Pub Date : 2025-01-01DOI: 10.1016/j.adaj.2024.10.001
Säde Stenlund MD, PhD, Jeremy Huynh RDH, MPH, Clifford Pau DMD, MSc, Erica Chuang MSc, MPH, Hannah Lishman PhD, David M. Patrick MD, MHSc
Background
Dentists in the United States and Canada have higher rates of prescribing broad-spectrum spectrum antibiotics than dentists in some other Western countries. The authors provide an overview of dental antibiotic prescribing trends from British Columbia, Canada.
Methods
The data include all prescriptions filed from pharmacies in British Columbia from 1996 through 2023. Dental antibiotic prescribing trends were explored visually and stratified according to patient-related characteristics, type of health service area, type of antibiotic, duration of therapy, and dentist’s experience. Interrupted time series regression analysis was conducted to investigate the impact of the COVID-19 pandemic on dental antibiotic prescribing.
Results
Dentistry accounted for an increasing proportion of overall antibiotic consumption in British Columbia. Dental prescriptions increased to a peak rate during the COVID-19 pandemic and remained elevated into 2023. The median duration of prescription converged toward a 7-day supply during the study period.
Conclusions
The authors documented how a decreasing trend in dental antibiotic prescribing prepandemic has been interrupted by means of continuously high rates after that event.
Practical Implications
Renewed efforts to ensure appropriateness of dental antibiotic prescribing are needed.
{"title":"Dental antibiotic use in British Columbia from 1996 through 2023","authors":"Säde Stenlund MD, PhD, Jeremy Huynh RDH, MPH, Clifford Pau DMD, MSc, Erica Chuang MSc, MPH, Hannah Lishman PhD, David M. Patrick MD, MHSc","doi":"10.1016/j.adaj.2024.10.001","DOIUrl":"10.1016/j.adaj.2024.10.001","url":null,"abstract":"<div><h3>Background</h3><div>Dentists in the United States and Canada have higher rates of prescribing broad-spectrum spectrum antibiotics than dentists in some other Western countries. The authors provide an overview of dental antibiotic prescribing trends from British Columbia, Canada.</div></div><div><h3>Methods</h3><div>The data include all prescriptions filed from pharmacies in British Columbia from 1996 through 2023. Dental antibiotic prescribing trends were explored visually and stratified according to patient-related characteristics, type of health service area, type of antibiotic, duration of therapy, and dentist’s experience. Interrupted time series regression analysis was conducted to investigate the impact of the COVID-19 pandemic on dental antibiotic prescribing.</div></div><div><h3>Results</h3><div>Dentistry accounted for an increasing proportion of overall antibiotic consumption in British Columbia. Dental prescriptions increased to a peak rate during the COVID-19 pandemic and remained elevated into 2023. The median duration of prescription converged toward a 7-day supply during the study period.</div></div><div><h3>Conclusions</h3><div>The authors documented how a decreasing trend in dental antibiotic prescribing prepandemic has been interrupted by means of continuously high rates after that event.</div></div><div><h3>Practical Implications</h3><div>Renewed efforts to ensure appropriateness of dental antibiotic prescribing are needed.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 1","pages":"Pages 37-45.e7"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.adaj.2024.10.004
Jiajia Xia MDS, Ziyu Ge DDS, Yanzhen Zhang MDS, Jue Shi DDS, PhD, Zhijian Xie DDS, PhD
Background
The autotransplant of third molars to replace missing teeth is gaining attention. This study aimed to analyze factors influencing the success, survival, and inflammatory root resorption (IRR) of autotransplanted third molars with completely formed roots.
Methods
A total of 160 patients who underwent autotransplant of third molars with completely formed roots were evaluated retrospectively, involving 168 teeth. Preoperative, intraoperative, and postoperative variables were assessed to identify prognostic factors for success, survival, and IRR.
Results
The average (SD) follow-up was 5.21 (1.99) years. The success, survival, and IRR rates were 75.0%, 91.1%, and 17.3%, respectively. Cox proportional hazards regression analysis revealed that both apical resection and retrofilling (ARR) (P < .001) and donor tooth replicas (P < .001 for success and IRR; P = .013 for survival) were associated significantly with success, survival, and IRR. Furthermore, root canal treatment timing and patient age significantly affected success and survival, respectively (P = .006 and P = .036). The use of donor tooth replicas significantly reduced both the surgical time (P < .001) and extraoral time of the donor tooth (P < .001), whereas ARR increased the extraoral time of the donor tooth (P = .002). The use of a single root donor tooth was associated with a reduced surgical time (P = .003).
Conclusions
Using donor tooth replicas and avoiding ARR contributed to increased success and survival rates and prevented IRR.
Practical Implications
Third molars with completely formed roots are suitable donors for replacing missing teeth, provided that appropriate preoperative, intraoperative, and postoperative indications are considered.
{"title":"Prognostic factors for autotransplanted third molars with completely formed roots","authors":"Jiajia Xia MDS, Ziyu Ge DDS, Yanzhen Zhang MDS, Jue Shi DDS, PhD, Zhijian Xie DDS, PhD","doi":"10.1016/j.adaj.2024.10.004","DOIUrl":"10.1016/j.adaj.2024.10.004","url":null,"abstract":"<div><h3>Background</h3><div>The autotransplant of third molars to replace missing teeth is gaining attention. This study aimed to analyze factors influencing the success, survival, and inflammatory root resorption (IRR) of autotransplanted third molars with completely formed roots.</div></div><div><h3>Methods</h3><div>A total of 160 patients who underwent autotransplant of third molars with completely formed roots were evaluated retrospectively, involving 168 teeth. Preoperative, intraoperative, and postoperative variables were assessed to identify prognostic factors for success, survival, and IRR.</div></div><div><h3>Results</h3><div>The average (SD) follow-up was 5.21 (1.99) years. The success, survival, and IRR rates were 75.0%, 91.1%, and 17.3%, respectively. Cox proportional hazards regression analysis revealed that both apical resection and retrofilling (ARR) (<em>P</em> < .001) and donor tooth replicas (<em>P</em> < .001 for success and IRR; <em>P</em> = .013 for survival) were associated significantly with success, survival, and IRR. Furthermore, root canal treatment timing and patient age significantly affected success and survival, respectively (<em>P</em> = .006 and <em>P</em> = .036). The use of donor tooth replicas significantly reduced both the surgical time (<em>P</em> < .001) and extraoral time of the donor tooth (<em>P</em> < .001), whereas ARR increased the extraoral time of the donor tooth (<em>P</em> = .002). The use of a single root donor tooth was associated with a reduced surgical time (<em>P</em> = .003).</div></div><div><h3>Conclusions</h3><div>Using donor tooth replicas and avoiding ARR contributed to increased success and survival rates and prevented IRR.</div></div><div><h3>Practical Implications</h3><div>Third molars with completely formed roots are suitable donors for replacing missing teeth, provided that appropriate preoperative, intraoperative, and postoperative indications are considered.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 1","pages":"Pages 46-56"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.adaj.2024.08.019
Jelena Roganović DMD, PhD, MSc
{"title":"Consent for Artificial Intelligence in Dentistry","authors":"Jelena Roganović DMD, PhD, MSc","doi":"10.1016/j.adaj.2024.08.019","DOIUrl":"10.1016/j.adaj.2024.08.019","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 1","pages":"Pages 6-7"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.adaj.2024.10.009
Michele Lodolo DDS, Richard Jordan DDS, MSc, PhD, Alessandro Villa DDS, PhD, MPH
Background
Chronic lymphocytic leukemia (CLL) is the most prevalent type of leukemia in adults, characterized by the accumulation of mature-appearing, immunologically dysfunctional B lymphocytes in the blood, bone marrow, and secondary lymphoid organs. Oral manifestations of CLL are infrequent and less documented. The authors present a case of CLL in remission with multiple lesions of the palatal mucosa and a literature review of all reported cases of oral manifestations of CLL.
Case Description
A 75-year-old woman with hereditary hemochromatosis, hypogammaglobulinemia, and CLL in remission on ibrutinib sought treatment for multiple, asymptomatic, erythematous papules of the palatal mucosa incidentally noticed by her general dentist. A complete blood count revealed mild absolute lymphocytosis. Extraoral examination was unremarkable. A biopsy of 1 of the palatal mucosa lesions was obtained. Histopathologic examination revealed a focus of B-cell CLL, supported by immunohistochemistry showing the cells positive for cluster of differentiation 5, cluster of differentation 43, PAX-5, BCL-2, and LEF-1. The patient’s hematologist-oncologist ruled out ibrutinib resistance due to Bruton tyrosine kinase (BTK) or PLCG2 mutations. Ibrutinib treatment was continued, and at the 1-year follow-up, only erythema of the palatal mucosa was observed.
Practical Implications
Oral health care providers should include CLL in the differential diagnosis for multiple erythematous papules of the palatal mucosa, particularly in the presence of absolute lymphocytosis. Early recognition of oral manifestations associated with CLL can prompt a timely referral.
{"title":"An unusual oral manifestation of chronic lymphocytic leukemia","authors":"Michele Lodolo DDS, Richard Jordan DDS, MSc, PhD, Alessandro Villa DDS, PhD, MPH","doi":"10.1016/j.adaj.2024.10.009","DOIUrl":"10.1016/j.adaj.2024.10.009","url":null,"abstract":"<div><h3>Background</h3><div>Chronic lymphocytic leukemia (CLL) is the most prevalent type of leukemia in adults, characterized by the accumulation of mature-appearing, immunologically dysfunctional B lymphocytes in the blood, bone marrow, and secondary lymphoid organs. Oral manifestations of CLL are infrequent and less documented. The authors present a case of CLL in remission with multiple lesions of the palatal mucosa and a literature review of all reported cases of oral manifestations of CLL.</div></div><div><h3>Case Description</h3><div>A 75-year-old woman with hereditary hemochromatosis, hypogammaglobulinemia, and CLL in remission on ibrutinib sought treatment for multiple, asymptomatic, erythematous papules of the palatal mucosa incidentally noticed by her general dentist. A complete blood count revealed mild absolute lymphocytosis. Extraoral examination was unremarkable. A biopsy of 1 of the palatal mucosa lesions was obtained. Histopathologic examination revealed a focus of B-cell CLL, supported by immunohistochemistry showing the cells positive for cluster of differentiation 5, cluster of differentation 43, PAX-5, BCL-2, and LEF-1. The patient’s hematologist-oncologist ruled out ibrutinib resistance due to Bruton tyrosine kinase (<em>BTK</em>) or <em>PLCG2</em> mutations. Ibrutinib treatment was continued, and at the 1-year follow-up, only erythema of the palatal mucosa was observed.</div></div><div><h3>Practical Implications</h3><div>Oral health care providers should include CLL in the differential diagnosis for multiple erythematous papules of the palatal mucosa, particularly in the presence of absolute lymphocytosis. Early recognition of oral manifestations associated with CLL can prompt a timely referral.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 1","pages":"Pages 68-73.e1"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.adaj.2024.11.004
Anita M. Mark
{"title":"Fresh start, fresh smile!","authors":"Anita M. Mark","doi":"10.1016/j.adaj.2024.11.004","DOIUrl":"10.1016/j.adaj.2024.11.004","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 1","pages":"Page 88"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.adaj.2024.10.015
Alonso Carrasco-Labra DDS, MSc, PhD, Deborah Polk PhD, For the RESPITE team and guideline panel
{"title":"Optimization of Acute Dental Pain Clinical Pathways","authors":"Alonso Carrasco-Labra DDS, MSc, PhD, Deborah Polk PhD, For the RESPITE team and guideline panel","doi":"10.1016/j.adaj.2024.10.015","DOIUrl":"10.1016/j.adaj.2024.10.015","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 1","pages":"Pages 7-8"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.adaj.2024.02.015
Éder Gerardo Santos-Leite DDS, MSc, Danyel Elias da Cruz Perez DDS, PhD, Alan Roger Santos-Silva DDS, PhD, Pablo Agustin Vargas DDS, PhD, Márcio Ajudarte Lopes DDS, PhD
{"title":"A yellow nodule on the floor of the mouth subjacent to the attached gingiva","authors":"Éder Gerardo Santos-Leite DDS, MSc, Danyel Elias da Cruz Perez DDS, PhD, Alan Roger Santos-Silva DDS, PhD, Pablo Agustin Vargas DDS, PhD, Márcio Ajudarte Lopes DDS, PhD","doi":"10.1016/j.adaj.2024.02.015","DOIUrl":"10.1016/j.adaj.2024.02.015","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 1","pages":"Pages 75-80"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140795932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-12DOI: 10.1016/j.adaj.2024.10.013
Craig S Miller
{"title":"Does dentistry need risk calculators for more consistent and objective decision making?","authors":"Craig S Miller","doi":"10.1016/j.adaj.2024.10.013","DOIUrl":"https://doi.org/10.1016/j.adaj.2024.10.013","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-12DOI: 10.1016/j.adaj.2024.10.012
Hounein Arbaji, Jason Mar, Daria Vasilyeva
{"title":"Persistent ulcerations in an older woman.","authors":"Hounein Arbaji, Jason Mar, Daria Vasilyeva","doi":"10.1016/j.adaj.2024.10.012","DOIUrl":"https://doi.org/10.1016/j.adaj.2024.10.012","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.adaj.2024.10.003
J. Tim Wright DDS, MS
{"title":"Courting water fluoridation","authors":"J. Tim Wright DDS, MS","doi":"10.1016/j.adaj.2024.10.003","DOIUrl":"10.1016/j.adaj.2024.10.003","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"155 12","pages":"Pages 993-994"},"PeriodicalIF":3.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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