Pub Date : 2026-01-16DOI: 10.1038/s41415-025-9205-2
João Mykael Alves Xavier, Ramon Targino Firmino, Igor Figueiredo Pereira, José Lima Silva Júnior, Renata de Souza Coelho Soares, Ana Isabella Arruda Meira Ribeiro
Introduction Remifentanil is widely used in orthognathic surgery for intra-operative pain management, inducing hypotension, and controlling intra-operative blood loss (IBL). Aim To evaluate the effectiveness of remifentanil in reducing IBL during orthognathic surgery compared with other hypotensive agents. Methods A systematic review was conducted across seven databases and grey literature up to May 2024, restricted to randomised controlled trials (RCTs). Risk of bias was assessed with RoB 2.0, and certainty of evidence with GRADE. Results From 3,883 articles, eight studies were included (388 participants, aged 22–29 years), and four contributed to meta-analysis. Qualitative synthesis showed greater IBL reduction with remifentanil within balanced anaesthesia protocols, especially when combined with sevoflurane. The meta-analysis found no significant difference between remifentanil and nitroglycerin (RR = 13.37; 95% CI: -84.18 to -110.72; very low certainty). When combined with sevoflurane, compared with desflurane and isoflurane, no significant effect was observed, though a trend favoured sevoflurane (RR = -0.26; 95% CI: -0.59 to -0.07; low certainty). Discussion Although remifentanil may reduce IBL, conflicting results and low certainty limit conclusions. Cardiovascular risks and delayed bleeding require attention. Evidence gaps include pseudoaneurysm incidence, osteotomy-specific outcomes, and transfusion needs. Conclusion Remifentanil may contribute to IBL reduction, particularly with sevoflurane, but evidence remains low certainty. Further high-quality RCTs are needed.
{"title":"Effectiveness of remifentanil in reducing blood loss in orthognathic surgery: a systematic review","authors":"João Mykael Alves Xavier, Ramon Targino Firmino, Igor Figueiredo Pereira, José Lima Silva Júnior, Renata de Souza Coelho Soares, Ana Isabella Arruda Meira Ribeiro","doi":"10.1038/s41415-025-9205-2","DOIUrl":"10.1038/s41415-025-9205-2","url":null,"abstract":"Introduction Remifentanil is widely used in orthognathic surgery for intra-operative pain management, inducing hypotension, and controlling intra-operative blood loss (IBL). Aim To evaluate the effectiveness of remifentanil in reducing IBL during orthognathic surgery compared with other hypotensive agents. Methods A systematic review was conducted across seven databases and grey literature up to May 2024, restricted to randomised controlled trials (RCTs). Risk of bias was assessed with RoB 2.0, and certainty of evidence with GRADE. Results From 3,883 articles, eight studies were included (388 participants, aged 22–29 years), and four contributed to meta-analysis. Qualitative synthesis showed greater IBL reduction with remifentanil within balanced anaesthesia protocols, especially when combined with sevoflurane. The meta-analysis found no significant difference between remifentanil and nitroglycerin (RR = 13.37; 95% CI: -84.18 to -110.72; very low certainty). When combined with sevoflurane, compared with desflurane and isoflurane, no significant effect was observed, though a trend favoured sevoflurane (RR = -0.26; 95% CI: -0.59 to -0.07; low certainty). Discussion Although remifentanil may reduce IBL, conflicting results and low certainty limit conclusions. Cardiovascular risks and delayed bleeding require attention. Evidence gaps include pseudoaneurysm incidence, osteotomy-specific outcomes, and transfusion needs. Conclusion Remifentanil may contribute to IBL reduction, particularly with sevoflurane, but evidence remains low certainty. Further high-quality RCTs are needed.","PeriodicalId":9229,"journal":{"name":"British Dental Journal","volume":"240 2","pages":"1-6"},"PeriodicalIF":2.3,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To study the accuracy of BruxChecker in assessing sleep bruxism. Methods In total, 35 subjects were categorised into two groups: 16 subjects with sleep bruxism (SB) and 19 with no sleep bruxism (NSB). Each participant wore a BruxChecker for 14 consecutive nights. Wear patterns were evaluated on nights one, seven and fourteen, focusing on abrasion (wear without perforation) and perforation areas. Clinical assessment was the reference standard, with BruxChecker perforation indicating a positive result for SB. Results The mean age was 28.0 ± 9.3 years (SB) and 21.6 ± 1.7 years (NSB). The SB group exhibited significantly larger abraded areas on the BruxChecker compared to the NSB group on all three nights. Additionally, the SB group had significantly greater perforation on the fourteenth night. The diagnostic performance of the BruxChecker varied over time. On the first night, sensitivity and specificity were 31% and 84%, respectively. By the seventh night, these values were 63% and 42%, respectively. On the fourteenth night, sensitivity increased to 94%, with specificity decreased to 32%. Conclusions BruxChecker may offer a practical and relatively cost-effective tool for assessing sleep bruxism in individuals with probable sleep bruxism. Its diagnostic performance appeared to improve when used over 14 consecutive nights, though its accuracy remains limited compared to standard methods.
{"title":"Accuracy of the BruxChecker oral device for the assessment of sleep bruxism","authors":"Pankaew Yakkaphan, Sakarin Tangpothitham, Wiphawi Srisomphot, Sujira Khaoropphan, Waroonporn Nitithamakul, Prawara Lertniti, Premthip Chalidapongse","doi":"10.1038/s41415-025-9203-4","DOIUrl":"10.1038/s41415-025-9203-4","url":null,"abstract":"Objective To study the accuracy of BruxChecker in assessing sleep bruxism. Methods In total, 35 subjects were categorised into two groups: 16 subjects with sleep bruxism (SB) and 19 with no sleep bruxism (NSB). Each participant wore a BruxChecker for 14 consecutive nights. Wear patterns were evaluated on nights one, seven and fourteen, focusing on abrasion (wear without perforation) and perforation areas. Clinical assessment was the reference standard, with BruxChecker perforation indicating a positive result for SB. Results The mean age was 28.0 ± 9.3 years (SB) and 21.6 ± 1.7 years (NSB). The SB group exhibited significantly larger abraded areas on the BruxChecker compared to the NSB group on all three nights. Additionally, the SB group had significantly greater perforation on the fourteenth night. The diagnostic performance of the BruxChecker varied over time. On the first night, sensitivity and specificity were 31% and 84%, respectively. By the seventh night, these values were 63% and 42%, respectively. On the fourteenth night, sensitivity increased to 94%, with specificity decreased to 32%. Conclusions BruxChecker may offer a practical and relatively cost-effective tool for assessing sleep bruxism in individuals with probable sleep bruxism. Its diagnostic performance appeared to improve when used over 14 consecutive nights, though its accuracy remains limited compared to standard methods.","PeriodicalId":9229,"journal":{"name":"British Dental Journal","volume":"240 2","pages":"1-9"},"PeriodicalIF":2.3,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-16DOI: 10.1038/s41415-025-9248-4
Abby Lindzon, S. M. Hashim Nainar
Objectives To explore linguistic characteristics of patient education materials (PEM) in paediatric dentistry. Methods A convenience sample of 52 PEM articles (2013–2023) was obtained from four sources: plain language summaries of Cochrane systematic reviews (n = 25), Journal of American Dental Association patient pamphlets (n = 15), online patient health information from the Canadian Dental Association (n = 7), and MedLine Plus (n = 5) websites. Two investigators manually evaluated articles using the Patient Education Materials Assessment Tool (PEMAT) – printed materials. Additional computerised analyses included five Linguistic Inquiry and Word Count (LIWC) measurements and two readability measurements (Flesch Reading Ease and Simple Measure of Gobbledygook). Descriptive and comparative statistics were undertaken. Results PEM articles from all four sources scored above the recommended 70% threshold for both PEMAT composite measurements (understandability/actionability) but minimal use (21%) of visual aids was identified. Mean values of LIWC summary measures (analytical thinking = 84, authenticity = 46, clout = 53, emotional tone = 29, big words = 26) indicated scope for linguistic improvement of PEM articles. Readability analyses indicated PEM articles were generally easy to read (≤Grade 6 level) except for Cochrane articles (Grade 9 level). Conclusions PEM articles evaluated in present study were sub-optimal thereby reducing parental ability to make well-informed decisions for their children.
{"title":"Linguistic assessment and readability of paediatric dental patient education materials: an exploratory study","authors":"Abby Lindzon, S. M. Hashim Nainar","doi":"10.1038/s41415-025-9248-4","DOIUrl":"10.1038/s41415-025-9248-4","url":null,"abstract":"Objectives To explore linguistic characteristics of patient education materials (PEM) in paediatric dentistry. Methods A convenience sample of 52 PEM articles (2013–2023) was obtained from four sources: plain language summaries of Cochrane systematic reviews (n = 25), Journal of American Dental Association patient pamphlets (n = 15), online patient health information from the Canadian Dental Association (n = 7), and MedLine Plus (n = 5) websites. Two investigators manually evaluated articles using the Patient Education Materials Assessment Tool (PEMAT) – printed materials. Additional computerised analyses included five Linguistic Inquiry and Word Count (LIWC) measurements and two readability measurements (Flesch Reading Ease and Simple Measure of Gobbledygook). Descriptive and comparative statistics were undertaken. Results PEM articles from all four sources scored above the recommended 70% threshold for both PEMAT composite measurements (understandability/actionability) but minimal use (21%) of visual aids was identified. Mean values of LIWC summary measures (analytical thinking = 84, authenticity = 46, clout = 53, emotional tone = 29, big words = 26) indicated scope for linguistic improvement of PEM articles. Readability analyses indicated PEM articles were generally easy to read (≤Grade 6 level) except for Cochrane articles (Grade 9 level). Conclusions PEM articles evaluated in present study were sub-optimal thereby reducing parental ability to make well-informed decisions for their children.","PeriodicalId":9229,"journal":{"name":"British Dental Journal","volume":"240 2","pages":"1-7"},"PeriodicalIF":2.3,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-09DOI: 10.1038/s41415-025-9503-8
Rosie Fletcher
{"title":"It's no joke – can psychological interventions help dental patients who gag?","authors":"Rosie Fletcher","doi":"10.1038/s41415-025-9503-8","DOIUrl":"10.1038/s41415-025-9503-8","url":null,"abstract":"","PeriodicalId":9229,"journal":{"name":"British Dental Journal","volume":"240 1","pages":"39-39"},"PeriodicalIF":2.3,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145916072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-09DOI: 10.1038/s41415-025-9512-7
G. Gazal, M. Kherbek, M. Z. Nassani
{"title":"Emergency extractions in patients on antiplatelet/anticoagulant therapy","authors":"G. Gazal, M. Kherbek, M. Z. Nassani","doi":"10.1038/s41415-025-9512-7","DOIUrl":"10.1038/s41415-025-9512-7","url":null,"abstract":"","PeriodicalId":9229,"journal":{"name":"British Dental Journal","volume":"240 1","pages":"10-11"},"PeriodicalIF":2.3,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41415-025-9512-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145916091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-09DOI: 10.1038/s41415-025-9456-y
Mohammed Turky, Paul M. H. Dummer
Objectives To describe the potential of digital twin (DT) technology to enhance personalised root canal treatment within endodontics, drawing upon its established applications in various healthcare sectors. Discussion DT models are gaining traction as transformative tools for enabling individualised decision-making across different medical disciplines. These models leverage multimodal patient data to simulate physiological and clinical outcomes. In endodontics, DTs could facilitate the simulation of intricate parameters, such as root canal morphology, access cavity preparation, microbial biofilm dynamics, disinfection protocols, clinical techniques for root canal preparation and filling, and the long-term behaviour of restorations. The application of DTs will empower clinicians to formulate more tailored treatment plans and improve prognostic predictions. Beyond their clinical applications, DTs can enrich research settings, linking laboratory research with tailored patient care. While deploying DTs in endodontics remains largely aspirational at this stage, it has the potential to shift the paradigm from standardised approaches to personalised treatments. Key challenges to address include data standardisation, interoperability among systems, ethical regulations, and the need for specialised clinician training. This article suggests actionable strategies for the translational development of DTs in endodontics, inspired by successful frameworks in other medical domains. Conclusion DT models can reshape the vision in endodontics, facilitating real-time, patient-specific simulation and clinical decision-making. Moreover, DT technology presents a cohesive framework that could enhance precision in endodontic practice while also expediting the translation of research findings into clinical applications. This advancement may lead to the development of personalised and predictive approaches to root canal treatment, significantly improving patient outcomes.
{"title":"Digital twins technology in endodontics: from reactive to predictive – a new frontier towards personalised root canal treatment","authors":"Mohammed Turky, Paul M. H. Dummer","doi":"10.1038/s41415-025-9456-y","DOIUrl":"10.1038/s41415-025-9456-y","url":null,"abstract":"Objectives To describe the potential of digital twin (DT) technology to enhance personalised root canal treatment within endodontics, drawing upon its established applications in various healthcare sectors. Discussion DT models are gaining traction as transformative tools for enabling individualised decision-making across different medical disciplines. These models leverage multimodal patient data to simulate physiological and clinical outcomes. In endodontics, DTs could facilitate the simulation of intricate parameters, such as root canal morphology, access cavity preparation, microbial biofilm dynamics, disinfection protocols, clinical techniques for root canal preparation and filling, and the long-term behaviour of restorations. The application of DTs will empower clinicians to formulate more tailored treatment plans and improve prognostic predictions. Beyond their clinical applications, DTs can enrich research settings, linking laboratory research with tailored patient care. While deploying DTs in endodontics remains largely aspirational at this stage, it has the potential to shift the paradigm from standardised approaches to personalised treatments. Key challenges to address include data standardisation, interoperability among systems, ethical regulations, and the need for specialised clinician training. This article suggests actionable strategies for the translational development of DTs in endodontics, inspired by successful frameworks in other medical domains. Conclusion DT models can reshape the vision in endodontics, facilitating real-time, patient-specific simulation and clinical decision-making. Moreover, DT technology presents a cohesive framework that could enhance precision in endodontic practice while also expediting the translation of research findings into clinical applications. This advancement may lead to the development of personalised and predictive approaches to root canal treatment, significantly improving patient outcomes.","PeriodicalId":9229,"journal":{"name":"British Dental Journal","volume":"240 1","pages":"21-25"},"PeriodicalIF":2.3,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41415-025-9456-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145916101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：