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To assess the efficiency of AI methods in finding radiographic features in Endodontic treatment considerations. This review was based on the PRISMA guidelines and QUADAS 2 tool. A systematic search was performed of the literature on cases with endodontic treatments, comparing AI algorithms (test) versus conventional image assessments (control) for finding radiographic features. The search was conducted in PubMed, Scopus, Google Scholar and the Cochrane library. Inclusion criteria were studies on the use of AI and machine learning in endodontic treatments using dental X-rays. The initial search retrieved 1131 papers, from which 24 were included. High heterogeneity of the materials left out a meta-analysis. The reported subcategories were periapical lesion, vertical root fractures, predicting root/canal morphology, locating minor apical foramen, tooth segmentation and endodontic retreatment prediction. Radiographic features assessed were mostly periapical lesions. The studies mostly considered the decision of 1–3 experts as the reference for training their models. Almost half of the included materials campared their trained neural network model with other methods. More than 58% of studies had some level of bias. AI-based models have shown effectiveness in finding radiographic features in different endodontic treatments. While the reported accuracy measurements seem promising, the papers mostly were biased methodologically. [ABSTRACT FROM AUTHOR]

Rapid maxillary expansion (RME) is a routine method for correcting transverse maxillary deficiency. This paper investigated the effect of RME on anchorage alveolar bone and examined the differences between micro-implant-assisted RME and conventional RME. Relevant articles were selected from the PubMed, EMBASE and Cochrane Central Register of Controlled Trials databases. Review Manager software (v.5.3) was used for the pooled analysis and Cochran Q and I2 statistic tests were used to assess the heterogeneity. Following conventional RME, the distal buccal alveolar bone thickness and the mesiobuccal alveolar thickness of the maxillary first molars were significantly reduced. Hyrax (standard mean difference [SMD]: −0.93, 95% confidence interval [CI]: −1.20–0.66) and Haas procedures (SMD: −0.88, 95% CI: −1.40–0.36) significantly reduced the buccal vertical alveolar height of the maxillary first molars. Similar results were obtained for the maxillary first premolars following RME. The thickness of the buccal alveolar bone decreased with conventional RME compared to when using the method assisted by micro-implants. Conventional RME can reduce the thickness and vertical height of maxillary alveolar bone, and there is less loss of alveolar bone when using micro-implant-assisted RME. Further research is needed to validate the findings. [ABSTRACT FROM AUTHOR]

The paper reports the demographic characteristics of patients with lichenoid lesions affecting only the upper labial mucosa, with or without associated lesions in the maxillary anterior gingiva, alongside the lesions' clinical and histopathological features, treatment, follow-up and prognosis. Also, a new case with lengthy follow-up is presented. A systematic review was performed in line with PRISMA guidelines. The literature search sources were PubMed, Scopus and Web of Science. In all, 26 patients (21 women, 5 men) were included in the review. 80.8% (n = 21) of the labial lesions were clinically erythematous and 19.2% (n = 5) were accompanied by white striations. The gingiva was affected in 46.2% of cases. All patients (100%, n = 24) reported symptoms. All of the lesions presented histological features of lichenoid inflammation. Granulomas were noted in 65.4% (n = 17) of the lesions. Topical corticosteroid was the most frequent therapy (89.5%, n = 17). Lichenoid lesions found solely in the upper labial mucosa, with or without adjacent gingival lesions, are rarely reported in the literature, and the reporting is often incomplete. A definitive aetiology could not be established for the lesions. Likewise, there is little information about this condition's long-term prognosis. [ABSTRACT FROM AUTHOR]

With an increased number of questionnaire-based knowledge, attitude, practice and other types of studies, there is a need to perform evidence-based research in such designs as well. The systematic reviews (SR) and meta-analyses (MA) of the questionnaire-based studies are difficult to conduct and summarise due to the wide variations in the questions included in each of them. The presentation of these reviews often leads to ambiguous conclusions, and meta-analysis is not possible due to wide heterogeneity. This paper aims to highlight a method known as the 'Knowledge-Attitude-Practice' or 'KAP' Heat Map, which was developed and validated for the effective presentation of the outcomes of varied questionnaires in systematic reviews. [ABSTRACT FROM AUTHOR]

This paper describes and reports the patient-specific characteristics of an urgent dental care clinic for COVID-19 infected, suspected, exposed or quarantined patients from March to December 2020 in the Hospital District of Helsinki and Uusimaa, Finland. The triage and the treatment protocol were established based on the scientific data. Patient files were evaluated from the hospital district's electronic medical record system. IBM SPSS software was used for statistical analysis. There were 1114 consultations and 257 visits at the clinic. Most of the patients were generally healthy with mean age of 35, had toothache and were suspected to be SARS-CoV-2 positive. Seventeen of the patients received positive tests for COVID-19 infection. The main treatment was tooth extraction, mostly due to caries. Statistically significant differences between COVID-19 infected and other patients occurred in age (45 vs 34 years-of-age, p =.009) and number of teeth (25 vs 28, p =.031). No SARS-CoV-2 infection transmission chains were traced to the clinic. During the challenging pandemic time, patients were carefully screened by specialists in clinical dentistry and treated safely and effectively. Patient-specific characteristics revealed no differences between COVID-19 infected and other patients in terms of symptoms or treatment needs. [ABSTRACT FROM AUTHOR]

Coffee is one of the most popular beverages in the world, with millions of people consuming it every day. The effect of coffee on teeth discoloration has long been a concern for both coffee drinkers and dental professionals. To address this concern, this study aimed to investigate the role of chlorogenic acids (CGAs) and the type of coffee in coffee-induced teeth discoloration. High-performance liquid chromatography with a photodiode array detector was used to determine the CGA contents of instant coffee produced by five manufacturers (Starbucks, Dunkin' Donuts, Kanu, Ediya, Coffee Bean). A total of 180 bovine tooth specimens were immersed in the coffee samples for varying durations (3, 9, 24, 48, and 72 h), and the discoloration levels were measured using a spectrophotometer. A linear mixed-effects model analysis was used to determine the significance of L*, a*, and b* values in relation to the duration of coffee immersion and coffee type. Both immersion time and coffee type had significant effects on tooth discoloration (p < 0.001), with some types of coffee being more strongly associated with tooth discoloration than others. The amount of CGAs present in coffee was found to be positively correlated with the degree of discoloration (p = 0.030). Prolonged exposure to coffee can exacerbate teeth staining, and different types of coffee can cause varying degrees of discoloration. Furthermore, coffee with higher levels of CGAs may lead to greater tooth discoloration. [ABSTRACT FROM AUTHOR]

Indication-specific optimum field-of-views (FOVs) have been assessed for CBCT scans of impacted maxillary canines and mandibular third molars, as 40∅ × 35 mm and 35∅ × 35 mm, respectively. The objective was to investigate possible changes in absorbed organs and effective doses, for these two imaging indications, performing CBCT examinations with optimum FOV sizes instead of commonly used FOVs. Additionally, radiation exposure-induced cancer risk was calculated for both imaging indications with optimum FOVs. An adult female head phantom (ATOM 702-D, CIRS, Norfolk, VA, USA) was scanned using Planmeca Viso G7 CBCT-device (Planmeca, Helsinki, Finland). Scanning factors, different FOV sizes, dose-area product (DAP) values and anatomical FOV locations were used for Monte Carlo PCXMC-simulation and ImpactMC software. In the PCXMC- simulation, 10-year-old child and 30-year-old adult phantoms were used to estimating effective and absorbed organ doses. The effective dose varied from 58 µSv to 284 µSv for impacted maxillary canines, and from 38 µSv to 122 µSv for mandibular third molars, the lowest dose value for each corresponding to optimum FOV. Effective dose reduction between the optimum FOV and the smallest common FOV of 50∅ × 50 mm, maintaining other scanning factors constant, was 33% for impacted maxillary canines, and 45% for mandibular third molars. At all examinations, the highest absorbed organ doses were in salivary glands or in oral mucosa. Optimum FOVs, 40∅ × 35 mm for impacted maxillary canine and 35∅ × 35 mm for mandibular third molar, could decrease effective doses received by young patients, and improve radiation safety in these common CBCT imaging procedures. [ABSTRACT FROM AUTHOR]

The aim was to examine what kinds of dental anxiety management techniques dentists use in the context of one-session treatment. The data consisted of videotaped treatment sessions for five dentally anxious adults. The treatment was conducted by two experienced dentists without formal training in the treatment of dentally anxious patients or behavioral management techniques. Theory-driven qualitative content analysis, based on the anxiety management classification of Milgrom et al. was used to identify and classify the techniques used during the treatments. Altogether, diverse categories of dental anxiety management techniques were identified under the main themes of enhancing trust and control and psychological management. Techniques that fell into enhancing trust and control included the categories of 'building a trustful relationship', 'informational control', and 'behavioral control'. These techniques were used consistently throughout the sessions. Additionally, psychological management techniques were identified and classified as 'behavioral strategies: relaxing the body' and 'cognitive strategies: relaxing the mind', which were regularly used in specific situations. The results indicate that a variety of dental anxiety management techniques were used during one-session treatments. The findings provide valuable insights for dentists in managing their patients with dental anxiety and improving their overall treatment experience. [ABSTRACT FROM AUTHOR]

Investigating the prevalence of mandibular ORN in a single Swedish Oncology Center. A total of 450 patients, treated with radiotherapy for squamous cell carcinoma in the oropharynx between 2004 and 2014 were included. Three different techniques of radiotherapy were studied. ORN diagnosis was set when clinical signs according to Marx were observed, or if radiological signs were staged according to Schwartz and Kagan. Using the staging system, 90 patients (20%) were diagnosed with ORN. The mean age of the ORN patients was 56.6 years, the older the patient the lower the risk of developing ORN (p =.01). The risk of developing ORN for patients receiving Intensity Modulated Radiotherapy was lower compared to patients treated with the other techniques in the multivariable analysis. Brachytherapy significantly increases the risk of ORN. The risk of ORN increased by 8% each year after radiation (p =.04). The mean time to the ORN diagnosis was 3.9 years. In the multivariate analysis, the risk of ORN increased by 13% each year after radiation (p =.0013). The mean radiation dose was of greater importance for the risk of ORN than the maximum dose. Elderly people with oropharyngeal cancer were less prone to develop ORN. [ABSTRACT FROM AUTHOR]

This cross-sectional study evaluated the number and characteristics of third molars extracted in a single visit in primary care and their associations with patient's age and sex and operator's experience. The data included all appointments where routine and surgical extractions of third molars were performed in 2016 in primary care of the City of Helsinki. Statistics included χ2 and Mann–Whitney U tests, and binomial logistic regression. In total of 10,894 appointments, the number of extracted third molars was 12,728, yielding an average of 1.2 third molars per visit. Mean age of patients (55% women, 45% men) at extraction was 32.2 years (range 12 − 97 years). Most appointments (83.7%, n = 9,118) comprised extraction of one, 15.8% two, 0.4% three, and 0.1% four third molars. Number of teeth extracted at a time did not differ by sex. Increasing age was associated with a reduction in the likelihood of several third molar extractions in a visit (OR 0.96; 95% confidence interval (CI) 0.96–0.97). Multiple third molars were extracted significantly more likely if the operator was experienced (OR 2.32; 95%CI 1.90–2.84). Multiple extractions were also associated with the mandible, operative extractions, unerupted teeth and caries. Third molars were typically extracted one at a time. In health care units, it is appropriate to consider extraction of several third molars in a single visit, if need for extraction of other third molars exist. Concentrating the extractions of younger patients on experienced operators would reduce the number of patients' visits. [ABSTRACT FROM AUTHOR]

The aims were (1) to study the association between dental anxiety (DA) and temporomandibular disorders (TMDs) and whether subgroups formed differ in psychological symptoms and pain sensitivity in the Northern Finland Birth Cohort 1966 and (2) to confirm the factor structure of the Hopkins Symptom Checklist-25 assessing psychological symptoms. Data were acquired using questionnaires and clinical examinations at age 46 years (n = 1889). Dental anxiety was assessed with Modified Dental Anxiety Scale (MDAS). Pain-related TMD (myalgia, arthralgia) were assessed according to modified diagnostic criteria for temporomandibular disorders. Pressure pain threshold and tolerance were measured with an algometer. Explanatory factor analysis revealed three factors, named 'depression', 'anxiety' and 'distress'. Those with high DA and myalgia and/or arthralgia reported higher depression (mean = 1.52), anxiety (mean = 1.61) and distress (mean = 2.06) scores, and lower pressure pain threshold (mean = 496 kPa) and tolerance (mean = 741 kPa) values than those with only DA (1.22; 1.56; 1.84; 613; 875), TMD (1.21; 1.39; 1.83; 600; 908) or neither (1.12; 1.29; 1.58; 707; 1006), respectively. Patients with DA and/or myalgia/arthralgia have similar profiles regarding pain sensitivity and psychological symptoms, the burden being highest among those with DA and a TMD diagnosis. [ABSTRACT FROM AUTHOR]

Kombuchas and other tea-based beverages are often perceived as healthy products despite the lack of knowledge on their effects on oral health. This in vitro study determined the erosive potential of commercial kombuchas, and ice teas compared to cola drinks. The pH and fluoride content of 7 kombuchas and 18 tea drinks were measured with ion-selective electrodes. Calcium dissolution from hydroxyapatite grains was quantified by atomic absorption spectroscopy after beverage exposure. The effect of beverages on the enamel surface was visualized by scanning electron microscopy (SEM). Distilled water, and cola drinks were used as negative and positive controls. The kombuchas exhibited lower pH values (2.82–3.66) than the ice teas (2.94–4.86), but still higher than the cola drinks (2.48–2.54). The fluoride concentration varied between 0.05 and 0.46 ppm and for 7 beverages the concentration was below the detection limit. The calcium release for kombuchas was 198–746 mg/l, for ice teas 16.1–507 mg/l, and for cola drinks 57.7–71.9 mg/l. Twenty-two beverages had a significantly greater calcium release than the cola drinks (p =.009–.014). The surface etching of the enamel was seen in the SEM analysis after beverage exposure. Tea-based beverages have even higher erosive potential than cola drinks. Kombuchas especially, displayed a considerable erosive potential. [ABSTRACT FROM AUTHOR]

Use of snus, a moist, smokeless tobacco product, may lead to local changes in the oral mucous membrane in the area where the snus is placed. It can also cause irreversible gingival retraction. This cross-sectional study aimed to investigate the relationship between use of snus, oral mucosal lesions (snus induced lesions) and gingival retractions among adolescents in Norway. All 18–20 years olds visiting public dental health clinics in the south-eastern region of Norway between October 2015 and December 2016 were invited to participate. All participants (n = 1363) filled in an electronic questionnaire before a clinical examination. Of these, 216 used snus daily. Snus induced lesions were observed in 79.2% of daily snus using participants. In adjusted regression analyses, the odds of having a more severe lesion as opposed to a less severe lesion were 1.12 times greater for each additional box of snus used in a month (p <.01). Women were 46% less likely to have a severe lesion than men (p =.03). Gingival retractions were observed in 18.4% of the participants. The odds for dental retraction were significantly higher by 34% for each year of snus use. Most of the adolescents using snus had snus induced lesions, whereas approximately one-fifth had gingival retractions. The severity of the lesion and gingival retraction increased with the amount of snus boxes used and the duration of the snus use, respectively. [ABSTRACT FROM AUTHOR]

To examine the relationship between tooth loss and co-occurrence of multiple chronic conditions (MCC) among American adults at working age. Data was from the Behavioural Risk Factor Surveillance System 2018, a cross-sectional telephone-based, nationally representative survey of American adults. We included participants aged 25–64 years. The survey included sociodemographic data, reported diagnosis of chronic conditions, the number of missing teeth and health behaviours. An aggregate variable of chronic conditions was created which included heart attack, angina, stroke, cancer, chronic pulmonary disease, diabetes, asthma, arthritis, depression, and kidney diseases. The association between the number of missing teeth and the aggregate of chronic conditions was assessed adjusting for confounders. The analysis included 202,809 participants. The mean number of MCC was 0.86 (95% Confidence Interval 'CI':0.85,0.87). Tooth loss was significantly associated with MCC with rate ratio 1.18 (95% CI:1.15,1.21), 1.53 (95% CI:1.48,1.59) and 1.62 (95% CI:1.55,1.69) for those reporting losing 1–5 teeth, 6 or more but not all, and all teeth, respectively after adjusting for demographic, socioeconomic, and behavioural factors. Tooth loss could be an early marker for the co-occurrence of multiple chronic conditions among adults of working age. The association could be attributed to common risk factors for oral and general health. [ABSTRACT FROM AUTHOR]

Optimization of radiographic examinations is essential for radiation protection. The objective of the study was to investigate the clinical applicability of a low-dose CBCT protocol as compared to the default for pre-surgical evaluation of mandibular third molars. Forty-eight patients (62 teeth) referred for pre-surgical mandibular third molar investigation were recruited after justification for CBCT. Two CBCT scans of each site were made using a default protocol and a low-dose protocol (Veraviewepocs 3D F40, J Morita Corp, Kyoto, Japan). The low-dose protocol had the same tube potential (90 kV) and exposure time (9.4 s) as the default, but with reduced tube current, from 5 mA to 2 mA. Four observers evaluated the visibility of five relevant anatomical variables. Image quality was ranked on a 3-point scale as diagnostically acceptable, doubtful, or unacceptable. The Wilcoxon signed-rank test compared differences between the two protocols. The significance level was set at p ≤.05. No significant differences were found between the two protocols for any observer regarding the visibility of the relationship and proximity between the roots and the mandibular canal; root morphology; and possible root resorption of the second molar. The periodontal ligament differed significantly in visibility between the two protocols (p ≤.05). This study indicates that a low-dose CBCT protocol with a 60% reduction of the tube current provides, in most cases, acceptable image quality for pre-surgical assessment of mandibular third molars. Optimization of CBCT protocols should be a priority according to recommended guidelines. [ABSTRACT FROM AUTHOR]

This study examines the attitudes and practices of ICU nurses towards the provision of oral care to their patients. We conducted this cross-sectional survey about oral health care practices in ICUs in Lithuania. We used a self-administered 20-item questionnaire to survey the current oral care practices, training, and attitudes of 108 nurses. The questionnaire was based on previous studies to gather information related to the attitudes, oral care practices, and training of ICU nurses. We used the chi-square test to analyze relationships between the categorical variables. Most (88, 82%) of the nurses stated that oral care is important. Although most (83, 77%) had adequate training, a clear majority (98, 91%) of the nurses reported a willingness to learn more. Most (78, 72%) of the nurses found the oral cavity difficult to clean, and (71, 66%) found doing so unpleasant. When performing oral care, the nurses used mostly foam swabs (62, 61%) and moisturizers (54, 53%). More than half (57, 57%) of the nurses expressed a need for more hospital support. Nurses working in ICUs reported that oral care is a high priority for their patients, but a difficult and unpleasant task. Nurses provided oral care mainly with toothbrushes, foam swabs, and moisturizers. [ABSTRACT FROM AUTHOR]

To investigate the prevalence of and factors associated with dental fluorosis in children living in areas of high caries risk in Stockholm and who had participated in a prospective, parallel, cluster-randomized, controlled caries prevention trial between ages 1 and 3 years. The study group comprised a random sample of the children who had completed the 2-year prevention trial (n = 2536) in 2011–2014. All children were instructed to use fluoride toothpaste; the test group received fluoride varnish applications twice a year. Dental fluorosis prevalences in the reference (n = 220) and the test (n = 234) groups were compared. Presence of fluorosis was determined using the Thylsturp & Fejerskov (TF) index on photos of the permanent maxillary incisors. No significant difference in dental fluorosis was observed between the two groups. Nearly one-third (29.7%) of the children in the study cohort exhibited dental fluorosis (TF index ≥ 1). Associations with use of fluoride toothpaste at age 1 year and with socioeconomic status factors were found. Biannual applications of fluoride varnish in toddlers was not associated with dental fluorosis, which when found was rarely of aesthetic concern. Parental education in tooth-brushing routines is recommended. [ABSTRACT FROM AUTHOR]

There is a knowledge gap in how dental clinicians recognise dental anxiety. The aim of this study was to identify, describe and generate concepts regarding this process. Eleven semi-structured interviews were conducted with dental clinicians from the public dental service of Östergötland, Sweden. Purposive and theoretical sampling was used. Theoretical saturation was reached after eight interviews. The interviews were audio-recorded and transcribed verbatim. Classical grounded theory was used to inductively analyse data by constant comparative analysis. The core category was identified as; 'the clinical eye', clinicians noticing behaviours possibly due to dental anxiety based on their knowledge, experiences, or intuition. The core category comprises the five categories: Sympathetic activation, Patient-reported anxiety, Controlling behaviours, Avoidance and Accomplishment. Initially there is usually uncertainty about whether a behaviour is due to dental anxiety or part of a patient's normal behaviour. To gain additional certainty, clinicians need to recognise a stressor as something in the dental setting by observing a change in behaviour, for better or for worse, in the anticipation, presence or removal of the stressor. Clinicians identify patients as dentally anxious if their behaviour changes with exposure to a stressor. [ABSTRACT FROM AUTHOR]

This register-based study assessed the frequency of and age-specified variation in tooth extractions in adults visiting private dentists in Finland in 2012–2017. Retrospective study design was used on the register-based data of private sector services. Data of the entire 6 years, 2012–2017, included records of a total of 6,252,039 patients. From among these, further detailed information was gathered in 2012 for 1,058,305 patients, and in 2017, for 985,043 patients. For each 6 years, the data were aggregated into patients' 5-year age groups that were observation elements. Proportions of patients undergoing oral surgical treatments were compared during the 6 years 2012–2017, and details of tooth extractions in 2012 and 2017. Linear regression modelling was used to analyse thinkable age- and year-related inclinations in oral surgical treatments. Across the 6 years, a total of 848,362 patients (13.6%) underwent oral surgical treatments, and the rates varied by year 13.3–13.8%. By age group, the smallest rates (9–10%) were for 35–49-year-olds and greatest (20–22%) for those aged below 25 or over 84. The rates in same-age groups were stable. In 2012 and 2017, mean numbers of tooth extractions per patient by year were 0.17 and 0.18, and per patients undergoing oral surgical treatments, 1.29 and 1.27, respectively. Proportion of patients undergoing oral surgical treatments and mean number of tooth extractions per patient was greater in younger and older age groups. Tooth extractions in adults are age-dependent and age-specified differences remain stable across the years. [ABSTRACT FROM AUTHOR]

The aim of this systematic review was to evaluate the effectiveness of conservative different therapeutic modalities for temporomandibular disorders (TMD) pain. An electronic systematic search was conducted in the MEDLINE (PubMed) database to identify the randomized clinical trials (RCTs) published between 2001 and 2021. The following, simple or multiple conjunctions, search keywords were selected: TMD pain, TMD management or conservative treatment or treatment strategies and TMD pain, therapeutic modalities or interventions and TMD. Studies included must have patients older than 18 years, with painful TMD, which diagnosis was performed by Research Diagnostic Criteria for TMD or Diagnostic Criteria for TMD. Outcome variables were pain relief and post treatment pain intensity reduction. Data were analysed with non-parametric tests and the level of significance was set at p<.05. Out of 1599 articles obtained, 28 RCTs fulfilled all selection criteria and were included. The results of this study show that there was a significant decrease in short-term post-treatment TMD pain with the use of occlusal splint alone or in combination with other therapeutic modalities when compared with the control group. Statistically significant differences were also detected between laser and photobiomodulation group and the control, in short-term treatment TMD-related pain. The primary findings of the present systematic review showed that the occlusal splint alone or combined with other therapeutic intervention presented positive effect on short-term TMD pain reduction. Secondary outcome suggests that laser and photobiomodulation therapy had, also, a significant role in short term pain relief. [ABSTRACT FROM AUTHOR]

The aim of this case-control study was to investigate whether cognitively impaired individuals have a higher burden of calcified carotid artery atheroma (CCAA) than controls without cognitive impairment. The study included 154 cases with Alzheimer's disease (n = 52), mild cognitive impairment (n = 51), or subjective cognitive decline (n = 51) diagnosed at a university memory clinic. Seventy-six cognitively healthy controls were sampled through the Swedish population register. All participants underwent clinical oral and panoramic radiographic examinations. Two oral and maxillofacial radiologists performed blinded analyses of the panoramic radiographs for signs of CCAA, which was registered as absent or present and, if present, unilateral or bilateral. Consensus assessment was used for all statistical analyses. CCAA was common (40%) in this middle-aged and older Swedish population. We found no differences in the prevalence of CCAA between cases and controls (40% vs. 42%). Cognitively impaired patients do not have a higher burden of CCAA than matched controls without cognitive impairment. [ABSTRACT FROM AUTHOR]

To compare alveolar bone height and width measurements from zero-echo-time MRI (ZTE-MRI) and cone beam CT (CBCT), in human specimens. Twenty posterior edentulous sites in human cadaver specimens were imaged with CBCT and ZTE-MRI. Bone height and width at 1, 3, 5, 7 and 9 mm from the top of the alveolar ridge was measured by two trained observers in cross-sections of a site where an implant was to be planned. Twenty percent of the sample was measured in duplicate to assess method error and intra-observer reproducibility (ICC). The differences between CBCT and ZTE-MRI measurements were compared (t-test). Inter- and intra-observer reproducibility was >0.90. The method error (average between observers) for bone height was 0.45 mm and 0.39 mm, and for bone width (average) was 0.52 mm and 0.80 mm (CBCT and ZTE-MRI, respectively). The majority of the bone measurement differences were statistically insignificant, except bone width measurements at 5 mm (p ≤.05 for both observers). Mean measurement differences were not larger than the method error. ZTE-MRI is not significantly different from CBCT when comparing measurements of alveolar bone height and width. [ABSTRACT FROM AUTHOR]

Children frequently experience pain and/or discomfort during dental treatment. Still, pain research in dentistry has mainly been performed on adults using quantitative methods while research on the child's perspective is scarce. This study aims to explore and describe children's experiences and/or thoughts regarding pain in conjunction with tooth extraction. Interviews were carried out with twelve Swedish 10–16-year-olds who had recently undergone tooth extractions due to orthodontic reasons. Interviews were transcribed verbatim and analysed according to grounded theory. A core category was identified and named 'handling the unavoidable unknown'. The informants recalled experiences of pain and discomfort during extractions. However, instead of focussing on pain, they described an urge for more information about the procedure and what to expect in terms of pain and/or discomfort, during and/or after treatment. They stated that the levels of pain/discomfort were manageable, while the lack of information negatively affected their coping abilities, causing feelings of unease. To improve patients' ability to deal with pain in conjunction with dental extraction, the dental team should ensure better and individually tailored information about the treatment. Thus, the use of psychological techniques is a cornerstone in pain management and must be reflected in clinical guidelines. [ABSTRACT FROM AUTHOR]

To investigate dental caries prevalence amongst adults in Central Norway and assess changes over the last 45 years. The cross-sectional HUNT4 Oral Health Study was conducted in 2017-2019. A random sample of 4913 participants aged ≥19 years answered questionnaires and underwent clinical and radiographic examinations. Data were compared to findings from previous studies in the same region conducted from 1973 to 2006. Mean number of decayed, missing and filled teeth (D3-5MFT) was 14.9 (95% CI 14.7, 15.1), 56% of adults had one or more carious teeth (D3-5T) and 11.8% had ≥4 D3-5T, with the mean number of 1.4 (95% CI 1.32, 1.42). For initial caries, mean D1-2S was 3.8 (95% CI 3.7, 3.9), being the highest for 19-24-year-olds at 8.6 (95% CI 7.9, 9.3). Comparisons with earlier studies showed a decline in mean D3-5MFT for 35-44-year-olds from 26.5 in 1973 to 10.8 in 2019. In 1973, 4.8% of 35-44-year-olds were edentulous, while in present study edentulousness was found only in individuals >65 years. Despite a substantial reduction in caries experience over the last 45 years, untreated dentine caries was common, evenly distributed across all age groups. Initial caries particularly affected younger individuals, indicating a need to evaluate prevention strategies and access to dental services. [ABSTRACT FROM AUTHOR]

The systematic review and meta-analysis aimed to evaluate the efficacy of Metformin (MF) with Platelet Rich Fibrin (PRF) over PRF alone in the treatment of periodontal osseous defects. An extensive electronic search for articles published up to September 2021 was conducted on 'Embase', 'PubMed' and other library databases accompanied with manual searching. Randomized controlled trials (RCTs), comparing MF plus PRF Vs PRF alone in periodontal osseous defects were identified in which periodontal pocket depth (PPD), Clinical attachment level (CAL) and Intrabony defect depth (IBD Depth) were the outcome measures. Four studies compared MF plus PRF vs.PRF alone in periodontal osseous defects. Meta-analysis was carried out for PPD reduction, CAL gain and IBD Depth changes. A standardized mean difference (SMD) of 1.86 for PPD reduction, 1.95 for CAL gain and 1.31 for IBD Depth reduction in all the studies was observed and the findings were statistically significant favouring test group. The systematic review indicates supplemental benefits of combination therapy of MF + PRF over monotherapy in resolving periodontal osseous defects. In our quest to achieve maximum regeneration in periodontal osseous defects, combination therapies such as MF + PRF have reported to be better treatment choices over other modalities. [ABSTRACT FROM AUTHOR]

To identify common resilience factors against non-communicable diseases (dental caries, diabetes type II, obesity and cardiovascular disease) among healthy individuals exposed to chronic adversity. The databases MEDLINE (via PubMed), Scopus and CINAHL were searched. Observational studies in English assessing resilience factors among populations living in chronic adversity were included. Intervention studies, systematic reviews, non-original articles and qualitative studies were excluded. There were no restrictions regarding publication year or age. No meta-analysis could be done. Quality assessments were made with the Newcastle-Ottawa scale (NOS). A final total of 41 studies were included in this systematic review. The investigated health resilience factors were divided into the following domains: environmental (community and family) and individual (behavioural and psychosocial). A narrative synthesis of the results was made according to the domains. Individual psychosocial, family and environmental factors play a role as health resilience factors in populations living in chronic adversity. However, the inconclusive results suggest that these factors do not act in isolation but interplay in a complex manner and that their interaction may vary during the life course, in different contexts, and over time. [ABSTRACT FROM AUTHOR]

The global COVID-19 pandemic has led to an increase in remote teaching and online assessment in higher education. The examination performance of undergraduate students of dentistry was evaluated to assess any possible association between the altered learning environment and learners' performance. Using administrative data from the University of Helsinki, the examination performance during the years 2018 and 2019 was compared with that of 2020. In 16 out of 22 courses (73%) taught remotely during the pandemic, a statistically significant difference (p <.05) between the awarded grades was observed, as compared to the two previous years. Annual variation in examination grades was common even before the onset of remote teaching, but more so after it. The grade variation during the pandemic was nearly as prevalent towards falling grades (26%) as towards rising grades (36%), implying a multifactorial cause possibly unrelated to remote teaching. Our results imply that online teaching did not systematically improve or worsen the examination performance of undergraduate students of dentistry. Our findings have important policy implications for educational practices in the future. The observed annual grade variation might reflect the effectiveness of remote teaching, changes in students' performance, or non-systematic grading. [ABSTRACT FROM AUTHOR]

To review publications exploring non-utilization of oral health services and to identify factors associated with non-utilization of oral health services among children and adolescents. An integrative review design was adopted. A search was conducted for research articles published during the period from 2000 to April 2021 in five databases, Medline via Ovid, Scopus, CINAHL, Cochrane Library and Web of Science. Inclusion criteria were original articles examining non-utilization of oral health services among 0–19 years old and studies published in peer-reviewed journals in English. Thematic analysis was undertaken to identify common themes. The Newcastle-Ottawa scale was used to evaluate the quality of the studies. Twenty-one geographically diverse articles were included. Nineteen studies were cross-sectional, one was a prospective cohort and one a case-control study. Non-utilization of dental health services tended to be higher in children than adolescents. There were predisposing (age, gender, ethnicity, parent's level of education), enabling (family income, dental insurance) and need factors (subjective and objective oral health related parameters) that had been shown to be associated with non-utilization of dental services among children and adolescents. This integrative review found predisposing, enabling and need factors to be associated with dental health service non-utilization. [ABSTRACT FROM AUTHOR]

The primary objective of the present study was to investigate the dimensional structure of the OHIP-14 in a sample of elderly Norwegians. A secondary objective was to describe associations between the exposed OHIP-14 dimensions and additional self-report oral health-related variables to assess the dimensions' criterion validity. A survey questionnaire including the OHIP-14 and additional self-report oral health-related measures was completed by 325 home-dwelling Norwegians aged 70+. Exploratory factor analysis was used to investigate the dimensional structure of the OHIP-14 in this sample. Bivariate correlations were used to describe associations between the exposed OHIP-14 dimensions and additional self-report oral health-related variables. Three dimensions named psychosocial impacts, oral function impacts and general function impacts were revealed. Convergent and discriminant validity of these dimensions were largely supported, and internal consistency reliability for each dimension was good. Statistically significant associations were found between the exposed dimensions and additional self-report oral health-related variables, supporting the dimensions' criterion validity. A three-dimensional structure of the OHIP-14 was exposed and validated in the present study sample. Since different aspects of oral health-related quality of life (OHRQoL) may be perceived and weighted differently in various populations, suggestions for future research include more profound investigations of the construct validity of the OHIP-14 and similar instruments assessing OHRQoL. Such research should include an exploration of various dimensions and the weights given to them through qualitative research in the target population(s). [ABSTRACT FROM AUTHOR]

The aim of this systematic review and meta-analysis is to identify the risk factors of external root resorption (ERR) on second molar (M2) due to presence of impacted third (M3) molar based on cone- beam computerised tomography (CBCT) findings. Search of PubMed via MEDLINE, SCOPUS, and Experta Medical dataBASE (EMBASE) was performed to identify studies assessing the risk factors of ERR in M2 due to the presence of impacted M3. M2 in close proximity to mesio-angular impacted M3 had 50% higher risk of root resorption than with vertical impacted M3 (RR 0.50 95% CI [0.35, 0.73], p =.0003). Presence of the impacted M3 in the lower arch with ERR in M2 was higher (38.3%) than in the upper arch (33.8%). With respect to the inclination of impacted M3, the incidence of ERR was higher with transverse, horizontal and mesio-angular impacted M3 with 54.5%, 47.5% and 44.5% of occurrence, respectively. ERR in M2 was significantly affected by the contact with impacted M3 and most importantly, the inclination of M3. The presence of mesio-angular, horizontal or transverse impacted M3 in close proximity to apical or middle portion of M2 could possibly be a strong risk factor for ERR in M2. [ABSTRACT FROM AUTHOR]

The aims of this systematic review were to evaluate the clinical masticatory performance of implant-supported restorations, observe the occlusal force changes in the distribution of the implant restoration and reveal the positive and negative contributing factors of implant design and components based on the outcomes of digital occlusal measurement. An extensive search was conducted through PubMed and CENTRAL to identify clinical trials on implant-retained restorations using digital occlusal analysis methods. Two researchers assessed the identified studies and data extraction independently, and the data synthesis strategies without meta-analysis that summarizes the effect estimates were adopted. The search screened 3821 titles and abstracts, then full-text analysis for 26 articles was performed, and 14 studies were included in the quantitative synthesis. Four of six studies for implant-retained overdenture showed statistically significant improved bite force when immediate loading (p =.00045,.00005,.00055, and.00005, respectively), and no statistically significant results in the other two studies (p =.225,.371, respectively.) However, the results of the favoured intervention were not statistically significant (p =.104,.166, respectively) in two studies of single posterior implant restorations. In all three studies, the bite force distributed on the implant prostheses of partially fixed implant-retained restoration increased statistically significantly (p =.013,.001,.05, respectively). The edentulous restoration supported by implants seems to significantly improves bite force and chewing efficiency compared with conventional dentures. Regular quantitative occlusal measurement is recommended to avoid the possible risk of overload. Smaller implants size and relatively small and flexible attachment designs may be more conducive to the stability and retention of the restoration of atrophy of alveolar bone. [ABSTRACT FROM AUTHOR]

(i) To study the measurement invariance of Orofacial Esthetic Scale (OES) and Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), (ii) to compare the perception of orofacial appearance (OA) and (iii) to study the frequency of individuals who have sought or received aesthetic dental treatment between Brazil and Finland. This was a cross-sectional observational study with snowball non-probability sample selection. Students and staff from universities in Finland and Brazil were invited to participate. Data were collected online using a demographic questionnaire, OES and PIDAQ. The samples consisted of 3636 Finns (75.0% female; age: 32.0 years) and 1468 Brazilians (72.6% female; age: 33.2 years). The frequency of receiving aesthetic dental treatment was estimated. If configurational invariance was observed, cross-national measurement invariance was verified by multigroup analysis. When measurement invariance was attested, factor scores were compared using Welch's t-test. OES showed configurational and measurement invariance and no significant difference between the countries. Despite similarity in satisfaction with OA, 71.9% of Brazilians had received aesthetic dental treatment, while 59.4% of Finns had never sought such treatments. PIDAQ did not present configurational invariance between the countries. Although there is no difference in satisfaction with OA, seeking and receiving aesthetic dental treatment is significantly greater for Brazilians. Psychosocial impact of OA is perceived differently in the studied countries. [ABSTRACT FROM AUTHOR]

To explore oral health by increasing degree of obesity and the influence of modifying factors. A cross-sectional design was used. Swedish females (n = 118; 18–35 years) with morbid obesity were recruited from the BAriatric SUbstitution and Nutrition study (BASUN). Body mass index (BMI) was used as continuous and categorized into 35–39.9 kg/m2/40–44.9 kg/m2/≥45 kg/m2. Oral examinations assessed dental caries using the ICDAS system, periodontal status and saliva characteristics. Information on sociodemographics, oral health behaviour and symptoms was collected via a questionnaire. Mean BMI was 42.2 kg/m3 (SD 4.0; range 35.0–63.7). Significantly higher frequencies of dentine caries (p =.001) and total caries (p =.046) were found with higher BMI with an increase in total caries by 0.59 tooth surface (p =.025) for each increasing BMI degree. There were consistent associations between obesity and dentine caries for the group with the highest BMI (≥45), adjusted RR 2.08 (95% CI 1.20–3.61), and all stages of caries, adjusted RR 1.41 (95% CI 1.02–1.96). High scores were found for dental plaque (50.2%) and gingivitis (34.5%). Young obese women exhibited poor oral health with higher caries levels by higher BMI. Dental care should adapt the prevention efforts for obese individuals. Trial Registration: The trial was prospectively registered on March 03; 2015; NCT03152617 [ABSTRACT FROM AUTHOR]

Pain referral on palpation has been suggested to be a clinical sign of central sensitization potentially associated with widespread pain conditions. Our aim was to evaluate if myofascial pain with referral is a better predictor for widespread pain when compared to no pain or local myofascial pain. Individuals at the Public Dental services in Västerbotten, Sweden, were randomly invited based on their answers to three screening questions for temporomandibular disorders (TMD). In total, 300 individuals (202 women, 20–69 yrs) were recruited, and examined according to the Diagnostic Criteria for TMD (DC/TMD) after completion of a body pain drawing. Widespread pain was considered present when seven or more pain sites were reported on the widespread pain index. A binary logistic regression model, adjusted for the effect of age and gender were used to evaluate the association between myofascial orofacial pain and widespread pain. Widespread pain was reported by 31.3% of the study sample. There was a 57.3% overlap with myofascial pain. Widespread pain was associated to myofascial orofacial pain with and myofascial orofacial pain (OR 4.83 95% CI 2.62–9.05 and OR 11.62 95% CI 5.18–27.88, respectively). These findings reinforce the existing knowledge on the overlap between painful TMD and other chronic pain conditions. [ABSTRACT FROM AUTHOR]

To investigate the effect of toothbrush bristles end configuration on the abrasive dentine wear at different brushing forces. One hundred and sixty bovine dentine samples were randomized into eight groups (n = 20). Groups (1 to 4) were brushed with tapered-end bristles at 1-, 2-, 3-, and 4-N brushing forces, respectively. Groups (5 to 8) were brushed with round-end bristles with the same brushing forces. The brushing sequence was carried out using an abrasive slurry (RDA = 121) for 25 min. Profiles were recorded using a contact profilometer. Mean and standard deviation were calculated for the abrasive dentine wear in each group. Two-way ANOVA was used to locate any significance. The significance values were corrected after Tukey (α = 0.05). Brushing with tapered-end bristles resulted in statistically significantly less abrasive dentine wear than round-end bristles regardless of the applied brushing force (1 N: 4.4 ± 1.5 vs. 7.7 ± 2.0 µm; 2 N: 7.7 ± 2.1 vs. 12.2 ± 2.7 µm; 3 N: 11.3 ± 2.6 vs. 19.4 ± 3.7 µm; 4 N: 11.2 ± 2.1 vs. 25.3 ± 4.8 µm). The interaction between bristle configuration and brushing force was statistically significantly (p < 0.001). Tapered-end toothbrushes might be a safer choice for patients, especially when showing signs of non-carious cervical lesion. However, other toothbrush properties should also be considered. [ABSTRACT FROM AUTHOR]

Sleep-disordered breathing (SDB) is common but often underestimated in children. The gold standard for assessing SDB is polysomnography, but it is expensive and time-consuming. The Paediatric Sleep Questionnaire (PSQ/SRDB) is a validated screening tool for SDB, which represents an efficient and alternative tool for screening SDB among children. However, a translated and validated Danish version of the PSQ/SRDB is not available yet. Our aim was to cross-culturally translate the PSQ/SRDB into Danish language for use in clinical and research settings. The translation was carried out through forward-backward translation techniques performed by a panel of experts, and the cross-cultural adaptation was achieved by pretesting of the pre-final version. Internal consistency of the Danish PSQ/SRDB version was measured by Cronbach's alpha coefficients, while Cohen's kappa was used to evaluate test-retest reliability. Construct validity was assessed by factor analysis of the principal components. The Danish PSQ/SRDB was administered to the caregivers of 348 children. An overall Cronbach's alpha of 0.72 was found, confirming the survey's consistency, with the results for the domains ranging 0.52–0.70. The Danish PSQ/SRDB showed moderate to perfect reliability for all items, except for one question (C14). Factor analysis performed on the Danish PSQ/SRDB showed that the predetermined four factors were similar with the original version of the PSQ/SRDB. The Danish version of the PSQ/SRDB has been successfully translated and cross-culturally adapted, suggesting that it can be used as an appropriate paediatric screening tool for SDB in Denmark. [ABSTRACT FROM AUTHOR]

Economic evaluations can support provision of adequate and affordable oral care, requiring valid information on costs. The aim was to assess the validity of (a) patients' self-report (PS) and routine electronic patient records (EPR) regarding time spent per visit and (b) PS regarding types of treatment and type of dental professionals involved. Data were collected in four dental clinics regarding time spent using PS and EPR, on types of treatment and dental professionals involved using PS. As reference standard for time spent, independent research assistants (RA) collected data on time per visit using stopwatches. As reference standard for types of treatment and of dental professionals involved, we used the dental clinic's Electronic Patient Files (DEPF). The two one-sided tests (TOST) equivalence procedure for the difference between paired means for time and kappa statistics for treatment and professional were used to assess agreement of data collection methods with the reference standards. Equivalence and agreement was good between (a) PS and RA registration concerning waiting time, appointment time and total time spent and (b) EPR and DEPF concerning appointment time. Agreement between PS and DEPF concerning types of treatment was moderate to fair (kappa values between 0.49 and 0.56 for preventive consultation, restoration, radiographs and extractions and between 0.15 and 0.26 for fluoride applications and sealants). Agreement between PS and DEPF for dental professional involved was fair (kappa = 0.41). Data collection regarding time using PS and EPR was valid. Data collection via PS on treatment and professionals involved were not sufficiently valid and should occur via DEPF. [ABSTRACT FROM AUTHOR]

This study aimed to explore oral health-related salutogenic factors in orally healthy older Swedish people, applying the three components of Antonovsky's Sense of Coherence (SOC) concept: comprehensibility, manageability and meaningfulness. Interviews were conducted with 12 orally healthy patients, aged 75 years and older, enrolled at public dental clinics. The interviews were subjected to qualitative content analysis, applying the SOC concept as the theoretical framework. Three themes were formulated under the predefined SOC components, describing the central meaning of the informants' perception of factors favourable to their good oral health. The theme 'comprehension of cause and effect' consisted of three categories, for example importance of oral hygiene, and reflected the component comprehensibility. The theme 'living in confidence and trust in supporting society' consisted of five categories, for example self-esteem, and reflected the component manageability. The theme 'good oral health as a basis for satisfaction and social confidence' consisted of two categories, for example social norms, and reflected the component meaningfulness. This study discloses how orally healthy elderly Swedish people perceive the lifelong impact of salutogenic factors in response to lifelong stressors on their oral health and highlights the important roles of their internal resources, dental professionals, family and society in supporting and reinforcing lifelong oral health. [ABSTRACT FROM AUTHOR]

To assess if and to what extent public dental health personnel (PDHP) receive inquiries from child welfare services (CWS), and to assess whether PDHP's experience of receiving inquiries is associated with PDHP's characteristics and whether the associations are influenced by PDHP's experience of reporting to CWS. Questionnaires were distributed to 1542 PDHP in Norway. Descriptive statistics were used for analysis. Negative-binominal-regression analyses with incidence rate ratios (IRRs) and confidence intervals (CIs) were used to estimate the association between received inquiries from CWS and PDHP characteristics. From a total of 1074 respondents, 52.4% had received inquiries from CWS (2012–2014) with a mean number of 3.9 (SD = 4.5). PDHP's likelihood of receiving inquiries was significantly associated with having many patients, working in small municipalities, working in eastern Norway, having good knowledge of the Health Personnel Act, and having experience reporting to CWS. Regional differences were the only association that varied according to PDHP reporting activity. PDHP receive inquiries from the CWS. The likelihood of receiving inquiries is associated with several characteristics of PDHP. To increase PDHP's likelihood of receiving inquiries, it is important to establish contact between the CWS and PDHS and ensure that the PDHP has good knowledge of the Health Personnel Act. [ABSTRACT FROM AUTHOR]

Objectives: To assess the efficacy and safety of hyaluronic acid (HA) injections to restore the lost interproximal papilla.Materials and Methods: A systematic literature search was conducted in PubMed/MEDLINE, Scopus and Cochrane electronic databases with no time restriction up to September 2021. Any clinical study evaluating HA injection into the interproximal papilla loss Class I and II according to Norland & Tarnow, were included based on the following PICO questions (1) Are HA injections effective for the reconstruction of the interproximal papilla loss? (2) What are the side/adverse effects of using HA for the reconstruction of interproximal papilla loss? The risk of bias assessment was performed using the Cochrane Collaboration's the Newcastle Ottawa and Joanna Briggs institute tools.Results: A total of 1497 titles were retrieved. From these, eleven were included and underwent full data extraction. However, due to heterogeneity in the data among the included articles, a meta-analysis could not be performed. Three articles reported no-differences in term of papilla tip to contact point distance or the papilla fill reduction. Finally, five studies showed a reduction in the black triangle with a percentage range between 19 and 47%.Conclusion: The non-surgical use of HA injection seems to have a positive effect on the re-establishment of interproximal papilla lost. However post-operative complications might develop. [ABSTRACT FROM AUTHOR]

To explore associations between salutogenic factors and selected clinical outcome variables of oral health in the elderly, combining Antonovsky's salutogenic theory and the Lalonde Health Field concept. The subjects comprised 146 individuals, aged 60 years and older, who had participated in a population-based epidemiological study in Sweden, 2011–2012, using questionnaire and oral examination data. A cross-sectional analysis used the selected outcome variables, such as number of remaining teeth, DMFT-index and risk assessment, and salutogenic factors from the questionnaire, clustered into domains and health fields, as artifactual-material, cognitive-emotional and valuative-attitudinal. This selection was based on findings from our previous analysis using a framework cross-tabulating two health models. The purpose was to facilitate analysis of associations not previously addressed in the literature on oral health. Bivariate and Multiple Linear Regression analyses were used. Numerous salutogenic factors were identified. Significant associations between outcome variables and salutogenic factors previously unreported could be added. Regression analysis identified three contributing independent factors for 'low DMFT'. This study supports the usefulness of a salutogenic approach for analysing oral health outcomes, identifying university education, the importance of dental health organization recall system and close social network, as important salutogenic factors. The large number of salutogenic factors found supporting oral health among the elderly indicates the complexity of salutogenesis and the need for robust analysing tools. Combining two current health models was considered useful for exploring these covariations. These findings have implications for future investigations, identifying important research questions to be explored in qualitative analyses. [ABSTRACT FROM AUTHOR]

Earlier results based on dental casts and radiographs have shown that additional X and Y chromosomes influence permanent and deciduous tooth crown sizes, with 47,XYY males exhibiting greater crown heights than 46,XY males. We studied here the effect of both X and Y chromosomes on tooth crown heights. The series consisted of 48 47,XXY males, 22 of their male relatives, and seven 47,XXX females with five female relatives. The population controls consisted of 27 males and 33 females. Measurements of all applicable teeth except for the third molars on both sides of the jaws were made on panoramic radiographs with a sliding digital calliper. Apart from a few teeth, the mean crown heights in the 47,XXY males were greater than those in the male population controls, the differences being statistically significant for one tooth in the maxilla and ten teeth in the mandible. With the exception of two teeth, the 47,XXX females had taller tooth crowns than the female population controls, the differences in the two teeth being statistically significant. The 47,XXY males had greater tooth crown heights than the 47,XXX females, except in one tooth, and the differences were significant in two teeth. The tooth crown heights of the male relatives of the 47,XXY males and the female relatives of the 47,XXX females were close to those in the general population. The present results demonstrated the effect of additional X and Y chromosomes in increasing crown heights. The differences between the 47,XXY males and 47,XXX females indicated a stronger effect of a Y chromosome on tooth crown height than of an X chromosome. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the relation between radiographic findings in large field of view (FOV) cone beam computed tomography (CBCT) exams and clinical findings of mandibular third molars in relation to the pre-operative patient information. Two hundred and nine mandibular third molars in 134 orthognathic patients examined with CBCT were removed. Three observers assessed tooth- and mandibular canal-related variables in CBCT images, and the findings were correlated to clinical findings during surgery for all observers: tooth angulation, number and morphology of roots and close relationship between the tooth and the mandibular canal. Moreover, positive (PPV) and negative (NPV) predictive values and positive (LR+) and negative (LR-) likelihood ratios were calculated for the canal-related variables. Inter- and intra-observer reproducibility was expressed as percentage accordance and kappa-statistics. Generally, there was high correlation between radiographic and clinical tooth-related variables. The opposite was true for the canal-related variables, since the PPV and LR + were low. The highest PPV and LR + were found when the mandibular canal was positioned between the roots of the third molar. Tooth-related findings in CBCT are reliable, whereas mandibular canal-related findings should not affect the information provided to the patient pre-operatively. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate clinical parameters associated with inflammation after adjunctive implantoplasty in conjunction with surgical treatment of peri-implantitis. Materials and methods: A systematic literature search was performed in 2 databases until 29. December 2020 to find publications that report on clinical parameters after surgical peri-implantitis treatment which included adjunctive implantoplasty. Clinical studies on implantoplasty reporting on BoP as outcome were included, but other clinical or radiographic outcomes were also considered. Results: The search resulted in 18 articles that fulfilled the inclusion criteria. The results indicated improvements of BoP and clinical parameters following surgical peri-implantitis treatment with adjunctive implantoplasty. Conclusions: Within its limits, the findings of the present scoping review indicated that BoP is reduced following surgical peri-implantitis treatment with adjunctive implantoplasty, and that this improvement is in line with surgical peri-implantitis treatment without adjunctive implantoplasty. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the association of dental caries with use of internet and social media to gain information on oral health and to evaluate the impact of this practice on oral health inequalities among 12 and 15-year-olds. Methods: Data from the Children’s Dental Health Survey (CDHS) 2013, England Wales and Northern Ireland were used. The survey included sociodemographic, health behaviours, use of internet and social media, and clinical dental data. The association between the prevalence of caries experience (DMFT ≥ 1) and the number of untreated dental decay with use of internet and social media was assessed adjusting for age, gender, country, deprivation, toothbrushing, dental visits and consumption of sugary drinks and food. Results: A total of 4414 children were included in the analysis. Children who reported using internet and social media to gain information on oral health had significantly higher odds for caries experience (1.29, 95%CI: 1.03–1.62) in the model adjusting for age, gender and country. After adjusting for behavioural and socioeconomic factors the relationship remained positive, but not statistically significant. The use of internet and social media was not significantly associated with the number of untreated caries. Social gradients in oral health remained significant after adjusting for use of internet and social media. Conclusions: The association between use of internet and social media, and dental caries could be mediated by health behaviours. Younger adults and children may be using the Internet and social media seeking information on dental caries, but longer online hours may also increase the caries risk. Internet-based health interventions should be supported by preventive strategies to promote effective and positive internet use. [ABSTRACT FROM AUTHOR]

The aim was to assess the degree of radiographic peri-implant bone loss over a follow-up period up to 15 years. In addition, another aim was to identify risk indicators for peri-implant bone loss and for moderate–severe peri-implantitis at patient- and implant level. This is a cross-sectional clinical and radiological study of 147 patients with a total of 425 implants in combination with data collected retrospectively for baseline variables. To calculate the peri-implant bone loss (primary outcome variable), the radiographic bone level measurements from baseline were compared to the radiographic bone level measurements at the final radiographic measurement. Multilevel analyses were adopted with peri-implant bone loss and peri-implantitis as outcome variables. The mean follow-up time was 12.5 years (range 10–15) and the mean age of the patients was 63 years (range 29–83). The mean peri-implant bone loss was 0.94 mm (S.D. 1.3). The prevalence of moderate–severe peri-implantitis at patient level was 17% and 8.9% at implant level. The peri-implant bone loss was significantly more pronounced in healthy implants if moderate–severe peri-implantitis was present in at least one implant within the same patient. The presence of moderate–severe peri-implantitis was significantly associated with general periodontitis Stages III or IV at follow-up and smoking. The presence of moderate–severe peri-implantitis at patient level was found to be a risk indicator of peri-implant bone loss in healthy implants, while smoking and general periodontitis Stages III and IV were risk indicators of moderate–severe peri-implantitis. [ABSTRACT FROM AUTHOR]

To describe and assess the available evidence of prediction methods of maxillary canine impaction (MCI). A systematic search was conducted through PubMed, Cochrane Library, Embase, EBSCOhost, Scopus, ScienceDirect, Bireme and Scielo until December 2020. This systematic review was conducted according to the PRISMA statement. The methodology of the selected studies was assessed using the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2). A total of 2391 articles were identified in the first approach and after a 2-phase selection, 11 studies were included in qualitative analysis. Prediction methods were constructed using equation-based models, geometric measurements and computational methods from clinical and imaging data to predict palatal/buccal MCI. The quality of evidence was low to moderate due to the presence of risk of bias in most of the studies included. Three cohort studies with the best methodological quality proposed prediction models based on geometric measurements, canine position and facial growth pattern that would allow predicting MCI from CBCT, lateral and panoramic radiographs. The evidence is limited and most of the studies present a low methodological quality. However, it is possible to suggest that some prediction methods based on the position of the canine and facial growth pattern could predict palatal/buccal MCI in mixed dentition. Cohort studies with better methodological quality and long-term follow-up are needed to better validate a prediction model. [ABSTRACT FROM AUTHOR]

To examine how hospital-affiliated dentists assess risk and evaluate oral foci of infection in patients facing certain medical treatments, and whether the nature of upcoming medical treatment affects the choice of dental intervention. A survey comprising six clinical cases (50 teeth) was sent to hospital-affiliated dentists in Sweden. A treatment option for the affected tooth/teeth in each case was selected whether the patient was facing heart valve surgery, chemotherapy, radiation therapy, intravenous bisphosphonate treatment, solid organ transplantation or was diagnosed with endocarditis. Consensus in choice of dental treatment was high in 62%, moderate in 32% and low in 6% of the assessments. High variability of choice of treatment was seen for eight teeth whereas the remaining 42 teeth often received the same therapy regardless of medical issue. Chemotherapy and radiotherapy were thought to entail the highest risk for oral infectious sequelae with a risk ranging from 1% to 100%. Pre-medical dental evaluations and recommended treatments are often uniform with the exception of the management of asymptomatic root canal treated teeth with persisting apical radiolucency and heavily decayed molars. In many instances, dental diagnosis has a greater impact on choice of treatment than the underlying medical issue and associated implications thereof. [ABSTRACT FROM AUTHOR]

This systematic review (SR) aims to evaluate the efficacy of modified coronally advanced flap (mCAF) on clinical and patient-reported outcomes in the treatment of multiple adjacent gingival recessions (MAGRs). Randomized controlled trials (RCTs), case-series and prospective clinical studies on treatment of Miller class I/II or RT1 MAGRs with ≥ 6 months follow-up were identified from the electronic databases and hand-searched journals. Complete root coverage (CRC) was the primary outcome variable. To evaluate treatment effects, meta-analysis was conducted, wherever appropriate. A total of 1395 recessions in 408 patients were evaluated in SR and meta-analysis was performed for four RCTs. Overall CRC achieved with mCAF was 70% and mean root coverage (MRC) ranged from 51.58 to 97.27%. Meta-analysis showed that combination of mCAF with connective tissue graft (CTG) or collagen matrix (CM) demonstrated significantly higher CRC% and recession reduction than mCAF alone. Limited evidence is available to support the use of platelet rich fibrin or enamel matrix derivative or acellular dermal matrix graft along with mCAF to further enhance its efficacy. mCAF is an effective procedure for treating MAGRs and in terms of achieving CRC and MRC. Additional use of CTG or CM further enhances treatment outcomes. [ABSTRACT FROM AUTHOR]

The effectiveness and safety of Bifidobacterium in dental caries prevention are controversial. Thus, we performed this systematic review and meta-analysis to explore the preventive value of Bifidobacterium. Eligible studies were identified from several databases, including PubMed, the Cochrane Library, Embase, Web of Science, and Scopus. Hand searches were also conducted in relevant bibliographies. We then extracted and pooled standardized mean difference (SMD) and risk ratio (RR) to analyze the anti-caries effect of Bifidobacterium with Stata 16.0 software. If the data obtained was not suitable for meta-analysis, qualitative descriptions were performed. Compared with the placebo control group, there was no statistically significant reduction in Streptococcus mutans and Lactobacilli counts in saliva in the test group. Also, there were no significant differences in Streptococcus mutans and Lactobacillus counts in dental plaque and no significant difference in caries incidence in deciduous teeth. There was no significant difference in the incidence of adverse events between the Bifidobacterium and control groups. Available evidence demonstrates that Bifidobacterium is neither effective in reducing Streptococcus mutans and Lactobacillus counts in the saliva or dental plaque nor in reducing the occurrence of caries in deciduous teeth. Evaluation of its safety requires further investigations. Therefore, Bifidobacterium is not a competent probiotic candidate to prevent dental caries. [ABSTRACT FROM AUTHOR]