BDJ Open最新文献

Introduction: People living in nursing or residential homes are at an increased risk of having or developing oral and dental diseases. This is due to contributing factors such as comorbidities and polypharmacy coupled with poor manual dexterity and lack of disease prevention and access to care. These risk factors combined with frequent and high sugar consumption increases risk of developing dental decay. Care home residents are a diverse population from different backgrounds. Little is known about decision making around nutrition in care settings and nutritional practices of older people in care homes, including the choices and challenges. The purpose of this study was therefore, to understand care home landscape and resident experiences.

Materials and methods: Semi-structured interviews were conducted with participants including residents, care home managers, carers and kitchen staff. Interviews were held face-to-face, recorded and transcribed and the findings were analysed using a thematic approach.

Results: A total of 17 participants across 4 care homes in one outer London borough took part in this study, with findings relating to both nutrition and oral health. Resident food preferences were collected upon admission into the home, including information on the incoming resident's lifestyle, routine and choices. Staff tried to maintain these where possible and accommodate to resident choices when possible. Opportunities for wider food choice was dependent on the residents' ability and willingness to request alternatives, their financial freedom to purchase their own foods, mobility to access food outside of the care home setting and food bought in by family and friends. This was compounded by residents being prescribed high calorie, high sugar meal supplemented for weight management. Participants reported that the structured routine revolved around meals and activities. Most care staff reported that an alternative healthy option was offered at mealtimes, but this was not the case in all homes. Care staff faced challenges managing weight of residents who had appetite loss and tried to accommodate and make provisions for those with these experiences and were aware of how to raise concerns. There was variation in mandatory training expectations, with no integration of oral health and nutrition.

Discussion: The findings provided valuable insight into the disparities between and within homes and highlights the challenges in this complex group with regards to nutritional choices. It is vital that a range of food options are in place to protect residents' rights to choose what they wish to eat, whilst offering healthy options and all care staff are educated on offering balanced, nutritious meal and snack options. By offering a range of foods, the healthier choice can be the easier choice.

Background: Direct effects of climate change on different domains of general health have been well documented with evidence-based literature; however, the implications for oral health and dentistry have been addressed in different forms of research papers and lack a comprehensive evaluation.

Objectives: We aimed to conduct a scoping review of the existing literature to elucidate the connections between the impact of climate change on oral health and dentistry, exploring how environmental shifts can influence dental diseases and practices and offering insights for future dental care using a systematic search strategy.

Methods: A systematic search was carried out using keywords in PubMed, Embase, and Scopus databases. Boolean operators were also used to combine the searches and elaborate the search strategy. We did not apply any restriction of time frame or language to the articles. A total of 10 papers were included in the final review. The findings from different papers have reported direct/indirect associations of climate change with oral diseases and conditions such as dental caries, dental erosion, and oral cancer; developmental defects of enamel; early childhood caries; periodontal disease; and dental trauma, skeletal, and dental fluorosis.

Discussion: The findings synthesize a nascent yet significant body of research exploring how environmental changes driven by climate change impact the dental profession and oral health outcomes. Continued research and policy attention are imperative to address the complex and evolving challenges posed by climate change to oral health.

Background: Oral appliances (OAs) are widely used in the management of obstructive sleep apnea (OSA), yet a comprehensive understanding of the research landscape in this field is lacking. This study aims to map the global research trends, influential publications, leading researchers, and emerging areas of interest related to OAs for OSA.

Methodology: Data were retrieved from the Scopus. The search included terms related to OSA and OA. Articles were screened using Rayyan software. VOS viewer™ and Bibliometrix were used for analysis. Data were visualized through network maps and graphs to identify key authors, research centers, countries, and keyword trends. Co-occurrence of keywords and citation patterns were assessed to understand the research dynamics.

Results: Out of 1370 initially retrieved articles, 753 were selected for final analysis, revealing a marked increase in scientific output in recent years. The study identified approximately 2400 researchers, with notable work from Cistulli P.A., Vanderveken O.M., and Lowe A.A., who formed key clusters. Major research hubs included The University of British Columbia, The University of Sydney, and Royal North Shore Hospital. The USA and Japan led in citations and publications. Global collaboration patterns were evident, showing contributions from various countries. Keywords like "obstructive sleep apnea," "mandibular advancement device," and "oral appliance" were frequently used, while emerging trends highlighted gaps in research related to tongue retaining and hybrid appliances. The top 20 cited documents from 1995-2020 encompassed reviews, clinical practice guidelines, and randomized trials, with the "Sleep" journal being the most cited source.

Conclusion: This bibliometric analysis provides a detailed overview of the research landscape on OAs for OSA. The study highlights significant trends, influential researchers, and key research centers. It also identifies emerging areas of interest and research gaps, offering guidance for future research to enhance the clinical effectiveness and adoption of OA therapy for OSA.

Objective: To effectively evaluate evidence-based dentistry (EBD) training outcomes, precise and validated assessment tools are essential. This study aimed to construct a Vietnamese version of the KACE questionnaire (Knowledge, Attitudes, Access, and Confidence Evaluation) and to assess its reliability and validity.

Methods: After translating the original KACE questionnaire, we conducted tests for face validity, content validity, and discriminant validity test. Cronbach's alpha and intraclass correlation coefficients (ICC) were calculated to evaluate the internal consistency and reliability of the Vietnamese KACE questionnaire.

Results: Thirty lecturers and 280 dental students completed the KACE questionnaire. Cronbach's alpha for the Attitude scale ranged from 0.90 to 0.97, for the Accessing Evidence scale from 0.90 to 0.96, and for the Confidence scale ranged from 0.83 to 0.93 across lecturers and dental student groups. The Knowledge scale had Cronbach's alpha from 0.55 to 0.79. The overall ICC of 0.861 indicated that the measurement is stable and consistent.

Conclusion: The Vietnamese adaptation of the KACE questionnaire is a reliable and valuable tool for assessing EBD competencies among Vietnamese dental students and practitioners.

Introduction: Demographic projections forecast that centenarians' population growth will continue. "CaT: Centenari a Trieste" is an ongoing study featuring the collection of demographic and anamnestic data, including the analysis of oral variables.

Aims: evaluate of the possible influence of past food preferences, taste perception and masticatory function on current cognitive status in a cohort of centenarians.

Design: Observational transversal study.

Materials and methods: 31 participants with mean age 102 ± 2 performed an examination of the oral cavity including the measurement of DMFT (Decayed Missing Filled Teeth), FTUs (functional teeth units), FOUs (functional occlusal units) and 6-n-propylthiouracil (PROP) taste perception assay. Results were correlated with dementia, subjective perception of oral health and food preferences.

Results: Masticatory function did not correlate with dementia but had a significant impact on oral health perception. When analyzing variables affecting food preferences, PROP taste perception profile and DMFT resulted significantly correlated. Early edentulism didn't show to affect past dietary preferences.

Conclusions: our data suggest that in centenarians masticatory function doesn't seem to correlate to cognitive function, but influences the self-perception of oral health. Such results are an interesting addition to knowledge on the topic as they refer to a population which has never been considered before.

Introduction: Periodontal disease (PD) and peri-implantitis (PI) can have a significant impact on oral health related quality of life. It is important that any patient reported outcome measures accurately reflect this impact.

Aims: To identify the measures used to assess the impact of periodontal disease and peri-implantitis on oral health related quality of life. To assess the psychometric properties of the measures identified by applying an adapted version of the Consensus-based standards for the selection of health measurement instruments (COSMIN) checklist.

Materials and methods: A search of the literature incorporated relevant MeSH terms across four separate databases: Scopus, Web of Science, Medline and Embase. Following the removal of duplicates, studies meeting the inclusion criteria were screened. Any condition specific measure or a measure appearing greater than five times was analysed in accordance with the COSMIN criteria.

Results: A total of 2103 articles were identified, of which 140 proceeded to full text review. A total of eight different OHRQoL measures were identified and psychometrically analysed.

Discussion: The majority of measures used to assess the impact of PD and PI were not validated on local populations and were non-specific, generated by clinicians and researchers. The three condition specific measures were adaptations of the Oral Health Impact Profile, a non-specific patient reported outcome measure which may not accurately reflect the specific signs, symptoms and overall impact of PD/PI on an individual's OHRQoL.

Conclusion: There is a necessity for a condition-specific instrument to be developed to ensure that the impact of periodontal disease and peri-implantitis on OHRQoL is captured accurately.

Introduction: Artificial Intelligence (AI) is a rapidly evolving technology, with various applications in dentistry including diagnosis, treatment planning, and prognosis. There are various AI-based applications for dental practitioners, however, their real-world evaluation through deployement studies is scarce, as most of the studies are validation studies. This review explores the potential pitfalls of focusing solely on technical performance metrics when evaluating AI-based applications in dentistry while overlooking the importance of clinical applicability.

Methods: An electronic search was performed on PubMed and Scopus while a manual search was conducted on Google Scholar "Dentistry", "Dental", "Artificial Intelligence", "Deep Learning, "Machine Learning", "Applications", "Diagnocat", "CephX", "Denti.AI", "VideaAI", "Smile Designer", "Overjet", "DentalXR.AI", "Smilo.AI", "Smile.AI", "Pearl", "AI deployment challenges in dental practice", "AI for treatment planning in dentistry", "AI in dental imaging", and "AI-based diagnosis in dentistry".

Results: The electronic search yielded a total of 34 studies, while 10 additional studies were obtained through a manual search, resulting in a total of 44 studies included in this review.  Among the 44 studies analyzed, 26 studies were retrospective, while 7 studies utilized a comparative design. The remaining studies comprised of 3 observational, 5 validation, 2 cross-sectional, and 1 prospective study. Further to evaluate the identified applications, relevant companies were contacted via email. Only one company's representative responded, offering a limited trial version which was insufficient for evaluating the application's effectiveness. AI technologies may offer lots of benefits for dental practice by enhancing patient-health-based outcomes, however, real-world applications are necessary to ensure its safety.

Conclusion: This work highlights the need for conducting deployment studies for such AI-based dental applications to translate and implement them into dental practice. Collaboration with stakeholders and dental practitioners to assess the use of such applications is of paramount importance.

Introduction: Pre-fabricated fibre posts facilitate post-endodontic restoration of endodontically treated teeth with insufficient coronal tooth structure. Recent advancements in digital dentistry have led to the introduction of custom-made fibre posts fabricated with computer-aided design-computer-aided manufactured (CAD-CAM) technology. However, evidence on the comparative performance of the different post-types is lacking. This systematic review with network meta-analysis aimed to analyse the current evidence on in-vitro studies comparing bond strength, catastrophic failures, fracture resistance, and cement film thickness between CAD-CAM fibre posts and other post types, including pre-fabricated fibre and custom-made cast-metal posts.

Materials and methods: A systematic search was conducted in PubMed, Scopus, and the Cochrane Central Register of Controlled Studies for in-vitro studies from inception until December 2023 (PROSPERO: CRD42024501614). Network meta-analysis and pairwise meta-analysis were performed. The ranking was performed using the surface area under the cumulative ranking (SUCRA) guidelines.

Results: Seven hundred forty-one articles were identified, of which 80 duplicates were removed, and 585 were excluded by screening the titles and abstracts. A total of 76 articles were assessed by full-text reading, and 16 were included in the quantitative synthesis. CAD-CAM fibre posts (SMD = 1.09 [95% CI: 0.01, 2.17]) P = 0.04 demonstrated higher bond strength when compared to pre-fabricated posts. CAD-CAM fibre posts (RR = 0.39 [95% CI: 0.23, 0.69]) P < 0.05 demonstrated a lower risk for catastrophic failures when compared to pre-fabricated fibre posts.

Conclusions: In-vitro studies demonstrated that CAD-CAM fibre posts demonstrated higher bond strength, lower catastrophic failure rates, and similar fracture resistance compared to pre-fabricated and cast metal posts. The data on bond strength and catastrophic failures of CAD-CAM fibre posts must be validated clinically by high-quality, randomised, controlled clinical trials.

Background: The application of Silver diamine fluoride is an effective approach in controlling dental caries. But the black discoloration caused by its application is unaesthetic and is of greater concern to the parents.

Aim: To assess the potential color masking ability of tooth colored restorative material over discoloration caused by 38% SDF using a UV‒VIS-NIR spectrophotometer.

Material and methods: 20 extracted teeth were taken and randomly divided into 4 groups: Group A: 38% SDF + GIC; Group B: 38% SDF + RMGIC; Group C: 38% SDF+ Composite; Group D: 38% SDF+ Cention N. Two readings were recorded, one on application of 38% SDF and second after application of test materials using a UV‒VIS-NIR spectrophotometer.

Result: The intragroup comparison for color masking ability (ΔE) for all four restorative materials revealed no statistically significant differences, with a test value of 1.168 and a p value of 0.353, and the highest mean was observed in Group A, i.e., 38% SDF + GIC (9.171966) Significant differences in color were observed, with more shifts toward yellow in group A (2.488 ± 2.957) and group D (1.686 ± 0.559) and more shifts toward green in groups B (-0.088 ± 0.34) and C (-0.062 ± 0.5). The mean lightness was greatest for Group C, i.e., the composite group (86.396 ± 3.741), and least for Group A, i.e., the GIC group (76.664 ± 8.213).

Conclusion: All 4 restorative materials were equally effective in terms of color masking over 38% SDF discoloration.

Background: Drug-associated gingival disorders can negatively impact on oral health. This study aimed to utilize the United States Food and Drug Administration Adverse Event Reporting System (USFDA AERS) to comprehensively assess the associations between medications and specific gingival disorders.

Methods: Data were extracted from the USFDA AERS from 2004-2024 using Preferred Terms for eight gingival disorders. Reports were deduplicated and disproportionality analysis was conducted using frequentist and Bayesian approaches to detect potential signals. Volcano plots were generated for each gum disorder to identify the drugs with the strongest signals based on the statistical significance and magnitude of association.

Results: A total of 11,465 reports were included. Several anti-osteoporotic drugs, anti-thrombotics, calcium channel blockers and immunosuppressants showed significant associations with multiple gingival disorders. Phenytoin was linked to hypertrophy and bleeding. Stomatological preparations were associated with discoloration and bleeding. Emergent signals were identified with finasteride, COVID-19 vaccine, and levothyroxine with gum disorders.

Conclusion: This study highlights the need for increased awareness of oral side effects amongst healthcare providers. Future research should explore the mechanisms of drug-induced gingival disorders and develop interdisciplinary management strategies to enhance oral health in patients on long-term medications.