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Acta Odontologica Latinoamericana : AOL Apr 2024A high prevalence of post-treatment apical periodontitis associated to variables such as endodontic treatment quality and missed canals has been reported.
Apical periodontitis in endodontically-treated teeth: association between missed canals and quality of endodontic treatment in a Colombian sub-population. A cross-sectional study.
UNLABELLED
A high prevalence of post-treatment apical periodontitis associated to variables such as endodontic treatment quality and missed canals has been reported.
AIM
The aim of this study was to evalúate the quality of endodontic treatment and the frequency of missed canals associated with teeth with apicalperiodontitis (AP) through CBCTin a Colombian sub-population.
MATERIAL AND METHOD
This was a cross-sectional study assessing 318 cone beam computed tomography (CBCT) scans of endodontically treated teeth from Colombian individuals. The scans were taken using J Morita X550 (J Morita Corporation, Osaka, Japan), with voxel size 0.125 to 0.20 mm. All endodontically treated teeth were assessed for quality of treatment, presence of missed canals and AP. Allsamples were analyzed bytwo endodontics specialists and an radiology specialist. Chi-square or Fisher 's test and odds ratio were calculated to identify the association and risk relationship between the presence of AP and the study variables.
RESULTS
Missed canals were found in 18.61% (86/462), and 95.3% were associated with AP. The frequency of AP was 62.34% (288/462) for all the evaluated teeth. AP was found in 27.43 % (79/288) of the teeth with adequate endodontic treatment, in contrast to 72.57% (209/288) of the teeth with inadequate treatment (P<0.01). The frequency of missed canals was highest in maxillary molars, with 55.23% (58/105), with 96.55% presenting AP. The second mesiobuccal canal wasthe most frequently missed canal, 88.52%o(54/61), with AP in 90.74% (49/54) of the cases.
CONCLUSIÓN
There was a high frequency of teeth with missed canals and PA. More than half of the teeth with missed canals were maxillary molars, with MB2 being the most common canal, commonly presenting apical periodontitis.
Topics: Humans; Cross-Sectional Studies; Periapical Periodontitis; Colombia; Female; Male; Root Canal Therapy; Adult; Middle Aged; Cone-Beam Computed Tomography; Tooth, Nonvital; Dental Pulp Cavity; Young Adult; Quality of Health Care; Aged
PubMed: 38920127
DOI: 10.54589/aol.37/1/59 -
Case Reports in Dentistry 2024Managing dental care in children with special health care needs poses distinct challenges. This case report explores these challenges within the context of a 9-year-old...
BACKGROUND
Managing dental care in children with special health care needs poses distinct challenges. This case report explores these challenges within the context of a 9-year-old boy with Down syndrome (DS) facing dental treatment refusal. Over ten months and 13 visits, a tailored approach was devised for the patient who presented with multiple cavities and retained primary teeth. Key strategies included gradually introducing dental procedures, including tooth brushing, intraoral examination, tooth preparation, extraction, and myofunctional therapy. Behaviour guidance techniques include tell-show-do, desensitization, positive reinforcement, and close collaboration between dental professionals and the patient's mother. This methodical approach helped overcome the child's initial refusal without sedation or general anaesthesia, facilitating successful dental care.
CONCLUSION
This case emphasizes the effectiveness of patient-centred strategies and detailed communication in pediatric dentistry for children with DS, providing valuable insights for managing similar challenges in dental care.
PubMed: 38919976
DOI: 10.1155/2024/2966972 -
Journal of Dermatology and Dermatitis Oct 2023To qualitatively assess surgeons' decision making for lip surgery in patients with cleft lip/palate (CL/P).
OBJECTIVE
To qualitatively assess surgeons' decision making for lip surgery in patients with cleft lip/palate (CL/P).
DESIGN
Prospective, non-randomized, clinical trial.
SETTING
Clinical data institutional laboratory setting.
PATIENTS PARTICIPANTS
The study included both patient and surgeon participants recruited from four craniofacial centers. The patient participants were babies with a CL/P requiring primary lip repair surgery (n=16) and adolescents with repaired CL/P who may require secondary lip revision surgery (n=32). The surgeon participants (n=8) were experienced in cleft care. Facial imaging data that included 2D images, 3D images, videos, and objective 3D visual modelling of facial movements were collected from each patient, and compiled as a collage termed the 'Standardized Assessment for Facial Surgery (SAFS)' for systematic viewing by the surgeons.
INTERVENTIONS
The SAFS served as the intervention. Each surgeon viewed the SAFS for six distinct patients (two babies and four adolescents) and provided a list of surgical problems and goals. Then an in-depth-interview (IDI) was conducted with each surgeon to explore their decision-making processes. IDIs were conducted either 'in person' or virtually, recorded, and then transcribed for qualitative statistical analyses using the Grounded Theory Method.
RESULTS
Rich narratives/themes emerged that included timing of the surgery; risks/limitations and benefits of surgery; patient/family goals; planning for muscle repair and scarring; multiplicity of surgeries and their impact; and availability of resources. In general, there was surgeon agreement for the diagnoses/treatments.
CONCLUSIONS
The themes provided important information to populate a checklist of considerations to serve as a guide for clinicians.
PubMed: 38919736
DOI: 10.31579/2578-8949/115 -
Cureus May 2024Several approaches have been suggested for implant removal. However, further research is necessary to review data regarding the amount of bone removed and the duration...
PURPOSE
Several approaches have been suggested for implant removal. However, further research is necessary to review data regarding the amount of bone removed and the duration of removal time for different procedures. This study evaluates and compares various implant removal techniques. Materials and methods: A polyurethane block was scanned to create an implant surgical guide. Afterward, implant-guided surgery was performed on 60 simulated bone blocks. The implants were then separated into four groups and removed utilizing the counter-torque ratchet, trephine drills, burs, and piezosurgery.
RESULTS
For the weight of bone loss, there were significant differences in the median between the counter-torque ratchet technique (CTRT) and trephine (p < 0.01), CTRT and bur (p < 0.01), trephine and piezo (p < 0.01), and bur and piezo (p = 0.04). All groups, except CTRT and the piezo group, demonstrated a statistically significant difference (p < 0.01) in the procedure durations. Regarding the volume of bone loss, a statistically significant difference (p < 0.01) was found between each group. Conclusions: CTRT showed the least amount of bone loss. On the other hand, the trephine technique was demonstrated to be the fastest. It is essential to consider the limitations and risks when choosing the approach for implant removal.
PubMed: 38919230
DOI: 10.7759/cureus.61104 -
International Journal of Surgery Case... Jun 2024Vitamin B12 deficiency can manifest through various oral manifestations such as glossitis, glossodynia, recurrent ulcers, cheilitis, dysgeusia, lingual paresthesia,...
INTRODUCTION AND IMPORTANCE
Vitamin B12 deficiency can manifest through various oral manifestations such as glossitis, glossodynia, recurrent ulcers, cheilitis, dysgeusia, lingual paresthesia, burning sensations, and pruritus. These oral signs can serve as early indicators of systemic conditions such pernicious anemia.
CASE PRESENTATION
A 67 year old northern African female presented at the oral surgery service with complaints of a sore mouth and difficulty eating certain types of food. Her medical history revealed hypothyroidism and no history of gastrectomy. She was diagnosed with pernicious anemia in 2014 and is under hydroxocobalamin injection 5000μg/month since then. Dental history indicated extraction of all teeth, and in 2014, the patient was diagnosed with oral lichen planus. There were no contributory oral habits. Intraoral examination revealed a band like erythematous lesion on the palate with two superficial ulcerations, diagnosed as related to her pernicious anemia. The patient was prescribed a mouthwash containing sodium bicarbonate and corticosteroid to reduce inflammation and alleviate pain. A low level laser therapy was also considered to reduce the burning sensations.
CLINICAL DISCUSSION
Pernicious anemia (PA) is an autoimmune disease characterized by the gradual atrophy of the gastric mucosa, predominantly affecting the body and fundus of the stomach, leading to vitamin B12 deficiency. Its insidious onset often masks its presence. Patients have no anemic symptoms. However, they can present with oral manifestations related to vitamin B12 deficiency. Those oral signs can precede hematological symptoms helping in early diagnosis of PA.
CONCLUSION
Dentists and other oral health care providers must be aware of this condition and its oral manifestations. Investigating vitamin B12 levels should be considered in patients presenting with oral ulcers, oral erythema or burning sensations without an apparent origin.
PubMed: 38917702
DOI: 10.1016/j.ijscr.2024.109931 -
Advances in Clinical and Experimental... Jun 2024The number and diversity of published peer-reviewed studies in the discipline of laser dentistry have grown considerably during the past 10 years.
BACKGROUND
The number and diversity of published peer-reviewed studies in the discipline of laser dentistry have grown considerably during the past 10 years.
OBJECTIVES
Within primary research, the development of protocols to guide and formulate clinical practice demands precision and ease of reproducibility. Errors in data acquisition and management may become amplified as the applied randomized clinical trials (RCTs) forge new levels of clinical diversity and predictability in the use of laser photonic energy in both ablative (surgical) and sub-ablative (photobiomodulation (PBM) or photodynamic therapy (PDT)) applications.
MATERIAL AND METHODS
A comprehensive range of empirical and computational operating parameters must be included in published studies to facilitate the uniformity of powerand time-related values of laser irradiation.
RESULTS
Choosing the correct "tissue irradiation parameters" is difficult and depends on the pathology and symptoms, the surface area to be treated, laser wavelength, the thermal relaxation time of each targeted tissue, and controlling penetration depth of the light into tissues. Therefore, to allow the reproducibility of the results, it is recommended that authors mention with the greatest care and clarity the irradiation parameters used in their study.
CONCLUSION
This paper outlines the concerns felt regarding the general shortfalls and proposes a minimum range of laser operating parameters that should be represented in future peer-reviewed publications.
Topics: Humans; Laser Therapy; Lasers; Reproducibility of Results
PubMed: 38917320
DOI: 10.17219/acem/189795 -
PloS One 2024Periodontitis is a highly prevalent complication of diabetes. However, the association between cystic fibrosis-related diabetes (CFRD) and periodontitis has not yet been...
OBJECTIVES
Periodontitis is a highly prevalent complication of diabetes. However, the association between cystic fibrosis-related diabetes (CFRD) and periodontitis has not yet been evaluated. The objective of this study was to assess if: 1) CFRD is associated with periodontitis among adults with CF, and 2) periodontitis prevalence differs by CF and diabetes status.
METHODS
This was a pilot cross-sectional study of the association between CFRD and periodontitis in adults with cystic fibrosis (CF) (N = 32). Historical non-CF controls (N = 57) from the U.S. National Health and Nutrition Examination Survey (NHANES) dataset were frequency matched to participants with CF on age, sex, diabetes status, and insulin use. We defined periodontitis using the U.S. Centers for Disease Control and Prevention and the American Academy of Periodontology (CDC/AAP) case definition, as the presence of two or more interproximal sites with CAL ≥3 mm and two or more interproximal sites with PD ≥4 mm (not on the same tooth) or one site with PD ≥5 mm. Because NHANES periodontal data were only available for adults ages ≥30 years, our analysis that included non-CF controls focused on this age group (CF N = 19, non-CF N = 57). Based on CF and diabetes status, we formed four groups: CFRD, CF and no diabetes, non-CF with diabetes, and non-CF and no diabetes (healthy). We used the Fisher's exact test for hypotheses testing.
RESULTS
There was no association between CFRD and periodontitis for participants with CF ages 22-63 years (CFRD 67% vs. CF no diabetes 53%, P = 0.49), this was also true for those ages ≥30 years (CFRD 78% vs. CF no diabetes 60%, P = 0.63). For the two CF groups, the prevalence of periodontitis was significantly higher than for healthy controls (CFRD 78% vs. healthy 7%, P<0.001; CF no diabetes 60% vs. healthy 7%, P = 0.001) and not significantly different than the prevalence for non-CF controls with diabetes (CFRD 78% vs. non-CF with diabetes 56%, P = 0.43; CF no diabetes 60% vs. non-CF with diabetes 56%, P = 0.99).
CONCLUSION
Among participants with CF, CFRD was not associated with periodontitis. However, regardless of diabetes status, participants with CF had increased prevalence of periodontitis compared to healthy controls.
Topics: Humans; Cross-Sectional Studies; Periodontitis; Male; Adult; Cystic Fibrosis; Female; Pilot Projects; Diabetes Mellitus; Prevalence; Middle Aged; Diabetes Complications; Young Adult
PubMed: 38917148
DOI: 10.1371/journal.pone.0305975 -
PloS One 2024Diversity, equity, and inclusion (DEI) mission statements continue to be adopted by academic institutions in general, and by dental schools around the globe in...
Diversity, equity, and inclusion (DEI) mission statements continue to be adopted by academic institutions in general, and by dental schools around the globe in particular. But DEI content seems to be under-developed in dental education. The objectives of this study were two-fold: to extract information from all the PBL cases at University of British Columbia's Faculty of Dentistry curriculum in terms of the diversity, equitable representation, and inclusion of patient and provider characteristics, context, and treatment outcomes; and; to compare these findings with the composition of the British Columbia census population, dental practice contextual factors, and the evidence on treatment outcomes within patient care. Information from all the 58 PBL cases was extracted between January and March 2023, focusing on patient and provider characteristics (e.g., age, gender, ethnicity), context (e.g., type of insurance), and treatment outcomes (e.g., successful/unsuccessful). This information was compared with the available literature. From all the 58 PBL cases, 0.4% included non-straight patients, while at least 4% of BC residents self-identify as non-straight; there were no cases involving First Nations patients although they make up 6% of the British Columbia population. Less than 10% of the cases involved older adults who make up almost 20% of the population. Only Treatments involving patients without a disability were 5.74 times more likely to be successful compared to those involving patients with a disability (p<0.05). The characteristics of the patients, practice context, and treatment outcomes portrayed in the existing PBL cases seem to differ from what is known about the composition of the British Columbia population, treatment outcome success, and practice context; a curriculum disconnect seems to exist. The PBL cases should be revised to better represent the population within which most students will practice.
Topics: Humans; Curriculum; Problem-Based Learning; British Columbia; Male; Female; Cultural Diversity; Education, Dental; Adult
PubMed: 38917078
DOI: 10.1371/journal.pone.0298843 -
International Journal of... Apr 2024Tuberculosis (TB) affecting the head-and-neck area can often resemble cancer, leading to misdiagnosis and delayed treatment. A better understanding of this condition is...
INTRODUCTION
Tuberculosis (TB) affecting the head-and-neck area can often resemble cancer, leading to misdiagnosis and delayed treatment. A better understanding of this condition is necessary for early diagnosis and prompt treatment initiation. This study examines the clinical and pathological characteristics of different types of TB in the head-and-neck region.
METHODS
This retrospective study analyzed patients diagnosed with TB in the head-and-neck region at a health center between January 1, 2018, and January 1, 2024. The study population consisted of patients who were diagnosed with TB of the head and neck.
RESULTS
The study analyzed data from 30 patients, comprising 14 (47%) males and 16 (53%) females, all of whom tested negative for HIV. Most cases (15, 50%) were observed in the age group of 15-24 years, with 5 (15.6%) subjects falling in the age bracket of 0-14 years. Among the types of lesions detected, cervical tubercular adenitis was the most frequently observed lesion, found in 22 (73%) subjects. Females are more susceptible to cervical tubercular adenitis, while males are more likely to experience laryngeal TB.
CONCLUSION
The clinical manifestation of TB affecting the head-and-neck region can exhibit a diverse range of symptoms, which may lead to misinterpretation and diagnostic errors. Therefore, health-care practitioners must understand and include the condition in differential diagnoses.
Topics: Humans; Male; Female; Retrospective Studies; Adolescent; Adult; Young Adult; Child; Child, Preschool; Infant; Middle Aged; Neck; Tuberculosis, Lymph Node; Tuberculosis; Head; Tuberculosis, Laryngeal; Aged; Infant, Newborn
PubMed: 38916384
DOI: 10.4103/ijmy.ijmy_89_24 -
Cureus May 2024A 48-year-old female with no significant past medical history presented to the emergency department with an uncommon scenario after accidentally ingesting a three-unit...
A 48-year-old female with no significant past medical history presented to the emergency department with an uncommon scenario after accidentally ingesting a three-unit dental bridge, leading to its impaction within the lower gastrointestinal tract. Despite initial conservative management with laxatives aimed at facilitating spontaneous passage, the foreign body remained lodged in the colon. Subsequently, the patient underwent endoscopic intervention via colonoscopy, during which the dental bridge was successfully extracted. This case highlights the complexity of managing foreign body ingestions, particularly when impaction occurs in uncommon locations, such as the colon. We emphasize the importance of individualized care strategies and recognize the potential of endoscopic procedures in resolving clinical scenarios involving foreign body ingestions.
PubMed: 38915983
DOI: 10.7759/cureus.61023