BDJ Open最新文献

Objective: This study investigates refusal rates of dentists in Damascus, Syria, to manage patients who disclose that they are carriers of tuberculosis, human immunodeficiency virus (HIV), hepatitis B and C (HBV/HCV), and patients with dental phobia, asthma, epilepsy, patients unable to afford dental care, and children. The aims are to identify to what extent dentists refuse patients who are diagnosed carriers of certain blood born viruses, require extra measures, take a lot of time, or do not pay.

Methods: A cross-sectional study was conducted in Damascus by distributing paper and electronic questionnaires to dental clinics based on the administrative divisions of the city.

Results: A total of 246 responses were collected. The average years of dental practice among respondents was 9.39 ± 9.8. Rates of refusal were as follows: children (n = 55, 22.4%), tuberculosis (n = 176, 71.5%), HIV (n = 192, 78.0%), HBV/HCV (n = 98, 39.8%), dental phobia (n = 58, 23.6%), asthma (n = 12, 4.9%), and epilepsy (n = 73, 29.7%). Acceptance of patients with tuberculosis, HIV, and HBV/HCV was positively associated with greater years of experience. Dentists who graduated outside of Syria were more likely to accept treating patients with HIV and HBV/HCV. A significant correlation was found between refusal rates for patients with tuberculosis, HIV and HBV/HCV.

Conclusions: The proportion of dentists in Damascus refusing to treat patients who disclose that they are carriers of tuberculosis, HIV/AIDS, and HBV/HCV was notably high. Managing patients who cannot afford treatment often involved reducing fees. The findings provide valuable insights into the systemic challenges in healthcare delivery and propose possible improvements in managing vulnerable population in resource-constrained settings.

Background: This study evaluates the use of large language models (LLMs) in generating Patient Education Materials (PEMs) for dental scenarios, focusing on their reliability, readability, understandability, and actionability. The study aimed to assess the performance of four LLMs-ChatGPT-4.0, Claude 3.5 Sonnet, Gemini 1.5 Flash, and Llama 3.1-405b-in generating PEMs for four common dental scenarios.

Methods: A comparative analysis was conducted where five independent dental professionals assessed the materials using the Patient Education Materials Assessment Tool (PEMAT) to evaluate understandability and actionability. Readability was measured with Flesch Reading Ease and Level scores, and inter-rater reliability was assessed using Fleiss' Kappa.

Results: Llama 3.1-405b demonstrated the highest inter-rater reliability (Fleiss' Kappa: 0.78-0.89). ChatGPT-4.0 excelled in understandability, surpassing the PEMAT threshold of 70% in three of the four scenarios. Claude 3.5 Sonnet performed well in understandability for two scenarios but did not consistently meet the 70% threshold for actionability. ChatGPT-4.0 generated the longest responses, while Claude 3.5 Sonnet produced the shortest.

Conclusions: ChatGPT-4.0 demonstrated superior understandability, while Llama 3.1-405b achieved the highest inter-rater reliability. The findings indicate that further refinement and human intervention is necessary for LLM-generated content to meet the standards of effective patient education.

Objective: This systematic review was conducted to evaluate the attachment of human gingival fibroblasts (HGFs) of the soft tissue, to titanium dioxide nanotubes (TNTs) compared to commercially pure titanium (cp-Ti) and its alloys, in in-vitro studies. It is postulated that the nanotopography of the TNTs provide cells with a biomimetic environment, allowing HGFs to form more focal adhesion (FA) attachment sites at the tubule edges.

Method: A comprehensive literature search was conducted on MEDLINE, DOSS, EMBASE and Google Scholar from January 2012 to January 2022. The identified studies were screened based on titles and abstracts for inclusion criteria. The relevant studies underwent data extraction. The risk of bias was assessed through the Office of Health Assessment and Translation (OHAT) tool.

Results: This systematic review included four studies evaluating cell proliferation, protein expression, gene expression and cell morphology of HGFs evocative of stronger and mature soft tissue attachment. A significant increase in the cell proliferation at TNTs compared to cp-Ti, at day 7 for three studies and at day 14, for one study was evident. In addition, a significant increase in the type 1 collagen protein expression at TNTs compared to cp-Ti, at day 6 for one study and day 7 for two studies. Enhanced cellular extensions from HGFs attached onto TNTs, compared to cp-Ti was observed in all four studies. All the primary effects evaluated suggest the formation of better interlaced fibers giving a stronger adhesion than the parallel ones which is the most relevant outcome of this research.

Conclusion: HGFs showed enhanced contact guidance onto TNTs but a true biological attachment was not confirmed. This review involved invitro studies which lack methodological rigor to compare among studies, lack information and have small sample sizes limiting effectiveness of parametric tests. The results may be unpredictable when translated to in-vivo studies mainly affected by confounding factors. Further research is needed to determine the precise mechanism of mechanical attachment between the soft tissue and the transmucosal surfaces.

Objective: Dental traumas are one of the most common reasons for children to visit the dentist. This study aimed to investigate the predictors of mothers' behavior based on the health belief model (HBM) for the prevention of dental trauma in 7-12-year-old children.

Methods: The current cross-sectional study was conducted on 700 mothers in Kashan city in 19 September 2023 to 2 March 2024 included in the study by multi-stage random cluster sampling method. The data collection tool was a valid and reliable researcher-made questionnaire consisting of demographic information, Knowledge, constructs of HBM, and preventive behavior for dental trauma. Data were analyzed using SPSS 21 and descriptive statistics (standard deviation, mean, median and range), inferential tests (Pearson correlation coefficient, regression) and path analysis to test the direct and indirect effect of model constructs on the dependent variable by AMOS software.

Results: Knowledge (r = 0.365, P < 0.001), perceived benefits (r = 0.166, P < 0.001), and self-efficacy (r = 0.425, P < 0.001) had a positive correlation and perceived barriers (r = -0.313, P < 0.001) had a negative correlation and a significant relationship with mothers' preventive behaviors. Knowledge, perceived barriers and self-efficacy explained and predicted a total of 33% of preventive behavior changes (R-Square=0.329). In the path analysis, self-efficacy (β = 0.327, P < 0.001), knowledge (β = 0.251, P < 0.001) and perceived barriers (β = -0.242, P < 0.001) had the most direct effect, and perceived severity (β = -0.017), perceived susceptibility (β = -0.004), and perceived benefits (β = 0.092) had an indirect effect on mothers' preventive behaviors (P < 0.05).

Conclusion: Knowledge, self-efficacy, and perceived barriers were key predictors of mothers' preventive behaviors. Interventions should target these factors to improve dental trauma prevention in children. The HBM effectively identified these predictors.

Objectives: The temporomandibular joint system and visual apparatus seem to be correlated. Our study aimed to examine the potential effects of occlusal splints on visual capacities (accommodation and ocular convergence) in individuals with temporomandibular disorders, followed for a period of 6 months and 1 year, assessing changes over this timeframe.

Materials and methods: Forty-two subjects were enrolled in a year-long study conducted at the Operative Unit of Odontostomatology of ASST Santi Paolo e Carlo, in collaboration with the University of Milan, Italy. A gnathological examination was followed by an orthoptic assessment using the stick of Duane and measuring convergence and accommodation at three jaw positions at different time points (T0, T1, T2, T3).

Results: After 6 months of occlusal splint therapy, an improvement in visual abilities at maximum intercuspation and resting positions was observed. In contrast, the open-mouth position did not yield statistically significant results. Further assessments at 1 year did not show significant changes. Occlusal splint therapy appears to positively influence visual capacities (in maximum intercuspation and resting positions). While the open-mouth position did not exhibit significant improvements.

Conclusion: Our study results highlight the importance of considering jaw positions in evaluating visual function, suggesting the possible integration of occlusal splints with an orthoptic assessment in comprehensive TMD management.

Objectives: The purpose of this study was to evaluate the effectiveness of the digital education system on the crown preparation performance of dental students in repetitive preclinical training sessions, and students' perceptions of the digital software in fixed prosthodontic practice.

Material and methods: Forty dental students in the third year were recruited for the preclinical training of all-ceramic crown preparation on the lower right first molar in seven sessions. The first session (S1) included the initial didactic course and the first crown preparation practice with the instructor's guidance. The second session (S2) comprised training in using the pedagogical Dental Teacher system. Students participated in five consecutive practice sessions (S2-S6), receiving only digital feedback. The seventh session (S7) was conducted with no digital or instructor support for all students. The abutment teeth were compared to the original tooth and measured via Exocad software. Each preparation received ten component scores corresponding to ten specific areas of the tooth and an overall score (out of 10) based on how well it matched the criteria. Participants were asked to complete a questionnaire survey to investigate their perception of the digital education software.

Results: In the occlusal surface, the scores significantly differed in the third/fourth session compared to the first session (p = 0.037), and this difference remained throughout the study (p = 0.002 for the fourth session and p < 0.001 for the fifth, sixth, and seventh sessions). No significant difference was found for the buccal and lingual surfaces. In the proximal surfaces, the reduction scores of the occlusal second differed significantly between sessions 1 and 5 and between session 1 and session 6. However, no difference in scores from the last and first sessions was found. In the cervical second, no score difference was observed during the study. The overall scores of tooth removal rose from a baseline of 6.52 ± 0.79 to 7.14 ± 0.67 in session 5 (p = 0.033) and 7.35 ± 0.75 in session 6 (p < 0.001), before falling to 7.05 ± 0.74 in the last session (p = 0.203). Participants using digital software reported high satisfaction (92.5-95.0%) and expressed interest in future use for prosthodontic training (100%). However, over 50% of students assumed that digital software was incapable of substituting for teachers for guidance or assessment of crown preparation.

Conclusion: The findings showed that the digital software improved students' overall performance in preclinical prosthodontics and facilitated precision in some specific areas of tooth preparation. Preclinical crown preparation training benefits from the utilization of digital evaluation software; however, this digital pedagogic system cannot entirely replace the teachers' roles.

Aim: To review the literature on the key determinants of health and well-being amongst dental nurses.

Method: A rapid review of the literature using Khangura's approach across seven health and social science databases was conducted (2002 to 2023), through OVID and the Cochrane Library, professional and health system databases-informed by past research exploring the health and well-being of dental professionals. A two-stage review process was implemented where records were screened by the primary researcher, with a second researcher independently reviewing 10% of the papers according to agreed inclusion and exclusion criteria. Data extraction and qualitative synthesis of the included studies were conducted, and quality was assessed using a Mixed Methods Appraisal Tool.

Results: Out of 4,450 identified papers, 44 underwent full-text screening and 37 studies were included for analysis. Four studies were of high quality, 13 moderate-high, 14 moderate-low and six low-quality. The overall health and well-being of dental nurses was variable and the determinants influencing well-being were grouped into micro-, meso- and macro-level factors with evidence across the three domains with the most frequently identified determinant being workplace characteristics. Dental nurses with extended duties had higher job satisfaction. There was evidence that during the COVID-19 pandemic, there were increased levels of anxiety, stress, burnout and isolation among dental nurses.

Conclusion: The body of research suggests that dental nurses' health and well-being determinants are comparable to those of other dental professionals. Dental nurses in different countries had similar determinants. It is important to recognise and improve the determinants of dental nurses' health and well-being to support retention within the profession. Organisational and policy changes may help improve the well-being of dental nurses. Further investigation into dental nurses' health and well-being over time is needed.

Objectives: This study aimed to evaluate and compare the knowledge, perceptions, attitudes, and clinical experiences of general dental practitioners (GPDs), pediatric dentists (PDs), and other dental specialists (ODSs) regarding minimal invasive dentistry (MID) in Damascus, Syria.

Materials and methods: It was an observational, quantitative study utilizing a questionnaire-based online survey. Demographic information data collected included gender, age, specialty, years of practice, number of patients treated per day, and daily working hours. The knowledge assessment evaluated participants' understanding of MID, their awareness of preventive treatment procedures, previous training, and sources of knowledge. Subsequently, attitude toward MID and chemomechanical caries removal (CMCR) questions assessed participants' perspectives on MID principles and their stance on CMCR. In addition, clinical practices explored the participants' application of CMCR in their daily practice. Descriptive statistics were utilized to illustrate the frequency and percentage of categorical variables. A chi-square test was performed to investigate the relationship between specialization, years of experience, and knowledge of the MID and CMCR. p-value below 0.05 was deemed statistically significant.

Results: A total of 252 participants were included in the study. According to MID's knowledge level, most respondents agreed on the importance of fluoride for remineralization (90.1%) and using sealants for high caries-risk children (64.7%). Caries risk assessments (CRA) are strongly agreed (90%). A small percentage of dentists reported rarely using the CRA technique. However, approximately one-third of them consistently evaluated patients' dietary habits. Additionally, 30.2% frequently assessed the patient's current fluoride exposure. 67.5% were familiar with the CMCR technique. The chi-square test revealed a significant relationship between knowledge and years of experience, particularly for those with 0-2 years of experience (p = 0.006). However, specialization did not impact knowledge, as indicated by the p = 0.076. Furthermore, the chi-square test showed that years of experience did not significantly affect knowledge of the technique.

Conclusions: This research provides important perspectives on how dental professionals are adopting MID and CMCR. Although practitioners received MID training during their university studies, only a small percentage expressed complete confidence in their abilities, indicating that dental training programs could be enhanced. It was also identified a strong consensus regarding the advantages of fluoride and preventive measures. However, views varied concerning specific diagnostic and treatment techniques, particularly ART and pit and fissure sealants in permanent teeth.

Background: Modern oral healthcare extensively uses polymer items and devices derived from various monomeric compounds. These materials are essential for personal protective equipment, infection barriers, packaging, and intraoral devices. The COVID-19 pandemic has led to an increased reliance on single-use polymer items, causing supply chain disruptions and higher costs. This systematic review explores the extent of polymer waste and pollution generated in oral healthcare clinics.

Materials and methods: A systematic review protocol was registered with PROSPERO and was formatted according to PRISMA guidelines and SWiM recommendations. Eligibility criteria included studies that provided quantified estimates of polymer waste or pollution in air or wastewater from oral healthcare clinics. Comprehensive electronic searches were conducted across several bibliometric databases, followed by data extraction and risk of bias assessments performed by two independent reviewers.

Results: A total of thirty studies were included in the review. Sixteen papers reported on waste audits that detailed polymer waste data, while eight studies focused on pollution caused by polymer nano- and microparticles in clinical settings. Additionally, six experimental studies investigated potential leakage of monomeric eluates or polymer particles from landfill waste. There was significant variation in the amount of polymer waste generated per patient, ranging from 81 to 384 g per operatory room per day. On-site sampling revealed the presence of polymer nano- and microparticles in the clinic air, which was influenced by dental procedures and the equipment used.

Conclusions: This review highlights critical knowledge gaps about polymer waste and pollution in oral healthcare clinics. The variability of study designs limited the feasibility of meta-analysis. Current evidence indicates substantial polymer waste generation, particularly from single-use items, as well as potential environmental impacts from monomeric eluates and polymer microparticles. Future research should focus on sustainable polymer waste management solutions to reduce environmental pollution in oral healthcare settings.

Objective/aim: Dental pulp inflammation is a critical condition in endodontics. Traditional diagnostic methods, such as patient pain history and percussion tests, often lack accuracy in reflecting the true status of pulp inflammation. This study explores the feasibility of using a rapid C-reactive protein (CRP) chairside point-of-care (POC) test as a potential adjunctive tool for detecting dental pulp inflammation. The findings provide preliminary insights to inform future larger-scale validation studies.

Materials and methods: This pilot cross-sectional observational study included 20 patients with deep carious lesions. Blood samples were collected from exposed pulp tissue under sterile conditions and analyzed using the CRP rapid POC test (index test). Patient pain history (clinical reference test) and percussion test outcomes were documented. The study assessed feasibility and preliminary diagnostic trends based on test performance and associations with clinical indicators.

Results: The CRP rapid POC test yielded positive results in 55% of cases. Preliminary findings suggest a potential association between CRP levels and percussion test results (p < 0.001), while no significant correlation was observed between CRP levels and patient pain history. The test demonstrated an observed sensitivity of 94.3%, specificity of 87.1%, positive predictive value (PPV) of 90.7%, and negative predictive value (NPV) of 91.9%. However, given the small sample size, these estimates should be interpreted with caution, and further research with larger cohorts is necessary for validation.

Conclusion: This pilot study suggests that the CRP rapid POC test may have potential as a diagnostic aid for detecting dental pulp inflammation. However, these findings are preliminary, and further validation through larger studies and gold-standard comparisons is necessary before clinical implementation can be considered.