Routine Dental Treatment Research Articles

Effect of self-efficacy and empathy characteristics of post-graduate residents on local anesthesia administration performances: Pilot study.

The "Profile and Competences for the European Dentist" document addresses some competencies as a must for graduating dentists, some of which are stated as providing humane and compassionate care to all patients and administering local anesthesia for pain management. Within this perspective, this study aims to investigate the effect of self-efficacy and empathy characteristics of post-graduate residents (post-grads) on the perceived pain and anxiety scores of children during local anesthesia administrations. Ten pediatric dentistry post-grads and 91 children aged between 5 and13 years participated in the study. Post-grads performed 120 injections as part of their routine dental treatment in children. Demographic data, self-efficacy, and empathy scale scores of post-grads, anxiety, and pain scores of children were recorded during injections. Self-efficacy scale scores of residents ranged between 66 and 74 with a mean score of 69.80±2.69. Empathy scale scores were between 77 and 97 and the mean was 89.20±6.24. Significant and negative correlations were observed between self-efficacy scores of post-grads and pain scores of children (r = -0.205 and p = 0.025). Empathy scores of post-grads established a significant and positive correlation with children's anxiety scores (r = 0.244 and p<0.007). Self-efficacy and empathy characteristics of post-grads were found to have an impact on the perceived pain and anxiety scores of children during local anesthesia administrations. Empathetic post-grads with higher self-efficacy provided an enhanced local anesthesia experience for child patients. Therefore, educational programs should also be organized aiming to develop self-efficacy and empathy characteristics of post-grads for a more humane and compassionate dental experience in child patients.

ODONTOGENIC FIBROMYXOMA: CASE REPORT AND A REVIEW OF THE LITERATURE

<h3>BACKGROUND</h3> Fibromyxoma is a rare benign ectomesenchymal intraosseous tumor and is essentially a form of myxoma. The abundant collagen content in the lesion characterizes it as fibromyxoma. Myxomas can be found in many parts of the skeleton such as the extremities; however, this tumor is classified as odontogenic because of the existence of odontogenic epithelium. Histopathologically, fibromyxoma contains collagen with stellate and spindled-shaped cells floating in a mucoid intercellular matrix. This myxomatous matrix gives the lesion the ability to infiltrate marrow spaces. <h3>CASE REPORT</h3> A 63-year-old African American male patient presented for routine dental treatment. A panoramic radiograph revealed a unilateral, partially well-defined, multilocular radiolucent lesion with straight thin septa and scalloped and corticated borders, extending antero-posteriorly from the distal root of tooth 19 to the left ramus, causing expansion and thinning of cortical boundaries. The mandibular canal was displaced inferiorly. Cone beam computed tomography revealed faint septa most consistent with an odontogenic myxoma. Histopathologic examination was consistent with an odontogenic fibromyxoma. The management was a left mandibular resection and placement of a reconstruction plate with condylar prosthesis. <h3>DISCUSSION/CONCLUSIONS</h3> Odontogenic fibromyxomas are benign but locally aggressive, with a 25% recurrence rate due to its ability to infiltrate adjacent marrow spaces. As a consequence, management of this tumor is more aggressive. The radiographic features are similar to benign multilocular lesions such as ameloblastoma and odontogenic keratocyst (OKC). Contrast magnetic resonance imaging maybe useful in differentiating among these lesions because fibromyxomas show homogenous high signal intensity owing to the collagenous content. The presentation of this lesion in our current case has clinical and statistical relevance for its rare nature.

Articaine in dentistry: an overview of the evidence and meta-analysis of the latest randomised controlled trials on articaine safety and efficacy compared to lidocaine for routine dental treatment

ObjectivesTo comprehensively review the existing studies of articaine in dentistry and conduct a systematic review and meta-analysis to answer the following Population, Intervention, Comparison and Outcome question: “Is articaine a safe and efficacious local anaesthetic for routine dental treatment compared to lidocaine?”MethodsDatabase searches were conducted in Medline Ovid, Medline Pubmed, Scopus, Emcare, Proquest and the Cochrane Central register of Controlled Trials. Inclusion criteria were all existing English, human, randomised controlled trials of interventions involving 4% articaine and 2% lidocaine in routine dental treatment. Twelve studies were included for meta-analysis using Cochrane Review Manager 5 software. Anaesthetic success odds ratios were calculated using a random-effects model.ResultsArticaine had a higher likelihood of achieving anaesthetic success than lidocaine overall and in all subgroup analyses with varying degrees of significance. Overall (OR: 2.17, 95% CI: 1.50, 3.15, I2 = 62%) articaine had 2.17 times the likelihood of anaesthetic success of lidocaine (P < 0.0001). For mandibular blocks (OR: 1.50, 95% CI: 1.14, 1.98, I2 = 0%) articaine had 1.5 times the likelihood of anaesthetic success of lidocaine (P = 0.004). For all infiltrations, maxillary and mandibular (OR: 2.78, 95% CI: 1.61, 4.79, I2 = 66%) articaine had 2.78 times the likelihood of anaesthetic success of lidocaine (P = 0.0002). None of the studies reported any major local anaesthetic-related adverse effects as a result of the interventions.ConclusionsArticaine is a safe and efficacious local anaesthetic for all routine dental procedures in patients of all ages, and more likely to achieve successful anaesthesia than lidocaine in routine dental treatment. Neither anaesthetic has a higher association with anaesthetic-related adverse effects.

Reduction of hsCRP levels following an Oral Health Education Program combined with routine dental treatment

ObjectivesThe present study aimed to determine the effect of a personalised oral health education program, in combination with routine dental treatment, on serum biomarkers of systemic disease compared to dental treatment alone in a population from a low-socioeconomic community with poor oral health. MethodsThis secondary analysis of a randomised clinical trial involved 295 participants (mean age, 45.4 ± 11 years) assigned to two groups. One group received dental treatment combined with the Oral Health Education Program (OHEPDT), while the second group (DT) received dental care without the Education Program. Serum levels of high-sensitivity C-reactive protein (hsCRP), lipid profile (total cholesterol, triglycerides, and high- and low-density lipoprotein cholesterol), and HbA1c levels were analysed at baseline and after 12 months. Changes in diet, smoking and alcohol consumption were also determined. ResultsNo intergroup differences were observed for the lipid profile and HbA1c levels. A reduction in the hsCRP levels at the 12-month follow-up was observed in the OHEPDT group, which was significantly different from the DT group (p = 0.01). Multivariate modelling indicated that baseline hsCRP levels (p = 0.000), baseline body mass index (p = 0.000), and higher consumption of vegetables (p = 0.021) predicted a reduction in hsCRP levels. ConclusionsThis study demonstrated that personalised oral health education combined with routine dental treatment was associated with a significant reduction in hsCRP levels subsequent to dietary behavioural changes. These findings suggest that personalised oral health education in combined with routine dental treatment may have beneficial effects on general health. Clinical significanceThe strategy for developing an oral health program that involves education of the modifiable common risk factors for general health has beneficial effects and should be one of the priority components of these programs to improve oral and general health, particularly for at-risk communities.

Sensitizing Family Caregivers to Influence Treatment Compliance among Elderly Neglected Patients-A 2-Year Longitudinal Study Outcome in Completely Edentulous Patients.

Healthcare workers have reported a certain segment of geriatric patients that are suffering from abuse/neglect, which in turn has been associated with anxiety, depression, and helplessness in the individual. Family caregivers (blood relations), being the most common perpetrators of elder abuse and neglect (EAN), have also been shown to respond to sensitization if the type of EAN and the interventions are appropriate. This study was aimed to comparatively analyze the influence of intervention (psychotherapeutic sensitization of FCG) upon long-term (24 months) treatment maintenance and satisfaction in elderly neglected patients. One hundred and fifty patients (aged 41–80 years) suffering from elder neglect (EN) (self-confession) and their respective FCGs, fulfilling the study criteria, participated in this longitudinal 2-year study. The patients were randomly distributed (simple random, convenient) in two equal groups (75 each), namely Group (GP) A (control) and GP B (test). A standardized, complete denture treatment was initiated for all the participants. Both the FCGs and the patients of GP B were sensitized (psychotherapeutic education) for EN, while there was no such intervention in GP A. The influence of such intervention was measured for denture maintenance [denture plaque index (DPI) scores] and treatment satisfaction (10-point visual analog scale). Absolute/relative frequencies and means were major calculations during data analysis. Differences between the groups for any treatment compliance parameter was done through the unpaired t-test, while Karl Pearson’s test determined the level of relationship between variables (p-value < 0.05). Decrease in mean DPI scores (suggesting improvement) was seen among patients in GP A from 1 month (m = 2.92) to 24 months (m = 2.77). A negligible increase in DPI scores was observed among patients of GP B from 1 month (m = 1.38) to 24 months (m = 1.44). Differences in mean values between the two groups were statistically significant at 24-month intervals, while the relationship between the variables was nonsignificant. FCG sensitization through psychotherapeutic education shows a long-term positive influence on the treatment compliance (maintenance and satisfaction). Identifying the existence of EAN among geriatric patients, followed by psychotherapeutic education of FCGs is recommended for routine medical and dental long-duration treatment procedures.

Dental therapists compared with general dental practitioners for undertaking check-ups in low-risk patients: pilot RCT with realist evaluation

BackgroundMany dental ‘check-ups’ in the NHS result in no further treatment. The patient is examined by a dentist and returned to the recall list for a further check-up, commonly in 6 or 12 months’ time. As the oral health of regular dental attenders continues to improve, it is likely that an increasing number of these patients will be low risk and will require only a simple check-up in the future, with no further treatment. This care could be delivered by dental therapists. In 2013, the body responsible for regulating the dental profession, the General Dental Council, ruled that dental therapists could see patients directly and undertake check-ups and routine dental treatments (e.g. fillings). Using dental therapists to undertake check-ups on low-risk patients could help free resources to meet the future challenges for NHS dentistry.ObjectivesThe objectives were to determine the most appropriate design for a definitive study, the most appropriate primary outcome measure and recruitment and retention rates, and the non-inferiority margin. We also undertook a realist-informed process evaluation and rehearsed the health economic data collection tool and analysis.DesignA pilot randomised controlled trial over a 15-month period, with a realist-informed process evaluation. In parallel, we rehearsed the health economic evaluation and explored patients’ preferences to inform a preference elicitation exercise for a definitive study.SettingThe setting was NHS dental practices in North West England.ParticipantsA total of 217 low-risk patients in eight high-street dental practices participated.InterventionsThe current practice of using dentists to provide NHS dental check-ups (treatment as usual; the control arm) was compared with using dental therapists to provide NHS dental check-ups (the intervention arm).Main outcome measureThe main outcome measure was difference in the proportion of sites with bleeding on probing among low-risk patients. We also recorded the number of ‘cross-over’ referrals between dentists and dental therapists.ResultsNo differences were found in the health status of patients over the 15 months of the pilot trial, suggesting that non-inferiority is the most appropriate design. However, bleeding on probing suffered from ‘floor effects’ among low-risk patients, and recruitment rates were moderately low (39.7%), which suggests that an experimental design might not be the most appropriate. The theory areas that emerged from the realist-informed process evaluation were contractual, regulatory, institutional logistics, patients’ experience and logistics. The economic evaluation was rehearsed and estimates of cost-effectiveness made; potential attributes and levels that can form the basis of preference elicitation work in a definitive study were determined.LimitationsThe pilot was conducted over a 15-month period only, and bleeding on probing appeared to have floor effects. The number of participating dental practices was a limitation and the recruitment rate was moderate.ConclusionsNon-inferiority, floor effects and moderate recruitment rates suggest that a randomised controlled trial might not be the best evaluative design for a definitive study in this population. The process evaluation identified multiple barriers to the use of dental therapists in ‘high-street’ practices and added real value.Future workQuasi-experimental designs may offer more promise for a definitive study alongside further realist evaluation.Trial registrationCurrent Controlled Trials ISRCTN70032696.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full inHealth Services and Delivery Research; Vol. 9, No. 3. See the NIHR Journals Library website for further project information.

RCT on the effectiveness of the intraligamentary anesthesia and inferior alveolar nerve block on pain during dental treatment

ObjectiveTo compare the effectiveness and complications of intraligamentary anesthesia (ILA) with conventional inferior alveolar nerve block (IANB) during injection and dental treatment of mandibular posterior teeth.Materials and methodsIn this randomized, prospective clinical trial, 72 patients (39 males, 33 females), scheduled for dental treatment of mandibular posterior teeth, were randomly allocated to ILA group (n = 35) received ILA injection or IANB group (n = 37) received the conventional IANB. Our primary outcome was to assess pain and stress (discomfort) during the injection and dental treatment, using the numeric rating scale (NRS) from 0 to 10 (0 = no pain, 10= the worst pain imaginable), whereas recording 24-h postoperative complications was our secondary outcomes.ResultsPatients in ILA group reported significantly less pain during injection when compared with IANB group (p = 0.03), while pain during dental treatment was similar in both groups (p = 0.2). Patients in both groups also reported similar law values of discomfort during treatment (p = 0.7). Although no signs of nerve contact or any other postoperative complications were observed, five patients in IANB group (none in ILA group) reported temporary irritations.ConclusionThis study showed equivalent effectiveness of both intraligamentary anesthesia and conventional inferior alveolar nerve block, for pain control during routine dental treatment of mandibular posterior teeth. Nevertheless, ILA showed significantly less pain during injection. No major postoperative complications in both groups were observed.Clinical relevanceILA could be considered as an effective alternative for routine dental treatment.Trial registrationNCT04563351

Paediatric dental care during and post-COVID-19 era: Changes and challenges ahead.

BackgroundCOVID-19 is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus is transmitted through respiratory droplets and by physical contact from contaminated surfaces to the mucosa. Its route of transmission has caused a significant challenge in medical and dental healthcare.ObjectiveThis article aims to review the literature and information available on the provision of paediatric dental treatment during and post-pandemic and to provide specific recommendations on the safe provision of paediatric dental care.ResultsChildren infected by SARS-CoV-2 have no or milder COVID-19 symptoms and are potential vectors in spreading the disease. Routine dental treatment is suspended in many countries because of the increased risk of cross-infection in dental practices. Only emergency dental care is provided for urgent conditions. It is necessary to gradually reinstate regular dental care to paediatric patients and maintain their good oral health. To control the disease transmission and maintain the oral health of the population, minimally intervention techniques that minimise or eliminate aerosol generation, plus comprehensive oral health preventive measures should be practised to safeguard safety at dental practices in this unprecedented time.ConclusionsRobust infection control guidelines should be implemented in dental clinics to minimise the risk of infection and to ensure the safety of patients and staff during the pandemic. Three levels of preventive care should be practised to prevent oral diseases and improve children's oral health in this COVID-19 era. Treatment should be prioritized to patients in urgent needs and aerosol-generating procedures should be minimized.

Trends in Dental Medication Prescribing in Australia during the COVID-19 Pandemic.

Introduction:The coronavirus disease 2019 (COVID-19) pandemic and subsequent restrictions on dental services have had a significant impact on the provision of dental care in Australia and around the world.Objectives:To investigate the impact of COVID-19 on medications prescribed by dentists under the Australian Pharmaceutical Benefits Scheme (PBS).Methods:Data on the number of dental prescriptions dispensed for all medications listed on the PBS Dental Schedule, from January 2019 to June 2020, were extracted from publicly available data sets. Analysis of prescription trends was performed for 1) total medications, 2) each major medication class, and 3) individual medications. The number of prescriptions dispensed in each month from January 2020 to June 2020 was compared to the same month in 2019 to determine the relative (percentage) change, and z statistics were used to determine whether changes were statistically significant.Results:There was a significant decrease in dental prescriptions in April 2020 compared to April 2019 (14,785, 18%; P < 0.05). Decreases in prescriptions for antibiotics (10,512, 16%; P < 0.05) and opioid analgesics (3,129, 18%; P < 0.05) were smaller compared to other major medication classes. There was a significant increase in June 2020, compared with June 2019, for prescriptions of amoxicillin with clavulanic acid (4,903, 20%; P < 0.05), tramadol (89, 46%; P < 0.05), and oxycodone (381, 73%; P < 0.05).Conclusion:Dental service restrictions during COVID-19 likely drove an unmet need for routine dental treatment, which had significant implications for public oral health following easing of restrictions. During the initial surge and subsequent lockdown, antibiotics and opioid analgesics may have been used an as alternative to routine operative treatment. Continued professional guidance is required to ensure dental prescribing remains evidence based during the pandemic period.Knowledge Transfer Statement:The COVID-19 pandemic and subsequent restrictions on dental practice have had a profound impact on the provision of dental care in Australia and elsewhere in the world. In this context, population-level medication surveillance is important to identify and respond to changes in prescribing patterns that have arisen due to COVID-19 and restrictions on the provision of dental care. This research is particularly important for governments, regulators, and professional associations to ensure therapeutic guidelines and recommendations during the pandemic period remain relevant and evidence based.

SARS-CoV-2 Infection and Oral Health: Therapeutic Opportunities and Challenges.

The novel corona virus, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), and the disease it causes, COVID-19 (Coronavirus Disease-2019) have had multi-faceted effects on a number of lives on a global scale both directly and indirectly. A growing body of evidence suggest that COVID-19 patients experience several oral health problems such as dry mouth, mucosal blistering, mouth rash, lip necrosis, and loss of taste and smell. Periodontal disease (PD), a severe inflammatory gum disease, may worsen the symptoms associated with COVID-19. Routine dental and periodontal treatment may help decrease the symptoms of COVID-19. PD is more prevalent among patients experiencing metabolic diseases such as obesity, diabetes mellitus and cardiovascular risk. Studies have shown that these patients are highly susceptible for SARS-CoV-2 infection. Pro-inflammatory cytokines and oxidative stress known to contribute to the development of PD and other metabolic diseases are highly elevated among COVID-19 patients. Periodontal health may help to determine the severity of COVID-19 infection. Accumulating evidence shows that African-Americans (AAs) and vulnerable populations are disproportionately susceptible to PD, metabolic diseases and COVID-19 compared to other ethnicities in the United States. Dentistry and dental healthcare professionals are particularly susceptible to this virus due to the transferability via the oral cavity and the use of aerosol creating instruments that are ubiquitous in this field. In this review, we attempt to provide a comprehensive and updated source of information about SARS-CoV-2/COVID-19 and the various effects it has had on the dental profession and patients visits to dental clinics. Finally, this review is a valuable resource for the management of oral hygiene and reduction of the severity of infection.

The Effect of a Personalized Oral Health Education Program on Periodontal Health in an At-Risk Population: A Randomized Controlled Trial

While periodontal disease is associated with many risk factors, socioeconomically disadvantaged communities experience the highest disease burden. The aim of this study was to evaluate the effectiveness of a personalized oral health education program, in combination with routine dental treatment, in participants from a low socioeconomic community. We used a randomized, controlled, examiner-blinded clinical trial. A total of 579 participants (aged 18–60 years) were randomly grouped: the intervention group (n = 292) received a personalized oral health education program in combination with routine dental care and the control group (n = 287) received routine dental care. All participants were assessed for improvement in oral health care behaviors, dental plaque, and periodontal status at baseline, 12 months, and 24 months. We found a significant drop (p < 0.001) in the plaque indices, Periodontal Probing Depths (PPD) and Bleeding on Probing (BOP) between baseline and the 12-month follow-up for both groups. For BOP, the number of sites positive was significantly different between baseline and the 24-month follow-up (p = 0.037). No differences were found between the two groups for any evaluated clinical outcome. The personalized oral health education program used in the current study did not appear to add significant improvement to clinical outcomes of periodontal health compared with routine restorative dental care per se.

Knowledge of Students and General Practitioners regarding the Treatment of Dentine Hypersensitivity

DHS is an oral health problem occurring in 10&ndash;20% of adults that can alter their lifestyle and quality of life. DHS may also be triggered by some routine dental treatments such as scaling and polishing, thus making a regular dental visit unpleasant and distressing for the patient. This cross-sectional study was carried out using an online survey among Riyadh dental students and general practitioners. An online questionnaire was constructed including demographic data and personal questions

Williams–Beuren syndrome: a complete guide for oral healthcare

Introduction:Williams–Beuren syndrome is a rare, congenital, multisystem disorder, resulting from genetic alterations on chromosome 7q11.23. Characteristic features of WBS are the developmental, physical and mental abnormalities associated with it. Typical facial features and a spectrum of tooth disorders are associated with this condition. Cardiac and renal involvement may be so severe that sudden death during oral healthcare procedures is a possibility. Photophobia and hyperacusis further make dental treatment a challenge in these patients.Corpus: Routine dental treatment in the dental office pose a significant risk, depending upon the mental and physical compromise of the patient, thereby making hospital admission a safer approach. A multispeciality approach is necessary to provide effective and safe oral healthcare to such patients. This article provides undergraduates, residents, general dental practitioners, and specialists involved in oral healthcare with a comprehensive overview of the condition with emphasis on its genetic basis, pathology, clinical features, diagnosis, and management of general and oral health.Conclusion: Adequate knowledge regarding the various aspects of Williams–Beuren syndrome allows the oral health care student or specialist to plan and manage oral procedures safely and effectively. Specialist referral and multidisciplinary care may be considered when appropriate.

A Review of Guidelines for Antibiotic Prophylaxis before Invasive Dental Treatments

Bacteraemia associated with invasive dental treatments can propagate infective endocarditis in high-risk cardiac patients. Over the past decade, antibiotic prophylaxis before dental treatment has been questioned. This review aims to compare the variations between the UK, European and American antibiotic prophylaxis guidelines before dental treatments. Antibiotic prophylaxis guidelines by the National Institute for Health and Care Excellence (NICE)—Clinical Guideline 64, Scottish Dental Clinical Effectiveness Programme (SDCEP), American Heart Association (AHA), European Society of Cardiology (ESC), European Society of Endodontology (ESE) and Belgian Health Care Knowledge Centre (KCE) position statements were compared regarding the indications, high-risk patients and prophylaxis regimens before dental treatments. In the United Kingdom, the NICE—Clinical Guideline 64 and SDCEP—Implementation Advice do not advise the prescription of prophylactic antibiotics for the majority of high-risk cardiac patients undergoing routine dental treatments. On the contrary, the AHA, ESC and KEC recommend the prescription of antibiotics prior to invasive dental procedures in high-risk cardiac individuals. The ESE also indicates prophylaxis before endodontic procedures for patients with other conditions, including impaired immunologic function, prosthetic joint replacement, high-dose jaw irradiation and intravenous bisphosphonates. Among these guidelines, there are variations in antibiotic prophylaxis regimens. There are variations regarding the indications and antibiotic prophylaxis regimens before invasive dental treatments among these available guidelines.

Dental Care during COVID-19 Outbreak: A Web-Based Survey.

Objective This survey aimed to assess the effects of coronavirus disease 2019 (COVID-19) on elective and urgency/emergency dental care and dentists concerned. Materials and Methods A web-based survey was performed using Google forms questionnaire sent to dentists in Brazil. Questions included: personal information, type of dental care provided during quarantine, if emergencies increased, the dental office biosafety routine, among others. The levels of concern about the impact of quarantine on dental care and patient oral health conditions and the economic impact on dental practices were evaluated using a 0- to 10-point scale. Statistical analysis included descriptive, percentages, one-way ANOVA, Tukey, and chi-square tests. Results During quarantine, 64.6% of the dentists attended only urgency/emergency treatments, while 26.1% maintained routine appointments, and 9.3% closed the dental offices. A higher percentage of dentists from the least affected states continued routine dental treatment; dentists were younger and presented a significantly lower level of concern about dental treatments and oral health conditions of their patients. An increase in urgency/emergency procedures was reported by 44.1% of the dentists, mostly due to the unavailability of routine/elective dental care and increased patient anxiety and stress. The main causes of urgency/emergency appointments were toothache, dental trauma, and broken restorations, besides the breakage of orthodontic appliances and temporomandibular disorders. Dentists reported a high level of concern about the economic impact caused by quarantine. Conclusions The pandemic/quarantine has negatively affected the clinical routine. Personal protection/hygiene care must be adopted and reinforced by dental professionals/staff to make dental procedures safer.

The effect of Angelman syndrome on enamel and dentin mineralization

To analyze the mineralization and ion content in deciduous, permanent teeth of Angelman syndrome in comparison to match-paired teeth from normal children. Three deciduous teeth and a third molar and a mesiodens extracted during routine dental treatment and their match-paired normal teeth were examined using energy dispersive X-ray spectrometer program under a scanning electron microscope. The morphology of the enamel and dentin of Angelman syndrome (AS) teeth was similar to normal but the thickness of the enamel of deciduous canine and permanent teeth was reduced. The most marked differences were found in the enamel-in AS teeth, the enamel contained nitrogen in concentrations similar to dentin, implicating that the protein content of the enamel is different from normal teeth where nitrogen is absent. AS affects morphology and mineralization of enamel. It caused hypoplastic enamel and abnormal protein content in comparison to match-paired normal teeth. These findings show that AS also affects odontogenesis in addition to the known oral motor challenges.

Apical periodontitis in relation to radiographic quality of endodontic treatment in a selected adult Turkish population: A cross-sectional study

Objective: The aim of this study was to examine the quality of root canal fillings and their relationship with apical periodontitis (AP) in a selected Turkish population. Material and Methods: The cases in this study was formed of patients attending routine dental treatment at the Faculty of Dentistry, University of Birun. 1024 patients were examined with panoramic radiographs and 1780 endodontically treated teeth with present periapical radiographs. Endodontic treatment quality was evaluated by obturation length, density, taper quality and iatrogenic errors. Presence of AP was analysed according to Ørstavik’s periapical index (PAI). The chi-square test was used for statistical analyses. Results: Statistically significant relationship was found between both the tooth type and location with obturation quality (p: 0.000; p &lt; 0.05). Obturation quality of maxillary and mandibular molars are significantly less than the other tooth types in the same location. Apical periodontitis were noticed in 740 teeth (41.6%). Inadequate obturation quality was found to be significantly effective on the periapical status of tooth types both in maxilla and mandible (p &lt; 0.05). Conclusion: The frequency of inadequate root canal obturations of endodontically treated teeth of the selected Turkish population was high, especially in molar teeth and women. Even though radiographic obturation quality is not the only success criteria in endodontic treatment, it is still one of the most important criteria regarding the positive correlation of “inadequate” obturations with AP.KEYWORDSPeriapical periodontitis; Radiography; Root canal obturation; Root canal theraphy.

Child abuse in India -A review

Child abuse in India -A review - IJPNS- Print ISSN No: - 2582-4023 Online ISSN No:- 2582-4031 Article DOI No:- 10.18231/j.ijpns.2019.002, IP Journal of Paediatrics and Nursing Science-J Paediatr Nurs Sci

Music as a nonpharmacological methodology for dental anxiety management in routine dental procedures during COVID-19 Pandemic

Background: Dental anxiety is one of the key reasons behind patient's unwillingness to seek dental treatment. It is quite challenging to manage and hinders the ability of dentist to deliver the best dental treatment. Many nonpharmacological therapies have been introduced to manage dental anxiety, and music therapy is one of such therapy. Aim and Objective: The aim of the study was to assess whether music has an effect in reducing anxiety levels in patients during routine dental procedures. This was a randomized control experimental study. Materials and Methods: In this study, 100 patients (mean age: 32 years) from the Outpatient Department of SDKSDC, Nagpur, India, who volunteered and consented to participate in the study were included in the study. Inclusion criteria were patients who require only routine dental treatment. Participants were randomly assigned into two groups: the control group (n = 50) and the study group (n = 50). Patients in the study group were exposed to relaxing, low tempo music through headphones during routine dental procedures which include scaling and restorative procedure. Both groups were assessed using Corah's dental anxiety scale, blood pressure, and heart rate, before and after treatment. Results: Music therapy was effective in reducing anxiety during the procedures; participants in the study group had significantly lower anxiety scores compared to the control group. Conclusion: Music therapy has been shown to be an effective nonpharmacological approach to reduce dental anxiety among patients during routine dental procedures.

Does preoperative paracetamol reduce pain after dental treatment? A randomized controlled double-blind study.

The present study compared the efficacy of preoperative administration of paracetamol and placebo in reducing postoperative pain after routine dental treatment in children. The primary objective was to compare postoperative pain level between the groups. The secondary objective was to identify other factors that can influence postoperative pain. A prospective, placebo-controlled parallel-group trial was conducted on two groups of children aged 5 to 12 years. One hundred and two children participated in the study, 51 in each group, 58 boys (56.9%) and 44 girls (43.1%). The average age was 7 ± 1.72 years, with no difference in age and sex between the groups. The study group received paracetamol (15 mg/kg) and the control group received placebo 15 minutes before dental treatment. Pretreatment baseline anxiety was recorded. Postoperative data were collected immediately at the end of the treatment, and by phone 2.5 hours after taking the remedy. The groups showed no difference in postoperative pain immediately after the treatment and 1.5 hours after treatment. The pain score was higher among children who received stainless steel crowns and combinations of crowns, pulpectomy, and extractions. Preoperative use of paracetamol has the same preemptive analgesic effect as placebo in pediatric patients who receive routine dental treatment. Postoperative pain can influence the willingness of children to receive consecutive treatments. Dental practitioners should prevent postoperative pain and recommend analgesia when necessary. Pain is expected after performing stainless steel crowns, pulpectomies, and extractions. The current study confirms that preoperative paracetamol has no beneficial effect.