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This study aimed to evaluate the effectiveness of a patient-centered standardized prophylaxis process in improving patient satisfaction and intentions to return to dental clinics. Conducted in a first-tier city in China from 9 June to 26 July 2023, the cross-sectional survey included 826 patients from 38 dental clinics. Among the respondents, 438 received standardized prophylaxis services, while 388 were in the non-standardized group, with a mean age of 38.2 ± 12.1 years and 50.24% male participation. The results revealed that patients in the standardized prophylaxis group reported significantly higher satisfaction scores (average 4.74 vs. 3.34, p < 0.0001) and greater intentions to return (average 4.77 vs. 4.10, p < 0.0001) compared to those receiving non-standardized care. The ordinal logistic regression analysis identified patient satisfaction as a strong predictor of return intention, with an odds ratio of 24.487, while the standardized service group had an odds ratio of 16.063, indicating a substantial positive effect on satisfaction. Age was also found to significantly affect return intention, reflected in an odds ratio of 0.969. Furthermore, the model showed strong predictive accuracy, which was supported by a Somers' D value of 0.806. Additionally, an impressive 89.9% of the observations were correctly ordered, which strengthens the reliability of the findings. These outcomes highlight the significant contribution of patient-centered, standardized practices to the satisfaction of the patients as well as the development of their desire to return for follow-up care. However, the findings should be interpreted with caution due to the study's cross-sectional nature, which limits causal inferences, and the specific demographic characteristics that may affect the general applicability of the results. Further research is needed to explore these dynamics across diverse populations and settings. [ABSTRACT FROM AUTHOR]

This case report describes the presentation and management of a 12-year-old female patient with a tissue mass and spacing between her upper front teeth. Clinical examination revealed a reddish pink, lobulated tissue mass measuring approximately 1.5 cm × 2 cm, extending from the upper labial frenum to the incisive papilla and involving the interdental gingiva of the two central incisors. The mass was moderately firm, pedunculated, and prone to bleeding. The patient had poor oral hygiene, exacerbating the condition. Radiographic evaluation ruled out underlying bony lesions, leading to a provisional diagnosis of pyogenic granuloma with differential diagnoses of gingival fibroma or traumatic fibroma. The treatment plan involved excision of the gingival overgrowth and frenectomy. Following routine oral prophylaxis, the surgical procedure was performed, with the excised tissue sent for histopathological evaluation, confirming the diagnosis as pyogenic granuloma. Postoperative care was provided, and the patient was advised against active orthodontic treatment. Regular follow-up appointments were scheduled to monitor healing and spontaneous space closure. This case report underscores the significance of considering both the aberrant labial frenum and the gingival overgrowth in treatment planning and highlights the need for meticulous follow-up care. [ABSTRACT FROM AUTHOR]

In a group of palliative patients, venous thromboembolism (VTE) is a significant cause of death and reduction in quality of life. Current guidelines and scientific research on thromboprophylaxis most often refer to the population of oncology patients, who differ in many aspects from patients receiving palliative care. Thus, doctors working with patients undergoing palliative treatment have to face many problems related to safety and effectiveness of antithrombotic therapy in this type of care. In the case of chronically ill patients, diagnostic process may be somewhat difficult because the symptoms resulting from the underlying diseases can mask VTE symptoms. The aim of this article is to review the literature on symptoms and thromboprophylaxis in this group of patients. According to the latest guidelines of the American Society of Clinical Oncology (ASCO), it is not recommended to use VTE prophylaxis in outpatient oncology patients routinely, but it should be considered in high-risk patients who received a Khorana score of at least 2 before starting a new chemotherapy cycle. In patients diagnosed with VTE, in long-term prophylaxis lasting at least 6 months, due to greater effectiveness, it is recommended to use low-molecular-weight heparins, edoxaban, rivaroxaban or apixaban instead of vitamin K antagonists, which can be used if the previously mentioned drugs are unavailable. There are some studies which show that thromboprophylaxis may be beneficial for patients in palliative care. On the other hand, another studies’ results suggest that patients won’t gain any benefit from prevention. As our article shows it is very crucial to conduct scientific research on palliative patients and create clear guidelines for prophylaxis for this group of people. [ABSTRACT FROM AUTHOR]

The surface of dental materials is exposed to various prophylaxis protocols during routine dental care. However, the impact of these protocols on the functional properties of the material's surface remains unclear. This study investigates the influence of different dental prophylaxis protocols on the surface properties and their effect on the mechanical performance of CAD-CAM restorative materials. Discs (Ø = 15 mm, thickness = 1.2 mm) were fabricated from resin composite (RC, Tetric CAD), leucite-reinforced (LEU, IPS Empress CAD), lithium disilicate (LD, IPS e.max CAD), and zirconia ceramics (ZIR, IPS e.max ZirCAD MT). The materials were subjected to six prophylactic treatments: untreated (CTRL), prophylactic paste fine (PPF), prophylactic paste coarse (PPC), pumice stone (PS), air abrasion with sodium bicarbonate jet (BJ), and ultrasonic scaling (US). Biaxial flexural fatigue tests, along with fractographic, roughness, and topographic analyses, were conducted. No significant changes in fatigue strength were observed for RC, LD, and ZIR under any prophylaxis protocols. However, LEU subjected to BJ treatment exhibited significantly reduced fatigue strength (p = 0.004), with a 22% strength reduction compared to the monotonic test and substantial surface alterations. Surface roughness analyses revealed increased roughness for RC treated with PPF, PPC, and PS compared to CTRL (p < 0.05), while LD exhibited decreased roughness following PPF, PS, and US treatments (p < 0.05). In ZIR, only the BJ protocol increased roughness (p = 0.001). In conclusion, dental prophylaxis protocols do not significantly affect the mechanical strength of RC, LD, and ZIR materials, thus allowing any protocol to be used for these materials. However, for LEU ceramics, the BJ protocol should be avoided due to its effect of reducing fatigue strength and damaging the surface. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the effect of an immune-boosting beverage with Sambucus nigra (SAM), an energy beverage (ENE), an in-office bleaching agent with a novel composition, and a fine-grain professional dental prophylaxis (PDP) paste on the surface roughness (Ra) and microhardness (MH) of CAD/CAM restorative materials over time. Methods: Feldspathic ceramic (FC) and polymer infiltrated ceramic network (PICN) specimens were prepared (N = 126). Glazing, polishing, bleaching and immersion in beverages groups were formed. Bleaching gel containing 25% Hydrogen Peroxide Superior was applied to the specimens with a bleaching pen. Ra and MH were measured at five time points of baseline, days 1, 14, 28 and after PDP. Scanning electron microscopy (SEM) images were taken after PDP. Statistics were performed by ANOVA and Bonferroni tests (α = 0.05). Results: Ra increased over time regardless of material type, polishing method, beverage type and bleaching (p < 0.0001). Glazed and polished FCs caused higher roughness than PICN, SAM and ENE than distilled water, and bleaching than no bleaching (p < 0.0001). For glazed or polished FCs, MH decreased slightly lower at all time points, but for PICN, MH increased until day 28, not changing after PDP. Beverages decreased the MH of ceramics at all time points, but PDP did not lead to a change for PICN (p < 0.0001). The MH decreased more in bleached specimens than in non-bleached specimens up to day 28 (p < 0.0001). According to the SEM images after PDP, the glazed FC had numerous crack marks, pores and detached particles. The polished FC had traces of mechanical polishing. The polymer part of the PICN had voids, but the ceramic part was better preserved. Conclusions: Both energy beverages and immune-boosting beverages can increase roughness on FCs compared to PICNs. There was no significant difference between glazing and polishing in terms of lower roughness in FCs. PDP tended to slightly increase the roughness for ceramics, while it tended not to change it for PICN. Beverages decreased the microhardness of ceramics. PDP further decreased the microhardness in glazed ceramics, but increased it in polished ones. In PICN the microhardness increased over time, but decreased slightly after PDP. [ABSTRACT FROM AUTHOR]

Abstract Background The effect of an immune-boosting beverage (SAM) containing Sambucus Nigra, an energy beverage (ENE), an in-office bleaching (BLE) agent with 25% hydrogen peroxide superior, glazing (GLA) or polishing (POL) methods, and professional dental prophylaxis (PDP) on the color of CAD-CAM restorative materials is unknown. Methods In total 210 specimens were prepared, consisting of CAD-CAM feldspathic (FC), zirconia-reinforced lithium disilicate ceramic (ZLS) and hybrid ceramic (HC). The ceramic specimens were divided according to the polishing methods of glazing (GLA) and mechanical polishing (POL). All materials were divided into two groups: with and without BLE. A 25% hydrogen peroxide superior (HPS) gel was used for BLE. After the baseline (BAS) measurement, the specimens were immersed in 3 different beverages (distilled water (DIS), SAM, ENE). After 28 days, a fine-grained (RDA 7) prophylaxis paste was applied. Statistical analysis of ∆E00 color difference values was performed by 3-way ANOVA and Bonferroni test (α = 0.05). Results The effect of all other actions except material-BLE-beverage on color for BAS-Day 28 was statistically different (p

Abstract Background The risk assessment of dental erosion among children and adolescents is an important aspect of dental care, as dental erosion constitutes a rapidly growing, global problem. Dental professionals rely solely on their own perception, as the current risk assessment process is not completely automatized, which affects the risk assessment reliability. Aim To explore dental professionals’ experiences with risk assessment of dental erosion among children and adolescents. Method In-depth interview was used as data collection method. A total of 11 dental professionals were interviewed. The interviews were analyzed using qualitative content analysis. Results The findings were summarized in the categories Professionals’ responsibility, Systematic approach , and Collaboration and communication. Dental staff perceived that their basic knowledge regarding erosion should be improved, and skills development was desired to reduce the knowledge gaps around the risk assessment of dental erosion. They alleged that the systematic approach could be improved by reducing workplace stress, implementing a universal dental erosion index, improving the existing risk assessment software, and automating the risk assessment of the condition. Dental professionals also experienced a need to calibrate and collaborate with each other and with other healthcare professionals to improve patient care. Conclusion Dental professionals experienced their basic knowledge of dental erosion and their risk assessment as good, but a more advanced skill development was required. Furthermore, they experienced the risk assessment software as a good tool that should be improved to compile more objective risk assessment. A universal erosion index was also requested.

Background: Restoring first permanent molars affected with molar incisor hypomineralization (MIH) is challenging. Focusing on improving the quality of life for children affected by MIH, at least until the complete eruption of first permanent molars to receive full coverage, to decrease the hypersensitivity and to be able to perform proper oral hygiene measures, the purpose of this study was to compare silver modified atraumatic restorative technique (SMART) versus the conventional restoration and fluoride varnish application on moderate to severe hypomineralized molars. The comparison considered the restoration survival, hypersensitivity, and digital surface area changes after one year follow up. Methods: Twenty-eight children were selected (20 girls and 8 boys) with at least 2 MIH molars with the same defect severity. The study comprised 2 groups; MOD group (moderate hypomineralized molar severity) and SEV group (Severe hypomineralized molar severity) (n = 28 tooth). Each group was further subdivided into 2 subgroups according to the technique of restoration: SMART subgroup and CONV subgroup (high viscosity glass ionomer restoration and fluoride varnish application) (each = 14 tooth). Evaluation was done in terms of the restoration survival (6 months and 12 months), hypersensitivity at 1 weak, 6 months and 12 months and occlusal surface area changes at 12 months). Professional Fluoride varnish application and home prophylaxis using MI paste were the protocol for each child patient. Results: There was no significant difference between the 4 subgroups, regarding tooth restoration integrity at 6-months vs. 12-months. However, a statistically significant difference in tooth restoration integrity between the 4 subgroups at 12-months (P =.049). Also, the hypersensitivity score, there was a statistically significant difference between the 4-time intervals (P <.001) and a statistically significant difference in surface area changes between the 4 subgroups. Conclusions: Selective removal of carious tissue and SMART restoration, combined with dental home and professional preventive measures every 3 months maintained the integrity of restorations in severely and moderately affected permanent molars up to 1 year. Trial registration: The study protocol was retrospectively registered on Clinical Trials (NCT05931822–05/ 07/2023). [ABSTRACT FROM AUTHOR]

The purpose of this material is to expose the fact that, by using ceramic masses, special results are obtained in manufacturing of the esthetic component of metal-ceramic crowns, the working technique presenting numerous advantages. Compliance with the manufacturing criteria of mixed metal-ceramic prosthetic restorations suitable to clinical situations lead to a high satisfaction both for the patients and for the dentist-dental technician team. Depending on the functional aspects of the prosthetic field, the dentist’s requirements and the patient’s wishes, the prosthetic restoration will be carried out following biomechanical, biofunctional and prophylactic principles. [ABSTRACT FROM AUTHOR]

Background: The effect of an immune-boosting beverage (SAM) containing Sambucus Nigra, an energy beverage (ENE), an in-office bleaching (BLE) agent with 25% hydrogen peroxide superior, glazing (GLA) or polishing (POL) methods, and professional dental prophylaxis (PDP) on the color of CAD-CAM restorative materials is unknown. Methods: In total 210 specimens were prepared, consisting of CAD-CAM feldspathic (FC), zirconia-reinforced lithium disilicate ceramic (ZLS) and hybrid ceramic (HC). The ceramic specimens were divided according to the polishing methods of glazing (GLA) and mechanical polishing (POL). All materials were divided into two groups: with and without BLE. A 25% hydrogen peroxide superior (HPS) gel was used for BLE. After the baseline (BAS) measurement, the specimens were immersed in 3 different beverages (distilled water (DIS), SAM, ENE). After 28 days, a fine-grained (RDA 7) prophylaxis paste was applied. Statistical analysis of ∆E00 color difference values was performed by 3-way ANOVA and Bonferroni test (α = 0.05). Results: The effect of all other actions except material-BLE-beverage on color for BAS-Day 28 was statistically different (p < 0.05). The effect of material, material-BLE, beverage on color for Day 28-PDP was statistically different (p < 0.05). After 28 days, the lowest color change was found in FC-GLA and HC immersed in DIS (p = 0.0001) and the highest in FC-POL immersed in ENE (p = 0.0002). PDP was efficient in color recovery in HC immersed to DIS, ENE and SAM (p = 0.0010). For FC, HC and ZLS, BLE caused a higher color change (p < 0.0001). Regardless of the material, the highest color change for BLE-beverage was found in BLE-treated specimens immersed in ENE (p = 0.0496) and the lowest color change was found in non-BLE-treated specimens immersed in SAM (p = 0.0074). Conclusions: In materials pre-exposed to 25% HPS, the effect of PDP on color recovery was lower than in unexposed materials. After 28 days, mechanical polishing produced higher color change in FC than glazing, however, in ZLS effects of glazing and mechanical polishing on color were similar. For material/polishing method, HC was the most effective. ENE caused higher color change than DIS and SAM. PDP was more effective than ENE in restoring color to DIS- and SAM-immersed specimens. [ABSTRACT FROM AUTHOR]

Introduction: Gingivitis is a common intraoral disease in patients with chronic kidney disease (CKD), which poses a particular interdisciplinary challenge. We aimed to determine the influence of an intensive oral prophylaxis program (OPP) compared to standard prevention measures on the tongue microbiome of young patients with CKD. Methods: Thirty patients with CKD (mean age 14.2 ± 5.2 years) and generalized gingivitis were included. The effects of the intensive OPP were compared with standard prophylaxis according to statutory health insurance (treatment as usual, TAU) as a control. Tongue swabs were taken from the patients at baseline (t1) and after 3 (t2) and 6 (t3) months. Next-generation sequencing of 16S rDNA genes was used to quantitatively characterize microbial communities. Results: There were no differences in the abundance, richness, or diversity of the observed genera and species between the two study groups at baseline or after 3 or 6 months. Furthermore, no change in predefined gingivitis and oral health bacterial clusters were found. At the phylum level, Firmicutes were decreased after intervention in the TAU group (t2TAU 42.9 ± 7.1 to t3TAU 34.8 ± 4.7 (npairs=14), p=0.003; false discovery rate 0.02). The decrease of Firmicutes was not significant in the OPP group. Conclusions: Despite the intensity of dental prophylaxis and decreasing clinical signs of inflammation and decreasing plaque amount, no clinically relevant changes in the tongue microbiome were observed. Our results confirm the conserved and stable nature of the tongue microbiome, even in children with CKD. [ABSTRACT FROM AUTHOR]

Background: This study focuses on the determination and classification of patients as rapid or slowcalculusformersbasedontherateofcalculusformationafteroralprophylaxis. It also aims to determine the factors that positively impact the formation and deposition of calculus in patients and identify the factors that accelerate or decelerate the deposition of calculus. Methods: The study was conducted in the Department of Periodontology, Dr Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University Chandigarh, India. We examined 51 patients after a month of the oral prophylaxis, recorded the amount of calculus present in the oral cavity, and then recorded a detailed history which was briefly divided into Age, Sex, Residence, Oral habits, and maintenance of oral hygiene. Results: An evident and meaningful link was found between age and the rate at which dental calculus forms. The average age of individuals differed significantly between the rapid and slow calculus formers, which could be ascribed to the decline in manual dexterity as age increases, resulting in less effective oral hygiene habits, including toothbrushing. None of the other factors dietary and oral hygiene related could be identified distinctly, probably owing to the small sample of the study. The oral health status exhibited a significant difference between slow and rapid calculus formers. Conclusions: Within the limitations of the study, the data analyzed, identified age as a significant determinant that impact the rate of formation of calculus in patients and reported a significant difference in the oral health status of rapid and slow calculus formers. [ABSTRACT FROM AUTHOR]

Introduction: Guidelines regarding postsurgical dental care have been common in adult total joint arthroplasty patients despite limited supporting evidence in the literature. There is anecdotal evidence that similar precautions are implemented frequently in postoperative pediatric orthopaedic patients without any published evidence to guide clinicians. Methods: A survey of the Active Members of the Pediatric Orthopaedic Society of North America (POSNA) was performed to assess the use of postsurgical guidelines regarding dental care (procedures and prophylaxis) in pediatric patients. A 20-question survey regarding this subject was developed with the input of, and approved by, the Evidence-Based Practice Committee of POSNA, and a link to participate was distributed to the Active Membership. Results: One hundred seventy-three POSNA Members opened the link to the survey. One hundred sixty-three respondents self-identified as Active, for a response rate of 19.8%. One hundred fifty-seven (96.3%) reported direct involvement in surgical and postsurgical care of pediatric orthopaedic patients. Sixty-two (39.4%) indicated use of a postoperative protocol regarding dental interventions. Forty percent of those indicating use of guidelines were uncertain of the specifics of the protocol(s) used at their institution. Eighty-five percent of those utilizing protocols felt that the use of guidelines was a valuable topic for investigation. Conclusions: These results demonstrate that many of the active Members of POSNA utilize postsurgical guidelines for dental care, particularly for those patients who have undergone spinal surgery with permanent implants. This is despite the fact that there is limited evidence to support their use in adult total joint patients and no literature regarding use of such guidelines in pediatric orthopaedic patients. Key Concepts: (1) There is limited and contradictory evidence that postsurgical dental guidelines are indicated in adult orthopaedic patients. (2) There is no published evidence supporting postsurgical dental guidelines in pediatric orthopaedic patients. (3) Almost 40% of active Pediatric Orthopaedic Society of North America Members responding to a survey appear to utilize postsurgical dental care guidelines in pediatric patients, particularly after spinal procedures utilizing implants. Level of Evidence: Level V

ABSTRACT: Aim: The current study's objective was to assess and contrast the benefits of herbal and chemical mouthwash in patients with persistent, widespread gingivitis. Material and Method: Forty-five patients between the ages of 30 and 50 having persistent generalized gingivitis were enrolled in the study and randomly assigned to three groups: Group A received oral prophylaxis, group B received oral prophylaxis and prescribed chemical mouthwash, group C received oral prophylaxis and prescribed herbal mouthwash. The patients were under observation for forty-five days. At the baseline, 7th, 30th, and 45th day gingival index was measured, and the data were statistically analyzed. The one-way ANOVA and Tukey's post-hoc test were performed. Result: The gingival index showed a significant difference. Over time, the gingival index tends to decrease with the use of herbal mouthwash. Conclusion: In summary, our initial investigation demonstrates that herbal mouthwashes are just as successful in reducing gingival inflammation as chlorhexidine further significant difference observed in 30th and 45th day with chlorhexidine. Therefore, in addition to routine dental care, these ayurvedic medications can be taken to reduce gingivitis. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate the effect of in-vivo produced Nisin which is an antimicrobial peptide (AMP) added to adhesive resin on shear bond strength (SBS) and the adhesive remnant index (ARI) of orthodontic brackets. Methods: Bacterial AMP was produced by fermentation and the ideal AMP/Bond concentration and antimicrobial efficacy of the mixture were tested. To evaluate the SBS and ARI scores of AMP-added adhesive resins, 80 maxillary premolar teeth extracted for orthodontic purposes were used and randomly assigned into 2 groups (n = 40). Group 1: Control Group (teeth bonded with standard adhesive resin); Group 2: Experimental Group (teeth bonded with AMP-added adhesive resin). Statistical analysis was performed using the SPSS package program and applying the Mann-Whitney U and Fisher's exact tests. P < 0.05 was considered as statistically significant. Results: Nisin synthesized in-vivo from Lactococcus lactis (L. lactis) (ATCC 7962) bacteria was provided to form a homogenous solution at an ideal concentration To find the minimum AMP/Bond mixture ratio that showed maximum antimicrobial activity, AMP and Bond mixtures were tested at various concentration levels between 1/160 and 1/2 (AMP/Bond). As a result, the optimum ratio was determined as 1/40. The antimicrobial efficacy of Nisin-added adhesive resin was tested against Streptococcus mutans (S. mutans) (ATCC 35,688) and Lactobacillus strains (cariogenic microorganisms). AMP formed a 2.7 cm diameter zone alone, while 1/40 AMP-bond mixture formed a 1.2 cm diameter zone. SBS values of the teeth bonded with Nisin added adhesive (17.49 ± 5.31) were significantly higher than the control group (14.54 ± 4.96) (P = 0.004). According to the four point scale, Nisin added adhesive provided a higher ARI score in favour of the adhesive and tooth compared to the control group (ARI = 3, n = 20). Conclusions: Nisin produced from L. lactis (ATCC 7962) had greater antimicrobial effects after mixing with adhesive bond against cariogenic microorganisms S. mutans (ATCC 35,688) and Lactobacillus strains. Nisin added adhesive increased shear bond strength (SBS) of orthodontic brackets and ARI scores in favor of adhesive & teeth. Clinical relevance: Clinicians should take into account that using Nisin-added adhesive resin in orthodontic treatments can provide prophylaxis against tooth decay, especially in patients with poor oral hygiene. [ABSTRACT FROM AUTHOR]

Infection management in solid organ transplantation poses unique challenges, with a diverse array of potential pathogens and associated antimicrobial therapies. With limited high-quality randomized clinical trials to direct optimal care, therapeutic "myths" may propagate and contribute to suboptimal or excessive antimicrobial use. We discuss 6 therapeutic myths with particular relevance to solid organ transplantation and provide recommendations for infectious diseases clinicians involved in the care of this high-risk population. [ABSTRACT FROM AUTHOR]

Focal osteoporotic bone marrow defects (FOBMDs) of jaws are rare and usually discovered as an incidental radiographic finding. They present as a poorly demarcated radiolucency affecting the posterior mandible of middle-aged women with pathogenesis remaining unknown. A 60-year-old female patient had visited our dental college for routine dental checkup and oral prophylaxis. Her radiograph revealed a well-defined radiolucency in the left mandibular posterior region as an incidental finding. Clinical examination revealed a diffuse swelling in the above-mentioned region which the patient had not noticed. The patient gave a history of trauma in the same region almost 20 years back. Incisional biopsy was performed. Microscopic examination revealed multiple bits of fatty fibro cellular tissue resembling the bone marrow with aggregates of blood cells. A diagnosis of FOBMD was given. FOBMD, although rare, should be included in differential diagnosis of the radiolucent lesions of the jaws. [ABSTRACT FROM AUTHOR]

(1) Background: Periodontal instrumentation with dental curettes is associated with discomfort, fatigue, and musculoskeletal diseases. The goal of this study was to compare comfort, fatigue, and muscle work using three different curettes. (2) Methods: Eight hygienists each scaled three typodonts using the three different curettes. Curette A was a prototype with a novel adaptive design, Curette B had a conventional stainless-steel design, and Curette C featured a conventional silicon-covered handle. Time-based work in four muscles, comfort, fatigue, tactile feedback, grip and blade position, and pinch and grasp strength were recorded. Statistical analysis was performed using a General Linear Model (GLIM) and Tukey's post hoc test. The level of significance was set at p < 0.05. (3) Results: Comfort, correct grasp, fingertip placement, and blade-to-tooth adaptation were significantly better with Curette A (p < 0.05). While pinch and grasp strength were significantly reduced post-instrumentation for Curettes B and C (p < 0.05), they remained unchanged for Curette A. Curette A required significantly less total muscle work and work in individual muscles, resulting in significantly less post-instrumentation fatigue than for Curettes B and C, but similar levels of tactile feedback (p < 0.05). (4) Conclusions: The ergonomic performance of a prototype adaptive periodontal curette was significantly better than that of two conventional instruments with rigid handle designs. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) directly affects oral health. Yet data about halitosis in young CKD patients and the impact of dental prophylaxis is limited. Therefore, as part of this randomized clinical trial, halitosis in young CKD patients undergoing intensive or standard oral preventive procedures was to be explored. Methods: Three volatile sulfur compounds (hydrogen sulfide, methyl mercaptan and dimethyl sulfide) were measured in 30 young patients with CKD (mean age 14.2 years; 16 males, 14 females). Breath samples were taken after 3 and 6 months and analyzed with selective gas chromatography (OralChroma). Tongue coating (Winkel Index) and clinical indices to determine local inflammation or oral hygiene (Papillary Bleeding Index and Quigley-Hein Index) were assessed. Within an extended anamnesis, patients and their mothers and nurses were questioned about the perceived halitosis. Corresponding quotes were noted verbatim. Patients were randomized to either intensive need-related oral health care measures (oral preventative program, OPP) or a one-stage standard prevention (treatment as usual, TAU). Results: While there were no differences in volatile sulfur compound levels between TAU and OPP at the three time points of measurements (p > 0.05), there was a tendency towards a reduction in dimethyl sulfide and hydrogen sulfide of affected patients within the OPP group over time. Looking at potential differences between both groups with regard to tongue coating, significant differences were observed between baseline and 3 months after study start in the OPP group, and between baseline and 6 months after study start in the TAU group (p < 0.05). The burden of halitosis was frequently reported by patients' mothers and nurses. Conclusions: Young CKD patients regularly suffered from halitosis and dimethyl sulfide was its main source. Preventive measures mainly resulted in a reduction of tongue coating. Trial registration: The German Clinical Trial Register (# DRKS00010580). [ABSTRACT FROM AUTHOR]

Background: Periodontitis represents the foremost oral condition in young men, strongly correlated with socioeconomic elements and oral health behaviors. This research aimed to assess the prevalence of periodontitis and associated associations with socio-demographics and oral health practices for subsequent Hazard Ratio (HR) estimation. Methods: A total of 46,476 young men were recruited to the study between August 2022 and October 2023. A questionnaire on socio-demographic factors and oral health-related behaviors related to periodontitis was completed. The standard procedure was used for oral examination. Logistic regression and hazard ratios were used to estimate the influencing factors, whereas the nomogram was used to predict the risk of periodontitis in young men. Results: A total of 46,476 young men were surveyed and completed the questionnaire. The overall prevalence of periodontitis among young men was 1.74%. Out of these, 1.7% had mild periodontitis and 0.6% had moderate periodontitis. Age and dental calculus were important factors in the periodontal health of young men. This nomogram, which includes 7 easily obtainable clinical characteristics routinely collected during periodontitis risk assessment, provides clinicians with a user-friendly tool to assess the risk of periodontal disease in young men. Conclusions: Regular dental prophylaxis is crucial for young men to maintain their gingival health and prevent the onset of periodontitis. Dental calculus plays a prominent role in this matter, as it serves as a significant contributing factor. [ABSTRACT FROM AUTHOR]

OBJECTIVE To evaluate the prevalence of oral bacteria in the conjunctiva of brachycephalic and nonbrachycephalic dogs. ANIMALS 12 brachycephalic (9.58 ± 3.55 years) and 12 nonbrachycephalic (8.33 ± 4.92 years) dogs without systemic disease, regardless of breed and sex, were included in the study, and half of the dogs in each group had periodontitis. METHODS This prospective study investigated clinical data including craniofacial ratio, ophthalmic examination results, and periodontal status of the included dogs. Bacterial samples were collected by swabbing the oral mucosa and conjunctival surfaces. The presence and quantity of bacteria were analyzed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, 16S rRNA sequencing analysis, and the 10-fold dilution method. Statistical analyses were performed to assess correlations and factors influencing the presence of oral bacteria in the conjunctiva. RESULTS The most common bacteria in the conjunctival flora in both groups were Micrococcus luteus, Corynebacterium spp, and Staphylococcus spp. The prevalence of oral bacteria on the conjunctival surface was 33%, with a significantly higher incidence in brachycephalic dogs (P = .027). Oral bacteria detected in the conjunctiva were predominantly Frederiksenia canicola, Neisseria spp, and Moraxella spp. Multiple regression analysis identified age, craniofacial ratio, and gingival index as factors influencing the presence of oral bacteria in the conjunctival flora. CLINICAL RELEVANCE Oral resident bacteria have often been isolated from severe infectious corneal ulcers. This study provided evidence that brachycephalic dogs may require dental prophylaxis to reduce their oral bacterial load and that the association of oral bacteria in ocular diseases should be considered. [ABSTRACT FROM AUTHOR]

IntroductionGingivitis is a common intraoral disease in patients with chronic kidney disease (CKD), which poses a particular interdisciplinary challenge. We aimed to determine the influence of an intensive oral prophylaxis program (OPP) compared to standard prevention measures on the tongue microbiome of young patients with CKD.MethodsThirty patients with CKD (mean age 14.2 ± 5.2 years) and generalized gingivitis were included. The effects of the intensive OPP were compared with standard prophylaxis according to statutory health insurance (treatment as usual, TAU) as a control. Tongue swabs were taken from the patients at baseline (t1) and after 3 (t2) and 6 (t3) months. Next-generation sequencing of 16S rDNA genes was used to quantitatively characterize microbial communities.ResultsThere were no differences in the abundance, richness, or diversity of the observed genera and species between the two study groups at baseline or after 3 or 6 months. Furthermore, no change in predefined gingivitis and oral health bacterial clusters were found. At the phylum level, Firmicutes were decreased after intervention in the TAU group (t2TAU 42.9 ± 7.1 to t3TAU 34.8 ± 4.7 (npairs=14), p=0.003; false discovery rate 0.02). The decrease of Firmicutes was not significant in the OPP group.ConclusionsDespite the intensity of dental prophylaxis and decreasing clinical signs of inflammation and decreasing plaque amount, no clinically relevant changes in the tongue microbiome were observed. Our results confirm the conserved and stable nature of the tongue microbiome, even in children with CKD.

Abstract Background Achieving sufficient professional mechanical biofilm removal (PMPR) can be challenging in supportive periodontal therapy (SPT), particularly in patients with prosthetic restorations. This experimental study aimed to simulate five years of SPT with periodic PMPR near the luting gap of ceramic restorations using a rubber cup with polishing paste (RCP), air polishing with two different low-abrasive powders (LAPA-1: glycine powder, LAPA-2: erythritol powder), and non-professional mechanical cleaning (control group) to measure the extent of volume loss in the luting gap after baseline (∆V = Vbaseline-V1-5; in µm3). Methods Two operators randomly performed PMPR ten times for thirty seconds on one of four sides of 30 crown replicas fixed with glass-ionomer cement (CGIZ: n = 15) or adhesive bonding (CAB: n = 15). The replicas were separated in a template during PMPR, and afterward, cleaned for five seconds per side with a sonic brush under flowing water. The artificial aging process between two PMPRs simulated a 5-year SPT with two PMPRs per year. Profilometric measurements were performed at baseline and after each second PMPR to obtain the mean change of ∆V. The statistical evaluation of the data was carried out using nonparametric tests with Bonferroni correction applied for multiple tests. Results Ninety-six out of 120 sides could be included in the analysis. PMPR methods showed a loss of substance in the luting gap with a ∆V (mean(standard deviation)) of -4.35 × 106(4.8 × 106)µm3 versus 8.79 × 104(1.05 × 106)µm3 for control at V5 (p ≤ 0.001). No significant differences of ∆V1-5 values could be identified in the control (p > 0.05), whereat all PMPRs showed a significant increasing loss of substance per simulated year (p ≤ 0.001). Intergroup comparison identified LAPA-1 as having the highest significant loss of substance determined on CAB (∆V: -1.05 × 107 (7,2 × 106) µm3), followed by LAPA-2 on CAB (∆V: -6.29 × 106 (4,24 × 106) µm3), LAPA-1 on CGIZ (∆V: -4.15 × 106 (3,25 × 106) µm3), LAPA-2 on CGIZ (∆V: -3.0 × 106 (2,23 × 106) µm3), RCP on CAB (∆V: -1.86 × 106 (2,23 × 106) µm3) and CGIZ (∆V: -1.2 × 106 (1,31 × 106) µm3; p ≤ 0.001)). Conclusions Within study limitations, all PMPRs caused a significantly higher loss of substance in the luting gap versus control without professional intervention, with the highest values in the CAB group for LAPA-1, LAPA-2 and RCP. Similar findings were observed for CGIZ, although the loss values were lower.

Background: The Brazilian Dental Specialty Centers (CEO, in Portuguese) represent the strategy of the National Oral Health Policy to provide secondary-level dental care. They offer more complex procedures, such as the treatment of periodontitis. This study aims to investigate the factors associated with the performance and the achievement goals of specialized procedures and the achievement gols of periodontics in CEO. Methodology: Analytical and cross-sectional study using secondary data. The database of the second cycle of the External Evaluation of the National Program for Improving Access and Quality in CEO (PMAQ-CEO, in Portuguese), was utilized, which assessed 1,042 CEO on-site in 2018. The data were analyzed using multiple Poisson regression, estimating the prevalence ratio (PR) (p < 0.05). Results: A third of the CEO (n = 305) performed all specialized procedures, with a higher prevalence observed in those with more than one bicarbonate jet prophylaxis unit (RP = 2.12; 95% CI: 1.160–3.881; p = 0.015) and when they had a higher percentage of specialist professionals (RP = 1.004; 95% CI: 1.002–1.006; p < 0.001). The periodontics goal was achieved by 617 (59.2%) CEO, with a higher prevalence among those who had a manager with supplementary training (PR = 1.21; 95% CI: 1.100-1.335; p < 0.001) and with a higher workload for the periodontist dentist (PR = 1.15; 95% CI: 1.103–1.201; p < 0,001). Conclusion: Although most CEOs do not perform allspecialized periodontics procedures, more than half achieved the established goals. The provision of specialized periodontics services in CEO and the achievement of goals are influenced by the quantity and professional qualifications, as well as the availability of equipment. [ABSTRACT FROM AUTHOR]

OBJECTIVES Enoxaparin for the prevention of venous thromboembolism (VTE) in pediatric patients is typically dosed twice a day. The use of once-daily dosing like that used in adult patients is limited because of a lack of safety and efficacy data. The aim of this study was to evaluate the safety and efficacy of once-daily versus twice-daily dosing of enoxaparin for pediatric VTE prophylaxis based on incidence of thrombotic and bleeding events. METHODS This was a 3-year retrospective chart review of enoxaparin received for VTE prophylaxis at Cohen Children's Medical Center, New Hyde Park, NY. Exclusion criteria were age 18 years or older, and renal dysfunction. RESULTS A total of 177 enoxaparin courses (81 in the once-daily and 96 in the twice-daily group) were included. The median dose in the once-daily group was 0.68 mg/kg/dose with dose capping at 40 mg/dose in 70% of patients. One patient in the once-daily group had a VTE, whereas no patients in the twice-daily group experienced a VTE. One major bleeding event occurred in the once-daily group (p = 0.46); however, minor bleeding events were comparable between the 2 groups (p = 0.69). CONCLUSIONS Once-daily enoxaparin prophylaxis appears to be safe and effective based on minimal differences in incidence of thrombotic and bleeding events when compared to twice-daily dosing. Based on this study, it may be reasonable to consider once-daily enoxaparin dosing for prophylaxis, especially in older children. A larger multicenter cohort study evaluating once-daily dosing for prophylaxis is warranted to validate the safety and efficacy specifically for risk-based dosing strategies. [ABSTRACT FROM AUTHOR]

Objective: Intraoral scanner (IOS) can acquire three‐dimensional color images of teeth. Thus, the detection of areas with plaque adhesion stained by plaque‐disclosing solutions using an IOS could be a potential oral hygiene evaluation method. This study aimed to verify the usefulness of obtaining O'Leary's plaque control record (PCR) measurements using an IOS in clinical practice. Methods: Twenty patients with >20% PCR measurements who underwent oral prophylaxis were enrolled in this study. A plaque‐disclosing gel was applied to stain the areas with plaque adhesion, and the dentition was scanned using the IOS. The PCR values obtained via the direct method and those obtained using the digital image were compared for the entire dentition, maxillary total area, the labial and palatal aspects of the maxillary anterior teeth, the buccal and palatal aspects of the maxillary posterior teeth, mandibular total area, the labial and lingual aspects of the mandibular anterior teeth, and the buccal and lingual aspects of the mandibular posterior teeth. Results: The IOS group tended to have higher values than the direct observation group. The labial and palatal aspect of the maxillary anterior teeth, the labial and lingual aspects of the mandibular anterior teeth did not differ significantly between the groups. Conclusion: Plaque adhesion was visualized easily and conclusively using an IOS. As the large tip size often hinders its use, it is necessary to develop a smaller IOS tip in the future. [ABSTRACT FROM AUTHOR]

Plaque-induced gingivitis is one of the most widely distributed periodontal disorder during childhood. The control of the pathogenic potential of the plaque is associated with oral hygiene status at individual, group, and population levels. We hypothesize that regular application of complex oral hygiene-prophylaxis could beneficially modulate salivary amino acids profile in children with different stage of plaque-induced gingivitis. Therefore, we aimed to study the salivary amino acids’ profile in relation to certain clinical indicators and environmental variables for plaque-induced gingivitis in children.

Background: Plaque-induced gingivitis is a chronic inflammatory condition characterized by complete reversibility of tissue damage once the periodontal biofilm has been disorganised. The aim of this study was to evaluate the efficacy of two commercially available mouthwashes (MWs) versus a chlorhexidine (CHX) 0.12% MW in reducing gingival bleeding (GB) in adults with plaque-induced gingivitis. Methods: The present study was a double-blind, parallel, randomized controlled trial involving 6492 gingival sites (i.e. 39 subjects × 28 teeth × 6 sites/tooth) aged 18–75 years. During a 2-week period, subjects were randomized to receive MWs: a control CHX 0.12% MW (group C, 1818 sites); a MW test containing CHX 0.09% + Citrox®/P complex (group CX, 2628 sites); a MW test based on natural compounds (group P, 2016 sites). GB was assessed at the inclusion visit (T0) and after 2 weeks of MW use (T1). Analyses of GB were compared between groups and then restricted to subjects with bleeding sites between 10 and 30% (moderate gingivitis) or ≥ 30% (severe gingivitis) at T0. Pairwise comparisons were made between groups and logistic regression was used to identify correlates of GB (T1). Results: For total bleeding site analysis, GB reduction between T0 and T1 ranged from 23% (C), 26% (CX) and 36% (P), respectively (all p < 0.05). Multiple comparison between groups showed that group C was significantly less effective (p < 0.05) than groups CX and P. Splitting the analysis, in patients with severe gingivitis (≥ 30% bleeding sites at T0), all MWs had a positive effect on GB with a reduction at T1 of 36% (C), 33% (CX) and 42% (P), respectively. While GB reduction between T0 and T1, was significant for all groups, the comparison among groups showed no significant difference between group C and CX, whereas the improvement was significant for group P. On the other hand, in adults with moderate gingivitis (< 30% bleeding sites at T0), only CX and P had a positive effect on GB reduction at T1(9% in CX and 2% in P, respectively), although the differences between the three groups were not significant. Conclusion: The daily use of MWs with natural components (groups P and CX) for 2 weeks should be considered positively as an adjunct to individual oral prophylaxis to reduce GB compared to the control MW containing CHX 0.12% (group C) in healthy adults with plaque-induced gingivitis. For subjects with severe gingivitis, it is advisable to first use natural MW (P) and then MW based on CHX 0.09% with natural components (CX), compared to MW with CHX 0.12% (C). For adults with moderate gingivitis, P and CX can be advisable, even if no definitive recommendations can be drawn. Trial Registration: ACTRN12622000215729, 07/02/2022. [ABSTRACT FROM AUTHOR]

The case report addresses the challenge of correcting anterior cross bite in mixed dentition period. It emphasizes the complexity of treating skeletal Class III malocclusion, especially in young patients, and highlights the importance of choosing appropriate orthodontic appliances for effective treatment. The subject of the case report is a 9-year-old girl, MK, who presented with a prognathic profile, upper and lower incisor proclination, and bimaxillary protrusion. The treatment plan was multifaceted, incorporating oral prophylaxis, fluoride application, indirect pulp capping, and strategic extractions. Key appliances used were the Quadhelix and Catalans appliances, supplemented by a lower inclined plane, removable Jack Screw appliance with a posterior bite plane, and a Nance Palatal Arch space maintainer. The report meticulously documents the treatment progression with detailed photographs and radiographs, capturing changes at 10 days, 24 days, and 3.5 months intervals. The case report concludes that the use of Quadhelix and Catalans appliances, in conjunction with a comprehensive treatment plan, effectively corrected the anterior crossbite in this patient. The treatment led to significant dental and skeletal improvements, as evidenced by the posttreatment cephalometric analysis. This case underscores the effectiveness of these appliances in pediatric orthodontic cases with similar presentations. [ABSTRACT FROM AUTHOR]

Preserving the outcome of orthodontic treatment is both important and challenging. However, there is insufficient evidence regarding the best way to ensure long-term treatment outcome. The aim of this study was to evaluate a pre-fabricated chain retainer (PFCR) in terms of: ability to maintain satisfactory treatment outcomes; periodontal and dental health; complications; and patient satisfaction. Overall, 130 patients who had completed orthodontic treatment with a fixed appliance during the period 2016–2019 (follow-up time range, 24–55 months) at a specialist orthodontic clinic in Varberg, Sweden and who had a PFCR in the lower jaw were invited to take part in the study. Little's irregularity index (LII) was recorded on dental casts. Caries, gingivitis, calculus, probing pocket depth, and gingival retractions were registered during clinical examinations. Patient satisfaction and retainer complications were evaluated using a questionnaire. In total, 76 patients (58.5%) agreed to participate. All patients, except for one, had their retainer still in place, and the complication rate was 40%. The LII scores were in the range of 0–4 mm (mean, 1.42 mm). At the retainer site, 82% had calculus, 74% had gingivitis, 1% had pocket depth >4 mm, 10.5% had gingival retractions >2 mm, and 0% had caries. All the patients expressed satisfaction with their retainer. PFCRs exhibit characteristics similar to those of traditional bonded retainers in terms of complications, stability, side-effects and patient experience. Therefore, they can be considered a viable alternative to traditional retainers installed in the lower anterior teeth. [ABSTRACT FROM AUTHOR]

Background: Effective plaque control is essential for improved oral health. Advancements in mechanical plaque removal using toothbrushes still continue. One such sophisticated intervention is the app-based toothbrush, a new innovative technology that helps to track the child's brushing habits. Aim: The aim of this study is to evaluate the plaque removal efficacy of three different toothbrushes in children aged 6-8 years. Methods: A randomized controlled clinical trial was conducted among primary school children with decayed missing filled teeth (dmft) score of =2. Baseline plaque score was collected using Turesky modification of the Quigley and Hein Index 1 week after oral prophylaxis. Children were randomly divided into three groups. Group I received conventional toothbrush (n = 25), group II received powered toothbrush (n = 25), and group III received app-based toothbrush (n = 25). Post-intervention plaque score, toothbrush wear and bite mark scores were done at the 15th, 30th, 45th and 90th day. Participant's opinion on their toothbrushes was evaluated using a questionnaire. Results and Conclusion: App-based toothbrush showed maximum plaque reduction followed by powered and conventional toothbrush. Significant reduction in plaque score was seen at 30th-, 45th- and 90th-day follow-up in group II (<0.001) and group III (<0.001). There was no appreciable difference in the toothbrush wear and bite mark score between the three groups. Children preferred app-based toothbrush in spite of the complex nature of using it. [ABSTRACT FROM AUTHOR]

In the context of optimizing dental care for patients who are elderly, the purpose of this in vitro study was to evaluate the surface gloss (with a micro-area gloss meter) of, surface roughness (with a compact surface roughness measuring instrument) of, and color change (with a dental colorimeter) in two commercially available injectable resin-based composites (Estelite Universal Flow (EUF) and Beautifil Flow Plus F00 (BFP)) as well as two glass–ionomer cements (GC Fuji II LC CAPSULE (FLC) and GC Fuji IX GP EXTRA CAPSULE (FGP)), before and after dental prophylaxis. After 24 h, the surfaces of each specimen were polished at 2500 rpm with a prophy brush (Mersage Brush, Shofu) and one-step prophylaxis paste (Prophy Paste Pro, Directa): under 100 or 300 gf load, and for 10 or 30 s, 4× cycles of cleaning. After mechanical cleaning, conditions were found for a significant reduction in the gloss level (EUF, BFP, or FLC; p < 0.05) and a significant increase in surface roughness (BFP; 300 gf load, 10 s × four cycles of cleaning). Overall, the longer time or higher prophylaxis load tended to decrease the surface gloss. However, the observed change in surface roughness varied between the restorative materials. There was no color change post-prophylaxis. [ABSTRACT FROM AUTHOR]

This study examined the utilization of antimicrobials in canines and felines receiving dental treatments in veterinary clinics in the United States, retrospectively. A total of 818,150 animals (713,901 procedures in dogs and 104,249 procedures in cats) underwent dental procedures under general anesthesia in 2020. These included dental prophylaxis and extractions. Patient demographic data, antimicrobial treatment, treatment duration, dose, periodontal disease score, whether tooth extractions were performed and how many extractions were performed was recorded. Our results showed that local or systemic antimicrobials were used in 116,723/713,901 (16.4%) procedures in dogs and 14,264/104,249 (14%) procedures in cats. Age, weight, extraction of one or more teeth and diagnosis of periodontal disease (any stage) were associated with increased likelihood of antimicrobial administration using univariable analysis (all P<0.001) and in the multivariable model. Clindamycin, amoxicillin-clavulanate and amoxicillin were the most common oral antimicrobials used in dogs and cats. Drugs classified as highest priority clinically important antibiotics (HPCIA) were administered to 30,960/116,723 (26.5%) of dogs and 7,469/14,264 (52%) of treated cats. The results obtained can inform interventions to optimize patient care and promote prudent use of antimicrobials during dental procedures in canine and feline patients. [ABSTRACT FROM AUTHOR]

Steroid hormones and the oral microbiota of pregnant women both appear as cumulative risk factors for gingivitis. This cross-sectional study, using real-time PCR, investigated the composition and diversity of the microbiota in interdental spaces of 3 months pregnant women with intact periodontium according the 2018 EFP/AAP classification. Bacteria identified were belonged to the red (Porphyromonas gingivalis Treponema denticola, and Tanerella forsythia), orange (Fusobacterium nucleatum, Prevotella intermedia, Campylobacter rectus, and Parvimonas micra), and green (Eikenella corrodens and A. actinomycetencomitans) Socransky complexes. Approximatively 109.11 bacteria were counted per interdental space in pregnant women. Bacteria from the red complex represented 33.80% versus 62.81% for the orange group versus 3.39% for the green group of the total number spread over the 3 groups. Dietary habits and physical activity did not have a significant impact on interdental microbiota, although a decrease in the median amount of 9 periodontopathogens was observed when fruit and vegetable consumption increased. Pregnant women who brushed their teeth at least twice a day had lower counts of total bacteria and 9 periodontal pathogens than those who brushed less. In 3 months pregnant women at high risk of periodontal disease (>30% bleeding sites), the dendogram revealed 2 clusters of the 9 periodontopathogens. This provides further support for the "key pathogen" hypothesis, among which Porphyromonas gingivalis plays a key role, indicating that specific bacteria in limited quantities can influence the host immune system and convert the microbiota from symbiotic to dysbiotic to induce inflammatory disorder. As a result, this study reported that 3 months pregnant women with healthy periodontium had high levels of interdental bleeding and a dysbiotic microbiota with periodontal pathogens of the Socransky orange and red complexes. These subjects were therefore potentially at increased risk of developing periodontal disease and, consequently, an adverse pregnancy outcome. So, preventive oral prophylaxis measures, in particular individual interdental prophylaxis, should be implemented as soon as pregnancy is established. [ABSTRACT FROM AUTHOR]

Aim: To compare caregivers' acceptance, consent, and concern toward utilization of a combination of basic behavior guidance technique (CBBGT) and Papoose Board (PB) for their special needs children and to evaluate the impact of PB usage on the caregiver's attitude and the association between their education level, monthly household income, and previous dental experience. Materials and Methods: This cross-over study incorporated 90 special needs children who were recruited to receive dental treatment with two ways of behavior guidance exposures consecutively in the order of A-B/B-A design. Exposure A is CBBGT (distraction, tell-show-do, and positive reinforcement), while Exposure B is PB. The dental procedures were either dental prophylaxis or restoration with a handpiece. Caregivers need to answer a paper-based questionnaire before and after exposure. The Wilcoxon sign rank test and logistic regression were utilized in order to establish the comparability, impacts, and association. Result: About 88 caregivers of special needs children aged between 2 and 15 years completed the sequence. Overall, 98.9% of the children presented with neurodevelopmental disorders. Twenty-seven caregivers were significantly concerned when the combination of basic BGT was applied to their children, and 14 caregivers felt the same for PB. However, the Wilcoxon sign rank test revealed insignificant caregiver scores on acceptance and consent for both methods but significantly improved attitudes towards the use of PB after observing the placement of their children. Conclusion: The studied caregiver demonstrated equivalent acceptance, consent, and concern toward the use of PB and a combination of basic BGT with improved attitudes after comprehensive explanation and real-time observation of PB usage during their children's dental treatment. [ABSTRACT FROM AUTHOR]

Recurrent aphthous stomatitis (RAS) is an inflammatory disease of the oral mucosa, which has a chronic course with periods of remission and exacerbations. RAS requires adequate diagnosis for the purposes of properly treating. The study on RAS remains relevant over many years and continues to be a priority in modern dentistry. The aim of the work is to analyze the information in the professional literature on pathogenetic variants of RAS and approaches to its treatment and prevention. Despite the variety of studies, the etiology and pathogenesis of the disease remain the subject of numerous discussions. This article provides a review of current research on the main etiopathogenetic mechanisms of the disease development and progression, specifies current recommendations for therapeutic approaches to treatment and prevention. Conclusions. To date, there is no definitive therapeutic tactic for recurrent aphthous stomatitis, so it is advisable to systematize and study methods for the prevention and treatment of this pathology, including pain relief, acceleration of ulcer healing and reduction of its episode frequency and severity. Considering the etiopathogenetic variant of the disease development (metabolic disorders, stress, allergies, etc.), preventive measures should be comprehensive and include oral hygiene, a sparing diet, multivitamin and micro-, macroelement complexes, etc.

Purpose: The aim of this study was to verify how the prevalence of viridans-streptococci is changed by two appointments of professional prophylaxis and after the subgingival instrumentation via scaling and root planing (SRP). Material and Methods: Samples of the subgingival biofilm were collected from 19 individuals with periodontitis receiving two appointments of professional prophylaxis and SRP before and after the treatment procedures and the presence of viridans-streptococci was analysed by microbiological cultivation. Non-parametric statistical testing using Friedman/Wilcoxon tests and chi-square testing was used for statistical analysis. Results: No statistically significant changes over time were found for the mutans-group. The prevalence of Streptococcus mitis decreased after two appointments of professional prophylaxis (p = 0.013). The prevalence of S. mitis decreased again after SRP (p <0.001). The prevalence of Streptococcus anginosus decreased after two appointments of professional prophylaxis (p = 0.002). After SRP five positive results for S. anginosus were detected (p = 0.026). For Streptococcus oralis and Streptococcus gordonii tendencies to statistical significance were found. The number of positive results for S. oralis increased after the first appointment of professional oral prophylaxis (p = 0.055). The number of positive results for S. gordonii increased after the first appointment of professional oral prophylaxis (p = 0.055). Conclusion: The step-wise periodontal therapy influences the prevalence of viridans-streptococci, especially S. mitis and S. anginosus. No tremendous increase of streptococci especially related to the carious process occurs in the subgingival biofilm. Clinical Relevance: The study reveals knowledge on changes of the composition of the subgingival biofilm due to different steps of periodontal therapy. [ABSTRACT FROM AUTHOR]

With the global population undergoing demographic shift towards aging, the prevalence of Alzheimer’s disease (AD), a prominent neurodegenerative disorder that primarily afflicts individuals aged 65 and above, has increased across various geographical regions. This phenomenon is accompanied by a concomitant decline in immune functionality and oral hygiene capacity among the elderly, precipitating compromised oral functionality and an augmented burden of dental plaque. Accordingly, oral afflictions, including dental caries and periodontal disease, manifest with frequency among the geriatric population worldwide. Recent scientific investigations have unveiled the potential role of oral bacteria in instigating both local and systemic chronic inflammation, thereby delineating a putative nexus between oral health and the genesis and progression of AD. They further proposed the oral microbiome as a potentially modifiable risk factor in AD development, although the precise pathological mechanisms and degree of association have yet to be fully elucidated. This review summarizes current research on the relationship between oral bacteria and AD, describing the epidemiological and pathological mechanisms that may potentially link them. The purpose is to enrich early diagnostic approaches by incorporating emerging biomarkers, offering novel insights for clinicians in the early detection of AD. Additionally, it explores the potential of vaccination strategies and guidance for clinical pharmacotherapy. It proposes the development of maintenance measures specifically targeting oral health in older adults and advocates for guiding elderly patients in adopting healthy lifestyle habits, ultimately aiming to indirectly mitigate the progression of AD while promoting oral health in the elderly.

Aim: This study evaluated the effect of two prophylaxis methods over the surface roughness of different resin composites. Materials and Methods: Ten disc-shaped specimens (7 mm x 2 mm) were made for each composite tested: MH - microhybrid composite with regular viscosity (Opallis); NH – nanohybrid composite with regular viscosity (Vittra APS); BF – high-viscosity bulk fill composite (Opus Bulk Fill); MHF - microhybrid flowable composite (Opallis flow); and OS – nanohybrid one-shade composite with regular viscosity (Vittra Unique). Initial roughness (Ra) values were obtained from each sample, and then they were divided into two groups (n = 5) following the prophylaxis method: SB – prophylaxis with sodium bicarbonate powder (125µm grain) using an air-powder polishing device (30 s application distanced 10 mm with 2 bar); and PP – prophylaxis with pumice paste and rotatory brush (30 s, 3000 rpm and pressure of 150 g). After that, a new Ra measurement (Raf) was obtained, and the difference was calculated (ΔRa). Data were compared using Three-way ANOVA followed by Bonferroni teste and the Ra difference (ΔRa) was analyzed by Two-way ANOVA followed by the Tukey test (p

Background: Tooth decay is an infectious disease which, in its initial phase, leads to the formation of cavities in the teeth through decalcification of the enamel and local tissue destruction. In addition to proper oral hygiene, prophylactic sealing of fissures and cavities with a sealant is a method of preventing the development of caries. The aim of this study is to summarise the effectiveness of fissure sealing of permanent teeth with fissure sealants compared to other preventive methods or no intervention. Method: An umbrella review was carried out to achieve the purpose of our study. Searches were performed in Medline (via PubMed), Embase (via OVID), and Cochrane Library databases. Quality assessment of the included studies was performed using the AMSTAR2 tool. In addition, a manual search for recommendations/clinical practice guidelines on dental prophylaxis was performed. Results: 204 publications were identified, of which 15 met the inclusion criteria. Based on the results of 3 systematic reviews, there was a statistically significant reduced odds of caries occurrence or development with prophylactic sealing of permanent teeth compared with no intervention – depending on the review and follow-up period odds ratio (OR) ranged from 0.06 [95%CI: (0.01–0.32)] to 0.28 [95%CI: (0.20–0.38)]. In the eight systematic reviews that analysed different sealants, there were no statistically significant differences between the types of materials used for prophylactic tooth sealing. For systematic reviews comparing the efficacy of fissure sealants with fluoride varnish, three reported no statistically significant difference in the efficacy of caries incidence, with only one systematic review based on 1 RCT finding a statistically significant difference in favour of fissure sealants. Conclusion: Compared to the no intervention, dental sealing is an effective method for the prevention of dental caries. However, it is not possible to conclude conclusively which type of sealant and which of the available prophylactic methods is more effective in preventing caries. [ABSTRACT FROM AUTHOR]

This article provides an updated review of guidelines and clinical studies on dental antibiotic prophylaxis in total joint replacement. The review found that there is no significant benefit of antibiotic prophylaxis in reducing the risk of prosthetic joint infections (PJI) following dental procedures. Routine activities like chewing and brushing were found to contribute more to bacteremia and potential joint infection than dental procedures themselves. The study concludes that antibiotic prophylaxis for dental procedures in patients with joint prostheses is not universally beneficial and should not be routinely recommended. Instead, emphasis should be placed on individual risk assessment, good oral hygiene, and adherence to evidence-based guidelines. Another systematic review of multiple studies found no increased risk of PJI following dental procedures in patients with hip or knee replacements. The use of prophylactic antibiotics also did not show a significant association with the incidence of PJI. Maintaining good oral hygiene and regular dental assessments were found to reduce the risk of PJI by at least 30%. The review suggests that current policies on antibiotic prophylaxis for patients with joint replacements undergoing dental treatment should be reconsidered. Several studies were reviewed to assess the evidence supporting the use of prophylactic antibiotics. The studies found no direct evidence to support the use of antibiotics prior to dental procedures in patients with prosthetic joints. The authors recommend against routine antibiotic prophylaxis, as it is not cost-effective and contributes to antibiotic resistance. However, maintaining good oral hygiene is important to prevent a small number of infections associated with oral [Extracted from the article]

Introduction: Reactivation of hepatitis B virus (HBV) infection induced by immunosuppressive cancer therapy is associated with fulminant liver disease and death. While national guidelines recommend HBV screening and antiviral prophylaxis for patients with cancer prior to initiating immunosuppressive therapy, compliance with these measures is unclear. This study characterized the burden of HBV infection among patients diagnosed with gynecological or dermatological cancers, with or without underlying HIV infection, before initiating immunosuppressive therapy. Methods: Between 2016 - 2018, we recruited study patients from the Dr George Mukhari Academic Hospital in Tshwane, South Africa. Demographic (age, sex) and clinical data (HIV test results, HIV antiviral regimen, type of cancer) were recorded using a standardized data collection form. All participants were tested for HBV surface antigen (HBsAg), and antibodies to the surface (anti-HBs) and core antigens (anti-HBc). For detection of HBV DNA, a nested polymerase chain reaction was used to amplify polymerase gene fragments which were Sangersequenced and analyzed using bioinformatics software. All statistical analyses were performed using R version 4.1.0 (2021-05-18) and R studio version 2022.07.2. Results: Study participants were predominantly female (96.3%, 103/107) with a median (IQR) age of 50 (17.5) years. Cervical cancer was the most frequent cancer diagnosis (72%). Over half (52.3%; 56/107) of the participants were HIV positive and all but four (92.9%) on highly active antiretroviral therapy at the time of enrollment. The prevalence of chronic hepatitis B in the study population was 11.2% [95% CI:6.2-19.1], increasing to 14.3% [95% CI:6.8-26.8] in the HIV positive sub-population. The overall prevalence of occult HBV infection was 20% [95% CI:12.8-29.7], 57.9% [95% CI:33.97-78.9] of whom tested negative for all serological markers. Phylogenetic inference showed that all polymerase gene sequences generated in this study were sub-genotype A2. Mutational analysis did not reveal any drug resistance-associated amino acid variations in this study. Conclusion: These findings suggest that chronic and occult HBV infections are more prevalent among cancer patients with or without underlying HIV infection compared to what has previously been reported for the general South African population. This underscores the need to scale-up universal HBV serological and molecular screening with timely institution of prophylaxis prior to initiating immunosuppressive cancer therapy. [ABSTRACT FROM AUTHOR]

Objective: Dental treatment for Down's syndrome is often carried out under general anesthesia due to the difficulty of cooperation, excessive dental procedures, and accompanying systemic diseases. The risk of endocarditis can be avoided by maintaining good oral hygiene, preventing tooth decay and administering prophylactic antibiotics before some dental treatments. Material and Method: Down Syndrome patients underwent dental treatment under general anesthesia were evaluated retrospectively. General anesthesia method, demographic variables, ASA scores, Oral Hygiene Index, Frankl scale, Houpt Scale, systemic diseases of the patients, antibiotic prophylaxis and dental treatments were examined as data. Results: Female/male ratio was 62/51, mean age was 14.14±10.28. Most patients were ASA II with 67.3%. The oral hygiene index was poor (%38). While 84.81% of the patients were sedated, 15.2% were given general anesthesia. Tooth extraction with tooth filling was the most performed dental treatment. The most common systemic disease was of cardiac origin. Antibiotic prophylaxis was administered to 82 of the patients. Conclusion: To treat patients with Down Syndrome, frequent use of general anesthesia and sedation, as well as frequent antibiotic prophylaxis, is required. In terms of these applications, it is necessary to create a treatment plan with the least risk to the patient. [ABSTRACT FROM AUTHOR]

Context: Gingivitis is among the most prevalent periodontal disease occurring in the oral cavity, which is plaque induced and if untreated, can progress to periodontitis. Various adjunct chemotherapeutic agents are available for plaque control with their own pros and cons. Hence, a plaque-controlling therapeutic agent which is readily available at low cost and without any side effects is the need of the hour. According to the ancient texts, Ayurveda and the traditional culture of India, Curcuma longa is used externally for inflammation of skin and mucosa. Aims: To evaluate the therapeutic effect of curcuma gel on gingival health and its possible usage in the treatment of gingivitis. Settings and Design: This study comprises hundred participants with gingivitis which were divided randomly in two groups. Subjects and Methods: Experimental group – Scaling and topical application of curcuma gel and control group – Scaling alone without the topical application of curcuma gel. Clinical parameters (Gingival Index, Gingival Bleeding Index, and Plaque Index) were assessed at different time intervals (0, 7, 14, and 21 days) in both experimental and control groups. Statistical Analysis Used: Within groups, a repeated measures ANOVA model was used for repeated observations over a period which is followed by the Dunnett test for multiple comparisons. Experimental and control groups were compared for normally distributed data by Student's t-test. Whereas for skewed data, the Wilcoxon test or Mann–Whitney U-test was employed. Results: Statistically significant improvement of gingival health parameters was seen in the group which received topical curcuma oral gel application after scaling compared with the control group. Conclusions: Significant improvement in clinical parameters of gingivitis on the application of Curcuma oral gel after scaling with no obvious adverse effects suggesting its possible use as a topical adjunct treatment in clinical or community level prevention as well as treatment programs in the future.

Background: Aerosols released during ultrasonic scaling can cause cross-contaminations. Infections like hepatitis and SARS-CoV-2 can spread through these aerosols. Preprocedural rinse is a cost-effective method to reduce aerosol contami-nation produced during ultrasonic scaling. Materials and Methods: This was a double-blinded randomised trial on 105 subjects diagnosed with chronic generalised periodontitis which was randomly allocated into three groups: Group I received 0.12% chlorhexidine (CHX), Group II received 5% Morinda citrifolia (noni) mouthrinse, Group III received distilled water. Participants were advised to mouthrinse for 60 seconds just before the start of ultrasonic scaling. The aerosols released during ultrasonic scaling were gathered on blood agar plates placed at three locations. Colony forming units (CFUs) were counted after 48 hours of incubation. Results: The highest CFU values were observed in the distilled water group and the lowest in chlorhexidine group (p

Purpose: To evaluate the clinical performance of two proposed onlay designs. Methods: Molars with occlusal and/or mesial/distal defects after root canal treatment were classified by design into three groups. Onlays without shoulders were the control group (Group C, n = 50). The designed onlays were Group O (n = 50) and the designed mesio-occlusal/disto-occlusal onlays were Group MO/DO (n = 80). All onlays had an occlusal thickness of approximately 1.5-2.0 mm, and the designed onlays had a shoulder depth and width of approximately 1 mm. In Groups C and O, the box-shaped retention was 1.5 mm in depth. The proximal box was connected with a dovetail retention in Group MO/DO. Patients were examined every 6 months and followed for 36 months. Restorations were evaluated by using the modified United States Public Health Service Criteria. Statistical analysis was performed by using Kaplan-Meier analysis, the chi-square test, and Fisher’s exact test. Results: No tooth fracture, debonding, secondary caries, or gingivitis was observed in any group. Groups O and MO/DO had satisfactory survival and success rates, and there was no significant difference in performance characteristics among the three groups (P > 0.05). Conclusion: The two proposed onlay designs were effective in protecting molars. [ABSTRACT FROM AUTHOR]

Aim: With the spread of technological possibilities, the idea that humanoid robots can accompany medical interventions has gained momentum. The objectives of this two-armed randomized controlled study were (i) to assess the effects of a human-like robot on behavior guidance during children's dental treatment, by a comparison of the dental anxiety scale, behavioral scale, pulse rate and amylase levels in the saliva and (ii) to determine whether the children would like to have treatment with a humanoid robot. Materials and Methods: One hundred two children (52 girls, 50 boys; mean age: 6.71±1.43 years) were included. The exclusion criteria were children showing definitely negative behavior (Frankl 1) during dental prophylaxis at the first visit and those children who had had dental treatment previously. Fifty children were assigned to the robot group (RG) and 52 children were assigned to the control group (CG). The Facial Image scale (FIS), Frankl Behaviour Rating scale (FBRS), physiological pulse rate and salivary alpha amylase (sAA) levels were used to assess the stress related changes. The Mann-Whitney U test and the Student's t-test were used to compare the groups. In-group comparisons were tested with the Wilcoxon signed-rank test. The chi-squared test, Continuity (Yates) correction, and the Fisher-Freeman-Halton test were used to compare qualitative data. Statistical tests were considered significant at a p-value set at 0.05. Results: The post-treatment FIS scores of the RG in the 6-10-year-olds were significantly lower than in the CG (p<0.05). Post-treatment FBRS scores were statistically significantly higher in the RG than in the CG in both younger and older children (p<0.05). In children aged between 6 and 10 years, pulse rates during and after treatment in the RG were significantly lower than those in the CG (p<0.05). No correlation was found between the children's anxiety/behavior and their sAA levels. Conclusion: The robot was found to be effective in reducing dental anxiety and pulse rates in children aged 6-10 years, and it was preferred more by the children of this age. [ABSTRACT FROM AUTHOR]

Background: Surgical site infection is an infection occurring within 30 days after surgery. It is recently reported that evidence-based information on the specific time when the majority of surgical site infections would develop is a key to early detect the infection as well as to preventing and early intervene against their pressing and fatal complications. Therefore, the current study aimed to determine the incidence, predictors, and time to development of surgical site infection among general surgery patients at specialized hospitals in the Amhara region. Method: An institution-based prospective follow-up study was conducted. The two-stage cluster sampling procedure was used. A systematic sampling technique with a K interval of 2 was applied to prospectively recruit 454 surgical patients. Patients were followed up for 30 days. Data were collected using Epicollect5 v 3.0.5 software. Post-discharge follow-up and diagnosis were done by telephone call follow-up. Data were analyzed using STATA™ version 14.0. Kaplan–Meier curve was used to estimate survival time. Cox proportional regression model was used to determine significant predictors. Variables with a P-value less than 0.05 in the multiple Cox regression models were independent predictors. Result: The incidence density was 17.59 per 1000 person-day-observation. The incidence of post-discharge Surgical site infection was 70.3%. The majority of surgical site infections were discovered after discharge between postoperative days 9 to 16. Being male (AHR: 1.98, 95% CI: 1.201 – 3.277, diabetes Mellitus (AHR: 1.819, 95% CI: 1.097 – 3.016), surgical history (AHR: 2.078, 95% CI: 1.345, 3.211), early antimicrobial prophylaxis (AHR: 2.60, 95% CI: 1.676, 4.039), American Society of Anesthesiologists score ≥ III AHR: 6.710, 95% CI: 4.108, 10.960), duration of the surgery (AHR: 1.035 95% CI: 1.001, 1.070), Age (AHR: 1.022 95% CI: 1.000, 1.043), and the number of professionals in the Operation Room (AHR: 1.085 95% CI: 1.037, 1.134) were found to be the predictors of time to development of Surgical site infection. Conclusion: The incidence of surgical site infection was higher than the acceptable international range. The majority of infections were detected after hospital discharge between 9 to 16 postoperative days. The main predictors of Surgical site infection were Age, Sex, Diabetes Mellitus, previous surgical history, the timing of Antimicrobial prophylaxis, American Society of Anesthesiologists score, pre-operative hospital stay, duration of surgery, and the number of professionals in the operation room. Hence, hospitals should give great emphasis on pre-operative preparation, post-discharge surveillance, modifiable predictors, and high-risk patients, as they found in this study. [ABSTRACT FROM AUTHOR]

Introduction: Plaque formation increases when mechanical disruption occurs in the oral cavity's self-cleaning systems during fixed orthodontic therapy. Hence, it is imperative that oral prophylaxis must be performed with more care in orthodontic patients. This can be efficiently done with the help of toothbrushes. There are various types of toothbrushes such as regular, orthodontic and electric toothbrushes which are most commonly used by patients to maintain proper oral hygiene and prevent plaque accumulation. Aim: To identify which toothbrush has the best cleaning efficiency, when used around orthodontic brackets. Materials and Methods: This in-vitro study was conducted in the laboratory set-up at Saveetha Dental College and Hospital, Chennai, Tamil Nadu, India. The study was conducted for a period of two weeks from 17th January 2022 to 30th January 2022, and used 24 permanent premolars extracted for orthodontic purposes which were divided into three groups: regular, orthodontic and electric toothbrushes. There were eight tooth samples in each group. Following premolar bracket bonding, a biofilm was formed around the teeth using E.faecalis culture in-vitro for three days. The samples were then carefully removed and treated with a disclosing agent before being put through a brushing simulation. The "Plaque index for Orthodontic Patients" (PIOP) index was used to estimate plaque scores before and after brushing based on how much biofilm was remaining on the tooth surfaces. Oneway Analysis of Variance (ANOVA) and Tukey's Post-hoc tests were used to determine the statistical significance. Results: The mean plaque scores after simulation in the toothbrush groups were 3±0.75 (regular), 1.75±0.70 (orthodontic) and 2.37±0.74 (electric). There was a statistically significant difference in mean plaque scores between groups as determined by one-way ANOVA {F(p=0.008)}. A Tukey's Post-hoc test revealed that the cleaning efficacy of orthodontic toothbrushes was statistically significant compared to the other two groups. Conclusion: The orthodontic toothbrushes produced a statistically greater level of tooth-cleaning effectiveness. [ABSTRACT FROM AUTHOR]