BMC Oral Health最新文献

Background: Oral health care programs offer a platform for experiential learning that include prospects for skills development; opportunities for knowledge application and for the creation of an awareness of community responsibilities. Gaining experience in the care for special needs patients is ideally achieved through exposure in special needs settings such as the school community.

Aim: This study investigated the perceptions and reflections of experiential learning by final year oral hygiene students in a special need's oral health care program at the University of Western Cape.

Methods: This study incorporated a concurrent triangulation study design that included final year Oral Hygiene students who participated in a special need's oral health care program. Students completed an on-line self-administered questionnaire, a reflective journal and participated in a focus group discussion.

Results: All respondents understood the concept of experiential learning. The predominant dispositions that emerged included student adaptation, awareness, empathy, and experience which were regarded as particularly important for personal growth. With regards to academic growth, facets of confidence, theory translation, clinical skill development and improved communication were identified as critical elements in development. Challenges included lack of cooperation from the learners and lack of kills in non-verbal communication. An increased awareness and a strong willingness to participate in community projects was also reported amongst the student respondents.

Conclusion: The experiential learning opportunity in the school-based special needs oral health care program was invaluable to the children as well as the students. This community -based program supported personal and academic growth and it provided authentic learning opportunities; facilitated professional development, improved clinical skills and competence, enhanced problem solving and communication skills and raised awareness on social responsibility. Challenges experienced pertained to cooperation and communication with the children. Suggestions included maintaining access to care for the children through oral care program initiatives, as well as ongoing rotation of Oral Hygiene students who are ideally positioned to provide promotive and preventive oral care to special needs individuals. Schools for special needs children provide an ideal platform to facilitate access to care and to provide experiential learning opportunities in authentic settings.

Background: Oral diseases are a significant global public health challenge. Current evidence indicates that several chronic conditions are individually associated with tooth loss. People are living with more than one chronic condition, known as multimorbidity (MM). Considering the common risk factors for oral and chronic diseases, this study aimed to evaluate the association between MM and tooth loss in the Chilean population.

Methods: Cross-sectional study with secondary data from the latest Chilean National Health Survey (ENS 2016-17). The number of remaining teeth was classified into four groups: functional dentition (≥ 20 remaining teeth), moderate tooth loss (10 to 19), severe tooth loss (1 to 9), and edentulism (0). MM was defined based on the number of chronic conditions as a binary variable (MM_≥ 2) and as a 4-level categorical variable (MM_G0-G3), G0: none, G1: 1, G2: 2-4, and G3: ≥5 conditions. Stratified analysis by age group (< 65, ≥ 65 years) was performed. Mean and SD were calculated for crude and adjusted remaining teeth. Significance level was set to 0.05. Prevalence ratios were estimated with Poisson regression models with robust variance, crude and adjusted for sex, age, geographic area, and educational level. Logistic regressions models were fitted to calculate odds ratios as a sensitivity analysis.

Results: Of 4,151 adults aged 17-98, 54.9% had MM and the prevalence of moderate, severe tooth loss and edentulism was 25.4%, 6.9% and 4.8% respectively. Adults aged ≥ 65 years with MM_≥ 2 were 1.66 [1.04-2.66] times more likely to have severe tooth loss than those without MM. Adults aged < 65 years with MM_G3 were 1.76 [1.12-2.77] times more likely to have moderate tooth loss and 2.55 [1.02-6.36] times more likely to have severe tooth loss than those without MM.

Conclusions: In this study, we found statistically significant associations between the number of chronic conditions and moderate/severe tooth loss in both analyzed age groups. These findings highlight the need to provide oral health care for adults with multimorbidity using a person-centred model and to seek strategies to prioritize health care.

Background: A comprehensive understanding of the root form and canal anatomy is essential for successful endodontic treatment. This study aimed to evaluate the root canal anatomy of mandibular premolars in the Pakistani population using cone beam computed tomography (CBCT) and to classify the findings with the new classification proposed by Ahmed et al. METHODS: Ethical exemption was obtained from Aga Khan University Hospital, Karachi. A total of 707 CBCT scans from Karachi and Lahore were included, comprising 592 scans from a tertiary care hospital in Karachi and 115 scans from a radiology center in Lahore. The study focused on sound, fully formed mandibular first and second premolars, excluding those with significant caries, restorations, or prior root canal treatments. Scans from different equipment were used, and calibration was achieved between a specialist endodontist and two dental residents. Data was analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 26. Descriptive statistics, Chi-square tests to determine association between the variables, and a significance level set at 5% (p <0.05) were utilized.

Results: A total of 2403 mandibular premolars were analyzed. The most common configuration was ¹MPM¹ (82.90%), with rare variations such as ¹MPM^1-3-1 (0.04%) and ²MPM^{1 B1 L2} (0.04%). Single-rooted premolars were predominant (98.87%), and no significant differences were observed when data was stratified by age or gender.

Conclusions: This is the first study in Pakistan involving multiple centers and using the classification system by Ahmed et al. to understand the anatomy of mandibular premolars. The findings indicate that while most premolars have a single root and canal, variations exist. These variations highlight the importance of understanding canal morphology for improving the success of endodontic treatment. Future studies should include a larger and more diverse dataset to fully represent the Pakistani population.

Background: Congenitally missing permanent canines (CMPC) have a significant impact on function and aesthetics. The prevalence is low, and the availability of rigorous studies on this issue in China is limited. This study was designed to investigate the prevalence and distribution of CMPC in patients and concomitant anomalies. Additionally, we aimed to compare the prevalence of CMPC between two age groups.

Methods: A total of 10,447 patient's panoramic radiograph (PR) images from August 2021 to December 2023 were reviewed and data regarding the location and number of CMPCs were recorded. Age and gender were obtained from the clinical records. Additionally, concomitant anomalies such as persistent primary canines, congenitally missing other permanent teeth, supernumerary teeth and microdontia were also recorded in patients with CMPC. 10,447 patients were divided into two groups: group A (< 121 months of age) and group B (≥ 121 months of age) to record the number of patients with CMPC. The data were presented as counts (n) and percentages (%), and statistically analysed using the Chi-square test.

Results: The average age of patients with CMPC was 9.2 years, with a prevalence of 0.69% (n = 72). The difference between genders was not statistically significant (p = 0.950). The prevalence of CMPC in group B (1.08%, 26/2400) was significantly greater than that in group A (0.57%, 46/8047) (p = 0.008). 89.42% (93/104) of the missing permanent canines had visible primary canines in patients. CMPC were more likely to occur in the maxilla (91.67%) than in the mandible (6.94%) (p<0.001). No significant difference was found between the left and right sides (p = 0.844). With respect to concomitant anomalies among those with CMPC, 22 patients had 58 congenitally other permanent teeth missing, 3 patients had 3 supernumerary teeth, and 12 maxillary lateral incisors from 7 patients presented with microdontia.

Conclusions: The prevalence of CMPC was 0.69%. CMPC were more likely to occur in the maxilla in the presence of persistent primary canines and were not influenced by gender or side. Early panoramic radiographs can improve the detection rate of CMPC, thereby facilitating prompt intervention and timely management.

Trial design: Parallel.

Objectives: To assess the effect of mini-screw assisted rapid palatal expansion (MARPE) with/without micro-osteoperforation (MOP) on the airway and pain intensity in non-growing patients with maxillary transverse deficiency.

Method: Two equal groups of twenty-four individuals aged ≥ 19 years old with maxillary transverse deficit were randomly assigned. MOP-facilitated MARPE was used to treat one group (MMG), and the other group was treated with MARPE without MOP (NMG). For airway evaluation, CBCT images were obtained 2 months before starting the palatal expansion and 3 months after finishing the expansion in 28 days. The Visual Analogue Scale (VAS) was used to measure the pain level.

Results: Significant suture opening was observed in both groups. All linear measurements of the nasal cavity and volumetric measurements of the nasal passage and oropharyngeal airway increased significantly in both groups, with no significant difference between them. Moderate pain was experienced in the first two weeks of expansion in MMG (5.11 ± 0.30), while more significant pain was recorded in NMG (6.87 ± 0.40). Pain decreased significantly in the following two weeks in MMG (2.77 ± 0.39) and in NMG (5.11 ± 0.32), with a significant difference between the two groups throughout the entire duration of expansion.

Conclusion: Transverse maxillary deficit was successfully treated with both expansion methods, with and without MOP, with comparable skeletal effects at the nasal levels and airway volumetric improvement. So, MOP did not provide any further advantage in improving the airway volume after maxillary expansion. However, it significantly reduced pain intensity throughout the entire duration of expansion.

Trial registration: The protocol registration and results system (PRS) of ClinicalTrials.gov has this RCT registered under the number NCT06502041 on 13/07/2024.

Background: During restoring class II and V cavities with resin composite, hemostatic agents are frequently used to control gingival bleeding and/or gingival fluid to provide a dry field which is crucial for efficient bonding. Hemostatic agents may adversely affect the bonding procedure, thus their removal prior to bonding is essential. The current study evaluates the effect of two hemostatic agents and different dentin cleansing protocols on the shear bond strength of resin composite to dentin using a universal adhesive.

Methods: Ninety premolars were sectioned to expose coronal dentinal surfaces which were divided into 3 groups: control group, not treated with hemostatic agent (n = 10); a group treated with Viscostat "20% ferric sulphate" (n = 40); and a group treated with Viscostat clear "25% aluminum chloride" (n = 40). The groups treated with hemostatic agents were subdivided into 4 subgroups according to the cleansing protocol: water, phosphoric acid, katana cleaner, and air abrasion. Shear bond strength (SBS) of resin composite bonded to the treated dentin using a universal adhesive was measured after thermocycling.

Results: Two-way ANOVA showed that hemostatic agent, cleansing protocol and their interaction has significant effect on SBS (p < 0.0001). Viscostat (10 ± 3.3 MPa) exhibited lower SBS than Viscostat Clear (16.2 ± 5.5 MPa). Acid etching (17.3 ± 7.3 MPa) showed higher SBS compared to Katana Cleaner (12.6 ± 4.7 MPa), water (12.1 ± 4.8 MPa) and air abrasion (10.8 ± 2 MPa).

Conclusion: The use of hemostatic agents can adversely affect the bond strength of universal adhesives to dentin. Phosphoric acid provided the best hemostatic agent-cleansing protocol while katana cleaner and air abrasion demonstrated inferior results.

Background: Gutka, a smokeless tobacco mixture containing tobacco and areca nut, is widely consumed in South Asia and impairs wound healing due to vasoconstrictive and cytotoxic effects. Wound healing assessment in oral surgery lacks standardisation, and phase-specific evaluation tools are seldom used. This study aimed to compare post-extraction healing after atraumatic tooth extraction in gutka chewers and non-chewers using the modified Inflammation Proliferation Remodeling (IPR) scale to validate this scale for clinical use.

Methods: A prospective cohort study at a dental college in Karachi, Pakistan, included 200 participants aged 18-45 undergoing atraumatic extraction of premolars or molars, divided into gutka chewers (n = 100) and non-chewers (n = 100). The modified IPR scale was developed and validated using content validity assessment by experts, pilot testing, inter-rater reliability (Cohen's kappa), and internal consistency (Cronbach's alpha). Wound healing was assessed using the validated modified IPR scale immediately post-extraction (Day 0), at the proliferative phase (Day 7), and the remodelling phase (6 weeks). Statistical analyses included Mann-Whitney U tests, multivariate linear regression, and Spearman's correlation.

Results: The modified IPR scale demonstrated good content validity, substantial inter-rater reliability (Cohen's kappa 0.80-0.86), and good internal consistency (Cronbach's alpha 0.84). No significant difference in IPR scores was observed between groups during the inflammatory phase (Day 0). Gutka chewers had significantly higher IPR scores during the proliferative phase (mean 5.9 ± 1.6 versus 4.2 ± 1.2; p < 0.001) and the remodelling phase (mean 3.6 ± 1.2 vs. 2.1 ± 0.9; p < 0.001), indicating delayed healing. Gutka use was a significant predictor of delayed healing (B = 1.2, p < 0.001) after adjusting for age and gender. Duration of gutka use positively correlated with higher IPR scores during the proliferative (rho = 0.46, p < 0.001) and remodelling phases (rho = 0.51, p < 0.001), reflecting a dose-dependent effect. The questionnaire was effectively validated with an 80% response rate and a 90.9% completion rate.

Conclusions: Gutka chewing is significantly associated with delayed post-extraction wound healing, with longer duration correlating with poorer outcomes. The modified IPR scale was effectively validated and proved to be a reliable tool for assessing wound healing progression, demonstrating its utility in clinical practice and research settings. Dental professionals should consider gutka use when planning patient care, and public health initiatives should aim to eliminate gutka consumption to improve oral health outcomes.

Background: The purpose of the study is to evaluate the effect of 7 different desensitizing agents on the shear bond strength (SBS) of zirconia restorations to dentin with a self-adhesive resin cement and determine the failure modes.

Methods: Eighty molars' occlusal surfaces were ground to expose dentin and were randomly divided into 8 groups (n = 10): 1. Gluma (HEMA/Glutaraldehyde) 2. Bifluoride (Sodium Fluoride/Calcium Fluoride) 3. Admira (Bis-GMA/HEMA) 4. Smart Protect (Glutaraldehyde) 5. Teethmate (Tetracalcium phosphate, Dicalcium phosphate) 6. Clinpro White (Sodium fluoride) 7. BisBlock (Oxalic acid) and 8. Control (No-treatment). After applying the agent, a self-adhesive resin cement (Rely-X U200) was used to lute zirconia discs (4 mm height and 4 mm diameter) to dentin. After stored in distilled water at 37 °C for 24 h, all groups were thermocycled for 2500 cycles between 5 ± 2 °C and 55 ± 2 °C. Specimens were submitted to SBS test with a universal testing machine at a crosshead speed of 0.5 mm/min until failure. SBS values were compared with ANOVA. Post-hoc multiple comparisons were performed with Dunnett T3. The failure modes of specimens were examined with stereomicroscope at a magnification of 20X and the distribution of the failure modes were evaluated with Pearson Chi-Square test.

Results: Regarding mean SBS values in MPa's; Admira (10.70 ± 3.99), Smart Protect (9.62 ± 3.93), and Gluma (8.90 ± 3.76) treatments showed higher SBS values compared to control group (p < .05) according to ANOVA. The SBS values of Teethmate (5.31 ± 2.37) and Clinpro White (4.32 ± 2.44) were higher than control group but the difference was not found significant (p > .05). BisBlock (2.33 ± 1.94) and Bifluouride (1.60 ± 1.47) groups showed the lowest SBS values but their difference between control group was not found statistically significant (p > .05). Most specimens showed adhesive failure but no statistically significant difference was found in the distributions of failure modes according to Chi-square test.

Conclusion: Within the limitation of the study; Admira, Smart Protect, and Gluma increased the SBS of the zirconia restorations to dentin and can be recommended to use on prepared dentin surfaces prior to the cementation.

Background: COSMIN (Consensus-based Standards for the selection of health Measurement INstruments) provides a framework for selecting and validating patient-reported outcome measurements (PROMs). This study aims to validate the Hungarian version of the GOHAI and, for the first time, to assess its Standard Error of Measurement (SEM), Smallest Detectable Change (SDC), and Measurement Invariance (MI) across general and clinical populations as well as different age groups, following COSMIN guidelines.

Materials and methods: The translation was performed using a forward-backward process. A mixed sample (n = 306) was recruited in Budapest from May 2023 to February 2024, consisting of the general population (45.1%), recruited from health kiosks and a nursing home, and the clinical population (54.9%), sourced from Semmelweis University's care units. The sample was further divided into two age groups: 18-64 years old (54.9%) and 65 + years old (45.1%). GOHAI was administered twice to 108 stable participants. For both the additive score (ADD-GOHAI) and simple count (SC-GOHAI), structural validity and measurement invariance by subgroups were assessed via Confirmatory Factor Analysis (CFA). Internal consistency was evaluated using Cronbach's alpha, and test-retest reliability was measured using the intraclass correlation coefficient (ICC). SEM was calculated using the SEM agreement formula, and SDC using: [Formula: see text]. Convergent and known-group validity were tested against predefined hypotheses for structural validity.

Results: Contrary to a three factor model, a single-factor model showed good fit in all subgroups for both scoring methods, with adequate internal consistency (Cronbach 𝛼: 0.76-0.85). Four of the six hypotheses for convergent validity and all ten hypotheses for known-groups validity supported the predefined criteria. Measurement invariance between clinical and general populations, or by age, was not demonstrated, so GOHAI's different measurement properties should be considered when comparing subpopulations. Test-retest reliability was adequate (ICC: 0.87-0.96). SDC was ≈5 points using ADD-GOHAI and 2-3 points using SC-GOHAI.

Conclusion: The Hungarian version of GOHAI demonstrates satisfactory psychometric properties across both general and clinical populations, as well as among both younger and older age groups. While the measurement properties of SC-GOHAI may be more stable between populations, ADD-GOHAI seems more suitable for individual follow-up. However, observed changes must be considered in relation to the measurement error associated with GOHAI.

Background: Cleft lip and palate (CLP) is one of the most common birth defects worldwide. It typically results in significant maxillary dysplasia, causing severe oral function problems and substantially affecting the patient's facial aesthetics. Maxillary anterior segmental distraction osteogenesis (MASDO) has gained popularity in recent years as an effective treatment for correcting maxillary dysplasia. However, the evaluation of its effectiveness in patients with CLP varies across different studies. Our research was aimed at providing evidence of the effects of MASDO among CLP patients.

Methods: A meta-analysis covered Medline, Web of Science, Embase, Scopus, and Cochrane Library. Controlled clinical trial studies published before February 2024 and analyzed changes in maxillary cephalometric landmarks before and after MASDO among patients with maxillary hypoplasia and CLP were included.

Results: Our meta-analysis included 10 papers in total. One study was at low risk of bias, seven were at medium risk, and two were at serious risk. MASDO significantly increased the maxillary length. The mean SNA angle increased by 6.43° (95% CI, 4.11° to 8.74°) and A-McNamara rose by 7.29 mm (95% CI, 6.21 mm to 8.37 mm). The maxilla also showed a slight counterclockwise rotation; however, this reached no statistical significance. The mandibular position did not vary remarkably. Moreover, a significant increase in upper anterior tooth tipping and overjet, a decrease in overbite, and an improvement in nasolabial soft tissue were observed.

Conclusions: MASDO might be a valid therapy option for CLP patients. It causes a significant increase in the maxillary length, anterior tooth crossbite, and nasolabial soft tissue were also greatly improved.