Asteria Monika, Helga Anindyastika Maranantan, Yogi Premadhika
et al.
Objectives: In root canal treatment, final root canal irrigation plays an essential role in removing smear layers, especially inorganic components, in order to achieve hermetic obturation of the root canal system. This study aimed to evaluate the root canal cleanliness, sealer penetration, and apical sealing ability of the root canal system following final irrigation using chelating agents, namely nano-chitosan, which was compared to EDTA and novel silver citrate (NSC).
Methods: This study used 135 premolars, which were divided into three evaluations: root canal cleanliness, sealer penetration, and apical sealing ability. Teeth were assigned into three groups. Group 1: EDTA, group 2: NSC, and group 3: nano-chitosan. Scanning Electron Microscope (SEM) was used to evaluate root canal cleanliness and apical sealing ability. A stereo microscope was utilized to evaluate sealer penetration. The root canal cleanliness data were analysed using the Chi-Square test, whereas sealer penetration and apical sealing ability data were analysed with a two-way ANOVA and LSD Post-Hoc test with a significance level of 95%.
Results: In the root canal cleanliness evaluation, all three final irrigation solutions showed similar cleanliness of the root canals (p>0.05). In the evaluation of sealer penetration and apical sealing ability, nano-chitosan produced the highest sealer penetration and apical sealing ability compared to EDTA and NSC (p<0.05).
Conclusion: All final irrigations produced the same root canal cleanliness; however, nano-chitosan final irrigation solution generated the longest sealer penetration and the greatest apical sealing ability than EDTA and NSC. (EEJ-2024-12-188)
Aim or purpose: High-quality Electronic Medical Records (EMRs) are crucial for digital dentistry data analysis and applications. Manual EMR quality assessment is resource-intensive and inconsistent, limiting data utility. Automated methods are needed for efficient data integrity. This study evaluated a Large Language Model (LLM) automating quality assessment for outpatient dental EMRs based on group standards. Materials and methods: 100 typical outpatient dental EMRs collected from February to December 2024 in hospital with known errors, manually de-identified, were randomly split into training (80) and testing (20) sets. Records were annotated by 3 senior quality control experts, providing the reference standard. The DeepSeek-r1 model assessed record quality based on group standard criteria, using evaluation prompts iteratively refined on the training set via expert feedback. Performance on the testing set was compared against the expert consensus reference using metrics including Cohen's Kappa for agreement, precision, recall, and F1-score (p<0.05). Evaluation time was also compared. Results: On the testing set, the LLM achieved 98.0% recall, 100% precision, and an F1-score of 0.990 for identifying annotated quality deficiencies. The LLM demonstrated strong alignment with expert consensus on the test set. Furthermore, automated assessment significantly reduced evaluation time per record compared to manual review. Conclusions: LLMs show significant promise as effective, efficient tools for automated dental EMR quality assessment. This technology can enhance data quality within digital dentistry workflows, improving applications such as clinical research and practice analytics, supporting digital transformation in dentistry.
Melanie Nasseripour, Ana Angelova Volponi, Susha Rajadurai
et al.
This paper describes some of the lessons learned during the COVID-19 pandemic from a study conducted with a group of clinical teachers and undergraduate dental students at the Faculty of Dentistry, Oral & Craniofacial Sciences (FoDOCS) at King's College London about the use of a combination of remote, online and in-person teaching methods that resumed from June 2020. In the narrative research, participants shared their experiences delivering online clinical workshops and their previous experiences delivering face-to-face sessions online, both during and before the pandemic. We conducted remote interviews with the participants via video conferencing, which were recorded, transcribed, and analysed using thematic analysis. Narrative accounts revealed commonalities organised into seven themes, highlighting some of the challenges encountered during the pandemic and providing insights into addressing different curricular constraints and concerns when utilising various delivery modes during emergency situations, such as pandemics. In our study, we concluded that students and teachers benefit from dissociating clinical learning from clinical treatment sessions to focus on the educational intent and content before applying them chairside with patients. Throughout the course, students and teachers were challenged by a lack of engagement. In addition, it is important to examine the online fatigue highlighted by both students and teachers and identify ways to improve time, literacy, and facilitation to create a more conducive learning environment.
Mawia Karkoutly, Amirah Alnour, Jamal Alabdullah
et al.
Abstract This study aimed to evaluate the histological success of pulpotomy in primary molars using white mineral trioxide aggregate (WMTA) mixed with 2.25% sodium hypochlorite (NaOCl) gel and to evaluate in vitro its physical and chemical properties. The study had a clinical stage and an in-vitro stage. The clinical study was conducted with 24 patients aged 8–10 years. It was a randomized controlled trial to perform a histologic evaluation of pulp response following pulpotomy. Primary first molars were randomly assigned in split mouth model to control group—WMTA + distilled water (DW) or experimental group – WMTA + NaOCl gel. Teeth were extracted after 7, 30 or 90 days and submitted to histological analysis. The second stage was an in-vitro study to evaluate the physical and chemical properties of the two materials tested. SEM and EDX analyses and pH level evaluations were performed after 24 h and 28 days. The histological findings revealed that while WMTA + NaOCl gel group showed better odontoblastic integrity (P < 0.05), WMTA + DW group had more favorable outcomes in dentin bridge formation and pulp calcification (P < 0.05). Pulp tissue hemorrhage and pulp fibrosis were similar between them (P > 0.05). Regarding materials’ in vitro evaluation, the pH level indicated a higher initial pH for the WMTA + NaOCl gel group, which equalized after 28 days. SEM analysis initially showed a less homogeneous surface for WMTA + NaOCl gel, but it became similar after 28 days. EDX analysis indicated higher calcium and silicon percentages in the WMTA + NaOCl gel group initially, which increased in both groups after 28 days. Adding 2.25% NaOCl gel to WMTA enhanced odontoblastic integrity in both the short and medium term. In addition, it had a similar chemical composition, surface morphology, and alkalinity when compared to WMTA + DW mixture.
Palang Chotsiri, Almahamoudou Mahamar, Halimatou Diawara
et al.
Abstract Background Primaquine (PQ) is the prototype 8-aminoquinoline drug, a class which targets gametocytes and hypnozoites. The World Health Organization (WHO) recommends adding a single low dose of primaquine to the standard artemisinin-based combination therapy (ACT) in order to block malaria transmission in regions with low malaria transmission. However, the haemolytic toxicity is a major adverse outcome of primaquine in glucose-6-phosphate dehydrogenase (G6PD)-deficient subjects. This study aimed to characterize the pharmacokinetic properties of primaquine and its major metabolites in G6PD-deficient subjects. Methods A single low-dose of primaquine (0.4–0.5 mg/kg) was administered in twenty-eight African males. Venous and capillary plasma were sampled up to 24 h after the drug administration. Haemoglobin levels were observed up to 28 days after drug administration. Only PQ, carboxy-primaquine (CPQ), and primaquine carbamoyl-glucuronide (PQCG) were present in plasma samples and measured using liquid chromatography mass spectrometry. Drug and metabolites’ pharmacokinetic properties were investigated using nonlinear mixed-effects modelling. Results Population pharmacokinetic properties of PQ, CPQ, and PQCG can be described by one-compartment disposition kinetics with a transit-absorption model. Body weight was implemented as an allometric function on the clearance and volume parameters for all compounds. None of the covariates significantly affected the pharmacokinetic parameters. No significant correlations were detected between the exposures of the measured compounds and the change in haemoglobin or methaemoglobin levels. There was no significant haemoglobin drop in the G6PD-deficient patients after administration of a single low dose of PQ. Conclusions A single low-dose of PQ was haematologically safe in this population of G6PD-normal and G6PD-deficient African males without malaria. Trial registration NCT02535767
Arctic medicine. Tropical medicine, Infectious and parasitic diseases
Abstract Background Periodontitis is the most common oral disease and is closely related to immune infiltration in the periodontal microenvironment and its poor prognosis is related to the complex immune response. The progression of periodontitis is closely related to necroptosis, but there is still no systematic study of long non-coding RNA (lncRNA) associated with necroptosis for diagnosis and treatment of periodontitis. Material and methods Transcriptome data and clinical data of periodontitis and healthy populations were obtained from the Gene Expression Omnibus (GEO) database, and necroptosis-related genes were obtained from previously published literature. FactoMineR package in R was used to perform principal component analysis (PCA) for obtaining the necroptosis-related lncRNAs. The core necroptosis-related lncRNAs were screened by the Linear Models for Microarray Data (limma) package in R, PCA principal component analysis and lasso algorithm. These lncRNAs were then used to construct a classifier for periodontitis with logistic regression. The receiver operating characteristic (ROC) curve was used to evaluate the sensitivity and specificity of the model. The CIBERSORT method and ssGSEA algorithm were used to estimate the immune infiltration and immune pathway activation of periodontitis. Spearman’s correlation analysis was used to further verify the correlation between core genes and periodontitis immune microenvironment. The expression level of core genes in human periodontal ligament cells (hPDLCs) was detected by RT-qPCR. Results A total of 10 core necroptosis-related lncRNAs (10-lncRNAs) were identified, including EPB41L4A-AS1, FAM30A, LINC01004, MALAT1, MIAT, OSER1-DT, PCOLCE-AS1, RNF144A-AS1, CARMN, and LINC00582. The classifier for periodontitis was successfully constructed. The Area Under the Curve (AUC) was 0.952, which suggested that the model had good predictive performance. The correlation analysis of 10-lncRNAs and periodontitis immune microenvironment showed that 10-lncRNAs had an impact on the immune infiltration of periodontitis. Notably, the RT-qPCR results showed that the expression level of the 10-lncRNAs obtained was consistent with the chip analysis results. Conclusions The 10-lncRNAs identified from the GEO dataset had a significant impact on the immune infiltration of periodontitis and the classifier based on 10-lncRNAs had good detection efficiency for periodontitis, which provided a new target for diagnosis and treatment of periodontitis.
A S M Ariful Islam, Nafisa Afroze, Md Shofikul Islam
et al.
Introduction: Orofacial clefts are the most common craniofacial birth defects, affecting a significant number of individuals worldwide. The alveolar cleft is a developmental defect that affects the alveolar process of the maxilla and is often associated with cleft lip and palate.
Methods: In this case report, we present the case of a 20-year-old female patient with alveolar cleft who underwent secondary alveolar cleft reconstruction using autologous iliac bone grafting. The aim of the procedure was to restore the function and form of the maxillary arch, facilitate ridge augmentation for further prosthetic rehabilitation, repair the nasal floor, and facilitate orthodontic treatment.
Results: The procedure was successful in achieving the desired outcomes, and the patient's occlusal relationship was improved. Additionally, the alar base symmetry was enhanced, and speech was improved.
Conclusion: Alveolar cleft reconstruction using autologous iliac bone grafting is a successful approach to treating alveolar clefts. The procedure can restore the form and function of the maxillary arch and facilitate further prosthetic rehabilitation and orthodontic treatment. The effectiveness of the procedure should be monitored closely to ensure optimal outcomes.
Update Dent. Coll. j: 2023; 13(1): 35-39
Objectives: The aim of this retrospective study was to evaluate the prevalence of pathologies associated with impacted third molars in relation to tooth position on cone-beam computed tomography images.
Material and Methods: In 348 cone-beam computed tomography images, the position of 640 impacted third molars (mesiodistal angulation, buccolingual inclination, impaction depth, and contact point localization) and the presence of pathologies (distal caries, external root resorption, marginal bone loss, and pathological follicular space) were evaluated. The data were analysed statistically with a significance level set at P < 0.05.
Results: Distal caries was mostly detected in relation to Class A (20.4%) and contact point at (12.5%) and above (10.5%) the cementoenamel junction (CEJ) (P = 0.000; P < 0.05). External root resorption and marginal bone loss were more common in mesioangular angulation (52.3% and 80.1%, respectively), Class C (53% and 73.8%, respectively), and contact point below the CEJ (53.2% and 73.3%, respectively) (P = 0.000; P < 0.05). Lingual inclination was identified as a new risk factor for associated pathologies (P < 0.05). Pathological follicular space was significantly more likely to occur in those with inverted angulation (100%) and absence of contact (31.5%) (P = 0.000 and P = 0.010, respectively; P < 0.05).
Conclusions: Pathologies arising in second molars in relation to impacted third molars are significantly associated with the three-dimensional position of impacted third molars, and watchful monitoring or prophylactic removal of impacted third molars should be considered, taking into account the relevant risk parameters for the related pathologies.
Jacopo Lanzetti, Federica Finotti, Maria Savarino
et al.
Background: In the literature, among oral health prevention programs dedicated to cancer patients, a wide heterogeneity is evident. The purpose of this work is to analyze the available scientific evidence for the treatment of head and neck cancer (HNC) patients undergoing resective surgery and radiotherapy and to draw up a diversified oral hygiene protocol during oncological therapy. Methods: PubMed was used as database. Studies published from 2017 to September 2022 were analyzed. Studies investigating the effectiveness of the preventive procedures carried out by the dental professionals in HNC patients undergoing postoperative adjuvant therapy have been taken into account. Results: The application of the search string on PubMed allowed the selection of 7184 articles. The systematic selection of articles led to the inclusion of 26 articles in this review, including 22 RCTs, 3 observational studies, and 1 controlled clinical study. Articles were divided according to the debated topic: the management of radiation-induced mucositis, xerostomia, the efficacy of an oral infection prevention protocol, and the prevention of radiation-induced caries. Conclusions: Dental hygienists are fundamental figures in the management of patients undergoing oncological surgery of the maxillofacial district. They help the patient prevent and manage the sequelae of oncological therapy, obtaining a clear improvement in the quality of life.
Summary: Here, we present a protocol for the selective differentiation of human pluripotent stem cells mimicking human developmental processes into expandable PRRX1+ limb-bud mesenchymal (ExpLBM) cells. This approach enables expansion through serial passage while maintaining capacity for chondrogenic differentiation.For complete details on the use and execution of this protocol, please refer to Yamada et al. (2021, 2022). : Publisher’s note: Undertaking any experimental protocol requires adherence to local institutional guidelines for laboratory safety and ethics.
Alicia Morales, Rafael Contador, Joel Bravo
et al.
Abstract Background The aim of this triple-blind placebo-controlled parallel-arm randomized clinical trial was to evaluate the clinical effects of Lactobacillus rhamnosus SP1 or azithromycin as an adjunct to scaling and root planing (SRP) in patients with stage III periodontitis. Methods Forty-seven systemically healthy participants with stage III periodontitis were recruited. Following SRP, the participants were randomly assigned to one of three treatment modalities; (1) placebo (n = 15), (2) probiotics (n = 16) and (3) antibiotics-azithromycin (n = 16). The participants were monitored at baseline, 3, 6, 9 and 12 months after therapy. Probing pocket depth (PPD), bleeding on probing (BOP), clinical attachment loss (CAL) and plaque accumulation (PI) were evaluated. Results All 47 participants completed the study. At 12 months, all groups showed significant improvements of PPD and PI (p < 0.012) irrespective of the treatment modality and without significant differences between the groups. Probiotics and azithromycin showed no added benefit in terms of CAL. While the placebo (p = 0.002) and the antibiotic-azithromycin (p = 0.002) group showed a significant reduction of BOP, only the placebo group revealed a significant reduction of CAL at 12 months follow-up (p = 0.003). The number of sites and teeth with PPD ≥ 5, ≥ 6 and ≥ 7 mm were significantly reduced in all groups at 12 months follow-up (p < 0.025) irrespective of the treatment regime and without significant differences between the groups. Conclusion The use of probiotics or azithromycin as an adjunct to SRP failed to provide additional benefits in the treatment of stage III periodontitis. The benefits of these two treatment regimes as an adjunct to SRP remain unclear. Trial registration NCT02839408, 10/28/2017, Clinicaltrial.gov.
Kristina Bertl, Pia Edlund Johansson, Andreas Stavropoulos
Abstract Objectives To assess patients' opinion on the use of 2 generations of power‐driven water flossers and their impact on gingival inflammation. Material & Methods In the present prospective cohort study 24 periodontitis patients under regular supportive periodontal therapy used daily 2 generations of a power‐driven water flosser (Sonicare AirFloss [SAF] and Sonicare AirFloss Ultra [SAFU]) for 12 weeks each. Patients were instructed to position the nozzle interproximally from the buccal aspect at each interproximal space. Patients' opinion was assessed by a questionnaire and interproximal bleeding on probing (BoP) was recorded. Results Overall satisfaction with SAF/SAFU was rated high, by about 80% of the patients. About 66% of the patients preferred SAF/SAFU compared to their previous interdental cleaning device and indicated that they would continue using SAF/SAFU after the study; none of the patients reported any discomfort or pain. Compared to only tooth brushing, daily use of SAF/SAFU caused a significant reduction of interproximal BoP values, which were well maintained over 6 months; that is, BoP at interproximal buccal and oral sites (pooled), as well as at interproximal buccal and oral sites separately, was proportionately reduced by 29.1%, 41.2%, and 24.8%, respectively (pooled: p = 0.027; buccal sites: p = 0.030; oral sites: p = 0.030). Conclusion Patients were very fond of the power‐driven water flossers tested herein, and daily use of the devices for 6 months (i.e., each device was used for 3 months) resulted in a significant reduction of gingival inflammation interproximally.
Brianna Poirier, Joanne Hedges, Lisa Smithers
et al.
Abstract Background During the 1970s, optimal oral health was experienced more frequently amongst Indigenous children in Australia than their non-Indigenous counterparts. As a result of public health interventions targeting oral disease, oral health has improved for most children; however, Indigenous children today experience oral disease at alarmingly high rates. A history of colonisation, assimilation, racism and cultural annihilation has had profound impacts on oral health for Indigenous peoples; compounded by environmental dispossession and a shift from traditional diets to one of processed and nutrient-poor foods, often high in sugar. Methods This project aimed to identify factors related to the increased occurrence of caries in Indigenous children. Using purposive sampling from the larger project, this paper thematically analyses 327 motivational interviews to explore current barriers impeding parental efforts to establish oral health and nutrition practices for Indigenous children. Representation of socioeconomic positions of families were compared across themes, as based on maternal age, employment, residency and number of children in care. Results Findings resulted in a conceptual model of barriers that exist across knowledge, social, structural and parental factors. Major thematic results include: social consumption of processed foods, busy households, misleading nutrition marketing, sugar cravings and lack of oral health and nutrition knowledge. Conclusion A discussion of the findings results in the following recommendations increased oral health promotion efforts in non-metropolitan areas; utilisation of community experiences in creating strategies that encourage oral health and nutrition knowledge; and the extension of oral health initiatives and future research to include all family members. Trial registration Australian New Zealand Clinical Trial Registry ACTRN12611000111976; registered 01/02/2011.
The proper choice of dental composite resins is necessary based on the minimal cytotoxicity and antiodontogenesis on human dental pulp stem cells for dental pulp-dentin tissue repair and regeneration. The aim of this study was to evaluate the cytotoxicity and antidifferentiation effects of dental bulk-fill resins, able to be polymerized as a bulk status for filling deep cavity of a tooth by single light curing, against human dental pulp stem cells (hDPSCs) from three compartments corresponding to depth (0-2, 2-4, and 4-6 mm) from the light-curing site. Three bulk-fill composite resins (SDR, Venus bulk-fill (VBF), and Beautifil Bulk Flowable (BBF)) and a conventional flowable composite resin (Filtek Z350 XT flowable restorative (ZFF)) were individually filled into a cylindrical hole (h=2 mm, Ф=10 mm), and three compartments (total ~6 mm of height) were combined as a single assembly for light curing. The resin samples from the three layers were separated and eluted in the culture medium. The extracts were exposed to hDPSCs, and cytotoxicity and differentiation capability were evaluated. Depth of cure and surface hardness according to depth were determined. All bulk-fill resins except BBF revealed cytotoxicity from 4 to 6 or 2 to 4 mm, while ZFF was cytotoxic at over 2 mm. Depth of cure was detected from 3.55 to 4.02 mm in the bulk-fill resins (vs. ~2.25 mm in conventional resin), and 80% hardness compared with that of a fully polymerized top surface was determined from 4.2 to 6 mm in the bulk-fill resin (vs. 2.4 mm in conventional resin). Antidifferentiation was revealed at a depth of 4-6 mm in the bulk-fill resin. There was a difference in depth of cytotoxicity and antidifferentiation between the bulk-fill composite resins, which was mainly due to different cure depths and ingredients. Therefore, careful consideration of choice of bulk-fill resins is necessary especially for restoration of deep cavities for maintaining the viability and differentiation ability of dental pulp stem cells.