Browsing by Subject "Dentistry"
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Item Accuracy of One-Piece vs. Segmented Three-Dimensional Printed Transfer Trays for Indirect Bracket Placement(MDPI, 2024-10-31) Alyammahi, Bayan; Khamis, Amar Hassan; Ghoneima, Ahmed; Orthodontics and Oral Facial Genetics, School of DentistryObjective: To assess the accuracy of three-dimensional (3D) printed one-piece vs. multiple segmented transfer trays for indirect bonding techniques in moderate and severe crowding cases. Methods: Eighty digital maxillary dental models were produced by an extraoral scanner. 3D-printed one-piece and segmented trays were virtually designed utilizing Maestro 3D Ortho Studio® v4 and printed using a NextDent printer. The sample was classified into two groups: Group 1 (moderate crowding) included 40 digital models with a space deficiency of 6-7 mm, and Group 2 (severe crowding) included 40 digital models with a space deficiency of 10 mm. Ortho classic brackets were then placed into the 3D printed models with the aid of the transfer trays, and the models with the final bracket positioning were scanned using iTero scanner. Four measurements were selected on each tooth to perform the analysis. Mann-Whitney and Kruskal-Wallis tests were used for comparisons. A p-value of ≤ 0.05 was considered statistically significant. Results: In the moderate crowding group, statistically significant differences were detected between the one-piece, segmented, and control groups for three measurements (p < 0.001), while the rest of the measurements showed no significant differences (p > 0.05). In the severe crowding group, no significant differences were detected for any of the measurements. Conclusions: One-piece and segmented 3D-printed transfer trays are considered accurate tools for indirect bonding in moderate and severe malocclusion cases. The severity of crowding did not affect the accuracy of bracket transfer in indirect bonding.Item Coronavirus disease 2019 (COVID-19): Experiences and protocols from the Department of Prosthodontics at the Wuhan University(Elsevier, 2020-07-10) Sa, Yue; Lin, Wei-Shao; Morton, Dean; Huang, Cui; Prosthodontics, School of DentistryStatement of problem: The novel Coronavirus Disease 2019 (COVID-19) is a global pandemic, and many countries and regions are still currently in the midst of the outbreak. This pandemic has caused prosthodontics units to suspend their clinical and educational operations in academia. Purpose: The purpose of this article was to review the experiences from the Department of Prosthodontics, Wuhan University School and Hospital of Stomatology (DP-WHUSHS) during the COVID-19 outbreak and the protocols DP-WHUSHS utilized to resume clinical activities after the outbreak. Material and methods: The descriptive approach was used in this article to provide a chronological narrative of the experiences and protocols from the DP-WHUSHS during the COVID-19 outbreak and after the outbreak. Results: During the COVID-19 outbreak period, clinical care was provided for patients with dental emergencies using enhanced Grade 2 or Garde 3 personal protective equipment (PPE). Teledentistry was used to provide care for patients with non-emergency needs. Online webinars and lectures were provided for the predoctoral students, residents, and dentists to minimize the interruption in their education and engage the dental community amid the pandemic. Various factors were considered before clinical activities resumed after the outbreak subsided. Additional resources were allocated for facility preparation and management and employee training. New infection control and clinical operation protocols were developed to minimize the healthcare-associated infection of airborne transmission diseases. The psychological health and mental wellness of the employees were emphasized. Distance or online education is still under rapid development to provide students and dentists opportunities to advance their knowledge amid the pandemic. Conclusions: Within the limitation of this descriptive review, the following conclusions were drawn. Patient welfare and emergency needs should be considered amid the pandemic. Enhanced Grade 2 or Grade 3 PPE should be used during the outbreak. Multifactorial considerations for work resumption after the outbreak included facility preparation and management, training for employees, and clinical operation management. In-person psychological consultation and online mental wellness programs were available to employees to improve their mental wellness. Distance or online education was under rapid development to minimize the interruption in education for the students and to engage the dental community amid a pandemic.Item COVID-19 and saliva: A primer for dental health care professionals(Wiley, 2020-08-23) Srinivasan, Mythily; Thyvalikakath, Thankam P.; Cook, Blaine N.; Zero, Domenick T.; Oral Pathology, Medicine and Radiology, School of DentistryTo contain the COVID‐19 pandemic, it is essential to find methods that can be used by a wide range of health care professionals to identify the virus. The less potential contagious nature of the collection process, the ease of collection and the convenience of frequent collection for real‐time monitoring makes saliva an excellent specimen for home‐based collection for epidemiological investigations. With respect to COVID‐19, the use of saliva offers the added advantages of greater sensitivity and potential for detection at an early stage of infection. However, the advantages from a diagnostic perspective also reflect the potential risk to dental professionals from saliva from infected patients. Although not validated in COVID‐19 patients, but by extension from studies of SARS‐CoV‐1 studies, it is suggested that using antimicrobial mouthrinses such as chlorhexidine, hydrogen peroxide or sodium hypochlorite solutions could reduce the viral load in saliva droplets and reduce the risk of direct transmission. Because large saliva droplets could deposit on inanimate surfaces, changing the personal protective equipment including the clinical gown, gloves, masks, protective eye wear and face shield between patients, as well as decontamination of the work surfaces in the clinic, could reduce the risk of indirect contact transmission.Item Dentin tubule occlusion by a 38% silver diamine fluoride gel: an in vitro investigation(Springer Nature, 2022) Kiesow, Andreas; Menzel, Matthias; Lippert, Frank; Tanzer, Jason M.; Milgrom, Peter; Cariology, Operative Dentistry and Dental Public Health, School of DentistryObjective: Silver diamine fluoride (SDF) is effective in treatment of dentin hypersensitivity and caries lesions. However, the non-viscous solution does not easily allow clinicians to control the application area. A 38% SDF experiment gel was compared in vitro to commercial SDF for its ability to penetrate and occlude dentinal tubules. Materials and methods: Human root surface dentin specimens were treated with gelled or standard 38% SDF or negative control. Penetration behavior was established by Drop Shape Analysis. Precipitates at the surface and within tubules were analyzed by SEM and EDX after treatment; Results: penetration depths up to 500 µm were observed for both SDF formulations. Both formulations occluded dentinal tubules similarly. Precipitates on the dentin surface and within dentinal tubules were found for both SDF formulations, with a slight tendency for the experimental gel SDF product to be more abundant than the commercially available one. Discussion: behavior of the experimental 38% SDF gel formulation appeared indistinguishable from the commercial 38% SDF product with respect to dentinal tubule penetration and occlusion. Conclusions: The experimental 38% SDF gel may be a suitable intervention for the prevention of dentin hypersensitivity.Item Dentists as Primary Care Providers: Expert Opinion on Predoctoral Competencies(Frontiers Media, 2021) Gordon, Sara C.; Kaste, Linda M.; Mouradian, Wendy E.; Beemsterboer, Phyllis L.; Berg, Joel H.; Murdoch-Kinch, Carol Anne; Oral Pathology, Medicine and Radiology, School of DentistryDentistry and medicine traditionally practice as separate professions despite sharing goals for optimal patient health. Many US residents experience both poor oral and general health, with difficulty accessing care. More efficient collaboration between these professions could enhance health. The COVID-19 pandemic disclosed further disparities while underscoring concerns that physician supply is inadequate for population needs. Hence, enhancing healthcare provider education to better meet the public's health needs is critical. The proposed titles “Oral Physician” or “Oral Health Primary Care Provider” (OP-PCP) acknowledge dentist's capacity to diagnose and manage diseases of the orofacial complex and provide some basic primary healthcare. The US Surgeon General's National Prevention Council and others recommend such models. Medical and dental education already overlap considerably, thus it is plausible that dental graduates could be trained as OP-PCPs to provide primary healthcare such as basic screening and preventive services within existing dental education standards. In 2018, 23 dental and medical educators participated in an expert-opinion elicitation process to review educational competencies for this model. They demonstrated consensus on educational expansion and agreed that the proposed OP-PCP model could work within existing US Commission on Dental Accreditation (CODA) standards for predoctoral education. However, there were broader opinions on scope of practice details. Existing CODA standards could allow interested dental programs to educate OP-PCPs as a highly-skilled workforce assisting with care of medically-complex patients and to helping to reduce health disparities. Next steps include broader stakeholder discussion of OC-PCP competencies and applied studies including patient outcome assessments.Item Dentists’ Information Needs and Opinions on Accessing Patient Information via Health Information Exchange: Survey Study(JMIR, 2024-01-11) Li, Shuning; Gomez, Grace Felix; Xu, Huiping; Rajapuri, Anushri Singh; Dixon, Brian E.; Thyvalikakath, Thankam; Biostatistics and Health Data Science, Richard M. Fairbanks School of Public HealthBackground: The integration of medical and dental records is gaining significance over the past 2 decades. However, few studies have evaluated the opinions of practicing dentists on patient medical histories. Questions remain on dentists' information needs; their perception of the reliability of patient-reported medical history; satisfaction with the available information and the methods to gather this information; and their attitudes to other options, such as a health information exchange (HIE) network, to collect patient medical history. Objective: This study aims to determine Indiana dentists' information needs regarding patients' medical information and their opinions about accessing it via an HIE. Methods: We administered a web-based survey to Indiana Dental Association members to assess their current medical information-retrieval approaches, the information critical for dental care, and their willingness to access or share information via an HIE. We used descriptive statistics to summarize survey results and multivariable regression to examine the associations between survey respondents' characteristics and responses. Results: Of the 161 respondents (161/2148, 7.5% response rate), 99.5% (n=160) respondents considered patients' medical histories essential to confirm no contraindications, including allergies or the need for antibiotic prophylaxis during dental care and other adverse drug events. The critical information required were medical conditions or diagnosis, current medications, and allergies, which were gathered from patient reports. Furthermore, 88.2% (n=142) of respondents considered patient-reported histories reliable; however, they experienced challenges obtaining information from patients and physicians. Additionally, 70.2% (n=113) of respondents, especially those who currently access an HIE or electronic health record, were willing to use an HIE to access or share their patient's information, and 91.3% (n=147) shared varying interests in such a service. However, usability, data accuracy, data safety, and cost are the driving factors in adopting an HIE. Conclusions: Patients' medical histories are essential for dentists to optimize dental care, especially for those with chronic conditions. In addition, most dentists are interested in using an HIE to access patient medical histories. The findings from this study can provide an alternative option for improving communications between dental and medical professionals and help the health information technology system or tool developers identify critical requirements for more user-friendly designs.Item Distal and Proximal Influences on Self-Reported Oral Pain and Self-Rated Oral Health Status in Saudi Arabia: Retrospective Study Using a 2017 Nationwide Database(JMIR, 2024-12-20) Abogazalah, Naif; Yiannoutsos, Constantin; Soto-Rojas, Armando E.; Bindayeld, Naif; Yepes, Juan F.; Martinez Mier, Esperanza Angeles; Biostatistics and Health Data Science, Richard M. Fairbanks School of Public HealthBackground: Oral health significantly influences overall well-being, health care costs, and quality of life. In Saudi Arabia, the burden of oral diseases, such as dental caries and periodontal disease, has increased over recent decades, driven by various lifestyle changes. Objective: To explore the associations between proximal (direct) and distal (indirect) influences that affect oral pain (OP) and self-rated oral health (SROH) status in the Kingdom of Saudi Arabia (KSA) using an adapted conceptual framework. Methods: This retrospective cross-sectional study used data from a national health survey conducted in KSA in 2017. The sample included adults (N=29,274), adolescents (N=9910), and children (N=11,653). Sociodemographic data, health characteristics, and access to oral health services were considered distal influences, while frequency and type of dental visits, tooth brushing frequency, smoking, and consumption of sweets and soft drinks were considered proximal influences. Path analysis modeling was used to estimate the direct, indirect, and total effects of proximal and distal influences on OP and SROH status. Results: The mean age of adult respondents was 42.2 years; adolescents, 20.4 years; and children, 10.58 years. Despite OP reports from 39% of children, 48.5% of adolescents, and 47.1% of adults, over 87% across all groups rated their oral health as good, very good, or excellent. A higher frequency of tooth brushing showed a strong inverse relationship with OP and a positive correlation with SROH (P<.001). Frequent dental visits were positively associated with OP and negatively with SROH (P<.001). Sweet consumption increased OP in adolescents (β=0.033, P=.007) and negatively affected SROH in children (β=-0.086, P<.001), adolescents (β=-0.079, P<.001), and adults (β=-0.068, P<.001). Soft drink consumption, however, was associated with lower OP in adolescents (β=-0.034, P=.005) and improved SROH in adolescents (β=0.063, P<.001) and adults (β=0.068, P<.001). Smoking increased OP in adults (β=0.030, P<.001). Distal influences like higher education were directly linked to better SROH (β=0.046, P=.003) and less OP (indirectly through tooth brushing, β=-0.004, P<.001). For children, high household income correlated with less OP (β=-0.030, P=.02), but indirectly increased OP through other pathways (β=0.024, P=.003). Lack of access was associated with negative oral health measures (P<.001). Conclusions: Among the KSA population, OP and SROH were directly influenced by many proximal and distal influences that had direct, indirect, or combined influences on OP and SROH status.Item Electrospun Azithromycin-Laden Gelatin Methacryloyl Fibers for Endodontic Infection Control(MDPI, 2022-11-09) Ayoub, Afzan A.; Mahmoud, Abdel H.; Ribeiro, Juliana S.; Daghrery, Arwa; Xu, Jinping; Fenno, J. Christopher; Schwendeman, Anna; Sasaki, Hajime; Dal-Fabbro, Renan; Bottino, Marco C.; Biomedical and Applied Sciences, School of DentistryThis study was aimed at engineering photocrosslinkable azithromycin (AZ)-laden gelatin methacryloyl fibers via electrospinning to serve as a localized and biodegradable drug delivery system for endodontic infection control. AZ at three distinct amounts was mixed with solubilized gelatin methacryloyl and the photoinitiator to obtain the following fibers: GelMA+5%AZ, GelMA+10%AZ, and GelMA+15%AZ. Fiber morphology, diameter, AZ incorporation, mechanical properties, degradation profile, and antimicrobial action against Aggregatibacter actinomycetemcomitans and Actinomyces naeslundii were also studied. In vitro compatibility with human-derived dental pulp stem cells and inflammatory response in vivo using a subcutaneous rat model were also determined. A bead-free fibrous microstructure with interconnected pores was observed for all groups. GelMA and GelMA+10%AZ had the highest fiber diameter means. The tensile strength of the GelMA-based fibers was reduced upon AZ addition. A similar pattern was observed for the degradation profile in vitro. GelMA+15%AZ fibers led to the highest bacterial inhibition. The presence of AZ, regardless of the concentration, did not pose significant toxicity. In vivo findings indicated higher blood vessel formation, mild inflammation, and mature and thick well-oriented collagen fibers interweaving with the engineered fibers. Altogether, AZ-laden photocrosslinkable GelMA fibers had adequate mechanical and degradation properties, with 15%AZ displaying significant antimicrobial activity without compromising biocompatibility.Item Embracing the Unprecedented Pace of Change: Artificial Intelligence's Impact on Dentistry and Beyond(Thieme, 2023) Turkkahraman, Hakan; Orthodontics and Oral Facial Genetics, School of DentistryItem Engineering of Injectable Antibiotic-laden Fibrous Microparticles Gelatin Methacryloyl Hydrogel for Endodontic Infection Ablation(MDPI, 2022-01-16) Ribeiro, Juliana S.; Münchow, Eliseu A.; Bordini, Ester A. F.; Rodrigues, Nathalie S.; Dubey, Nileshkumar; Sasaki, Hajime; Fenno, John C.; Schwendeman, Steven; Bottino, Marco C.; Biomedical and Applied Sciences, School of DentistryThis study aimed at engineering cytocompatible and injectable antibiotic-laden fibrous microparticles gelatin methacryloyl (GelMA) hydrogels for endodontic infection ablation. Clindamycin (CLIN) or metronidazole (MET) was added to a polymer solution and electrospun into fibrous mats, which were processed via cryomilling to obtain CLIN- or MET-laden fibrous microparticles. Then, GelMA was modified with CLIN- or MET-laden microparticles or by using equal amounts of each set of fibrous microparticles. Morphological characterization of electrospun fibers and cryomilled particles was performed via scanning electron microscopy (SEM). The experimental hydrogels were further examined for swelling, degradation, and toxicity to dental stem cells, as well as antimicrobial action against endodontic pathogens (agar diffusion) and biofilm inhibition, evaluated both quantitatively (CFU/mL) and qualitatively via confocal laser scanning microscopy (CLSM) and SEM. Data were analyzed using ANOVA and Tukey's test (α = 0.05). The modification of GelMA with antibiotic-laden fibrous microparticles increased the hydrogel swelling ratio and degradation rate. Cell viability was slightly reduced, although without any significant toxicity (cell viability > 50%). All hydrogels containing antibiotic-laden fibrous microparticles displayed antibiofilm effects, with the dentin substrate showing nearly complete elimination of viable bacteria. Altogether, our findings suggest that the engineered injectable antibiotic-laden fibrous microparticles hydrogels hold clinical prospects for endodontic infection ablation.