BDJ Open最新文献

Objective: To evaluate educational impact of game-based learning (GBL) in orthodontic education.

Methods: A systematic search was undertaken across four databases (Scopus, PubMed, ProQuest Dissertations & Theses Global, and Google Scholar) to identify relevant articles published from January 2000 to December 2023. Additionally, the reference lists of identified literature were examined to further search for relevant literature. The last search was performed on 28 January 2024.

Results: Following the article selection process, seven articles were included in this systematic review, comprising four randomized control trials and three questionnaire surveys. Six articles were assessed to have a moderate risk of biases, whereas one research exhibited a low risk of bias. GBL interventions assessed in five articles were designed in digital format, while one study implemented evaluated traditional learning, and another employed a card game format. Two RCTs indicated a greater effectiveness of GBL in enhancing learner performance compared to traditional learning methods, while one article found no significant difference. Across all articles, positive perceptions of GBL were consistently highlighted at both undergraduate and postgraduate levels.

Conclusion: This systematic review supports the potential of GBL in orthodontic education. The implementation of GBL is recommended to integrate entertaining and educational elements, fostering learner performance within engaging learning environments. However, it is imperative to acknowledge that the overall quality of evidence is limited, primarily due to the moderate risk of biases identified in six of the included articles. Consequently, further high-quality experimental studies are required to validate the effectiveness of GBL in orthodontic education.

Introduction: Decades of evidence have demonstrated a lack of workforce diversity and sustaining disparities in academic dentistry and professional practice. Underrepresented minority students may face challenges and implicit bias during the dental schools' admission/selection process. This review collected papers from different countries to summarize the Equity-Diversity-Inclusion (EDI)-related strategies that dental schools worldwide have used in their admissions process to increase diversity.

Methods: A comprehensive search using MEDLINE (via PubMed), ERIC, Cochrane Reviews, Cochrane Trials, American Psychological Association Psyc Info (EBSCO) and Scopus was done between January and March-2023. All types of articles-designs were included, except comments and editorials, and all articles selected were in English. Two independent investigators screened the articles. Extracted data were general characteristics, study objectives, and EDI-related strategies.

Results: Sixteen publications were used to construct this manuscript. The year with the greatest number of publications was 2022. Type of studies were case studies/critical reviews (50%), cross-sectional (including survey and secondary data analysis) (n = 5, 31.25%), qualitative methods of analysis (n = 2, 12.5%), and retrospective/secondary data collection (n = 1, 6.25%). The strategies described in the articles were related to (1) considering the intersectionality of diversity, (2) using noncognitive indicators during the school admissions process to construct a holistic selection process, (3) diversifying, professionalizing, and providing training to admissions persons who had leadership roles with the support from the dental school and the university, and (4) allocating financial investments and analyzing current policies and procedures regarding EDI.

Conclusions: This review aggregated interesting findings, such as: some schools are considering the intersectionality of diversity as a way to include underrepresented minorities and to diversify the students-body. The recent growth in publications on EDI during dental admission/selection process might indicate a positive movement in this field.

Aim: The aim of this study was to evaluate the long-term clinical outcomes of zirconia-based prostheses used for tooth-supported or implant-supported single crowns and fixed dental prostheses (FPD).

Methods: The authors conducted a prospective analysis of 562 zirconia core restorations supported by endodontically treated teeth or titanium implant in 276 patients in a general dental private practice, with a follow-up period of 15 years. The study was stopped after patients achieved 15 yrs of follow-up. The study analyzed the failure and complication rates of single and multiple crowns, based on Kaplan Meier analysis.

Results: During follow-up period, there were 26 complications and 156 failures. The crown level analysis revealed a cumulative failure rate of 28.33% and complication rate of 8.47% for zirconia crowns after 15 years. The complication rate was found to be higher for titanium implant-supported than for natural teeth-supported crowns. The different types of crown-based failure include: veener fracture 5.01% (N = 29), metal zirconia led to 14.85% (N = 86) loss of retention, and 1.73% (N = 10) loss of crown due to extraction.

Conclusion: Based on these findings, zirconia core restorations appear to be a reliable long-term solution for crowns and fixed dental prostheses.

Clinical relevance: The study suggests that zirconia restorations can be successfully used for long-term prostheses on natural teeth or implants supported. The study results provide clinicians valuable information when selecting prosthetic restorations material.

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.