BDJ Open最新文献

Background: Bacterial infection plays an important role in persistent periapical lesions and inadequate disinfection of root canals is considered the biggest factor responsible for endodontic treatment failure. Antimicrobial Photodynamic Therapy (aPDT) has become the latest choice to eradicate microorganisms in root canals.

Objective: This study aims to evaluate the effectiveness of Antimicrobial Photodynamic Therapy (aPDT) in bacterial count reduction compared to Passive Ultrasonic Activation (PUI) and Ca(OH)2 dressings.

Materials and methods: Forty-five anterior single canal teeth with medium-sized periapical lesions (2-5 mm) were divided into three groups according to the disinfecting technique (each group consists of 15 canals with 1:1:1 allocation ratio): Group A: Ca(OH)2 dressing. Group B: Passive Ultrasonic Activation (PUI). Group C: Antimicrobial Photodynamic Therapy (aPDT). Direct bacterial viable count method was used to count the colonies forming units (CFU) before and after the disinfecting and the bacterial count reduction was estimated, the statistical analysis was performed at a 95% confidence level using the Chi-square and Mann-Whitney U test.

Results: aPDT showed no statistically significant difference when compared to passive ultrasonic irrigation (P > 0.05) but showed higher and more promising results when compared to Ca(OH)2 dressings (P < 0.05).

Conclusions: aPDT has the ability and effectiveness as a disinfecting technique in necrotic and infected root canals.

Clinical significance of the study: The results of this clinical trial provide that aPDT can be considered an adjunct method for root canal disinfection with the same effectiveness as passive ultrasonic irrigation.

Background: Stroke is a major public health problem, with the disabilities of the patients increasing their risk of poor oral health. Currently, in Ghana and Nigeria, no guideline exists for oral health care in stroke patients, while most of our acute stroke care settings have no documented protocol.

Aim: This study sought to understand the perspectives of healthcare professionals in Ghana and Nigeria about oral healthcare in acute stroke patients.

Methods: A qualitative inductive approach was employed to explore healthcare professionals' perspectives. After obtaining informed consent, in-depth interviews were conducted among doctors, nurses, and physiotherapists using semi-structured question guides. Participants' responses were audiotaped for transcription and analysis. Interviews were conducted until data saturation was reached. Data were analyzed thematically to generate themes and sub-themes using an inductive approach.

The results: Twenty-five (25) health care professionals (HCP) aged 25-60 years with a mean age of 36.2 ± 4.2 years were interviewed. There were 15 (60.0%) males and 10 (40.0%) females. HCP included nurse practitioners 14 (56.0%), medical doctors 7 (28.0%), and physiotherapists 4 (16.0%). The HCP demonstrated adequate knowledge of stroke and considered oral health important for esthetic and clinical reasons. They, however, reported being unable to give it the required attention due to inadequate collaboration between the various professional cadres, insufficient equipment, and a skewed focus on other clinical needs of the acute stroke patients.

Conclusions: The findings indicate that HCPs perceived oral health care as very important among patients with acute stroke. However, they reported a lack of collaboration and integration of oral health care in routine stroke care as a major impediment.

Objectives: The effectiveness of an Isomalt-containing mouthrinse to prevent caries development was investigated.

Methods: Human enamel blocks were randomly assigned to five groups (n = 30/group): De-ionized distilled water (DDW), and mouthrinse containing either (IFC) 1% Isomalt, 225 ppm fluoride, and 0.05% cetylpyridinium chloride (CPC), (IF) 1% Isomalt and 225ppm fluoride, (FC) 225 ppm fluoride and 0.05% CPC or (F) 225 ppm fluoride. During 7-day demineralization in a Microbial Caries Model, mouthrinses were applied once daily for 1 min. Demineralization was assessed using Surface Microhardness testing for percentage change in SMH (%ΔSMH) and Transverse Microradiography for mineral loss (ΔZ). Data analysis (α = 0.05) used paired t-test (Intra-group comparison using SMH) and ANOVA/Tukey's for inter-group comparisons (%ΔSMH and ΔZ).

Results: With SMH, relative to sound enamel baseline, demineralization was significant (P < 0.001) in all groups, except in IFC. Intergroup comparison with %ΔSMH showed significantly (p < 0.001) greater demineralization in DDW compared to other groups, and in IF, FC, and F compared to IFC (P < 0.001). With ΔZ, relative to DDW, all groups significantly (p < 0.0001) inhibited demineralization at varying percentages.

Conclusions: Mouthrinse containing Isomalt, fluoride, and CPC inhibited demineralization amidst cariogenic biofilm; thus, highlighting its potential as a more effective caries control tool than mouthrinse with only fluoride.

Objective: This study underscores the transformative role of Artificial Intelligence (AI) in healthcare, particularly the promising applications of Large Language Models (LLMs) in the delivery of post-operative dental care. The aim is to evaluate the performance of an embedded GPT model and its comparison with ChatGPT-3.5 turbo. The assessment focuses on aspects like response accuracy, clarity, relevance, and up-to-date knowledge in addressing patient concerns and facilitating informed decision-making.

Material and methods: An embedded GPT model, employing GPT-3.5-16k, was crafted via GPT-trainer to answer postoperative questions in four dental specialties including Operative Dentistry & Endodontics, Periodontics, Oral & Maxillofacial Surgery, and Prosthodontics. The generated responses were validated by thirty-six dental experts, nine from each specialty, employing a Likert scale, providing comprehensive insights into the embedded GPT model's performance and its comparison with GPT3.5 turbo. For content validation, a quantitative Content Validity Index (CVI) was used. The CVI was calculated both at the item level (I-CVI) and scale level (S-CVI/Ave). To adjust I-CVI for chance agreement, a modified kappa statistic (K*) was computed.

Results: The overall content validity of responses generated via embedded GPT model and ChatGPT was 65.62% and 61.87% respectively. Moreover, the embedded GPT model revealed a superior performance surpassing ChatGPT with an accuracy of 62.5% and clarity of 72.5%. In contrast, the responses generated via ChatGPT achieved slightly lower scores, with an accuracy of 52.5% and clarity of 67.5%. However, both models performed equally well in terms of relevance and up-to-date knowledge.

Conclusion: In conclusion, embedded GPT model showed better results as compared to ChatGPT in providing post-operative dental care emphasizing the benefits of embedding and prompt engineering, paving the way for future advancements in healthcare applications.

Aim: A healthy diet could help to prevent both oral and systemic diseases, with dentists and nutritionists supplementing their skills. The dental setting, where patients periodically refer to seeking oral health care, represents a powerful opportunity for nutritional counselling. To the best of our knowledge, no study is available on patients' attitudes towards dietary counselling in the dental setting. This cross-sectional study investigates patients' attitude towards receiving nutritional support within the dental setting and it elucidates whether a transdisciplinary approach would be well accepted.

Materials and methods: A questionnaire was administered to patients attending three different clinics: a private clinic, a hospital dental clinic of the national healthcare system and the private dental practice within the same hospital.

Results: Three hundred thirteen questionnaires were collected. Most dental patients acknowledged receiving nutritional advice from both dentists and nutritionists. The nutritionist within the dental setting was positively perceived, providing useful advice to prevent oral and systemic diseases and also drawing up a diet with periodic follow-ups.

Discussion and conclusion: These findings support the positive attitude of patients towards receiving nutritional counselling within the dental setting. The dental clinics can be pivotal in oral and systemic disease screening and prevention and a multidisciplinary approach is highly encouraged.

Background: Professionalism is a dynamic construct that requires constant revision based on contemporary practices and attitudes.

Objectives: The purpose of this study was to cross-culturally adapt an already validated English questionnaire assessing patient perceptions of professionalism among dentists, into the Malay language.

Methods: An original 24-item questionnaire was cross-cultural adapted in the Malaysian context through two phases. Phase I included content and face validity from experts' evaluation which was followed by translation into the Malay language. Phase II involved psychometric assessment including construct validity and reliability analysis.

Results: Expert evaluation indicated that all items demonstrated excellent content validity for the characteristics of relevance (CVI = 0.75-1.00 Kappa = 0.72-1.00) and clarity (CVI = 0.75-1.00 and Kappa= 0.72-1.00). A total of 300 dental patients completed the questionnaire. EFA was done on the first dataset and the second dataset was subjected to CFA which showed composite reliability (CR) ranging between 0.741 and 0.897 indicating acceptable reliability among items. The final questionnaire had 20 items with 3 domains; Patient expectation of a dental care provider, Ethics and Dentist's professional responsibilities, Patient communication and confidentiality.

Conclusion: This study has successfully validated the questionnaire for patient perception of professionalism in the Malaysian context.

Objectives: The study explored the expression profile of miRNAs in Notch-activated periodontal ligament stem cells (PDLSCs) and examined their potential cellular targets.

Methods: PDLSCs were cultured and treated with indirect immobilized Jagged1. The miRNA expression profile was examined using NanoString analysis. Bioinformatic analysis was performed together with enrichment, and miRNA expression was evaluated and validated using a quantitative polymerase chain reaction (qPCR).

Results: A total of 26 miRNAs were differentially expressed in Jagged1 treated PDLSCs compared with the controls. Pathway analysis revealed that altered miRNAs were significantly associated with the transforming growth factor β (TGF-β) signaling pathway. Target prediction analysis demonstrated that 11,170 genes as predictable targets of these altered miRNAs. Enrichment of predicted target genes revealed that they were related to ErbB, Ras and MAPK signaling pathways and small GTPase transduction.

Conclusions: The research concludes that several miRNAs are differentially expressed in jagged-1 treated PDLSCs. In translational terms the differential functionality of these miRNAs offer promise for the development of targeted regenerative materials that are necessary for managing lost tissue replacement in periodontal diseases.

Objective: The aim of this study was to evaluate the influence of combining primers and cements from two different resin cement systems on the microtensile bond strength (μTBS) between zirconia and human dentin.

Materials and methods: A total of 120 specimens of zirconia cemented to dentin were allocated into eight groups based on cement type (RelyX Ultimate or Panavia V5) and primers (Tooth Primer, Clearfil Ceramic Primer and Scotchbond Universal Adhesive) combinations, applied to dentin or ceramic surfaces. Following artificial aging with 5000 thermocycles, μTBS tests were conducted. Statistical analysis was performed using One-way ANOVA and Tukey's post hoc tests (p ≤ 0.05), and failure modes were assessed.

Results: The Panavia V5 cement system demonstrated the highest bond strength (19.4 ± 4.4 MPa), significantly higher than the other groups except when RelyX cement was used with Panavia primers (16.9 ± 3.7 MPa). Cohesive fractures within the cement layer were the predominant failure mode.

Conclusions: The combination of primers from different adhesive cement system brands may significantly affect the bonding effectiveness. Therefore, using products from a single product line of the same adhesive cement system, and following the manufacturer's recommendations for indications and use, is crucial for a more predictable clinical outcome.