Dental Treatment Research Articles

Spatial Prior-Guided Bi-Directional Cross-Attention Transformers for Tooth Instance Segmentation.

Tooth instance segmentation of dental panoramic X-ray images is of significant clinical importance. Teeth exhibit symmetry within the upper and lower jawbones and are arranged in a specific order. However, previous studies frequently overlook this crucial spatial prior information, resulting in the misidentifications of tooth categories, especially for adjacent or similarly shaped teeth. In this paper, we propose SPGTNet, a spatial prior-guided transformer method, designed to both the extracted tooth positional features from CNNs and the long-range contextual information from vision transformers, specifically for dental panoramic X-ray image segmentation. Initially, a center-based spatial prior perception module is employed to identify the centroid of each tooth, thereby enhancing the spatial prior information for the CNN sequence features. Subsequently, a bi-directional cross-attention module is designed to facilitate the interaction between the spatial prior information of the CNN sequence features and the long-range contextual features of the vision transformer sequence features. Finally, an instance identification head is employed to generate the tooth segmentation results. Extensive experiments on three public benchmark datasets demonstrate the effectiveness and superiority of our proposed method compared to other state-of-the-art approaches. The proposed method accurately identifies and analyzes tooth structures, thereby providing crucial information for dental diagnosis, treatment planning, and research.

Does the use of a 3-mm extended tray during an at-home bleaching treatment increase gingival irritation? A randomized clinical trial

Gingival irritation is a common side effect of at-home bleaching, but how the design of the bleaching tray affects its occurrence is unclear. The purpose of this randomized clinical trial was to determine whether a direct relationship is present between the design of bleaching trays and the risk of gingival irritation during at-home bleaching treatments. This clinical trial was registered at ClinicalTrials.gov. (NCT06371664). Seventy-two participants were randomly assigned to 2 experimental groups: extended bleaching tray (3mm) and nonextended bleaching tray (1mm). Over a period of 3 weeks, participants underwent a nightguard dental bleaching treatment (6 to 8 hours) using 16% carbamide peroxide gel. Gingival irritation was evaluated subjectively by participants daily and objectively by clinicians at each visit. Tooth sensitivity was recorded daily using a 5-point numerical scale. Tooth color measurements were also made with a dental spectrophotometer. The risk of gingival irritation and the risk and intensity of tooth sensitivity were analyzed with the Pearson chi squared test and Fisher exact test. The color analysis was conducted with the Student t test (α=.05). Subjectively, the risk of gingival irritation was 66.7% in the extended group and 47.2% in the nonextended group, showing no statistically significant difference (P>.05). However, objectively, the risk of gingival irritation was significantly higher in the extended group (88.9%) compared with the nonextended group (63.9%) (P=.01(95% CI 1.06 to 1.83). Tooth sensitivity intensity was significantly higher in the extended tray group (P<.001), although the design did not significantly influence the risk of tooth sensitivity (P>.05). No significant differences were found between groups regarding color change (P>.05). The use of an extended bleaching tray design increases the risk of gingival irritation and the intensity of tooth sensitivity. Therefore, the nonextended tray is recommended to minimize adverse reactions.

Comparative efficacy of microimplant-assisted rapid palatal expansion versus surgically assisted rapid palatal expansion in the treatment of maxillary transverse discrepancy

Background: The maxillary transverse discrepancy is an arch-length reduction that has an unsatisfactory effect on the aesthetics of the face and position while resulting in functional damage. Because of these variations, the goal of this study is to assess the efficacy, stability, and potential adverse effects of Microimplant-Assisted Rapid Palatal Expansion (MARPE) and Surgically Assisted Rapid Palatal Expansion (SARPE) in MTD in adolescents and adults. Methods: An electronic search was conducted in five distinct databases, and the findings contained only peer-reviewed literature from 2018 to 2024. Randomised controlled studies comparing the efficacy of MARPE and SARPE in inducing skeletal and dental alterations, treatment stability, and relapse rates were among the study selection criteria. Data extraction included a review of patient demographics, types of therapies provided, outcomes obtained, and side effects noted. Results: The findings of the study demonstrate that both procedures are appropriate for the treatment of MTD, but MARPE provides advantages in terms of morbidity and patient satisfaction, whilst SARPE may provide faster and more stable outcomes in some circumstances. This study encourages doctors to consider individual patient needs before determining which maxillary transverse discrepancy treatment strategy to use. Conclusion: This study discovered that the MARPE has superior skeletal results and stability than the SARPE, albeit with a higher risk of surgical complications. It is critical to ensure that the unique patient population is carefully selected.

Development and application of a quantitative LC-MS/MS assay for the analysis of four dental local anesthetics in human plasma and breast milk

Local anesthetics (LAs: articaine, lidocaine, bupivacaine, and mepivacaine) are essential for dental pain management. However, there are concerns that the lipophilic LAs could cross into breast milk causing toxicity to the infant. Our objective was to establish a multi-analyte LC-MS/MS method for the concurrent quantification of local anesthetics (LAs) in human plasma and breast milk, clarifying the transfer of LAs from plasma to breast milk, thereby offering crucial data for the safe assessment of LAs during the nursing period. Sample preparation for plasma and breast milk involved protein precipitation and a single dilution step. The chromatographic analysis was conducted using an ACQUITY UPLC BEH C18 column. Detection was facilitated by a triple quadrupole mass spectrometer employing positive electrospray ionization. The method demonstrated excellent linearity for articaine, mepivacaine, and bupivacaine across the range of 0.5 to 500 ng/mL, and for lidocaine from 1.0 to 1000 ng/mL in both plasma and breast milk, with correlation coefficients (R2) of 0.99 or higher. The method was effectively utilized in the analysis of samples from three nursing mothers who received dental treatment involving LAs. Articaine and lidocaine excretion in milk was confirmed, but it presented no significant safety risks to the breastfed infants.

Skeletal and dental effects of skeletally anchored forsus fatigue resistant devices during class II malocclusion treatment: A meta-analysis and systematic review

OBJECTIVE: To evaluate and compare the skeletal and dental treatment effects of Class II malocclusion cases using skeletally anchored Forsus (miniscrew-anchored FRD or miniplate-anchored FRD), with conventional Forsus FRD. MATERIALS AND METHODS: Unrestricted electronic search of six databases and additional manual searches were performed up to July 2023. Randomized controlled trials having one treatment arm with skeletal anchored Forsus FRD in treatment of Class II malocclusion and another matched treatment group treated with conventional Forsus FRD were included in this review. Risk of bias assessment was performed using Cochrane’s Risk of Bias Tool. No restrictions were set concerning treatment duration, or the cephalometric analysis used. Skeletal and dentoalveolar outcomes data were extracted by two authors independently. RESULTS: Three studies using miniscrews as means of skeletal anchorage were evaluated and qualified for the final review and meta-analysis. Three other studies using miniplates were considered in the systematic review but were not qualified for a meta-analysis. The data gathered from the miniscrews anchored FRD papers included a total of 93 Class II patients (46 treated with miniscrew-anchored Forsus FRD, 47 treated with conventional Forsus FRD). The meta-analysis showed a statistically significant reduction in the SNA angle in favor of miniscrew-anchored Forsus FRD (mean difference: −0.26, CI: −0.50 to −0.02), a nonsignificant difference in the SNB (mean difference: 0.17, CI: -0.06 to 0.39), a statistically significant increase in the SN–MP angle in favor of miniscrew-anchored Forsus FRD (mean difference: 0.53, CI: 0.06–1.00)—a statistically significant reduction in the L1-MP angle in favor of miniscrew-anchored Forsus FRD (mean difference: −2.12, CI: −4.96 to −2.12). Data from miniplate-anchored FRD included 31 Class II patients treated with mini plate anchored FRD. Although meta-analysis was not applicable to these studies, lower incisor inclination was observed to be less. CONCLUSIONS: Based on the existing evidence, the use of skeletal anchorage could not enhance forward mandibular growth. However, miniscrew-anchored Forsus FRD could minimize mandibular incisor protrusion while miniplates could even retract the mandibular incisor position with a headgear effect on the maxilla.

Role of Laboratory Tests in Enhancing Diagnosis and Treatment Planning for Dentists: A Review of Evidence-Based Practices.

The purpose of this review is to simplify and guide dentists through the main laboratory investigations frequently used in dentistry for diagnosis and patient management. It emphasizes the critical role of laboratory tests in dental practice, highlighting their significance for accurate diagnosis, effective treatment planning, and ongoing monitoring of oral health. Systemic conditions often manifest through oral symptoms, making laboratory assessments essential for identifying undiagnosed health issues that may impact dental treatment outcomes.A comprehensive literature search was conducted using PubMed and Google Scholar to gather relevant studies, ensuring a thorough examination of existing knowledge on the subject. This review defines commonly used laboratory tests, including complete blood count (CBC), coagulation tests, hemoglobin A1c (HbA1c), liver function tests, immunological assays, and microbiological and virological evaluations. Each test provides valuable insights into patient health, aiding in the detection of conditions such as anemia, diabetes, and liver disease, which can complicate dental procedures. By adopting an evidence-based, personalized approach to patient care, dental professionals can enhance safety and treatment success. This article underscores the necessity of integrating laboratory assessments into routine dental practice, promoting a holistic understanding of patient health and improving overall treatment outcomes.

Oral health statuses of individuals diagnosed with gastroparesis: A Cross-Section study.

Gastroparesis (GP) is a debilitating gastric motility disorder associated with digestive dysfunction, reduced quality of life (QoL), and increased mortality rates. There is no known cure for GP and treatment options are limited. The oral cavity is responsible for initiating digestion, yet the impact of GP symptom frequency on oral health status and oral healthcare utilization is not well understood. A 21-item electronic survey was developed and disseminated to a private GP social media forum. Survey questions explored GP symptom frequency, oral health status, dental care utilization, and oral health education post GP diagnosis. Descriptive and inferential statistics analysed data. There were 434 study participants. An overwhelming 83% reported GP negatively influenced their oral health and oral function. Significance was observed between GP symptom frequency and oral health status (p = <0.0001). The majority (81%) reported receiving dental care post GP diagnosis, yet (63%) reported current untreated dental concerns. Interestingly, (74%) of participants reported that they have never been educated about oral health risks associated with GP by any healthcare professionals. GP negatively affects oral health. Study participants reported a need for extensive dental treatments and high levels of untreated dental concerns. Results strongly support that preventive oral healthcare and education must be provided for individuals with a GP diagnosis. As leading oral disease prevention specialists, dental hygienists must be aware of the effects of GP on the oral cavity to help provide person-centred evidence-based care, improve digestive processes, and increase QoL for GP sufferers.

Dental Management of Pedatric Patient with Autism Spectrum Disorder under General Anesthesia: A Case Report

Autism spectrum disorder or autism, corresponds to "a pervasive developmental disorder (PDD), characterized by an abnormal or a deficient development. It is manifested before the age of three, with a characteristic disturbance in the functioning of each of the following three areas: social interaction, verbal and non-verbal communication, and restricted and repetitive behaviors. The combination of these three elements corresponds to the autistic triad. The latter appears in different forms, with varying degrees of severity, and can also vary with age. The oral care of this patient remains delicate, due to the difficulty of communication and the apprehension of his behavioral response. The young female, 13 years old and in good general health, presented to the dental center of Cheikh Khalifa Hospital with spontaneous pain in the right mandibular and left maxillary sectors. She was diagnosed with one of the autistic spectrum disorders: Asperger's syndrome. In our case, the patient was uncooperative and unable to attend the dental treatment in a vigorous state or under conscious sedation. General anaesthesia was the choice option. This last resort allows the patient to lose consciousness, eliminates pain and relaxes the muscles, making dental treatment a pleasant experience. The aim of this poster is to illustrate, through a case study, the protocol for managing a patient with autism spectrum disorder, and to demonstrate the indication for general anesthesia in the treatment of this patient.

Prosthetic stomatitis: treatment and prevention

Relevance. Traumatic prosthodontic stomatitis is the most frequent in clinical prosthetic dentistry, increasing the effectiveness of prevention and treatment of which is considered an urgent problem of practical dentistry. Objective. To study the effectiveness of using various domestic means for oral care in patients suffering from traumatic prosthetic stomatitis. Materials and methods. The study involved 42 elderly patients suffering from denture stomatitis due to the use of removable acrylic dentures. The patients were divided into 2 groups. In the control group after dentures correction they were recommended to use rinses and irrigations of the oral cavity with antiseptic solutions for a week, and later with infusions of medicinal herbs. Patients of the main group during their follow-up used local anti-inflammatory and wound-healing agents produced by thedomestic industry, as well as those improving the fixation of removable dentures. The effectiveness of denture stomatitis treatment and prevention of recurrence was evaluated on the basis of the patient’s complaints and clinical condition of the oral mucosa. Results. . It was established that for effective therapy of denture stomatitis it is necessary to use specially produced anti-inflammatory agents for the oral cavity during the period of acute inflammatory changes in the mucous membrane of the denture bed, and when using removable acrylic dentures it is necessary to recommend ASEPTA denture fixation cream, which has proved itself not only in the aspect of optimization of microbiota and mucosal immunity of the mouth, but also for optimization of psychophysiological state of patients. Their use makes it possible to achieve 81.47% efficacy of prosthetic stomatitis treatment on the 5th day and 100% efficacy of therapy on the 7th day from the beginning of their use by the patient, as well as in the nearest period to provide prevention of this disease recurrence. Conclusion. For secondary prophylaxis of traumatic prosthetic stomatitis, which occurs most often among the complications when patients use removable acrylic dentures, it is advisable to use specially produced by the domestic industry means possessing anti-inflammatory and wound-healing properties, as well as favorably acting on the mucous membrane of the prosthetic bed.

울산지역 일부 고등학생의 치과공포에 대한 관련요인 분석

This study explored the effects of personal characteristics on dental fear in some high school students in Ulsan, and studied the correlation and causal relationship between general fear and dental fear. Data collection was conducted with 401 students enrolled in three high schools from April 22 to May 30, 2024. The validity and reliability of the questionnaire tool were analyzed by applying exploratory factor analysis and principal component analysis, and individual substrate types were classified through cluster analysis. Through t-test, one-way ANOVA, and Scheffe's post-test, the difference in fear related to dental treatment and general fear according to personal characteristics was compared, and the causal relationship between personal characteristics, general fear factors, and fear factors related to dental treatment was identified through path analysis. As a result of the study analysis, female students felt more fear in general than male students, and there was a significant difference between dental fear and general fear according to individual temperament, and as a result of studying the influence relationship between each factor through path analysis, the factor that has the greatest influence on the fear related to dental treatment was found to be the fear of physical threats. On the other hand, fear varies depending on temperament in all fear factors, so a customized approach is necessary to control dental fear.

Provision of Public Dental Services During the COVID-19 Pandemic: Experiences of Dental Staff in Greater Western Sydney, Australia.

The coronavirus (COVID-19) pandemic led to significant changes in health service delivery. Despite the risk in high-exposure environments, frontline workers such as dental staff were expected to continue delivering essential services. This study specifically sought to explore the experiences of dental staff in New South Wales and determine their perceptions of dental care delivery during a pandemic. Purposive sampling was used to recruit twenty-four dental staff from two local health districts. A deductive framework, as described by Braun and Clark, was used to analyse the transcripts. Four major focus areas were identified: responding to protocol changes, adapting to the impact of changes in policy and protocol, modifying dental treatment planning and recommendations for training and implementation of policies. Dental staff reported that management staff were doing all they could and were most supported working in a team. Reduced contact with patients and personal protective equipment helped staff feel safe when seeing patients. Mental health and remote dentistry services could be more supported. Unique challenges were experienced by dental staff and their management during the global COVID-19 pandemic. Future considerations include improved support for staff and further investigation into the effectiveness of options such as teledentistry.

Health Tourism and Grey Tourism: A Virgin Opportunity for Economical growth of Nepal

Health tourism has emerged as a growing fashion worldwide in last few decades. It is driven by the longing to travel to other countries to improve/maintain their health while experiencing the indigenous, cultural and tourist attractions of destinations. Health tourism can be defined as traveling to foreign countries for no less than a day and no more than a year to get the treatment they need to get better. According to Magablih (2001), health tourism is the movement of a patient, with the purpose of getting services that help in recovering his ailment, or at least in stabilizing his medical case, outside his own country for a period of time not less than 24 hours and up to 1 year, each time, and the patient has no intent to work or reside permanently. Available Literatures shows two major branches of Health tourism viz. medical tourism and wellness tourism. Medical tourism involves traveling to foreign countries to seek modern medical treatments and procedures, including elective surgeries, dental treatments, cosmetic surgeries, transplant and specialized surgeries like cardiac surgery and orthopedic therapy. Wellness tourism, on the other hand, focuses on holistic health practices such as yoga, meditation, Ayurveda, and the use of local herbs. This branch emphasizes positive human functioning and preventive care rather than treating illness. Nepal is doing well in wellness tourism but has lot of possibilities in health and grey tourism.

Postoperative acute psychological complications following dental procedures under general anesthesia in uncooperative children

BackgroundTo ensure comprehensive dental treatment under general anesthesia(GA) is a viable option, postoperative complications must be minimized. This study investigates the incidence and determinants of acute psychological complications following comprehensive dental treatment under general anesthesia in uncooperative children.Materials and methodsThis study included 71 healthy children aged 5 to 10 years who exhibited uncooperative behavior during dental examinations. All participants received parental consent. Data was collected using a checklist encompassing demographic information, treatment details, physical complications, and psychological complications. The Modified Child Dental Anxiety Scale faces version (MCDASf) questionnaire was administered pre-operatively and five days post-operatively.ResultsThe first day exhibited the most pronounced physical and psychological complications. While the most physical complications had diminished by the fifth day, the psychological effects remained permanent. Tooth extraction was associated with a statistically significant impact on fear of being left alone(P < 0.001), unspecified fear (P = 0.001), nyctophobia (P = 0.001), and excessive crying(P < 0.001).ConclusionPsychological complications persisted for a longer period compared to physical complications. The number of extracted teeth under GA had a significant influence on children’s fear.

Exploration and innovative application of digital technology in pediatric dentistry

Pediatric dentistry treats patients aged 0-18 years, encompassing the characteristics of general dentistry. The clinical techniques are closely related to restorative dentistry, endodontics, orthodontics, and maxillofacial surgery, while also possessing unique aspects. It particularly focuses on the growth and development patterns of children's dentition and maxillofacial structures. Currently, digital technology has deeply integrated with various clinical disciplines of dentistry, and pediatric dentistry has made significant progress with pediatric-specific digital applications. On one hand, the introduction of mature digital technologies is enabling the digital transformation of pediatric dental treatment models; on the other hand, there is innovative development of new digital technologies tailored to the specific needs of pediatric dental care, filling gaps in the field. Based on years of research in digital technology for pediatric dentistry, our team details the current innovative applications and scientific explorations in this area from these two perspectives. Additionally, we anticipate the potential expansion of digital technologies not yet applied in pediatric dentistry, providing a reference for clinical scholars in the field to conduct exploratory research.

Assessment of Gingival Biotype in the Esthetic Zone among Dental Students at University of Tripoli

The form and structure of the soft tissue and maxillary anterior teeth at the esthetic zone play an important role in determining the outcome. The gingival biotype is important because of the structural characteristics of the periodontics. This study targeted to determine gingival biotype prevalence and characteristics in the esthetic zone among Libyan dental students. A cross-sectional study was done for 220 students aged between 20 and 30 years. In the periodontal department, healthy periodontal tissues with no loss of attachment and the presence of all upper anterior teeth were selected. Clinically, gingival biotype was examined and recorded according to the transparency of the periodontal probe and visual inspection. The present study evaluated the frequency of gingival biotype and its association with gender and crown shape. All measurements were made for a total of students according to gingival transparency and were statistically evaluated. This study has shown that gingival biotype varies among different genders, ages, and tooth forms in our population. Understanding tissue biotypes can help dentists choose the correct dental treatment for better results.

Evaluating the Diagnostic Inter-rater Reliability Between Virtual and In-person Sick-call Examinations at a Military Dental Treatment Facility.

Teledentistry, also known as "virtual" dental examinations, is an innovative approach to increasing access to care. The objective of this study was to evaluate the diagnostic inter-rater reliability between virtual and in-person examinations for patients seeking emergency dental care (sick call) at a military dental treatment facility. One hundred subjects received both virtual and in-person examinations on the same day, in random order. The virtual examiner and subject were stationed in separate rooms and used only a laptop equipped with a camera, microphone, and speaker to complete the virtual exam. In contrast, the in-person examiner had access to all standard care modalities in a dental treatment room. After the first encounter, the subject proceeded to the corresponding virtual or in-person exam, and both examiners determined a diagnosis. Inter-rater agreement was determined between the two encounters for both diagnosis specialty category and diagnostic code using the Kappa coefficient. The results of the inter-rater analyses showed a Kappa score of 0.644 for the diagnosis specialty category (P < .001) and a Kappa score of 0.714 for diagnostic codes (P < .001). Both analyses indicated "substantial" agreement. We conclude that teledentistry can be an effective tool for determining a diagnosis and improving access to care for dental emergencies at military dental treatment facilities.

2D Facial Analysis Performed by a Human Operator Versus an Artificial Intelligence Software

Background: Artificial intelligence (AI) has been a contribution in recent years to the development of new tools for dental, surgical, and esthetic treatment. In the case of image diagnosis, AI allows automated analysis of some facial parameters. The aim of this study was to evaluate the precision and reproducibility of these IA analyses compared with a human operator. Methods: Thirty subjects were selected, and frontal and profile photographs were taken of each. The photographs were previously calibrated and then analyzed by a human operator and an AI for vertical, horizontal, symmetry parameters, and facial profile angles. Results: Statistically significant differences were found in at least 1 vertical, horizontal, symmetry, and facial profile measurement. Conclusions: The 2D facial analysis performed on photographs using AI is an interesting and constantly evolving tool. However, there are still many differences with the analysis performed by the human operator, so it should be used carefully. Further studies using metric measurements should be performed to contrast the values obtained by human operators and AI and to analyze the accuracy of point selection in facial soft tissues.

An Investigation Into Contaminated Waste Composition in a University Dental Clinic: Opportunities for Sustainability in Dentistry.

Many international dental organizations have been advocating for sustainable practices in dentistry, whereby significant reductions in environmental impacts are needed. The aim of this study was to analyze dental clinical waste in a university clinic setting to explore opportunities for sustainable practices. Fifty dental units (chairs) that are routinely used in delivery of dental treatment and involved supervising clinicians, dental students, and patients were randomly selected, and the clinical waste generated was collected, segregated, and weighed. Statistical analysis was performed to analyze differences in waste production based on treatment performed. The mean waste production generated by each chair was 81.4 g of aprons, 56.2 g of gloves, 17.2 g of masks, 24.0 g of sterile wrappings, 48.8 g of other plastics, 100.8 g of cellulose-based items, and 25.8 g of miscellaneous items. Higher waste was generated from the chairs performing endodontic procedures when compared with examinations. A potential annual greenhouse gas saving of approximately 10 kg CO2e per year (when one patient is treated daily) can be achieved if sterile wrapping plastics were to be recycled. Simple yet achievable opportunities for efficient clinical waste management at university clinics exist, which in turn will increase environmental sustainability in the post-COVID-19 era. Increased awareness and incentives for sustainable measures could potentially enhance the possibility of wider adoption of ecofriendly approaches.

Does dental treatment bring health to high-risk people with recurring disease?

Does dental treatment bring health to high-risk people with recurring disease?

Comparative evaluation of anxiety levels among adult patients undergoing dental treatment in pediatric and conventional operatory: a randomised clinical trial

Background: Individuals of all ages often experience anxiety before undergoing dental procedures. Therefore, it's crucial for dentists to create a calming operatory environment with distraction techniques to help alleviate adult patient anxiety. This clinical trial evaluated adult patient anxiety in both conventional and pediatric operatory rooms. Methods: This prospective split-mouth randomized controlled clinical trial was 11 conducted between November 2023 and April 2024. Twenty-four adult patients (13 females and 11 12 males) with a mean age of 37±4.53 years participated in this study. Each participant (n=24) received 13 both conventional and pediatric operatory. Pre- and post-operative pulse rates and anxiety scores 14 were measured using a pulse oximeter and modified Corah’s dental anxiety scale, respectively, in both 15 operatory rooms. Results: The study found a statistically significant decrease in both pulse rate and anxiety scores post-operatively in both operatory settings (p&lt;0.05). However, the reduction in anxiety was more pronounced in the pediatric operatory compared to the conventional operatory (p=0.0433). Participants reported greater comfort and reduced anxiety in the pediatric setting, with 83% favoring its vibrant ambiance and 87% feeling less anxious after treatment in this environment. Conclusions: The vibrant environment of a pediatric dentistry operatory, featuring colorful walls, television, music, and other engaging elements can serve as a more effective for reducing anxiety compared to the plain and monotonous ambiance of the operatory.