BDJ Open最新文献

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.

Background: The postoperative symptom severity (PoSSe) scale, which was developed in the UK, measures the impact of postoperative morbidity on patients' quality of life after lower third molar surgery. It has recently been used in Chinese populations but without having been adapted and validated for these populations. The aim of this study was to cross-culturally adapt and psychometrically evaluate a Chinese version (Simplified Chinese) of the PoSSe scale for applications in third molar surgery in Chinese patient populations.

Methods: We employed a rigorous multi-step cross-cultural adaptation process, including forward and backward translation followed by pilot testing, where participants documented the relevance and ease of understanding of the PoSSe items. The psychometric evaluation of the final Chinese version took place in a sample of 101 patients undergoing lower third molar surgery in Tianjin, China. Cronbach's Alpha (α) coefficient was calculated for the reliability evaluation, while the Spearman correlation coefficient (r_s) and Pearson's correlation coefficient (r) were used for validity assessment.

Results: The PoSSe scale demonstrated excellent internal consistency (Cronbach's α = 0.80 for the whole sample; α = 0.80 among patients with bone removal during surgery; α = 0.81 among patients without bone removal during surgery). For validity assessment, PoSSe scores had statistically significant associations with the extent of surgical trauma (osteotomy and duration of surgery), self-reported pain and clinically assessed trismus. The strength of these associations varied between the two groups (with and without bone removal during surgery) in the expected direction. The results suggest that the Chinese version of the PoSSe scale has acceptable linguistic clarity, cultural relevance, and context appropriateness, showing excellent internal consistency and validity and can be confidently used for clinical and research applications in Chinese patient populations.

Conclusions: The PoSSe scale has been successfully cross-culturally adapted for postoperative use among Chinese patients undergoing third molar surgery and demonstrated successful psychometric assessment for its reliability and validity, which allows future informative studies in China, also in terms of comparison across countries involving China that could assess the cultural equivalence of the measure.

Objective: To evaluate the impact of salbutamol sulfate inhalation on the surface roughness and color stability of hybrid ceramics using an inhaler and nebulizer at different doses over three time periods.

Materials and methods: A total of 120 samples of Lava Ultimate (LU), Cerasmart (CS), and Nacera Hybrid (NH) were divided into three equal groups. Each group was subdivided into two subgroups according to the use of inhaler or nebulizer. Each subgroup was subdivided into two divisions according to the minimum and maximum doses of inhalation. The samples were cut rectangular and polished according to the manufacturers' instructions. They were exposed to salbutamol in acrylic boxes and then kept in artificial saliva for 30, 60, and 90 days which was equivalent to 4, 8, and 12 months. The surface roughness and color change (ΔE) were measured before and after exposure to salbutamol via a non-contact profilometer and a reflective spectrophotometer based on CIE L*a*b* respectively. The data were tabulated and statistically analysed using a three-way ANOVA test and the significance level was set at P ≤ 0.05.

Results: Cerasmart recorded the highest statistically non-significant roughness change (1.2298 ± 0.331%, P > 0.05). NH had the highest statistically significant ΔE (ΔE = 6.174, P ≤ 0.0001). The maximum dose used in three-month exposure period had the highest statistically significant change in roughness and color (P ≤ 0.0001). Additionally, the inhaler-treated groups presented significantly higher values than the nebulizer-treated groups for ΔE only (P < 0.05). Eventually, Pearson correlation analysis revealed a statistically significant positive direct relationship between roughness and ΔE (P = 0.013).

Conclusions: Salbutamol can significantly affect the color of hybrid ceramics while causing a non-significant increase in their surface roughness.

Aim: Oral functions related to eating, including mastication, swallowing, and taste, are fundamentally a multisensory experience that relies on the crossmodal interaction of touch, gustation, temperature, pain, and proprioception. The brain mechanisms of oral multisensory processing related to eating have remained unknown.

Methods: The current systematic review summarizes the findings from neuroimaging studies (mainly functional magnetic resonance imaging) focusing on the interaction of multiple sensory stimuli in human participants. Neuroimaging studies of human adults on the interaction between multiple sensory stimuli related to oral functions were identified and extracted via three electronic databases and reviewed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Results: Thirteen primary studies were eligible to be included in this review. Five studies investigated the interaction of intraoral (i.e., sensorimotor, taste, and noxious) stimuli. Six studies investigated the interaction between intraoral and extraoral (i.e., auditory, olfactory, and visual) stimuli. One study investigated the audio-visual interaction on dental fear, and another study investigated sensorimotor processing of eating tools. The studies showed great diversity in the experimental design of crossmodal interaction. Regarding the brain features related to the interaction, the somatosensory and motor regions were mostly reported in the studies.

Conclusions: The systematic review revealed a complex pattern of brain activation of oral multisensory processing, which can be attributed to the diversity in the experimental design of crossmodal interaction. The findings highlight the role of multisensory integration in maintaining oral health.

Objectives: The push-out bond strength to the intraradicular dentin was evaluated in this in vitro study using an epoxy-based endodontic sealer loaded with silver-gold nanoparticles. Additionally, the benefits of using the nanoparticles as a canal pretreatment before applying the sealer were evaluated in comparison to using the sealer alone.

Methodology: After being decoronated and instrumented, thirty extracted human central incisors were obturated and then divided horizontally into three parts (coronal, middle, and apical) with a thickness of 2 mm. Three groups of slices were created at random: Groups I (control) and II received AH Plus sealer, AH Plus sealer loaded with silver gold nanoparticles, and III received nanoparticles as a pretreatment for the canal prior to gutta-percha and AH Plus sealer for obturation. The specimens were loaded at a rate of 0.5 mm/min utilizing a Universal Test Machine and put through a push-out test. Statistics were applied to each data collection. Additionally, the significance level was set at P ≤ 0.05.

Results: A push-out test showed that the groups differed significantly from one another. The tested groups differed significantly in both the coronal and middle portions, with group (II) exhibiting the highest push-out strength values. Group (II) had the highest push-out strength values in the apical portion (3.66 ± 0.72), followed by group (III) (2.90 ± 1.45), while group (I) had the lowest value (2.88 ± 1.73). There was no significant difference between the groups.

Conclusions: the experimental AH Plus sealer combined with silver-gold nanoparticles demonstrated the most effective adhesion followed by nanoparticles as a canal pretreatment prior to sealer application when compared to AH Plus sealer alone.

Introduction: Journal clubs are integral to continuing medical education, promoting critical thinking and evidence-based learning. However, inconsistent engagement, reliance on faculty expertise, and the complexity of research articles can limit their effectiveness. Generative Artificial Intelligence (Gen AI), particularly Large Language Models (LLMs) offers a potential solution, but general-purpose LLMs may generate inaccurate responses ("hallucinations"). Retrieval-Augmented Generation (RAG) mitigates this by integrating AI-generated content with curated knowledge sources, ensuring more accurate and contextually relevant responses. This study explores the development and preliminary evaluation of a RAG-enhanced LLM to support journal club discussions.

Materials and methods: A specialized LLM was deployed using Microsoft Azure's GPT-4o. A vector database was created by embedding journal club articles using text-embedding-ada-002 (Version 2) for efficient information retrieval. A dedicated website provided user-friendly access. The study followed a design-based research (DBR) approach, engaging residents and faculty who interacted with the LLM before and during journal club sessions. Data collection included focus group discussions (FGDs) and questionnaires assessing engagement, usability, and impact.

Results: The study involved a total of 13 residents and three faculty members as participants. 50% of residents reported a positive experience, while the rest had a neutral response, citing both advantages and limitations. The LLM improved article summarization, query responses, and engagement as reported by residents. Moreover, the faculty observed enhanced discussion quality and preparation whereas overall challenges included the need for precise prompts and occasional misleading responses.

Conclusion: The study highlights the potential of a RAG-enhanced LLM to improve journal club engagement and learning. Future advancements in AI and open-source models may enhance accessibility, warranting further research.