Australian dental journal最新文献

Background: Chronic periodontitis is one of the most common inflammatory diseases worldwide. Micronutrients play a significant impact on health and periodontal disease progression. However, there is still a lack of conclusive studies confirming the causal association of micronutrients with chronic periodontitis.

Materials and methods: Genome-wide association study pooled data on chronic periodontitis were collected from the FinnGen consortium, and 14 micronutrients (calcium, copper, zinc, potassium, magnesium, selenium, iron, carotenoids, vitamin B6, B12, C, D, E and folate) were obtained from the OpenGWAS and UK Biobank Study. Instrumental variables were screened by strict criteria. Five Mendelian randomization (MR) methods were used. Finally, the robustness of the findings was verified by sensitivity analyses.

Results: We found that vitamin D reduced the risk of chronic periodontitis (OR: 0.605, 95%CI: 0.398-0.921, P = 0.019). However, we had no evidence of a significant association between other micronutrients and chronic periodontitis. Multiple sensitivity analyses confirmed the robustness of the findings. A variety of sensitivity analysis methods confirmed the reliability of the results.

Conclusion: In this study, we found a potential causal relationship between vitamin D and chronic periodontitis by MR analysis, whereas we did not find an association between 13 other micronutrients and chronic periodontitis. This result might provide new ideas for the prevention and treatment of chronic periodontitis to some extent. However, despite the rigorous analytical methods used in this study, this finding needs to be interpreted with caution. Further randomized controlled studies might provide more in-depth references to the findings of this study.

Background: This study aimed to evaluate the current status of dental sleep medicine education across dental schools in Australia and New Zealand and gain further insights into the educational background of dentists who have sat the Australasian Sleep Association Fellow of Dental Sleep Medicine examination in 2023.

Methods: Online surveys were carried out, and descriptive statistics were used to analyse data.

Results: All dental schools responded to the survey. Seventy per cent of the schools included dental sleep medicine as part of their curriculum, with an average total teaching time of 2.6 h. Dentists who sat the Fellow of dental sleep medicine examination spent on average 87 h preparing for the examination. All dental schools included discussion on pathophysiology of obstructive sleep apnoea and oral appliance therapy, but did not adequately discuss advanced sleep medicine topics, clinical aspects in treatment planning or contemporary dental sleep medicine topics, whereas dentists that completed the Fellow of dental sleep medicine examination gained knowledge in all aspects of the field.

Conclusion: Findings from the study reveal that dental schools across Australia and New Zealand are not delivering adequate levels of education in dental sleep medicine, and hence the current dental sleep medicine curriculum needs to be reviewed and improved.

Background: Xerostomia (dry mouth) is a common yet severe problem, causing difficulty with eating, speaking, dental caries, and discomfort. Access issues to dental services, including cost and availability of dental practitioners, can delay timely diagnosis and management of dry mouth. Thus, there is a need for innovative approaches to manage xerostomia, involving non-dental primary care health practitioners.

Methods/designs: This proof-of-concept study assessed the feasibility of a co-designed oral health education resource to enable pharmacists to support their clients in managing xerostomia. The co-design process involved input from consumers with lived experience and an expert advisory group. Ten community pharmacists then participated in a pilot programme to deliver oral health advice on dry mouth to their clients. Pre- and post-intervention surveys assessed the pharmacists' confidence, recommendations and knowledge on dry mouth.

Results: Through the co-design process, several resources were developed, including an information guide for pharmacists, a flyer and a sticker for clients. Participating pharmacists had an increase in confidence, knowledge and ability to provide dry mouth management advice when supported by appropriate resources.

Conclusion: It is feasible for pharmacists to provide oral healthcare advice in a community pharmacy setting if they receive the right training, resources, and support.

Background: During the COVID-19 pandemic, non-urgent dental treatments were deferred. To identify and prioritize urgent dental patients, teledentistry was implemented across NSW public dental services. This study aimed to establish the validity of teledentistry examinations to provide a clinical diagnosis compared to face-to-face, clinical examination.

Methods: A retrospective review using convenience sampling was used to source clinical data from a public dental service for two periods in 2020 and 2021. Researchers compared the diagnoses identified from teledentistry consultations with follow-up face-to-face consultations, diagnoses were grouped into 14 sub-categories that broadly covered common oral health conditions and pathologies. Sensitivity, specificity, NPV and PPV were calculated.

Results: The study included 1965 patients who underwent teledentistry followed by face-to-face consultations, with a mean age of 47.79 ± 21.92 years. Teledentistry showed high specificity ranging from 74.08% to 99.95% while the sensitivity ranged from 18.75% to 100%. The highest specificity (99.90%) was noted for diagnosing orthodontic concerns. The lowest specificity was observed for irreversible pulpal diseases at 74.08%.

Conclusion: Teledentistry has a role in public dental services, diagnosing various dental conditions and identifying patient acuity. It can provide patients with oral health information/advice and ensures effective use of emergency appointments within public dental services.

Background: Medication-related osteonecrosis of the jaw (MRONJ) is a serious, debilitating condition of the jaw bones. Dental extraction is the most significant independent risk factor for MRONJ. This interim study aimed to evaluate the demographics, medical data and outcomes of patients at risk for MRONJ who underwent dental extractions in a dedicated MRONJ clinic following a risk reduction protocol at a large public dental clinic in New South Wales Health.

Methods: A retrospective study analysed demographic and clinical data of patients at risk for MRONJ who underwent dental extractions between March 2020 and April 2024.

Results: Data from 329 at-risk patients who underwent 836 dental extractions were included. Most patients were women (75.1%) with a median age of 74 years (IQR 67-80). The primary indication for medications was osteoporosis (85.4%), with Denosumab being the most frequently prescribed (66.9%). Eighteen patients (5.5%) developed MRONJ at 8 weeks of follow-up. Patients categorized as high-risk had a higher incidence of MRONJ (72.2%) compared to the low-risk group (22.2%).

Conclusion: This study is the first retrospective audit carried out after implementing preventive protocols in this dedicated MRONJ clinic. The higher incidence of MRONJ in patients classified as 'high risk' underscores the importance of considering individual risk factors in their treatment.

Objective: The aim of this study was to assess the effect of RME on upper airway structure and its relationship to improvements in sleep disordered breathing.

Methods: The study was carried out in 23 children with malocclusion and OSA. Clinical assessment visits, daytime sleepiness questionnaire, polysomnography and orthognatodontic examination were performed before (T0) and 4 (T1) and 12 (T2) months after RME. CB CT scans with 2D and 3D reconstructions were performed before (T0) and 12 after months (T2) RME. The relationship between airway changes and improvements in sleep disordered breathing were evaluated.

Results: In all cases, opening of the mid-palatal suture was successfully achieved. Volume of the total upper airways, nasal cavity, nasopharynx and oropharynx increased significantly as well as the nasal osseous width. The increase in posterior suture, pterygoid process, maxillary, nasal cross-sectional width were significantly correlated with total upper airway volume, nasal cavity volume, nasopharyngeal airway volume, and oropharyngeal airway volume. The improvement in AHI was correlated with the increase in total upper airway volume at 12 months.

Conclusion: The study provides important details about the effect of RME on upper airway structure, including an enlarged posterior suture, pterygoid process, maxillary width and nasal cross-sectional width and enlarged airway volume.

Background: This study evaluates the mechanical properties of dental crown prosthodontic materials by investigating the flexural strength and stress distribution of various ceramic materials, including milled zirconia and two ceramics fabricated using LCM technology, employing Finite Element Analysis (FEA).

Methods: Seventy-five samples were divided into five groups: milled zirconia, Zirconia-210, Zirconia-230, Alumina-350 and Alumina-500. Flexural strength tests, including three-point bending, Weibull analysis and FEA, were conducted to analyse stress distribution. Data were evaluated using one-way ANOVA and Tukey's test.

Results: 3D-printed zirconia showed superior flexural strength compared to milled zirconia and alumina. Zirconia-210 had the highest flexural strength (886.35 MPa), while Alumina-350 had the lowest (424.49 MPa). Alumina-350 exhibited higher von Mises stress (25.77 MPa) than the control group (22.83 MPa), whereas Alumina-500 had the lowest stress (22.65 MPa). Zirconia models showed a slight increase in von Mises strain, while alumina models showed a decrease compared to the control.

Conclusion: Our study found that 3D-printed zirconia displayed higher flexural strength when compared to milled zirconia and alumina. Moreover, there were noticeable variations in stress levels and strain behaviours observed in the materials.

Tumour metastasis to the jaw is an uncommon finding. When it does present, it is usually evidence of widespread metastatic disease and represents an unfavourable prognostic indicator. The clinical presentation of metastatic disease in the jaw can vary and may occur in the oral soft tissues, subcutaneous tissues adjacent to bone, mandible or maxillary alveolus and can mimic dental pathology. The radiographic appearance of metastatic disease is most commonly an expansive, lytic lesion with irregular borders. This case report describes the presentation of an otherwise medically well 76-year-old male patient to his dentist with a mobile lower left pre-molar. Following extraction of the tooth, a rapid increase in the jaw swelling resulted in further medical investigation, leading to a diagnosis of metastatic prostate cancer. This case serves to remind dental practitioners to remain vigilant when dental treatment of seemingly obvious dental pathology does not resolve within the expected timeframe, and to maintain a low threshold for medical review and investigation when suspicious lesions arise. This is particularly relevant in the older patient when the incidence of other diseases, such as cancer, is more common.