History Of Caries Research Articles

Genome-wide association meta-analysis identifies two novel loci associated with dental caries

BackgroundTooth loss significantly impacts oral function and overall health deterioration. Dental caries and periodontal disease are major contributors to tooth loss, emphasizing the critical need to prevent these conditions. Genetic studies have played a crucial role in deepening our understanding of the underlying mechanisms of these diseases. While large-scale genome-wide association studies (GWAS) on dental caries and periodontal disease have been conducted extensively, research focusing on Asian populations remains limited. Given substantial genetic and lifestyle variations across ethnicities, conducting studies across diverse populations is imperative. This study aimed to uncover new insights into the genetic mechanisms of these diseases, contributing to broader knowledge and potential targeted interventions.MethodsWe conducted a GWAS using genome data from 45,525 Japanese individuals, assessing their self-reported history of dental caries and periodontal disease. Additionally, we performed a meta-analysis by integrating our results with those from a previous large-scale GWAS predominantly involving European populations.ResultsWhile no new loci associated with periodontal disease were identified, we discovered two novel loci associated with dental caries. The lead variants of these loci were intron variant rs10974056 in GLIS3 and intron variant rs4801882 in SIGLEC5.ConclusionOur study findings are anticipated to advance understanding of the underlying mechanisms of dental caries and periodontal disease. Thes insights may inform better management strategies for patients affected by these conditions.

Abstract We127: Infective Endocarditis in COVID-19 - An Unusual Suspect

Introduction: The COVID-19 pandemic globally overwhelmed healthcare systems and the complications associated with this illness have contributed to poor outcomes. The hypercoagulable state associated with COVID-19 is well recognized in the literature. Thromboembolic complications such as left ventricular thrombus (LVT), deep venous thrombosis (DVT) and pulmonary embolism (PE) have been increasingly reported. Dhakal et al. published an association between COVID-19 and cardiovascular disease, including possible complication by infective endocarditis (IE) which was confirmed by Amir et al. reporting the first case. Since then, there have been few reported cases. We present a case of COVID-19 in a patient who developed LVT, complicated by non-valvular IE by an underreported organism, Granulicatella adiacens. Case Presentation: A 55-year-old male with history of dental caries, provoked DVT/PE, NSTEMI x2 and STEMI in-stent restenosis requiring thrombectomy presented to the hospital with a 2-day history of shortness of breath, fatigue, cough, change in mentation and right-sided weakness. He tested positive for COVID-19 by NAAT. CXR revealed cardiomegaly and multiple bilateral infiltrates. CT head demonstrated acute ischemic stroke of the left occipital, parietal and posterior temporal lobes, also confirmed on MRI. CTA neck showed 30% stenosis of left ICA. Blood cultures x2 resulted positive for G. adiacens. Echocardiogram was obtained, demonstrating reduced EF of 35% and the presence of a large, 2.7 x 2.2cm mobile thrombus in the apical-septal region of the left ventricle, not visualized on previous echocardiogram 6 months earlier. Methods: Data was collected from direct patient care and electronic medical records. Discussion: G. adiacens is a fastidious gram-positive coccus, part of the nutritionally variant streptococci (NVS) species, and part of the normal oral and gastrointestinal flora. It is also found in dental plaques and endodontic abscesses. NVS account for less than 5% of cases of bacteremia and IE. G. adiacens account for even fewer cases. Two separate meta-analyses conducted by Quintero-Martinez et al. and George et al. failed to reveal any cases of IE attributable to G. adiacens in the setting of COVID-19 infection. In conclusion, we believe that the hypercoagulable state of COVID-19 infection led to endocardial damage and development of LVT, thereby creating a nidus for microorganism adherence from underlying dental carries resulting in thromboembolic stroke.

Minimally invasive teeth whitening enhancements after orthodontic treatment with in-office bleaching: two case reports

Background: Teeth discoloration is one of the adverse effects of orthodontic treatment which causes aesthetic issues that effect on a person’s appearance. The management of teeth discoloration can be done with bleaching because it is easier to perform, faster, more effective, and more conservative than other treatments such as crowns and veneers. There are two types of bleaching techniques supervised by dentists: home bleaching and in-office bleaching. In-office bleaching is one of the most conservative and non-invasive treatment options to restore the aesthetics of discolored teeth. Purpose: This case report observes management of tooth discoloration after orthodontic treatment with in office bleaching using hydrogen peroxide 40%. Case 1: A 24-year-old woman came to Universitas Hasanuddin Dental and Oral Hospital with complaints of yellowish upper and lower teeth after removal of her fixed orthodontic appliance. Case 2: A 24 years old woman came to Universitas Hasanuddin Dental and Oral Hospital with complaints of upper and lower front teeth appearing yellowish in color, noticed from 2 years ago and had undergone orthodontic treatment for four years. Case Management: From clinical examination, both patients’ teeth have no history of caries, sensitive tooth and gingival recession. The Teeth were sensitive to vitality test. The discoloration was treated with external bleaching using 40% hydrogen peroxide. Conclusion: External Bleaching using 40% hydrogen peroxide have results in significant discoloration without changing the shape and arrangement of the patient’s teeth

The Association of Dental Caries or Dental Implant Placement Within One Year of Primary Total Hip Arthroplasty on Medical and Implant Complications

BackgroundTotal hip arthroplasty (THA) adverse events among patients who have dental diagnoses remain unclear. We sought to determine if dental caries or dental implant placements increased (1) 90-day medical complications, (2) 90-day readmissions, and (3) 2-year implant-related complications, including periprosthetic joint infections (PJIs) after THA. MethodsA nationwide database for primary THAs from 2010 to 2021 was queried to compare 3 patient cohorts. Patients who had a history of dental implants or caries within 12 months prior to THA (n = 1,179) or 12 months after THA (n = 1,218) were case-matched to patients who did not have dental history (n = 6,090) by age and comorbidities. Outcomes included 90-day complications, 90-day readmissions, and 2-year implant-related complications. Logistic regression models computed the odds ratios (ORs) of complications and readmissions. P values less than .006 were significant. ResultsPatients who had dental caries or implant placement 12 months before or after THA experienced 1.6-fold greater odds of 90-day medical complications compared to case-matched patients. Readmissions within 90 days increased for patients who had a dental history before (11.7% versus 8.3%; OR: 1.49, P < .0001) and after (14.2% versus 8.3%; OR: 1.84, P < .0001) THA compared to case-matched patients. A dental caries diagnosis or dental implant placement within 12 months following THA increased 2-year implant complications compared to case-matched patients (15.2% versus 9.3%; OR: 1.69, P < .0001), including PJIs (5.3% versus 2.8%; OR: 1.98, P < .0001), dislocations (4.4% versus 2.7%; OR: 1.63, P = .002), and THA revisions (3.9% versus 2.5%; OR: 1.61, P = .005). ConclusionsDental diagnoses within 12 months of THA are associated with increased medical complications. Dental diagnoses occurring 12 months after THA are associated with greater implant-related complications, including PJIs. Delaying invasive dental procedures for 12 months after THA may be advisable.

History of caries arresting - prevention

History of caries arresting - prevention

History of dental caries in Inuit populations: genetic implications and ‘distance effect’

ABSTRACT Dental caries is considered the third most important scourge in the world. In North America, Inuit populations are the population the most severely affected by dental caries. It is often assumed that this situation can be explained by a combination of factors classical for Indigenous populations: remoteness (geographical distance), low economic status and low health literacy (cultural distance). Using a bibliographic approach, we tested this hypothesis of the “distance effect” by exploring the caries prevalence in other Indigenous populations living in high-income countries. Next, we tested whether the high prevalence of caries is due to population-specific characteristics by tracking caries prevalence over the past few centuries. In result, we showed that while other Indigenous populations are more impacted by caries than the general populations, the Inuit populations present the highest prevalence. Paradoxically, we showed also that past Inuit populations were almost immune to caries before 1950. These two elements suggest that the prevalence of caries observed presently is a recent maladaptation and that beyond the effect of cultural and geographical distance, specific biocultural factors have to be investigated.

Increase in Odontogenic Cervicofacial Infection Requiring Hospitalization in Children During COVID-19 Quarantine

The aim of this study was to evaluate the effect of Coronavirus disease-2019 (COVID-19) quarantines on children hospitalizedfor odontogenic cervicofacial infection. The data of patients aged 1 month-18 years, who were followed up with the diagnosis ofodontogenic cervicofacial infection in Çanakkale Onsekiz Mart University Hospital between January 2019 and June 2021 wasexamined, retrospectively. Thirteen patients with a mean age of 8.5±3.8, 7 of whom were male were included in the study. Three of the patients were diagnosed in the pre-COVID-19 period and 10 of them were diagnosed in the second year of COVID-19. Five patients had a known history of dental caries. On physical examination, it was determined that all patients had dental caries in the area corresponding to the infection site. Four patients required abscess drainage, all of whom were presenting in the second year of COVID-19, we isolated Eikenella corrodens, Streptococcus anginosus and Streptococcus intermedius microorganisms in 3 patients. The mean duration of hospitalization was 5.3±3 days. In conclusion, COVID-19 quarantine causes an increase in odontogenic cervicofacial infection requiring intravenous antibiotics and abscess drainage.

Coexistence of pulmonary actinomycosis with diffuse panbronchiolitis: A case report

Abstract Pulmonary actinomycosis is difficult to diagnose, and many clinicians lack an understanding of the disease. Delayed diagnosis and misdiagnosis are common. Diffuse panbronchiolitis (DPB) is a rare clinical and pathologic syndrome that involves pulmonary bronchiolitis and chronic sinusitis. This report describes a case of DPB complicated with pulmonary actinomycosis. A 77-year-old Chinese male was admitted with complaints of chronic cough, expectoration, shortness of breath, and fever. He had a history of smoking, drinking, and dental caries. Chest examination revealed coarse crackles. Pulmonary function tests showed an obstructive defect. Computed tomography of the chest showed consolidation shadows, thickening and dilatation of bronchiolar walls, and diffuse central lobular nodules in both lungs. Histopathological examination of a surgical lung biopsy specimen confirmed DPB combined with actinomycosis. The patient’s symptoms and radiological findings were significantly improved after penicillin combined with azithromycin therapy. Actinomycosis should be considered in older men who have structural lung diseases with recurrent lung infections. Early histological diagnosis and combination antibiotic therapy are very important in such patients.

Streptococcus cristatus bacteremia in a patient with poor oral hygiene: a case report

BackgroundStreptococcus cristatus is a member of the Mitis streptococcus group. Like other members of this group, it resides on mucosal surfaces of the oral cavity. However, little is known about its ability to cause disease as there are only a handful of cases in the literature. Two of these cases involved infective endocarditis with significant complications. However, these cases involved additional microbes, limiting the inferences about the pathogenicity of Streptococcus cristatus.Case presentationA 59-year-old African American male with end-stage cryptogenic cirrhosis and ascites presented with fatigue and confusion. A paracentesis was negative for spontaneous bacterial peritonitis, but two separate blood cultures grew Streptococcus cristatus. Our patient had a history of dental caries and poor oral hygiene, which were likely the source of the infection. Echocardiograms revealed new aortic regurgitation, indicating “possible endocarditis” per the Modified Duke Criteria. However, since his clinical picture and cardiac function were reassuring, we elected against treatment for infective endocarditis. He was treated for bacteremia with a 2-week course of cephalosporins consisting of 8 days of ceftriaxone, transitioning to cefpodoxime after discharge. Despite having end-stage liver disease, our patient did not experience any significant complications from the infection.ConclusionA patient with end-stage cirrhosis and poor oral hygiene developed bacteremia with an oral bacterium called Streptococcus cristatus. Unlike previous cases in literature, our patient did not meet criteria for a definitive diagnosis of infective endocarditis, and he experienced no other complications from the infection. This suggests coinfectants may have been primarily responsible for the severe cardiac sequelae in prior cases, whereas isolated Streptococcus cristatus infection may be relatively mild.

Influence of height discrepancy between pulp chamber floor and crestal bone in the mechanical fatigue performance of endodontically-treated teeth restored with resin composite endocrowns

ObjectiveTo explore and characterize the effect of the discrepancy between crestal bone height (CB) and pulp chamber floor (PCF) in the fatigue performance of endodontically-treated teeth rehabilitated with an endocrown restoration. Materials and methodsA total of 75 human molars free of defects, caries history or cracks were selected, then endodontically treated and randomly allocated into 5 groups (N = 15) according to the difference between PCF and CB, as follows: PCF 2 mm above, PCF 1 mm above, PCF leveled, PCF 1 mm below and PCF 2 mm below. Endocrown restorations were made with composite resin (Tetric N-Ceram, shade B3, Ivoclar) in 1.5 mm thickness and luted with a resin cement (Multilink N, Ivoclar) onto the dental elements. Monotonic testing was performed to define the fatigue parameters, and a cyclic fatigue test was used until failure of the assembly. The collected data were submitted to statistical survival analysis (Kaplan-Meier followed by Mantel-Cox and Weibull), fractographic analysis and finite element analysis (FEA) were performed as complementary analyzes. ResultsThe PCF 2 mm below and PCF 1 mm below groups presented the best results regarding fatigue failure load (FFL) and number of cycles for failure (CFF) (p < 0.05), but presented no difference between each other (p > 0.05). The PCF leveled and PCF 1 mm above groups presented no statistical difference between them (p > 0.05), but performed better than the PCF 2 mm above group (p < 0.05). The rate of favorable failures of PCF 2 mm above, PCF 1 mm above, PCF leveled, PCF 1 mm below and PCF 2 mm below groups were 91.7%, 100%, 75%, 66.7% and 41.7%, respectively. FEA showed different stress magnitudes according to the pulp-chamber design. ConclusionThe insertion level of the dental element to be rehabilitated with an endocrown interferes in the mechanical fatigue performance of the set. The discrepancy between the CB height and the PCF has a direct effect, where the higher the PCF in relation to the CB, the greater the risk of mechanical failure of the restored dental element.

History of dental caries

Dental caries is the single most common chronic childhood disease.

Dental caries and risk of newly-onset systemic lupus erythematosus: a nationwide population-based cohort study

Objective This study investigated whether patients with history of dental caries are associated with an increased risk of newly-onset systemic lupus erythematosus (SLE). Methods A total of 501,461 carious patients and 258,918 controls without carious teeth were enrolled between 1997 and 2013 from the National Health Insurance Research Database. Subgroup analyses were conducted based on restorative materials including amalgam, composite resins, or both. The cumulative incidence and hazard ratios (HRs) of SLE development were derived after adjusting for age, sex, socioeconomic status, income, insured classification, comorbidities, and frequency of dental visit in a multivariable model. Results The risk of SLE was significantly higher in carious patients (HR = 1.98, 95% confidence interval [CI] = 1.65–2.38) compared to controls. Dose-dependent relationship between caries and risk of SLE was identified. The risk of SLE was higher among those who had dental visits ≧11 (HR = 2.53, 95% CI = 1.86–3.43), followed by those with 3–10 dental visits (HR = 1.86, 95% CI = 1.36–2.54), when compared to those with 1–2 visits, and was higher among those who had carious teeth extractions ≧5 (HR = 1.88, 95% CI = 1.19–2.97), followed by those with 1–4 carious teeth extractions (HR = 1.36, 95% CI = 1.17–1.59) than those without extraction. The risk of SLE for dental caries management among different restorative materials, including amalgam, composite resins, or both, was not statistically different. Conclusions Patients with dental caries were associated with higher SLE risks. The relationship between dental caries and risk of SLE was dose-dependent, regardless of the material used for the restoration.

Prediction model for early childhood caries risk based on behavioral determinants using a machine learning algorithm

BackgroundAn easily accessible caries risk prediction model (CRPM) based on nonbiological predictors is lacking. Developing a CRPM for community screening is essential for children's dental health promotion by a public health approach. ObjectiveThis study aimed to develop and validate a caries risk prediction model (CRPM) for children using a machine learning algorithm based on dental care behavioral factors and other nonbiological factors using a 3-month multicenter cohort. MethodsChildren aged 12 months to 60 months were recruited at three primary care settings and three kindergartens in Chengdu, China. Dental examination was conducted for all enrolled children by calibrated pediatric dentists at baseline and three months later. All parents of the enrolled children were asked to complete a questionnaire with dental-related information. Machine learning algorithms, including random forest, logistic regression, and adaptive boosting, were used to develop a prediction model. Sensitivity, specificity, accuracy, precision, negative predictive value and F-score were reported to estimate the internal validation of the models. ResultsA total of 481 out of 745 children without a history of caries experience at baseline remained for analysis. In the total sample population, 236 (49.1%) children were female, and the mean age was 31.2 months. During the follow-up exams, 66 (13.6%) children had new-onset caries. The child's age, height, weight, family caries status, brush teeth two minutes per time, fluoride toothpaste usage, brushing twice per day, parental monitoring brushing teeth, mother delivery method, brushing child's teeth every day, child number counts, and night feeding frequency in the last month were measured and included in a prediction model. Of the prediction models, the highest area under the curve of RF was 0.91 (95% CI: 0.87- 0.94), followed by 0.86 (95% CI: 0.81-0.91) of LR and 0.81 (95% CI: 0.76-0.86) of AdaBoost. ConclusionIn this CRPM, new onset of dental caries in three months among children aged < 60 months could be predicted by answering twelve nonbiological questions. A good model performance was shown within the internal validation. Dental home care could be improved by referring the CRPM result before new caries onset.

Mundhygienekenntnisse und -verhalten bei Kindern

Objectives: Oral hygiene plays an important role in eliminating biofilms and preventing dental caries. However, the implementation of oral health knowledge that children learn from their parents and through school dental health programs remains poorly studied. The aim of this study was to investigate oral hygiene knowledge and its practical utilization in children and young adolescents (CYAs) aged 2-15 years. Materials and methods: Using a questionnaire-based, interview-style community survey, an on-site practical assessment of CYAs' toothbrushing skills was conducted during two 1-day public science-promoting events held at a major German university hospital in consecutive years. CYAs first answered questions on toothbrushing frequency, dental aids used, and dental care. They subsequently underwent diagnostic staining and demonstrated their brushing technique and method. CYAs' responses (percentages) to questionnaire items addressing oral hygiene knowledge and practice, and on-site assessment of toothbrushing skills served as the main outcome measures. Results: Of 244 participating CYAs, 178 (73%) CYAs had no history of caries; the percentage increased with age from 5% in 2- to 5-year old children to 40% in those aged > 10 years. Of 117/244 (48%) indicating that teeth should be brushed three times daily, 80/117 (68%) self-reported brushing twice daily, 32/117 (27%) reported brushing three times, and 4/117 (3%) stated doing so only once. Although 131/244 (54%) considered that teeth should be brushed for 3 min, 77/131 (59%) self-reported actually doing so and 41/131 (31%) reported brushing for 2 min. Seventeen of 42 (40%) participants aged >10 years showed no systematic brushing method, with 21/42 (50%) failing to clean their teeth completely. Participants aged 6-10 years exhibited the highest proportion (97/134, 72%) of complete cleaning. Good adherence to oral health recommendations (i.e., brushing ≥ twice a day for ≥2 min) was observed in 212/244 (87%) CYAs, while the remaining 32/244 (13%) exhibited poor adherence.Conclusion: CYAs knew about the importance of oral hygiene and cleaned their teeth frequently. However, translation of their knowledge into practice showed deficiencies. Repeated encouragement to put oral health knowledge into practice is important.

The Importance of Oral History: Does Dental Implant Placement or Caries One Year Before or After Primary Total Knee Arthroplasty Increase Medical Complications and Periprosthetic Joint Infections?

BackgroundConsensus regarding prior dental problems on the outcomes of total knee arthroplasty (TKA) patients is lacking. Therefore, our objectives were to determine the association of dental caries or dental implant placement in TKA patients on the following: (1) medical complications; (2) health care utilization (lengths of stay and readmissions); (3) implant-related complications; and (4) expenditures. MethodsA retrospective query was performed using an administrative claims database for 3 patient cohorts undergoing primary TKA from 2010 to 2020. Patients who had a history of dental caries or implant placement 1 year prior to TKA (n = 1,466) and 1 year after TKA (n = 1,127) were case-matched to patients who did not have a dental history by age and comorbidities. Outcomes included 90-day complications, health care utilization parameters, 2-year implant complications, and expenditures. Logistic regression models computed odds ratios (OR) of complications and readmissions. P values less than 0.005 were significant. ResultsPatients who had a dental implant placement prior to TKA had higher frequency of complications (20.05 versus 14.01%; OR: 1.53, P < .0001), including myocardial infarctions (2.52 versus 1.23%; OR: 2.08, P = .0002) and pneumonia (2.52 versus 1.24%; OR: 2.06, P = .0002). Lengths of stay (3.28 versus 2.98 days; P = .255), readmission rates (4.71 versus 4.28%; P = .470), and implant-related complications including periprosthetic joint infections (3.14 versus 2.63%; OR: 1.20, P = .279) were similar between patients lacking dental history. Expenditures were higher in patients who had a postoperative and preoperative dental history ($19,252 versus $19,363 versus 17,980; P < .001). ConclusionDental caries or implant placement may reflect overall worse medical condition resulting in more complications and higher costs after TKA. Dental history screening preoperatively may assist arthroplasty surgeons in minimizing complications.

Do additional high-fluoride interventions among low caries prevalence orthodontic cases using fixed appliances reduce caries incidence?

Design Three-arm randomised controlled trial (RCT). Three groups were contrasted: group one used only a 1,450 ppm fluoride toothpaste as an adjunctive caries prevention method. Group two used only 5,000 ppm fluoride toothpaste as an adjunctive caries prevention method. Group three was similar to group one but with the addition of a fluoride mouth rinse (0.2% sodium fluoride). The Decayed Initial Filled Surfaces (DIFS) index based on progress radiographs was used as the primary outcome variable.Case selection Prospective orthodontic patients with a low caries prevalence are willing to participate in the RCT.Data analysis Non-parametric statistical tests were used to compare the changes in DIFS between the groups. A Cochrane-Mantel-Haenszel method was applied to control for differences in baseline values during relative risk calculations.Results All groups had an increase in DIFS during treatment (between 36% and 48% of the participants). Caries incidence was not significantly affected in either treatment group when considering two cut-off values for DIFS (one and two points). The same applied to the use of decayed filled teeth as the outcome variable.Conclusions This clinical trial assessed the potential impact of supplementary, high-fluoride interventions on caries incidence during orthodontic treatment with fixed appliances. Included cases had a low caries history. Adjunctive, fluoride-based interventions had no bearing on the incidence of caries as measured through the DIFS index.

Caries Experience among Children with History of Neonatal Stunting.

Children with neonatal growth retardation (defined as birth length <48cm) are at risk for chronic malnutrition that begins before birth and continues into infancy. Stunting can adversely affect a child's growth and development, including oral health itself, and especially the experience of dental caries. This study analyzed the dental caries experience in children with neonatal growth retardation. AND METHODS: This was a baseline and 1-year follow-up analysis of a cohort of stunted children in a potential stunting site in Bandung City. Annual data collection included interviews with mothers and dental and anthropometric examinations of children. Descriptive analysis was performed in SPSS. Data were recorded on paper forms and manually entered into a Microsoft Excel spreadsheet for later analysis using IBM SPSS (version 23.0). After assessment, descriptive statistics was generated prior to bivariate analysis. Fifty-five children met the inclusion criteria and participated in the 1-year study. Decay, missing, filling teeth (Dmft) was in the intermediate category (4.13) at baseline and fell into the high category (5.16) at 1-year follow-up, although the increase in caries remained in the low category. Dysplastic children with a history of neonatal developmental delay experience dental caries beginning in the first year of life and may become more severe later in life.

The influence of prior dental pathology on medical complications and peri-prosthetic joint infections following primary shoulder arthroplasty.

Antibiotic prophylaxis before invasive dental procedures is a common practice in the USA. Consensus regarding the influence of prior dental pathology (DP) on postoperative complications is lacking. The objectives are to determine the association of DP prior to shoulder arthroplasty (SA) on: (1) lengths of stay (LOS), (2) medical complications, (3) readmissions, (4) implant-related complications including peri-prosthetic joint infections (PJIs) and (5) healthcare expenditures. The PearlDiver database was queried for primary shoulder arthroplasty from 2010 to 2020. Patients with history of dental caries or dental implant placement before SA represented the study group (n = 1419). Patients without prior DP represented controls (n = 7062). Study group patients were 1:5 ratio matched to controls by age, sex, and comorbidities. Outcomes included LOS, 90-day complications, readmissions, 2-year implant-related complications, and healthcare reimbursements. Logistic regression was used to calculate odds ratios (OR) of complications and readmissions. T tests compared LOS and costs. P values < 0.003 were significant. LOS (2.17 vs. 2.07days; p = 0.071) were similar between groups. Patients with DP had higher 90-day medical complications compared to controls (OR: 1.74, p < 0.0001), including myocardial infarctions (2.2% vs. 0.8%; OR: 2.79, p < 0.0001), acute kidney injuries (8.3% vs. 4.6%; OR: 1.92, p < 0.0001), and pneumonias (8.7% vs. 5.3%; OR: 1.72, p < 0.0001). Readmission rates (1.97% vs. 1.54%; p = 0.248) were similar. Two-year implant complications were higher in patients with DP compared to controls (16.1% vs. 11.5%; OR: 1.38, p = 0.0003), including dislocations (6.4% vs. 4.5%; OR: 1.45, p = 0.002) and mechanical loosenings (4.0% vs. 2.4%; OR: 1.67, p = 0.001); however, PJIs were similar (2.2% vs. 1.9%; OR: 1.12, p = 0.583). Healthcare expenditures between groups were similar ($12,611 vs. $12,059; p = 0.075). Patients with prior DP have higher 90-day medical complications and 2-year implant-related complications. Two-year incidence of PJIs were similar between groups. These findings can help shoulder surgeons counsel patients with a pertinent dental history. Retrospective comparative study.

CHARACTERIZATION OF THE ORAL HEALTH OF INDIVIDUALS WITH SPECIAL NEEDS AT CERCI PORTALEGRE

Introduction: At the present time, progress has been made between the relation in oral health and general health. Therefore, deepen knowledge of the oral health status of a population is essential for the establishment of health promotion measures. Since populations with special needs require a multidisciplinary approach, it is even more important to define these measures. The first step will be to establish the baseline values of a population, and thus to better understand their oral health needs. Objectives: This work aims to characterize the oral health status of a population with special needs at Cerci Portalegre. Methods: After obtaining the informed consent of the heads of the institution and the individuals’ legal guardians, as well as the consent of the individuals, the observation of the oral cavity was carried out to collect the present and past history of dental caries using the DMFT index (index of decayed, missing and filled teeth) and the evaluation of bacterial plaque accumulation on the dental surface by the DI’S index (bacterial plaque index). Results: Forty individuals were observed, 29 men and 11 women, with a mean age of 35 years. It was observed that these individuals had a mean value of DMFT of 4.7 decayed, missing and filled teeth, with no statistically significant difference between men and women (p=0.952). The mean value of DI’S was 2.02 which represents a high value of bacterial plaque accumulation which, being an etiological factor of oral diseases, indicates a risk of developing oral health problems. Conclusions: Patients with disabilities in most cases require more care at the level of oral health, due to their physical and mental inability to perform correct oral hygiene habits. Therefore, promoting oral health and educational measures may play a relevant role in the study population for the prevention of oral health problems and consequently other health problems.

T-shaped toothbrush for plaque removal and gingival health in children: a randomized controlled trial

BackgroundTo evaluate an experimental T-shaped toothbrush for plaque removal and gingival health when compared to a conventional toothbrush among children.MethodsThis single blind parallel randomized controlled trial was conducted on 8–10-year-old healthy schoolchildren with no history of recent antibiotic intake, proximal caries or more than 3 missing teeth per quadrant. A computer-generated randomization list allocated child to the 2 groups. Each child received detailed instructions for tooth brushing. Gingival health and plaque scores were recorded in school at baseline, 2 weeks, 1 month and 3 months in a portable dental chair by an examiner who was blind to the allocated toothbrush. A general feedback on the use of the T-shaped toothbrush was obtained at 3 months. Data was analyzed using two-way repeated measure ANOVA, Generalized estimating equation and Bonferroni test.ResultsA total of 195 eligible children were invited, 110 parents gave consent and 100 children completed the study; 50 in each group. There were statistically significant reductions in mean gingival and plaque scores at each visit when compared to baseline for both toothbrushes (p < 0.05). There were no statistically significant differences between scores for the two toothbrushes at each visit (p > 0.05). Majority of participants gave positive feedback regarding the T-shaped toothbrush.ConclusionsBoth toothbrushes had similar efficacy in removing plaque and improving gingival health among children. The T-shaped toothbrush is an alternative to the conventional toothbrush for oral hygiene in children.Trial registration Retrospectively registered at ClinicalTrials.gov Registry—NCT03989479 18/06/2019.