University Dental Hospital Research Articles

Factors Influencing Level of Anxiety and Pain in Patients’ Receiving Endodontic Treatment

Abstract: Background: Dental anxiety is a vicious cycle in which avoidance of dental care, poor oral health, and psychosocial consequences are prevalent. It might be a significant impediment to receiving prompt dental care until absolutely required. Objectives: To evaluate the level of dental anxiety and pain in patients receiving root canal treatment and to identify factors that might increase anxiety levels. Materials and Methods: This was a cross-sectional study conducted at Fatima Jinnah Dental College Hospital, Karachi, Pakistan from the period of August-December 2022. The study included participants who scheduled their first appointment for endodontic treatment during this period. Participants were included between the ages of 18 and 60, those who provided verbal consent. The sample size of 100 cases were calculated through power analysis at a 95% confidence interval. Data was analyzed by using SPSS version 20 software. P-value <0.05 was considered significant. Result: According to the Modified dental anxiety scale, the average score was 12.7±4.53, which is considered to be a moderate anxiety. The Pearson correlation of mean anxiety score showed statistically significantly results such as gender (p<0.001), age (p<0.001), level of education (p=0.015), employment (p=0.029), ethnicity (p=0.009) and level of pain (p=0.008). The study showed a lower pain threshold among female patients than males with a statistically significant result (p=0.008). Conclusion: The incidence of dental anxiety among study participants ranged from mild to moderate. Women, young patients, and those with less education were more concerned than their male counterparts. Patients who need urgent root canal therapy more commonly experience dental pain and anxiety.

Retrograde Study Using Radiographic Comparison of Bone Fill Observed after Guided Tissue Regeneration by the Type of Periodontal Bone Defect

Background and Objectives: The current study aimed to compare the extent of bone growth achieved after guided tissue regeneration (GTR) based on the location and nature of the initial periodontal lesion. Materials and Methods: The study sample included 80 patients who underwent GTR at Kyungpook National University Dental Hospital since 2012 and were radiologically followed up for at least 2 years after treatment. The patients were divided into four groups based on the location (maxilla and mandible) and nature (furcation involvement and intrabony defects) of the lesion. Differences in bone levels before and after treatment were analyzed. Additionally, a comparison of outcomes based on the type of bone graft material used was conducted. Statistical analysis included a comparison of groups using a t-test, assuming equal variance. Results: The proportion of bone growth observed in the maxillary furcation, mandibular furcation, maxillary intrabony, and mandibular intrabony lesions was 26%, 22%, 31%, and 34%, respectively. No statistically significant differences in the amount of bone fill were observed between the groups. However, a significant positive correlation was found between the initial depth of the bone defect and the amount of bone fill observed after treatment. Conclusions: Contrary to previous evidence, the current study observed no significant differences in the amount of bone fill after GTR based on the location and nature of the lesion. Furthermore, the amount of bone regenerated was directly proportional to the initial depth of the alveolar bone defect.

Audit of dental record-keeping at a university dental hospital.

Good record-keeping is fundamental in clinical practice and essential for practising dental practitioners and those in training. This study aimed to evaluate the level of compliance with clinical record-keeping by undergraduate dental students and staff at a university dental hospital. The selected study setting was the Admissions and Emergency section at a university dental hospital. A retrospective, cross-sectional review was undertaken of 257 clinical records. The CRABEL scoring system was used to evaluate 12 variables. The 12 variables included: patient name, patient hospital number, date of examination, patient main complaint, medical history, dental history, proposed treatment, proposed procedure for next visit, patient consent signature, treatment and treatment codes, student name and signature, clinical supervisor name and signature. STATA® 13 was used for descriptive analysis and all tests were conducted at 5% significance level. The median CRABEL score was 87 and interquartile range (IQR: 70-92). A CRABEL score of 100 was achieved by the students in the variable patient main complaint, indicating a 100% compliance with this variable. Other variables such as signature of supervisors showed poor compliance. The CRABEL scores showed no statistically significant difference (p = 0.86) between the students and clinical supervisors. The overall audit showed that there was poor compliance with record-keeping. The study highlights the importance of good record keepings so that key information can be accessed for proper diagnosis and treatment of the patient. An electronic filing system presents an alternative manner of documenting medical records.

Awareness of Nutrition Facts Labeling and Its Relation to Oral Health Practices and Caries Experience Among Adult Patients.

To investigate the relationship between the usage of nutrition facts labels (NFL) and oral and dietary practices and the decayed, missing, and filled teeth (DMFT) score. A self-administered questionnaire was distributed to a convenient sample of 150 adult dental patients attending the King Abdulaziz University Dental Hospital in Jeddah, Saudi Arabia. Electronic dental records were accessed to record each patient's DMFT score. Only 38% (N=57) of the participants read the NFL on their food. A statistically significant association was found between patients' DMFT scores and the NFL reading. Participants who said they read NFLs had lower mean DMFT scores than those who said they did not (8.4 vs. 10.5). The results of this study demonstrate that there is low usage of NFL among participants. A significant association was noted between the reading of the NFL and caries experience as measured using the DMFT index.

A New Deep Learning Algorithm for Detecting Spinal Metastases on Computed Tomography Images.

Retrospective diagnostic study. To automatically detect osteolytic bone metastasis lesions in the thoracolumbar region using conventional computed tomography (CT) scans, we developed a new deep learning (DL)-based computer-aided detection model. Radiographic detection of bone metastasis is often difficult, even for orthopedic surgeons and diagnostic radiologists, with a consequent risk for pathologic fracture or spinal cord injury. If we can improve detection rates, we will be able to prevent the deterioration of patients' quality of life at the end stage of cancer. This study included CT scans acquired at Tokyo Medical and Dental University (TMDU) Hospital between 2016 and 2022. A total of 263 positive CT scans that included at least one osteolytic bone metastasis lesion in the thoracolumbar spine and 172 negative CT scans without bone metastasis were collected for the datasets to train and validate the DL algorithm. As a test data set, 20 positive and 20 negative CT scans were separately collected from the training and validation datasets. To evaluate the performance of the established artificial intelligence (AI) model, sensitivity, precision, F1-score, and specificity were calculated. The clinical utility of our AI model was also evaluated through observer studies involving six orthopaedic surgeons and six radiologists. Our AI model showed a sensitivity, precision, and F1-score of 0.78, 0.68, and 0.72 (per slice) and 0.75, 0.36, and 0.48 (per lesion), respectively. The observer studies revealed that our AI model had comparable sensitivity to orthopaedic or radiology experts and improved the sensitivity and F1-score of residents. We developed a novel DL-based AI model for detecting osteolytic bone metastases in the thoracolumbar spine. Although further improvement in accuracy is needed, the current AI model may be applied to current clinical practice. Level III.

Dental and endodontic-related stress amongst undergraduate students before and during the COVID-19 pandemic: A mixed-methods study.

To determine and explain the principal sources of stress among preclinical and clinical dental undergraduate students with a particular focus on the stressors linked to endodontics. A mixed-methods study, with an explanatory sequential design, was employed. Volunteer students of second, third and fourth years were asked to complete both the Dental Environment Stress (DES) questionnaire and a bespoke questionnaire for endodontic-related stress assessment, which had 21 questions in common with the DES. The results were analysed by Kruskal-Wallis and Marginal Homogeneity tests. In the second part of the study, a qualitative phase was conducted through focus group interviews of students from each academic year included in the study. Interviews were analysed by inductive content analysis. The DES questionnaire determined that for all years the most stressful domains were 'performance pressure', 'workload' and 'clinical training'. According to the endodontic stress questionnaire, the most stressful domains were 'self-efficacy beliefs', 'endodontic clinical training' and 'faculty and administration' in early years, while they were 'endodontic patient treatment', 'performance pressure in endodontics' and 'clinical training' in later years. Comparing questions common to both questionnaires revealed that the stress score was lower for the endodontic stress questionnaire than in the DES questionnaire for 17 questions, being significantly lower for 13 questions (p < 0.05) and significantly higher for no question. The qualitative study showed that students' dental and endodontic-related stress was linked to different domains: patient, clinical procedure, organization, staff, academic education, evaluation and COVID-19-related issues. Qualitative aspects highlighted the important role that patients and COVID-19 have played in student stress. However, they suggested a possible explanation for the lower endodontic stress observed in this dental university hospital, which was based on: the nature of the teaching in endodontics, the consensus between endodontic supervisors, the use of a logical, progressive procedure and the considerable experience that students gain over the years. Students considered endodontics stressful; however, education can play a central role in reducing stress, particularly during the early parts of the undergraduate course.

Ocular Manifestations of Human Immunodeficiency Virus Infection in the Combination Antiretroviral Therapy Era.

Since the introduction of combination antiretroviral therapy (cART) in Japan in 2008, the spectrum of ocular manifestations in patients with human immunodeficiency virus (HIV) has changed. This study, conducted at Tokyo Medical and Dental University Hospital between January 2012 and August 2023, aimed to understand the epidemiology and clinical features of ocular manifestations in patients with HIV during the cART era. Of the 218 patients diagnosed with HIV, 23 (10.55%) exhibited ocular manifestations; all were male, aged 32-73. The most prevalent ocular complication was uveitis (60.67%). Notably, the prevalence of uveitis in this cART era has surged compared to earlier Japanese studies. Our data also suggest a potential direct link between uveitis and HIV, particularly in patients who have not yet undergone cART. However, cytomegalovirus retinitis, another prevalent ocular disease in our study, appeared more strongly associated with patients who commenced cART. Neither ocular condition was significantly correlated with CD4+ T-cell count. Importantly, our observed ocular manifestation prevalence (10.55%) was lower than that in previous studies, emphasizing the potential influence of cART and national healthcare support. These findings provide unique insights into the evolution of ocular manifestations in patients with HIV in Japan amidst cART availability.

Comparison of Salivary Secretion, pH, and Buffer Capacity Between COVID-19 Vaccinated and Unvaccinated Child Patients Visiting Dental Clinics of University Hospitals in Riyadh City, Saudi Arabia.

This study aimed to assess and compare the salivary secretion, pH, and buffer capacity between COVID-19 vaccinated and unvaccinated child patients visiting the clinics of private university dental hospitals in Riyadh, Saudi Arabia. This is the first comparative assessment of salivary parameters between unvaccinated and COVID-19-vaccinated child patients. The study sample comprised COVID-19 unvaccinated (n = 66) and vaccinated (n = 66) pediatric dental patients aged 4-12 years seeking dental care in clinics of private university hospitals. Paraffin-stimulated saliva was collected from unvaccinated and vaccinated study participants, and the amount of saliva secreted per minute was noted. Salivary pH and buffering capacity (by 5 mmol Hydrochloric acid titration) were measured using a benchtop digital pH meter. The data obtained were compared between unvaccinated and vaccinated participants using an independent t-test. The results showed a significantly higher salivary secretion rate in unvaccinated than vaccinated study participants (0.83 ± 0.24 mL/min vs 0.67 ± 0.24 mL/min, p = 0.001). Similarly, unvaccinated subjects compared to vaccinated subjects exhibited a significantly higher pH (7.33 ± 0.39 vs 7.04 ± 0.46, p < 0.001) and buffering capacity (6.31 ± 1.55 vs 5.40 ± 1.22, p < 0.001). Moreover, unvaccinated females demonstrated a significantly higher salivary secretion (0.87 ± 0.23 vs 0.71 ± 0.25, t = 2.627, p = 0.011) and buffering capacity 6.19 ± 1.52 vs 5.34 ± 1.25, t = 2.404, p = 0.019) than vaccinated females. Similarly, unvaccinated male exhibited significantly higher salivary secretion (0.80 ± 0.25 vs 0.64 ± 0.23, t = 2.670, p = 0.009), salivary pH (7.39 ± 0.45 vs 6.94 ± 0.41, t=4.309, p<0.001) and buffering capacity (6.42 ± 1.60 vs 5.45 ± 1.21, t = 2.875, p = 0.005) than the vaccinated male subjects. The vaccinated subjects showed a significantly lower mean salivary secretion, pH, and buffering capacity than unvaccinated participants. Hence, COVID-19 vaccination is likely to affect salivary parameters among pediatric patients.

Estimation of Mandibular Third Molar Development Using the Correlation in Dental Developmental Stages

This study aims to confirm the average chronologic age according to the developmental stages of the mandibular canine (L3), first and second premolars (L4, L5), and second and third molars (L7, L8) in children and adolescents, and to confirm the developmental stage of L3, L4, L5, and L7, which can estimate the development of L8. A total of 1,956 digital panoramic radiographs of healthy individuals aged between 6 and 15 years who visited Seoul National University Dental Hospital from January 2019 to December 2020 were selected. The developmental stages of L3, L4, L5, L7, and L8 on both sides were evaluated using the dental maturity scoring system proposed by Demirjian and Goldstein. The average age at which the follicle of L8 was first observed was around 9.34 ± 1.35 years and varied from 6 to 12 years. The possibility of agenesis of L8 was high when no traces of L8 were observed after the following stages: L3, L4, and L5 at the developmental stage F and L7 at the developmental stage E; the age was about 10 years. In estimating the development of L8, when only one tooth was considered, estimation accuracy with L5 was the highest, and there was no significant difference when all four teeth were included. This study showed the age distribution according to the developmental stages of L3, L4, L5, L7, and L8 in children and adolescents and confirmed the developmental stages of L3, L4, L5, and L7, which can be used to estimate the development of L8.

Trend Analysis of Pediatric Dentistry Patients at Seoul National University Dental Hospital: a Study on the Impact of the COVID-19 Outbreak

This study aims to investigate changes in dental service use among pediatric patients during the COVID-19 pandemic. The analysis was performed by collecting information about the number of visits, age, gender, diagnoses, and treatments for patients at the Pediatric Dentistry Department of Seoul National University Dental Hospital from January 2017 to December 2022. Compared with the period from 2017 to 2019, the total number of visits decreased during the COVID-19 pandemic, with a substantial decline in 2020. Patients in all age groups, except those aged 10 - 14, experienced decreased visits, and there was no significant gender difference. Z29.8 (need for other specified prophylactic measures) declined in all age groups, especially among those aged 0 - 4, except for those 20 years and older. K02.1 (caries of dentine) was sought by the age groups in the following order: 10 - 14, 15 - 19, 5 - 9, and 0 - 4 years, with the most significant decrease in the 0 - 4 years age group compared to others. K07.4 (malocclusion, unspecified) decreased in younger groups aged 9 and below but increased in older groups aged 10 and above. During the period from 2020 to 2022, preventive, restorative, pulp, and trauma treatments decreased, but surgical and orthodontic treatments increased compared with the previous three years. The use of sedation decreased and general anesthesia increased during COVID-19 compared to pre-pandemic. This study describes the impact of the COVID-19 pandemic on pediatric dentistry, making it a valuable reference for future pandemics.

Usefulness of oral health assessment performed by multiple professionals using a short video recording acquired with a tablet device

Background/purposeAppropriate oral health assessment and management can improve the oral health and nutritional status of hospitalized patients. The active participation of dental professionals in the nutritional support team (NST) can help achieve this outcome. However, the participation of dental professionals in NSTs is often limited, indicating the requirement for establishing a remote oral health assessment method. This study aimed to establish a multidisciplinary oral health assessment system using short video recordings with a tablet device. Materials and methodsFifty inpatients receiving NST aid at the Tokyo Medical and Dental University Hospital were included in this study. The degree of agreement between the oral health assessment performed at the bedside and using the short video recordings of the oral health acquired with a tablet device by a single dentist and the degree of agreement for evaluations performed using the video recordings between multiple professionals were evaluated. The oral health status was assessed using the Oral Health Assessment Tool (OHAT). ResultsThe intraclass correlation coefficient (ICC) of the OHAT total scores for oral health assessment performed at the bedside and using the videos by a single dentist was 0.914 (95% confidence interval [CI], 0.854–0.950). ICCs of the OHAT total scores for the video assessment performed by dentists and multiple professionals were 0.904 (95% CI, 0.838–0.944) and 0.802 (95% CI, 0.676–0.883), respectively. ConclusionComprehensive oral health assessment of patients can be performed by multiple professionals using the short video recordings of the oral health acquired with a tablet device.

2329. What Causes a Cluster to Grow? Factors Associated with a Nosocomial COVID-19 Cluster at a University Hospital in Central Tokyo

Abstract Background Coronavirus disease 2019 (COVID-19) remains a significant threat to hospital infection control. Despite the decrease in severity and mortality associated with changes in the variants of concern and increased vaccination, SARS-CoV-2 transmissibility remains high, and nosocomial clusters continue to be reported in various countries. Although COVID-19 may be detected in multiple patients and healthcare workers (HCWs) in a given ward within a few days, it is uncertain whether these cases will develop into a large cluster. Methods The present, retrospective cohort study of nosocomial COVID-19 clusters was conducted at Tokyo Medical and Dental University Hospital from January 2022 to January 2023 using data from the hospital’s infection prevention and control team. A nosocomial COVID-19 cluster was defined as consisting of more than 2 COVID-19 cases occurring within 5 days in the same ward. Cases with a clear epidemiological link and clusters outside the ward were excluded. We collected information regarding community trends, the index case details, and each cluster's ward profile. Predictors of cluster expansion to more than 5 cases were also examined. Results 66 clusters were identified at the hospital during the study period. The median number of COVID-19 cases per cluster was 3 (range: 2-22), and their median duration was 5 days (range: 1-27). 37 (56.1%), 25 (37.9%), and 4 (6.1%) clusters comprised both inpatients and HCWs, only HCWs, and only patients, respectively. The index case of 51 clusters (77.3%) was a HCW. 18 (27.3%) and 47 (72.7%) clusters contained &amp;gt; 5 and &amp;lt; 5 cases, respectively. No significant intergroup difference was found in terms of community prevalence, index case and ward characteristics, the rate of close contact or history of previous clusters. However, “clusters occurring during the non-epidemic period” and “infections &amp;gt; 3 occurring within 3 days” tended to develop into clusters containing more than 5 cases. Conclusion Nosocomial clusters can occur anywhere, and predicting them is challenging. Further research is needed to identify the factors leading to cluster development and to establish effective infection prevention and control measures. Disclosures All Authors: No reported disclosures

Morphometric Assessment of Alveolar Antral Artery Using Medical Computed Tomography.

This study aimed to investigate the prevalence, diameter, and position of the alveolar antral artery (AAA) in paranasal sinus computed tomography (CT) images and to correlate the location of the AAA with tooth position, the presence of teeth, and residual alveolar bone height (ABH). A retrospective study was conducted at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, from November 2016 to October 2021. CT images of 100 maxillary sinuses from 50 patients managed for modified endoscopic sinus surgery and sinus lifting by a single surgeon were selected and obtained from the Infinitt picture archiving and communication system radiology system (Infinitt Healthcare Co., Seoul, Korea). The location of the AAA in the lateral wall of the maxillary sinus was evaluated in correlation with the area of the first and second molars (M1 and M2), the presence of teeth, and the residual ABH. In this study, we found that the intraosseous type is the most common type of AAA. Furthermore, the location and distance of the AAA are significantly affected by tooth position, an edentulous state in the case of the first molar, and residual ABH. Pre-evaluation of the diameter, position, and distance to the AAA using CT images is essential to help prevent hemorrhage. The existence and wide range of the AAA distances based on the tooth position, edentulous state, and residual ABH should be considered even if CT imaging cannot locate the AAA.

Effect of ergonomics awareness in controlling work-related musculoskeletal-pain among dental students: A cross-sectional study.

Dentistry is a profession that demands a high level of physical work and excessive repetitive movements in strained positions, both of which are risk factors for developing musculoskeletal pain (MS-P). This study aims to assess the awareness of ergonomics and physical activities in controlling MS-P among dental students. A cross-sectional study conducted at a university dental hospital in Saudi Arabia, through a validated self-administered questionnaire, distributed to undergraduates and postgraduate's dental students. Out of 402 students responded to the questionnaire, 337(83.8%) reported suffering from MS-P with 67.7% of participants did not take any measures to alleviate their symptoms and the majority reported limited physical activity. Females reported significantly higher MS-P than males. Lower back (56.5%), neck (56.2%) and shoulder (50%) were the most frequently reported MS-P. Unexpectedly, undergraduate reporting significantly more pain than interns and postgraduate students (P = 0.009). The dental students' awareness of ergonomics and MSDs were insufficient. Physical activity, student's awareness of MSD and ergonomics were the major factors for controlling MS-Ps. Therefore, this study highlights the importance of enhancing students' knowledge of the importance of controlling work-related MS-P, especially during their university educational hours.

NIMG-08. ANALYSIS OF11C-METHIONINE PET UPTAKE AND PROGNOSIS IN LOWER GRADE GLIOMAS

Abstract PURPOSE The 2021 WHO Classification of Tumors of the Central Nervous System incorporates molecular alterations into the classification system, with the goal of creating more homogenous disease categories with greater prognostic value. This study aimed to assess the correlation between 11C-methionine uptake, molecular features and prognosis in newly diagnosed lower-grade gliomas (LGGs). METHODS 93 newly diagnosed LGG patients (Grade 2: 39 patients, Grade 3: 54 patients) who underwent surgery at Tokyo Medical and Dental University Hospital from 2000 to 2020 and imaged preoperatively using 11C-methionine PET were retrospectively included in this study. These patients were re-classified according to the 2021 WHO classification. The tumor-to-normal ratio (T/N) of 11C-methionine uptake was calculated by dividing the mean standardized uptake value (SUV) for the tumor by the mean SUV of the normal brain. RESULTS 44 out of 93 gliomas were IDH wild-type tumors and re-classified as glioblastoma or pediatric-type gliomas according to the 2021 WHO classification and therefore excluded from the analysis. Remaining 49 LGGs were re-classified in two types- Oligodendrogliomas, IDH-mutant and 1p/19q- codeleted (n=25), and Astrocytomas, IDH-mutant (n=24)- following the indications provided by the 2021 WHO classification. The median T/N ratio in Oligodendrogliomas, IDH-mutant and 1p/19q- codeleted were 1.83 in grade 2 and 2.83 in grade 3, which were significantly higher than those in Astrocytoma, IDH-mutant (grade2: 1.38, grade3:1.62). Kaplan–Meier survival analysis revealed that Oligodendroglioma, IDH-mutant and 1p/19q- codeleted had significantly better outcomes regardless of WHO grade. CONCLUSION The results indicated that LGG categories reclassified with molecular classification correlate with the T/N ratio of methionine uptake and the prognosis.

A study on dislocation of the centre of rotation in nasomaxillary complex growth and development

ABSTRACT Purpose This study aimed to detect the centre of spiral similarity (CS), an improvement of the centre of rotation when the jaw shows standard growth, and to evaluate and examine the dislocation of CS depending on the skeletal type, sex and age. Materials and Methods This study included 107 patients aged 5–15 years (62 females and 45 males) examined at Osaka Dental University Hospital’s Department of Orthodontics for the primary complaint of malocclusion. For each patient, lateral cephalometric radiographs were taken before and after treatment. Skeletal types were classified into three groups (Class I, II and III) according to the McNamara analysis, and degrees of cervical vertebral maturation were classified into two groups (under 11 and 11 or over). We calculated CS using our previously reported method, derived the projective CS (pCS) to evaluate the dislocation of CS and compared pCS between skeletal groups. Results The CS of Class I was located approximately 17–21 mm anterior and 4–8 mm inferior to the sella. Significant differences in pCS were found between Classes I and III. Furthermore, the sign of pCS showed an opposite trend depending on sex. Conclusion The CS of ‘Class I and under 11’ is located near the spheno-ethmoidal synchondrosis, while that of ‘Class III and under 11’ was away from there in alternate directions for males and females. Our results provide insights into the trends that require different treatment strategies based on sex or other personal characteristics in orthodontics.

The effect of COVID-19 on dental treatment under conscious sedation in children: a retrospective study at Dental University Hospital, Riyadh, Saudi Arabia

Background: This study aimed to assess the effect of the COVID-19 pandemic on the number of cases and types of dental procedures performed under conscious sedation for children at Dental University Hospital (DUH), Riyadh, Saudi Arabia during the period between 2019-2021. Methods: This retrospective chart review study used digital and paper records for data collection. The sample was comprised of children aged 3 to 11 years of age who received dental treatment under conscious sedation from 2019 to 2021 at DUH. Descriptive statistics were presented, and negative binomial regression analysis was performed to assess the difference in the number of performed procedures by different academic year. Results: Two hundred and twenty-seven subjects had dental treatment under conscious sedation from 2019 to 2021. Most of the sample were Saudi (88.5%) and classified as ASA I (97.8%). The number of sedation cases were almost 55% lower than the number of cases that were done in 2020 and almost 62% lower than the cases that were performed in 2019. There was a significant decrease in the pulp therapy and preventive procedures (p=0.03, and p=0.02, respectively). No statistically significant differences were found in other procedures. Conclusions: There was a considerably huge decrease in the number of cases treated under conscious sedation as an effect of the pandemic. Pulp therapy and preventive procedures were the most affected. Our findings indicate the need to establish a protocol for delivering dental care while ensuring the safety of the patients in such difficult situations.

Prevalence of methicillin resistant staphylococcus aureus and its SCCmec type among students at a private dental college hospital in Chennai

Background: Since asymptomatic nasal carriage of Methicillin-resistant S. aureus (MRSA) is on the rise among healthcare professionals (HCPs), their prompt detection and decolonization would substantially decrease disease transmission. The study's primary goal was to identify MRSA nasal carriers among dental students/CRIs and determine their SCCmec type and their susceptibility to mupirocin. Methods: Anterior nasal swabs from 102 healthy dental students/ CRIs were collected aseptically and subjected to standard microbiological testing. The antibiotic susceptibility pattern of the S. aureus isolates was determined by Kirby Bauer disc diffusion method and mecA-mediated oxacillin (methicillin) resistance was determined using the cefoxitin disc method. PCR analysis of MRSA isolates determined the presence of mecA and their SCCmec types. D test deduced inducible clindamycin resistance. Results: Of the 102 participants screened, only 8(7.8%) carried S. aureus. Antibiotic susceptibility testing revealed that 5/8(62.5%) were MRSA isolates. Of which, only 2 MRSA isolates harbored mecA, and both belonged to the SCCmec type V. All S. aureus isolates were sensitive to Vancomycin, teicoplanin, and tigecycline when tested using agar screening method while 2/8 (25%) of the S. aureus isolates were D test positive and belonged to iMLSB phenotype. Conclusion: MRSA nasal carriers amongst HCWs/dental students are a cause of concern as they are a significant reservoir for transmission of MRSA among their co-workers as well as the community. Our results signify the need for screening for MRSA carriage and decolonization with mupirocin to substantially decrease the transmission of MRSA among dental students/patients.

Conventional gingivectomy for chronic gingival enlargement in orthodontic treatment: a case report

Background: Gingival enlargement, also known as gingival overgrowth, is an enlargement of the gum tissue. There are many possible causes for enlarged gums. Gingival enlargement is general feature of gingival diseases. It is common note to chronic inflammatory gingival enlargement was caused by poor of oral hygiene. Orthodontic braces can interfere with good oral hygiene, contributing to the development of the inflammatory process. One of the most common soft tissue problems related to fixed orthodontic appliances is gingival hypertrophy or hyperplasia. Maintaining oral hygiene is hindered in cases of gingival hypertrophy due to orthodontic appliances. The most widely used surgical method to treat gingival hypertrophy is gingivectomy.&#x0D; Case Report : A 27-year-old patient was referred to the periodontal clinic of Airlangga University Dental Hospital because of primary gingival swelling with gingival bleeding during brushing in the anterior mandibular region. On intra oral examination showed excessive gingival with probing depth was range 4 mm on teeth 42-32, revealing the presence of pseudopockets. Clinical examination revealed generalized gingival enlargement as well as generalized bleeding on examination. After explaining the condition and treatment to the patient, he was registered for phase I treatment. After evaluating phase I therapies, phase II treatment with gingivectomy and gingivoplasty were required using a scalpel.&#x0D; Conclusion: Conventional gingivectomy gives satisfactory result in treating the inflammatory gingival enlargement.

A service evaluation of the multidisciplinary team approach to hypodontia

Introduction Patients with hypodontia can be seen by a multidisciplinary team clinic (MDT) for treatment planning at the University Dental Hospital of Manchester (UDHM). The MDT consists of orthodontics, restorative dentistry and oral surgery colleagues.Aims and methods A retrospective case-note analysis was conducted on 558 hypodontia patients seen on Manchester Hypodontia Clinic (MHC) between 2016-2022 to assess service utilisation and treatment planning outcomes.Results The average age of patients attending the MHC was 16 (range 8-50). The distribution of mild, moderate and severe hypodontia in the sample was 28%, 37% and 35%, respectively. Most common treatments proposed were fixed appliances, extractions, implants and resin-bonded bridges. Out of 558 patients seen for consultation on the MHC, 365 (65%) were accepted for treatment. The average number of visits for treatment was 15.5 (range: 1-55). The average number of did not attend/was not brought appointments, patient cancellations and hospital cancellations were 0.8, 1.4 and 1.8, respectively.Conclusion Hypodontia patients referred to UDHM are triaged by consultants in orthodontics or restorative dentistry, and if MDT planning is required, they are booked onto the MHC. There are sufficient patients with complex cases of moderate and severe hypodontia to justify a regular MDT hypodontia clinic.