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ABSTRACT Background Methods Results Conclusion Antimicrobial resistance is a significant threat to global health. Antimicrobial stewardship is reducing inappropriate antimicrobial prescribing to counter it. Dentists prescribe ~10% of all antibiotics worldwide, yet up to 90% of antibiotic prescriptions by dentists are inappropriate. The aim of this systematic review was to update a 2017 review evaluating the effects of antibiotic stewardship interventions in dental settings, using the international consensus on core outcomes for dental antibiotic stewardship.Systematic database searches were undertaken in April 2023, of the: Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials, MEDLINE via OVID, EMBASE via OVID, Dentistry and Oral Sciences Source, the US National Institutes of Health Trials Register, the World Health Organisation International Clinical Trials Registry Platform and the ISRCTN registry databases. Randomised controlled trials (or non‐randomised studies with clearly reported mechanism of group formation and inclusion criteria) of interventions to optimise and/or reduce dental antibiotic prescribing were eligible for inclusion. Two authors independently screened for eligible studies. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool, certainty of evidence assessed using GRADE. Meta‐analysis was planned whether the results of studies reported similar outcomes, otherwise narrative synthesis was undertaken.Three eligible studies randomising 2148 participants were included. The interventions were combinations of education, audit and feedback and written behaviour change messages, guideline summary, practice visits and patient leaflets. None of the control groups received an intervention. All three included studies measured the quantity of antibiotics prescribed and two measured the appropriateness of prescribing. None measured patient‐reported or adverse outcomes. Two included studies were assessed as ‘high risk’ and one with ‘low risk’ of bias. There was high‐certainty evidence that audit and personalised feedback with individualised behaviour change messages can be effective. Evidence for in‐person education was low‐certainty. Guideline dissemination alone was ineffective at improving antibiotic prescribing. Due to different outcomes reported, meta‐analysis was inappropriate.Although various dental antibiotic stewardship interventions have been reported in the literature, none provided high‐certainty evidence of effectiveness and only three have been evaluated using a randomised design. To strengthen the body of evidence, well‐powered, robust, randomised controlled trials are required, with adequate follow‐up, reporting the internationally‐agreed core outcomes and including a parallel process evaluation is recommended.Trial Registration: PROSPERO (CRD42023411476) [ABSTRACT FROM AUTHOR]

Nanodiamonds (NDs) are utilized for various purposes in dentistry, such as tissue regeneration, gene therapy, and medication delivery. Despite the examination of their potential for dental uses, there is currently no published review summarizing the conducted investigations. Additional investigations are required to comprehend the biological compatibility of NDs in dentistry. NDs have been proven effective for a variety of applications in dentistry because of unique qualities such as target cell selectivity, nanometer size, and fluorescence. Nanodiamonds find various applications in dentistry, encompassing roles in directed tissue regeneration, reinforcing polymers, and administering medications for treating infections and cancer. Researchers have also suggested the potential use of nanodiamonds as coatings for antibacterial or bioactive dental implants. Nevertheless, investigations on their biological compatibility have been scarce and insufficient so far, necessitating significantly further studies to envision the potential use of NDs in dentistry. It is believed that within the ten years to come, these emerging substances will discover several kinds of daily usage in dental practice. [ABSTRACT FROM AUTHOR]

New self‐healing resin composites with tertiary amine microcapsules enhance the mechanical performance of dental restorations. However, a higher concentration of dibenzoyl peroxide (BPO) must be added to the composite to react with the core material when the microcapsules rupture, reducing the shelf life of dental materials due to their reactivity. As a result, one approach to reducing the amount of BPO dissolved in dental resin is to microencapsulate it. Thus, this manuscript described the encapsulation of BPO in poly(urea‐formaldehyde) (PUF) microcapsules (MC) and investigated its effect on the flexural strength of BisGMA/TEGDMA composites. To synthesize hollow MC, poly(acrylic acid) (PAA) was tested as a continuous phase viscosity modifier. The MC were then infiltrated with BPO dissolved in linseed oil as core materials. PAA in continuous phase increased MC diameter due to improved air bubble stability. BPO dissolved in linseed oil was successfully infiltrated into empty PUF MC, causing the MC shell wall to expand. The dental resin had adequate adhesion to the PUF shell, which ruptured under induced stress. Thus, the MC filled with BPO as a healing agent has the potential to reduce the amount of BPO that is typically dissolved in the monomeric phase of dental materials, which can increase the shelf life of self‐healing dental materials. Highlights: The reactivity of dibenzoyl peroxide (BPO) affects resin stability in dental materials.When combined with tertiary amines, BPO acts as a healing agent in self‐healing composite materials.BPO dissolved in linseed oil can be infiltrated in PUF microcapsules and increase its size.Hollow microcapsules synthesized in a more viscous continuous phase have a larger diameter.Microencapsulated BPO is released during stress stimuli in dental resin. [ABSTRACT FROM AUTHOR]

Skull anatomy is a difficult region for anatomy students to learn and understand but is necessary for a variety of health professional students. To improve learning, a 3D‐printed human skull was developed, produced, and distributed to a course of 83 dental students for use as a take‐home study tool over the 10‐week anatomy course. The 70% scale human skull derived from CT data had a fully articulating mandible, simulated temporomandibular joint, and accurate cranial structures. At the course end, students completed a perception survey and responses were compared with those who made a grade of A, B, or C in the course. Students overall reported using the model less than 3 h per week, but those who scored an A in the course reported using the model more frequently than those who scored a B or C. Free responses revealed that students used the model in a variety of ways, but found that the model was quick and easily accessible to check understanding while studying at home in the absence of direct observation by faculty. Overall, this study provides evidence on the feasibility of large‐scale 3D printing and the benefits of the use of a 3D‐printed model as a take‐home study aid. [ABSTRACT FROM AUTHOR]

Introduction: Oral Health Therapists (OHTs) are a growing workforce globally, with skills in oral health prevention, treatment planning and management of disease. These professionals receive their training through a three‐year undergraduate program which leads to the Bachelor of Oral Health degree in Australia and New Zealand. The aim of this study was to describe the learning environment for OHT students in Australia and New Zealand. OHT students were requested to complete the Dundee Ready Education Environment Measure (DREEM) to indicate their perceptions of the environment of their educational program. Materials and Methods: Bachelor of Oral Health students from 10 universities in Australia and New Zealand were invited to participate in the survey. The analysis of the students' experiences focused on five domains of educational environment: learning, teaching, academic self‐perception, atmosphere and social self‐perception. Total DREEM scores were compared to previously published literature for other health professions students. Results: A total of 336 OHT students completed the study, which represented 30% of all OHT students enrolled in the 10 participating universities. Using the DREEM, participants perception of the environment was more positive than negative with an average DREEM total score of 141 (70.5%) out of a maximum score of 200. The model demonstrates university region to be a major predictor in the overall DREEM score, with regional universities scoring higher than urban universities (p =.012). Conclusions: The DREEM was used to describe OHT students perceptions of the learning environment in Australia and New Zealand. This study found that the university region is a significant predictor of positive experiences for OHT students. By identifying the strengths and weaknesses of contemporary Oral Health programs, this study offers insights into future improvements. [ABSTRACT FROM AUTHOR]

Age estimation methods through developmental atlases are simplified by image comparison using radiographs. Atlas‐based methods have been utilized to create population‐specific charts addressing population diversity. To tackle the absence of a dedicated atlas for the Brazilian population, the objective of the present study was to create a new atlas for dental development in Brazil based on the London Atlas chart. The new atlas (RP Atlas) is based on the median of tooth development, eruption, and resorption in individuals aged 5 to 23. The sample (567 individuals) was divided between females (n = 290) and males (n = 277). The RP Atlas was handcrafted, scanned, colored, and clustered in two atlases divided by sex. The development of a specific atlas for the Brazilian population has the potential to enhance the accuracy of age estimation in forensic scenarios, notably in a mixed country like Brazil. Further research is needed to assess the suitability of the newly developed atlas for the Brazilian population. Research Highlights: Atlas development methods provide a more straightforward image comparison using OPGs.Methods for age estimation need to be adaptable to a population‐specific approach.RP Atlas is Brazil's first specific atlas of tooth eruption and development.From 18 years old onwards, dental development has unstable patterns. [ABSTRACT FROM AUTHOR]

There is an ever‐increasing chance that dentists are likely to experience patients who need additional management for psychiatric disorders. Dissociative identity disorder (DID) is characterised by the presence of two or more distinct personality states or identity fragments that control an individual's behaviour, thoughts and emotions. The aim is to offer additional insights into patients with DID and their management within a dental care setting. This will be demonstrated through the use of a case report as a practical illustration. In order to gain insight into the effects of DID on healthcare, particularly within a dental care environment, a comprehensive review of relevant literature has been conducted by searching, evaluating and synthesising existing academic and scholarly literature on DID. Additionally, the case reported is an example of how a 27‐year‐old patient with DID has been managed in an Intermediate Minor Oral Surgery setting. Patients often have their DID prompted by stress, as was the case with this patient. There are steps which can be taken in the dental setting to help reduce the patient's anxiety, understand their personalities and foresee any possible issues that could arise. In this case, intravenous sedation was used to extract the patient's wisdom teeth, and no other personalities presented during the procedure. The examination of existing literature along with a case report highlights the feasibility of effectively treating individuals with DID. This can be achieved through the careful recognition and handling of different personalities, triggers and potential challenges, all of which should be integrated into the treatment strategy. [ABSTRACT FROM AUTHOR]

Objectives: Oronasal fistulas are common sequelae following cleft lip and palate surgery and can significantly impact a patient's quality of life. They result from various factors, including surgical techniques, tissue management, and patient‐specific factors. This case report explores the modern approach to oronasal fistula closure using periodontal plastic surgery principles. Materials and Methods: The report presents two cases of patients with oronasal fistulas due to previous maxillofacial surgical intervention. These patients underwent microsurgical procedures that involved partial flap thickness preparation of the fistula areas, the use of connective tissue grafts from the palate, and meticulous suturing techniques to ensure graft integrity. The procedures were performed in stages, and postoperative care was provided. Results: Both cases demonstrated successful fistula closure and graft survival. The patients reported improvements in breathing, speech, aesthetics, and quality of life. The second case also included guided bone regeneration and implant placement. Conclusions: Oronasal fistulas resulting from maxillofacial surgery can be effectively treated using periodontal plastic surgery techniques, significantly improving patients' quality of life and aesthetic outcomes. This approach represents a valuable addition to the existing repertoire of oronasal fistula closure methods. Summary: In this case report, we present two adult patients who underwent oronasal fistula closure procedures applying principles of periodontal plastic surgery, highlighting successful outcomes and the potential application of these techniques in similar cases. [ABSTRACT FROM AUTHOR]

Introduction: Resilience is defined as an individual's capacity to effectively adapt in the face of challenges without detrimental effects on their health and well‐being. This scoping review identifies and rationalises the published concepts that underpin resilience in oral health professional (OHP) education. It provides recommendations for the development of evidence‐based strategies for promoting resilience in OHP education. Methods: The PRISMA and Arksey and O'Malley methodological frameworks for scoping reviews were used to determine the methodology and answer the question 'What concepts contribute to resilience in OHP Education?'. The search strategy included published literature searches and internet searches. Results: In total, 744 articles on resilience and coping were identified, and 59 were included after excluding irrelevant records. Most studies used surveys as their study design and focused on undergraduate dental students in North America and Asia. Three main themes were identified: factors that contribute to resilience, measurement tools and scales and enhancing resilience. This review highlights a positive correlation between increased resilience and improved outcomes for dental students. Conclusion: Resilience and its related factors are not well understood. There is insufficient evidence to support interventions for building resilience due to inconsistent measuring methods and limited research validating resilience scales in OHP education. Investigators should accurately understand the terminology for clarity and consistency. Validated outcome measures and student feedback should be used to determine the effectiveness of interventions. It is important to teach students coping strategies to manage stressors, and digital applications for building resilience should be developed and tested in OHP student populations. [ABSTRACT FROM AUTHOR]

Objective: To determine whether blended learning results in better educational outcomes compared to traditional learning in the acquisition of oral surgery technical skills for 4th‐year undergraduate dental students. Materials and Methods: Seventy‐three students participated in this two‐arm parallel randomized controlled trial. Only students in the blended learning group had access to the online preparation platform for oral surgery practical work (PW) on a pig's jaw and to the debriefing. Kirkpatrick's four‐level model was used to assess the educational outcomes directly after (levels 1 and 2) and 6 months later, after the start of the students' clinical activity (levels 3 and 4). Results: For level 1, higher global satisfaction scores were found for students in the blended learning compared to the traditional learning group (p =.002). For level 2, blended learning resulted in an increase in knowledge score (p <.01), comparable to that observed in the traditional learning group. For level 3, students in the blended group made more progress in 6 months than those in the traditional group in terms of feeling able to assess and perform anaesthesia (p =.040) and surgical tooth extraction (p =.043). No difference in level 4 was found for the 6‐month clinical surgical activity between groups, but students in the blended group felt more able to assess and perform the surgical management of a failed extraction requiring bone removal (p =.044). Conclusion: Blended learning for oral surgery PW had a positive impact on three of the four Kirkpatrick levels (level 1, 3 and 4). Efforts should focus on the procedures that are perceived as the most difficult. [ABSTRACT FROM AUTHOR]

Brugada syndrome is an inherited cardiovascular disorder, which can affect the rhythm of the heart. Dental treatment can often present as an obstacle for patients with Brugada syndrome as the use of local anaesthetic can have adverse effects on the electrical conduction system of the heart. Aim: The aim of this series is to discuss the aetiopathogenesis, presentation and management of Brugada syndrome and its relevance to dentistry and the dental team. Methods: The authors present a series of three Brugada syndrome patients who underwent dental intervention in a hospital setting. Results and Conclusion: The series highlighted the importance of multidisciplinary care for patients with Brugada syndrome. Liaising with other teams, such as cariologists and GMPs, allows a patient centred approach and better understanding of patient management. [ABSTRACT FROM AUTHOR]

Objectives: Antimicrobial resistance is an alarming global public health concern, threatening the effective treatment of common infections. This phenomenon is driven by the improper prescription of antibiotics. This study aimed to elucidate the patterns of antibiotic prescription in implant dentistry among European dentists and their awareness of antibiotic resistance. Materials and Methods: An anonymous online validated questionnaire was distributed via e‐mail to 6431 recipients through the European Association for Osseointegration. It comprised of 17 structured questions investigating demographic variables, working environment, clinical experience, attitude towards antibiotic prescription in particular in relation to implant dentistry and COVID‐19 pandemic, and awareness of antibiotic resistance. Data were collected from April to May 2023. Results: 281 dentists from 33 European countries completed the survey. Almost 80% affirmed to routinely prescribe antibiotics as prophylaxis as well as after dental implant placement, especially in medically compromised patients or in cases of bone grafting. Amoxicillin, alone (61%) or in combination with clavulanic acid (56%), was the most common antibiotic of choice. Awareness of penicillin resistance among respondents was high. For peri‐implantitis treatment, more than half reported the use of systemic antibiotics. The large majority (95%) did not prescribe more antibiotics since the beginning of COVID‐19 pandemic. Less than 40% declared to follow national guidelines for antibiotic prescription. Conclusion: This survey revealed a high prescription rate of antibiotics in implant dentistry, despite the awareness about antibiotic resistance among the respondents. The development and adherence to European guidelines has been identified as a potential strategy for improving antimicrobial stewardship. [ABSTRACT FROM AUTHOR]

The dilemma surrounding faculty shortages within dental education continues to present significant challenges for the dental profession. There remains a tremendous need to create an effective and sustainable pathway for the recruitment of faculty into dental academia, with an emphasis on the establishment of a more diverse and representative faculty composition. This perspective paper proposes a blueprint to nurture and inspire dental students into academia. [ABSTRACT FROM AUTHOR]

Objective Subject and Methods Results Conclusions To analyze trends of antibiotic consumption and expenditure in Chinese stomatology hospitals between 2014 and 2018 with a longitudinal study design, and show the impacts of the comprehensive policy on dental antibiotic use in China.Consumption was quantified as the number of daily defined doses (DDDs) and expenditure as the procurement costs, using medical institutions' drug procurement data from the Chinese Monitoring Network for Rational Use of Drugs. Descriptive statistics was employed and the compound annual growth rate (CAGR) was calculated to show the average annual growth rate.Between 2014 and 2018, overall antibiotic consumption increased from 842.6 thousand DDDs to 1376.7 thousand DDDs (p < 0.001) and expenditure increased from 11.6 million RMB to 20.9 million RMB (p < 0.001), where other β‐lactam antibacterials accounted for the largest proportion of total consumption (37.1%–50.1%) and expenditure (52.9%–66.6%), and also increase the largest (CAGR = 18.4%, p < 0.001). The proportion of oral antibiotics was nearly 9 times of parenteral antibiotics in consumption (CAGR = 0.3%, p = 0.023) and only 2 times in expenditure (CAGR = −1.7%, p = 0.112). The non‐restricted group accounted for more than 90% of consumption (CAGR = 0.6%, p < 0.001). In 2018, oral first‐generation cephalosporins (22.8%), oral imidazole derivatives (22.3%), and oral second‐generation cephalosporins (19.2%) were the most frequently used antibiotic classification, while parenteral second‐generation cephalosporins were top one (19.8%) for expenditure. At chemical substance levels, the consumption of oral cefradine ranked top one (21.4%) and parenteral cefuroxime accounted for the largest proportion of expenditure (14.5%) in 2018. Oral cefradine, oral metronidazole, and oral cefaclor were the top three frequently consumed antibiotics throughout the five years.Despite the potential antibiotic overuse, the comprehensive antibiotic stewardship regulations of China got a satisfactory and better performance in dental practices. More effort is needed to establish more explicit guidelines to improve antibiotic stewardship, such as priority recommending amoxicillin and its derivatives for endodontic infections. [ABSTRACT FROM AUTHOR]

Summary: Collaborative approaches across healthcare to address obesity are needed but intervention in dental settings is not widely implemented. Here we systematically synthesized the views of both the public and dental teams about delivering weight management interventions in dental settings and identified potential barriers to implementation. A systematic review of five databases from inception to April 3, 2023 was completed. Proportional meta‐analyses were performed with quantitative data and thematic analysis of qualitative data. A total of 7851 studies were screened and 33 included in the review. The prevalence of height and weight screening in dental settings varied (4%–87%) with an average of 29% undertaking screening (p = <0.01; 95% CI: 14%–46%). A significant proportion of the public were supportive of weight screening in dental settings (83%; p = <0.01; 95% CI:76%–88%). Significant barriers to providing weight screening and/or intervention included fear of offending patients (57%; 95% CI: 45%–68%) and a lack of time (48%; 95% CI: 30%–66%). Qualitative data revealed further barriers including stigmatizing views of dental teams toward people living with overweight/obesity. Enablers of weight discussion included associating weight with oral health. Overall, whilst some barriers were identified, there is potential for weight management interventions to be used more routinely in dental settings. [ABSTRACT FROM AUTHOR]

Background: Limited evidence exists on the outcome of the modified coronally advanced tunnel (MCAT) with acellular dermal matrix (ADM) for the treatment of gingival recession defects (GRD) especially when complicated by restored cervical lesions. Therefore, the aim of this case report was to assess the short‐ and long‐term clinical outcomes of maxillary Type 1 recession defects (RT1) associated with restored cervical lesions treated with MCAT with ADM. Methods and Results: A 43‐year‐old female patient, presented with multiple adjacent RT1 recessions in the left maxilla, previously treated with overhanging cervical resin restorations. The case was approached with a careful evaluation of the diagnostic determinants of root coverage, removal of the aberrant resin restorations, treatment with MCAT with ADM, and periodical evaluation over a follow‐up of 10 years. The treatment was followed by complete root coverage, improvement of gingival phenotype, and perfect root coverage esthetic score. Outcomes were periodically assessed and were maintained over 10 years of follow‐up. Conclusion: MCAT with ADM is an effective technique for the treatment of multiple GRD complicated by cervical restorations. Complete root coverage and excellent esthetic outcomes were obtained and maintained in the long term. [ABSTRACT FROM AUTHOR]

Titanium (Ti) dental scaffolds are widely used in dental prosthetics due to their excellent mechanical properties and biocompatibility. However, conventional Ti scaffolds manufactured through machining often do not fit perfectly with the bone defect site. Laser powder bed fusion (LPBF) technology enables the personalised manufacturing of custom‐made Ti scaffolds. A custom‐made Ti scaffold was prepared using LPBF and its surface roughness was improved through chemical polishing. To enhance the surface roughness, a nitric acid mixed solution with a specific composition of HF: HNO3:C3H6O3 = 2:2:3 was used. The polishing mechanism was investigated by adjusting the F/Ti ratio to control the formation and dissolution of the oxide film. As a result, the surface of the Ti scaffold after polishing exhibited a smooth and flat appearance compared to the LPBF part, with a reduced surface roughness (Ra) of 1.23 ± 0.19 μm. The custom‐made Ti scaffold also demonstrated favourable mechanical properties, with a bending strength of 335.18 ± 33.62 MPa and stiffness of 2.13 ± 0.21 GPa. Furthermore, in vitro cell tests confirmed the excellent biocompatibility of the custom‐made Ti scaffold. The authors present a feasible strategy for the further clinical application of custom‐made Ti scaffolds, offering enhanced surface properties and addressing the limitations of conventional machining methods. [ABSTRACT FROM AUTHOR]

Objective: This study investigated whether insurance status and/or developmental disability moderated the association between adverse childhood experiences (ACE) and unmet dental needs among children aged 0 to 17 in Ohio. Methods: We utilized cross‐sectional data from the 2021 Ohio Medicaid Assessment Survey to assess the dental needs of children. ACE scores, dental insurance status, and developmental disability status were analyzed using multivariable logistic regression to identify their potential association with parental‐reported unmet dental needs. Results: The weighted sample represented 2,752,222 children in Ohio. Over half reported zero ACEs (55.8%) and no dental needs (56.1%). Approximately 1 in 9 lacked dental insurance (11.1%), and 1 in 10 had a developmental disability (9.9%). Children with one to three ACEs had three times the odds of unmet dental needs compared to children with zero ACEs (OR = 3.20; 95%CI [2.10, 4.89]), and children with four or more ACEs had eight times the odds of unmet dental needs (OR = 8.78; 95%CI [5.26, 14.67]). Children lacking dental insurance had over six times higher odds of unmet dental needs compared to children with dental insurance (OR = 6.10; 95%CI [3.92, 9.49]). The presence of developmental disability status did not moderate the presence of unmet dental needs; however, the lack of dental insurance status significantly moderated the association between ACEs and unmet dental needs. Conclusion: Insurance status, not developmental disability, moderated the association between ACEs and unmet dental needs among children in Ohio. Efforts to ensure continuous access to dental insurance are warranted. [ABSTRACT FROM AUTHOR]

Background Methods and Results Conclusion Key points While the nasal fossa and nasopalatine canal are recognized limitations for immediate implants in esthetic areas, the canalis sinuosus (CS) and its branches have been largely overlooked. Neglecting this anatomy can lead to sensory issues, pain, and implant failure underscores the necessity of meticulous pre‐surgical assessment and planning to mitigate risks and ensure implant success. This case highlights the need for comprehensive pre‐surgical evaluation and precise planning to minimize these complications and ensure successful implant outcomes in this scenario.A 41‐year‐old woman with a history of root perforation and external root resorption was referred for dental implant placement. Following clinical evaluation and computed tomography, the presence of an accessory canal of the CS was identified. After meticulous planning to avoid implant contact with this structure, ridge preservation was performed. After 6 months, the implant was successfully placed following guided osteotomy. The case demonstrates clinical and radiographic stability after 36 months of follow‐up.The correct diagnosis and planning, within a multidisciplinary team, can lead to successful implant placement in a challenging site with an anatomical variation. This study, to our knowledge, represents the first to propose an alternative treatment approach in the presence of CS in an esthetic region.Why is this case new information? This case emphasizes the importance of thorough pre‐surgical evaluation to mitigate potential complications related to the CS. It is the first, to our knowledge, to propose an alternative treatment approach in the presence of this anatomical variation in an esthetic region. What are the keys to successful management in this case? Comprehensive pre‐surgical evaluation, precise planning with detailed CBCT assessment to identify the CS, careful consideration of its anatomy during surgical intervention, knowledge of the limitations of tissue reconstructions, and precise clinical strategies to minimize associated complications. What are the primary limitations to success in this case? The need to position the implant with a safety margin from the CS led to implant positioning resulting in fenestration of the buccal bone plate, preventing its reconstruction due to the bone envelope's design, resulting in a discrepant gingival margin compared to the contralateral tooth, which did not allow for further crown lengthening due to a rather short root. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Key points Encountering a retained root tip post‐extraction and prior to implant placement is a possible clinical complication. There are numerous approaches for removing retained roots that may be traumatic or atraumatic. Regardless of the approach, careful treatment planning is important to minimize complications, reduce morbidity, and preserve bony structures. The aim of the current case study is to introduce a technique and digitally generated device used for identifying and atraumatically removing a retained root tip and simultaneously placing a stable dental implant.A 63‐year‐old female with a history of myocardial infarction, hypertension, and acute pancreatitis presented for implant placement at site #5. Clinical examination revealed adequate interocclusal, mesiodistal, and buccolingual dimensions for implant placement. Radiographic examination using cone beam computed tomography revealed that retained root #5 interfered with implant placement. Digital planning was used to extract the root tip with minimal trauma to maintain adequate bone for simultaneous implant placement with good primary stability.The follow‐ups at 1, 3, and 6 weeks and 4, 8, and 10 months revealed good bone preservation with an osseointegrated implant.Employment of digital planning to create a palatal window allowed excellent accuracy in removing the retained root while maintaining the bony foundation for a well osseointegrated dental implant. Pre‐planning using cone beam computed tomography scan merged with an intraoral digital scan is necessary for precise location of a retained root and correct implant placement with excellent primary stability. A digitally planned 3D surgical guide is a useful method for extracting retained roots during implant placement to minimize bone damage. Digital planning provides a precise and minimally invasive implant surgery. [ABSTRACT FROM AUTHOR]

Multiple‐choice questions (MCQs) are the most popular type of items used in knowledge‐based assessments in undergraduate and postgraduate healthcare education. MCQs allow assessment of candidates' knowledge on a broad range of knowledge‐based learning outcomes in a single assessment. Single‐best‐answer (SBA) MCQs are the most versatile and commonly used format. Although writing MCQs may seem straight‐forward, producing decent‐quality MCQs is challenging and warrants a range of quality checks before an item is deemed suitable for inclusion in an assessment. Like all assessments, MCQ‐based examinations must be aligned with the learning outcomes and learning opportunities provided to the students. This paper provides evidence‐based guidance on the effective use of MCQs in student assessments, not only to make decisions regarding student progression but also to build an academic environment that promotes assessment as a driver for learning. Practical tips are provided to the readers to produce authentic MCQ items, along with appropriate pre‐ and post‐assessment reviews, the use of standard setting and psychometric evaluation of assessments based on MCQs. Institutions need to develop an academic culture that fosters transparency, openness, equality and inclusivity. In line with contemporary educational principles, teamwork amongst teaching faculty, administrators and students is essential to establish effective learning and assessment practices. [ABSTRACT FROM AUTHOR]

Purpose: Item analysis of multiple‐choice questions (MCQs) is an essential tool for identifying items that can be stored, revised, or discarded to build a quality MCQ bank. This study analyzed MCQs based on item analysis to develop a pool of valid and reliable items and investigate stakeholders' perceptions regarding MCQs in a written summative assessment (WSA) based on this item analysis. Methods: In this descriptive study, 55 questions each from 2016 to 2019 of WSA in preclinical removable prosthodontics for fourth‐year undergraduate dentistry students were analyzed for item analysis. Items were categorized according to their difficulty index (DIF I) and discrimination index (DI). Students (2021–2022) were assessed using this question bank. Students' perceptions of and feedback from faculty members concerning this assessment were collected using a questionnaire with a five‐point Likert scale. Results: Of 220 items when both indices (DIF I and DI) were combined, 144 (65.5%) were retained in the question bank, 66 (30%) required revision before incorporation into the question bank, and only 10 (4.5%) were discarded. The mean DIF I and DI values were 69% (standard deviation [Std.Dev] = 19) and 0.22 (Std.Dev = 0.16), respectively, for 220 MCQs. The mean scores from the questionnaire for students and feedback from faculty members ranged from 3.50 to 4.04 and from 4 to 5, respectively, indicating that stakeholders tended to agree and strongly agree, respectively, with the proposed statements. Conclusion: This study assisted the prosthodontics department in creating a set of prevalidated questions with known difficulty and discrimination capacity. [ABSTRACT FROM AUTHOR]

Purpose/objective: Cannabis and the endocannabinoid system (ESC) are rarely included in training programs for healthcare providers. Knowledge within the medical and dental health professionals is lacking regarding the treatment of patients using medical or recreational cannabis. Patients are unaware of the risks associated with cannabis use, and healthcare providers should be prepared to assess, educate, and treat the patients who use cannabis. With the increased legalization and use of cannabis for medical and recreational purposes across the US, this study demonstrated the lack of cannabis education provided in dental hygiene programs. Methods: In 2021, an online survey was conducted with 327 dental hygiene program directors. Respondents were asked to answer 26 questions. Results: With a 21% response rate and 100% completion rate, 60% of the participants responded that cannabis content was provided in their dental hygiene program, 38% responded with a "no," and one responded with "I do not know." No significant difference was found regardless of whether cannabis was legal in the state for medical or recreational use and whether the cannabis content was included in the dental hygiene curriculum. Conclusions: The results indicate that every dental hygiene program should provide cannabis content, and each patient should receive a cannabis assessment at every dental hygiene appointment. Further research is required to identify standardized educational content on cannabis and the ESC, which will enable educators to teach students. The development and implementation of a standardized cannabis use assessment and the creation of standardized recommendations for patients who use cannabis to alleviate adverse oral health effects are important. [ABSTRACT FROM AUTHOR]

Background/Aim: Childhood dental trauma poses a prevalent concern, and the limited knowledge of lay caregivers toward the needed immediate actions can adversely affect a child's well‐being. This study aimed to create and validate an educational comic book for lay individuals, designed to guide immediate actions in dental trauma cases, and assess its effects toward enhancing reader knowledge. Methodology: The four‐stage study involved: (1) Literature review and script development; (2) Version 1 of the comic book creation (including illustrations, layout, and design) and Flesch Readability Index (FI) calculation; (3) Version 1 validation by expert judges, assessed by the Content Validity Index (CVI); (4) Version 1 refinement based on the judges' feedback, recalculation of FI, and a pilot test (CVI) involving lay individuals who validated the final material (Version 2). The validation process involved 67 participants, including 13 specialist judges and 54 elementary school teachers. Results: The CVI for Version 1 was calculated at 0.89 (89%), indicating a favorable level of agreement on the evaluated criteria. The FI was determined as 91.1%, indicating a high level of readability. The FI for Version 2 was 92.1% (indicating a very easy level of comprehension). The CVI calculated for the target audience after the pilot test was 0.99 (99%), denoting a substantial agreement among the participants. In assessing the level of knowledge, a significant increase was observed in the rate of correct answers after the comic book was read by lay individuals (p < 0.05), inasmuch as the percentage rose from 50.5% before to 81.2% after reading it. Conclusion: The educational comic book proved valid in terms of readability, appearance, and content. Furthermore, it had a positive impact on gaining the knowledge needed to take the appropriate actions, thus making it a valuable tool for guiding the lay population in cases of dental trauma. [ABSTRACT FROM AUTHOR]

Objectives: Dental residents experience high stress in their demanding programs and gender‐based harassment/discrimination can contribute to their stress. The objectives were to compare stress, satisfaction, experienced sexual harassment and observed discrimination of women in dental graduate programs with high, medium, and low percentages of women and to explore relationships between these constructs of interest. Methods: Note that, 112 pediatric dentistry (PD), 44 prosthodontics, and 56 oral and maxillofacial surgery (OMS) residents responded to a survey. Results: PD residents had the lowest personal life‐related stress (4‐point scale with 4 = very stressful: PD = 2.99/P = 3.67/OMS = 3.56; p < 0.001), faculty‐related stress (2.68/3.66/3.03; p < 0.001), lack of confidence‐related stress (2.79/3.31/2.96; p < 0.01) and academic stress (2.65/3.24/3.02; p < 0.001), while prosthodontics residents had the highest stress levels. The average frequency of experiencing sexual harassment was highest for OMS residents and lowest for PD residents (5‐point scale with 1 = never: 1.15/2.62/2.74; p < 0.001). PD residents observed least and OMS residents most frequently that female residents were treated less positively by other residents because of their gender (1.59/2.57/3.00; p < 0.001). Prosthodontics residents had the lowest job satisfaction score (5‐point scale with 1 = lowest satisfaction: 4.12/3.14/4.20; p < 0.001). The more frequently male and female residents experienced sexual harassment, the higher their personal life‐related stress, faculty‐related stress, lack of confidence‐related stress, and academic stress, and the lower their career satisfaction, specialty content satisfaction, and stress‐related satisfaction. Women's frequencies of observed gender‐based discrimination were associated with higher stress and lower satisfaction, while men's frequencies of these observations were not associated with stress, but associated with increased satisfaction. Conclusions: Dental residents' stress, career satisfaction, experienced sexual harassment, and observed discrimination of women residents differ depending on the dental specialty program. Both male and female residents report more stress and less satisfaction the more they experience sexual harassment. The more women observe discrimination of women, the more stressed and the less satisfied they are. For men, the frequencies of these observations are not associated with stress, but positively associated with increased satisfaction. [ABSTRACT FROM AUTHOR]

The aim of this study was to provide a follow‐up to the 2015 national survey of women in dental education to re‐examine factors and perceived barriers to pursuing administrative and leadership roles. At the beginning of 2023, a survey was administered to full‐time women faculty in predoctoral dental programs in the United States. The survey instrument employed a structured format along with open‐ended questions to capture qualitative data. The overall response rate was 26% (527/1994) and included respondents from fifty‐five of the sixty‐seven dental schools contacted. Half of respondents indicated holding an administrative position and 20% reported administration as their primary appointment. There was a significant increase in the number of women holding a leadership role in 2023 (76%) compared to 2015 (53%). Those seeking a leadership position in 2023 were less likely to have participated in leadership training (p<0.01) and less likely to have previously sought an administrative position (p>0.01). Women in leadership and administrative roles were more likely to indicate receiving extra compensation for administrative duties (p<0.01) and a desire for higher rank (p = 0.04) compared to 2015, but perceptions persist among the majority of respondents (71%) that women are not being compensated equally to their male counterparts. Respondents highlighted the negative impact of the COVID‐19 pandemic on career advancement and the positive culture changes that have contributed to greater workplace flexibility. Overall, respondents sent a resounding message that women in dental education need structural change to achieve success: pay equity, mentorship, and inclusive and supportive work environments. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this cross‐sectional study was to investigate whether the characteristics of dental schools and the profiles of their deans were associated with curricular activities related to LGBTQ+ in Brazilian dental schools. Methods: A survey was mailed to the deans of all Brazilian dental schools for the purpose of assessing the development of pedagogical activities focused on the topic of oral health of the LGBTQ+ population, and the characteristics of the institutions and profiles of their deans. The data collected were analyzed with hierarchical multiple logistic regression models in order to analyze associations between variables of interest. Results: Of the deans approached, 156 (response rate of approximately 32.4%) completed and returned the survey. The majority of dental schools (67.3%) of the sample were private institutions and 39% of them developed pedagogical activities directed toward the LGBTQ+. This percentage was much lower in public institutions (18%). The results of the hierarchical multiple logistic regression demonstrated that deans who attributed high relevance to the theme "oral health of the LGBTQ+ population" were more likely to develop pedagogical activities directed toward the LGBTQ+ population (odds ratio = 4.74; 95% confidence interval: 1.65–13.48), than those who attributed low or little importance to this topic (p < 0.05). Conclusion: A low percentage of activities aimed at the LGBTQ+ population was observed in the sample of Brazilian dental schools. Deans must be aware of the importance of the topic and be motivated to implement pedagogical activities for this population. [ABSTRACT FROM AUTHOR]

Introduction: Bruxism is a spectrum of masticatory muscles activities. According to the recent evidence and international consensus, there is no indication to treat bruxism unless clinical consequences are present. The aim of the present study was to investigate the approach of Italian dentists to bruxism in their clinical practice. Methods: An anonymous online survey was developed, composed by 26 items grouped into five sections: (1) Characteristics of the respondent (Q1–Q6); (2) Bruxism frequencies (Q7–Q11); (3) Bruxism assessment (Q12–Q15); (4) Bruxism management (Q16–Q20); (5) Occlusal splints therapy (Q21–Q26). Results: A total of 384 practitioners, including specialists and non‐specialists, participated in this survey. The majority of the respondents reported that 1–3 out of ten patients presented with bruxism. The diagnosis is mainly performed with non‐instrumental methods, and facial pain and dental wear are the major clinical consequence associated with bruxism. Almost the entire sample of respondents report to offer occlusal splints to bruxism patients, and 41% refer to perform occlusal adjustments. Almost half of the respondents have never proposed any form of cognitive‐behavioural therapy. Conclusion: The results of the current survey highlighted several inconsistencies in Italian dentists' approaches to bruxism, suggesting the need for better education of practitioners and for the development of a standardized protocol to assess and manage bruxism in dental practices. [ABSTRACT FROM AUTHOR]

Background: Haptic technologies have opened a new avenue in preclinical dental education, with evidence that they can be used to improve student performance. The aim of this systematic review was to (1) determine the effect of haptic simulators on motor skill acquisition during preclinical dental training, (2) explore students' perception, and (3) explore the ability of haptic systems to distinguish users based on their initial level of manual dexterity. Methods: A comprehensive search of articles published up to February 2023 was performed using five databases (i.e., PubMed/Medline, ScienceDirect, Web of Sciences, Scopus, and Cochrane Library) and specialized journals. The Preferred Reporting Items for Systematic Review and Meta‐Analysis 2020 guidelines were followed, and the risk of bias was assessed. Only studies on the application of haptic simulators in dentistry preclinical training were included. Qualitative synthesis of data was performed, and the protocol was registered in PROSPERO (ID = CRD42022337177). Results: Twenty‐three clinical studies, including 1303 participants, were included. The authors observed a statistically significant improvement in dental students' motor skills in various dental specialties, such as restorative dentistry, pediatric, prosthodontics, periodontics, implantology, and dental surgery, after haptic training. Haptic technologies were perceived well by all participants, with encouraging data regarding their ability to differentiate users according to their initial level of manual dexterity. Conclusions: Our work suggests that haptic simulators can significantly improve motor skill acquisition in preclinical dental training. This new digital technology, which was well perceived by the participants, also showed encouraging results in discriminating users according to their level of experience. [ABSTRACT FROM AUTHOR]

Purpose: This research explores continuing professional development (CPD) requirements for dental regulatory/licensing authorities located in the USA/Canada and their preferences toward different learning and assessment strategies. Methods: Data were first retrieved through an environmental scan of CPD requirements posted on the websites for the 62 regulatory/licensing authorities located in the USA/Canada. Subsequently, an electronic questionnaire was distributed to the appropriate contact at each regulatory authority to capture additional data related to knowledge and preferences. Results: The environmental scan revealed that Canadian CPD programs had a significantly higher (p < 0.05) average of required CPD hours (26.67 ± 5.44) when compared to the USA (18.20 ± 4.23). For the survey component, 35 completed responses were received (response rate 56%). A total of 54% of respondents selected from a Likert scale that they "rarely" incorporate formative assessments, and 68% only "sometimes" or "often" incorporate summative assessments into their CPD programs. Additionally, 63% of respondents "never" incorporated predisposing activities, and 57% "never" incorporated reinforcing activities. It was perceived that renewal fees were insufficient to finance ongoing CPD costs (60%) and external industry sponsorships were required to sustain programs (43%). Respondents indicated that there is an insufficient number of evidence‐based courses available in a variety of dental disciplines. Conclusions: Formative and summative assessments and predisposing and reinforcing learning activities were not viewed as essential tools in CPD programs. Costs and human resources could be possible obstacles in incorporating learning activities and assessments. Future studies can build from the initial results of this study to improve the quality of learning in CPD programs. [ABSTRACT FROM AUTHOR]

Objectives: Research shows that adults who were Deaf or Hard of Hearing (HoH) had poorer oral health than adults who did not belong to this community. The objectives were to assess dentists' education, knowledge, attitudes, and professional behavior related to treating patients from the Deaf or HoH community and the relationships between these constructs. Methods: A total of 207 members of the American Dental Association and the Michigan Dental Association responded to a mailed or web‐based survey concerning their education, knowledge, attitudes, and professional behavior related to treating patients from the Deaf or HoH community. Results: On average, the respondents disagreed that they were well educated in classroom‐based, clinical, or community‐based dental school settings (five‐point answer scale with 1 = disagree strongly; mean = 2.29/2.27/2.35) or by their professional organization (mean = 2.00) about treating Deaf or HoH patients. However, the more recently the respondents had graduated from dental school, the better they described their education about this topic (r = 0.29; p < 0.001). Additionally, 45.9% agreed/strongly agreed that they would like to attend a continuing education course about this topic; 68.9% agreed/agreed strongly that negative consequences for patients' general health can occur; and 61.1% that patients cannot be well educated about oral hygiene if Deaf or HoH patients do not have appropriate interpretive support in dental offices. The better dentists were educated about this topic, the more knowledge they had (r = 0.50; p < 0.001). On average, the respondents agreed more strongly that they were comfortable treating adult patients who communicated orally than patients using American Sign Language (4.02 vs. 3.25; p < 0.001). Conclusions: These findings show that efforts are needed to improve dental school and continuing education curricula about dental treatment for Deaf and HoH patients. The more recently the respondents had graduated, the more positively they described their education. Increased dental school and continuing education efforts are still urgently needed. [ABSTRACT FROM AUTHOR]

Background: Despite the importance of regular dental visits for detecting oral cancer, millions of low‐income adults lack access to dental services. In July 2009, California eliminated adult Medicaid dental benefits. We tested if this impacted oral cancer detection for Medicaid enrollees. Methods: We analyzed Surveillance, Epidemiology, and End Results‐Medicaid data, which contains verified Medicaid enrollment status, to estimate a difference‐in‐differences model. Our design compares the change in early‐stage (Stages 0–II) diagnoses before and after dropping dental benefits in California with the change in early‐stage diagnoses among eight states that did not change Medicaid dental benefits. Patients were grouped by oropharyngeal cancer (OPC) and non‐OPC (oral cavity cancer), type, and the length of Medicaid enrollment. We also assessed if the effect of dropping dental benefits varied by the number of dentists per capita. Results: Dropping Medicaid dental benefits was associated with a 6.5%‐point decline in early‐stage diagnoses of non‐OPC (95% CI = −14.5, −3.2, p = 0.008). This represented a 20% relative reduction from baseline rates. The effect was highest among beneficiaries with 3 months of continuous Medicaid enrollment prior to diagnosis who resided in counties with more dentists per capita. Specifically, dropping dental coverage was associated with a 1.25%‐point decline in the probability of early‐stage non‐OPC diagnoses for every additional dentist per 5000 population (p = 0.006). Conclusions: Eliminating Medicaid dental benefits negatively impacted early detection of cancers of the oral cavity. Continued volatility of Medicaid dental coverage and provider shortages may be further delaying oral cancer diagnoses. Alternative approaches are needed to prevent advanced stage OPC. [ABSTRACT FROM AUTHOR]

Introduction: Older people represent a growing proportion of the population in most high‐income countries. The impact of oral diseases on health and well‐being is far‐reaching, and future graduates should be able to meet their needs in this phase of life. This research tested the feasibility of involving dental students in direct community engagement to explore older peoples' oral health concerns and information needs. Materials and Methods: Seventeen older people were recruited locally to attend workshops with eight dental students in a health and well‐being centre. First, older people selected oral health‐related topics important to them, raising relevant questions and concerns. Students provided evidence‐informed feedback on these selected topics at a subsequent workshop. Participants (students and older people) reflected on their involvement (via questionnaires, discussions and personal reflections). Qualitative data were analysed using thematic analysis. The structure, process and outcome of the study were explored. Results: Structure: Both students and older people were willing to participate in workshops. Workshops in the community facilitated active engagement between both groups without the constraints of clinics. Process: Students considered pre‐workshop preparations adequate but raised issues about their ability to manage 'strong characters' within discussion groups. Outcome: Older people welcomed the initiative. Important topics raised by them were addressed by students giving them advice on maintaining their oral health. Students reported an improved understanding of how older people can be supported and expected a significant impact on future practice. Conclusion: Student involvement in direct community engagement was welcomed by all, demonstrating the feasibility and positive impact of the design whilst highlighting issues of importance for older people's oral health. [ABSTRACT FROM AUTHOR]

Introduction: Teaching caries lesion management with operative care requires tooth models with highly realistic anatomical detail and caries lesions that can be assessed using ICDAS. This study aimed to develop and evaluate a new 3D‐printed teeth model for ICDAS assessment and caries removal for pre‐clinical hands‐on education. Methods: Printable tooth with different layers for enamel, dentin and carious lesions was designed and tested by 31 dental students. They were asked to visually and radiologically assess the ICDAS severity of the simulated carious lesions, establish the therapeutic strategy according to CariesCare 4D, and perform a qualitative assessment of the models based on five‐point Likert scale items. Results: Concerning carious lesions, the texture was realistic, and the shade was adequate for 94% and 97% of the participants. Ninety per cent of the participants found the model adequate to perform an ICDAS visual assessment. Seventy‐four per cent of the students found the hardness adequate. Concerning the difference in shade and the noticeable hardness difference between enamel and dentin, participants have mixed agreement with a proportion of 61% and 55%, respectively. All the participants agreed these 3D‐printed models provide a good caries simulation, are suitable for hands‐on operative dentistry courses, and that learning outcomes better than the standard model. Conclusion: The present work shows that rapid prototyping paves the way for customized educational models capable of supporting operative but also preoperative skills. 3D printing opens up new opportunities by reducing the gap between pre‐clinical training and clinical reality in caries management, which can positively impact the quality of patient care. [ABSTRACT FROM AUTHOR]

Background: To evaluate and compare efficacy of pinhole surgical technique (PST) alone and with advanced platelet rich fibrin (A‐PRF) in the management of bilateral multiple adjacent gingival recession defects (MAGRD). Methods: One hundred and sixty five MAGRD were randomly assigned to control group (treated with PST) and test group (PST with A‐PRF). Clinical parameters of gingival recession depth (GRD), gingival recession width (GRW), width of keratinised gingiva (WKG), complete root coverage (CRC) and gingival thickness (GT) on ST‐CBCT was measured at 2, 4 and 6 mm apically from the gingival margin. Also, root coverage aesthetic score and patient satisfaction ratings were recorded at baseline, 6 and 12 months postoperatively. Results: Substantial reduction in GRD (Test: 1.29 ± 0.69 mm and Control 0.98 ± 0.30 mm) (p < 0.001) and GRW (Test: 2.03 ± 0.90 mm and control 1.73 ± 0.99 mm) (p < 0.05) with associated gain in WKG and GT was observed (p < 0.001). Mean GT values were increased in both the groups at 2, 4 and 6 mm from the crest. Comparison of Test and Control groups yielded significant reductions in GRD (−0.17 ± 0.56 mm) and WKG (0.73 ± 1.07 mm) favoring the Test group (p < 0.05). Similar increase in GT was observed with better results in Test than control group. (p < 0.001). Conclusion: Both groups exhibited sound clinical outcomes with test group offering better resolution of MAGRD in comparison to control group. Also, it enhances clinical and therapeutic end results in terms of attaining reduction in GRD and GRW along with greater gain in KTW and GT. Clinical Significance: PST as a minimally invasive approach has numerous benefits, some of which include the absence of scarring and improved aesthetics linked to faster wound healing. The addition of A‐PRF enhances the intended therapy outcomes, which is beneficial for both patients and professionals in the field of periodontics. [ABSTRACT FROM AUTHOR]

Due to the low cost, natural origin, higher safety margins, and little to negligible adverse effects of herbal medications, the use of plants and plant derivatives in medicine is becoming increasingly widespread. Terminalia chebula is among the most significant medicinal plants in ayurvedic, siddha, unani, and homeopathic remedies. It is ranked first in Ayurvedic material medicine. T. chebula has been shown to have established effects against various bacterial and fungal infections, including dental caries pathogens. In recent years, there has been a rise in interest in dentistry and medicine related to Enterococcus faecalis. The research aimed to assess the antibacterial effectiveness of different concentrations of T. chebula ethanolic fruit extract (10%, 40%, and 100%) in opposition to E. faecalis and compare it with 2% chlorhexidine. For the study, T. chebula ethanolic fruit extracts were obtained and prepared with Group I: −10% concentration, Group II: −40% concentration, Group III: −100% concentration, and Group IV: −2% chlorhexidine. Colonies of E. faecalis were cultivated in brain heart infusion (BHI) broth at 37°C and were inoculated in 16 BHI agar plates. Then, on the petri dishes, four wells were created (8 mm diameter) using a metal borer. The Agar well diffusion method was used to examine the antibacterial activity, and the zones of inhibition around the wells were noted. The obtained data were statistically analyzed using one‐way ANOVA and post‐hoc tests. The result shows that as the concentration increases, there is an increase in the efficacy of the antibacterial property of the extract before it reaches the saturation point. The decreasing order of antibacterial was chlorhexidine >100% T. chebula >40% T. chebula >10% T. chebula. The production of contemporary pharmaceuticals from T. chebula was addressed, as the global scenario is currently evolving toward using nontoxic plant products with traditional medicinal benefits. [ABSTRACT FROM AUTHOR]

Introduction: The concept of ideal preparations in dental schools are highly emphasized during the first two years of students' learning. However, students do not have as much opportunity to practice skills that would prepare them for real‐life stituations such as non‐ideal preparations and caries removal. Objective: This study aimed to determine the benefits of utilizing carious typodont teeth in the Operative curriculum for first‐ and second‐year UCSF dental students Methods: This study was completed by hosting a workshop in which the students performed a Class II preparation on #19 carious typodont tooth. The students filled out pre‐ and post‐surveys with questions about their confidence with performing a preparation and their opinions on the current curriculum. Results: The pre‐survey responses showed that the majority of the first‐ and second‐year students did not believe that the traditional non‐carious typodont teeth were a good representation of prepping on real, carious teeth. The pre‐survey responses also showed that most of the first‐ and second‐year students thought that the addition of carious typodont teeth would improve their learning experience. The post‐survey results displayed that the majority of the students thought that prepping carious typodont teeth helped to better reinforce concepts such as preparation design, taught them the difference between ideal and non‐ideal preparations, and allowed them to better understand tooth anatomy with the addition of the dentin layer. Conclusion: The use of the carious typodont teeth in pre‐clinical operative lab was found to be beneficial to first‐ and second‐year UCSF student's learning based on the pre‐ and post‐survey results. [ABSTRACT FROM AUTHOR]

Dentigerous cysts are among the most common cysts of the jaw. They are attached to the crown of an unerupted tooth, most frequently third molars and maxillary canines. They are often asymptomatic and may therefore be diagnosed late. We report a case of a primary intraosseous carcinoma arising from the wall of a dentigerous cyst and describe the expression of typical genes associated with tumour growth and prognosis. The tumour expressed cytokeratins (CK) 5/6, 8, 14 and 19, but not CK7. Ki‐67 and P53 were upregulated in dysplastic epithelium and tumour tissue. Although rare, the possibility for tumour development in the wall of a common cyst should be considered. The case emphasizes the importance of histopathological examination of surgical specimens, even if the clinical diagnosis seems obvious. [ABSTRACT FROM AUTHOR]

Aim: To use auto‐transplantation of a central incisor and canine and repositioning of a lateral incisor with corticotomy as an alternative to complex lengthy orthodontics and possible tooth loss. Method: Following initial consultation in a joint orthodontic/oral surgery clinic in Guy's Hospital, the decision was made to carry out auto‐transplantation of the ectopic teeth under general anaesthesia. The procedure included extraction of retained primary teeth, auto‐transplantation of upper right permanent central incisor and canine, segmental osteotomy/corticotomy to reposition the lateral incisor, followed by splinting of the upper 3–3 for 6 weeks. The patient was reviewed multiple times over a 2.5‐year period and no signs of inflammation, ankylosis, sensitivity, root resorption, mobility or loss of vitality was noted. Discussion: Auto‐transplantation is an underutilised technique despite being used for over 70 years. It does, however, have its limitations and there are several factors that can affect its success and predictability. This case highlights that it can be an excellent alternative to lengthy and difficult orthodontic treatment and resulted in avoidance of loss of teeth. This treatment method reduced time and cost to the NHS as well as improved the patient journey. It is important to work closely with colleagues and adopt a multidisciplinary approach to treatment planning and have an awareness for alternative treatment options that are available for joint orthodontic/oral surgery cases. Conclusion: Auto‐transplantation, in certain cases and conditions, can be very successful and save both patient and the NHS time and money. Greater awareness of this technique is required so that it can be offered more regularly as a treatment option. [ABSTRACT FROM AUTHOR]

Objectives: This brief communication documents the prevalence of maxillary central incisor talon cusps in Cayo Santiago rhesus monkeys (Macaca mulatta) and assesses whether talon cusp presence occurs at equivalent frequencies across matrilines. Materials and Methods: The data on cusp presence vs. absence were analyzed by logistic regression in 170 monkeys (82 females, 78 males) from seven different matrilines. Sample sizes per matriline ranged from 10 to 42. Observations of talon cusps were blind with respect to matriline and sex. Results: Talon cusps were present in 9.4% of the sample. By matriline, cusp frequencies ranged from 0%—Matrilines 073 and 106%—to 19.1% in Matriline 076. The frequency of the talon cusp in Matriline 076 was significantly greater than the frequency of the cusp in the remainder of the sample. There was no statistically significant difference in the frequency of the talon cusp by sex. Conclusions: This study suggests that the talon cusp in rhesus monkeys, as in humans and baboons, is a rare trait. Elevated prevalence of the talon cusp in Matriline 076 suggests the possibility of a genetic influence on talon cusp expression. [ABSTRACT FROM AUTHOR]

Objective: To develop a comprehensive decision‐making tree for evaluating mid‐facial peri‐implant soft tissue dehiscence in the esthetic zone and provide a systematic approach for assessing various clinical case scenarios, determining appropriate treatment strategies, and considering factors such as the need for soft tissue augmentation, prosthetic changes, or implant removal. Clinical Considerations: This clinical decision tree illustrates numerous case scenarios with various esthetic complications around an esthetically compromised, but clinically healthy single implant and provides clinicians with possible solutions as a predictable map for horizontal and vertical soft tissue augmentation in order to manage different clinical circumstances. According to current evidence, the key to treating such esthetic complications is the use of an adequate pre‐surgical prosthetic interdisciplinary approach with proper surgical techniques in order to optimize soft tissue dimensions and create better esthetic results. This may be accomplished through a purely surgical, combination of surgical and prosthetic, or purely prosthetic approaches. Conclusions: The present report describes a series of successfully treated peri‐implant esthetic complication cases in accordance with the decision‐making tree that the authors recommend in order to achieve better long‐term esthetic outcomes. Clinical Significance: The combination of adequate pre‐surgical prosthetic interdisciplinary collaboration and proper surgical technique is critical in the optimization of sufficient soft tissue dimensions and contributes to a more highly esthetic result. This study demonstrates a clinical decision‐making tree to provide comprehensive, effective therapy of an esthetically compromised dental implant by using one of the following approaches: purely prosthetic, purely surgical, or a combination of surgical and prosthetic with or without abutment removal. [ABSTRACT FROM AUTHOR]

Background: Successful periodontal therapy can lead to poor esthetic results, especially in the anterior region, for which there are treatment options such as direct composite or indirect veneer restorations. Until now, there are no data describing the long‐term results of veneer restorations in periodontally treated patients. The aim of this retrospective study was to evaluate the outcome of anterior porcelain veneer restorations in periodontally compromised and noncompromised patients. Methods: Periodontally healthy and periodontally compromised patients, who had received anterior veneer restorations at least 5 years ago, were invited to a follow‐up examination. Groups were divided according to their periodontal diagnosis (periodontally healthy, stage I/II, stage III/IV). Tooth loss, veneer loss, biologic parameters, and complication rates were examined. Also, veneers were evaluated according to modified United States Public Health Service criteria. Results: A total of 68 patients with 312 veneers were examined with a mean follow‐up time of 8 years. Veneered teeth in patients with periodontitis stage III/IV showed no difference regarding tooth‐specific, overall, and functional veneer survival when compared to periodontally healthy patients (Kaplan–Meier analyses). In Cox regression analysis, follow‐up time had an impact on complications and veneer loss, whereas periodontal diagnosis showed no significant influence on the survival of restorations. Comparative tests showed that patients with severe periodontitis at baseline have slightly lower veneer survival rates after 8 years and slightly higher complication rates after 13 years. Conclusion: Long‐term results and complication rates of veneer restorations in periodontally compromised patients are comparable to periodontally healthy patients over a mean follow‐up of 8 years. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to conduct a process evaluation of the Kimberley Dental Team (KDT), a not‐for‐profit, volunteer organization providing care to remote Aboriginal communities in Western Australia. Methods: A logic model was constructed to detail the operational context of the KDT model. Subsequently, the fidelity (the extent to which each of the programme's elements were implemented as planned), dose (types and quantity of services provided) and reach (demographic characteristics and communities serviced) of the KDT model were evaluated using service data, deidentified clinical records and volunteer rosters maintained by KDT from 2009 to 2019. Trends and patterns of service provision were analysed using total counts and proportions over time. A Poisson regression model was used to explore changed in the rates of surgical treatment over time. The associations between volunteer activity and service provision was also investigated using correlation coefficients and linear regression. Results: A total of 6365 patients (98% identifying as Aboriginal or Torres Strait Islander) were seen over the 10‐year period with services being provided across 35 different communities in the Kimberley. Most services were provided to school‐aged children, consistent with the programme's objectives. The peak preventive, restorative and surgical rates occurred among school‐aged children, young adults and older adults respectively. A trend was observed indicating a reducing rate of surgical procedures from 2010 to 2019 (p <.001). The volunteer profile showed significant diversity beyond the conventional dentist–nurse structure and 40% being repeat volunteers. Conclusions: The KDT programme maintained a strong focus on service provision to school‐aged children over the last decade with the educational and preventive components being central to the care being provided. This process evaluation found that the dose and reach of the KDT model grew with an increase in resources and was adaptive to perceived community need. The model was shown to evolve through gradual structural adaptations contributing to its overall fidelity. [ABSTRACT FROM AUTHOR]

Objectives: To explore and assess what is known about oral health promotion through health‐promoting primary schools in developing countries. Methods: A scoping review was conducted using the Arksey & O'Malley framework. Web of Science, PubMed, Scopus and Cochrane Library were searched, followed by the reference lists of the resulting studies. The UN classification of developing countries was used to define the countries included and the search was between 1986 and 2021. Quality assessment was carried out using Joanna Briggs Institute's quality appraisal tools. Results: The search resulted in 33 studies of which almost half were randomized controlled trials. The oral health promotion strategies were oral health education (n = 16) delivered by teachers, parents or peers, or multicomponent involving both toothbrushing (n = 15) and dietary components (n = 2). Most of the included studies were conducted in Asia (n = 25/33). Conclusions: Findings suggested that comprehensive, multicomponent theory‐based oral health promotion showed improvements in oral health outcomes of schoolchildren, particularly if delivered using a whole‐school approach. However, further research on feasibility and implementation of oral health promotion through health‐promoting primary schools in developing countries should be considered. [ABSTRACT FROM AUTHOR]

Purpose: E‐learning is frequently integrated into dental education, yet little is known on the effectiveness of e‐learning in both instilling foundational knowledge and facilitating translation of newly acquired knowledge and skill into clinical application. The objective of this study was to investigate the impact of learning modality on acquisition of knowledge and translation to clinical skill using objective feedback from oral anesthesia manikins and subjects' self‐reported confidence scores. Methods: This mixed‐method study involved first year dental students (n = 52) who volunteered to participate in a learning intervention, simulation exercise, and survey in 2022. Students were randomly assigned to lecture (n = 26) or e‐learning (n = 26) cohorts and then participated in the intervention, postintervention assessment, and a simulation to evaluate correct approaches for each dental block and attempts to success. Results: All subjects scored significantly higher on post‐intervention assessment compared to pre‐intervention assessment (8.2 vs. 5.9; p < 0.0001) with no significant differences between intervention groups when comparing preintervention and postintervention scores. Furthermore, there were no significant differences between the two cohorts when comparing abilities to correctly approach each dental block or attempts to success. Finally, all students reported a significant increase in confidence in most categories following intervention and simulation, with no significant differences between lecture and e‐learning cohorts. Conclusion: Our findings suggest students learning via e‐learning are equally capable as those learning via lecture at demonstrating newly acquired knowledge and skill in both assessments and clinical simulations. Results support incorporating supplemental e‐learning and oral anesthesia manikin exercises for students learning the anatomy of dental injections. [ABSTRACT FROM AUTHOR]

Objectives: Dentin hypersensitivity (DH) affects patients' oral health‐related quality of life, but is not always optimally treated in dental offices. The objectives were to assess dentists' DH‐related education, knowledge, and professional behavior and explore relationships between education, knowledge, and behavior. Methods: Survey data were collected from 220 ADA members in the United States. Descriptive and correlational analyses were performed. Results: About half of the respondents agreed/strongly agreed that their dental school had educated them well about diagnosing DH in classroom‐based (53.6%) and clinical settings (48.9%). Lower percentages agreed being well educated about treating DH (40.9%/37.3%). The majority self‐educated themselves about DH after dental school by attending continuing education courses in person or online (60.6%/36.8%), reading articles (64.1%), or consulting with colleagues (59.6%). The majority knew that patients with DH describe their pain as stimulated (91.4%) and that recessed gingiva (89.6%), abrasion lesions (72.3%), tooth whitening (63.1%), erosion lesions (58.6%), and abfraction lesions (51.4%) are risk factors for DH. The majority diagnosed DH with patient self‐reporting, confirmed by exams (81.8%), applying air blasts (53.7%), or cold‐water (52.3%). They treated patients with DH often/very often with over‐the‐counter desensitizing agents (90%), and prescribing fluoride formulations toothpaste (82.8%) and/or potassium nitrate toothpastes (60.9%). In their offices, the majority (73.2%) educated their patients often/very often about DH and used fluoride dental varnish for treating DH (71.8%). The more recently respondents had graduated from dental school, the more positively they described their dental school education (r = 0.14; p < 0.05), the more ways to diagnose DH they used (r = 0.16; p < 0.05) and the more often they used fluoride dental varnish in their offices (r = 0.23; p < 0.001). The more dentists had educated themselves, the more methods for diagnosing DH they used (r = 0.23; p < 0.001) and the more often they used potassium oxalate products (r = 0.19; p < 0.01), Arginine/calcium products (r = 0.19; p < 0.01) and dentin bonding (r = 0.22; p < 0.001). Conclusions: More recently graduating from dental school correlates with more positive evaluations of DH‐related dental school education. The finding that most dentists engage in self‐education about DH after dental school should motivate dental educators to increase education about this topic not only in dental school, but also in continuing education courses. [ABSTRACT FROM AUTHOR]

Radiographic evaluation of bone changes is one of the main tools in the diagnosis of many oral and maxillofacial diseases. However, this approach to assessment has limitations in accuracy, inconsistency and comparatively low diagnostic efficiency. Recently, artificial intelligence (AI)‐based algorithms like deep learning networks have been introduced as a solution to overcome these challenges. Based on recent studies, AI can improve the detection accuracy of an expert clinician for periapical pathology, periodontal diseases and their prognostication, as well as peri‐implant bone loss. Also, AI has been successfully used to detect and diagnose oral and maxillofacial lesions with a high predictive value. This study aims to review the current evidence on artificial intelligence applications in the detection and analysis of bone loss in the oral and maxillofacial regions. [ABSTRACT FROM AUTHOR]

Introduction: Objective structured clinical examinations (OSCEs) are an essential examination tool within undergraduate dental education. Fear of spread of the COVID‐19 virus led to dental institutions exploring alternative means of conducting OSCEs. The aim of this scoping review was to investigate what structures, processes and outcomes of dental OSCEs were reported during the COVID‐19 pandemic. Materials and Methods: This scoping review was conducted and reported adhering to the Preferred Reporting Items for Systematic Reviews and Meta‐analyses extension for scoping review guidelines (PRISMA‐ScR). Published literature was identified through a systematic search of PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Resources Information Center (Eric), ProQuest and Google Scholar. Identified articles were independently reviewed by two authors (KS, AD), followed by synthesis in terms of the reported structures, processes and outcomes. Articles reporting cancellation or rescheduling were also included, extracting data on reasons and any suggestions/recommendations. Results: The search yielded a total of 290 studies of which 239 sources were excluded after removal of duplicates, leaving 51 studies for title and abstract evaluation. Thirty‐four articles were excluded as they did not report on the topic of interest, leaving 17 for full‐text evaluation, of which nine were analysed according to the pre‐set themes. All dental OSCEs taking place (n = 6) were conducted online whilst the remaining (n = 3) were either cancelled or rescheduled. Data on structures reported specific online videoconferencing software used and provision of staff and student training. Processes on the execution of online OSCEs varied significantly from one study to the other, providing rich data on how dental institutions may carry out such assessments tailored to their need. Information regarding outcomes was sparse, as little attention was paid to the results of the students compared to pre‐pandemic, lacking investigation into reliability and validity of online dental OSCEs. Conclusion: Dental OSCEs could be conducted online implementing well‐planned structures and processes; however, further evidence is needed to prove its reliability and validity based on outcomes. Dental institutions may need to consider alternative methods to assess practical competencies if online OSCEs are to take place. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate whether discriminatory episodes occurring in the university environment were associated with dental students' self‐perceived overall quality of life and assess the cumulative effect of perceived discriminatory experiences on the overall quality of life. Methods: In this cross‐sectional study, all students enrolled in three Brazilian dental schools were invited to participate in a survey between August and October 2019. The outcome was students' self‐perceived quality of life, measured through the overall quality of life item of the World Health Organization—Quality of Life Abbreviated Version (WHOQOL‐BREF). Descriptive, bivariate, and multivariable logistic regression analyses (95% confidence intervals and α of 5%) were conducted using RStudio software. Results: The sample was composed of 732 students (70.2% response rate). The great part was female (66.9%), white or yellow skin color (67.9%), and were children of highly educated mothers. About 68% of the students reported having experienced at least one of the seven discriminatory experiences presented in the questionnaire and 18.1% reported neutral or negative quality of life. In multivariable analyses, it was estimated that students who experienced at least one episode of discrimination were 2.54 times (95% CI: 1.47–4.34) more likely to report worse quality of life than their counterparts who reported no experience of discrimination. There was also a 25% (95% CI: 1.10–1.42) increase in the odds of reporting poorer quality of life for each additional discriminatory experience reported. Conclusion: Reporting at least one discriminatory situation in the academic environment was associated with worse quality of life among dental students, and a cumulative effect was also noted. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to compare the effects of 10 commercially available instrument handle designs' mass and diameter on forearm muscle activity during a simulated periodontal scaling experience. Methods: A convenience sample of 25 registered dental hygienists was recruited for this IRB‐approved study. Ten commercially available instruments were categorized into four groups based on their masses and diameters: large diameter/light mass, small diameter/light mass, large diameter/heavy mass and small diameter/heavy mass. Participants were randomized to four instruments, one from each group. Participants scaled with each instrument in a simulated oral environment while muscle activity was collected using surface electromyography. Muscle activity was compared among the four instrument group types. Results: Muscle activity of the flexor digitorum superficialis was not significantly influenced by instrument mass (p = 0.60) or diameter (p = 0.15). Flexor pollicis longus muscle activity was not significantly influenced by instrument mass (p = 0.81); diameter had a significant effect (p = 0.001), with smaller diameter instruments producing more muscle activity. For the extensor digitorum communis and extensor carpi radialis brevis, instrument mass did not significantly affect muscle activity (p = 0.64, p = 0.43), while diameter narrowly failed to reach significance for both muscles (p = 0.08, p = 0.08); muscle activity for both muscles increased with smaller diameter instruments. Conclusion: Results from this study indicate instrument diameter is more influential than mass on muscle activity generation; small diameter instruments increased muscle activity generation when compared to large diameter instruments. Future research in real‐world settings is needed to determine the clinical impact of these findings. [ABSTRACT FROM AUTHOR]