Australian dental journal最新文献

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.

Background: Decision-making in dentistry is a complex process, and this study evaluated factors that influence dentists' approaches in permanent mature teeth with irreversible pulpitis.

Methods: An online questionnaire was distributed to a group of dental practitioners. The questionnaire surveyed dentists' opinions about the management of vital permanent teeth with irreversible pulpitis including a case scenario.

Results: Data from 262 respondents were analysed. Barriers to perform vital pulp therapy (VPT) included presuming it an inappropriate long-term treatment (29.7%), lack of knowledge, insufficient access to materials, inadequate training and lack of confidence. Patient's preference (79.44%) and tooth restorability (91%) were the most frequently reported factors influencing treatment decisions. Dentists aged 25-35 years and who have 1-5 years of experience ranked extraction as a more successful treatment (P = 0.008; P = 0.003, respectively). Non-Australian graduates ranked pulpotomy to be a more successful procedure (P = 0.007), and public sector/hospital practitioners favoured extraction more than practitioners from other sectors (P = 0.003). Postgraduates/specialists preferred pulpotomy (P = 0.012) more than general dentists. Participants' clinical approaches for the management of symptomatic irreversible pulpitis: root canal treatment (45.0%), indirect pulp capping (22.9%), direct pulp capping (15.8%), pulpotomy (17.1%) and extraction (6.3%).

Conclusions: Female, more experienced, overseas-educated dentists and endodontists preferred VPT for irreversible pulpitis in permanent mature teeth more than other participants. © 2024 Australian Dental Association.

Background: To evaluate whether the prevalence of traumatic dental injuries (TDIs) in permanent anterior teeth among school children is associated with sleep behaviours and disorders.

Methods: A cross-sectional study was carried out with a representative sample of schoolchildren aged 8 to 10 years (n = 1402) from Florianopolis, Brazil. Clinical examinations for TDIs were performed according to the classification proposed by Andreasen. Parents/caregivers completed a questionnaire addressing sociodemographic characteristics and sleep behaviours/disorders (sleep duration, insomnia, sleep rhythmic movement, snoring, and signs of sleep apnoea). Descriptive analysis and Poisson regression were performed.

Results: The prevalence of TDIs was 10.9%. Insomnia was observed in 3.0% of the children, snoring in 42.8%, sleep rhythmic movement in 27.9%, and signs of obstructive sleep apnoea in 33.6% of the schoolchildren. Most children (75.2%) slept less than eight hours a day. The prevalence of TDIs was higher among schoolchildren with an increased overjet (PR: 1.65; 95% CI: 1.15-2.35; P < 0.01), after adjusting for monthly family income, caregiver's schooling, and sleep behaviours. The prevalence of TDIs was not associated with sleep behaviours/disorders.

Conclusions: Parent-reported sleep disorders such as insomnia, sleep rhythmic movement, snoring and signs of sleep apnoea were not associated with the prevalence of TDIs in schoolchildren. © 2024 Australian Dental Association.

Background: Periodontitis is a common oral disease and the chronic inflammation caused by it may influence the development of cancers in the upper gastrointestinal tract. Many observational studies have established a relationship between the two, but the results are not entirely consistent.

Methods: Two-sample MR was performed using publicly available genome-wide association studies data for periodontitis, oral, gastric and oesophagal cancers. The Inverse Variance Weighting (IVW) method serves as the primary method, with MR Egger, Weighted Median, Simple Model and Weighted Model Algorithm methods as complementary methods to assess genetic causal associations. Cochran Q-test, MR-Egger regression and MR polytropic residuals and outliers were used to assess heterogeneity and horizontal pleiotropy.

Results: IVW results did not support a causal association between periodontitis and oral (OR = 1.00, 95% CI: 1.00, 1.00) and oesophagal cancer (OR = 1.00, 95% CI: 1.00, 1.00). Similarly, there was again no causal association between periodontitis and gastric cancer, which was integrated with an OR of 1.04 (95% CI: 0.97, 1.12). Complementary method results were consistent with IVW and heterogeneity and horizontal pleiotropy were not found in most studies.

Conclusions: The findings of our MR study do not support a causal relationship between periodontitis and oral, gastric and oesophagal cancers.