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The renowned Late Miocene locality of Maragheh (northwest Iran) has yielded ample material of chalicotheres, most of which has never been described in detail. The present study concerns the taxonomic evaluation of this material and its attribution to the large schizotheriine Ancylotherium pentelicum. This allows a detailed comparison to schizotheriine material from other localities, and based on this, we provide an overview of the diagnostic features of Ancylotherium that separate it from all other chalicotheres. This improves our understanding of the type species A. pentelicum. Additionally, we discuss the palaeobiogeography of the species, which is best known from the Balkan Peninsula. Maragheh marks the easternmost occurrence of A. pentelicum, but its presence has even been suggested in Africa. Lastly, we discuss the existence of sexual size dimorphism in the species, based on the herein described material along with previously described specimens of A. pentelicum from other fossil sites, such as the famous Late Miocene localities Pikermi and Samos (Greece). Specifically, it is shown that many postcranial elements exhibit great size variability that is most probably associated with significant sexual dimorphism. [ABSTRACT FROM AUTHOR]

In this retrospective cohort study the survival rate, clinical parameters, patient satisfaction with aesthetics and oral health-related quality of life of 3D printed temporary crowns were evaluated. Temporary crowns were 3D printed with a Form3B out of Permanent Crown Resin (Formlabs GmbH). Anonymized data for the restorations' survival (in-situ) was evaluated retrospectively for 98 temporary crowns of 63 patients fabricated within 19 months. Among these restorations, further analysis was conducted for 42 temporary crowns of 24 patients regarding clinical parameters (modified USPHS criteria), patient satisfaction with aesthetics and impact on oral health-related quality of life (OHRQoL) (OHIP 14). Descriptive statistical analysis (significance level of α = 0.05) included a Kaplan–Meier curve for survival analysis, a Kolmogorov–Smirnov test for USPHS, aesthetics and OHIP data, followed by a Wilcoxon test for USPHS and OHIP data and Chi-squared test for aesthetics data. Cronbach's alpha was calculated for OHIP data. The average observation period for survival analysis was 256 days. The survival rate was satisfactory at 98% and n = 2 catastrophic failures (i.e. fracture) occurred. Total OHIP scores, with good reliabilities, improved from 6.63 to 2.21 significantly (p = 0.005) and patient satisfaction with aesthetics (p < 0.001) as well. Clinical analysis with modified USPHS criteria revealed encouraging results. [ABSTRACT FROM AUTHOR]

Background: Oral health conditions are common in children and young people (CYP) with kidney disorders. There is currently limited literature on how confident paediatric nephrology teams feel to identify and manage oral health concerns for their patients. Method: An exploratory mixed-method survey was distributed across all 13 UK specialist paediatric nephrology centres with responses received from consultants, registrars, specialist nurses and special interest (SPIN) paediatricians. Results: Responses received from 109 multidisciplinary team members of 13/13 (100%) UK tertiary units. Ninety-two percent (n = 100) of respondents reported they had never received any training in oral health and 87% (n = 95) felt that further training would be beneficial to optimise care for patients and improve communication between medical and dental teams. Most respondents reported that they did not regularly examine, or enquire about, their patients' oral health. Only 16% (n = 17) reported that all their paediatric kidney transplant recipients underwent routine dental assessment prior to transplant listing. Severe adverse oral health outcomes were rarely reported and only 11% (n = 12) of respondents recalled having a patient who had a kidney transplant delayed or refused due to concerns about oral infection. Seventy-eight percent (n = 85) felt that joint working with a dental team would benefit patients at their unit; however, 17% (n = 18) felt that current infrastructure does not currently support effective joint working. Conclusions: Across the UK, paediatric kidney health professionals report lack of confidence and training in oral health. Upskilling subspecialty teams and creating dental referral pathways are recommended to maximise oral health outcomes for CYP with kidney diseases. [ABSTRACT FROM AUTHOR]

Purpose: Oral health (OH) has significant effects on pregnancy and infant outcomes. This study assesses the perspectives of obstetrical clinicians about OH education and promotion. Methods: A fifteen-item survey was developed and circulated to obstetrics and gynecology (OBGYN) and family medicine (FM) physicians, and other prenatal health clinicians in Massachusetts (MA). Additionally, eight physicians were purposively sampled for in-depth interviews to discuss their experience with prenatal OH training and practice. Bivariate relationships between outcome variables from the survey (e.g., previous OH training, awareness of OH guidelines, asking about OH during prenatal visits) were analyzed along with coding and analysis of the qualitative interview data. Results: The majority (77%) of the 86 survey respondents did not feel well-trained in OH. We found significant associations between being well-trained in OH and: (1) awareness of state guidelines (X2 = 11.85, p < 0.001); (2) asking about OH during prenatal visits (X2 = 9.21, p = 0.002); and (3) routinely referring patients for dental care (X2 = 15.35, p < 0.001). Lack of access to dental insurance and dental professionals were found to be major perceived barriers to care. Responses from the interviews reinforced these findings. Significance: Poor oral health is associated with adverse outcomes in pregnancy. This study provided a better understanding of how many prenatal clincians in a state like Massachusetts are trained in oral health. This study has also helped to determine what the associations are between adequate oral health training and various clinical outcomes, as well as what the anticipated major barriers are for prenatal patients with regards to accessing oral health. It has also reaffirmed the importance of a standardized oral health training curriculum for prenatal health professionals. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this systematic review was to explore and identify the factors that influence the accuracy of intraoral scanning in implant dentistry, with a specific focus on scan bodies (ISBs). Methods: Following the PRISMA 2020 guidelines, this study conducted a thorough electronic search across MedLine, PubMed, and Scopus to identify relevant studies. Articles were screened based on titles, abstracts, and full texts for relevance. The Robins I tool assessed the risk of bias in various study types. Data extraction occurred based on predetermined parameters for studying specimens and assessing outcomes. Results: 16 studies met the specified criteria and were consequently included in the systematic review. Due to variations in variables and methods across the selected studies, statistical comparison of results was not feasible. Therefore, a descriptive review approach was chosen, acknowledging the substantial heterogeneity in the reviewed literature. Conclusions: The precision of virtual scan results is contingent upon diverse characteristics of ISBs and implants. These factors encompass their placement within the dental arch, structural design, shape, material composition, color, and the manufacturing system, all of which contribute to scan accuracy. Additionally, considerations such as the intraoral scanner (IOS) type, scanning technique, use of scan aids, inter-implant distance, scan span, and the number of implants warrant evaluation. In the context of capturing implant positions, intraoral scanning with ISBs demonstrates comparable accuracy to traditional impression methods, particularly in single and short-span scenarios. However, the existing data lacks sufficient information on in vivo applications to formulate clinical recommendations. [ABSTRACT FROM AUTHOR]

Currently, many aquariums and zoos around the world keep walruses in captivity. However, the presence of tusks in walruses creates difficulties in their maintenance and preservation of their health since they wear them down on the structure of the pools. In this study, the morphometric parameters of walrus skulls from captivity and wild of similar age were examined (35 skull measurements and 21 mandible measurements were taken). An examination of the skulls of three female walruses that were kept in the Moscow Zoo for 8, 11, and 22 years, respectively during the period of 1953–2005 was conducted. The tusks of one walrus, at the age of 4 years, were surgically removed, while the tusks of the others were not. There were slight deviations in the skull development of these walruses. The skull of captive walruses is slightly smaller in the mastoid processes and zygomatic arches, and facial part, and the lower jaw is smaller in width and symphysis circumference compared to wild walruses. The surface of the skull and lower jaw is smoother in comparison to wild walruses. Diseases such as odontogenic osteomyelitis, pulpitis, periodontitis, dental calculus and caries are observed. Due to frequent inflammations and surgical interventions, early fusion of sutures is noted, leading to skull deformities. [ABSTRACT FROM AUTHOR]

Glasses based on the basic composition of lithium disilicate (Li2O.2SiO2) together with derived samples containing increasing CeO2 replacing Li2O (0.1, 0.2, 0.5, 1 Mol %) were prepared by melting – annealing method, samples from the prepared parent glasses were thermally heat treated through two-step regime (450° C /10 h – followed by 650° C / 6 h) to convert them to their glass – ceramics derivatives. The main purpose of this study is to find out the main properties of the prepared glass – ceramics to be applied as dental candidates. The optical, FTIR, and thermal expansion properties of the parent glasses were examined to identify the main structural groups which are defined as tetrahedral stronger SiO2 building groups. The detailed separated crystalline phases within the prepared glass–ceramics were identified together with their textural features. The Vickers microhardness data for both the parent glasses and their glass -ceramics derivatives were evaluated. SEM and EDAX measurements indicate the ability of the prepared samples to form hydroxyapatite upon immersion in SBF solution. [ABSTRACT FROM AUTHOR]

Objective: Head and neck squamous cell carcinoma (HNSCC) is a prevalent cancer that originates from the squamous cells. The role of the replication factor C subunit 3 (RFC3) in HNSCC progression remains elusive. The aim of this study was to uncover RFC3 significance in HNSCC. Methods: The Cancer Genome Atlas (TCGA-HNSCC) dataset was initially used to assess RFC3 expression and its association with HNSCC clinical features. Subsequently, quantitative reverse transcription PCR (RT-qPCR) confirmed RFC3 mRNA expression in oral squamous cell carcinoma (OSCC), a primary HNSCC type. Survival rates were evaluated using the Kaplan–Meier plot, while the Tumor Immune Estimation Resource (TIMER) database probed RFC3-immune cell interaction. Additionally, in silico tools were used to examine the RFC3 protein network and engagement in HNSCC pathways. Results: RFC3 expression is significantly upregulated in HNSCC, including OSCC. Upregulated RFC3 expression was significantly correlated with the clinicopathological features of HNSCC, including tumor stage, grade, metastasis, and patient survival. RFC3 is also associated with immune cell infiltration. Functional analysis has highlighted its involvement in DNA replication, mismatch repair, and cell cycle pathways. Interestingly, RFC3 high expression is linked to well-known oncogenic signaling pathways, such as MYC/MYCN, HIPPO, and mTOR. Conclusions: In conclusion, RFC3 can be considered a novel prognostic biomarker for HNSCC, and further studies on its functional mechanisms may help to use RFC3 as a therapeutic target for HNSCC. Clinical relevance: The clinical relevance of this study lies in identifying RFC3 as a novel biomarker and prognostic indicator for HNSCC, offering insights that could impact future clinical approaches. [ABSTRACT FROM AUTHOR]

A randomized controlled trial established initial efficacy of a novel parent training (PT) intervention for improving oral hygiene and oral health in underserved children with ASD (Fenning et al., 2022), a population at risk for unmet dental needs. The present study describes our emic approach to PT development alongside treatment outcome data examining feasibility, acceptability, and engagement. Families with Medicaid-eligible children with ASD ages 3 to 13 years (85% male, 62% with intellectual disability) were assigned to receive PT (n = 60) or a psychoeducational toolkit (n = 59). Results indicate strong retention, fidelity, and adherence, with quantitative and qualitative metrics revealing high treatment satisfaction and utilization. Discussion focuses on implications for individualizing treatment to optimize engagement of underrepresented families. [ABSTRACT FROM AUTHOR]

Background: 'Temporomandibular joint disorders (TMDs)' denote an umbrella term that includes arthritic, musculoskeletal and neuromuscular conditions involving the temporomandibular joint, the masticatory muscles, and the associated tissues. Occlusal devices are one of the common treatment modalities utilized in the conservative management of TMDs. The indications for the available 'oral splints' or 'oral orthotic occlusal devices' remain ambiguous. Methods: A joint international consortium was formulated involving the subject experts at TMJ Foundation, to resolve the current ambiguity regarding the use of oral orthotic occlusal appliance therapy for the temporomandibular joint disorders based on the current scientific and clinical evidence. Results: The recommendations and the conclusion of the clinical experts of the joint international consort has been summarized for understanding the indications of the various available oral orthotic occlusal appliances and to aid in the future research on oral occlusal orthotics. Conclusion: The use of the oral orthotic occlusal appliances should be based on the current available scientific evidence, rather than the archaic protocols. [ABSTRACT FROM AUTHOR]

Dental biometrics is a type of biometrics that uses dental information to identify individuals. Well-known biometric features such as fingerprints and gait images have been successfully used to identify individuals. However, these features can be easily damaged. Teeth are more durable than other biometric features. Therefore, dental biometrics are used when other biometric features are not available. There are several types of dental radiographs. Panoramic radiographs are a type of x-ray that show the entire jaw. In these x-rays, all the teeth are viewed together. Panoramic x-rays contain more information about the tooth and jaw structures. However, they also contain unwanted elements such as the bite disc, mandible, nasal bone, etc. This makes them more difficult to process. All types of dental radiographs have difficulties in processing due to slight differences in brightness, overlapping or differently aligned teeth. Identifying individuals from dental radiographs often involves the following main steps: jaw separation, tooth segmentation, feature extraction, and feature matching. The accuracy of jaw and tooth segmentation influences the next steps. In this study, a new fully automatic method for separating mandible, maxilla, and teeth in panoramic radiographs is proposed. The proposed method achieved high accuracy in jaw separation. It also achieved better jaw separation performance than comparable studies. Although the proposed method is a fully automatic method, its performance in tooth separation is close to that of the compared semi-automatic method. In the proposed study, a jaw separation ratio of 0.99, based on the number of correctly aligned teeth, was achieved. The detection rate of the separators for the teeth in the mandibular jaw is 0.90 and the accuracy is 0.86. For maxillary teeth, these values are 0.92 and 0.90, respectively. The results are promising for the automatic segmentation of panoramic radiographs for human identification. [ABSTRACT FROM AUTHOR]

Objectives: Dental caries is the most common chronic disease in humans, caused by the acid produced by the microflora in the mouth that dissolves the enamel minerals. Bioactive glass (BAG) has been used in various clinical applications due to its unique bioactive properties, such as bone graft substitutes and dental restorative composites. In this study, we introduce a novel bioactive glass–ceramic (NBGC) prepared through a sol–gel process under a water-free condition. Materials and methods: The anti-demineralization and remineralization effects of NBGC were evaluated by comparing the measurements of bovine enamel surface morphology, surface roughness, surface micro-hardness, enamel elements, and mineral content before and after related treatments with a commercial BAG. The antibacterial effect was characterized by minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC). Results: Results showed that NBGC had greater acid resistance and remineralization potential compared to commercial BAG. The fast formation of a hydroxy carbonate apatite (HCA) layer suggests efficient bioactivity. Clinical relevance: In addition to its antibacterial properties, NBGC shows promise as an ingredient in oral care products that can prevent demineralization and restore enamel. [ABSTRACT FROM AUTHOR]

Computer-based learning applications and mobile technology have transformed many aspects of the educational experience over the last decade, producing software aimed at improving learning efficiency and streamlining the presentation of course materials. One such class of software, purpose-created to take advantage of spaced learning and spaced testing principles, are electronic flashcard applications. We provide a perspective on the novel use of the Quizlet flashcard application in a tertiary educational setting. To reduce cognitive load for international graduate dental students taking a pharmacology review course, we implemented Quizlet, which integrates both spaced learning and self-testing, to improve the student learning experience. This study assessed students' perceptions of the Quizlet flashcard system in a student cohort comprised of two consecutive years' classes (n = 51 students in total). Results indicated broad acceptance of Quizlet based on ease of use of the software and ease of study of the material. Our data provide insight into the use of this common software in a professional healthcare tertiary education setting and further demonstrate the successful application of electronic flashcards for a mixed international student cohort. Further research should include an assessment of the impact of flashcard on long-term knowledge retention in this setting. [ABSTRACT FROM AUTHOR]

Background: Transcatheter aortic valve implantation-related infective endocarditis (TAVI-IE) is a well-recognised and serious complication following TAVI. The purpose of this study was to describe the clinical characteristics, microorganism spectrum, and outcomes of TAVI-IE in an Irish context. Methods: A prospective registry was used to assess the baseline demographics, procedural variables, and clinical outcomes of patients undergoing TAVI between 2009 and 2020 at two tertiary referral Irish Hospitals. Results: A total of 733 patients underwent TAVI during the study period. During a follow-up duration of 1,949 person-years (median 28 months), TAVI-IE occurred in 17 (2.3%) patients. The overall incidence was 0.87 per 100 person-years and the median time from TAVI to presentation with IE was 7 months [IQR: 5–13 months]. In those who developed TAVI-IE, the mean age was 78.7 years, 70.5% were male, and there was a trend towards more permanent pacemaker implantations post-TAVI (17.6% vs. 5.86%; p = 0.08). The dominant culprit microorganisms were streptococci (41.1%) and four (23.5%) cases were attributed to dental seeding. Major complications of TAVI-IE included one (5.8%) stroke, one (5.8%) in-hospital death, and two (11.7%) urgent surgical aortic valve replacements. The Kaplan–Meier estimate of survival at 1-year was 82% (95% CI = 55–95). Conclusions: This Irish cohort of TAVI-IE exhibited a similar incidence and time to presentation compared to prior international registries; however, the 1-year mortality rate was comparatively lower. The need for rigorous dental clearance pre-TAVI and maintenance of dental health post-TAVI is underscored by the high prevalence of oral streptococcus species in this cohort. [ABSTRACT FROM AUTHOR]

In this study, a home dental care system consisting of an oral image acquisition device and deep learning models for maxillary and mandibular teeth images is proposed. The presented method not only classifies tooth diseases, but also determines whether a professional dental treatment (NPDT) is required. Additionally, a specially designed oral image acquisition device was developed to perform image acquisition of maxillary and mandibular teeth. Two evaluation metrics, namely, tooth disease and NPDT classifications, were examined using 610 compounded and 5251 tooth images annotated by an experienced dentist with a Doctor of Dental Surgery and another dentist with a Doctor of Dental Medicine. In the tooth disease and NPDT classifications, the proposed system showed accuracies greater than 96% and 89%, respectively. Based on these results, we believe that the proposed system will allow users to effectively manage their dental health by detecting tooth diseases by providing information on the need for dental treatment. [ABSTRACT FROM AUTHOR]

Objectives: To investigate whether artificial CAD/CAM processed (computer-aided design/manufacturing) teeth could be a feasible option for the production of dental in vitro models for biomechanical testing. Material and methods: Disks (n = 10 per group) made from two different CAD/CAM-materials, one fiber-reinforced composite (FRC; Trinia, Bicon) and one polymethylmethacrylate-based resin (PMMA; Telio CAD, Ivoclar Vivadent), as well as bovine teeth (n = 10), were tested for their shear bond strength (SBS) and scored according to the adhesive remnant index (ARI). In addition, CAD/CAM-manufactured lower incisor teeth were tested for their ultimate load (Fu). Results: With regard to SBS, both PMMA (17.4 ± 2.2 MPa) and FRC (18.0 ± 2.4 MPa) disks showed no significant difference (p = 0.968) compared to bovine disks (18.0 ± 5.4 MPa). However, the samples differed with regard to their failure mode (PMMA: ARI 4, delamination failure; FRC: ARI 0 and bovine: ARI 1.6, both adhesive failure). With regard to Fu, FRC-based teeth could withstand significantly higher loads (708 ± 126 N) than PMMA-based teeth (345 ± 109 N) (p < 0.01). Conclusion: Unlike PMMA-based teeth, teeth made from FRC showed sufficiently high fracture resistance and comparable SBS. Thus, FRC teeth could be a promising alternative for the production of dental in vitro models for orthodontic testing. Clinical relevance: CAD/CAM-processed teeth made from FRC enable the use of standardized geometry and constant material properties. Using FRC teeth in dental in vitro studies has therefore the potential to identify differences between various treatment options with rather small sample sizes, while remaining close to the clinical situation. [ABSTRACT FROM AUTHOR]

Objectives: This study estimated the prevalence of dental fear/anxiety (DFA) and phobia in Asian youths and investigated the fear/anxiety response components and triggers for those with DFA. Materials and methods: A convenience sample of youths, aged 17 to 24 years old, was recruited from a local polytechnic. The Index of Dental Anxiety and Fear-4C + (IDAF-4C +) was employed to assess the occurrence of DFA (IDAF-4C) and phobia (IDAF-P) as well as to ascertain fear/anxiety-inducing stimuli (IDAF-S). Psychological distress was determined with the Patient Health Questionnaire-4 (PHQ-4). Sociodemographic, IDAF-4C + , dental attendance patterns, and PHQ-4 data were gathered electronically. Statistical analyses were conducted with chi-square, Kruskal–Wallis, and relevant post hoc tests (α = 0.05). Results: A total of 215 participants were enrolled (mean age of 18.9 ± 2.0 years; 87.4% women). Of these, 12.6/6.0% had moderate-to-high (MH)/high-to-extreme (HE) DFA and 0.9% experienced dental phobia. Significant differences in scores were observed between the HE/MH and no-to-moderate (NM) groups for all IDAF-4C components. Apart from the cost of dental treatment, IDAF-4S scores varied significantly among the three DFA groups. The two most highly rated DFA stimuli were painful/uncomfortable procedures and needles/injections for the HE group, while they were needles/injections and the cost of dental treatment for the MH and NM groups. Conclusions: Moderate-to-extreme DFA existed in 18.6% of the Asian youths examined. The emotional and physiological components of the IDAF-4C appear to contribute more to the DFA response. Dental pain including needles/injections and the cost of dental treatment troubled Asian youths the most. Clinical relevance: DFA is a common problem among Asian youths, and understanding its extent, nature, and triggers is central for effective interventions. [ABSTRACT FROM AUTHOR]

Purpose Of the Review: Migraine and other primary headache disorders can be localized in the face resembling facial or dental pain, indicating the influence of the trigeminovascular system in the structures innervated by the maxillary (V2) and mandibulary (V3) branches of the trigeminal nerve. Disorders of oral and craniofacial structures may influence primary headache disorders. In the current article, we review the potential links of this interplay.Recent Findings: This interplay may be related to anatomy, with the trigeminal pathway and the involvement of both peripheral and central mechanisms, and the presence of calcitonin gene-related peptide (CGRP), a key mediator in migraine pathophysiology. CGRP is also involved in the pathophysiology of temporomandibular disorders (TMD) and their comorbidity with migraine and is also implicated in dental and periodontal pathology. Inflammatory and pathological processes of these structures and their trigeminal nociceptive pathways may influence the trigeminovascular system and consequently may exacerbate or even potentially trigger migraine. [ABSTRACT FROM AUTHOR]

Aim: To compare the sedation regimen Dexmedetomidine alone and its combination with low dose Ketamine through intravenous route in terms of safety, efficacy and recovery profile in uncooperative paediatric dental patients requiring pulpectomy. Material and methods: Thirty anxious and uncooperative 2–6-year-old children requiring pulpectomy in at least one primary molar were enrolled. Propofol was used as an induction agent. Drugs were administered through the intravenous route as per group assignment, i.e., Dexmedetomidine (1 µg/kg) with ketamine (0.5 mg/kg) administered over 10 min followed by a maintenance dose of Dexmedetomidine (0.2–0.8 µg/kg/h) in group A and Dexmedetomidine (1 µg/kg) administered over 10 min followed by a maintenance dose in group B. The sedation was titrated to achieve Houpt's overall behavior score of 4/5. The primary outcome measure was the successful completion of treatment. Secondary outcome measures were vital signs, quality of sedation, time need for the procedure, recovery time, intra-operative and post-operative adverse sequelae. Results: Results showed that both of the regimens were similar in efficacy, safety and recovery profile. Also, the required dose of dexmedetomidine and the need for rescue boluses was similar in both of the study groups. Conclusion: Dexmedetomidine either alone or in combination with ketamine proved to be a safe and efficacious agent for paediatric dental sedation. No beneficial evidence of adding ketamine was observed. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed to clinically assess the association between periodontitis and COVID-19-related outcomes. Material and methods: Data pertaining to patient demographics, medical history, blood parameters, periodontal clinical examination and aMMP-8 point-of-care diagnostics (both site-level and patient-level) was recorded for eighty-two COVID-19-positive patients. COVID-19-related outcomes such as COVID-19 pneumonia, death/survival, types of hospital admission and need of assisted ventilation were also assessed. Results: Males were predominantly afflicted with COVID-19, with advanced age exhibiting a greater association with the presence of periodontitis. Higher severity of periodontitis led to 7.45 odds of requiring assisted ventilation, 36.52 odds of hospital admission, 14.58 odds of being deceased and 4.42 odds of COVID-19-related pneumonia. The aMMP-8 mouthrinse kit was slightly more sensitive but less specific than aMMP-8 site-specific tests. Conclusions: Based on the findings of the present study, periodontitis seems to be related to poorer COVID-19-related outcomes. However, within the constraints of this work, a direct causality may not be established. Periodontitis, by means of skewing the systemic condition for a number of comorbidities, may eventually influence COVID-19 outcomes in an indirect manner. Clinical relevance: The study is the first to clinically, and by means of a validated point-of-care diagnostic methodology, assess the association between periodontal health and COVID-19-related outcomes. Assessment of the periodontal status of individuals can aid in the identification of risk groups during the pandemic along with reinforcing the need to maintain oral hygiene and seeking periodontal care. [ABSTRACT FROM AUTHOR]

Objectives: To compare the efficacy of digital periapical (PA) radiography with cone-beam computed tomography (CBCT) by altering the gray-scale range for the detection of bone-implant interface gaps. Methods: Titanium implants were placed in 52 blocks of bovine rib such that 42 had no gaps and served as the control group. The implants were subsequently placed in the same blocks with 0.25 mm increase in the osteotomy size to serve as the test group. The remaining 10 blocks were used for random arrangement of the test and control blocks within a fabricated wax arch. CBCT with change in the gray-scale range and digital PA were obtained and evaluated by two observers regarding the presence/absence of gaps. The two imaging modalities were compared by the receiver operating characteristic (ROC) curve, Kappa and McNemar tests (α = 0.05). Results: PA and CBCT showed moderate agreement for gap detection (k = 0.60). There were no significant differences in the area under the ROC curve (AUC) between CBCT and PA (P = 0.45). The frequency of correct diagnoses on PA radiographs was significantly higher in the test group (P = 0.016), while not significant on the CBCT images (P = 0.344). PA showed higher sensitivity (100%) compared to CBCT (83.33%). However, the specificity of CBCT (92.86%) was greater than that of PA (83.33%). Conclusions: Certain gray-scale ranges in CBCT enhance the assessment of bone–implant interface which brings the accuracy of CBCT closer to digital PA radiography as the modality of choice. [ABSTRACT FROM AUTHOR]

Osmotic swelling and residual stress are increasingly recognized as important factors in soft tissue biomechanics. Little attention has been given to residual stress in periodontal ligament (PDL) biomechanics despite its rapid growth and remodeling potential. Those tissues that bear compressive loads, e.g., articular cartilage, intervertebral disk, have received much attention related to their capacities for osmotic swelling. To understand residual stress and osmotic swelling in the PDL, it must be asked (1) to what extent, if any, does the PDL exhibit residual stress and osmotic swelling, and (2) if so, whether residual stress and osmotic swelling are mechanically significant to the PDL's stress/strain behavior under external loading. Here, we incrementally built a series of computer models that were fit to uniaxial loading, osmotic swelling and residual stretch data. The models were validated with in vitro shear tests and in vivo tooth-tipping data. Residual stress and osmotic swelling models were used to analyze tension and compression stress (principal stress) effects in PDL specimens under external loads. Shear-to-failure experiments under osmotic conditions were performed and modeled to determine differences in mechanics and failure of swollen periodontal ligament. Significantly higher failure shear stresses in swollen PDL suggested that osmotic swelling reduced tension and thus had a strengthening effect. The in vivo model's first and third principal stresses were both higher with residual stress and osmotic swelling, but smooth stress gradients prevailed throughout the three-dimensional PDL anatomy. The addition of PDL stresses from residual stress and osmotic swelling represents a unique concept in dental biomechanics. [ABSTRACT FROM AUTHOR]

Background: Due to fear and/or behaviour management problems, some children are unable to cooperate for dental treatment using local anaesthesia and psychological support alone. Sedation is required for these patients in order for dentists to be able to deliver high quality, pain-free dental care. The aim of this guideline is to evaluate the efficacy and relative efficacy of conscious sedation agents and dosages for behaviour management in paediatric dentistry and to provide guidance as to which sedative agents should be used. Methods: These guidelines were developed using a multi-step approach adapted from that outlined by the National Institute for Clinical Excellence (NICE (2020) Developing NICE Guidelines: the manual. https://www.nice.org.uk/process/pmg20/chapter/introduction#main-stages-of-guideline-development. Accessed 7 Oct 2020). Evidence for this guideline was provided from a pre-existing Cochrane review (Ashley et al. Cochrane Database Syst Rev 12:CD003877, 2018) supplemented by an updated search and data extraction up to May 2020. Results: Studies were from 18 different countries and had recruited 4131 participants overall with an average of 70 participants per study. Ages ranged from 0 to 16 years with an average age of 5.6 years across all included studies. A wide variety of drugs or combinations of drugs (n = 38) were used and delivered orally, intranasally, intravenously, rectally, intramuscularly, submucosally, transmucosally or by inhalation sedation. Twenty-four different outcome measures for behaviour were used. The wide range of drug combinations and outcome measures used greatly complicated description and analysis of the data. Conclusion: Oral midazolam is recommended for conscious dental sedation. Midazolam delivered via other methods or nitrous oxide/oxygen sedation could be considered, but the evidence for both was very low. [ABSTRACT FROM AUTHOR]

The tooth cavity is the common problem in the enamel surface due to the predominance of the demineralization process. It can be controlled with different factors like sufficient salivation in remineralization agents, antibacterial protection, and pathologic factor. Fluoride ion (F−) is the oral hygiene active ingredient and best choice for control caries, prevent decay, crumbling of the bone tooth. F−. In general forms fluorapatite (FA) on the enamel surface, which inhibits mineral loss during the demineralization process. However, recommended optimum deposition of FA on the enamel surface, otherwise, FA leads to inhibit full remineralization. However, regularly consume fluoride causes dental fluorosis during tooth development. Hence, need for an alternative non-fluoride agent for dental caries, which can include effective remineralization without risks associated with F−. This review described fluoride release and re-release ability with application of dental materials, remineralizing potential of fluoridated and non-fluoridated products in dentistry such as casein phosphopeptides, nanohydroxyapatite, tricalcium phosphate, dicalcium phosphate dehydrate, polyols, SensiStat, trimetaphosphate, and herbal products. Lastly, dental perspectives are described. Based on literature results and discussion, nanohydroxyapatite, fluoride, and tricalcium phosphate are best among toothpaste to enhance the remineralization process. Recently, the focus of restorative dentistry is shifted toward more conservative approaches. Hence, F− releasing filling materials with different fluoride-releasing abilities like GIC, giomers, cermets, compomers, and composite materials proved beneficial for the patient. The presence of fluoride anions in the oral cavity has added advantage of being a potent antibacterial and antifungal agent. Highlights: Remineralizing potential of fluoridated vs. non-fluoridated products in dentistry. Fluoride release and re-release ability with the application of dental materials. Dental perspectives. [ABSTRACT FROM AUTHOR]

Introduction and aim: Healthcare information is becoming more readily available and searched for online, particularly on websites such as YouTube™. The accuracy and content of these websites is often questionable. We aimed to evaluate the quality of information available on surgical extraction of wisdom teeth on YouTube™. Materials and methods: We searched for the terms 'wisdom teeth', 'third molar', and 'wisdom tooth extraction' on YouTube™. The first 3 pages of results for each search term were assessed for inclusion and were independently rated by two assessors. Three separate scales to rate the quality of online information were used—DICSERN (range 0–5), HONcode (range 0–8) and the Global Quality Scale (GQS)(range 1-5). Cohen's kappa test was used to assess inter-rater reliability. Results: The searches returned 179 videos, but 114 were excluded (37 duplicates, 3 unrelated, 57 non-surgical, 13 <10k views, 4 non-English). Of the 65 videos included, the average length was 6 minutes and 34 seconds, and the average percentage positivity was 89%. The mean DISCERN score was 1.47 (SD 1.13), and the mean score for GQS was 2.15 (SD 0.6). No video met all HONcode criteria with the mean score being 2.96 (SD 0.9). There was good inter-rater reliability for the DISCERN score (kappa= 0.744) and HONcode score (kappa =0.866) but less reliability for GQS (kappa = 0.204). Conclusion: The standard of information on YouTube™ on surgical extraction of wisdom teeth varies, but is of poor quality overall. Patients should be advised to be cautious of such sources for information on this topic. [ABSTRACT FROM AUTHOR]

Forensic odontology has contributed significantly in forensic investigations and involves various branches of dentistry including orthodontics. The current communication presents evidence-based perspective highlighting synergistic union of different specialties for Forensic Facial Approximation (FFA). It brings forth commonality in principles of anthropology, forensic science, anthropometry, anatomy, paleontology, forensic odontology, with orthodontics, used in FFA. Various attributes and skills of orthodontists' aid in dental and skull profiling and the corresponding sex, age, and ethnicity-based soft tissue assessments for facial soft tissue thickness (FSTT), may aid a life-like appearance. They can assist hard tissue profiling by their expertise in growth of skeletal and soft tissue, along with the evolutionary trends in occlusion, and diet formulations. Their knowledge in identifying teeth patterns, dental/skeletal jaw relationships, cranial/facial indices, vertical/horizontal facial proportions, can help prepare skull for orientation and reconstruction. The dental, photographic, and radiographic records maintained by orthodontists and general dentists are instrumental in data retrieval, used in various software, clinical, or research areas. These can provide normative values for comparative analysis or facial recreation. The orthodontists can also assist anthropologists and forensic specialists in the virtual reconstructions due to their ease in using latest digital technologies including three-dimensional (3D) facial scan, stereo-photogrammetry, 3D printing, automated soft-tissue landmarks, growth, and age predictions. Thus, the current study established the commonality in concepts of various forensic disciplines with orthodontics, which can strengthen both forensic on-field facial approximations and hard/soft tissue research to further enhance the accuracy of contemporary digital software used in FFA. [ABSTRACT FROM AUTHOR]

Objectives: The present case series aimed to examine lip repositioning surgery (LRS) outcomes related to changes in external and internal upper lip (UL) dimensions, utilizing both conventional clinical and novel radiographic approaches. Materials and methods: Patients (n = 13) diagnosed with hypermobile UL (>8-mm mobility during smile) and excessive gingival display (≥4-mm) were included and assessed at baseline and 6 months postoperatively. Clinical parameters at rest included total lip and internal lip length (vestibular depth). At maximum smile included total lip, philtrum (ergotrid), and vermilion lengths. Cephalometric parameters included anterior maxillary height; lip length; nasolabial angle; anteroposterior lip thickness; internal lip length (vestibular depth); and vestibular fornix position (using novel approach employing radiopaque marker). Linear mixed-effect models, Pearson's correlation, and linear regression were used for statistical analyses. Results: LRS did not affect total UL length at rest (p = 0.418). It resulted in significant internal UL length decrease (−3.8 ± 2.1 mm, p < 0.001) and significant increases of vermilion length (1.9 ± 1.0 mm, p < 0.001) and anteroposterior lip thickness (0.7 ± 0.7 mm, p = 0.002). The clinical and radiographic measurements of total UL length at rest (r ≥ 0.734) and of internal UL length (r ≥ 0.737), and the two radiographic assessments of vestibular depth (r = 0.842), were strongly correlated. Conclusions: LRS resulted in significant decrease of vestibular depth/internal UL length and in significant increases of UL vertical vermilion length and UL anteroposterior thickness, without affecting total UL length at rest. Clinical relevance: The documented lip dimensional outcomes should help practitioners when treatment-planning LRS and counseling patients seeking treatment for hypermobile UL. [ABSTRACT FROM AUTHOR]

Taxi and for-hire vehicle (FHV) drivers are a largely immigrant, low-income occupational group at increased cardiovascular disease (CVD) risk. Poor dental health is a CVD risk factor, and dental care access is an unexamined taxi/FHV driver CVD risk factor. A cross-sectional survey was administered to 422 taxi/FHV drivers (2016–2017) to identify predictors of access to dental health care among drivers. One-third (n = 128, 30.3%) reported needing dental care/tests/treatment within the past six months, and nearly one-half (n = 61, 48%) were delayed/unable to obtain care. Only 57.6% (n = 241) had past-year dental cleanings. Not having enough money to cover household expenses was a significant predictor of being delayed/unable to obtain needed dental care/tests/treatment in the prior six months (0.5 OR; 95% CI, 0.28–0.89; p <.05). Lack of dental insurance coverage (2.72 OR; 95% CI, 1.60–4.63; p <.001) or lack of primary care provider (2.72 OR; 95% CI, 1.60–4.63; p <.001) were associated with lack of past-year dental cleaning. Seventeen percent of drivers with Medicaid were unaware of their dental coverage, which was associated with both inability to access needed dental care/tests/treatment in the past 6 months (p =.026) and no past-year dental cleaning (p <.001). Limited understanding of dental coverage was associated with both an inability to access needed dental care/tests/treatment in the past 6 months (p =.028) and lack of past-year dental cleaning (p =.014). Our findings can inform targeted intervention development to increase taxi/FHV driver dental care access/uptake, potentially improving their CVD risk. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the type and the amount of fluoridated dentifrice applied on children's toothbrushes by parents/guardians according to descriptions typically recommended by scientific societies, as well as to assess the influence of demographic and socioeconomic variables on dentifrice use. Methods: Parents/guardians of children (0–7 years old; n = 306; convenience sample) attending vaccination centres from Araçatuba (Brazil), answered to a structured questionnaire comprising items related to interviewees' education, child's age, gender, brushing habits and use of fluoridated dentifrice. The amount of toothpaste used by children during toothbrushing was estimated using a portable scale. Similarly, the interviewees were requested to apply dentifrices on toothbrushes according to eight descriptions, ranging from "smear" to "all bristles", following a random sequence. Data were submitted to Mann–Whitney's, Kruskal–Wallis' and Friedman's tests, and Spearman's correlation coefficient (p < 0.05). Results: The type of toothpaste and the amount of product used at home were not affected by the respondents' educational level or family income. However, child's age was significantly correlated with the amount of toothpaste placed on the toothbrush (r = 0.324, p < 0.001). Also, the amount of toothpaste placed on the toothbrush increased according to what would be expected from the descriptions, although wide variations were observed within each description, with large interquartile and overall ranges. Conclusion: The amount and the type of dentifrice used by children were influenced by their age, while parents/caregivers' interpretation on verbal instructions regarding appropriate dentifrice quantities varied widely. This reinforces the need for educative measures on the appropriate use by dentifrices by children. [ABSTRACT FROM AUTHOR]

Purpose: To assess and compare teaching of paediatric dentistry in the undergraduate curriculum among dental schools in the Arabian region. Methods: A 28-item online cross-sectional questionnaire survey was conducted of undergraduate dental programme directors in the Arab region. The survey included questions related to the programme's content, method of instruction on specific paediatric dentistry topics as well as the director's opinion on the level of training obtained by the undergraduate students at the end of the programme. Results: The final sample included 31 dental schools representing undergraduate programmes in ten Arabian countries (60.8% response rate). All programmes provided theoretical and practical education on communicative behaviour management techniques and caries prevention. Pulpectomy and formocresol pulpotomy were taught in the form of theoretical and practical education in 87.1% and 80.6% of the programmes, respectively. The method of education on common orthodontic topics was mainly theoretical with the exception of space maintainers. Instructions on managing trauma to permanent dentition was theoretical and practical in most programmes (61.3%). Most respondents rated the level of training of students in behaviour management and caries prevention as good to reasonable, while only 22.6% thought that the level of training was excellent in pulp therapy. Conclusion: Variations were observed in paediatric dentistry education among undergraduate dental programmes in the Arabian region in terms of topics, instruction methods, year of introduction of paediatric dentistry education, and number of clinical sessions offered. This study establishes a framework for future paediatric dentistry curriculum development and/or improvement in the Arabian region. [ABSTRACT FROM AUTHOR]

Fractal dimension (FD) calculated on oral radiographs has been proposed as a useful tool to screen for osteoporosis. This systematic review and meta-analysis firstly aimed at assessing the reliability of FD measures in distinguishing osteoporotic patients (OP) from healthy controls (HC), and secondly, to identify a standardized procedure of FD calculation in dental radiographs for the possible use as a surrogate measure of osteoporosis. A comprehensive search was conducted up to September 2020 using PubMed, Web of Science, and SCOPUS databases. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement was followed. Meta-analysis was performed on FD values calculated for HC and OP. Overall, 293 articles were identified. After a three steps screening, 19 studies were included in the qualitative appraisal and 12 were considered for meta-analysis. The methodological quality of the retrieved studies was generally low. Most of the studies included used White and Rudolph and box counting to process the images and to calculate FD, respectively. Overall, 51% of the studies found a meaningful difference between HC and OP groups. Meta-analyses showed that to date, FD measures on dental radiographs are not able to distinguish the OP from HC group significantly. From the current evidence, the use of FD for the identification of OP is not reliable, and no clear conclusion can be drawn due to the heterogeneity of studies. The present review revealed the need for further studies and provided the fundamentals to design them in order to find a standardized procedure for FD calculation (regions for FD assessment; images processing technique; methods for FD measurement). More effort should be made to identify osteoporosis using dental images which are cheap and routinely taken during periodic dental examinations. [ABSTRACT FROM AUTHOR]

People living with HIV (PLWH) who use drugs experience worse health outcomes than their non-using counterparts. Little is known about how often they seek dental care and the factors that influence their utilization. PLWH with substance use disorders who were inpatients at 11 urban hospitals (n = 801) participated in a National Institute on Drug Abuse Clinical Trials Network study to improve engagement in HIV outcomes. Dental care utilization at each time point during the study period (baseline, 6 months and/or 12 months) was assessed (n = 657). Univariate analysis and logistic regression were used to examine factors associated with dental care utilization. Over half (59.4%) reported not having received any dental care at any timepoint. Participants with less than high school education had lower odds of reporting dental care utilization than those with more than education (aOR = 0.60 [95% CI 0.37–0.99], p = 0.0382). Participants without health insurance also had lower odds of reporting dental care utilization than those with insurance (aOR = 0.50 [95% CI 0.331–0.76], p = 0.0012). Higher food insecurity was associated with having recent dental care utilization (OR = 1.03 [95% CI 1.00, 1.05], p = 0.0359). Additionally, those from Southern states were less likely to report dental care utilization (aOR = 0.55 [95% CI 0.38, 0.79], p = 0.0013). Having health insurance and education are key factors associated with use of dental care for PLWH with substance use disorders. The association between food insecurity and dental care utilization among this population suggests the need for further exploration. [ABSTRACT FROM AUTHOR]

Dynamic occlusal loading during mastication is clinically relevant in the design and functional assessment of dental restorations and removable dentures, and in evaluating temporomandibular joint dysfunction. The aim of this study was to develop a modelling framework to evaluate subject-specific dynamic occlusal loading during chewing and biting over the entire dental arch. Measurements of jaw motion were performed on one healthy male adult using low-profile electromagnetic field sensors attached to the teeth, and occlusal anatomy quantified using an intra-oral scanner. During testing, the subject chewed and maximally compressed a piece of rubber between both second molars, first molars, premolars and their central incisors. The occlusal anatomy, rubber geometry and experimentally measured rubber material properties were combined in a finite element model. The measured mandibular motion was used to kinematically drive model simulations of chewing and biting of the rubber sample. Three-dimensional dynamic bite forces and contact pressures across the occlusal surfaces were then calculated. Both chewing and biting on the first molars produced the highest bite forces across the dental arch, and a large amount of anterior shear force was produced at the incisors and the second molars. During chewing, the initial tooth-rubber contact evolved from the buccal sides of the molars to the lingual sides at full mouth closure. Low-profile electromagnetic field sensors were shown to provide a clinically relevant measure of jaw kinematics with sufficient accuracy to drive finite element models of occlusal loading during chewing and biting. The modelling framework presented provides a basis for calculation of physiological, dynamic occlusal loading across the dental arch. [ABSTRACT FROM AUTHOR]

Objectives: We evaluated the initial and follow-up treatment costs of different post-restorations in a practice-based German healthcare setting. Methods: A total of 139 incisors, canines, or premolars received post-restorations placed by eight general dental practitioners in Germany, and were followed over a mean ± SD 7.1 ± 4.5 years. Preformed metal (MP, n = 68), glass-fiber (GF, n = 28), or cast post-and-core buildups (MC, n = 23) had been used to retain crowns or bridge anchors. Preformed metal and glass-fiber had also been used to retain directly built up post-retained composite restorations (PC, n = 20). Material and treatment costs for the initial post-restorations as well as restorative, endodontic, or surgical re-treatments were estimated from a public-payer-perspective in Germany. Associations between total and annualized total costs and covariates were assessed using generalized linear modeling. The study was registered in the German Clinical Trials Register (DRKS-ID: DRKS00012938). Results: MC showed highest initial treatment costs (557.23 Euro), but the least re-treatments (6/23, 26%), while PC showed lowest initial costs (203.52 Euro) but the most re-treatments (11/20, 55%). Costs for MP/GF post-crowns were initially similarly costly (496.47/496.87 Euro), and both also showed similar re-treatments (35%/36%). The overall annual failure rate was 5.2% (MC: 3.5%, MP: 4.6%, GF: 5.3%, PC: 10.3%). Including costs for the resulting re-treatments, mean total costs were 591.66 Euro (MC), 548.31 Euro (MP), 526.37 Euro (GF), and 361.81 Euro (PC). Annualized total costs were 171.36 Euro (MC), 141.75 Euro (MP), 146.12 Euro (GF), and 135.65 Euro (PC). Total and annualized total costs were highest for MC, with PC being the significantly less costly option (p < 0.001). Conclusions: Within German healthcare, both initial and follow-up costs for post-restorations were considerable. Saving costs initially may, at least partially, be offset by more complications long-term. Clinical relevance: Dentists need to be aware that the placement of posts is not only initially costly but also comes with significant long-term costs for treating occurring complications. This should be communicated with patients and considered during treatment planning. [ABSTRACT FROM AUTHOR]

Background: The parenting style is shifting universally. Children lack the skills needed to deal with life stressful situations like those present in dental setting. Previous studies showed a correlation between parenting style and the child's dental behaviour. No studies have been performed in the Kingdom of Saudi Arabia (KSA) to relate parenting style to child's dental behaviour. The purpose of this study is to correlate parenting styles with the dental behaviour of their children, in Riyadh, KSA. Methodology: Two hundred and eighty-two healthy preschool children aged 3–6 years were recruited in their first dental visit, to a postgraduate Paediatric Dentistry Clinics of the Dental University Hospital at KSU, Riyadh, KSA. The Parenting Styles and Dimensions Questionnaire was completed by the primary caregiver/parents. The behaviour of the children was evaluated after dental prophylaxis and fluoride application in the dental chair using Frankl behavior rating scale. Family and child demographic data were evaluated through a questionnaire. Results: Two hundred and eighty-two healthy Saudi children participated in the study with their parents. Two parenting styles were identified among Saudi parents including authoritative (94%, n = 265) and permissive parenting styles (6%, n = 17). Most of the children behaved positively (n = 205, 72.7%). Significant correlations were detected between parenting style and parent's dental anxiety (P value 0.02) but not significantly correlated to a child's dental behaviuor. Conclusion: In the KSU sample studied, two parenting styles were identified among Saudi parents, authoritative and permissive parenting styles. Parenting style was correlated to parental dental anxiety and had an influence on a child's dental behaviour. Clinically, interesting correlations were identified regarding factors affecting child/s first dental visit behaviour. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to determine whether a handheld (HH) X-ray device (Nomad Pro 2) is capable of producing equivalent or even superior X-ray image quality in comparison to a wall-mounted (WM) dental X-ray unit (Heliodent Plus) on the basis of objectifiable image quality parameters. Methods: Anatomical, radiological and biological dental X-ray image quality parameters of a handheld dental X-ray device (Nomad Pro 2, Kavo Kerr, Biberach, Germany) were compared to a standard wall-mounted dental X-ray unit (Heliodent Plus, Sirona Dental Systems, Bensheim, Germany) using a maxillofacial phantom. In addition, the effect of different operators (dentists, dental students, dental assistants) on the dental X-ray image quality was measured. Results: HH and WM devices showed comparable image quality for anterior teeth, premolars, molars and bitewing images. During the two-month investigational period, the radiation exposure level for the operator of the Nomad Pro 2 was 0.1 mSv for 203 images. Dentists as the highest trained personnel enrolled in the study achieved better image quality with the Nomad Pro 2 as compared to dental students and dental assistants, especially in the molar region. Conclusions: A HH device delivers a comparable image quality to a WM device. In addition, there seem to be short learning curves with regard to image acquisition when using a handheld device, which is further minimised by the previous training of the operating personnel. HH dental X-ray devices, such as the Nomad Pro 2 are a promising adjunct for dental radiology in cases where WM units are of limited practicability. [ABSTRACT FROM AUTHOR]

Objectives: Selective serotonin reuptake inhibitors (SSRI) are a group of drugs that selectively and strongly block the serotonin transporter. Aim of this study was to evaluate the mandibular bone structure of patients who are using SSRIs with fractal analysis and panoramic morphometric indices [mandibular cortical width (MCW), panoramic mandibular index (PMI) and Klemetti index (KI)] and to compare with control group. Methods: Patients who declared using SSRIs for more than six months had been included in the study group. In total, 212 dental panoramic radiographs (DPR) were assessed. For fractal analysis; three regions of interest (ROIs) were determined: ROI1 and ROI2 were chosen within trabecular bone, ROI3 was selected from cortical bone. MCW, PMI, and KI were obtained from DPRs. The study group was categorized into five subgroups of various SSRIs. The fractal dimension (FD) values and panoramic morphometric indices of these subgroups were also compared. Results: There was no significant difference between the groups for age and gender (p = 0.57, p = 0.5). There were significant differences in the mean FD values between the study and control groups both for the ROI1 and ROI2 (p < 0.01, p < 0.01). There was no significant difference between the groups for the mean FD value of ROI3, MCW, PMI and KI (p = 0.93, p = 0.98, p = 0.74, p = 0.06). There were no significant differences for all the values between the SSRI subgroups (p = 0.52, p = 0.7, p = 0.76, p = 0.24, p = 0.31, p = 0.08) Conclusions: Trabecular rich sites of the mandible were found to be affected by SSRI usage. [ABSTRACT FROM AUTHOR]

Purpose: To compare direct clinical and indirect digital photographic assessment of resin composite restorations. Ninety-two posterior resin composite restorations were classified using World Dental Federation (FDI) criteria by two different clinical examiners (C1 and C2). In the same appointment of clinical assessment, intraoral high-quality digital photographs were taken and posteriorly two different digital examiners (D1 and D2) classified the images of each restoration. Restorations of each patient were assessed once by C1 and C2 independently. D1 and D2 assessed the digital images from different locations and in different time. Data were analyzed using the Cohen's kappa coefficient, Kruskal–Wallis non-parametric test and Dunn's multiple shared test, with 95% confidence. Agreement levels varied from very good (0.81–1.00) to fair (0.21–0.40). Statistically significant differences (p < 0.05) between assessments were found for surface lustre, staining, color match and translucency, esthetic anatomical form, fracture of material and retention and marginal adaptation. The classification of the resin composite restorations varied significantly according to clinical or high-quality digital photographic assessments. Overall, clinical assessment detected more demand for repair or replacement. [ABSTRACT FROM AUTHOR]

Only a limited number of techniques are available for assessing the effect of different coating materials on cell adherence to screws. In this study, we describe a simple and inexpensive method for evaluation of cell adhesion on irregular surfaces such as the surgical or implant screws. For this purpose, we prepared semi-submerged screws in the petri dishes using agar. Using BSA- or HA-coated screws, we tested whether BSA or HA could improve cell adherence when used as coating materials. Agar-coated screws were used as internal control. Then the "ratio of cell adherence" was calculated by subtracting the reference RCA value obtained from the agar coated screws (internal control). When compared to that of the non-coated screws both the HA- and BSA-coating improved cell adherence on the screws by 2.34 and 2.72 fold respectively. Similarly, MTT assay data revealed that the metabolic capacities of cells on HA- or BSA-coated screws were improved by 2.36 and 2.86 fold respectively. These findings suggest that this protocol can be used for comparing the ability of cells to attach on irregular surfaces such as dental or orthopedic screws and assessing their viability. [ABSTRACT FROM AUTHOR]

This review will summarize the research information regarding the regenerative potential of dental stem cells for the treatment of neurodegenerative disorders. As compared to existing treatment modalities, the stem cell therapy seems promising, and accumulating evidences about the differentiation of stem cells into various lineages are proving it. The incidence of neurodegenerative diseases such as Alzheimer's, Parkinson's, stroke, and peripheral neuropathy is increasing due to the rise in life expectancies of people which have put a huge burden on economies. Finding a promising treatment could benefit not only the patients but also the communities. Dental stem cells hold a great potential to differentiate into neuronal cells. Many studies have reported the differentiation potential of the dental stem cells with the presence of neuronal lineage markers. In this review, we conferred how the use of dental stem cells can benefit the above-mentioned bedridden diseases. [ABSTRACT FROM AUTHOR]

Objectives: To test the validity of a novel protocol for 3D sagittal jaw discrepancy assessment (skeletal class determination) through comparison with common 2D indexes by the use of reduced FOV (10 × 10) CBCT which shows at least from the Frankfurt plane to the B point vertically, and from the most anterior between A and B point to Po point horizontally. Methods: A sample of CBCT scans of 109 adult patients (46 females; 63 males; mean age 30 years ± 11.6) equally distributed between I, II and III class was selected. Skeletal class was evaluated with specific software using the distance of A and B point's projection (AF-BF) on FHp (Frankfurt horizontal plane) and compared to 2D common indexes (ANB and Witts appraisal). The validity and reliability of the aforementioned analyses were determined using intra-class correlation coefficients, quadratic weighted Cohen's K and sensitivity. Result: A selected range of values of 2.5 ± 2.5 AF-BF showed a solid correlation with the ANB angle (r = 0.846, K = 0.838, p < 0.001) and moderate with Wits appraisal (r = 0.723, K = 0.720, p < 0.001). Conclusions: AF-BF showed high reliability in skeletal class determination on reduced FOV CBCT without the use of S and N cephalometric landmarks. Key Points: • Reduced FOV CT allows skeletal class determination for orthodontic purposes. • A new 3D-reduced FOV cephalometry is proposed. • AF-BF is a reliable alternative to ANB. [ABSTRACT FROM AUTHOR]

Digital radiography is gaining popularity among general dental practitioners. It includes digital intraoral radiography, digital panoramic radiography, digital cephalography, and cone-beam computed tomography. In this study, we focused on the methods to assess image quality of these techniques, except for digital cephalography, in the light of historical issues. We stressed on the importance of the development of a standardized phantom and quantitative analysis of diagnostic image quality using it, especially in the aspect of psychophysical properties of these digital systems. There is no missing link in the image quality assessment in digital intraoral radiography and cone-beam computed tomography in dental use. However, there are missing links between physical and diagnostic image qualities in panoramic radiography. The development of a semi-standardized phantom and the corresponding quantitative analysis method for image quality may be required in digital panoramic radiography. Quantitative image quality assessment using a standardized phantom will also be promising in the future artificial intelligence era. [ABSTRACT FROM AUTHOR]

Introduction: Medical devices such as hip, knee, breast, vascular prostheses, among others, are very useful in different pathologies. We cannot doubt that their use is a great tool, besides being an advance in medicine; they provide a change in the quality of life of many patients; however, they are not exempt from adverse reactions and events. Methods: We conduct a systematic review about lymphoma in the presences of prostheses other than breast implants. Results: We selected 21 publications with a total of 24 patients. The largest number of prostheses was related to long bones in a total of 13 prostheses. The most frequent symptoms were: pain (52%), inflammation (24%), visible or palpable mass 20%. The most frequent type of lymphoma was non-Hodgkin B cell lymphoma in 14 cases. Discussion: The presence of microparticles make biological degradation and wear of the implants, with macrophage and lymphocyte activation and the consequent production of proinflammatory cytokines such as tumor necrosis factor α, interleukin-1β, interleukin-6, and prostaglandin 2 (PGE2). Conclusion: Lymphoma is not a common disease in patients with prostheses, and more data are needed to identify risk factors and make proper diagnoses. Level of Evidence III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Purpose: Although dental caries can be identified on CT and may be treatable, the literature provides little, if any, guidance on the responsibility of a neuroradiologist in reporting them. Untreated dental caries can impact diet and nutrition and can result in a variety of complications such as an odontogenic abscess, tooth loss, sinusitis, and dental pain, which can impact quality of life. The estimated prevalence of untreated dental caries in adults is 27%. In our experience, the prevalence of untreated dental caries in patients presenting to the Emergency Department (ED) is higher but dental caries are often unmentioned or unrecognized. We aim to determine the frequency of unreported dental caries and propose a paradigm for reporting and management.Methods: Our research was IRB-approved and HIPPA compliant. We searched the radiology database for adult patients who underwent a CT of the facial bones while in the Emergency Department between January 1, 2015 and June 30, 2015. The examinations were reviewed by a faculty neuroradiologist for the presence of untreated dental caries. Untreated dental caries were documented and characterized by depth. Caries that were partially or completely obscured by dental amalgam artifact were excluded. The radiology reports were reviewed to evaluate reporting frequency. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) software.Results: A total of 200 patients (113 male, 87 female; age 18-98 years) underwent 200 CT examinations of the facial bones. One hundred fourteen (57%) patients had at least one dental caries. When caries were present, 14.9% of radiology reports included caries in the findings section and 9.6% of the reports mentioned caries in the impression.Conclusions: The presence of dental caries should be mentioned in the radiology report. The prevalence of untreated dental caries is higher in our cohort than reported in the general population, and dental caries are underreported by neuroradiologists at our institution. A paradigm for reporting and management was created upon collaboration with faculty from the University of Vermont Dental and Oral Health practice. A visit with a dentist should be recommended within 6 months if caries are limited to the enamel, within 3 months if caries involve the dentin, and within 2 weeks if caries extend in to the pulp. Further research is necessary to determine the clinical impact of improved reporting. [ABSTRACT FROM AUTHOR]

Management of patients undergoing treatment for cancer requires a multidisciplinary team including general dentistry providers; however, the relative knowledge and training of general dentists in the management of this patient population are relatively unknown. The purpose of this study was to assess the oncology curricula of postgraduate general dentistry training programs, from the perspective of the program directors, to better understand the opportunities for and/or barriers to dental care for cancer patients. A cross-sectional survey was sent to the 275 Commission on Dental Accreditation–accredited programs; 82 program directors responded (response rate, 30%). More than 50% of respondents indicated "none" or "little" curricular emphasis on cancer biology, bone marrow transplantation, immunotherapy, or prosthetics for use during head and/or neck surgery. Conversely, more than 50% of respondents indicated "moderate" or "substantial" emphasis on acute oral effects of cancer-related therapy, long-term oral effects of cancer-related therapy, antiresorptive medication pharmacology, radiotherapy techniques and biological effects, and osteonecrosis of the jaw. Residents had the most experience with radiotherapy patients and the least with bone marrow or transplantation patients. Overall, general dentistry program directors were enthusiastic to participate in the multidisciplinary team but reported challenges to including oncology curricula in residency training programs. Training for general dentistry providers in formalized postgraduate residency programs may be variable or limited—as a result, communication regarding patient management is critical. Opportunities exist to enhance the general dentistry curricula and, thereby, improve access to dental care for patients receiving treatment for cancer. [ABSTRACT FROM AUTHOR]

Purpose: To assess different types of dental injuries associated with facial bone fractures.Method: One hundred dentate patients were selected randomly of all age and gender who had maxillofacial trauma only and having dental injury in association with facial bones fractures were included. They were thoroughly examined for injury/fracture to facial region as well as for dental injuries (teeth). Tooth injuries were noted according to Ellis classification. The data was collected, compiled, and put to statistical analysis.Results: Dental injuries were more in females than males found to be statistically significant with (p < 0.05).Crown fracture of maxillary teeth was more as compared to mandibular except molars found to be statistically significant (p < 0.05). Root fracture was more in maxillary incisors followed by canine as compared to mandibular incisors and canines found to be insignificant. Avulsion, extrusion and luxation were more in maxilla as compared to mandible found to be significant.Conclusion: Different types of tooth injuries associated with facial bone fracture found more in females and maxillary teeth. [ABSTRACT FROM AUTHOR]

Purpose: To compare the surface of computer-aided design (CAD) models of the maxilla produced using ultra-low MDCT doses combined with filtered backprojection (FBP), adaptive statistical iterative reconstruction (ASIR) and model-based iterative reconstruction (MBIR) reconstruction techniques with that produced from a standard dose/FBP protocol.Methods: A cadaveric completely edentulous maxilla was imaged using a standard dose protocol (CTDIvol: 29.4 mGy) and FBP, in addition to 5 low dose test protocols (LD1-5) (CTDIvol: 4.19, 2.64, 0.99, 0.53, and 0.29 mGy) reconstructed with FBP, ASIR 50, ASIR 100, and MBIR. A CAD model from each test protocol was superimposed onto the reference model using the ‘Best Fit Alignment’ function. Differences between the test and reference models were analyzed as maximum and mean deviations, and root-mean-square of the deviations, and color-coded models were obtained which demonstrated the location, magnitude and direction of the deviations.Results: Based upon the magnitude, size, and distribution of areas of deviations, CAD models from the following protocols were comparable to the reference model: FBP/LD1; ASIR 50/LD1 and LD2; ASIR 100/LD1, LD2, and LD3; MBIR/LD1. The following protocols demonstrated deviations mostly between 1-2 mm or under 1 mm but over large areas, and so their effect on surgical guide accuracy is questionable: FBP/LD2; MBIR/LD2, LD3, LD4, and LD5. The following protocols demonstrated large deviations over large areas and therefore were not comparable to the reference model: FBP/LD3, LD4, and LD5; ASIR 50/LD3, LD4, and LD5; ASIR 100/LD4, and LD5.Conclusions: When MDCT is used for CAD models of the jaws, dose reductions of 86% may be possible with FBP, 91% with ASIR 50, and 97% with ASIR 100. Analysis of the stability and accuracy of CAD/CAM surgical guides as directly related to the jaws is needed to confirm the results. [ABSTRACT FROM AUTHOR]

Aim: To investigate the frequency and reported intensity levels of dental treatment pain and discomfort in children, in conjunction with regular dental visits.Methods: The study included 2363 children in four different age cohorts. Data was collected from structured interviews by dental personnel regarding pain experiences or discomfort after treatments, including analgesia, extractions, operative treatments and radiographic examinations.Results: One-third of all treatment occasions were experienced as painful and/or causing discomfort. Treatment sessions including analgesia were assessed as painful in 49.7% of occasions, with injection being the most common given reason for pain. Extraction was painful in 62.4% of occasions, with injection as the main reason for pain. Operative treatments were assessed as painful in 38.8% of occasions, with drilling as the most common reason for pain and discomfort. Pain was reported in approximately 19% of all radiographic examinations.Conclusions: Injection was the major reason for pain during treatment, including injection and extraction, while drilling was the most common cause of pain during restorative treatment. Dentists should try to minimise the experience of pain and discomfort by using all available measures to perform pain-free and effective dental injections. [ABSTRACT FROM AUTHOR]

Between 1943 and 1945, the Kooskia Internment Camp (KIC) in north central Idaho was home to 265 Japanese American men. As detainees of the U.S. Department of Justice, these individuals were treated as foreign prisoners of war and were therefore subject to the conditions of the 1929 Geneva Convention, which guaranteed the right to adequate health care. In 1943, the internees created a petition demanding improved health care and recreational opportunities. The remains of oral-hygiene products recovered archaeologically at Kooskia, such as toothpaste tubes, dentures, and mouthwash, and a review of wartime advertisements for these products suggests that dental health was a means of both assimilation into mainstream American culture and maintenance of Japanese ethnic character. This article examines the petition and dental artifacts as acts of “survivance” and “residence” by the Japanese American internees at Kooskia. [ABSTRACT FROM AUTHOR]

This was the first study to develop and pilot test an assessment tool for the examination of human papillomavirus (HPV)-related oropharyngeal cancer (OPC) knowledge, perceptions, and clinical practices of oral health students. An interdisciplinary team developed the tool using surveys that examined this topic in other populations. The tool was then pilot tested at two different dental programs. Results from the pilot informed revisions to the final version of the tool. Of the 46 student participants, 18 were first-year dental hygiene and 28 were first-year dental students. The majority of participants were female (N = 29, 63%) and ages 18 to 29 years old (N = 41, 89%). Four scales used in the questionnaire were analyzed for reliability. Of these, the HPV and HPV-OPC knowledge and the HPV vaccination knowledge scales had Cronbach alphas of 0.71 and 0.79, respectively. Questions assessing HPV and the role of dental professionals had a correlation coefficient of 0.71. Questions assessing willingness to administer vaccines in the dental office had a correlation coefficient of 0.85. Assessing oral health students' HPV-OPC knowledge, perceptions, and clinical practices are important for future assessment of possible HPV-OPC cases. Dental professionals may be optimally positioned to provide HPV patient education. The tool developed and pilot tested in this study can help schools assess their students' knowledge and guide their dental curriculum to address deficiencies. Since this topic has not been effectively examined with dental health students, the results could help improve dental education and dental care. [ABSTRACT FROM AUTHOR]