BMC Oral Health最新文献

Background: Climate change is a global challenge, caused by increasing greenhouse gas (GHG) emissions. Dental clinical practice contributes to these emissions through patient and staff travel, waste, energy and water consumption and procurement. Carbon footprinting quantifies GHG emissions. This study assessed the Carbon Footprint (CFP) of private dental clinics in Egypt.

Materials and methods: Data were collected from private dental clinics in Alexandria and Elbeheira, in Northwestern Egypt from July to August 2024 through interview questionnaires. A CFP calculator was used to estimate carbon emissions from patient and staff travel, waste, energy and water consumption, and procurement. To determine the average CFP per clinic and per patient visit, the CFP of all clinics was averaged, both with and without considering the depreciation of dental equipment.

Results: Data from 27 dental clinics were collected. The average CFP of an Egyptian private dental clinic, which, per year, received 3,322 patient visits, and where 5 personnel worked 279 days was 14,426.8 kg CO₂e, or 4.3 kg CO₂e per patient visit. The largest contributor to the CFP was patient travel (45.6%), followed by staff travel (19.6%), energy consumption (18%), procurement (12.4%), waste (4.2%), and water consumption (0.3%). After considering the yearly depreciation of dental equipment, the CFP per clinic in a year increased by 12.2%.

Conclusion: Private dental clinics in Egypt produce substantial carbon emissions. Patient travel was the major contributor to the CFP. While there was a high CFP of electricity consumption, the CFP of gas was zero. The high CFP of waste was likely due to improper segregation and the lack of recycling. Country-specific CFP calculators are needed to accurately measure the carbon emissions of dental clinics in various settings. Preventing oral diseases, raising public awareness to sustainable practices, promoting walking and cycling, improving public transportation, implementing waste recycling, shifting to renewable sources of energy, and local manufacturing of dental products are important to reduce carbon emissions in dental clinics.

Background: Children's oral health significantly impacts their overall well-being, daily activities, and social interactions. Dental treatments under general anesthesia are often required for extensive dental problems, special health care needs, or dental phobias, particularly in pediatric populations. The objective of this meta-analysis was to systematically review and synthesize existing research on how dental treatments under general anesthesia affect the oral health-related quality of life (OHRQoL) in children.

Methods: The electronic databases such as PubMed, EMBASE, Ovid MEDLINE, Web of Science, and Scopus were systematically reviewed following PRISMA guidelines to identify studies evaluating OHRQoL changes after dental treatments under general anesthesia. Studies involving ECOHIS and COHRQoL scales in pre- and postoperative assessments were included. The mean differences between scale measurements before and after dental treatments under general anesthesia were reported as the standard mean difference (SMD), and effect sizes for Hedges' g were classified as follows: small effect (0.2), medium effect (0.5), large effect (0.8). All meta-analysis statistical computation was carried out using the Hartung-Knapp-Sidik-Jonkman method for the random effects model.

Results: A total of 36 papers satisfied the inclusion criteria and were subsequently included in the investigation. In the pooled analysis, treatments under general anesthesia in children improved OHRQoL (ECOHIS) in the short term with a significantly large effect size (SMD = 1.66, 95% CI: 1.07-2.24, p < 0.001; τ² = 2.18, I² = 98.9, p < 0.001). Similarly, dental treatment under general anesthesia increased the COHRQoL score in children with a significantly large effect size (SMD = 1.32, 95% CI: 0.81-1.84, p < 0.001; τ² = 0.78, I² = 97.3, p < 0.001).

Conclusion: The findings of this meta-analysis suggest that there was evidence that OHRQoL of children receiving dental treatment under general anesthesia improves with a large effect size in the short-term following treatment.

Background: Aurora kinase A (AurkA) plays a vital role in mitosis and is therefore critical in tumors development and progression. There are a few studies on AurkA expression in salivary gland tumors. The aim of the present study was to evaluate the expression pattern of AurkA in the most common benign and malignant salivary gland tumors by immunohistochemistry.

Methods: In this retrospective cross-sectional study, 68 cases including 25 pleomorphic adenomas (PAs), 21 adenoid cystic carcinomas (ADCa), 15 mucoepidermoid carcinomas (MEC), and 7 normal salivary glands (NSG) were enrolled from the archive of the Department of Pathology of Shiraz School of Dentistry, Iran. The expression of AurkA in the tissue samples was assessed by immunohistochemical method and was analyzed using statistical analysis (p < 0.05).

Results: Of total cases analyzed, the majority of benign and malignant tumors were found to involve minor salivary glands compared to major salivary glands (p < 0.001). In addition, all lesions studied expressed AurkA. More than half of the tumor tissues showed AurkA staining percentages between 26 and 50% and 76-100% compared to NSG (p = 0.08). In 44.1% of cases, cells had a weak staining score, 27.9% a moderate score and the rest (27.9%) a strong score (p = 0.64).

Conclusion: Although AurkA was observed to be expressed in all tumor tissues, further studies are needed to clearly understand the role of AurkA and the possibility of using it as a diagnostic, prognostic and therapeutic factor.

Background: Anatomically formed healing abutments were suggested in literature to address many of the issues associated with immediate posterior implant insertion such as large extraction sockets that are extremely hard to seal without reflecting the mucoperiosteal flap, extraction sockets anatomy that are not suitable for regular healing abutment placement, and potentially high occlusal stresses when planning a temporary implant supported prothesis to improve the conditioning of supra implant tissue architecture and the emergence profile of the implant supported restorations.

Purpose: To clinically evaluate the peri-implant soft tissue profile of single posterior implant retained restorations and to assess patient related outcomes of the implant restorations that were conditioned immediately by CAD-CAM socket sealing abutments (SSA) versus those conditioned by Titanium (Ti) standard healing abutments (SHA).

Methods: Twenty participants received twenty-two single maxillary immediate implants after flapless minimally invasive tooth extraction and 3D guided implant placement in the posterior area (premolar and molar) and allocated randomly into two groups (n = 11), the intervention group: patients received PEEK SSA and the control group: the patients received Ti SHA. Modified Pink Esthetic Score (PES) was evaluated at 3 observation periods: Baseline T0 (immediate after implant supported crown insertion), 6 months T1 and 1 year of clinical performance T2. Patient satisfaction was assessed one week and one year after crown insertion using visual analogue scale (VAS).

Results: At base line, after six as well as 12 months, SSA group showed statistically significant higher total modified PES scores than SHA group (P-value < 0.001). At the 2 clinical observation periods (baseline and after one year), SSA group showed statistically significantly higher overall satisfaction score than SHA group (P-value < 0.001).

Conclusion: After one year of clinical observation period, CAD-CAM PEEK socket sealing abutments together with flapless minimally invasive tooth extraction and 3D guided implant placement provided superior outcomes compared to Ti SHA in terms of peri-implant soft tissue profile.

Trial registration: This study was registered on clinicaltrials.gov with ID no. NCT05276765 on 03/03/2022.

Background: This study assessed stress distributions in simulated mandibular molars filled with various materials after the removal of fractured instruments from the apical thirds of the root canals.

Methods: Finite element models of the mesial and distal root canals were created, where fractured instruments were assumed to be removed using a staging platform established with a modified Gates-Glidden bur (Woodpecker, Guangxi, P.R. China). Each canal was treated with different materials: Biodentine (Septodont, Saint Maur-des-Fosses, France), mineral trioxide aggregate (MTA), and gutta-percha. In addition to these, four control models were also created. In total, 14 models were generated and subjected to a 300 N force applied at a 45° angle to simulate the stress.

Results: Model 1 (Biodentine) and 2 (Gutta-percha + Biodentine) showed the lowest stresses among mesial root canal models, whereas Model 5 (Gutta-percha) showed the highest. Among distal root canal models, Model 6 (Biodentine) and 7 (Gutta-percha + Biodentine) showed the lowest stresses, while Model 10 (Gutta-percha) showed the highest. In addition, Biodentine (Septodont) and Gutta-percha + Biodentine (Septodont) produced similar stress levels in both mesial and distal roots, while MTA and Gutta-percha + MTA led to increased stresses, especially in the distal root. Among the control models, the highest maximum von Mises stress values were in Model 13 and Model 14, which had a staging platform and were not filled with any root canal filling material, after the broken instrument was removed.

Conclusions: Biodentine (Septodont) may be preferable to MTA for filling staging platform cavities post-fractured instrument removal due to lower stress levels. Furthermore, calcium silicate-based materials alone or in combination with Gutta-percha showed similar stress levels, suggesting their potential use for root canal filling. All models demonstrated structural integrity within safe limits.

Background: In dentistry, local anesthetic is frequently used to manage pain throughout several phases of dental treatments, including tooth extraction. The study aimed to compare the effectiveness of two techniques for controlling pain during mandibular exodontia (tooth extraction), specifically focusing on the pain experienced during injection and extraction of mandibular anterior and premolars teeth. The two techniques being compared are the intraligamentary injection technique (ILI) and the incisive nerve block technique (INB).

Materials and methods: In this study, 100 mandibular anterior and premolars and teeth that were indicated for extraction were included. The effectiveness of the two local anaesthesia techniques, intraligamentary injection technique (ILI) and incisive nerve block (INB), were compared using Modified Dental Anxiety Scale for Dental Extraction Procedure (MDAS-DEP) and visual analogue scale (VAS) during the injection and extraction stages of the procedure.

Results: A total of 100 participants (42 females, 58 males) with a mean age of 50.97 ± 11.59 years took part in the study. The mean VAS score in the INB group was 6.14 after injection and 3.86 after extraction, while in the ILI group, it was 5.46 and 2.90, respectively. There was a statistically significant difference between the two groups both after injection (p = 0.001) and extraction (p < 0.001), as well as within each group (Control: p < 0.001; Study: p < 0.001). For MDAS-DEP, the INB group had mean scores of 15.86 and 11.26 after injection and extraction, respectively, while the ILI group had scores of 15.68 and 10.94, showing a significant difference within each group after both injection (p < 0.001) and extraction (p = 0.001). However, no significant difference was found when comparing MDAS-DEP scores between the two groups from injection to extraction (p = 0.802).

Conclusion: The intraligamentary injection technique (ILI) appears less painful during injection and provides profound pain relief during extraction. The results suggest that ILI can be used as a sole anaesthetic technique during extraction of lower anterior and premolar teeth.

Trial registration: This trial was retrospectively registered on 27/01/2023 with the identifier ISRCTN83272316 in Isrctn.com.

Background: Artificial intelligence (AI) and large language models (LLMs) like ChatGPT have transformed information retrieval, including in healthcare. ChatGPT, trained on diverse datasets, can provide medical advice but faces ethical and accuracy concerns. This study evaluates the accuracy of ChatGPT-3.5's answers to frequently asked questions about oral cancer, a condition where early diagnosis is crucial for improving patient outcomes.

Methods: A total of 20 questions were asked to ChatGPT-3.5, selected from Google Trends and questions asked by patients in the clinic. The responses provided by ChatGPT were evaluated for accuracy by medical oncologists and oral and maxillofacial radiologists. Inter-rater agreement was assessed using Fleiss's and Cohen kappa tests. The scores given by the specialties were compared with the Mann-Whitney U test. The references provided by ChatGPT-3.5 were evaluated for authenticity.

Results: Of the 80 responses from 20 questions, 41 (51.25%) were rated as very good, 37 (46.25%) as good, 2 (2.50%) as acceptable. There was no significant difference between oral and maxillofacial radiologists and medical oncologists in all 20 questions. Of the 81 references to ChatGPT-3.5 answers, only 13 were scientific articles, 10 were fake, and the remaining references were data from websites.

Conclusion: ChatGPT provided reliable information about oral cancer and did not provide incorrect information and suggestions. However, all information provided by ChatGPT is not based on real references.

Background: The aim was to evaluate the stresses in teeth, with external root resorption (ERR) restored with different materials using finite element analysis (FEA).

Methods: In this study, a Micro-CT scan was conducted on a prepared maxillary central tooth. DICOM-compatible images obtained from the sections were converted into stereolithography format using Ctan software. Utilizing the VRMesh Studio program, a solid model was generated based on the 3D image obtained through micro-CT scanning. External root resorption cavities were strategically designed at the apical, middle, and coronal thirds levels on the buccal surface of the tooth root. Subsequently, these created resorption cavities were restored using Biodentin, mineral trioxide aggregate (MTA), and glass ionomer cement (GIC). The models were devided into 12 groups according to their location,the type of restoration, material used and the null group was added. To allow measurement of Von Mises stress values, a simulated oblique force of 100 N, was applied directed towards the palatal region of the upper central tooth at a 45° angle to the occlusal plane.

Results: The highest von Mises stress value in the dentin was observed in the unrestored coronal cavity model (99.00 MPa). FEA results demonstrated that using a repair material significantly reduced the stress levels in the dentin. The lowest stress values were seen in cavities restored with Biodentine. The stress values in cavities treated with Biodentine and MTA were found to be similar.

Conclusions: Restoring the external resorption cavity in the tooth significantly reduced stress levels in the dentin. Biodentine and MTA absorbed more force, transmitting less stress to the dentin compared to GIC.

Clinical relevance: Biodentin and MTA can be used in the repair of external resorption cavities.

Background: The continuous development in digital prosthodontics allowed the customization of attachments and retentive inserts which offers an easy and cheap solution for regular maintenance of locator overdentures during daily practice. The present study compared the change in retention values of the fully digitally manufactured custom-made locator attachment retentive insert with the ready-made ones after insertion, removal, and masticatory cycles.

Methods: A complete denture was constructed over a mandibular edentulous epoxy model. Two implants were inserted into the model between the laterals and canines following the prosthetically driven implant protocol. Locator retentive attachment inserts were digitally designed using free-form modeling software and milled from PEEK (Poly Ether Ether Ketone). After the pick-up of the ready- and custom-made retentive inserts, an insertion, removal, and masticatory cycles test simulating 1 year of patient usage was performed. The change in retention values was recorded at baseline, 6 months, and after one year of simulated clinical use. An independent sample t-test was used to compare the data between the two studied groups.

Results: There were statistically significant differences in retention values between the custom-made and ready-made locator inserts at baseline and after 6 months. (p = 0.001*). On the other hand, there was no significant difference in retention after 1 year of simulated use. (p = 0.083, NS) CONCLUSIONS: The custom-made milled locator retentive attachment insert can be used as an alternative to the ready-made one due to their comparable retention values after 1 year of simulated use.

Objective: This systematic review and meta-analysis aim to evaluate the therapeutic potential of boric acid as a local drug delivery agent in the treatment of periodontitis.

Methods: Following PRISMA guidelines, we registered a comprehensive protocol with PROSPERO. By employing PICOS criteria, we evaluated randomized controlled trials assessing the effects of subgingival boric acid application alongside non-surgical periodontal therapy in treatment of periodontitis. Studies were systematically searched across multiple databases, with establishment of the eligibility criteria. Data extraction and risk of bias assessment were conducted independently by reviewers.

Results: Among 1,640 records screened, 6 studies met the inclusion criteria, comprising 281 participants aged 18-65 years. At 1-month, boric acid demonstrated significant improvements in probing pocket depth (PPD), but insignificant differences were observed in clinical attachment level (CAL), and gingival index (GI). However, at 3 and 6 months, we found significant reductions in PPD while at 6 months, a significant increase in CAL gain were observed favoring boric acid. No significant changes in GI were noted at any follow-up duration.

Conclusion: Boric acid adjunctive therapy in non-surgical periodontal treatment shows promising efficacy in improving clinical parameters, particularly PPD and CAL, over time. While early outcomes may not show significance, sustained benefits are evident at longer follow-up periods. These findings underscore the potential of boric acid as a valuable addition to periodontal therapy, demanding further investigation to reveal its precise mechanisms and optimize clinical application.