Special Care in Dentistry最新文献

Objective: This systematic review aimed to verify if individuals with thalassemia present changes in radiomorphometric indices and fractal analysis that can be accessed using panoramic radiographs.

Material and methods: Observational studies that evaluated cortical and trabecular bone patterns in dental routine radiographs were selected from six bibliographic databases. Risk of bias was analyzed using the Joanna Briggs Institute Critical Appraisal Checklists. Quality of evidence was verified using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.

Results: Two hundred three studies were initially retrieved from databases. Three cross-sectional studies, encompassing a total of 129 thalassemic patients, were deemed eligible after applying the inclusion criteria. Bone mineral density (BMD) evaluations were performed using panoramic radiographs and considered the following radiomorphometric indexes: mandibular cortical index (MCI), mandibular cortical width (MCW), panoramic mandibular index (PMI). Fractal dimension analysis (FDA) and simple visual estimation (SVE) were also employed. Overall, FDA and MCW from thalassemia individuals were lower than controls.

Conclusion: FDA and MCW are frequently altered in patients with thalassemia and may be employed as screening tools for reduced BMD. However, the certainty of evidence for this outcome was very low, mainly due to methodological flaws.

Introduction: Two biomarkers that are gaining attention for their roles in the progression of both periodontal and cardiovascular diseases are vitronectin and fetuin-A. This study evaluated vitronectin and fetuin-A expression in saliva samples of periodontitis (P) patients with and without coronary artery disease (CAD) after scaling and root planing (SRP).

Methods: Sixty patients were divided into three groups: PH + SH (periodontally and systemically healthy), P (stage II/III grade B periodontitis), and P + CAD (periodontitis with CAD). Demographic, periodontal, and cardiac parameters were recorded. Unstimulated saliva samples were collected at baseline (day 0) and after SRP. On day 90, periodontal parameters and vitronectin/fetuin-A expression were reassessed.

Results: P + CAD patients had higher age, weight, BMI, and lower income (p < .001, .025, .002, < .001, respectively), along with elevated plaque index, bleeding on probing, probing pocket depth, and reduced clinical attachment levels (p < .001). Vitronectin was elevated, while fetuin-A was lower in P + CAD, but both improved post-SRP (p < .001).

Conclusions: Enhanced vitronectin and fetuin-A levels post-SRP indicate their potential as biomarkers and therapeutic targets for both periodontal and CAD.

Aims: People with disabilities (PWD) often face more significant oral healthcare needs than the general population. This study, conducted in response to the urgent and pressing need for improved dental care for PWD, aims to assess the infrastructural and work process flow of dental centers in Delhi that provide specialized dental care for PWD.

Methods and results: A descriptive cross-sectional study was conducted across primary, secondary, and tertiary healthcare centers in Delhi, evaluating their infrastructure adaptations and work processes in delivering oral healthcare to PWD. The findings, which highlight the disparities in adaptations and work processes among different healthcare centers, are crucial for understanding the current state of oral healthcare for PWD in Delhi. The study reveals that while secondary and tertiary healthcare centers exhibit better adaptations for PWD than primary centers, challenges persist with insufficient accessibility and smooth functioning of the work process.

Conclusion: This study underscores the need for dentists to be equipped with the competence to address the unique needs of PWD. It also highlights the significant potential for improvement in oral healthcare for PWD, as dentists should become more aware of the importance of designing clinics that are accessible for PWD.

Aims: This systematic review aimed to assess the impact of oral health training for caregivers of individuals with disabilities.

Materials and methods: A systematic review was conducted using five electronic databases: Medline (PubMed), SciELO, Web of Science, LILACS, and CAFe, adhering to PRISMA guidelines. The PICO strategy was defined as follows: Participants: caregivers of individuals with disabilities; Intervention: training or education in oral health for caregivers; Control: no caregiver training; and Outcomes: evaluating whether oral health training for caregivers improves the oral health of people with disabilities. The study aimed to address the research question: "What is the impact of oral health training for caregivers of individuals with disabilities?" The study was preregistered in PROSPERO (CRD42023416760).

Results: A total of 14 studies were included, with trained caregivers being either staff members or parents, and various disabilities reported, with cerebral palsy being the most prevalent. Caregiver training methods varied, such as instructions on the importance of oral health care, supervised oral hygiene, and demonstration of toothbrushing techniques. Overall, the intervention groups showed an improvement in measures such as to the Gingival Index, Plaque Index, Simplified Oral Hygiene Index, and Gingival Bleeding Index on upon probing. Additionally, improvements were observed in the quality, frequency, and duration of toothbrushing among intervention groups.

Conclusion: The findings suggest that oral health training for caregivers has a positive impact on the oral health of individuals with disabilities, potentially leading to better oral health outcomes.

Aims: To analyze the protective properties of fluor dental varnishes in teeth subjected to radiotherapy.

Methods and results: Eighty teeth were irradiated with a single dose of 60 Gy. Samples were randomized, and the following groups were made: negative control (n = 16); irradiation control (n = 16); irradiation + Duraphat (n = 16); irradiation + Mi Varnish (n = 16); and irradiation + Rivastar (n = 16). Energy dispersive x-ray (EDX) analysis and Raman spectrometry were performed to analyze the elemental composition and enamel's chemical structure. The Mi Varnish group presented a lower value (p < .05) in the Ca/F ratio than the other groups. Duraphat group presents differences (p < .05) in the ratio 1070 cm¹-960 cm^-1 compared to all the other groups.

Conclusion: Based on these in vitro results, the different varnishes used showed a similar preventive effect on the lesions produced by radiotherapy, with none standing out over the others.

Introduction: Older adults living in long-term care facilities (LTCFs) often have poor oral health and difficulty accessing dental services. The aim was to implement a virtual dental home (VDH) program for residents in two LTCFs utilizing asynchronous teledentistry techniques and mobile dental equipment.

Methods: This pilot project was a 6-month longitudinal cohort study in two LTCFs. Dental hygienists and dentists from a local community health care center utilized asynchronous teledentistry to provide diagnostic and preventive dental services onsite and to establish a dental home for additional comprehensive care services. Data were collected, including resident's demographics, oral health status, and dental services received. Descriptive data analyses, Wilcoxon signed rank, and McNemar tests were conducted.

Results: Thirty-four residents completed in-person baseline oral exams and 16 residents completed the recall exams. Ninety-two percent (n = 23) of dentate residents (n = 25) had untreated caries and 64% (n = 16) of dentate residents had at least one sextant of severe gingival inflammation. The median number of teeth with active untreated caries (p = .01) significantly decreased and arrested caries (p = .02) significantly increased from baseline.

Conclusion: Iowa's VDH pilot project was successful in establishing a dental home using asynchronous teledentistry for residents in two LTCFs and providing resident access to preventive and disease control dental services.

Introduction: Individuals with intellectual and developmental disabilities (IDDs) face numerous challenges in accessing dental care. Despite difficulties, more evidence exploring difficulties among this cohort in India is needed. This study aims to conduct a scoping review of articles published in India exploring access to dental care among individuals with IDD.

Method: We followed the Arksey O'Malley framework for scoping reviews and the PRISMA guidelines for reporting studies. Findings were analyzed based on Levesque's framework for access.

Results: Seventeen articles were collated from five databases. The perceived need for dental care was low, and dental visits were mainly need-based and infrequent. Knowledge regarding dental care did not translate to dental visits. Patient-related barriers were cost, transportation difficulties, fear, lack of dentist skills, patient behavior, and cooperation. From the providers' perspective, most dentists were willing to treat but noted infrastructural and knowledge-based limitations.

Conclusion: Access to dental care was limited due to infrastructure constraints and a lack of dentist training. Caregivers and individuals with IDD did not prioritize dental health, faced communication barriers, and were afraid of dental procedures. It is important to improve preventive dental care and raise awareness among caregivers of individuals with IDD in India. Training dentists and incorporating special care dentistry into the standard dental curriculum will improve access.

Background: Oral health education (OHE) for hearing and speech-impaired (HSI) adolescents relies heavily on sign language. However, it is not effective in conveying oral health concepts due to communication barriers, resulting in suboptimal oral health outcomes. This study aims to evaluate the impact of the jigsaw puzzle assisted visual reinforcement (JPVR) technique on toothbrushing knowledge, practices, and clinical parameters among HSI adolescents.

Methods: The study was carried out as a single-blind randomized controlled trial in a public school in Belagavi, India for a period of three months. The study included 95 participants who were randomly allocated into two groups. One group received sign language with JPVR technique, and the other group received only sign language. A self-designed 15-item closed-ended questionnaire (Cronbach's alpha value of 0.88; content validity ratio = 0.85) was developed to assess the knowledge, and practices at baseline and 3 months. Plaque and gingival indices were also recorded.

Results: At the end of 3 months, the knowledge gained and practices improved in JPVR group were significantly higher compared to sign language group (p = .001). The mean plaque score was significantly lower in JPVR group than that in the sign language group (p = .001); however, gingival index did not show any statistically significant difference at 3 months.

Conclusion: The current study demonstrated that OHE utilizing JPVR technique led to significant improvements in toothbrushing knowledge, practices, and plaque scores compared to that of conventional sign language. This promising strategy has the potential to be cost-effective and does not incorporate specialized sign language training for health professionals.

Background: Ageism is one of the common forms of discrimination and prejudice. It has also been shown to be present in health professionals, including doctors, nurses, and medical students.

Aims: The aim of this study was to translate the Ageism Scale For Dental Students (ASDS) into Polish, perform a culture adaptation, and conduct a preliminary validation analysis.

Methods: The survey was administered to 202 third-, fourth-, and fifth-year students at the Jagiellonian University (No. 1072.6120.283.2020). Data were analyzed using principal components analysis (PCA) with an oblique, Promax rotation, and confirmatory factor analysis (CFA). Cronbach's alpha (α) was calculated to check the internal consistency reliability. Discriminant validity was analyzed using the Mann-Whitney and Kruskal-Wallis test.

Results: PCA produced a 10-item scale distributed into three factors, which explains 59.52% of the total variance. Factor 1 ("preconceived notions about dental treatment") contained four items (α = 0.703), Factor 2 ("cost-benefit of providing care for older patients")-four items (α = 0.660) and Factor 3 ("dentist-older patient interaction")-two items (α = 0.662). CFA confirmed that the model is a good fit (RMSE = 0.058, 90% CI from 0.014 to 0.092, CFI = 0.950, and TLI = 0.926). The discriminant validity showed statistically significant differences in factors or individual items related to the year of the study, gender, and having a history of living with an older person(s) or an older patient(s) treated.

Conclusion: The validation of the ASDS conducted in Poland identified 10 items with sufficient validity and reliability.

Objective: This systematic review evaluated the main clinical, radiographic, histopathological and treatment-related characteristics of ligneous gingivitis (LG) and periodontitis (LP) in individuals with plasminogen deficiency (PD).

Material and methods: Studies in humans diagnosed with PD, focusing on the evaluation of oral characteristics and treatment of the LG/LP were considered for inclusion criteria. Electronic searches were performed up to April 2024 in five databases and in the grey literature. Risk of bias was assessed according to the Joanna Briggs Institute Critical Appraisal Checklists for case reports. It was provided a narrative synthesis of the results.

Results: A total of 17 studies were included. All were case reports that analyzed 17 individuals with PD who presented with LG/LP. The relative frequency of PD type I was 56%, while type II constitutes the remaining 44%. In most studies, patients exhibited ulceration clinically, bone loss radiographically, and subepithelial eosinophilic material accumulation on histopathological evaluation. Conventional periodontal scaling was the most used management. All included studies provided well-described clinical characteristics and confirmed plasminogen deficiency through laboratory testing. Only three studies had a risk of bias values lower than 15%.

Conclusions: Current evidence is limited and varied, complicating the diagnosis and treatment of GL/PL. Future studies should provide a more detailed account of treatments and include extended clinical and radiographic follow-up.