADA dental clinic. Pre- and post-treatment assessments included questionnaires related to the degree of dental anxiety, post-traumatic stress, generalized anxiety, and depression. Patients underwent a panoramic X-ray before treatment. Before dental restoration, patients underwent an oral health examination to determine the mucosal and plaque score (MPS) and the total number of decayed, missing, and filled teeth (DMFT). Patients were referred to dentist teams for further dental treatment and rehabilitation (phase 2) after completing CBT in the TADA team (Phase 1). Results from the dental treatment in phase 2 is not included in this study.ResultsAll patients completed the CBT treatment. There were significant improvements in symptoms of dental anxiety, post-traumatic stress, and depression and moderate changes in symptoms of generalized anxiety. Dental statuses were heterogeneous in terms of the severity and accumulated dental treatment needs. The TADA population represented the lower socioeconomic range; 15% of patients had higher education levels, and half received social security benefits. All patients were referred to and started adapted dental treatment (phase 2).ConclusionsTADA treatment approach appears acceptable and potentially beneficial for patients with odontophobia and dental anxiety related to psychological trauma experiences. The findings suggest that further research, including larger controlled studies, is warranted to validate these preliminary outcomes.Trial registrationThe study was approved by the regional ethical committee in Norway (REK-Midt: 488462) and by the Data Protection Board at Møre and Romsdal County Authority.

Oral and dental health status in patients with chronic headache

IntroductionHeadache is an illness with high prevalence and adverse effects on quality of life. As oral or dental problems such as pain can trigger or aggravate it, we aimed to investigate and compare oral and dental health status in patients affected with chronic headaches and healthy individuals.MethodsThe present case-control study included 60 patients with chronic headaches (case) and 60 healthy individuals (control) in Rasht, Iran. The demographic characteristics and clinical examinations, including decayed/missing/filled teeth (DMF-T) and community periodontal index of treatment needs (CPITN) indices, as well as bruxism, frequency of tooth brushing and flossing, and maxillary and mandibular tooth wear were recorded in a checklist. Data analysis was performed using the IBM SPSS version 28 at a significance level of 0.05.ResultsThe case group consisted of 25 men (41.7%) and 35 women (58.3%) with an average age of 32.55 ± 6.62 years, while the control group had 27 men (45%) and 33 women (55%) with an average age of 30.95 ± 6.33 years. The study groups were not significantly different in bruxism, frequency of tooth brushing and flossing, DMFT, CPTIN, and maxillary and mandibular tooth wear.ConclusionIt seems that chronic headaches do not significantly affect the oral and dental health of the sufferers. Moreover, it appears that these patients are well aware of the role of oral and dental hygiene in triggering or aggravating the episodes of headaches.

Do Pandemics Trigger Death Thoughts?

The current article aims to investigate the effects of pandemics of varying severity on death-thought accessibility in two studies while controlling for health anxiety. Study 1 ( n = 203) examined the effect of standard mortality salience (MS), severe pandemic, mild pandemic, and dental conditions on death-thought accessibility as assessed by the death word fragment task (DWFT). Study 1 did not find significant effects of MS and delay on death-thought accessibility, which could be attributable to the less-sensitive nature of the DWFT. Thus, Study 2 ( n = 163) was conducted with more sensitive death-thought accessibility measures. Results from Study 2 found that response time toward death and positive words on the lexical-decision task was significantly faster than in standard MS and dental conditions. Both studies recruited predominantly Americans (Study 1) and Europeans (Study 2), which limits the generalizability of the results to other populations. Future studies can consider replicating the studies in other populations.

Dental caries status and treatment need among pregnant women attending antenatal clinics in Dar-Es-Salaam region, Tanzania

BackgroundLiterature shows that pregnant women are more susceptible to dental caries due to several reasons, including changes in salivary flow, reduced pH in the oral cavity, and sugary dietary cravings. The unmet need for care is of special concern, as the failure to obtain treatment can affect the health status of the mother and her unborn child.ObjectivesTo determine dental caries status and treatment needs among pregnant women attending antenatal clinics in the Dar-es-Salaam region.Materials and methodsA descriptive cross-sectional hospital-based study was conducted among 461 pregnant women aged 14–47 years. Informed consent was obtained from participants during data collection. Dental caries status and treatment need were diagnosed according to the WHO criteria. The Data collected was cleaned and analyzed using SPSS version 23.0 software for generating frequency distribution tables, chi-square tests, and logistic regression analysis. The Confidence Interval was 95% (p < 0.05).ResultsThe overall prevalence of dental caries was 69%, with a mean DMFT score of 2.86 (± 3.39). Untreated dental decay was observed in 60.5% of study participants, which needed more restorative treatment (fillings & RCT) than a tooth extraction. Caries experiences differed significantly among the pregnant women in various gravidity. In logistic regression, dental caries experience was significantly higher among multigravida respondents (p-values = 0.04) (OR: 1.840, CI 1.021–3.319).ConclusionThis study demonstrated a high level of dental caries experience and the presence of treatment needs. Multiple pregnancies were a major factor that contributed to high levels of dental caries.

The Effect of Oral and Dental Health Status on the Self-Esteem Levels of Turkish University Youth

Objectives: This study aimed to investigate the impact of oral and dental health status on the self-esteem levels of Turkish university youth. Methods: This descriptive cross-sectional study included a sample of 962 Turkish university youth, aged 16 - 24, who met all the study criteria during the 2020 - 2021 academic year. Data were collected using a questionnaire and the Rosenberg Self-Esteem Scale (RSES). The data were analyzed with SPSS version 23.0. T-tests were used for pairwise comparisons, and one-way ANOVA was used for multiple comparisons. Results: Among the students who participated in the study, 56.7% were found to have high self-esteem, with a mean RSES score of 1.69 ± 1.62. Statistically significant differences were found between the RSES score and several factors, including decayed teeth (P &lt; 0.01), presence of halitosis (P &lt; 0.01), tooth color (P &lt; 0.01), crooked teeth (P = 0.045), and toothache (P = 0.008). It was determined that dental crookedness, decayed teeth, bad breath, dark yellow teeth, the presence of tooth fillings, and extracted teeth were negatively associated with self-esteem. However, no statistically significant differences were found between self-esteem and factors such as the presence of tooth fillings, extracted teeth, tooth brushing habits, frequency of dental visits, or snack food consumption (P &gt; 0.05). Conclusions: The results of this study reveal that poor oral care negatively impacts individuals' self-esteem. Issues related to oral and dental health, particularly concerning the appearance and condition of teeth, affect young people's relationships and self-confidence in social environments. It is crucial to develop family and school education programs, as well as national policies, particularly during childhood and university years, when attitudes toward oral and dental health are being established.

Application of digital workflow and technologies in clinical paediatric dentistry: a scoping review.

The purpose of the present scoping review is to map the literature reporting on the application of digital workflows and digital technologies in the diagnosis, treatment, or management of dental conditions in paediatric patients. Furthermore, the review focuses on identifying possible knowledge gaps in the area and developing specific recommendations for future investigations. An electronic search was performed on 3 databases up to July 2023. After the authors independently screened the retrieved articles, they extracted the data and assessed the risk of bias using the JBI (The Joanna Briggs Institute) critical appraisal tools and the Cochrane Risk of Bias 1 tool, depending on the study design assessed. After full-text assessment, 58 studies were identified that met the inclusion and exclusion criteria. The results were divided into two groups according to the study design: 36 were research articles, and 22 were case reports; only the research articles were included in the qualitative synthesis. The most common topic was Scanners/3d digital model analysis (11 articles), followed by Digital Imaging (8 articles). Digital applications were also a popular topic, and tele-dentistry and artificial intelligence were also present in the included studies. Studies investigating the use of digital workflows and digital technologies in the diagnosis, treatment or management of dental conditions in paediatric dentistry are lacking. In general, future investigations should be based on higher quality studies; furthermore, the lack of studies on the clinical validation of digitally fabricated orthodontic devices and restorations in paediatric patients provides insights for future research.

К вопросу об осложнениях сахарного диабета: систематический обзор литературы

INTRODUCTION. The article presents an overview of the trigger role of diabetes mellitus in the development of periodontal pathology in patients aged 40-70 years. During the analytical systematic review, the emphasis was placed on the currently studied issues related to the characteristics of the clinic, glycemic status and risks of a complicated course, including with regard to microvascular, neurological and other disorders. The focus is on the dental status and glycemic profile of patients with diabetes mellitus and its role in regulating the adaptive potential of patients with diabetes mellitus. AIM. To assess the risks of diabetes in the regulation of periodontal pathology and other most significant complications. MATERIAL AND METHODS. the search was conducted in the database on evidence-based physiotherapy (PEDro), by keywords: "diabetes mellitus", "rehabilitation", "microvascular and other complications", "periodontal pathology" from 2000 to 2024. A total of 284 sources were selected as of March 2024, of which 26 were systematic reviews, 9 were Cochrane reviews, 17 – Clinical recommendations (American Association for Diabetes Mellitus), as well as Clinical recommendations for diabetes mellitus (70.5%). The search was conducted in the sources Web of Science, PubMed and Scopus in accordance with the principles of PRISMA and initially revealed 185 entries. Of these, 40 articles were included in the 2013-2024 publication study. Keywords were used: "periodontal pathology", "diabetes mellitus", "rehabilitation", "microvascular and other complications". RESULTS: the analysis of the collected Russian and foreign literature allowed us to summarize that in the treatment of patients with type 2 diabetes with periodontal pathology, the participation of specialists (endocrinologist, dentist, rehabilitologist, hygienist, neurologist) of a multidisciplinary team is necessary to compile an optimal rehabilitation program aimed at preventing the occurrence of complications and their progression, to achieve a speedy and complete restoration of lost dental functions and reduce glycemic risks. CONCLUSION. A personalized approach, individually selected therapies with an assessment of the dental status and glycemic profile in patients with diabetes mellitus and periodontal pathology will help to achieve the best results in recovery and elimination of complications. KEYWORDS: diabetes mellitus patients, dental status, glycemic profile, microvascular, neurological disorders

A Review of Radiology and Optical Coherence Tomography in Dental Diagnostics

Background: The rapid evolution of imaging technologies has significantly transformed dentistry, improving the diagnosis and treatment of various dental conditions. While traditional radiological methods such as X-rays and Cone Beam Computed Tomography (CBCT) remain the cornerstone of dental imaging, the emergence of Optical Coherence Tomography (OCT) offers a non-invasive, radiation-free alternative. This review examines the comparative efficacy of X-ray and OCT technologies in diagnosing hard tissue conditions in the oral cavity. Methods: The review analyzed the application of OCT and radiology in dental diagnostics through a custom-built Swept-Source OCT system, assessing its performance against traditional radiological methods. The study utilized both in vivo and ex vivo evaluations, considering variables such as resolution, depth penetration, and image clarity across different dental conditions. Results: OCT demonstrated superior capabilities in detecting early-stage cavities, fractures, and minor imperfections, particularly when high-resolution imaging was required. However, its limited penetration compared to X-rays restricted its application in comprehensive bone assessments. Radiology, especially CBCT, provided essential volumetric data crucial for evaluating bone density, fractures, and post-surgical conditions, though it posed concerns related to radiation exposure. Combining both modalities proved beneficial, offering complementary insights that enhanced overall diagnostic accuracy. Conclusion: While X-ray-based radiology remains indispensable for broad evaluations of dental and bone structures, OCT presents a valuable adjunct, particularly for high-precision assessments of soft tissues and small surface defects. The synergistic use of these technologies can provide a more holistic approach to dental diagnostics, potentially improving patient care and treatment outcomes. Future advancements in OCT could further expand its role in routine dental practice, enhancing diagnostic accuracy while minimizing radiation exposure risks.

Caries Risk Assessment in Adults with Highlights to Nutrigenomics and Nutrigenetics

Abstract Caries risk assessment and caries management by risk assessment cannot be related only to children and their parents' answers. Camra and Cariogram have been working for decades in few countries. Prediction and preventive measures are especially important for young adults (16-25 years old), young professionals (25-35 years old), before pregnancy and during menopause. Aim To develop a card for an easy caries risk assessment with chair-aside questions, clinical examination and salivary tests. To draw up a protocol for patient treatment and follow-up related to the caries risk. Methodology It is based on the data of 1,167 participants in 6 different clinical studies conducted within various research trials, granted programmes and projects during the 30-year period from 1988 to 2018. Prediction of risk can be useful if 4 groups, i.e. low risk, moderate risk, high risk and very high risk groups are evaluated. Results Packages of measures were targeted for each group. Among the important factors were the type, habits and frequency of nutrition, detected with 6 targeted questions, lifestyle hygiene with 5 questions, dental status with 6 parameters (DMFT scores, gingival status, size of teeth, etc.) and oral hygiene. Biochemical patterns of saliva, i.e. salivary flow rate and pH, with and without stimulation were included. Low risk and Moderate risk groups of different ages do not need further tests. High risk and Very high risk groups can be additionally tested with chair-aside tests for Streptococcus mutans and Lactobacilli counts and oral sucrose clearance for preventive evaluation of dental caries management. The card validation and tests last no longer than 40 minutes, 1 page for a single patient. Conclusions Caries risk in adults can be measured, assessed and predicted in relation to nutrigenomics. Treatment behaviour can be managed and targeted for each patient, according to the group for long, lifetime saving of natural teeth in the mouth. In the last 100 years, concentrated and refined foods have decreased all sizes of the upper first and second incisors as a natural physiological response and a change has been observed in the anatomy of canines, making them stronger via enlargement of their MD sizes. From this current academic year, "Caries risk" is included into our new lecture programme.

Association Between ABO Blood Group, Dental Caries, Gingivitis, Impacted Teeth and Malocclusion Among Saudi Adults: A Cross-Sectional Study.

Whether there is a relationship between blood group and the likelihood of acquiring oral diseases. Therefore, the present study investigated the potential association between ABO blood groups and various dental conditions, including dental caries, gingivitis, malocclusion, and impacted teeth, in Saudi adults aged 18 years and older. A cross-sectional study was conducted on 300 participants who met the inclusion criteria. Data collection included assessment of dental caries status using the decayed missing filled teeth (DMFT) and decayed missing filled surfaces (DMFS) indices, evaluation of gingivitis using the Gingival Index, classification of malocclusion according to Angle's classification system, and recording the presence or absence of impacted teeth. The AB blood group had the significantly highest mean DMFS score (8.58±6.63), while the O blood group had the lowest mean DMFS score (6.37±4.43). Additionally, blood group O showed a slightly higher prevalence of gingivitis (51.92%) than the other blood groups. Blood group A demonstrated a higher prevalence of both Class II (34.2%) and Class III (19%) malocclusions, with statistically significant differences. Regarding impacted teeth, blood group AB (48.8%) had the highest occurrence. There exists an association between oral disease and ABO blood group in Saudi adults. The results of this study indicate that individuals with specific blood types may be more prone to oral diseases, which can aid in the early diagnosis and prevention of these conditions.

Factors Associated With the Suspension of Domiciliary Dental Care for Older Adults During the First Wave of the Coronavirus Disease 2019 (COVID-19) Pandemic: A Comparative Study in the Japanese Local Government.

Objective The novel coronavirus has reduced the availability of dental services, including domiciliary dental care. The suspension of dental treatment worsens the dental condition. However, the impact on domiciliary dental care during the coronavirus disease 2019 (COVID-19) pandemic remains unclear. Therefore, the aim of this study is to determine the impacts of the COVID-19 pandemic on domiciliary dental care and associated factors. Materials and methods This comparative study used Japanese prefectural claims data, including data from older adults who utilized domiciliary dental care. We compared the suspension of dental treatment during the firstwave of the COVID-19 pandemic with that before the COVID-19 pandemic. The outcome was the completion of four consecutive months of treatment. The chi-squared test, t-test, and logistic regression were applied. Result Approximately 23.4% of participants suspended home dental services during the first wave of the COVID-19 pandemic, whereas 11.7% suspended these services before COVID-19. Logistic regression clarified the effect of the following variables (during the first wave of COVID-19 vs. before COVID-19): care need level of long-term care was 1-5 (=severe) (odds ratio (OR): 0.92 vs. no significance (NS)), visit by hospital dentists (OR: 1.83 vs. NS), volume of patients in the visited place (2-9 people, OR: NS vs. 0.72; over 10 people, OR: 0.58 vs. 0.32), planned physicians' visit (OR: 0.71 vs. 0.77), and taxed income per population (OR: NS vs. 1.00). Discussion Domiciliary dental care, especially those in care facilities, were a vulnerable population during the pandemic. This may contribute to the delivery of domiciliary dental care during any future pandemics.

Initial screening for dental abnormalities identified by labial and buccal photographs in dogs and cats.

To evaluate the dental abnormalities by visually assessing the labial and buccal photographs in dogs and cats and analyze their prevalence based on age and breed. 1,096 client-owned dogs and 775 client-owned cats. Data were collected from patients who visited 26 private veterinary clinics from January to December 2022. Each animal was evaluated through dental photographs taken from the labial and buccal sides. Correlations between the prevalence of the identified dental abnormalities and age, craniofacial type, and breed, were analyzed. Calculus, discoloration, epulis, fractured teeth, gingival recession, gingivitis, malocclusion, missing teeth, and persistent deciduous teeth could be identified by analyzing the dental photographs in both dogs and cats. Enamel defects in dogs and tooth resorption in cats could be identified. Brachycephalic dogs had a significantly higher prevalence of malocclusion (OR, 1.93; 95% CI, 1.36 to 2.75) and missing teeth (OR, 3.63; 95% CI, 2.71 to 4.91) compared to nonbrachycephalic dogs. Brachycephalic cats had a significantly higher prevalence of fractured teeth (OR, 1.95; 95% CI, 1.24 to 3.04) and a lower prevalence of gingival recession (OR, 0.30; 95% CI, 0.15 to 0.55) compared to nonbrachycephalic cats. Calculus, persistent deciduous teeth, and possibly gingivitis could be identified in dogs and cats by analyzing labial and buccal photographs. The assessment of some dental abnormalities such as fractured teeth, missing teeth, and tooth resorption can be limited without a complete dental examination under anesthesia. Although the assessment of dental conditions may be underestimated, the data on the prevalence of the dental abnormalities evaluated through the photographs could be utilized for screening dental diseases.

Oral And Dental Evaluation Of Bone Marrow Transplant Patients: A Retrospective Observational Study

This retrospective observational study aims to evaluate the oral and dental conditions of 100 bone marrow transplant (BMT) patients. The study assessed oral pathologies, including root canal treatments, extractions, squamous cell carcinoma cases, oral prophylaxis procedures, and restorations. The findings provide valuable insights into the oral health challenges faced by BMT patients, emphasizing the need for specialized dental care and preventive measures in this vulnerable population

Oral Health and Quality of Life in People with Autism Spectrum Disorder.

This article delves into the intricate relationship between oral health, quality of life, and behavioral characteristics in individuals with autism spectrum disorder (ASD). Background/Objectives: Autism has been associated with various challenges, and this study seeks to elucidate the impact of ASD on oral health outcomes and overall well-being. The research focuses on assessing overall oral health by evaluating various parameters, such as the condition of lips, tongue, gums and tissues, natural teeth, dentures, oral hygiene, and dental pain in individuals with ASD. Additionally, the study explores the influence of age, sex, and certain variables, like basic daily living skills on oral health practices, aiming to identify potential correlations between these factors and oral health outcomes. Methods: We employed standardized instruments to quantitatively measure and analyze the impact of oral health status on the overall quality of life experienced by individuals with ASD. Results: The study found a statistically significant positive association between oral health, measured by the Oral Health Assessment Tool (OHAT), and quality of life, as indicated by EuroQol 5-Dimensions Youth version (EQ-5D-Y) total scores (β = 0.13045, p = 0.00271). This suggests that better oral health is linked to higher quality of life. When adjusting for age and sex in a multiple linear regression model, the association remained significant but with a slightly reduced effect size (β = 0.10536, p = 0.0167). Age also showed a marginally significant positive association with quality-of-life scores. ANOVA results indicated that participants with advanced oral health status reported significantly higher quality-of-life scores than those with poorer oral health (p = 0.00246). The study also found that intelligence quotient (IQ) does not substantially influence dental health status, while the "Autonomy" subscale of the EQ-5D-Y is positively related to the OHAT. Conclusions: Unhealthy oral conditions significantly impact the overall quality of life in individuals with ASD. Therefore, it is crucial to include regular dental assessments and treatments in therapeutic protocols for patients with ASD.

Dental Services of the International Summer Camp Event: Experiences from the 25th World Scout Jamboree, South Korea

This study aims to analyze dental care at the 25&lt;sup&gt;th&lt;/sup&gt; World Scout Jamboree (WSJ) using a predesigned standardized dental chart to provide a reference for the operation of dental emergency clinics at future large-scale youth events. The dental charts of all patients treated at the 25&lt;sup&gt;th&lt;/sup&gt; WSJ emergency dental clinic were examined. Fisher’s exact tests were used to analyze the differences between youth scouts and adult leaders. Eighty visits of 71 patients were included in the study. The largest number of patients was from Asia-Pacific (49.3%), followed by patients from Europe (40.8%). In terms of chief complaints, oral ulcers (19.7%), lesions of the lips (18.3%), and orthodontic discomfort (15.5%) were the most prevalent. The analysis showed a significant difference (&lt;i&gt;p&lt;/i&gt; = 0.0023) between youth scouts and adult leaders in the distribution of patients in the first half (July 30&lt;sup&gt;th&lt;/sup&gt; - August 3&lt;sup&gt;rd&lt;/sup&gt;) and second half (August 4&lt;sup&gt;th&lt;/sup&gt; - August 8&lt;sup&gt;th&lt;/sup&gt;) of the event. There was a higher incidence of dental conditions associated with hot and humid environments, unlike typical emergency dental settings. Therefore, despite adequate preparation, unexpected dental visits may occur, and it is recommended that operations be conducted in community-based dental hospitals to allow for immediate and efficient responses in international camps.

A study on the clinical application of the comprehensive dental hygiene care process

Objectives: This study aimed to identify the key components and tools for Comprehensive Dental Hygiene Care (CDHC) among dental hygienists and provide foundational data for widespread implementation in dental institutions. Methods: A third Delphi survey involving experts derived the CDHC components and materials. Dental hygienists’ characteristics and the CDHC application status were analyzed for frequency. The perceived need for and willingness to apply the CDHC components based on general characteristics were assessed using t-tests. Results: The results of the Delphi survey identified the following CDHC components: 11 for medical history; three, dental history; five, oral hygiene practices; seven, dental conditions; three, occlusion conditions; six, periodontal conditions; and, three, other examinations. Planning included 3 items for healthy gums and 4 for gingivitis and mild periodontitis. Evaluation included 7 items for mild periodontitis, 5 for patient education, and totally 27 CDHCrelated materials. Dental hygienists’ needs and willingness varied, with higher levels among those in clinics, university graduates, those in counseling or managerial roles, team leaders or those at higher positions, and those with &gt;6 years of experience (p&lt;0.05). Conclusions: The Delphi survey identified the CDHC clinical application process, confirming the strong desire of dental hygienists to apply it in practice.

Diagnostic and Therapeutic Indications of Different Types of Mandibular Advancement Design for Patients with Obstructive Sleep Apnea Syndrome: Indications from Literature Review and Case Descriptions.

Mandibular advancement devices (MADs) are considered a primary alternative treatment for adults with moderate to severe obstructive sleep apnea (OSA) who are unable to tolerate or do not respond to continuous positive airway pressure (CPAP) therapy, supported by substantial scientific evidence. While a range of designs and materials for MADs are commercially available, there is a lack of clear diagnostic guidelines to assist clinicians in selecting the most appropriate device based on a multidisciplinary evaluation of OSA patients. This narrative review seeks to outline the key characteristics of MADs that clinicians should evaluate during both the diagnostic and treatment phases for patients with OSA. An extensive search of academic databases was conducted to gather relevant studies that address therapeutic and diagnostic recommendations for the design and titration of MADs. The search was carried out across EMBASE, Scopus, PubMed, and Web of Science up to May 2024. From a total of 1445 identified citations, 1103 remained after duplicate removal. Based on the inclusion criteria, the full text of 202 articles was retrieved, and 70 studies were ultimately included in this review. The extracted data were organized to generate clinical insights, aimed at guiding orthodontists in optimizing diagnostic and decision-making processes for treating OSA patients with MADs. The analysis led to the identification of key clinical questions that can assist orthodontists in enhancing their approach and choosing the appropriate appliance basing on the diagnosis and clinical dento-orofacial characteristics. Bibloc appliances could be preferred over mono-bloc devices due to the possibility of arranging the mandibular advancement according to the patient's clinical condition and orofacial symptoms. Provisional devices could be used as screening tools to verify the patient's adherence to the therapy. Regardless of the MAD design, type and programmed advancement, it must be under-lined that the rule of the orthodontist/dental specialist is secondary to the other sleep-medicine specialists (ORL, pulmonologist) and must be related to (1) a preliminary assessment of MAD usage (dental anatomical conditions), (2) testing a diagnostic MAD usable during a sleep examination (PSG or DISE), (3) final treatment with a definitive MAD.

Virtual dental autopsy: undertaking forensic dental identification remotely using an intra-oral video camera.

The aim of this study was to evaluate whether a forensic odontologist working remotely could accurately undertake forensic dental identifications using videos produced by non-dental forensic staff operating an intra-oral video camera (IOVC). The study's aims were to assess the accuracy and time taken to perform remote forensic dental identifications in this manner. Eight cadavers from the Centre for Anatomy and Human Identification (CAHID), University of Dundee, UK, were examined by a forensic odontologist via a traditional dental examination. Their dental condition was recorded to serve as ante-mortem records for this study. Videos of each dentition were produced using an IOVC operated by a medical student. Post-mortem records were produced for each dentition from the videos by a remote second forensic odontologist who was not present at the traditional dental examination. The ante-mortem and post-mortem records were then compared, and identification was classified as positively established, possible or excluded. Established identifications were positively made in all eight cases although there were some non-critical inconsistencies between ante-mortem and post-mortem records. Before the second opinion, 85.6% of the teeth per study subject were charted consistently. After the second opinion, the percentage of consistency increased to 97.2%. Each video on average was about 4.13 minutes in duration and the average time taken to interpret and chart the post-mortem dental examination at the first attempt was 11.63 minutes. The time taken to chart from the videos was greater than is typical of a traditional dental examination. This pilot study supports the feasibility of undertaking remote dental identification. This novel "tele-dental virtopsy" approach could be a viable alternative to a traditional post-mortem dental examination, in situations where access to forensic dental services is difficult or limited due to geographical, logistical, safety, and/or political reasons.

Evaluation of General Anesthesia and Sedation and Follow-Up Compliance in Pediatric Dental Procedures: A Comprehensive Analysis of Long-Term Outcomes and Gender Differences.

This retrospective study evaluated the effectiveness of different types of general anesthesia (GA) and sedation in pediatric dental procedures, focusing on treatment outcomes and follow-up compliance with an emphasis on gender differences. Clinical records of 1582 pediatric patients, aged 0-18 years, were analyzed to examine the distribution, duration and impact of anesthesia types on dental procedure complexity. The study population was divided into three age groups: 0-6, 7-12 and 13-18 years. We assessed follow-up attendance rates by gender and anesthesia type, calculated the decayed, missing and filled (DMF) index and evaluated the need for further treatment and reasons for retreatment. Our findings indicated that general anesthesia with inhalational agents and muscle relaxants was the most frequently used method (1260 instances), followed by nitrous oxide sedation (163 instances) and sevoflurane GA with a laryngeal mask airway (158 instances). Inhalational GA with muscle relaxants had the longest average duration (2.78 h) and the highest DMF index (7.43), reflecting its use in more severe dental conditions. Gender analysis revealed a slight male predominance in using inhalational GA with muscle relaxants (55.87% male vs. 44.13% female). Female patients demonstrated higher follow-up compliance across all periods. Overall, our results highlight the importance of tailored anesthesia and sedation plans, as well as follow-up protocols, in pediatric dentistry. This study provides valuable insights for practitioners in selecting appropriate anesthesia and sedation types and developing strategies to improve follow-up compliance and treatment success.

Pattern of pediatric emergency dental care during COVID-19 pandemic in Saudi Arabia

ObjectiveAt the beginning of the COVID-19 pandemic, it was recommended to provide emergency dental care and avoid aerosol-generating procedures (AGPs) when possible. This study aimed to determine how Saudi Arabian pediatric patients utilized emergency dental services at the national level at the beginning of the COVID-19 pandemic and what situations required an AGP. MethodsData was collected from all Ministry of Health dental facilities in Saudi Arabia between March and May 2020. All pediatric dental patients who received emergency dental care during the COVID-19 lockdown were included in this study. ResultsThe majority of the 1,544 pediatric dental patients who received emergency dental care during this period received treatment for caries (77.9 %). AGPs were predominant in the treatment of urgent dental conditions (51.5 %). About 64 % of cases with pulpal inflammation and 52.4 % with abscesses underwent an AGP. ConclusionEmergency and urgent dental conditions were the main reason for seeking dental care during the pandemic (75.8 %), while only 24.2 % of cases were considered non-urgent. Despite the recommendations, AGPs were required for some urgent conditions to relieve the associated pain, and this comprised 46.8 % of dental treatment provided.