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Journal of Dental Education Sep 2023To identify behavioral, preferential, and professional factors influencing the use of amalgam in private practices; and to compare the incidence of the placement of...
OBJECTIVES
To identify behavioral, preferential, and professional factors influencing the use of amalgam in private practices; and to compare the incidence of the placement of amalgam versus composite resin restorations in the province of Ontario and its pedagogical implications on dental curricula.
METHODS
Participants responded anonymously to a 23-question online survey about their current use of dental amalgam and composite resins as well as their opinions regarding both dental materials. The explanatory variables were associated bivariately with the outcome variables, and the most significant predictors were identified using the multivariate analysis.
RESULTS
Higher percentages of amalgam use were reported among clinicians who trained in Canada only (P = .009), who graduated before 1980 (p = <.001) and who work outside private practice (p = <.001). Familiarity with amalgam was higher among clinicians who are female (p = <.001), older (p = <.001), trained only in Canada (p = .017), who graduated prior to 2000 (p = <.001), and who work in locations with populations over 100,000 (p = .042). Familiarity with composite resin was higher among clinicians who graduated more recently (p = .002). A higher percentage of females (p = <.001), younger clinicians (p = <.001), recent graduates (p = <.001), and clinicians who work in private practice (p = .043) suggested that over 50% of dental student training time be allocated to amalgam.
CONCLUSIONS
Decreased amalgam use was reported by later dental graduates and private practitioners; this may be impacted by familiarity with dental amalgam. As amalgam remains a safe and effective dental material, its removal may not be prudent. Dental educators play a crucial role in the future of amalgam opinion and use.
Topics: Humans; Female; Male; Dental Restoration, Permanent; Dental Amalgam; Composite Resins; Curriculum; Education, Dental
PubMed: 37280767
DOI: 10.1002/jdd.13252 -
Acta Stomatologica Croatica Sep 2023The aim of the study was to assess the biocompatibility of modern composite and amalgam dental fillings.
OBJECTIVES
The aim of the study was to assess the biocompatibility of modern composite and amalgam dental fillings.
MATERIAL AND METHODS
The research was conducted on 150 healthy patients between the ages of 10 and 20 who had amalgam and composite fillings between 6 and 12 months. Under conditions, a swab of buccal cells near the fillings was taken, and the cytotoxic and genotoxic impact of composite and amalgam fillings on these cells was analyzed using the extended micronucleus test (cytomeassay).
RESULTS
The results showed statistically significant differences between the groups of subjects with amalgam and composite fillings and subjects without fillings for the following parameters: number of micronuclei (p=0.006), number of buds (p<0.001), number of binuclear cells (p<0.001), number of nucleoplasmic bridges (p<0.001).The number of micronuclei was statistically significantly higher in the group of subjects with amalgam and composite fillings compared to the group without fillings. The results for nuclear buds, for the number of binuclear cells and the number of nucleoplasmic bridges showed that the group with amalgam fillings had a statistically significantly higher number of these changes compared to other groups.The results of the analysis of the relationship between the parameters of the micronucleus test and the number of amalgam and composite surfaces did not show statistically significant values. Parameters indicating cell cytotoxicity were not statistically significantly elevated in subjects with fillings. The results of the analysis of the influence of the patients' lifestyle on the results of the micronucleus test showed statistically significant results for certain predictors (diagnostic X-ray radiation, coffee consumption, consumption of cooked, dried meat and baked food).
CONCLUSION
Based on the results, it can be concluded that the buccal cells of subjects with amalgam fillings showed the highest degree of genotoxic changes, followed by those with composite fillings and the least buccal cells of patients without fillings.
PubMed: 37808410
DOI: 10.15644/asc57/3/2 -
Journal of the American Dental... Aug 2023Advancements in dental materials and changing parental preferences are modifying the frequency of use of restorative materials. This insurance claims analysis examined...
BACKGROUND
Advancements in dental materials and changing parental preferences are modifying the frequency of use of restorative materials. This insurance claims analysis examined the trends in the use of amalgam and resin composite in the United States.
METHODS
Commercial dental insurance claims were analyzed to compare 505,994 restorations, corresponding with procedure codes for 1-, 2-, and 3-surface amalgam or resin restorations. Paid claims collected nationwide from January 2010 through March 2020 were analyzed. Data for children aged 3 through 12 years were used, resulting in 219,632 unique patient identification numbers. Generalized estimating equation models applied to logistic regression were used. All tests were conducted using a 2-sided 5% significance level.
RESULTS
In general, girls were less likely to receive amalgam than boys. A $20,000 increase in median household income was associated with a 16% decrease in the odds of amalgam being placed. Pediatric dentists (performing 15.1% of all restorations) were not as likely as general dentists (18.4%) to use amalgam. Having more surfaces in a restoration was associated with higher probability of amalgam placement. The percentage of amalgam restorations was higher for 2010 (26.9%) than for 2011 through 2020, and this pattern recurred in several of the years analyzed. Generally, patient age at time of amalgam restoration increased over time.
CONCLUSION
The use of amalgam is trending down; the sharpest decline was noted in 2014. Pediatric dentists were less likely to use amalgam than general dentists. Girls and patients with higher socioeconomic status were less likely to have amalgam.
PRACTICAL IMPLICATIONS
The findings of this study can inform and support clinical decisions and the formation of public policies.
Topics: Male; Child; Female; Humans; Dental Restoration, Permanent; Pediatric Dentistry; Dental Materials; Composite Resins; Dental Amalgam; Insurance
PubMed: 37500233
DOI: 10.1016/j.adaj.2023.04.015 -
International Dental Journal Feb 2024
Topics: Humans; Dental Amalgam; Dental Materials; Composite Resins; Glass Ionomer Cements; Dental Restoration, Permanent; Materials Testing; Resin Cements
PubMed: 38218597
DOI: 10.1016/j.identj.2023.10.006 -
BMC Oral Health May 2024The use of artificial intelligence in the field of health sciences is becoming widespread. It is known that patients benefit from artificial intelligence applications on...
Evaluating the accuracy of Chat Generative Pre-trained Transformer version 4 (ChatGPT-4) responses to United States Food and Drug Administration (FDA) frequently asked questions about dental amalgam.
BACKGROUND
The use of artificial intelligence in the field of health sciences is becoming widespread. It is known that patients benefit from artificial intelligence applications on various health issues, especially after the pandemic period. One of the most important issues in this regard is the accuracy of the information provided by artificial intelligence applications.
OBJECTIVE
The purpose of this study was to the frequently asked questions about dental amalgam, as determined by the United States Food and Drug Administration (FDA), which is one of these information resources, to Chat Generative Pre-trained Transformer version 4 (ChatGPT-4) and to compare the content of the answers given by the application with the answers of the FDA.
METHODS
The questions were directed to ChatGPT-4 on May 8th and May 16th, 2023, and the responses were recorded and compared at the word and meaning levels using ChatGPT. The answers from the FDA webpage were also recorded. The responses were compared for content similarity in "Main Idea", "Quality Analysis", "Common Ideas", and "Inconsistent Ideas" between ChatGPT-4's responses and FDA's responses.
RESULTS
ChatGPT-4 provided similar responses at one-week intervals. In comparison with FDA guidance, it provided answers with similar information content to frequently asked questions. However, although there were some similarities in the general aspects of the recommendation regarding amalgam removal in the question, the two texts are not the same, and they offered different perspectives on the replacement of fillings.
CONCLUSIONS
The findings of this study indicate that ChatGPT-4, an artificial intelligence based application, encompasses current and accurate information regarding dental amalgam and its removal, providing it to individuals seeking access to such information. Nevertheless, we believe that numerous studies are required to assess the validity and reliability of ChatGPT-4 across diverse subjects.
Topics: Dental Amalgam; United States; United States Food and Drug Administration; Humans; Artificial Intelligence; Surveys and Questionnaires
PubMed: 38789962
DOI: 10.1186/s12903-024-04358-8 -
Parkinson's Disease 2023Environmental toxicants are thought to play a major role in the pathogenesis of Parkinson's disease. In reviewing the literature on heavy metals known to be toxicants,... (Review)
Review
Environmental toxicants are thought to play a major role in the pathogenesis of Parkinson's disease. In reviewing the literature on heavy metals known to be toxicants, we noted several recent studies on mercury suggesting a possible role in the etiology of some cases of this disease. We therefore undertook a review of this association, focusing especially on peer-reviewed articles to avoid the bias inherent in much of the literature regarding mercury. For most people, our contemporary exposure to mercury comes from dental amalgam tooth restorations and from eating fish contaminated with mercury. In both cases, mercury is known to get into the brain in utero and at all ages. It remains in the brain for many years and is known to produce permanent neuropsychological deficits. Mercury toxicity can produce tremors and other Parkinsonian clinical symptoms. It can also produce neurochemical and neuropathological changes similar to those found in Parkinson's disease, including the loss of dopamine neurons, degeneration of tubulin and axons, dysfunction of mitochondria, and the aggregation of alpha-synuclein. Relatively few studies have assessed mercury in parkinsonian patients, but almost all reported a statistically significant association. Published studies suggest some promising leads in the relationship between mercury exposure and Parkinson's disease. However, studies of patients are relatively few, and the need for research is clear. A search of Parkinsonian research studies currently funded by the US National Institutes of Health, Parkinson's Foundation, and the Michael J Fox Foundation yielded no studies on mercury. We believe such studies should be supported.
PubMed: 37744289
DOI: 10.1155/2023/4709322 -
Supportive Care in Cancer : Official... May 2024This study is to conduct a comprehensive scoping review to map scientific evidence and clarify concepts regarding the commonly recommended preventive and restorative... (Review)
Review
PURPOSE
This study is to conduct a comprehensive scoping review to map scientific evidence and clarify concepts regarding the commonly recommended preventive and restorative dental treatments for patients diagnosed with head and neck cancer (HNC) and subjected to radiotherapy.
MATERIAL AND METHODS
This systematic scoping review was performed under the PRISMA-ScR guidelines. The study's experimental design was registered in the Open Science Framework. In vitro studies that evaluated preventive and restorative dental treatment over 50 Gy radiation doses were included. The search was conducted in November 2023 in five electronic databases (PubMed, Scopus, Web of Science, Cochrane Library, and Embase) without language or date restriction. A search strategy was applied based on keywords, MeSh terms, or synonyms. A descriptive analysis was conducted.
RESULTS
A total of 49 studies, out of 3679 original articles identified, were included and reviewed. Of the included studies, three evaluated saliva stimulants and 35 evaluated fluoride-based preventive materials: gel (n = 18) toothpaste (n = 11) mouth rinse (n = 8) and varnish (n = 5) while 14 evaluated restorative materials: resin composite (n = 12) glass ionomer cement (n = 6) and amalgam (n = 1) Of those studies, 36 were clinical trials and 13 were in vitro studies.
CONCLUSION
Fluoride gel was the most frequently recommended preventive material for preventing radiation caries with supportive clinical evidence. Resin composite and glass ionomer were the most frequently used restorative materials, respectively. However, there is not yet clinical evidence to support the use of resin composite in irradiated teeth.
Topics: Humans; Dental Caries; Head and Neck Neoplasms; Dental Restoration, Permanent
PubMed: 38702458
DOI: 10.1007/s00520-024-08522-2 -
Journal of Dentistry Aug 2023To systematically assess aspects of teaching of posterior composite restorations (PCRs) in permanent teeth in dental schools. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To systematically assess aspects of teaching of posterior composite restorations (PCRs) in permanent teeth in dental schools.
STUDY SELECTION
Quantitative studies reporting on dental schools' teaching regarding the placement of PCRs in permanent teeth. Random-effects meta-analyses and meta-regressions were performed. Risk of bias was assessed based on the Medical Education Research Study Quality Instrument (MERSQI).
SOURCES
Electronic databases (MEDLINE via PubMed, EMBASE via Ovid, Web of Science, and Scopus) were searched in January 2023.
DATA
Forty sources reporting on 34 studies having surveyed 1,286 dental schools were included. Overall, 92.7% (95%-CI: 88.2-95.5) of dental schools reported to teach PCRs. PCRs in three-surface Class II cavities are taught by 82.0% (95%-CI: 70.4-89.7). The mandatory use of liners in deep cavities is taught by 78.3% (95%-CI: 68.9-85.5), and 44.0% (95%-CI: 34.3-54.2) reported to teach bulk-fill composites. While most posterior restorations placed by students were composites (56.1%; 95%-CI: 46.0-65.8), 94.7% (95%-CI: 86.6-98.0) of dental schools (still) teach posterior amalgam restorations. The proportion of dental schools teaching PCRs in three-surface Class II cavities increased and the mean proportion of PCRs among all posterior restorations increased over time (p≤0.003).
CONCLUSIONS
The teaching of PCRs in dental schools around the world reflects the increased use of resin composite in clinical practice, with students in countries where dental amalgam continues to be used, placing more posterior composites than restorations of dental amalgam. The teaching of PCRs, which is anticipated to increase, will continue to be refined with further developments in adhesive materials, devices, instrumentation, and techniques.
CLINICAL SIGNIFICANCE
Graduating dentists can be expected to be familiar with the use of resin composites for the restoration of posterior teeth.
Topics: Humans; Dental Restoration, Permanent; Dental Amalgam; Dental Cavity Preparation; Composite Resins; Dental Caries; Students; Teaching
PubMed: 37336355
DOI: 10.1016/j.jdent.2023.104589 -
British Dental Journal Sep 2023Aim This study aimed to explore disparities in experience of UK dental foundation trainees in amalgam use at dental school compared to their first year in dental...
Aim This study aimed to explore disparities in experience of UK dental foundation trainees in amalgam use at dental school compared to their first year in dental practice.Methods A modified version of the 'survey of Yorkshire dentists' targeted the dental foundation trainees. A mixed-method of quantitative and thematic content analysis was undertaken for the close-ended and free-text responses, respectively.Results Only 35% of participants described their confidence level as 'satisfactory' in placing dental amalgam before starting their dental foundation training and 51% scored the level of teaching between 'very poor' and 'satisfactory'. In total, 63% of respondents were in favour of receiving additional support in placing amalgam restorations during their undergraduate training. Participants indicated that the consequences of amalgam phase-out are increased appointment times and decreased quality of care due to patient and health service unaffordability of amalgam alternatives.Conclusion These findings raise concerns regarding newly qualified undergraduates' confidence, experience and skill in placing amalgams. This suggests the need to increase undergraduate education and training to improve undergraduates' skills and confidence in amalgam procedures to reduce the gap between the dental schools and real-world practice.
Topics: Humans; Dental Amalgam; Schools, Dental; Students; Dental Care
PubMed: 37684467
DOI: 10.1038/s41415-023-6228-4