Digital dentistry, including CAD/CAM dentistry, is perhaps the most disruptive innovation in dentistry to date. The rapid development of digital dentistry technologies over the past several decades has enabled clinicians to improve patient care by significantly reducing the time necessary for the restorative phase of treatment. Advancements in intra-oral scanning and computer-aided design and manufacturing (CAD/CAM), in conjunction with new dental CAD/CAM ceramic materials, have simplified patient care and made same-day dentistry a reality. This review aims to present the most recent advancements described in current literature as well as to document the successful implementation of digital dentistry into a predoctoral program. The overall process of CAD/CAM same-day dentistry and the accompanying advancements in software and materials were presented and discussed. Implementation of technology and personnel requirements were reviewed. CAD/CAM dentistry has been influential in shaping and improving dental practice and education, and this influence will only continue with time.

The color match between natural teeth and restorative materials is critical in dentistry for achieving aesthetic outcomes. Various factors such as light source, brightness, opacity, and visual perception influence teeth color. The intrinsic color of dental structures is determined by light absorption and scattering within the tooth material. Recent advancements in CAD/CAM systems have improved treatment approaches in prosthodontics, particularly with the introduction of new temporary materials. However, data on the color stability and masking ability of these CAD/CAM materials is limited. Telio® CAD-Temp and VITA CAD-Temp® blocks were cut into slices and polished. Composite resin specimens were prepared using a custom-designed metal resin former and light-cured. A healthy bovine incisor was used to create another type of base. Samples were paired randomly and assigned to experimental groups based on base type and thickness (n=30). Samples were stored in a controlled environment for 24 hours before color evaluation using an EasyShade® V spectrophotometer. Color difference (ΔE) was calculated using L*, a*, and b* values. Statistical analyses included Shapiro-Wilk test, Levene’s test, and three-way ANOVA, with post-hoc comparisons using the Bonferroni method (α=0.05). ΔE was classified according to perceptibility (PT=1.2) and acceptability (AT=2.7) values.

Objectives: The hierarchical structure of enamel gives insight on the properties of enamel and can influence its strength and ultimately caries experience. Presently, past caries experience is quantified using the decayed, missing, filled teeth/decayed, missing, filled surface (DMFT/DMFS for permanent teeth; dmft/dmfs for primary teeth) or international caries detection and assessment system (ICDAS) scores. By analyzing the structure of enamel, a new measurement can be utilized clinically to predict susceptibility to future caries experience based on a patient’s individual’s biomarkers. The purpose of this study was to test the hypothesis that number of prisms by square millimeter in enamel and average gap distance between prisms and interprismatic areas, influence caries experience through genetic variation of the genes involved in enamel formation. Materials and Methods: Scanning electron microscopy (SEM) images of enamel from primary teeth were used to measure number of prisms by square millimeter and interprismatic spaces, prism density and gap distances between prisms in the enamel samples. The measurements were tested to explore a genetic association with variants of selected genes and correlations with caries experience based on the individual’s DMFT+ dmft score and enamel microhardness at baseline, after an artificial lesion was created and after the artificial lesion was treated with fluoride. Results: Associations were found between variants of genes including ameloblastin, amelogenin, enamelin, tuftelin, tuftelin interactive protein 11, beta defensin 1, matrix metallopeptidase 20 and enamel structure variables measured. Significant correlations were found between caries experience and microhardness and enamel structure. Negative correlations were found between number of prisms by square millimeter and high caries experience (r value= -0.71), gap distance between prisms and the enamel microhardness after an artificial lesion was created (r value= -0.70), and gap distance between prisms and the enamel microhardness after an artificial lesion was created and then treated with fluoride (r value= -0.81). There was a positive correlation between number of prisms by square millimeter and prism density of the enamel (r value= 0.82). Conclusions: our data support that genetic variation may impact enamel formation, and therefore influence susceptibility to dental decay and future caries experience. Clinical Relevance: The evaluation of enamel structure that may impact caries experience allows for hypothesizing that the identification of individuals at higher risk for dental caries and implementation of personalized preventative treatments may one day become a reality.

Dental anxiety (DA) negatively affects patients’ oral and overall health. This study explored attitudes and clinical practices of licensed Ohio general dentists who treat patients with DA. Methods: An anonymous self-administered mail survey was sent to 500 general dentists licensed and practicing in Ohio. Responses to 21 pre-coded questions were analyzed. Frequencies were examined; cross-tabs, Chi-Square, and Fischer’s Exact Test were calculated for statements according to dentists’ gender. Alpha was set at p = 0.05. Results: Nearly all respondents treated anxious patients; males were more likely to find it challenging than females. Dentists were most familiar with distraction, although half found nitrous oxide to be an effective tool. Female dentists were more likely than males to be familiar with anxiolytics and find them effective. Conclusion: Overall, Ohio general dentists are most familiar with using distraction and nitrous oxide during appointments for anxious patients. Gender differences exist in attitudes towards anxiolytic use for patients with DA. Practice Implications: By identifying techniques that are comfortable for patient and practitioner, oral health disparities associated with DA may be reduced.

Background: The aim of this audit is to evaluate the characteristics of dental infections requiring hospitalisations, which may help improve preventative and management policies. Methods: This study retrospectively evaluated the patients’ records admitted to a public hospital due to dental infections between 2018 and 2019. Results: A total of 102 patients, mostly in thirties with equal gender distribution were admitted with dental infections, presenting with pain (100%), swelling (99%), Trismus (40.2%), dysphagia (27.4%), fever (21%) >37°C, Tachycardia (24.75%) and Tachypnoea (9.3%). Most patients presented (68%) on weekends, outside regular working hours and public holidays. 54 (52.5%) patients had taken prior antibiotics. Dental Caries, smoking, mental health issues and illicit drug use were featured strongly. The majority of patients (56.4%) underwent treatment under local anaesthesia. The total length of hospital stay was 271 days (mean 2.66). Augmentin was the most prescribed antibiotics. Complications were reported in 8.8% patients, primarily related to airway compromise. Conclusion: Dental infections leading to hospitalizations continue to be a burden on the healthcare system. A notable finding was the presentations primarily on weekends, outside regular hours and public holidays and the majority requiring dental intervention under local anaesthesia. Provision of on call emergency dental services may reduce length of hospital stay and admissions.

Introduction: Dental students’ use of online material to supplement learning has been studied, but educator awareness and reaction to the findings of this research is unknown. This small local study aimed to investigate dental students’ use of online content as a learning tool from an educator’s perspective.Methods: Educators at an Irish dental school completed a survey based on dental students’ use of online learning. Quantitative descriptive analyses were carried out as appropriate on the data collected, and a subsequent focus group was held to gain deeper insight into survey results. Data were analysed for themes by deductive and inductive coding methods.Results: This study found a sample of educators were aware of some student behaviours around online videos. Most educators correctly thought that students are likely to refer to online videos to prepare for dental procedures. Several educators believed that teachers should incorporate videos into their learning, but do not themselves upload or recommend online videos. Most recalled discussing accuracy and/or relevancy of online content with their students. Fewer thought that students would discuss contradictory videos with them. Focus group participants expressed concern over the accuracy of online content. This along with a lack of time were some reasons deterring them from referring students to online videos. Conclusions: An opportunity exists for dental educators and their students to have local dialogue around (1) student use, critical appraisal, and sharing of dental procedural video material; and (2) perceived benefits and challenges of incorporating both school-produced and online videos into teaching and learning. Although arguably non-generalizable beyond this context, this study may inform future research and serve to spark conversations within schools regarding video use for teaching clinical dental procedures.

In the face of 21st-century environmental challenges, including climate change, migration pressures, and waste disposal issues, certain healthcare sectors, notably dentistry, pose a significant global environmental footprint with concerns about carbon emissions and waste production. This scoping review delves into the paradox that healthcare, while dedicated to safeguarding health, inadvertently contributes to environmental degradation through waste accumulation and disposal. The analysis of relevant pertinent literature emphasizes the imperative for an environmentally sustainable approach to dental waste measurement, disposal methods, and comprehensive education for stakeholders. Aligned with the World Conference on Sustainable Development and the United Nations' 2030 Agenda, the study adhered to PRISMA-ScR scoping review guidelines and Institute of Medicine's recommendations. The study utilized Medline/PubMed and international organization websites for data retrieval, employing Boolean operator queries in Medline. A systematic literature analysis identified six cross-sectional studies (2004-2018) highlighting variations in dental waste composition due to the lack of standardized identification methods. This heterogeneity underscores the need for a proposed research model, emphasizing comprehensive methodologies and healthcare staff training in waste management. The study advocates for environmentally conscious dental practices, contributing to broader sustainable healthcare goals through sharing of a research protocol for dental solid waste management.

Background: Our study investigates the prevalence and causes of injuries among undergraduate dental students during clinical sessions. Methods: The study was conducted at the Department of Dentistry, National and Kapodistrian University of Athens, focusing on injuries reported from 2021 to 2024. Data were collected through self-reported questionnaires and clinical records. The primary variables assessed included the type of injury, the instrument involved, the clinical procedure being performed, and the immediate actions taken post-injury. Serological testing was conducted on both students and patients to assess the risk of bloodborne pathogen transmission. Results: The findings revealed a high prevalence of injuries, with needles being the most common cause, followed by burs and dental probes. The most frequent injury type was piercing, primarily affecting the fingers. Periodontal treatments, restorative procedures, and endodontic treatments were the main activities leading to injuries. Despite normal medical records for most patients treated by injured students, serological testing showed significant positivity rates for HCV and HBV. It is noteworthy that most injured students demonstrated their commitment to safety by adhering to recommended post-exposure protocols, including wound cleaning, disinfecting, and serological testing. Our study highlights the critical need for enhanced biosafety awareness and training among dental students to reduce injury risks. Conclusions: These findings underline the necessity for integrated safety protocols and continuous education to improve clinical practices and ensure student safety.

Smart Dental Materials refer to materials used in dentistry with additional functionality to enhance treatment outcomes, which may improve oral health. Smart materials for dental restorations can react to stimuli such as a specific temperature, a different pH, or mechanical stress, repair small cracks or damage by themselves, and interact beneficially with biological surroundings. For example, they might release ions and promote tooth remineralization or have antibacterial properties to prevent bacterial growth. Others can have enhanced mechanical properties like strength and wear resistance to ensure these materials can withstand the daily masticatory forces. This review presents our current comprehension of smart dental materials designed for tooth restoration. We focused on what these materials need to be effective, like durability, biocompatibility, and aesthetic requests, besides identifying new ideas for their design. A detailed analysis of the current challenges faced in formulating these materials, such as the balance between enough ions released with proper physicochemical properties and achieving the desired biological response, was discussed. We also discussed how these cutting-edge technologies are being leveraged to overcome existing limitations, creating more dental materials with potential clinical translation. The review also discusses the practical challenges in implementation and the prospects for these materials in dentistry.

Aim: This study aimed to investigate the relationship between dental caries, dental anxiety, and salivary cortisol levels in children visiting pediatric dental clinics and their implications on pediatric oral health. Materials and Methods: A cross-sectional study was conducted at a dental university in the UAE. A total of 60 children, aged 4-12 years, were included. Salivary cortisol levels were measured using an Enzyme-Linked Immunosorbent Assay (ELISA) kit. Dental caries status was evaluated, and dental anxiety levels were assessed using the Modified Dental Anxiety Scale (MDAS). Statistical analyses, including Mann-Whitney U test and Pearson's correlation coefficient, were performed to determine significant differences and associations. Results: The study group showed significantly higher salivary cortisol levels compared to the control group (p<0.0001). A strong positive correlation was found between salivary cortisol levels and dental caries status (p<0.001). However, no significant difference in dental anxiety levels was observed between the study and control groups (p=0.85). A strong positive correlation was found between dental anxiety levels and dental caries status (p<0.001). Conclusion: The findings indicate a significant association between salivary cortisol levels and dental caries, suggesting that higher cortisol levels are associated with active caries. Dental anxiety levels were positively correlated with dental caries. Understanding the relationship between these variables can contribute to better oral health strategies and interventions for children, emphasizing the importance of managing dental anxiety and stress in pediatric dental care. Clinical Significance: This study highlights the potential of salivary cortisol as a biomarker for assessing stress and its impact on oral health in children. By addressing dental anxiety and stress, dental professionals can provide child-friendly dental care, enhance preventive measures, and improve oral health outcomes in pediatric patients.

The paper analyzes the phenomenon that condition the durability and reliability of a type of dental bur based on the wear of the active part and with effect on its quality. For the experimental study, a conical-cylindrical dental bur and a sample dental material in cobalt-chromium alloy, cylindrical shape, tested on a specially made experimental installation were used. The paper was limited to the consideration of a single parameter (loss of mass, mw by wear of the active part of the dental bur tested) for the establishment the durability and reliability, useful for the extension of the lifetime or even optimization of its operation. The wear phenomenon of the active part of dental bur is studied based on the results and experimental data obtained in the work process that was validated by interpolation and led to polynomial functions which approximate very well the dependent parameter, mw, considered in the experimental program. The results of the interpolation showed that in the first 11 h of work, the dental bur works with high efficiency, after which it can be easily decommissioned (optimizing operation, possibly constructive solutions); i.e., it should be replaced with a new one (criterion for replacing of worn dental bur).

Background: The COVID-19 pandemic has changed the way dentistry has been practiced world over , this study sought to assess the impact of the COVID-19 pandemic on the patterns of attendance for dental treatment in a large hospital in Kuwait compare them to data from the year prior to the pandemic Methods: A total of 176,690 appointment records of 34,250 patients presenting to the AlJahra specialist hospital, Kuwait for dental treatment from April 2019 to March 2021 were analyzed. Types of procedures and the departments to which they presented were analyzed and the patterns of attendance before and during the pandemic were compared; Results: While there was a significant reduction in the number of orthodontic, endodontic and periodontal procedures there was no impact on oral surgery, restorative procedures or pediatric dentistry; Conclusions: There has been a return in the numbers of patients availing dental treatment, however, there has been a definite shift in the use of certain dental procedures .

The effect of the different dental implants positioning region on the stress performance of the implant-supported prosthesis is not yet clear. This study evaluated the dental treatment with six dental implants in three different models and three different occlusal loading conditions, in terms of the biomechanical response of implants, prosthetic screw and maxilla, using three-dimensional finite element analysis. The finite element models were modelled containing external hexagon implants, as well as a Cobalt-Chromium superstructure. Three types of loads were applied: in the area of ​​the central incisors, first premolar and in the second molars. For the finite element simulations, the von-Mises stress peaks in the implant and in the surrounding cortical bone were analyzed. All recorded results reported higher values ​​for the implant-supported prosthesis in group C compared to the groups A and B. The highest stress values, ​​regardless the evaluated model, was in the prosthesis in group C and in screws, the smallest were in group A.

Introduction: Dental health problems including dental plaque are common health problems affecting people of different age groups globally. Air-polishing is a safe tooth polishing technique used by dental professionals for stain and plaque removal and as preventive procedure for dental health. Here we report the technical improvisation of existing air-polishing technique by supplementing cannabinoid powder into the classic polishing powder for effective removal of supragingival and subgingival plaque and inhibition of plaque forming bacteria. Methods: The cannabidiol (CBD) powder was added to the tooth polishing powder (AIR-N-GO, classic) at 1% (wt/wt) ratio. The study was conducted on 12 patients, of which 6 received regular polishing treatment and 6 received CBD-supplemented polishing treatment. The dental plaque samples were collected before and after each treatment and subjected to in vitro microbiological analysis and the colony forming units (CFU) were analyzed using automated colony counter. Results: Based on in vitro microbiological analysis, the average CFU of interdental space samples collected from post-CBD-supplemented polishing treatment was significantly reduced (linear fold change between 3.9-18.4) compared to that of post-regular polishing (linear fold change between 1.0-2.6) treatment. Conclusions: CBD-supplemented polishing powder can help in effective removal and killing of dental plaque bacteria during the polishing treatment. CBD powder can be added as enhancing supplement to the existing polishing powders.

To identify gender- and age-related associations between adult dental checkups and unmet dental care needs, we analyzed data of 14,000 participants, ages ≥ 19, from the 7th Korea National Health and Nutrition Examination Survey (2016–2018) (KNHANES VII). Data was collected via self-report questionnaires and interviews. Complex sample chi-square test and multiple logistic regression analysis indicated 31.7% of participants had unmet dental care needs; in the prior 12months, 67.1% had not utilized dental services, and 43.3% had not received dental checkups. Odds ratios (ORs) for dental checkups and unmet dental needs were 8.87 (CI:7.80–10.09, p < 0.001) for those who used dental services and 1.28 (CI: 1.13–1.44, p < 0.001) for those who had not. Significant age-dependent associations between those not receiving dental checkups and the rate of unmet dental care include men and women aged 50–59 years (OR: 1.77; CI = 1.22–2.58 and OR: 1.43; CI: 1.02–2.02; p = 0.040, respectively) and women ≥ 70 years (OR = 1.79, CI = 1.20–2.66, p = 0.004). Reducing unmet dental care needs requires greater public health promotion and education regarding regular dental checkups; additional practical strategies could enhance dental checkup compliance.

Teeth include mesenchymal stem cells (MSCs), which are multipotent cells that promote tooth growth and repair. Dental tissues, specifically the dental pulp and the dental bud, constitute a relevant source of multipotent stem cells, known as dental-derived stem cells (d-DSCs): dental pulp stem cells (DPSCs) and dental bud stem cells (DBSCs). Cell treatment with bone-associated factors and stimulation with small molecule compounds are, among the available methods, the ones who show excellent advantages promoting stem cell differentiation and osteogenesis. Recently, attention has been paid to studies on natural and non-natural compounds. Many fruits, vegetables and some drugs contain molecules that can enhance MSC osteogenic differentiation and therefore bone formation. The purpose of this review is to examine research work over the past 7 years that has investigated two different types of MSCs from dental tissues that are attractive targets for bone tissue engineering: DPSCs and DBSCs. We focused on articles hypothesizing the identification and study of compounds that induce proliferation and osteogenic differentiation of the two d-DSC populations, representing an interesting issue for regenerative medicine. The reconstruction of bone defects in fact is still a challenge for personalized medicine.

Computer-aided design/computer-aided manufacturing (CAD-CAM) technology is growing in significance for prosthodontic treatment due to its impact on clinical performance and patient outcomes. It has been integrated into dental education to allow students to experience digital workflows. Despite these advancements, many dental students still lack sufficient knowledge of CAD-CAM technologies. A cross-sectional survey was conducted at the College of Dentistry, Imam Abdulrahman Bin Faisal University. Based on previous studies, a validated questionnaire was distributed to undergraduate dental students and interns. The questionnaire assessed their knowledge and attitudes toward CAD-CAM technology in prosthetic dentistry. The responses were analyzed using descriptive statistics, and a chi-square test was used to study the association between knowledge and practice and the study year level. A total of 170 students participated in the study, with a mean age of 22.2 (±2.5) years. The proportion of female participants was 65.9%, and 34.1% for males. Knowledge varied across academic levels, with 4th- and 5th-year students demonstrating greater theoretical knowledge, while 6th-year students and interns showed more practical experience. Only three of the 18 knowledge-related questions received a correct response rate above 70%. Most participants (86%) reported acquiring knowledge from undergraduate courses, and 88% expressed interest in further training. CAD-CAM technology was most commonly practiced for fixed prostheses, and intraoral scanning was the most frequently used digital workflow. The study highlights the need to improve CAD-CAM education. While lower-level students displayed solid theoretical knowledge, advanced students benefitted from more practical exposure. Increasing hands-on experience and access to digital equipment is essential for preparing students to meet the demands of modern digitalized dentistry.

Background and Objectives: Mechanical and biological complications can lead to system fracture or screw loss on dental implants. Narrow and regular platforms have been used without a consensus about the effect of distance the abutment from the prosthetic platform margin. The aim of this study is to evaluate different insertion torques in the deformation of tri-channel platform connections through two- and three-dimensional measurements with micro-CT. Materials and Methods: 164 implants were divided into groups (platform diameter and type): 3.5, 3.75, and 4.3 mm NP (Narrow Platform), and 4.3 mm RP (Regular Platform). Each implant-platform group was then divided into four subgroups (n = 10) with different torques: T45 (45 Ncm), T80 (80 Ncm), T120 (120 Ncm) and T150 (150 Ncm). The implant-abutment-screw assemblies were scanned and the images obtained were analyzed. Results: A significant difference was observed for the linear and volume measures between the different platforms (p &lt;0.01) and the different implant insertion torques (p &lt;0.01). Qualitative analysis suggested higher deformation resistance for the 3.75 NP compared to the 3.5 NP, and RP was more resistant compared to the NP. Conclusions: The 0.25-mm increment in the implant platform did not increase the resistance to the applied insertion torques; the 4.3-mm implant was significantly stronger compared to the 3.5-mm implant and the proposed micro-CT analysis was considered valid for both 2D and 3D analyses of micro gaps, qualitatively and quantitatively.

Although CAD/CAM ceramics present a promising alternative to metal-ceramic fixed dental prostheses, little is known about their mid- and long-term clinical performance. This systematic review aims to estimate the survival and success rates and describes the underlying complication characteristics for CAD/CAM tooth-supported fixed dental prostheses (FDPs). We systematically searched MEDLINE and Web of Science to find relevant prospective studies with a follow-up of at least one year. We estimated pooled 1-, 5- and 10-year survival and success rates by combining the collected data in a Poisson regression model. Descriptive statistics were conducted to evaluate the distribution of failures and complications in the included studies. Risk of bias for the included studies was assessed with an adapted checklist for single-arm trials. Pooled estimated 1-, 5-, and 10-year survival rates ranged from 93.80% to 94.66%, 89.67% to 91.1%, and 79.33% to 82.20%, respectively. The corresponding success rates, excluding failures but including any other types of intervention, were 94.53% to 96.77%, 90.89% to 94.62%, and 81.78% to 89.25%. Secondary caries was the most frequent cause of failure, followed by chipping of the veneering. The most common cause of complication, excluding failures but requiring intervention, was chipping of the veneering. Risk of bias was generally acceptable for the included studies, with 7 studies associated with low risk of bias, 8 studies with a moderate risk of bias, and 3 studies with serious risk of bias. The current meta-analysis on CAD/CAM supported FDPs revealed satisfying survival and success rates for up to 10 years of exposure. More prospective studies focusing on long-term performance are needed to strengthen the evidence currently available in the literature.

Cone-beam computed tomography (CBCT) has become a vital tool in implantology, playing a key role in both pre- and post-surgical phases. Preoperatively, CBCT provides detailed three-dimensional evaluation of anatomical structures, offering precise information on bone quality and quantity, as well as the location of critical structure. This accuracy enhances surgical planning, reducing intra- and postoperative risks and ensuring more precise implant placement. Post-surgically, CBCT is equally important for monitoring osseointegration and detecting potential complications, such as failed integration, infections, or implant misalignment. Its high-resolution imaging capabilities enable clinicians to make accurate therapeutic adjustments, improving treatment outcomes. Overall, CBCT improves decision-making in implantology, offering greater predictability and safety compared to traditional two-dimensional radiography, significantly enhancing the success rates of implant-based oral rehabilitation procedures.

Today, legislative framework addresses the metal alloys’ corrosion issues, demanding the re-striction of use of the probable carcinogenic, mutagenic and toxic for reproduction at humans (CMG) metals, like nickel, cobalt and chromium, and demand to develop new biomaterials. Therefore, the aim of this research is to evaluate and compare ion release of standard dental alloys and their hypoallergenic equivalents. Six types of orthodontic alloy wires (nickel-titanium (NiTi), coated NiTi, stainless steel (SS), Ni-free SS, cobalt-chromium (CoCr), and titanium-molybdenum (TMA) were immersed into artificial saliva of pH 5.5 and 6.6. Release of metal ions was measured by inductively coupled plasma-mass-spectrometry (ICP-MS) after 3, 7, 14 and 28 days. Data analyses were done using analysis of variance, results with P

Abstract: With a resurgence in ITRT (Immediate Tooth Replacement Therapy) as a method of preserving both hard and thus soft tissues for improved aesthetic outcomes, this multi-centre, retrospective study will look at two novel products and their effect on these outcomes. A new synthetic particulate graft material along with a novel Implant design was utilized in the study and a 1 year follow up assessment, analysed for hard and soft tissue regeneration.

Objective: The purpose of the present study was to analyze the management of dental extractions in patients affected by coagulation disorders in order to prevent bleeding intraoperative and postoperative complications. Subjects and Methods: This study included 17 patients with a diagnosis of a coagulation disorder, who had been subjected to a single or multiple dental extraction. Recombinant activated Factor VII was administered in those patients who were affected by a deficit of factor VII ranged between 10,5% and 21%. The other patients were treated locally with tranexamic acid. Results: A total of 50 teeth were extracted, 7 by surgical extraction and 43 by simple extraction. Of the 17 patients included 9 of them suffering from factor VII deficiency, 5 from factor V deficiency, 1 from Glanzmann's thrombasthenia and 2 from Haemophilia A. Pretreatment with recombinant activated factor VII was performed on a total of 8 patients with factor VII deficiency; the remaining 9 patients underwent tranexamic acid treatment. 1 hemorragic postoperative complication was observed. Conclusions: Surgical and no surgical extractions appear to be a safe procedure for patients affected by coagulation disorders when appropriate prophylaxis is adopted.

Implants are increasingly used in dentistry. Nevertheless, several factors can cause treatment failure. To assess initial wound healing, various indices have been developed. The purpose of this study was to assess the relationship between early wound healing and implant success. Fifty single implants (25 in women and 25 in men) were placed in patients meeting the inclusion. The implants (Ticare®) were placed via the two-stage technique. Patients were assessed at 24 hours, one week, one month, two months and one week postimplantation. At the final evaluation, implantation failure or success was recorded. Postoperative pain in these patients at one week after placement was assessed with a visual analogue scale (VAS), and the Wachtel soft tissue early healing index was used to measure healing. Two months after implant placement, the success rate was 92%. No statistically significant relationship was found between the Wachtel index and short-term implant success or failure. Additionally, there was no relationship between implant success or failure and variables such as smoking, diabetes status, age, sex or guided bone regeneration (GBR). Neither the Wachtel index nor any of the other variables studied is a predictor of early implantation success.

This study sought to evaluate the awareness, comprehension, and practices concerning Forensic Odontology among dental students and faculty at a Dental School in Cyprus. An online, cross-sectional, descriptive survey was disseminated to the entirety of dental students and faculty of the School of Dentistry, European University Cyprus, in November 2022. Of those surveyed, 47 faculty members and 304 students responded, yielding response rates of 66.2% and 80%, respectively. The survey revealed that 87% of faculty and 65% of students were familiar with Forensic Odontology. A noteworthy 94% of faculty and 85% of students recognized teeth as DNA repositories. A high percentage, 98% of faculty and 89% of students, acknowledged the role of Forensic Odontology in the identification of criminals and deceased individuals. Awareness of age estimation through dental eruption patterns was evident in 85% of faculty and 81.6% of students. A substantial proportion (80% of faculty) maintained dental records, while 78% of students recognized the importance of dental record-keeping in ensuring quality care. Interestingly, 57% of students and 64% of faculty were aware of the possibility of dentists testifying as expert witnesses. The majority, 95.7% of faculty and 85% of students, concurred that physical harm, scars, and behavioral alterations predominantly indicate child abuse. The survey underscored a robust awareness of Forensic Odontology among respondents. Despite faculty's comprehensive understanding, there's a pronounced need to bolster their inclination towards attending relevant seminars. Emphasis on improved record-keeping practices for potential forensic applications is paramount.

Since the development of CBCT had been utilized in dentistry, the images of the CBCT can assist the surgeon to evaluate the anatomy carefully. Despite the value of the radiology evaluation, the implant procedures may require additional consideration rather than only evaluating the anatomical factors. The purpose of this study is to evaluate the predictability of using CBCT alone to plan for implant placement on the edentulous patient digitally CBCT images were analyzed by clinicians, measuring the ridge heights and widths of 4 selected implant sites in the maxillary and 2 selected implant sites in the mandibular arches for 91 patients planning for the implant-supported overdenture. (A total of 47 patients out of the 91 had completed the implant placement on the edentulous ridge, contributing to 55 upper and/or lower arches (136 dental implants). . Both predictabilities are low, implying the CBCT planning for implant placement on the edentulous ridge is not a good index and is insufficient to predict the surgical procedures as a solo method. The finding of this study indicates that digital planning by CBCT is insufficient to serve as an individual tool to predict implant procedures. Further information and evaluation must be considered for implant placement on the edentulous ridge.

This research addresses a gap in the literature by conducting a comprehensive analysis of patients’ level of satisfaction with dental care. Methods: By combining quantitative and qualitative survey methods with the PSQ questionnaire this study aims to augment ongoing initiatives to enhance dental patients’ experiences by painting a more comprehensive depiction of patients' level of satisfaction; Results: When asked about their overall level of satisfaction 77,1% of the patients said they received excellent services from the office personnel and 72,2% said they trust their doctors; Conclusions: Assessing patient satisfaction in the realm of dental services quality is crucial for enhancing service quality and accuracy, benefiting both patients and dentists, and ultimately improving public health.

Background: SARS-CoV-2 has resulted in a global pandemic, COVID-19. The disease has spread outrageously from Wuhan, china to rest of the world affecting millions of people. The human transmission is mainly known to occur by aerosols. As almost every dental procedure is associated with aerosol production, oral health care professionals are at a high risk of getting the infection. An attempt has been made to render cohesive practical suggestions for dental professionals amid COVID-19 outbreak. Objectives: The paper aims at providing evidence based information in managing dental patients during this pandemic. Material and Methods: The paper provides a broad overview of predominant findings based on electronic database search regarding COVID-19 outbreak and its effect on dental practice. Conclusion: Dental care should not be neglected due to the pandemic. Thorough knowledge about the disease and its prevention will not only help us in providing care to these patients but will also help in preventing the nosocomial spread of infection.

Background and Objectives: Total rehabilitation of atrophic maxillae with zygomatic implants (ZI) has become a more common practice nowadays. However, the need for training and expertise of surgeons to correctly perform the technique in order to minimize possible complications has been described. The objective of this article is to describe an atypical case of tearing for 24 hours after the installation of a zygomatic implant. Materials and Methods: A 58-year-old male patient, with dark skin, without systemic alterations, who during the installation of one of the ZIs suffered a greenstick fracture of the zygomatic body, thus, a second, deeper milling was performed in the zygomatic body. Results: After the uneventful surgical procedure, the molding was performed, and the patient complained of excessive tearing in his right eye with regression 24 hours after surgery. The implant-supported prosthesis was installed one week after surgery and the patient continues to rehabilitate without functional or aesthetic complaints.Conclusions:Therefore, since the literature on the subject of postoperative complications of ZIs is still scarce, we believe that since the milling and installation of IZs are always close to the foramen of the zygomaticofacial nerve, this type of complication may become more frequent due to the increase in indications for rehabilitation using ZIs.

Although the connection of implant abutments to implant analogs and implant bodies has been evaluated separately, comparative evaluation of connections to implant analogs and implant bodies has not been evaluated. The objective of this study was to identify whether torque applied during laboratory manufacturing and during restoration cementation affects the compatibility between the implant body-abutment and the implant analog-abutment, as well as to spot any structural differences. Three different implant system with internal conical connection (Bioinfinity, Dant, and Dentist) were used. For each group, straight abutments (n=20) were tightened to implant analogs (n=10) and implant bodies (n=10) with hand tightening and using torque wrench device. The fitting of componenets were evaluated for each group using linear and volumetric micro-CT analysis. For linear analysis, when the mean differences (difference between measurements of the linear distance of abutments during hand tightening and applying torque) values between implant analog and implant body were compared within groups, There was no statistically significant difference observed in all groups (p&gt; 0.05). Throughout the fabrication and clinical phases, it is recommended to tighten the abutments on the analogs with a torque wrench instrument to minimize the risk of prosthetic incompatibility.

Anemia is a condition of decreased red blood cell number or hemoglobin concentration, or of disturbance in their function, ultimately leading to decreased oxygen transport to tissues. Many factors and diseases may lead to anemia, with wide manifestations systemically as well as orally. Therefore, a sound understanding of this condition is essential for the dental practitioner, with emphasis on alerting signs, dental management and proper communication with patient’s physician.

Dental scaling has high importance in oral health due to its effect on preventing the teeth root destruction. Moreover, it can influence other health aspects such as reducing the risk factor of infective endocarditis. There are various devices applicable to dental scaling. It is essential to select the most appropriate type of instrument to achieve more efficient scaling. Multi-Attribute Decision Making (MADM) is a mathematical approach widely applied in for selecting the best alternative based on essential criteria. In the present research, several criteria including cost, ease of use and sterilization, durability and effectiveness considered as criteria for device selection. The experts in the related field were asked to score the criteria and corresponded alternative. According to the results, obtained by applying the TOPSIS method, Piezon Master is the most option which is mainly due to its durability and effectiveness. The second rank belongs to Cavitron due to its ease of use and sterilization in addition to affordable cost.

Objectives: Aim to assess the perceptions of virtual learning among dental residents and faculty and employ Regulatory Focus Theory (RFT) to understand the impact of motivational orientations on virtual learning during COVID pandemic. Methods: 46 dental residents and 10 faculty in Upstate New York participated in the study (June -August 2021). Questionnaires were used to collect demographics, perceptions of virtual learning, burnout, and RFT types (promotion and prevention focus). Multiple regression analyses were used to examine factors associated with perceptions of virtual learning and burnout. Results: Overall, 70% of residents and 44% of faculty found virtual learning effective. Younger residents with less experience preferred virtual learning more than their older, experienced peers. Residents trained outside the U.S. and Canada favored in-person learning more than those trained within. Furthermore, residents with a higher promotion focus score found virtual learning more interactive for didactic courses. Additionally, 52% of residents experienced burnout, with a higher incidence among females (p=0.044). Conclusions: Virtual learning is well-received by dental residents and faculty, with potential for continued use post-pandemic. Future efforts should focus on creating an inclusive and supportive educational environment that meets the motivational and well-being needs of dental residents and faculty.

Odontogenic infections are infections of the orofacial structures arising from dental disease. Despite its preventability, it exerts a significant burden on healthcare infrastructure worldwide. Our study explored the various different microbiological, social, and epidemiological characteristics of 103 cases of odontogenic infections at our regional center which demonstrated specific predilections for the young and middle-aged, those with diabetes mellitus, African American/Black and Hispanic ethnicities, posterior teeth, left-sided dentition, and male gender. However, nuances and exceptions to these trends were also seen with specific groups that may complicate treatment.

The objective was to compare the color match and color stability behavior of single and multishade resin-based composites (RBCs) used for direct restorations. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized clinical trials evaluating the shade performance of single-shade RBCs in direct restorations were included. A search of the scientific literature was performed in 5 databases (April 2024). The meta-analysis was performed using RevMan 5.4, calculating the risk difference (RD) and 95% confidence interval (CI) of the dichotomous outcome using a random effects model. Bias was assessed using the RoB 2.0 tool, and certainty of evidence was assessed using the GRADE tool. Four studies with 263 restorations analyzed were selected. The results showed comparable performance between single-shade RBCs and multishade RBCs in terms of color match and color stability over 12 months. Three studies had a low risk of bias with all expected results, and one study had some concerns. The certainty of evidence for color stability was considered low for all follow-up periods due to the small number of events and sample size. According to the United States Public Health Service Evaluation (USPHS) and the World Dental Federation (FDI), there is comparable clinical color performance between single-shade and multishade RBCs over 12 months.

Background: Acceleration of mass vaccination strategies is the only pathway to overcome the COVID-19 pandemic. Healthcare professionals and students have a key role in shaping public opinion about vaccines. This study aimed to evaluate the attitudes of dental students globally towards COVID-19 vaccines and explore the potential drivers for students' acceptance levels; Methods: A global cross-sectional study was carried out in February 2021 using an online ques-tionnaire. The study was liaised by the scientific committee of the International Association of Dental Students (IADS), and data was collected through the national and local coordinators of IADS member organizations. The dependent variable was the willingness to take the COVID-19 vaccine, and the independent variables included demographic characteristics, COVID-19-related experi-ence, and the drivers of COVID-19 vaccine-related attitude suggested by the WHO-SAGE; Results: A total of 6639 students from 22 countries representing all world regions responded to the ques-tionnaire properly. Their mean age was 22.06 ± 2.79 (17-40) years, and the majority were females (70.5%), in clinical years (66.8%), and from upper-middle-income economies (45.7%). In general, 22.5% of dental students worldwide were hesitant, and 13.9% rejected COVID-19 vaccines. The students in low- and lower-middle-income (LLMI) economies had significantly higher levels of vaccine hesitancy compared to their peers in upper-middle- and high-income (UMHI) economies (30.4% vs 19.8%; p < 0.001); Conclusions: The global acceptance level of dental students for COVID-19 vaccines was suboptimal, and their worrisome level of vaccine hesitancy was influenced by the socioeconomic context where the dental students live and study. The media and social media, public figures, insufficient knowledge about vaccines, and mistrust of governments and the pharmaceutical industry were barriers to vaccination. The findings of this study call for further implementation of epidemiology (infectious diseases) education within undergraduate dental curricula.

Purpose: The aim of this study was to compare the topical anesthetic effect of a 10% atomized lidocaine spray and an EMLA cream at different time intervals using parameters of visual analogue scale (VAS) score and heart rate (HR). Methods: The randomized split-month study included 30 patients (17 boys, 13 girls) aged 8.22 ± 1.8 years. Application of atomized lidocaine spray or cream was randomly used in the upper second premolar region. The parameters was measured before and at each needle insertion after 10,30,60 and 120 sec. Paired t -test and independent t-test were used for statistic analyses. Results: Compared to the first applications (10 sec), atomized lidocaine and EMLA cream applications significantly decreased scores of VAS at the applications at 30 and 120 seconds, respectively. Despite atomized lidocaine showed early effect compared to EMLA, there were no significant differences in VAS scores between the atomized lidocaine and EMLA cream at the 60 and 120 seconds measurements. Although HR significantly increased at first anesthetic administration with the atomized lidocaine spray, HR significantly decreased at 30 and 120 seconds administrations. Conclusion: Atomized 10% lidocaine-based topical anesthetics significantly reduced pain more rapidly and better than EMLA from needle pricks in the buccal mucosa. Therefore, atomized lidocaine topical anesthesia could be used as a substitute for EMLA cream before buccal anesthetic administration. On the other hand, further comprehensive studies are required to explore the effects of several doses of atomized lidocaine in various areas of the oral cavity.

Cleidocranial dysplasia (CCD) – is an autosomal dominant skeletal dysplasia with a prevalence of 1 in 1 million individuals. This rare disorder is associated with clavicular hypoplasia or aplasia, delayed closure of fontanels, brachycephalic skull, delayed exfoliation of primary teeth , delayed eruption of permanent and, multiple supernumerary teeth, and morphologic abnormalities of maxilla and mandible. The purpose of this paper is to describe the multidisciplinary surgical, pediatric stomatologic and orthodontic treatment of CCD. A case of a young boy suffering from CCD along with the long-term management, is described in the present report. The patient was 8 years and 5 months old when first presented in the clinic and has been treated for another ten years by the interdisciplinary team comprised of the pediatric dentist, the orthodontist, and the maxillofacial surgeon. The report encompasses a detailed description of the clinical and radiographic findings as clinical, surgical, and orthodontic interventions. The treatment of such cases requires long-term management, close cooperation of specialists, and proper dental age assessment.

Background: Patients with thromboembolic disease, prosthetic valves, or coagulation issues are commonly prescribed anticoagulants and antiplatelets. Although common professional oral hygiene might not represent a health concern for these patients, anticoagulant and antiplatelet medication might constitute a challenge for dentists and dental hygienists since possible prolonged bleeding might interfere with dental procedures. The aim of the present study was to investigate the bleeding time of different anticoagulants and antiplatelets during a professional hygiene session adapting the Ivy test to the oral environment; Methods: 93 consecutive patients undergoing professional oral hygiene were recruited. Debridement during oral hygiene was performed using ultrasonic mechanical instrumentation, and bleeding sites were assessed and treated with gentle pressure using sterile gauzes. The time for bleeding cessation was recorded. Patients were categorized into six groups based on their drug intake, Control: no anticoagulants or antiplatelets DTI: direct thrombin inhibitors (dabigatran) AntiXa: directa factor Xa inhibitors (endoxaban, apixaban, rivaroxaban) VKA: vitamin K antagonists (warfarin, acenocoumarol) SAPT: single anti-platelet therapy (acetylsalicylic acid or clopidogrel) DAPT: dual anti-platelet therapy (acetylsalicylic acid and clopidogrel). Bleeding time was measured in seconds and mean values were assessed among the different groups. Differences between groups were investigated with Kruskal-Wallis test followed by Dunn’s post-hoc correction for multiple comparisons or two-way ANOVA followed by Dunnett post-hoc; Results: Control patients presented the lowest bleeding time 50 sec, followed by AntiXa (98), SAPT (105), DTI (120), DAPT (190) and VKA (203). A statistically significant difference was present among control and DTI (p=0.004), VKA (p&lt;0.001), DAPT (p&lt;0.001). Conclusions: Based on the present outcomes, an increased risk of prolonged bleeding emerged in patients taking VKA and DAPT. However, bleeding did not interfere with the oral hygiene ses-sion The optimal period for dental treatment of these patients should be 2-3 hours before the next dose, without the need to temporarily suspend the medication.

Background: Fiber-reinforced composites (FRCs) have been proposed as an alternative to traditional metal alloys for the realization of frameworks in full-arch implant supported prostheses. The aim of the present in vitro study was to evaluate the deflection under load of seven prostheses endowed with frameworks made of different materials, including different types of fiber reinforced composites (FRCs). Methods: A master cast with four implant analogues in correspondence of the two lateral incisors and the two first molars was used to create full-arch fixed prostheses with the same shape and different materials. Prostheses were made in different materials (framework+veneering material): gold alloy+resin (Au+R), titanium+resin (Ti+R), FRC with multi-directional carbon fibers+resin (ICFRC+R), FRC with unidirectional carbon fibers+composite (UCFRC+C), FRC with glass fibers+resin (GFRC+R), FRC with glass fibers+composite (GFRC+C), resin (R, full-acrylic prosthesis). Flexural tests were conducted using Zwick/Roell Z 0.5 machine and the deflection of the lower surface of the prosthesis was measured in order to obtain load/deflection graphs. Results: Greater rigidity and less deflection were recorded for UCFRC+C, GFRC+C, followed by Ti+R, and Au+R. The greatest deformations were observed for resin alone, ICFRC+R and GFRC+R. The results were slightly different in the incisal region probably due to the greater amount of veneering material in this area. Conclusions: When used to realize full-arch frameworks, Au and Ti allow a predictable mechanical behavior with gradual deformations with increasing load. UCFRC also demonstrated good outcomes and less deflection than ICFRCs when loaded. The GFRC full-arch framework may be a valid alternative, however showed greater deflections. Further studies are needed in order to evaluated how different prosthesis design and material thickness might affect the outcomes.

A healthy 47-year-old woman consulted the Oral Surgery and Implantology Unit of the University Hospitals of Geneva with a request to treat her painful tooth 11 and replace the missing tooth 21. The dental history revealed that the patient had lost teeth 21 and 22 due to advanced caries. On clinical examination, tooth 11 showed an ill-fitting prosthetic crown with overhanging margins, an increased localized probing depth of 8 mm in the disto-vestibular area and sensitivity to percussion. The edentulous site 21 showed horizontal bone atrophy. Radiological examination revealed a well-defined unilocular radiotransparent lesion surrounded by a thin radiolucent border, located at the apex of tooth 11 and measuring 10 x 8 mm. The treatment consisted of extraction of 11, enucleation of the apical lesion, insertion of implants at sites 11 and 21 with simultaneous bone augmentation in a single surgical procedure with aesthetic and functional results at 3-year follow-up without any complications. Our case highlights that immediate implant placement in case of cystic periapical lesion represents a good valid alternative to standard treatment.

This study aimed to analyse the effect of chlorhexidine digluconate (CHX DG) mouthwash on the adhesion of oral bacteria to orthodontic appliances. The interactions of four bacteria (S. mutans, A. actinomycetemcomitans, S. oralis, and V. parvula) with two alloys (stainless steel [SS] and nickel-titanium [NiTi]) and three CHX DG solutions (commercial products Curasept and Perio Plus, and pure CHX DG, all with 0.12% active substance) were tested. The adhesive effect on the orthodontic wires was evaluated after 24 h for S. oralis and after 72 h for the other bacteria. The minimum bactericidal concentration of the solution for each bacterial strain was determined using the dilution method to test the antibacterial action. Salivary-pretreated orthodontic arch wires were exposed to minimal bactericidal concentrations of solution and bacteria. Commercial antiseptic products, especially Perio Plus, showed better inhibition of bacterial adhesion to both alloys than pure CHX DG solution (p&lt;0.05). A. actinomycetemcomitans was most inhibited in the adhesion of all bacteria by the CHX DG products. Greater inhibition of streptococci adherence was observed on SS, while A. actinomycetemcomitans on NiTi. Inhibition of V. parvula was product dependent. In conclusion bacterial adhesion depends on the alloys, antiseptic products, and the bacteria. CHX DG is effective at inhibiting bacterial adhesion to orthodontic elements and is recommended for the chemical control of biofilms during orthodontic treatment with fixed appliances.

Primary stability is an important factor for dental implant success. In the past years, a new method for bone site preparation was introduced, named osseodensification (OD). OD produces a condensation of the trabecular portion of the bone, increasing bone-to-implant contact and primary stability. This study aims to compare the effect of OD in cylindrical and conical implants to conventional instrumentation. A total of 40 implants, divided in 4 groups, were placed in porcine tibia: cylindrical conventional (1a); cylindrical OD (1b); conical conventional (2a); and conical OD (2b). Each implant was measured for implant stability quotient (ISQ), insertion torque (IT) and removal torque (RT). Group 2b showed the higher values for each of the evaluated parameters; groups 1b and 2b showed better results than 1a and 2a, respectively. Regarding IT and RT, group 1b achieved higher values than group 2a, but not for ISQ. The inter-groups comparison showed significant difference between groups 1a vs 2a, 1a vs 2b and 1b vs 2b for ISQ, and 1a vs 1b and 1a vs 2b for RT analysis. OD resulted in improved ISQ, IT and RT of both cylindrical and conical implants. Conical implants groups showed higher ISQ, but cylindrical OD resulted in higher IT and RT, compared to conical conventional ones.

Introduction: Dental segmentation in panoramic radiograph has become very relevant in dentistry, since it allows health professionals to carry out their assessments more clearly and helps them to define the best possible treatment plan for their patients. Objectives: In this work, a comparative study is carried out with four segmentation algorithms (U-Net, DCU-Net, DoubleU-Net and Nano-Net) that are prominent in the medical literature on segmentation and we evaluate their results with the current state of the art of dental segmentation in panoramic radiograph. Methods: These algorithms were tested with a dataset consisting of 1,500 images, considering experiment scenarios with and without augmentation data. Results: DoubleU-Net was the model that presented the best results among the analyzed models, reaching 96.591% accuracy and 92.886% Dice using the dataset with data augmentation. Another model that stood out was Nano-Net using the dataset without data augmentation; this model achieved results close to that of the literature with only 235 thousand trainable parameters, while the literature model (TSASNet) contains 78 million. Conclusions: The results obtained in this work are satisfactory and present paths for a better and more effective dental segmentation process.

The aim of this study was to compare the screw removal torque of mini conical prosthetic components and straight trunnion of indexed morse taper implants, after mechanical cycling. The sample consisted of 40 implants and 20 mini-conical prosthetic components (MC group) and 20 straight trunnion components (ST group). Each group consisted of 10 specimens, with 2 implants in each, and cobalt-chromium metallic crowns were screwed into each sample. The components of the MC group received a torque of 20 N.cm with a digital torque wrench and after 10 minutes were retightened with the same value as the initial torque. The components of the ST group received a torque of 30 N.cm, with a digital torque wrench and after 10 minutes, they were retightened with the same value. The screws of the respective crowns of the two groups received a torque of 10 N.cm and after 10 minutes were retightened with the same value. Each group was subjected to the fatigue test in a mechanical cycler at 2.000.000 cycles, with a load of 250 N and frequency of 4 Hz. At the end of the fatigue test, the loosening torque of each screw of the specimens was measured through a digital torque wrench. The data were analyzed by two-way ANOVA and Tukey test. In both groups, there were loss of torque. The results showed no statistic difference between MC and ST groups.

Abstract: The study aimed to determine the factors associated with the avoidance of dental preventive care in adolescents and their parents in the framework of The Youth and Parents Risk Factor Behavior Survey in Slovakia has been initiated during the years 2015/2016. The data were collected using two separate standardized questionnaires: (i) the questionnaire for adolescents (n=515) and (ii) the questionnaire for parents (n=681). The study group consisted of 57 adolescents (54.4% males) who did not visit the dentist for preventive care in the previous year. The control group consisted of 458 adolescents (35.8% males) who visited a dentist for preventive care at least once in the previous year. A significantly higher number of males (54.4%), older adolescents (21.4%) were not visiting dental preventive care regularly. Incomplete family (56.1%), stressful situations at home (17.5%), and feeling unwell were observed as the factors contributing to the avoidance of dental preventive care. More than 34.5% of adolescents were not visiting either dental preventive care but also pediatric preventive care (AOR=5.14; 95%CI=2.40, 10.99). Divorced mothers and mothers with household income lower than 900 € had significantly higher dental care avoidance in their children. A significantly higher percentage of fathers from the exposed group were not visiting dental preventive care regularly (47.8%; p&lt; .05). The results of the study can be used as an educational intervention steps focusing on the influence of parental and adolescent behavior in dental preventive care.

Dental healthcare providers, staff and patients are constantly exposed to the risk of infection or cross-infection in the dental office, particularly due to the formation of biofilms within Dental Unit Waterlines (DUWLs). Good water quality, achieved with environmentally friendly means, is essential in ensuring the safe operation of the clinic. The aim of this study was to evaluate the practices and protocols used in dental offices of Metropolitan Athens in Greece with regards to water quality in DUWLs. The questionnaire about water quality was distributed to dental practitioners in 2022 and was completed by 206 dentists. Water supplied to dental units was mainly from the public network (65.0%), with 55.8% using in-office filtration. Most dentists (71.8%) do not know the active substance of the antiseptic used for the DUWLs, while 96.1% reported having an antiseptic reservoir embedded in the dental unit. Daily flushing with a small and a large amount of fluid was practiced in approximately 83% and 61% of dental offices, respectively. Dental associations should raise awareness regarding water quality and maintenance of DUWLs in dental offices, investing in lifelong learning, while implementing protocols and green strategies.

Keywords: Artificial Intelligence in Implantology; AI in Dental Implantology; Machine Learning in Dental Implantology; Deep Learning in Implant Dentistry; Robotics in Dental Implantology; AI-Based Implant Planning.

This work presents a new, original and very interesting approach to a calculus pro-blem of beams with intermediate supports by Transfer-Matrix Method, a very easy method to program to quickly obtain good results. To exemplify the applicability of this approach is given in dentistry, the calculus of a dental bridge on three poles. The dental restorations are very important for improving the general state of health as a result of improving mastication and aesthetic appearance. The approach of this study consists of to present a theoretical study about an indeterminate beam with intermediate support and after, to particularize for an application of a dental restoration case, with a dental bridge on three poles and with two missing teeth between the three poles, assimilated to a simple static indeterminate beam. The results obtained in the presented case study were validated with those obtained by the classical calculation of the Resistance of Materials, with the equation of the three moments of Clapeyron. Due to the ease and elegance of solving various problems with TMM, their approach will continue with other new and original case studies with different modeling and requests, and they will be presented in future research.

This in vitro study evaluated the protective effect of a Si-containing toothpaste associated with different fluoride concentrations by reducing the depth of demineralized lesions in dentin after cariogenic pH cycling. Methods: Sixty bovine dentin blocks (4x4x2mm) were randomly assigned into five groups (n = 12/group): RGS1 (Si-toothpaste with 1450 ppm F), RGS2 (Si-toothpaste with 1100 ppm F), RGS3 (fluoride-free Si-toothpaste), negative control-NC (fluoride-free toothpaste), and positive control-PC (1450 ppm F toothpaste). The specimens underwent a three-day pH cycling model simulating the oral environment with twice-daily brushing. Mineral loss (ΔF) and lesion depth (ΔFmax) were assessed using quantitative light-induced fluorescence (QLF), and scanning electron microscopy (SEM) provided morphological analysis. Elemental analyses were determined with an energy-dispersive X-ray spectrometer (EDS). ANOVA/Tukey's test were used for data analysis (α = 5%). Results: The groups treated with fluoride silicon-toothpastes (RGS1, RGS2) significantly reduced the mineral loss and lesion depth compared to the PC group. The NC group exhibited the greatest mineral loss and lesion depth. SEM images revealed occluded superficial dentin tubules and a protective mineral layer in groups treated with Si-toothpaste, whereas no deposition (NC group) or a limited mineral deposition (PC group) was observed in the control groups. EDS confirmed Si in the toothpaste formulations. Conclusions: Findings suggest that Si-toothpastes favored protection against dentin demineralization even at a lower concentration or free of fluoride, with dentin tubule occlusion, thus consisting of a promising oral care product over traditional fluoride toothpastes.

Introduction: Early childhood caries is a significant public health problem among preschool children. The COVID-19 pandemic, which restricted dental services, altered family dynamics, affected child development, and created new demands on caregivers, may have exacerbated this issue. Objective: Analyze the occurrence and severity of caries and identify associated factors in preschool children attending public municipal daycare centers in Salvador, Bahia, Brazil, Methodology: A cross-sectional epidemiological study was conducted to investigate caries in children aged 2 to 5 years in 2022 and 2023. Caries was assessed using the decayed, extracted, filled, and missing teeth (DEFT) index, and prevalence was calculated. Sociodemographic, family dynamic, dietary, and healthcare utilization data were obtained through a questionnaire. After descriptive and exploratory analyses, robust Poisson multivariable regression was conducted at a 5% significance level, considering socioeconomic, psychosocial, and behavioral aspects. Results: A total of 440 preschoolers participated, with a mean age of 55 months. The majority were Black or mixed race (88.86%) and female (52.73%). The prevalence of caries was 30.91% and the mean DEFT score was 1.1. In the multivariable analysis, low family income (up to one minimum wage) and not playing outdoors during the pandemic were associated with a higher prevalence of caries. Conclusion: The prevalence and severity of caries remain high, and the pandemic has contributed to the maintenance of this epidemiological scenario. Public health measures and policies promoting social justice should be planned to improve oral health conditions in childhood.

The paper presents theoretical notions with practical applications for establishing of one dental bur lifetime (durability and reliability based on the active part wear considering a series of statistical indicators. For the justification application of theoretical notions in practice, a conical-cylindrical dental bur was studied experimentally, to obtain a series of data in the work process, necessary for statistical calculation. The parameter taken into consideration in this paper is mass lost through the dental bur active part wear, tested. This is useful for the dental bur lifetime establishment and its extension or even optimization in operation. The loss of mass of the dental bur active part is analyzed in the work process by the results and experimental data obtained and validated by a numerical calculation statistical-mathematical. The numerical calculation approximates very well the mass lost through the wear at different rotation speeds and operation times, with those experimentally determined ones, based on which it was established lifetime. The results showed that the dental bur works with high yield in the first 20 hours of work, , after which it should be replaced with a new one.

Childsmile is Scotland’s national child oral health improvement programme designed to reduce inequalities in oral health and ensuring universal access to NHS dental services by working closely with children and their families. Research has shown that parents with more dental concerns are less likely to bring their children for regular preventive dental check-ups. Therefore, a communication toolkit named ‘Chatterbox’ was created to help families access dental care services. This study aimed to evaluate the acceptability of Chatterbox from the perspective of parents with young children and from staff who work with them. Thirty parents of young children, volunteers, and staff affiliated with three third-sector family support organisations in Dundee participated in in-depth interviews, focus groups, and observations to assess the objectives of Chatterbox. Framework analysis was conducted to capture the themes, patterns, and findings triangulated using observations and field notes. Chatterbox was found to promote effective communication, identify barriers to dental attendance, provide a platform for reflection, convey the complexities of daily life, and boost parents' confidence to seek assistance. Chatterbox has the potential to help parents in accessing preventive dental care for their young children, when used with trained support workers.

(1) Background : When placing implants in the maxillary posterior region with insufficient alveolar bone, a maxillary sinus elevation is necessary. Autogenous bone, though biologically ideal, poses risks and discomfort due to donor site harvesting. Block-type autogenous tooth bone graft material, made from the patient’s own extracted tooth, offers similar biological stability without these drawbacks; (2) Methods : This study observed the progress of 19 implant patients who were treated with maxillary sinus elevation procedures using block-type autogenous tooth bone graft material at the Daegu Catholic University Medical Center. Extracted teeth were processed into demineralized tooth block bone. After elevating the sinus membrane, implants and the tooth bone graft material were placed in the space, and the bony window was repositioned. Postoperative evaluations through clinical observation and radiographic imaging assessed sinus membrane elevation, alveolar bone height increase, and implant osseointegration; (3) Results : Results showed proportional increases in alveolar bone height to the graft material size, with long-term stability. No postoperative complications occurred, even with sinus membrane perforation, and implants remained stable; (4) Conclusions : The study concludes that maxillary sinus lifts using block-type autogenous tooth bone graft material provide excellent bone induction and biocompatibility, making it a highly beneficial method for both dentists and patients.

Immediate load of full-arch rehabilitations over implants, specially over 4 implants are very well documented in the literature. More recently, the use of computed surgical guides to help the planning and the execution of these treatments, in many situations without the need of raising a flap, and diminishing the appearance of hematomas, bleeding and with less trauma to the patient has gained preference among implantologists. The objective of this case report is to show a clinical case of an immediate load full-arch fixed rehabilitation over 4 implants produced by 3D printing manufacturing technology, and placed with a computed surgical guide, in the same appointment, and the 24 months follow-up. The patient returned after 3 months to replace the immediate temporary fixed prosthesis for a new one, with metallic bar, better teeth and more delicate. Soft and hard tissue around the implants seemed to be stable, without signs of inflammation, either on the 3 or the 24 months follow-up. 3D printing of implants by direct metal laser sintering is a technology that seems to be promising for oral implantology, with solid studies showing reliable results, as seen in this single case. More clinical studies are necessary to testify its efficacy.

Abstract: Background: Dental fear and uncooperative behavior can hinder dental treatment quality. Pediatric Procedural Sedation and Analgesia (PPSA) is used to facilitate treatment when coping capacity is exceeded. Out-of-hospital PPSA has been associated with more adverse outcomes compared to hospital-based settings. Updated Dutch PPSA guidelines recommending two anesthesiologists and a ventilator during out-of-hospital PPSA have increased costs and raised concerns about the accessibility to specialized high quality dental care for children in the Netherlands. Aim: This study aims to investigate the impact of the updated 2017 guideline on the occurrence rate of adverse events during PPSA, as recorded in the anesthesia complication database of twelve participating Dutch dental clinics, with adjustments made for age, weight, and duration of treatment. Method: Data of 25,872 children treated at 12 dental clinics performing out-of-hospital PPSA between 1997 and 2019 were analyzed. Eligible children were aged 2-18 with ASA classification I and II. A logistic two-level mixed-effects model is used to estimate the updated guideline’s impact on adverse events. Results: In the final model we analyzed the data of 21,759 children in nine dental clinics. The OR of the occurrence rate of an adverse event adjusted for age, weight, and duration of treatment was 0.75 (95% CI 0.64 – 0.89) after the implementation of the updated guideline, compared to before the updated guideline. This outcome was significant with a P=0.001, indicating a protective effect. The average odds per clinic of having an adverse event was 0.04 with a 3.81% chance. Conclusion: Our findings demonstrate a significant reduction in adverse events after the implementation of the updated guideline and highlight the importance of adherence to evidence-based guidelines in improving patient safety and the quality of care provided during pediatric procedural sedation and analgesia in out-of-hospital dental clinics. Our study underlines the necessity of considering the complex underlying mechanisms that play a role in the development and implementation of evidence-based practice and safety initiatives on the occurrence of adverse events.

This study aims to develop a novel retention method combining the retrievability of the screw retention method with the ideal occlusal table and the aesthetics capability of cement retention. Coping was developed to have lateral screw access allowing the screw to lock coping using lateral forces from screw tightening and friction between the tip of the screw and the sandblasted surface of an abutment. Sandblasting parameters varied based on particle size. Results show a positive correlation to surface roughness and indicate a positive correlation to retention force. The highest surface roughness and retention force result was shown by groups that were sandblasted using 686 μm of aluminum oxide. Experiment on the tightening strength of 48 subjects measured in simulated conditions similar to assembly conditions of lateral screw retention implant resulted in a mean of 69.75 Nmm with the highest and lowest values of 120.67 Nmm and 34.67 Nmm. This result became the basis of tightening torque variation. Each group's retention capability is measured and compared to cement-retained dental implants. Results show that tightening torque correlates positively with retention force, with the highest average retention score showed by lateral screw retained under tightening torque of 200 Nmm with 317.87 N higher than cement-retained.

Dentifrice performance in the removal of dental plaque is influenced by the interactions of dentifrice components with tooth surfaces. This randomized controlled clinical study assessed the effectiveness and safety of a novel fluoride dentifrice formulation that included a micro-fibrillated cellulose network with entangled microcrystalline cellulose and silica particles (ProtegeraTM), and compared this to a positive control fluoride dentifrice (Crest Cavity Protection™). Whole mouth dental plaque levels in 82 healthy adults were measured after the first supervised use, and following a week of twice daily use at home. Overall, the novel dentifrice was at least three times more effective in whole mouth plaque reductions than the reference dentifrice (p < 0.001), with a 38.6% reduction on first use, a 30.9% reduction at day 7, and a 41.6% reduction from day 1 to day 7, compared to reductions of 12.0%, 9.6%, and 11.6% respectively for the positive control. No safety issues arose from the use of the novel dentifrice. These results indicate that including micro-fibrillated cellulose enhances plaque removal effectiveness, without causing adverse changes to oral soft tissues.

Effective oral care is a critical requirement to maintain high quality of life. Most oral diseases are caused by plaque (oral biofilm), which is also correlated with systemic diseases. A common method to remove biofilm is brushing teeth with a toothpaste. However, 3.5 billion people in the world have oral diseases, meaning that more efficient methods of removing biofilms are needed. We have developed a toothbrush applying bioelectric effect (BE) utilizing an electric force for biofilm removal. It demonstrated significantly higher biofilm removal efficiency than non-BE manual toothbrushes. Tests were performed in saline and toothpaste conditions using various pressure. Results showed that the BE toothbrush had a significantly higher biofilm removal efficiency in saline (0.5 N: 215.43 ± 89.92 %, 2.5 N: 116.77 ± 47.02 %) and in a toothpaste slurry (0.5 N: 104.96 ± 98.93 %, 2.5 N: 96.23 ± 35.16 %) than non-BE manual toothbrushes. Results also showed that BE toothbrushes were less dependent on toothpaste. This study suggests that the application of BE can be a new solution to plaque problems in oral care.

Very poor oral health, common among older adults, is associated with cognitive decline.This study aimed to investigate the association between denture use, chewing ability, and cognitive function in Korean middle-aged adults using samples representing middle-aged people at the national level. This longitudinal study included 9,998 middle-aged adults via Korea Longitudinal Study of Aging 7th special survey data. Denture use, chewing ability, health-related factors, and general characteristics were assessed by the Computer Assisted Personal Interview. After controlling general characteristics using a generalized estimating equation model, the association of denture use and MMSE scores with chewing ability of those with or without dentures and MMSE scores were analysed. Twenty-four percent of participants wore dentures among them, 35.1% complained of difficulty chewing when wearing dentures. Among participants who did not wear dentures, 16.4% complained of difficulty chewing. MMSE scores were lower among denture-wearers than non-denture wearers (β = -0.026, p < 0.001). In both groups, MMSE scores decreased with chewing difficulty and were significantly reduced among non-denture wearers (p < 0.05). Chewing ability was closely associated with cognitive function. Given the negative effect of difficulty chewing on cognitive function, maintaining chewing ability should be of great concern.

Titanium (Ti) and Ti-based alloys are commonly used in dental implants, and surface modifications of dental implants are important for achieving osseointegration (i.e., direct connection between the implant surface and bone). This study investigated the effect of an eco-friendly etching solution—a hydrogen peroxide–sodium bicarbonate mixture—on the surface properties and contact angles of and osteoblast adhesion and proliferation on Ti surfaces. Disk-shaped Ti specimens were prepared using different surface treatments (machining, sandblasting, and sandblasting/acid-etching), and they were immersed in the etching solution and then ultrasonically cleaned. Surface characterization was performed using scanning electron microscopy, digital microscopy, contact angle analysis, and X-ray photoelectron spectroscopy. MG-63 osteoblasts were cultured on the specimens, and their adhesion to the specimen surface and their proliferation were examined using staining and the MTT assay, respectively. Additional etching with the etching solution caused the formation of nano/micro hierarchical structures, increased the surface roughness, and enhanced the hydrophilicity. Osteoblast adhesion and proliferation were found to improve on the modified surfaces. The eco-friendly etching method has the potential to enhance the biological properties of Ti implant surfaces and to thereby improve the dental implant performance.

The medical use of Cannabis has a very long history. Although many principles are present in cannabis, called cannabinoids, Δ9tetrahydrocannabinol (Δ9-THC), cannabidiol (CBD) and can-nabinol (CBN) are the three main cannabinoids most present and described. CBD itself is not re-sponsible for psychotropic effects of cannabis since does not produce the typical behavioral effects associated to the consumption of this drug. Cannabidiol (CBD) has recently gained growing at-tention in modern society and seems to be more and more explored in dentistry. Several subjective findings suggest some therapeutic effects of CBD, which are strongly supported by research evi-dence. However, there is a plethora of data regarding CBD’s mechanism of action and therapeutic potential, which are in many cases contradictory. We will first provide an overview of scientific evidence on the molecular mechanism of CBD’s action. Furthermore, we will map the recent de-velopments regarding possible oral benefits of CBD. In summary, we will highlight CBD’s prom-ising biological features for dentistry application, despite exiting patents suggest current the compositions for oral care as the main interest for industry.

The aims of this study are to determine the oral health status of a rare sample of 19th-century migrant settlers to South Australia, how oral conditions may have influenced their general health, and how the oral health of this group compares with contemporaneous samples in Australia, New Zealand, and Britain. Dentitions of 18 adults and 22 subadults were investigated using non-destructive methods (micro-CT, macroscopic, radiographic). Extensive carious lesions were identified in 17 adults and 4 subadults, from this group 1 subadult and 16 adults had antemortem tooth loss. Sixteen adults showed evidence of periodontal disease. Enamel hypoplastic (EH) defects were identified in 14 adults and 9 subadults. Many individuals with dental defects also had skeletal signs of co-morbidities. South Australian individuals had the same percentage of carious lesions as the British sample (53%), more than other historic Australian samples, but less than a contemporary New Zealand sample. Over 50% of individuals from all the historic cemeteries had EH defects suggesting systemic health insults during dental development were common during the 19th century. The overall oral health of the South Australian settlers was poor but, in some categories, (tooth wear, periapical abscess, periodontal disease), better than the other historic samples.

Evidence regarding the effect of the onlay preparation design for different CAD/CAM restorative materials considering the preservation of cusps is lacking. Molars were 3D modeled in four preparation designs for onlay restoration: traditional design with functional cusp coverage (TFC), non-retentive design with functional cusp coverage (NFC), traditional design with non-functional cusp coverage (TNFC), non-retentive design with non-functional cusp coverage (NNFC). Restorations were simulated with two CAD/CAM restorative materials: LD – lithium disilicate (IPS e.max CAD) and RC - resin composite (GrandioBloc). A 100 N axial load was applied to the occlusal surface simulating the centric contact point. Von Mises (VM) and maximum principal (Pmax) stresses were evaluated for restorations, cement layer and dental substrate. The non-retentive preparation design reduced the stress concentration in the tooth structure in comparison to the conventional retentive design. For LD onlays, the stress distribution on the restoration intaglio surface showed that the preparation design as well as the prepared cusp, influenced the stress magnitude. The non-retentive preparation design provided better load distribution in both restorative materials and more advantageous for tooth structure. The resin composite restoration on non-functional cusp is recommended when functional cusp is preserved, in order to associate conservative dentistry and low stress magnitude.

The aim of this study was to synthesize and characterize a novel Methacrylate- functionalized Calcium Phosphate (MCP) used as a bioactive compound for innovative dental composites. The characterization was accomplished by Attenuated Total Reflectance Fourier-Transform Infrared Spectroscopy (ATR-FTIR), X-Ray Diffraction Analysis (XRDA), Scanning Electron Microscopy (SEM), and EnergyDispersive Spectroscopy (EDS). The incorporation of MCP as a bioactive filler in esthetic dental composite formulations and the ability of MCP containing dental composites to promote precipitation of hydroxyapatite (HAp) on the surfaces of those dental composites was explored. The translucency parameter, depth of cure, degree of conversion, ion release profile, and other physical properties of composites were studied with respect to the amount of MCP added to the composites. Composites containing 3 Wt.%, 6 Wt.%, and 20 Wt.% MCP were evaluated at 7, 14, and 21 days. The progress of surface precipitation of hydroxyapatite on MCP-containing dental composites was studied by systematically increasing the MCP content in the composite and the time of specimen storage in Dulbecco’s phosphate-buffered solution with calcium and magnesium. It was found that there was a direct correlation between the percentage of MCP in a composite formulation, the amount of time the specimen was stored in PBS, and the deposition of hydroxyapatite on the composite’s surface

The results of the bibliographic analysis show that the most explored nanomaterials in dentistry are graphene and carbon nanotubes, and their derivatives. A detailed analysis and a comparative study on their applications show that, although they are quite similar, graphene based materials seem to be more promising for most of the applications of interest in dentistry. The bibliographic study also demonstrated the potential of zeolite based materials, although the low number of studies on their applications shows that they have not been totally explored, as well as other porous nanomaterials that found important applications in medicine, such as metal organic frameworks, have not been explored. Subsequently, it is expected that the research effort will concentrate in graphene and zeolite based materials in the incoming years. Thus, present review paper presents a detailed bibliographic study, with more than 200 references, in order to describe briefly the main achievements that have been described in dentistry using nanomaterials, compare and analyze them in a critical way, with the aim of predicting the future challenges.

Autogenous demineralized dentin matrix (ADDM), derived from human extracted tooth, is commonly used as a bone-graft substitute to reconstruct alveolar defects when placing dental implants. The purpose of this retrospective study is to examine efficacy of ADDM in terms of surgical complications and marginal bone resorption by analyzing the medical records and radiographs of patients who received ADDM graft from 2008 to 2011 in our institute. Occurrence of complications, marginal bone loss around implants were investigated with regard to the type of defect, location of bone grafting, and types of bone graft techniques. ADDM-based bone grafting was performed on 221 sites in 82 patients and 208 implants were placed afterwards: The percentage of complications after bone grafting was 15.84%, and the implant survival rate was 95.19%. All complications were resolved with conventional treatment except for the 10 cases of osseointegration failure. The average marginal bone loss was 0.31 mm at the last examination after the average follow-up period of 7.2 years. Within the limitation of this study, the results of long-term follow-up are consistent with the short-term results of relevant studies. ADDM can produce promising clinical outcomes when used for alveolar ridge augmentation around implants.

Zirconia has recently become one of the most popular dental materials in prosthodontics being used in crowns, bridges, and to implants. However, weak bonding strength of dental adhesives and resins to zirconia surface has been a grand challenge in dentistry, thus finding a better adhesion to zirconia is urgently required. Marine sessile organisms such as mussels use a unique priming strategy to produce a strong bonding to wet mineral surfaces; one of the distinctive chemical features in the mussel’s adhesive primer proteins is high catechol contents among others. In this study, we pursued a bioinspired adhesion strategy, using a synthetic catechol primer applied to dental zirconia surfaces to study the effect of catecholic priming to shear bonding strength. Catechol priming provided a statistically significant enhancement (P < 0.05) in shear bonding strength compared to the bonding strength without priming, and relatively stronger bonding than commercially available zirconia priming techniques. This new bioinspired dental priming approach can be an excellent addition to the practitioner’s toolkit to improve dental bonding to zirconia.

The regeneration of bone tissue is a main purpose of most therapies in dental medicine. For bone regeneration, calcium phosphate (CaP)-based substitute materials based on natural (allo- and xenografts) and synthetic origins (alloplastic materials) are applied for guiding the regeneration processes. The optimal bone substitute has to act as a substrate for bone ingrowth into a defect, while it should be resorbed even in the time frame needed for complete regeneration up to the condition of restitution ad integrum. In this context, the modes of action of CaP-based substitute materials have been frequently investigated and it has been shown that such materials strongly influence regenerative processes such as osteoblast growth or differentiation and also on osteoclastic resorption due to different physicochemical properties of the materials. However, the material characteristics needed for the required ratio between the formation of new bone tissue and material degradation has not been found until now. The addition of different substances such as collagen or growth factors and also of different cell types have already been tested but did not allow for sufficient or prompt application. Moreover, metals or metal ions are differently used as basis or as supplement for different materials in the field of bone regeneration. Moreover, it has already been shown that different metal ions are integral components of bone tissue playing functional roles in the physiological cellular environment as well as in the course of bone healing. The present review focuses on frequently used metals as integral parts of materials designated for bone regeneration with the aim to give an overview of currently existing knowledge about the effects of metals in the field of bone regeneration.

The purpose of this finite element analysis (FEA) was to evaluate the stress experienced by both the prosthetic components and the bone in relation to varying cement thicknesses ranging from 20 to 60 μm, utilized in the attachment of a zirconia crown on a conometric cap. The study focused on two distinct types of implants (Cyroth and TAC, AoN Implants, Grisignano di Zocco, Italy) featuring a Morse cone connection. Detailed three-dimensional (3D) models were created to repre-sent the bone structure (cortical and trabecular) and the prosthetic components, encompassing the crown, cement, cap, abutment, and the implant. The two implants were placed in a 1.5 mm sub-crestal position and subjected to an inclined load of 200 N at 45° on the crown. The results re-vealed that an increase in cement thickness resulted in a reduction of von Mises stress on the cor-tical bone for both Cyroth and TAC implants, while the decrease in stress on the trabecular bone was relatively less pronounced. However, the TAC implant exhibited a higher stress field and de-formation in the apical area compared to the Cyroth implant. In summary, this study investigated the impact of cement thickness on stress transmission across prosthetic components and peri-implant tissues by means of FEA analysis, indicating that the 60 μm cement layer manifested higher stress values nearing the material strength limit.

In the era of digital information consumption, YouTube has emerged as a prominent platform for disseminating knowledge across various domains. One such area that has gathered significant attention is teeth whitening, with a plethora of videos offering insights into professional proce-dures, home remedies, and personal experiences. This study delves into the vast landscape of teeth whitening content on YouTube, meticulously categorizing videos into professional and amateur domains. The aim is to critically analyze the information presented, considering its accuracy, re-liability, and potential impact on public perceptions and oral health choices. A total of 100 videos in Greek (n1= 73) and in English (n2= 27) were studied. The analysis was based on views, likes, publication year, duration, presence of background music, and the presence of a description. The completion date of the search was October 7, 2023. Professional videos predominantly present whitening as a painless, conservative, and economical procedure, emphasizing safety measures. Bleaching mechanisms involving hydrogen peroxide and carbamide are explored, with various application techniques discussed, including whitening strips, splints, and in-office procedures. Contradictory findings on the efficacy of home versus in-office treatments are highlighted. In-ternal and external discoloration factors are delineated, with contraindications specified. Amateur videos, garnering greater public appeal, present personal experiences, product promotions, and homemade remedies, reflecting a concerning trend of misinformation. The analysis incorporates viewer engagement metrics, emphasizing the impact of non-professional content. As social media platforms play an increasingly influential role in shaping healthcare narratives, understanding the nuances of dental discourse on YouTube becomes crucial for both practitioners and the public. This exploration encompasses a spectrum of topics, ranging from the chemical intricacies of bleaching agents to the societal dynamics influencing viewer preferences. By unraveling the complexities of online dental information, this study seeks to contribute valuable insights to the evolving land-scape of oral health education in the digital age. Future research should adopt a multi-platform approach and explore the dynamic interaction between content creators and viewers for a more holistic comprehension of online dental information.

Age estimation in dental radiographs Orthopantomography (OPG) is a medical imaging technique that physicians and pathologists utilise for disease identification and legal matters. For example, for estimating post-mortem interval, detecting child abuse, drug trafficking, and identifying an unknown body. Recent development in automated image processing models improved the age estimation's limited precision to an approximate range of +/- one year. While this estimation is often accepted as accurate measurement, age estimation should be as precise as possible in most serious matters, such as homicide. Current age estimation techniques are highly dependent on manual and time-consuming image processing. Age estimation is often a time-sensitive matter in which the image processing time is vital. Recent development in Machine learning-based data processing methods has decreased the imaging time processing; however, the accuracy of these techniques remains to be further improved. We proposed an ensemble method of image classifiers and transfer learning techniques to enhance the accuracy of age estimation using OPGs from one year to a couple of months (1-3-6). This hybrid model is based on convolutional neural networks (CNN) and K nearest neighbours (KNN). The hybrid (HCNN-KNN) model was used to investigate 1,922 panoramic dental radiographs of patients aged 15 to 23. These OPGs were obtained from the various teaching institutes and private dental clinics in Malaysia. To minimise the chance of overfitting in our model, we used the principal component analysis (PCA) algorithm and eliminated the features with high correlation. To further enhance the performance of our hybrid model, we performed systematic image pre-processing. We applied a series of classifications to train our model. We have successfully demonstrated that combining these innovative approaches has improved the classification and segmentation and thus the age-estimation outcome of the model. Our findings suggest that our innovative model, for the first time, to the best of our knowledge, successfully estimated the age in classified studies of one year old, six months, three months and one-month-old cases with accuracies of 99.98, 99.96, 99.87, and 98.78 respectively.

Purpose/Objective: Frequent consumption of fermented carbohydrates and bottle feeding contribute to the development of early childhood caries (ECC). There are no substantial findings on the effects of breastfeeding patterns on oral health conditions in children in the United States. We aimed to assess the nexus between exclusive breastfeeding during the first 6 months and oral health disorders, namely toothache, decayed teeth, or unfilled cavities in early childhood. Materials and Methods: Design: Cross-sectional epidemiologic design of nationally representative data collected via telephone surveys in the United States was utilized. Setting: National Survey of Children’s Health, 2012 Participants: Population-based random sample of parents/guardians of 24,655 children aged 6 months to 5 years. Main Outcome and Measure: Parent-reported oral health condition including toothache, decayed teeth or unfilled cavity in the past 12 months. Results: A total of 2,392 (9.7%) children aged 6 months to 5 years experienced an oral health disorder, mainly toothache, decayed teeth, or unfilled cavity in the previous 12 months. Relative to non-Hispanic White children (7.7%), a greater proportion of non-Hispanic Black (12.9%) and multi-racial children (12.6%) experienced oral health disorders (OHD). In the univariable model, relative to children who never breastfed, those who were breastfed exclusively for 6 months were 28% less likely to present with OHD, Odds Ratio (OR) = 0.72, 95% CI, 0.52-0.98. After adjustment, the protective nature of exclusive breastfeeding against OHD did not remain, adjusted OR (aOR) =1.11, 99% CI 0.79-1.57. Children of mothers with fair/poor health were almost twice as likely to have poor OHD compared with children of mothers with excellent/very good health (aOR = 1.79, 99% CI 1.08-2.69). Conclusions and Relevance: Exclusive breastfeeding for the first six months of life improved pediatric OHD and remains mutually beneficial for mothers and children. These findings suggest the importance of exclusive breastfeeding and maternal health in relation to dental hygiene in children.

Lidocaine hydrochloride (HCl) 2% with 1:100,000 epinephrine (LW/E) is widely used to prevent pain during dental procedures and has been associated with injection sting, jittering effects, slow onset, and a bitter aftertaste. Since LW/E’s introduction in 1948, no significant modifications have been proposed. This study aims to design and characterize an improved dental lidocaine HCl injectable formulation without epinephrine (LW/O/E) via buffers, sweeteners, and amino acids. LW/O/E injections were prepared with pH and osmolality values of 6.5 – 7.0 and 590-610 mOsm/kg. Using the electronic tongue (ETongue), the LW/O/E injectable formulations were characterized for viscosity, injectability, and taste analysis. The results were compared with the LW/E control. In vivo efficacy and anesthetic duration of the samples were measured through radiant heat tail-flick latency (RHTFL) and hot plate (HP) tests and local toxicity was assessed after a single intra-oral injection in Sprague Dawley rats (SDR). The viscosity and injectability values of the LW/O/E samples were found to be comparable to the LW/E injection. ETongue taste analysis showed an improvement in bitterness reduction of the LW/O/E samples compared to the LW/E formulation. Toxicity studies of samples in SDR showed minor and transient signs of erythema/eschar and edema. Anesthetic duration via RHTFL and HP paw withdrawal latency time in SDR were found to be comparable for the LW/O/E Sample 3A and the LW/E injection (p<0.05). In conclusion, the buffered, higher osmolality and reduced bitterness developed LW/O/E formulation (Sample 3A) could be considered a promising alternative to the LW/E formulation for dental use.

(1) Background: This study aimed to compare the effect of polyetheretherketone (PEEK) and titanium abutments on implant prosthetic systems and supporting bone using three-dimensional finite element analysis (FEA); (2) Methods: A three-dimensional finite element analysis was conducted using CATIA and Abaqus software to model mandibular first molar implant systems with titanium and PEEK abutments. Under external loading conditions, finite element analysis was conducted for the stresses in implant components and surrounding bones of each group; (3) Results: The implant fixture of the PEEK model exhibited the highest von Mises stress (VMS). The lowest VMS was observed in the abutment screw of the titanium model. Both implant systems demonstrated similar stress distribution and magnitudes in cortical and cancellous bones; (4) Conclusion: PEEK abutments show similar stress distribution in surrounding bone compared to titanium. However, PEEK absorbs the stresses within the implant system and exhibits the highest VMS values due to its low mechanical and physical properties. Therefore, PEEK abutments need improved mechanical properties for better clinical application.

The first treatments with dental implants had low success rates (75%). Nowadays, oral rehabilitation with titanium dental implants has a high success rate (95-98%). The success rate significantly increases due to increased scientific knowledge about osseointegration, changes in surgical techniques, and the development of implant surface treatments. Despite the high success rate of implants, no protocol defines the time for the prosthesis to be installed and loaded after surgery. This work compares a new dental implant's primary (mechanical) and secondary (osseointegration) stability. Dental implant with micro- and nano-roughness surface was placed in 24 patients with a minimum of 35 N.cm and a maximum of 60 N.cm. Primary stability was quantified with a torque wrench and Ostell Mentor. The secondary stability 45 and 60 days after surgery was measured with Ostell. The results showed no statistical difference in secondary stability at 45 and 60 days postoperatively among implants. The success rate of dental implants can be associated with the surface morphology with micro and nano-roughness and the shape of the fillets of the implant threads. When the manufacturer's guidelines are followed, it is possible to prosthetically rehabilitate the patient with an implant 45 days after surgery.

Zirconia-reinforced lithium silicate (ZLS) is utilized as a material for prosthetic tooth crowns, offering enhanced strength compared to other dental glass-ceramics. In this study, we investigate a commercial ZLS material, provided in a fully crystallized form. We examine the effects of an optional post-processing heat treatment on micro-contact damage using controlled indentation tests simulating the primary modes of contact during chewing: axial and sliding. Our findings indicate that the heat treatment does not affect mechanical properties such as the elastic modulus, hardness and indentation fracture toughness. However, it does enhance the resistance to contact damage by fracture and chipping in both axial and sliding modes, as well as the resistance to crack initiation measured from sliding tests. This improvement is attributed to the refinement of the flaw population achieved through the heat treatment. The results are analysed within the framework of contact and fracture mechanics, and the implications for prosthetic dentistry are briefly discussed.

(1) Background: Tooth extraction is one of the oldest and most well-known surgical procedures in dental medicine. It is still routinely performed to date by both general practitioners, oral surgeons, and dental undergraduates. The Benex extraction system allows for the extraction of teeth in vertical direction, which avoids most trauma against the surrounding alveolar bone and soft tissues; (2) Methods: The study included 56 patients who were recruited from the department of Oral Surgery at the Faculty of Dental Medicine, Medical University – Plovdiv. Patients were divided into two groups of 28 patients – Group I (control group) and Group II (study group). For each group the success of the extraction, buccal cortical plate preservation, pain experience and early wound healing were assessed; (3) Results: There was no statistical significance between the success of the extractions in both groups. The Benex extractions preserved the buccal cortical plate in 95% of the cases, whereas the forceps extractions only in 71.8%, which shows a statistical significance. On the seventh day patients in group II reported less pain, without a significant difference. There was a significantly bigger number of completely healed extraction wounds on the 10th day; (4) Conclusions: Atraumatic extractions allow for more hard and soft tissues to be preserved in the extraction site. This is all crucial for the successful outcome and aesthetically pleasing results of a following prosthetic or implant restoration.

Hybrid materials are a recent addition in the field of Restorative Dentistry for computer-assisted design/ computer-assisted manufacturing (CAD/CAM) indirect restorations. The long–term clinical success of modern dental restorative materials follows a multifactorial pattern. Among the characteristics, affecting the longevity of a restoration, mechanical properties and physicο – chemical interactions are of utmost importance. While numerous researchers constantly evaluate the mechanical properties, the biological background of resin–based CAD/CAM biomaterials is scarcely investigated and, therefore, less described in the literature. This review aims to analyze the biofilm formation on the surfaces of novel hybrid, resin–based CAD/CAM materials and evaluate the methodological protocols followed to assess microbial growth. It is demonstrated that the surface structure, the composition and the finishing and polishing procedures on the surface of a dental restorative material influence the initial bacterial adhesion; however most studies focus on in vitro protocols, whereas in vivo and/or in situ research of microbiomics in CAD/CAM restorative materials is lacking, obstructing in that manner the accurate understanding of the bioadhesion phenomenon in the oral cavity.

Abstract: This study aimed to evaluate the long-term impact of paediatric dentistry programmes on children and adolescents to reduce oral health inequalities. It measures and assesses the improvement effects of paediatric dentistry programmes on the oral health of children and adolescents as part of the efforts to decrease oral health disparities in this age group. It included 406 individuals who participated in student and paediatric dentistry programmes between 2013 and 2019 at screening facilities in Gwangjin-gu, Seoul. Frequency analysis was conducted for demographic characteristics, and binary logistic regression analysis was performed to identify factors influencing the prevalence of dental caries as the dependent variable. Data were analysed using PASW Statistics with the statistical significance level set at α=0.05. Regarding oral health indicators based on the frequency of participation in paediatric dentistry programmes for children and adolescents, participants with seven or more sessions had lower prevalence rates of dental caries, malocclusion, and periodontal disease than those with only one session. Second, when comparing oral health indicators in paediatric dentistry programmes between primary and adolescent age groups, individuals under continuous management showed a decrease in permanent teeth affected by dental caries, dental caries prevalence, and malocclusion prevalence (excluding primary school age). Third, binary logistic regression analysis revealed significant influences (p

Background: Restorative materials might significantly affect load transmission at peri-implant bone. The aim of the present study is to evaluate the shock absorption capacity of two different polymeric materials to be used as frameworks for implant-supported prostheses. Methods: A masticatory robot was used to compare the shock absorption capacity of polyether-ketoneketone (PEKK) Pekkton®ivory (Cendres+Mètaux) and glass fiber-reinforced composite (GFRC) TRINIATM (Bicon). Five identical sample crowns for each of the materials was tested un-der the same conditions described in previously published papers (Menini et al. 2013). Forces transmitted at the simulated periimplant bone were recorded and statistically analysed. Results: The statistical analysis of forces transmitted at the simulated dental implant revealed significant differences between all the materials tested and significant differences with the mate-rials tested in a previously published paper (Menini et al. 2013: zirconia, glass ceramic, composite resin, acrylic resin). Only differences between PEKK and veneered PEKK and between PEKK and one of the previously tested composite resins were not statistically significant. PEKK samples demonstrated significantly greater shock absorption capacity compared to GFRC. Conclusions: PEKK revealed optimal shock absorption capacity. Further studies are needed to evaluate its efficacy in case of long span prostheses with reduced prosthetic volume.

High insertion torques increase the primary stability of dental implants, which might be beneficial for immediate loading protocols, but may lead to local ischemia and necrosis of the bone-implant interface. This study compared the outcomes of implants placed with low (&lt;45Ncm), conventional(45-70Ncm), and high (≥75Ncm) insertion torques in All-on-4 concept cases with up to 2-year follow-up. Patients included in this study presented edentulous or partially dentate arches with an indication for full-arch rehabilitation. Implants were installed following the All on four protocol and were divided into 3 groups: Low, Conventional, and High torque, and were followed periodically for 2 years with ISQ measurements. The results showed no significant differences in success rates between the three groups. This suggests that high insertion torques may maintain higher primary stability values for immediately loaded implants during the healing period. Further studies are necessary to confirm these findings.

Peri-implantitis continues to be one of the major reasons for implant failures. We propose a new approach for incorporating MTA into Zirconia implant surfaces with Nd:YAG laser and investigate the biological response of peri-implant cells as well as the microbiological response. Discs of Zirconia stabilized with Yttria and Titanium were produced according 4 tested groups: Nd:YAG laser textured Zirconia coated with MTA (Zr MTA); Nd:YAG laser textured Zirconia (Zr Textured); Zirconia and Titanium discs (Zr and Ti ). Contact profilometry was used to evaluate surface roughness. Human osteoblasts, gingival fibroblasts and S. oralis were cultured on samples. Cell adhesion and morphology, cell viability, cell differentiation markers and bacterial growth were assessed. Zr Textured roughness was significantly higher compared to all other groups. Cellular adhesion was observed at 1 day in all samples in both cell lines. Osteoblasts viability was lower in Zr MTA group, unlike fibroblasts viability was shown to be higher in Zr MTA group compared to Zr Textured group at 3 and 7 days. Osteocalcin and IL-8 release by osteoblasts were higher in Zr MTA. Zr Textured showed higher IL-8 values released by fibroblasts. No differences in S. oralis CFUs were observed between groups. The results suggest that Zirconia implant surfaces coated with MTA seems to promote fibroblasts proliferation and osteoblasts differentiation, however does not appear to have antibacterial properties.

Creating environmentally sustainable oral healthcare culture requires embedding contents in dental curriculum. This study aimed to explore the current knowledge and drivers among dental students and educators regarding environmentally sustainable dentistry (ESD) in the United Arab Emirates (UAE) and identify barriers and enablers to embrace it. A cross-sectional survey using online questionnaire was carried out in undergraduate dental educational institutes. Data analysis included descriptive statistics and thematic analysis. Most students and educators were not aware of ESD content in their curriculum. However, the majority of educators were familiar with ESD concept, while students were mostly unfamiliar. Nonetheless, students largely agreed on its im-portance and their interest in learning it, as they view it relevant to their future practice. Educators agreed that the dental profession has a responsibility to be environmentally friendly and expressed desire in introducing ESD content into the curricula. Several barriers were reported such as lack of knowledge, curriculum space, educational resources, and time. Meanwhile, enablers included providing training and resources. There is no explicit presence of ESD content in the dental curricula. Regardless of the lack of in-depth knowledge among educators and more so with students, they both have positive views toward incorporating ESD into dental curricula.

Age estimation is an important tool when dealing with human remains or undocumented minors. Although the skull, the skeleton or the hand-wrist are used on age estimation as maturity indicators, they often present lack of good conditions for a correct identification or estimation. Few systematic reviews (SRs) have been recently published; therefore, this umbrella review critically assesses their level of evidence and provides a general comprehensive view. An electronic database search was conducted in four databases (PubMed, Cochrane, WoS, LILACS) up to December 2022, focusing on SRs of age estimation through forensic dentistry procedures. The methodological quality was analyzed using the measurement tool to assess SRs criteria (AMSTAR2). Eighteen SRs were included, five of critically low quality, six of low quality, three of moderate quality and four of high quality. The SRs posited that Willems’ method is more accurate and less prone to overestimation; most methods seem to be geographically sensitive; and 3D-Imaging and artificial intelligence tools demonstrate high potential. The quality of evidence on age estimation using dental approaches was rated as low to moderate. Well-designed clinical trials and high standard systematic reviews are essential to corroborate the accuracy of the different procedures of age estimation in forensic dentistry.

Today, dental implantology is a reliable technique for the treatment of partial and total edentulism. The fixing of dentures on dental implants can be achieved by a number of different techniques. The choice of technique depends on the specific needs of the patient, the condition of the jawbone and the design of the prosthesis itself. Currently, the two most common types of prosthetic abutment connections are cemented or screwed connections, both of which have disadvantages and ad-vantages. The aim of this study is to analyze, with Finite Element Analysis (FEA), a new Cone Morse connection system between the prosthesis and implant. The connection retention has been analyzed by adopting three different approaches: analytical, in vitro and the FEA method. The systems formed by abutment, healing-cap, and crown with three different inclination conditions were modeled in 3D: 0°, 15° and 30°. With Ansys finite element software, the effect of tilt on system retention was studied. The FEA analysis showed comparable results with in vitro studies regarding the retention strength for an abutment-cap system with a taper of 4°, obtaining 66.6 N compared to 68 N calculated through an in vitro study. The inclination of the abutment affects the retention of the system because the hole made on the surface of the abutment, decreases the contact area between the components. The Cone Morse prosthesis implant connection system is the most stable and efficient system compared to the threaded or cemented system. Retention is influenced by factors such as abutment conicity, insertion strength and the contact surface be-tween components.

Microbiological control of dental pathologies presents a significant clinical challenge for dental surgeons, particularly considering drug-resistant microorganisms. To address this issue, Antimi-crobial Photodynamic Therapy (PDT) has emerged as an effective and complementary technique for microbial reduction. This therapy involves the application of a photosensitizer dye (PS) either topically or systemically, followed by exposure to low-power lasers with appropriate visible light wavelengths. PDT has found a valuable place in dentistry across various specialties, including surgery, periodontics, endodontics, dentistry, implantology, orthodontics, and pediatrics. In the realm of pediatric dentistry, managing microorganisms during dental treatments has become a major challenge.This article reviews the evidence supporting the potential of photodynamic therapy in combating bacteria, fungi, and viruses, with a particular focus on areas such as endodontics, restoration in deciduous teeth, implantology, and periodontics for bacterial control. Additionally, PDT has shown promise in stomatology, specifically in the treatment of mucositis and herpes. Considering its promising results and ease of application, photodynamic therapy presents an in-teresting alternative for clinical practice. However, it is important to note that specific protocols must be followed for each application, encompassing the type of photosensitizer, concentration, pre-irradiation time, light type, wavelength, energy, power, and mode of light delivery. Researchers have been steadily refining these protocols to facilitate PDT's integration into clinical practice.

The purpose of this study was to evaluate the outcomes of implants placed in horizontally augmented alveolar ridges using porcine bone grafts and to investigate the long-term stability of the porcine bone grafts. A retrospective analysis was conducted on 55 sites that underwent horizontal ridge augmentation using porcine bone grafts and implant placement with a follow-up period longer than 5 years. Furthermore, additional analysis was conducted on 24 sites where porcine bone grafts were used exclusively and implants were placed simultaneously with horizontal ridge augmentation. The mean follow-up period after prosthesis loading was 67.3 months, with a mean marginal bone loss of 0.18 mm at 1 year and a cumulative mean marginal bone loss of 0.37 mm over the entire follow-up period. Of the 55 implants, 2 were lost and 4 did not meet the success criteria, resulting in a survival rate of 96.4% and a success rate of 89.1%. In 24 sites, the mean marginal bone loss was 0.22 mm at 1 year and 0.40 mm at 65.8 months, with 100% survival and success rates. Porcine bone grafts can be successfully used in horizontal ridge augmentation for implant placement in cases of ridges with insufficient horizontal width.

Background: Bleeding disorders can be divided into three categories: congenital coagulation disorders (CCDs), antiplatelet induced bleeding disorders (APBDs) and anticoagulant induced bleeding disorders (ACBDs). Implant placement can be challenging in this kind of patients. The aim of this study is to provide evidence on implant surgery in patient with bleeding disorders and to generate some practical recommendations for clinicians. Material &amp; Methods: Pubmed/MEDLINE, Scopus, Web of Science and Cochrane Library databases were screened. The latest search was performed in July 2022. Case Reports, Case Series, Cohort Studies, Cross-Sectional Studies, Case Control Studies, Reviews, Consensus Reports, Surveys and Animal Studies were included in the analysis. Results: Seventeen articles on CCDs were found, fourteen on APBDs, twenty-six on ACBDs. Most of these articles were case report or case series. Patients with CCDs can be treated after the infusion of the missing coagulation factor. Patients with APBDs can be treated without withdrawing the therapy. Patients with ACBDs should be treated depending on the anti-coagulative medication. Conclusion: Despite the low level of evidence, dental implants can be safely placed in patients with bleeding disorders. However, careful preoperative evaluation and the adoption of local and post-operative bleeding control measures are mandatory.

We sought to evaluate the effects of non-surgical periodontal treatment (NSPT) on periodontal clinical parameters, systemic blood pressure (BP) and plasma levels of systemic inflammation markers in patients with combined refractory arterial hypertension (RAH) and stage III grade B periodontitis. Twenty-seven participants with RAH and periodontitis received NSPT. The analyzed clinical parameters were probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and plaque index (PI). An assessment was performed for systemic BP, complete blood count, coagulogram, creatinine measurement, C-reactive protein (CRP), glycated hemoglobin, cholesterol, glutamic oxaloacetic transaminase, glutamate pyruvic transaminase, waist-hip ratio, and body mass index. In the follow-up period, twenty-two patients were evaluated at baseline and after 90 and 180 days. The data were submitted to statistical analysis (α=0.05%). As expected, the clinical results showed a significant improvement in the percentages of PI, BOP, PD and CAL, which were statistically significant at 90 and 180 days (p&lt;0.0001). Importantly, NSPT significantly reduced the blood level of CRP (p&lt;0.02). However, no significant reduction in BP parameters was noted in the evaluated follow-up periods. NSPT, despite the benefits in periodontal clinical parameters, reduced the plasma level of CRP but not the BP in patients with combined RAH and periodontitis.

The purpose of the study was to evaluate the success of procedural conscious sedation, using inhaled equimolar nitrous oxide-oxygen (NOIS – EMONO), in patients undergoing routine dental and oral surgery procedures in a Swiss university hospital setting. Materials and methods: The authors conducted a retrospective cohort study of patients that underwent NOIS-supported procedures between 2018 and 2022 at the oral surgery department of the University Hospital of Geneva (HUG), Switzerland. The primary outcome was the measurement of the procedure success and efficacy as defined by the European Society of Anesthesiology. Secondary objectives included the analysis of the types of treatments performed, their indications, patient behavior, and the patient - clinician satisfaction score. Results: 55 patients were included in the study, 85% underwent surgical procedures, the remaining 15% underwent restorative and preventive procedures. The overall treatment success rate was 98.2%, and 97.9% for surgically treated patients. 62% of patients appeared relaxed, calm, and serene, while 16% expressed pain or fear during the procedure. Infiltrative administration of local anesthesia caused stress in 22% of patients, this was significantly lower in sub cohorts who received local topical anesthetics (0%) or a combination of systemic and local topical analgesics (7%). Patients (75%) and clinicians (91%) were satisfied with the procedure. Conclusion: Inhaled equimolar nitrous oxide-oxygen procedural sedation used during dental procedures and oral surgery results in high treatment success and satisfaction rates. The administration of additional topical anesthetics helps reduce the anxiety and stress related to infiltrative anesthesia. Further dedicated studies and prospective trials are needed to confirm these findings.

IntroductionDiversity is known to be important but diversity of staff working in dental schools in the UK and Ireland is low in comparison with the dental profession and the overall population. AimsTo provide a detailed snapshot of the diversity of dental academic staff in 2021 including staff working in academic and clinical roles.MethodsAn online survey was circulated to dental schools by Dental Schools Council. Questions included dates of graduation and key career milestones, demographics and indicators of esteem. Free text questions were also included.ResultsThere was a high degree of variability in dental academic careers which made direct comparisons difficult. Neither gender nor race appeared to be associated with a faster career progression. Females and those of racialised minority were less represented at the most senior grades. For those who had completed specialty training, racialised minority staff were far less likely to be working at consultant grade than their White equivalents.ConclusionThere are differences in career progression between staff in dental schools. The high amount of individual variability makes these difficult to quantify except at the most senior positions. Qualitative information is needed to contextualise the results and provide additional information.

Periodontal disease is one of the most common conditions affecting dogs worldwide and is reported to be particularly prevalent in racing greyhounds. A range of potential risk factors have been hypothesised. Previous research has suggested, regular tooth brushing can reduce both calculus and gingivitis, but the frequency required is unclear. Here, we report a controlled blinded in-situ in which kennel staff brushed 160 racing greyhounds’ teeth (living at six kennel establishments), either weekly, daily or never over two-month period. All visible teeth were scored for calculus and gingivitis, using previously validated scales. We calculated average scores for each of three teeth groups and overall averaging the teeth groups. Changes were compared to baseline. After two months, the total calculus scores (controlling for baseline) were significantly different in the three treatemnet groups, (F(2,129) = 10.76, p&lt;0.001) with both weekly and daily brushing resulting in significant reductions. Gingivitis was also significantly different (F(2,128) = 4.57, p=0.012), but in this case, only daily brushing resulted in a significant reduction. Although dogs in different kennels varied significantly in their levels of both calculus (F(5,129) =8.64, p&lt;0.001), and gingivitis (F(5,128)=3.51 p=0.005), the intervention was generally similarly effective in all establishments. Teeth groups varied and incisors were not significantly affected by treatment. Since trainers implementing the routine, reported minimal time commitment and positive experiences, we suggest that daily brushing is recommended for racing greyhounds, and that demonstrations should include attention to all teeth groups including incisors. Similar trials need to be conducted with retired greyhounds since these have been shown to present particularly high levels of periodontal disease.

Background Bangladesh has been attracting international students on various subjects in recent times. Every year students from different parts of the world come to study undergraduate and postgraduate courses, mostly at private universities in Bangladesh. This study evaluates the depression status among international students who are studying dentistry in Bangladesh. Methods This cross-sectional survey was conducted among International undergraduate dental students who enrolled in the Bachelor of Dental Surgery program in nine public and private dental colleges in Bangladesh. A total of 206 students completed the survey, and CES-D 10 items Likert scale questionnaire was used for data collection. The Cronbach alpha for CES-D 10 scale items for this population is 0.812. Results The majority of the students (79.5%) are below 24 years of age, and students who cannot communicate well in Bengali (Bangla), about 60% of them have experienced depression. About 77.3% (p< 0.00) of the international students having financial difficulties exhibited depression. The international students who went through financial problems were two times more likely to suffer from depression (OR=2.38; p-value <0.01). Conclusion This study tried to highlight the struggles faced by international students in Bangladesh studying dentistry. It is evident from the findings that several factors influence students' mental well-being during demanding dental education years.

Background: The treatment plan of prosthetic restorations supported by dental implants require comprehensive scientific knowledge to deliver prostheses with good prognosis, even before the implant insertion. This review aims to analyze the main prosthetic determinants of the prognosis of implant-supported prostheses. Methods: A systematic review of the literature was conducted with a PICO question: "For partially or complete edentulous subjects treated with implant-supported prostheses, which prosthetic factors could affect clinical outcomes?". A literature search was performed electronically in PubMed (MEDLINE), Scopus and Cochrane Library with the following equation [PROGNOS* OR RISK] FACTOR IMPLANT DENTAL, and by hand search in relevant journals and throughout the selected papers. Results: This revision was carried out based on 50 papers focused on several prosthodontics-related risk factors that were grouped as follows: implant-connection, loading protocol, transmucosal abutments, prosthetic fit, provisionalization, type of retention, impression technique, fabrication technique, and occlusion. More than a half of the studies were systematic reviews (30%), meta-analysis (16%) or prospective evaluations of prosthesis with various kinds of events (18%). But also narrative reviews of literature (14%) and in vitro/animal studies (16%) were found. Conclusions: The current literature provides insufficient evidence for most of the investigated topics. However, based on the accumulated data, it seems reasonable to defend that the best treatment approach is the use of morse taper implants with transmucosal abutments, recorded by means of rigidly splinted copings through the pick-up technique, and screwed by milled prosthesis occlusally adjusted to minimize functional overloading.

ABSTRACT: Aims: This study aimed to explore the impacts of neighborhood-level socioeconomic contexts (e.g., income, education) on the therapeutic and preventative dental quality outcome of children aged 3 to 15 years. Materials and Methods Anonymized billing data of 842 patients reporting to a university Children’s Dental over three years met the inclusion criteria. Their access to care (OEV-CH-A), topical fluoride application (TFL-CH-A) and dental treatment burden (TRT-CH-A) were determined by dental quality alliance (DQA) criteria. The three oral health variables were aggregated at a neighborhood-level and analyzed with census data provided by Statistics Canada within a GIS framework. The forward sortation area (FSA) was chosen as a neighborhood spatial unit and regression models were run both the individual and neighborhood level. Results: The individual-level regression models showed significant negative associations between OEV-CH-A (p=0.027) and TFL-CH-A (p=0.001) and the cost of dental care. There was a significant negative association between TRT-CH-A and median household income. Neighborhood-level Ordinary Least Squares (OLS) linear regression models show negative associations of all three dental health variables (OEV-CH-A, TFL-CH-A, TRT-CH-A) with median household income and the number of households without a college degree. Conclusion: GIS and spatial quantitative approaches may be an effective tool to explore the impacts of socioeconomic variables on oral health outcomes.

It is currently recognized that an injudicious strategy in the last decades has been not only focusing of research typically on caries in children, but also the narrow focusing on fluoride, because despite sufficient availability of fluoride in water and oral healthcare products, caries levels escalate steadily as people get older and caries remain a main public health issue to be settled. In the last two decades the scientific community intensified efforts of exploring other products for caries prevention, herbal products being one of these approaches. Because preliminary evidence indicated that clinical trials for caries prevention with herbal products are heterogeneous in design, quality and products evaluated, we performed a scoping review intended to explore the main characteristics of such clinical trials. From an initial collection of 1986 unique papers from different literature databases, 56 articles satisfied the inclusion and exclusion criteria. The species investigated, dosage forms, study designs, duration of intervention, controls, endpoints, quality of reporting and risk of bias are discussed. 85.71% of the trials reviewed here reported positive results but given the methodological flaws and biases affecting them, it is difficult to conclude on the efficacy of those products based on the studies published thus far.

This study evaluates inequalities in the use of dental services according to place of birth before and after the economic crisis in Spain. A cross-sectional study was performed in the population aged 18 to 65 years in Spain. We used data from three Spanish National Health Surveys for years 2006 (before the crisis), 2014 and 2017 (after the crisis). Log-binomial regression was used to quantify the association between region of origin and use of dental care services before and after controlling for the selected covariates. In 2006, we found a greater probability of not using dental care services in immigrants from Asia (PR:1.36, 95% CI:1.10–1.67) and Africa (PR:1.16; 95% CI:1.05–1.28) compared to the natives. For 2014, the probability of not using dental care services was greater for all immigrants compared to the natives, with the greatest odds for those from Africa (PR:1.71; 95% CI:1.46–2.01) and Asia (PR:1.3; 95% CI:1.23–1. 47). The associations for 2017 were weaker in magnitude than the ones observed for 2014, although stronger than for 2006. This study suggests that the economic recovery did not have the same impact for natives and immigrants regardless of regions of origin, given the observed inequalities in use of dental services.

Anterior-tooth (ANT) contacts induce short latency reflex inhibition of human jaw-closing muscles. The jaw is a rigid class 1 lever for pinpoint-targeting muscle force into a single bite-point, the pivoting food particle. See-saw reflex movements around the food particle fulcrum multiply the food-crushing force. Unpredictable jolts of reaction force caused by food-crushing are subjected to the rostral ANT and caudally to the two articulate ends of the jaw triangle. Compression/distraction strains of food-crushing must be monitored and inhibited by withdrawal reflexes. The mesencephalic ganglion (Vmes), neural myelin sheath, and muscle stretch receptors evolved subsequently to the advent of jaws to improve the velocity of proprioceptive and withdrawal reflexes. In mammalians, the spindles of the taut motor units, stretched by the food-fulcrum send excitatory monosynaptic feedback for the efferent neurons of the respective ipsilateral muscle units, via Vmes. In the Vmes, the spindle-input-mediating afferent neurons are coupled with another source of afferent feedback, which is also excitatory, from the back-tooth (BAT) mechanoreceptors. The two sources of excitatory pulses are summated and targeted for the efferent neurons to boost the stretched and taut motor units. Likewise, the afferent feedback from ANT mechanoreceptors is also coupled in the Vmes with concomitant feedback from spindles. The ANT output, however, is inhibitory to negate the excitatory feedback from the stretched jaw-muscle units. The inhibitory feed from ANT temporarily blocks the excitatory potential of masticatory motor efferent neurons to protect the ANT and jaw-joints from inadvertent strains. The inhibitory inputs from ANT alternate with the excitatory inputs from BAT to determine which jaw-closing muscle units are activated or inhibited at any given instant of food-crushing. The Vmes exists in all jawed vertebrates, and its’ evolution was probably motivated by demands for the control of bite force. The monosynaptic unilateral food-crushing excitatory and inhibitory reflexes (UFCR) override the coexisting bilaterally executed feed for jaw muscles from the central nervous system. Hypothesis: The Vmes-mediated UFCR combine neural inputs from tooth contacts with concomitant feedback from muscle stretch receptors for the control of mammalian food-crushing bite force.

Objective: Determine the feasibility of utilizing longitudinal electronic dental record (EDR) data to track change over time in patient periodontal disease (PD) and to generate three patient cohorts: 1) patients whose disease did not change over time, 2) patients whose PD progressed, and 3) patients whose disease improved over time using informatics approaches. Methods: We conducted a retrospective study of 28,908 patients who received a comprehensive oral evaluation between January 1, 2009, and December 31, 2014, at the Indiana University School of Dentistry (IUSD) clinics. We developed and tested three automated computer applications to: 1) diagnose periodontitis cases from periodontal charting, 2) retrieve clinician-documented diagnoses from clinical notes, and 3) track disease change over time. We also evaluated the density of longi-tudinal EDR data for the following follow-up times: 1) none, 2) up to 5 years, 3) >5 and <=10 years, and 4) >10 and <=15 years Results: Thirty-four percent (n=9,954) of the study cohort had up to five years of follow-up visits with an average of 2.78 visits with periodontal charting information. An average of three patient visits per year that contained periodontal charts (63,552) were utilized to obtain a diagnosis, which is considered excellent. For clinician-documented diagnoses from clinical notes, 42% of patients (n=5,562) had at least two PD diagnoses to determine their disease change. In this cohort with cli-nician-documented diagnoses, 72% percent of patients (n=3,919) did not have a disease status change between their first and last visits, 669 (13%) patients' disease status progressed, and 589 (11%) patients’ disease improved. Conclusions: This study demonstrated the feasibility of utilizing longitudinal EDR data to track disease changes over 15 years during the observation study period. We found excellent longitudinal data when diagnoses generated from periodontal charting were considered (three visits per pa-tient). This information can be now utilized for studying the clinical course of periodontitis.