Toothache Research Articles

Individual and Contextual Factors Associated with Adolescents' Self-Perceived Need for Treatment.

The present study aimed to investigate associations between the self-perceived dental treatment need and clinical factors, familial characteristics, and school context in adolescents. A cross-sectional study was conducted with a representative sample of 746 students aged 15 to 19 years in a medium-sized city in Brazil. Data collection involved the use of a sociodemographic questionnaire, an oral health questionnaire, and the Family Adaptability and Cohesion Scales (FACES III) instrument. Clinical examinations were performed by two trained and calibrated examiners (Kappa > 0.80) using the Nyvad criteria. A robust logistic regression analysis for complex samples was performed using a multilevel approach (α = 5%). The individual factors associated with the self-perceived treatment need were dental pain (OR = 1.08; 95% CI: 1.01-1.16), the loss of the first molars (OR = 1.09; 95% CI: 1.03-1.15), and disengaged family cohesion (OR = 1.15; 95% CI: 1.01-1.31). In terms of context, attending a public school was associated with the self-perceived treatment need (OR = 1.17; 95% CI: 1.02-1.33). Thus, the individual factors of toothache, tooth loss, and a disengaged family, as well as the school context, exerted an influence on the self-perceived treatment need.

Clinical validation of a fast-acting acetaminophen: a randomized, active and placebo controlled dental pain study

Objectives To address the need for faster pain relief of over-the-counter (OTC) analgesic users, a novel drug delivery technology was developed to achieve faster absorption of orally administered acetaminophen with the goal of delivering earlier onset of pain relief. Previous development studies suggested that a 1000 mg dose of this fast-acting acetaminophen (FA-acetaminophen) formulation provided faster absorption and onset of action versus, commercially available OTC fast-acting analgesics, 1000 mg of extra-strength acetaminophen (ES-acetaminophen) or 400 mg of liquid-filled ibuprofen capsules (LG-ibuprofen). This study was designed as the definitive trial evaluating the onset of pain relief of FA-acetaminophen versus these same OTC comparators. Methods This single-dose, randomized, double-blind, placebo- and active-controlled clinical trial compared analgesic onset, overall efficacy, and safety of FA-acetaminophen 1000 mg, ES-acetaminophen 1000 mg, LG-ibuprofen 400 mg, and placebo over 4 h in a postsurgical dental pain model. Following removal of 3 to 4 impacted third molars, 664 subjects with moderate-to-severe pain were randomized in a 4:4:2:1 ratio to FA-acetaminophen (249), ES-acetaminophen (232), LG-ibuprofen (124), or placebo (59). Mean age was 18.9 years; 45.5% were male; 57.5% had severe baseline pain intensity. Subjects stopped a first stopwatch if/when they had perceptible pain relief and a second stopwatch if/when their pain relief became meaningful to them. Pain intensity difference (PID) and pain relief (PAR) were obtained using an 11-point numerical rating scale. Findings FA-acetaminophen 1000 mg had faster median time to onset of pain relief (15.7 min) compared to ES-acetaminophen 1000 mg (20.2 min, p = 0.035), LG-ibuprofen 400 mg (23.2 min, p < 0.001), and placebo (non-estimable), statistically greater mean PAR and PID scores than other treatment groups at 15 and 30 min, and a statistically greater percentage of subjects with confirmed perceptible pain relief at 15 and 20 min. At 25 min, FA-acetaminophen 1000 mg had a statistically significantly greater percentage of subjects with confirmed perceptible pain relief than LG-ibuprofen 400 mg and placebo. No clinically significant adverse events were reported. Conclusions This study supports previous studies, demonstrating faster onset of analgesia with FA-acetaminophen 1000 mg compared to OTC ES-acetaminophen 1000 mg and OTC LG-ibuprofen 400 mg. ClinicalTrials.gov Identifier NCT03224403 https://clinicaltrials.gov/ct2/show/NCT03224403

Effects of a new magnetostrictive ultrasonic scaler and a traditional piezoelectric ultrasonic scaler on root surfaces and patient complaints

Tooth wear and pain are the primary concerns of patients undergoing periodontal scaling. The aims of this study were to compare the effects of a new magnetostrictive ultrasonic scaler and a traditional piezoelectric ultrasonic scaler on tooth surface roughness and calculus removal and to determine their impacts on patient discomfort during supragingival cleaning. This article had two parts: an in vitro study and a clinical study. In the in vitro study, thirty teeth with subgingival calculus were randomly assigned to two scaling treatment groups: magnetostrictive scalers (n = 15) and piezoelectric scalers (n = 15). Surface roughness measurements were taken at baseline and after scaling, and the root samples were visualised by SEM after scaling. Additionally, a single-centre randomised split-mouth clinical trial was conducted. Eighty-five participants diagnosed with chronic gingivitis or periodontitis were randomly assigned to receive supragingival scaling. The magnetostrictive scaler was used in half of the mouths (n = 85), and the piezoelectric scaler was used in the other half of the mouths (n = 85). Data on pain, noise, and vibration were collected using a VAS questionnaire, and the operating time was recorded. In both in vitro and clinical studies, magnetostrictive scalers were reported to be more effective than piezoelectric scalers in removing dental deposits (P < 0.05). Additionally, the root surface after scaling with the magnetostrictive scaler was smoother than that after scaling with the piezoelectric scaler in the in vitro study (P = 0.02). SEM examination also revealed that fewer dental materials were lost after instrumentation with the magnetostrictive scaler than after instrumentation with the piezoelectric scaler. Piezoelectric scalers caused less discomfort to patients in terms of pain, noise, and vibration than magnetostrictive scalers (P < 0.05). According to this clinical study, the magnetostrictive scaler caused more discomfort during supragingival scaling than the piezoelectric scaler. Moreover, the magnetostrictive scaler was also more efficient and produced a smoother root surface with less material loss after scaling than the piezoelectric scaler, as demonstrated in the in vitro study.

Evaluating Knowledge, Self-Reported Confidence Levels, and Prescription Patterns among Dental Practitioners Regarding Analgesics in Dentistry: A Cross-Sectional Study.

Background and Objectives: Dental pain is a common problem that often leads to unscheduled dental visits and requires a comprehensive understanding of analgesics, including their indications and contraindications. The aim of this study was to investigate dentists' knowledge, self-reported confidence levels, and prescribing patterns of analgesics in dentistry. Materials and Methods: A nationwide cross-sectional online survey was conducted, resulting in 379 responses. Of these, 68.6% were general dentists, and 31.4% were specialists. The collected data included sociodemographic information, levels of knowledge, and prescription patterns. The survey questionnaire explored self-perceived practices, patient information during prescription, and guiding factors. Descriptive statistics and a generalized linear model for regression were used for data analysis. Results: Higher levels of knowledge were observed in specific contexts such as secondary/tertiary healthcare (p = 0.022), specialization in endodontics (p = 0.003), and a higher number of working hours with patients (p = 0.038). Conversely, increased self-confidence was observed among endodontists (p = 0.008), oral surgeons (p = 0.011), and dentists with more than 6 h of patient interaction (p ≤ 0.001). Orthodontists and prosthodontists demonstrated lower knowledge levels, while specialists in family dentistry exhibited lower self-confidence. Self-confidence and knowledge displayed a significant positive correlation (r = 0.039, p < 0.001). The most frequently prescribed medication was ibuprofen (97.9%), primarily for surgical (83.9%) and endodontic procedures (60.9%), with the main indications being pulpal (85.8%), periradicular (57.3%), and postoperative pain (40.1%). Conclusions: This study reveals significant knowledge and confidence gaps among dentists, including limited awareness of the efficacy of nonsteroidal anti-inflammatory drugs for odontogenic pain, a lack of time for effective counseling, and perceived deficits in pharmacology education. To address these issues, targeted educational interventions are recommended to improve analgesic prescribing practice, close knowledge gaps, and increase dentists' confidence in more effective pain management.

Timeline of diagnosed pain causes in children with severe neurological impairment.

Pain's causes in children with severe cognitive impairment may be challenging to diagnose. This study aimed to investigate if there is a relationship between pain causes and the age of children. We conducted a multicenter retrospective study in three Italian Pediatric Units. Eligible subjects were patients from 1 to 18 years with severe neurological impairment. We collected data regarding diagnoses, pain causes and medical or surgical procedures. The timing of pain episodes was categorized into age-related periods: infants and toddlers (0-24 months), preschool children (3-5 years), schoolchildren (6-12 years), and adolescents (13-17 years). Eighty children with severe neurological impairment were enrolled. The mean age was 11 years (±5.8). Gastroenterological pain was most common in the first years of life (p = 0.004), while orthopaedic and tooth pain was the most typical in schoolchildren and adolescents (p = 0.001 and p = 0.02). Concerning surgical procedures, PEG placement and gastric fundoplication were significantly more common in the first 5 years of age (p = 0.03), and heart surgery was typical of infants (p = 0.04). Orthopaedic surgery was more commonly reported in older children and adolescents (p < 0.001). Some causes of pain are more frequent in children with severe neurological impairment in defined age-related periods. Specific age-related pain frequencies may help physicians in the diagnostic approach.

Modulation of TRPV1 on Odontoblast-like Cells Using Capsazepine-Loaded Nanogels.

The modulation of TRPV1 emerges as a promising strategy for dental pain management. This study aimed to assess TRPV1 modulation in a human odontoblast-like cell model using Capsazepine (CZP) loaded in a nanogel delivery system. Gelatin nanogels, synthesized via the emulsification-gelation technique, were characterized and loaded with the TRPV1 antagonist, CZP. HPLC determined a remarkable 67.5 ± 0.04% CZP loading efficiency, with 71.7% of nanogels falling within the 300-950 nm size range, as evidenced by light microscopy. Moreover, CZP-loaded nanogels had a low cytotoxicity. An FTIR analysis showed no adverse chemical interactions, ensuring stability and active release. When examining biological responses, TRPV1 expression and channel activity were assessed in odontoblast-like cells. On the fifth day post-treatment, cells treated with CZP-loaded nanogels exhibited an increased TRPV1 expression and a reduction in calcium fluxes after agonist stimulus (F/F0 ratio 1.18 ± 0.18), resembling the response in free CZP-treated cells (1.28 ± 0.15). A two-way analysis of variance and the Tukey's test were used to determine statistical significance (p < 0.05). This delivery system, proven to be economical and straightforward, holds promise for dental pain management and potential local use. Local administration minimizes systemic adverse effects, making it a practical solution for releasing molecules in the oral cavity.

Prospective Evaluation of Dental Practitioners' Knowledge, Attitude, and Practice Toward Adult Dental Pain Management: A Cross-Sectional Multicenter Study.

Background Dental pain among adults is a prevalent concern impacting oral health and quality of life. Dental pain management presents a significant challenge for dental practitioners in effectively alleviating patient discomfort. Among the medications available, non-steroidal anti-inflammatory drugs (NSAIDs) are considered the most effective analgesics in dental care. While numerous studies have been conducted to assess the role of antibiotics in dental practice, there is a scarcity of studies specifically examining the prescription patterns of analgesics. The primary aim of this study was to evaluate the knowledge, attitudes, and practices of dental practitioners (DPs) in India concerning the management of adult dental pain. Method This survey utilized a computer-aided questionnaire-based approach. A total of 110 dentists, including 16 from metropolitan areas and 84 from non-metropolitan cities practicing at dental healthcare setups, clinics, and hospitals, were interviewed as part of the survey. The participants comprised dental professionals specializing in prosthodontics, endodontics, orthodontics, periodontics, oral surgery, pedodontics, and oral medicine. The study was conducted between September 2022 and January 2023. Results The primary reason patients seek dental consultation, as reported by 95% of dentists, is tooth cavities, followed by tooth sensitivity, post-root canal treatment, and pulpitis. All surveyed dentists prescribed NSAIDs to their patients for managing dental pain. Local anesthesia (LA) was the second choice for 75% of dentists, prescribed to 23% of their patients. The primary use of NSAIDs was for patients experiencing severe pain and to manage post-procedure pain. Eighty percent of DPs recognized ketorolac as a fast-acting molecule, providing immediate relief within 10-15 minutes. Overall, analysis indicated that 98% of DPs are satisfied and 67% are extremely satisfied with ketorolac among monotherapies for dental pain management due to its quick onset of action, fast pain relief, and usefulness in post-surgical pain management. Conclusion NSAIDs like ketorolac, diclofenac, and aceclofenacwere the preferred prescriptions for overall dental pain management. Dental practitioners associated ketorolac with fast pain relief, quick onset of action, and effectiveness in post-surgical pain management, emphasizing its lasting effects. The insights from the study contribute to enhancing dental pain management strategies.

New ways ahead?

Micheal Sultan discusses the innovations happening around treating dental pain.

Possible association between oral health status and appetite loss in community-dwelling older adults.

This study aimed to evaluate the association between the oral health status and appetite in community-dwelling older adults. We enrolled 100 people aged ≥65 years who had participated in long-term care prevention projects between December 2018 and January 2019. Appetite was assessed using the Council on Nutrition Appetite Questionnaire score. The oral health status was assessed based on the number of teeth, occlusal condition, swallowing function, tongue coating, and the Oral Health Assessment Tool. A multiple linear regression analysis was performed with appetite as the dependent variable and each variable related to oral health status as an independent variable. The analysis was adjusted for sex, age, activities of daily living, cognitive function, smoking habit, and alcohol consumption. Dental pain was associated with poor appetite in community-dwelling older adults. No other oral health status parameter was associated with appetite. Thus, controlling dental pain is critical to prevent appetite loss while considering other factors.

Effect of Combination of Calcium Hydroxide and 2% Chlorhexidine Gel as Intracanal Medications in Comparison to Calcium Hydroxide Paste on Postoperative Pain and Bacterial Endotoxins in Necrotic Teeth: Randomized Clinical Trial

Effect of Combination of Calcium Hydroxide and 2% Chlorhexidine Gel as Intracanal Medications in Comparison to Calcium Hydroxide Paste on Postoperative Pain and Bacterial Endotoxins in Necrotic Teeth: Randomized Clinical Trial

Knowledge of Dental Pain Emergency in 45-59 Years Old Community in Cimahi with Clickdent Aplication

Dental pain is an unpleasant sensory and emotional experience due to tissue damage, and it is usually felt only in the form of a sensation and described as being different from other sensations. Clickdent is a dental application that can help users manage their dental health by providing information associated with dental health, tracking dental appointments and reminders, and connecting users with dental professionals. This study aimed to characterize the level of knowledge of dental pain emergencies and their management among individuals aged 45-59 using clickdent application. This research employed a descriptive research design with a survey method. The subjects of this study were the residents of Cimahi city, aged 45 to 59 years. The data was gathered through the completion of a questionnaire by the subjects. A total of 100 samples were collected using random sampling, and the obtained data was analyzed using descriptive analyses. The collected data were processed using Microsoft Excel in picture and table. The results showed that the respondent’s level of knowledge about dental pain emergencies had good result with an average of 64.62% answered correctly. It can be concluded that the community has good knowledge about dental pain emergency and the treatment. Clickdent applications can be useful tools to improve dental health management and facilitate access to dental professionals.

EXtraction or PREServation? EXPRESS survey of patients' preference for toothache in public health facilities of Eastern India.

To investigate patients' preference for extraction or preservation for toothache and hypothetical anterior tooth pain along with the specific reason for their choice. Cross-sectional analytical semi-structured interview study. A sample of 703 adult dental outpatients visiting secondary and tertiary government health centres with toothache due to dental caries in Eastern India. Patients preferring restorative or extraction services for toothache, specific reason, and socio-demographic background factors for anterior and posterior teeth. Half (50.1%) choose preservation for present toothache and 79.9% for hypothetical front tooth pain. Immediate relief from toothache for extraction and the motive to preserve natural teeth for preservation were the main reasons expressed. In logistic regression, participants preferring extraction were more likely to be aged 25-34 years (OR = 1.94), 55+ years (OR=33.32), have primary and below education level (OR=1.99), have had a previous extraction (OR=1.99) and be unaware of preservation options (OR=2.34). For assumed anterior tooth pain, those between 25-34 years (OR=0.39) were more likely to choose preservation. Participants with primary and below education levels (OR=1.99) and unaware of preservation options (OR=1.95) chose extraction of the front tooth irrespective of their choice of treatment for the present toothache. Notable differences between the choices to preserve or extract a posterior tooth were not found. There was greater preference towards preserving anterior teeth. Future research should identify additional barriers to the preference and utilization of restorative services.

Prediction of drug candidate from Rosmarinus officinalis L to inhibit IL-6R, IL-1R1, and TNF-α: In silico study

Tooth pain is a manifestation of pulpitis caused by dental caries. Toothache can be treated using eugenol. However, eugenol has several disadvantages, including its toxic effects on fibroblast pulp tissue in a dose-dependent manner. This research assesses the binding affinity of drug candidates, predicting physicochemical properties, pharmacokinetics, drug-likeness, LD50, and toxicity. Molecular docking results show that Rosmarinic acid, Carnosic acid, Carnosol, Ursolic acid can bind strongly to IL-6R and IL-1R1. Meanwhile, only the compounds Carnosic acid and Ursolic acid bind strongly to TNFR-1. Pharmacokinetic predictions of drug candidates show that only the Carnosol compound is able to penetrate the blood brain barrier and the human gastrointestinal tract. Drug-likeness prediction showed that all compounds met Lipinski's rule of five. However, the Ursolic acid compound has an MLOGP &gt; 4.15. Toxicity prediction shows that Ursolic acid and Rosmarinic acid have a better LD50 than Eugenol.

A rare case of fibrous dysplasia in the mandible: a case report

Background: Fibrous dysplasia (FD) is a benign fibro-osseous lesion of the bone which can be monostotic FD and the polyostotic form. Polyostotic FD with café-au-lait spots of the skin and hormonal imbalances is called McCune–Albright syndrome. Besides, Mazabraud syndrome is characterized by polyostotic FD and intramuscular myxomas. FD has its onset during childhood or early adolescence and usually occurs within the first or second decade of life.&#x0D; The mode of presentation of the FD of the jaw ranges from asymptomatic to dental anomalies, pain, and facial asymmetry. Given the clinical history and radiological assessment, cystic lesions have some important differential diagnoses which range from cystic ameloblastoma, fibrous dysplasia, aneurysmal bone cyst, and odontogenic keratocyst.&#x0D; Case report: This presents a 19-year-old female who presented to the maxillofacial surgeons’ clinic with a referral from a peripheral hospital. Her major complaint was right-sided facial swelling which was noticed 4 years before the presentation. A plain radiograph revealed an expansile lesion of the mid-right mandible appearing as a well-outlined, fairly oval multiloculated cystic radiolucent mass with multiple internal septations. A preliminary diagnosis of a complex cystic right jaw mass with benign features was made with possible differential diagnoses such as ameloblastoma, fibrous dysplasia, aneurysmal bone cyst, and odontogenic keratocyst were suggested as possible differential diagnoses. Finally, she had an excision biopsy with a histological diagnosis of fibrous dysplasia. The outcome of the surgery was satisfactory at one year review.&#x0D; &#x0D;

Expression of GABAA Receptor Subunits α1 and β2 in Healthy Human Dental Pulp

BACKGROUND: Gamma-aminobutyric acid (GABA), the main inhibitory neurotransmitter in the mammalian central nervous system (CNS), has a well-established role in pain modulation. While numerous studies have delved into the expression of GABA and its receptors in dental pulp, the exact influence of these receptors on dental pain signaling has not been fully elucidated. This study aimed to investigate the gene and protein expression of the two most abundantly expressed GABA type A (GABAA) receptor subunits, GABAA receptor subunit α1 (GABRA1) and β2 (GABRB2), in healthy human dental pulp.METHODS: Six tooth samples were collected from healthy individuals referred for orthodontic treatment. Total RNA was isolated from the pulp tissues of three samples and reverse transcription-polymerase chain reaction (RT-PCR) was performed to assess gene expression of GABRA1 and GABRB2. The other three samples were examined using immunohistochemistry (IHC) for visualization of GABRA1 and GABRB2 proteins within the dental pulp.RESULTS: RT-PCR analysis reported the presence of both GABRA1 and GABRB2 in the dental pulp, and independent t-test analysis revealed that the expression of GABRA1 was significantly higher than GABRB2. The immunohistochemical staining provided compelling visual evidence of the expression of GABRA1 and GABRB2 proteins within the odontoblast layer of dental pulp, clearly indicating their presence in the cell bodies and odontoblastic processes extending into the dentin.CONCLUSION: The presence of α1 and β2 subunits of the GABAA receptor in healthy human dental pulp offers valuable insights for further research into the potential roles of GABAA receptors in dental pain signaling.KEYWORDS: γ-aminobutyric acid, GABAA receptors, GABRA1, GABRB2, dental pain, pain signaling

Reported need for and access to oral health care services during the COVID-19 pandemic in Canada.

The COVID-19 pandemic interrupted routine and preventive dental services until precautions could be implemented to limit virus transmission. Access to services for dental emergencies was maintained. The objective of this study was to describe the reported need for, access to, and receipt of oral health care in Canada during the first year of the pandemic. The 2021 Survey on Access to Health Care and Pharmaceuticals During the Pandemic collected information from Canadians aged 18 years and older. Respondents were asked whether they needed (routine) dental care in the previous 12 months, whether they received that care, whether they experienced any mouth or tooth pain (indicative of a dental emergency), and whether and how COVID-19 affected service access. Of the 44.5% of Canadians who reported needing dental care in the 12 months before the survey, 5.8% did not receive the care they reportedly needed. Almost 20% of those with a reported need had their appointment cancelled, rescheduled, or delayed because of COVID-19, and this was more common for individuals with unmet dental care needs (46.9%) than it was for those who had received dental care (17.1%). For those requiring more urgent care, 23.3% of Canadians experienced pain in their mouth or teeth in the previous 12 months. Among those with dental pain, 64.2% sought treatment, and the majority (86.4%) received the treatment they needed. One-third (33.2%) avoided care for their dental-related pain because of fear of contracting COVID-19. During the first year of the pandemic, many Canadians experienced cancelled or delayed dental services or did not receive the oral health care services they reportedly needed. Ongoing monitoring could help determine whether these COVID-19 service interruptions will have lasting effects on Canadians' oral health.

Impact of oral health management by nurses and dental professionals on oral health status in inpatients eligible for the Nutrition Support Team: A longitudinal study.

As the participation of dental professionals in multidisciplinary care is often limited, instructions on oral health management provided by dental professionals to other professionals are important to achieve transdisciplinary oral health management; however, the effectiveness of such instructions remains unclear. In this longitudinal study, we aimed to determine the impact of oral health management provided by dental professionals and nurses instructed on oral health management by dental professionals on the oral health of inpatients eligible for a Nurition Support Team (NST). The study participants were 117 patients (66 men and 51 women, mean age: 71.9 ± 12.5 years) who received oral health management during the NST intervention period. The participants received oral health management from nurses (Ns group) or dental professionals (D group). The nurses who conducted the oral health management received instructions from dental professionals. Oral health was assessed at the beginning and end of the NST intervention using the Oral Health Assessment Tool (OHAT). The Ns and D groups showed significant improvements in the total OHAT scores at the end of the NST intervention. Both groups showed significant improvements in the OHAT subitems of lip, tongue, gums and tissues, saliva, oral cleanliness and dental pain, while only the D group showed a significant improvement in the denture subitem. Effective oral health management provided by dental professionals or by nurses trained by them improved the oral health status of inpatients eligible for NST at an acute-care hospital.

Dental Caries diagnosis from bitewing images using convolutional neural networks

BackgroundDental caries, also known as tooth decay, is a widespread and long-standing condition that affects people of all ages. This ailment is caused by bacteria that attach themselves to teeth and break down sugars, creating acid that gradually wears away at the tooth structure. Tooth discoloration, pain, and sensitivity to hot or cold foods and drinks are common symptoms of tooth decay. Although this condition is prevalent among all age groups, it is especially prevalent in children with baby teeth. Early diagnosis of dental caries is critical to preventing further decay and avoiding costly tooth repairs. Currently, dentists employ a time-consuming and repetitive process of manually marking tooth lesions after conducting radiographic exams. However, with the rapid development of artificial intelligence in medical imaging research, there is a chance to improve the accuracy and efficiency of dental diagnosis.MethodsThis study introduces a data-driven model for accurately diagnosing dental decay through the use of Bitewing radiology images using convolutional neural networks. The dataset utilized in this research includes 713 patient images obtained from the Samin Maxillofacial Radiology Center located in Tehran, Iran. The images were captured between June 2020 and January 2022 and underwent processing via four distinct Convolutional Neural Networks. The images were resized to 100 × 100 and then divided into two groups: 70% (4219) for training and 30% (1813) for testing. The four networks employed in this study were AlexNet, ResNet50, VGG16, and VGG19.ResultsAmong different well-known CNN architectures compared in this study, the VGG19 model was found to be the most accurate, with a 93.93% accuracy.ConclusionThis promising result indicates the potential for developing an automatic AI-based dental caries diagnostic model from Bitewing images. It has the potential to serve patients or dentists as a mobile app or cloud-based diagnosis service (clinical decision support system).

Validity and Reliability of the Romanian Version of a Modified Short Form of Fear of Dental Pain Questionnaire.

The design of the study was cross-sectional. Data were collected through an online questionnaire completed by university students, administered from January to March 2024. The survey included information about past dental treatments, the Dental Anxiety Scale (DAS), and items of s-FDPQ. 186 participants were included in the study. The Romanian version of the modified s-FDPQ had a good reliability Sperman-Brown coefficient is 0.878, and Cronbach alpha is 0.92. The questionnaire had a good convergent validity, with all items being moderately correlated with the DAS score. The one-factor model was tested and has a good fit according to the confirmatory factor analysis. The participants were afraid of pain mostly regarding having a wisdom tooth extracted or a dental implant inserted. A statistically significant higher fear of dental pain was observed in those who did not previously have a root canal treatment (p=0.008) and in those who had dental implants in the past (p=0.046). Those attending regular dental check-ups had lower levels of fear of dental pain. The Romanian version of s-FDPQ, modified by adding a question about dental implant insertion, has good reliability and validity. Fear of dental pain seemed to be influenced by features of dental procedures and previous dental experience.

A double-blinded, placebo-controlled, cross-over pilot trial in healthy men to study the effects of Angelica gigas herbal supplement on prostate cancer–relevant inflammatory cytokines.

170 Background: The ethanol extract of the root of Angelica gigas Nakai (AGN) dose-dependently inhibits animal models of prostate cancer. Multi-omic analyses have implicated immune and anti-inflammatory responses in the anti-cancer action. In our single dose-PK study (NCT02114957) in healthy volunteers with AGN dietary supplement CognI.Q, we observed a near doubling of the natural killer (NK) mRNA signature in peripheral blood mononuclear cells (PBMC) at 24 h after dosing while the inflammatory cytokine IL-8 mRNA was decreased by one half over the pre-dose baseline. Given NK incapacitation and inflammation have been linked to prostate cancer, the current trial (NCT03630328) was designed to assess safety and to delineate CognI.Q-specific immune and anti-inflammation functions. Methods: We used a double-blinded, placebo-controlled and crossover trial design to monitor hepatic and renal safety metrics based on Comprehensive Metabolic Panel (CMP) and compare the immune cell and cytokine responses to CognI.Q and placebo. Supplement period of 3 weeks was followed with a 2-week washout period. We employed the Ella microfluidic multiplex immunoassay to evaluate select plasma cytokines. Results: Fourteen healthy men completed the trial protocol. Physical examination on study visit days did not reveal any adverse events. Blood CMP monitoring detected abnormal hepatic integrity values in three subjects, all in the second washout period and were attributed to use of anti-allergy medication, an herbal tea for tooth ache, and excessive alcohol, respectively. Analysis of plasma cytokines detected corresponding elevation of MIG, CCL4, CXCL10 and IL-8 with these hepatic damage events. With the exclusion of these subjects or time point, the plasma cytokine measurement did not reveal a significant response to CognI.Q supplement vs. placebo. Conclusions: CognI.Q supplement at the current recommended dose (400 mg, twice per day) did not impair hepatic integrity or renal function, nor did it modulate select plasma cytokines in healthy men. Phase I dose-escalation trials should be implemented to establish safety profile and assess immune and inflammation modulatory effects of AGN supplement beyond the current dose. Clinical trial information: NCT03630328 .