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BMC Oral Health Jun 2024Disturbances in the oral mucosa is a major concern among patients undergoing chemotherapy. One of the most significant barriers in the implementation of oral care is the...
OBJECTIVE
Disturbances in the oral mucosa is a major concern among patients undergoing chemotherapy. One of the most significant barriers in the implementation of oral care is the lack of knowledge. The aim of the study was to assess gingival and periodontal health status of chemotherapy patients before and after the provision of oral hygiene instructions.
METHODS
A single group, pre-post test was conducted to assess oral health status of patients at the daycare chemotherapy, Aga Khan University Hospital, Karachi, Pakistan. Oral hygiene instructions were given with study models and leaflets. Patients were followed for 6-weeks. Oral health was assessed by using Simplified-Oral Hygiene Index (OHI-S) and Community Periodontal Index (CPI). Differences in indices were analyzed in STATA version-15.0 using Generalized Estimating Equation (GEE) and Wilcoxon Signed-rank test.
RESULTS
Out of 74, 53 (72%) patients completed study follow-up. Improvement in the OHI-S was found in 14 (26%) patients (p-value < 0.001). GEE showed that age [adjusted OR = 1.10; 95% CI: 1.03-1.11], current chemotherapy cycle [adjusted OR = 1.19; 95% CI: 0.98-1.46], highest education level [Adjusted OR = 1.37; 95% CI: 1.08-12.7] and cancer therapy [Adjusted OR = 0.12; 95% CI: 0.24-0.55] were significantly associated with the change in OHI-S. Wilcoxon signed-rank test showed positive changes in the CPI (p-value < 0.001).
CONCLUSIONS
Basic oral hygiene instructional intervention can be effective in improving the oral hygiene of chemotherapy patients. Nurses should also play a key role in providing psychological and nutritional support to patients.
Topics: Humans; Female; Male; Oral Health; Oral Hygiene; Adult; Middle Aged; Antineoplastic Agents; Periodontal Index; Tertiary Care Centers; Patient Education as Topic; Oral Hygiene Index; Age Factors; Follow-Up Studies; Pakistan; Young Adult; Neoplasms; Aged
PubMed: 38835001
DOI: 10.1186/s12903-024-04093-0 -
Clinical Oral Investigations Jun 2024Clinical trials testing new devices require prior training on dummies to minimize the "learning curve" for patients. Dentists were trained using a novel water jet device...
OBJECTIVES
Clinical trials testing new devices require prior training on dummies to minimize the "learning curve" for patients. Dentists were trained using a novel water jet device for mechanical cleaning of dental implants and with a novel cold plasma device for surface functionalisation during a simulated open flap peri-implantitis therapy. The hypothesis was that there would be a learning curve for both devices.
MATERIALS AND METHODS
11 dentists instrumented 44 implants in a dummy-fixed jaw model. The effect of the water jet treatment was assessed as stain removal and the effect of cold plasma treatment as surface wettability. Both results were analysed using photographs. To improve treatment skills, each dentist treated four implants and checked the results immediately after the treatment as feedback.
RESULTS
Water jet treatment significantly improved from the first to the second implant from 62.7% to 75.3% stain removal, with no further improvement up to the fourth implant. The wettability with cold plasma application reached immediately a high level at the first implant and was unchanged to the 4th implant (mean scores 2.7 out of 3).
CONCLUSION
A moderate learning curve was found for handling of the water jet but none for handling of the cold plasma.
CLINICAL RELEVANCE
Scientific rational for study: Two new devices were developed for peri-implantitis treatment (Dental water jet, cold plasma). Dentists were trained in the use of these devices prior to the trial to minimize learning effects.
PRINCIPAL FINDINGS
Experienced dentists learn the handling of the water jet very rapidly and for cold plasma they do not need much training.
PRACTICAL IMPLICATIONS
A clinical study is in process. When the planned clinical study will be finished, we will find out, if this dummy head exercise really minimised the learning curve for these devices.
Topics: Humans; Dental Implants; Plasma Gases; Decontamination; Water; Peri-Implantitis; Surface Properties; Wettability
PubMed: 38833072
DOI: 10.1007/s00784-024-05749-5 -
BMC Public Health Jun 2024During the pandemic, many police dentists had the crucial responsibility of ensuring law and order while providing dental care by taking government-approved health...
Fear of COVID-19 associated with burnout syndrome in dentists of the Health Directorate of the National Police of Peru: a cross-sectional study at national level under multivariable regression model.
BACKGROUND
During the pandemic, many police dentists had the crucial responsibility of ensuring law and order while providing dental care by taking government-approved health measures to stop the spread of the coronavirus. The aim of this study was to assess the association between the fear of COVID-19 and Burnout syndrome in Peruvian dentists belonging to the Health Department of the National Police of Peru (PNP), taking into account possible confounding variables.
METHODS
This cross-sectional and analytical study included 182 PNP dentists. The Fear COVID-19 Scale assessed fear of COVID-19 and the Maslach Burnout Inventory Test assessed burnout syndrome. The association between the fear of COVID-19 and Burnout syndrome (self-fulfilment) was analyzed using Spearman's Rho. A multivariable Poisson regression model with a robust variance estimation method was employed to evaluate the impact of fear of COVID-19 on the various dimensions of Burnout syndrome, considering possible confounding variables. The statistical significance level was set at p < 0.05.
RESULTS
Under bivariate analysis, fear of COVID-19 was significantly linked with low direct intensity toward emotional exhaustion (Rho = 0.325, p < 0.001), very low direct intensity toward depersonalization (Rho = 0.180, p = 0.015), and very low inverse intensity toward self-fulfilment (Rho =-0.186, p = 0.012). Under multivariable analysis, it was observed that dentists who exhibited fear of COVID-19 were 3.4 and 3.7 times more likely to experience emotional exhaustion and depersonalization, respectively (APR = 3.40, 95% CI: 1.74-6.63 and APR = 3.68, 95% CI: 1.31-10.37), as compared to those who did not display fear of COVID-19. Moreover, none of the potential confounding factors were found to have a significant impact on emotional exhaustion (p > 0.05), depersonalization (p > 0.05), and self-fulfilment (p > 0.05).
CONCLUSION
Fear of COVID-19 was significantly associated with emotional exhaustion and depersonalization, and inversely associated with self-fulfilment. PNP dentists who exhibited fear of COVID-19 were at greater risk for emotional exhaustion and depersonalization. In developing Burnout syndrome, no significant impact was observed from factors such as age, gender, marital status, children, hierarchy, years of service, work area, private practice, work over 40 h per week, type of service, work performed, sport practice and daily exercise time.
Topics: Humans; Cross-Sectional Studies; COVID-19; Burnout, Professional; Male; Female; Dentists; Adult; Peru; Police; Fear; Middle Aged; Surveys and Questionnaires
PubMed: 38831272
DOI: 10.1186/s12889-024-18979-9 -
Heliyon Jun 2024Dentists utilize various techniques and materials for post and core restoration of endodontically treated teeth, which remains a noteworthy health concern and can be...
BACKGROUND
Dentists utilize various techniques and materials for post and core restoration of endodontically treated teeth, which remains a noteworthy health concern and can be addressed through interdisciplinary strategies to enhance outcomes. Therefore, this study aimed to evaluate the technical quality of the residual gutta-percha (GP) and posts by analysing the periapical radiographs of endodontically restored teeth.
METHODS
A total of 594 periapical digital radiographs were evaluated for tooth type, post material, post shape, design, diameter, length, residual GP, GP length, GP tapering, GP homogeneity, and final restoration. Frequency distribution and cross-tabulation of the variables were performed.
RESULTS
Maxillary molars had the highest frequency of restorations, including posts, accounting for 27.4 %, followed by maxillary premolars (25.4 %) and maxillary anterior teeth (19.2 %). The prefabricated metallic posts were most commonly used (81.0 %), among these, 50.4 % were screwed posts. Tapered posts were the most commonly used (65.6 %). The percentage of posts with an acceptable length was 58.2 %. The most commonly used posts exhibited a width of one-third of the root diameter, accounting for 87.0 %. Suitable GP lengths were observed in 61.1 % of the restorations, and 62.8 % demonstrated adequate GP homogeneity. The findings of this study revealed that crown restoration accounted for 42.6 % of the studied sample.
CONCLUSIONS
The technical quality of the remaining GP after restoration was comparable to that of previous epidemiological investigations. However, the technical quality of the post was deemed suboptimal.
PubMed: 38828307
DOI: 10.1016/j.heliyon.2024.e31637 -
Journal of International Society of... 2024The success of composite restorations relies on material selection and practitioner-related factors that shape the overall outcome. This study explores the practices of...
AIM
The success of composite restorations relies on material selection and practitioner-related factors that shape the overall outcome. This study explores the practices of Palestinian general dental practitioners in placing posterior composites, examining the impact of work sector, experience, and gender on their choices.
MATERIALS AND METHODS
The study was conducted as an online cross-sectional questionnaire and involved 351 participants, with a response rate of 69.8%. The survey comprised 18 closed-ended questions covering demographics, material selection, and composite placement in special cases, techniques, and factors influencing the choices. Statistical analyses included descriptive statistics, chi-squared tests, and Fisher's exact tests.
RESULTS
Composite was the predominant choice for small-size (83.7%) and large-size posterior cavities (60.4%). Practitioners commonly opted for composite restorations in cases involving occlusal parafunctional activity (60%), poor oral hygiene (78%), and subgingival cavities (72.2%). Only 19.6% and 5.3% reported occlusal and gingival beveling, respectively. Rubber dams for isolation stood at 30%, one-step self-etch adhesives at 44.9%, and the oblique layering technique at 51%. Light-emitting diode curing units were popular (97.55%), but monitoring output with a radiometer was infrequent (93.5%). Tofflemire metal matrix usage was 46.1%, whereas a sectional matrix system was employed by 29.8%. A 2 mm layer exposure to light curing for 20 s was reported by 62%, and 27.75% utilized additional light-curing postmatrix band removal.
CONCLUSION
The study highlights the need for Palestinian dental professionals to update their clinical approaches in placing composite restorations in posterior teeth. Gender, work sector, and experience influence practitioners' choices, emphasizing the importance of tailored continuing education programs for improving clinical practices.
PubMed: 38827352
DOI: 10.4103/jispcd.jispcd_157_23 -
Journal of Migration and Health 2024The Global Strategy for Human Resources for Health 2030, requires member states to half their dependency on an international workforce by 2030. In order to design...
INTRODUCTION
The Global Strategy for Human Resources for Health 2030, requires member states to half their dependency on an international workforce by 2030. In order to design policies towards that goal, country-specific research on migration motivations of the health workforce is required. The United Kingdom (UK) is a net importer of health professionals and whilst there is a body of research on doctors' and nurses' migration, there is no research on the migration motivations of migrant dentists in the UK. This research explored the migration motivations of internationally qualified dentists (IQDs) in the UK and presents a typology to understand the global migration of dentists in the context of oral health workforce.
METHODS
The paper presents qualitative data from semi-structured interviews conducted between August 2014 and October 2017, of IQDs working in the United Kingdom. The topic guide for interviews was informed by the literature, with new themes added inductively. A phenomenological approach involving an epistemological stance of interpretivism, was used with framework analysis.
RESULTS
A total of 38 internationally qualified dentists ( = 18, = 20), migrating from the five World Health Organization regions, and working in general practice, NHS hospitals and in community dental services across the four nations of the UK were interviewed. Seven types of internationally qualified dentists were identified working in the UK. They were , and . The categories were based on their migration motivations, which were complex, multifactorial, and included personal, professional, national, and international drivers. The typology, based on their migration motivations, offered a structured, comprehensive understanding of the migrant dental workforce. This typology involving dentists provides additional dimensions to and migrants described in the context of other health professionals. The is a new category proposed as an extension to existing typology in health professional migration.
CONCLUSIONS
The typology of internationally qualified dentists has congruency with other health professionals' typology in categories previously described and demonstrates that each of these categories are complex, fluid and change in response to policy changes. The new category of along with oral health dimensions of and adds to the existing typology in health professional migration.
PubMed: 38826513
DOI: 10.1016/j.jmh.2024.100232 -
Patient Preference and Adherence 2024Pregnant women witness many changes in the body as well as in the oral cavity with many factors influencing these changes. This study evaluated the relationship between...
PURPOSE
Pregnant women witness many changes in the body as well as in the oral cavity with many factors influencing these changes. This study evaluated the relationship between oral health status, perceptions, and pregnancy outcomes.
METHODS
A cross sectional study design was implemented to recruit a convenience sample of women attending Obstetrics and gynecology department in public hospitals in East and capital city of Saudi Arabia. To collect data, a validated self-administered questionnaire in English and Arabic was used. The questionnaire covered background information, perceived oral health status, and dental visits.
RESULTS
About 64.4% of the 481 women recruited had dental problems, 49.7% reported deterioration in their oral health during pregnancy, and 17.5% reported adverse pregnancy outcomes. Only 40.7% of pregnant women rated their oral health as good, and only 22% visited a dentist during their pregnancy. Dentists were the most common source of oral health information (44.1%), followed by social media (38.9%). Dental problems during pregnancy were significantly associated with adverse outcomes (P=0.007). Oral health perceptions of pregnant women, not visiting the dentist during pregnancy, and gingival problems were also significantly associated with adverse pregnancy outcomes (P=0.001). Those with fair to poor oral health were twice as likely to experience adverse pregnancy outcome. Those who intended to visit the dentist during their pregnancy but did not do so, as well as those who did not visit the dentist at all were 12 and 9 times more likely to experience adverse pregnancy outcomes respectively.
CONCLUSION
Dental complaints during pregnancy, oral health perceptions, and a lack of dental visits were all linked to increased likelihood of adverse pregnancy outcomes. There is a need for interprofessional collaboration to dispel myths and encourage oral health care and regular dental visits during pregnancy.
PubMed: 38826504
DOI: 10.2147/PPA.S456721 -
International Heart Journal 2024Periodontitis is a common chronic infection and is associated with cardiovascular disease. This study evaluated whether basic oral care for periodontal disease could...
Periodontitis is a common chronic infection and is associated with cardiovascular disease. This study evaluated whether basic oral care for periodontal disease could improve endothelial function in patients with acute coronary syndrome (ACS).This study enrolled 54 patients with acute coronary syndrome admitted to Kagoshima City Hospital and who had undergone percutaneous coronary intervention. Flow-mediated endothelium-dependent dilatation (FMD) was measured before discharge (initial FMD) and at 8 months after percutaneous coronary intervention (follow-up FMD). The following periodontal characteristics were measured: periodontal pocket depth (PPD, mm), plaque control record (%), and bleeding on probing (%). All patients received basic oral care instructions from dentists. The oral health condition was generally poor in the participants and there were 24 patients (44.4%) who had severe PPD. Despite the intervention of basic oral care, the periodontal characteristics did not improve during the study period; initial FMD and follow-up FMD did not significantly differ (4.38 ± 2.74% versus 4.56 ± 2.51%, P = 0.562). However, the follow-up FMD was significantly lower in patients with severe PPD (≥ 6.0 mm, n = 24) than in patients without severe PPD (≤ 5.0 mm, n = 30) (FMD: 3.58 ± 1.91% versus 5.37 ± 2.67%, P = 0.007). FMD tended to be worse in patients with severe PPD than in patients without severe PPD (ΔFMD: -0.55 ± 2.12 versus 0.81 ± 2.77 %, P = 0.055). In conclusion, during the use of basic oral care, endothelial function improved in patients without severe PPD, while it worsened in patients with severe PPD.
Topics: Humans; Acute Coronary Syndrome; Male; Female; Endothelium, Vascular; Aged; Middle Aged; Percutaneous Coronary Intervention; Periodontitis; Oral Hygiene; Oral Health
PubMed: 38825489
DOI: 10.1536/ihj.23-553 -
Scientific Reports Jun 2024Most artificial intelligence (AI) studies have attempted to identify dental implant systems (DISs) while excluding low-quality and distorted dental radiographs, limiting...
Most artificial intelligence (AI) studies have attempted to identify dental implant systems (DISs) while excluding low-quality and distorted dental radiographs, limiting their actual clinical use. This study aimed to evaluate the effectiveness of an AI model, trained on a large and multi-center dataset, in identifying different types of DIS in low-quality and distorted dental radiographs. Based on the fine-tuned pre-trained ResNet-50 algorithm, 156,965 panoramic and periapical radiological images were used as training and validation datasets, and 530 low-quality and distorted images of four types (including those not perpendicular to the axis of the fixture, radiation overexposure, cut off the apex of the fixture, and containing foreign bodies) were used as test datasets. Moreover, the accuracy performance of low-quality and distorted DIS classification was compared using AI and five periodontists. Based on a test dataset, the performance evaluation of the AI model achieved accuracy, precision, recall, and F1 score metrics of 95.05%, 95.91%, 92.49%, and 94.17%, respectively. However, five periodontists performed the classification of nine types of DISs based on four different types of low-quality and distorted radiographs, achieving a mean overall accuracy of 37.2 ± 29.0%. Within the limitations of this study, AI demonstrated superior accuracy in identifying DIS from low-quality or distorted radiographs, outperforming dental professionals in classification tasks. However, for actual clinical application of AI, extensive standardization research on low-quality and distorted radiographic images is essential.
Topics: Humans; Dental Implants; Artificial Intelligence; Radiography, Dental; Algorithms; Radiography, Panoramic
PubMed: 38824187
DOI: 10.1038/s41598-024-63422-z -
Journal of Dentistry May 2024This study aimed to assess the reliability of AI-based system that assists the healthcare processes in the diagnosis of caries on intraoral radiographs.
OBJECTIVES
This study aimed to assess the reliability of AI-based system that assists the healthcare processes in the diagnosis of caries on intraoral radiographs.
METHODS
The proximal surfaces of the 323 selected teeth on the intraoral radiographs were evaluated by two independent observers using an AI-based (Diagnocat) system. The presence or absence of carious lesions was recorded during Phase 1. After 4 months, the AI-aided human observers evaluated the same radiographs (Phase 2), and the advanced convolutional neural network (CNN) reassessed the radiographic data (Phase 3). Subsequently, data reflecting human disagreements were excluded (Phase 4). For each phase, the Cohen and Fleiss kappa values, as well as the sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy of Diagnocat, were calculated.
RESULTS
During the four phases, the range of Cohen kappa values between the human observers and Diagnocat were κ=0.66-1, κ=0.58-0.7, and κ=0.49-0.7. The Fleiss kappa values were κ=0.57-0.8. The sensitivity, specificity and diagnostic accuracy values ranged between 0.51-0.76, 0.88-0.97 and 0.76-0.86, respectively.
CONCLUSIONS
The Diagnocat CNN supports the evaluation of intraoral radiographs for caries diagnosis, as determined by consensus between human and AI system observers.
CLINICAL SIGNIFICANCE
Our study may aid in the understanding of deep learning-based systems developed for dental imaging modalities for dentists and contribute to expanding the body of results in the field of AI-supported dental radiology..
PubMed: 38821394
DOI: 10.1016/j.jdent.2024.105105