Exploring the practice of common oral diseases among the patients visiting in the selected dental college and hospital in Bangladesh

Background:Having the ability to identify potential health risk factors such as lifestyle,ethnicity,health status,and social determinants associated with oral health status risk,health care providers can take an active role in health screening to discover any need for clinical preventive services,including dental preventive services,and can detect health problems.Methods:A descriptive type of cross-sectional study was conducted to explore the practice of common oral diseases among the patients visiting in the selected dental college and hospital in Bangladesh from October 2019 to December 2019.About 100 patients were interviewed through a semi-structured questionnaire,followed by an oral examination through a checklist and a face-to-face interview.A systematically random sampling technique was employed to select the study population.Results:Among them,the(21-30)year age group shows a maximum 20%,whereas the(71-80)year age group represents the minority with only 2%.Among them,56%were male and 44%were female.Students represent the majority of 26%,whereas others(day laborers)represent only 4%.Decayed teeth remained in 72%of cases,teeth were missing in 31%of cases,and filled teeth were present in 24%of cases.A majority of 71%clean teeth once daily,whereas only 29%clean teeth twice daily.Again,only 30%brush teeth at night and a maximum of 95%brush teeth in the morning.Moreover,a maximum of 68%use toothpaste and brushes,while only 4%use meswak for cleaning their teeth.About 4%of cases with no debris,51%of cases with less than 1/3rd of the tooth with debris,32%of cases with 1/3rd-2/3rd of the tooth with debris,and 13%of cases with more than 2/3rd of the tooth with debris were present.Again,about 30%had no calculus,52%less than 1/3rd of tooth,16%in between 1/3rd and 2/3rd of tooth,and 2%more than 2/3rd of the calculus was present.About 47%of mild,22%of moderate,6%of severe and 25%had no inflammation.Furthermore,for treatment purposes,20.69%was advised for scaling,19.66%for filling,16.90%for root canal treatment,17.59%for extraction,17.24%for prosthodontic treatment,1.03%for orthodontic treatment,2.07%for pulpotomy,2.41%for pulpectomy,and 2.41%for minor surgery.Overall,about 72%of the respondents,mostly the students,are suffering from decayed teeth,which may be due to a lack of frequency of brushing,indicating 95%that it is once daily.In addition,the most alarming situation among them is about 20.69%required scaling,which may be due to improper and inadequate brushing maintenance.Conclusion:to some extent,the above scenario may reflect the negative hallmark for our country’s younger generation in terms of oral health practice.Therefore,the establishment of a preventive oral health policy by our policymakers for the general population,mostly school-going students,on an emergency basis.

Classification and detection of dental images using meta-learning

Meta-learning of dental X-rays is a machine learning technique that can be used to train models to perform new tasks quickly and with minimal input.Instead of just memorizing a task,this is accomplished through teaching a model how to learn.Algorithms for meta-learning are typically trained on a collection of training problems,each of which has a limited number of labelled instances.Multiple Xray classification tasks,including the detection of pneumonia,coronavirus disease 2019,and other disorders,have demonstrated the effectiveness of meta-learning.Meta-learning has the benefit of allowing models to be trained on dental X-ray datasets that are too few for more conventional machine learning methods.Due to the high cost and lengthy collection process associated with dental imaging datasets,this is significant for dental X-ray classification jobs.The ability to train models that are more resistant to fresh input is another benefit of meta-learning.

Magnification:The game changer in dentistry

During dental examinations and treatments,many dentists are using magni-fication to improve their vision.The dental operating microscope serves as the most effective tool for this purpose,enhancing the quality,longevity,and outcome of clinical work.This review will explore the latest research and data on the importance of magnification devices in dentistry,including diagnostic methods,treatment options and ergonomics in specialities such as restorative dentistry,endodontics,pedodontics,periodontics,and prosthodontics.This review aims to provide insights into the optimal magnification for different clinical situations,the specific benefits of dental operating microscopes for each dental branch,and their limitations.

Efficacy of antimicrobials in preventing resistance in solid organ transplant recipients:A systematic review of clinical trials

BACKGROUND In the absence of effective antimicrobials,transplant surgery is not viable,and antirejection immunosuppressants cannot be administered,as resistant infections compromise the life-saving goal of organ transplantation.AIM To evaluate the efficacy of antimicrobials in preventing resistance in solid organ transplant recipients.METHODS A systematic review was conducted using a search methodology consistent with the preferred reporting items for systematic reviews and meta-analyses.This review included randomized clinical trials that evaluated the efficacy of antimicrobial agents(prophylactic or therapeutic)aimed at preventing antimicrobial resistance.The search strategy involved analyzing multiple databases,including PubMed/MEDLINE,Web of Science,Embase,Scopus,and SciELO,as well as examining gray literature sources on Google Scholar.A comprehensive electronic database search was conducted from the databases’inception until May 2024,with no language restrictions.RESULTS After the final phase of the eligibility assessment,this systematic review ultimate-ly included 7 articles.A total of 2318 patients were studied.The most studied microorganisms were cytomegalovirus,although vancomycinresistant enterococci,Clostridioides difficile,and multidrug-resistant Enterobacterales were also analyzed.The antimicrobials used in the interventions were mainly maribavir,valganciclovir,gancic-lovir,and colistin-neomycin.Of concern,all clinical trials showed significant proportions of resistant microorga-nisms after the interventions,with no statistically significant differences between the groups(mean resistance 13.47%vs 14.39%),except for two studies that demonstrated greater efficacy of maribavir and valganciclovir(mean resistance 22.2%vs 41.1%in the control group;P<0.05).The total reported deaths in three clinical trials were 75,and there were 24 graft rejections in two studies.CONCLUSION All clinical trials reported significant proportions of antimicrobial-resistant microorganisms following interventions.More high-quality randomized clinical trials are needed to corroborate these results.

Immunohistochemical expression of matrix metalloproteinase-9 and 13 in oral squamous cell carcinoma and their role in predicting lymph node metastasis

BACKGROUND One of the main characteristics of oral squamous cell carcinoma(OSCC)is that it metastasizes to cervical lymph nodes frequently with a high degree of local invasiveness.A primary feature of malignant tumors is their penetration of neighboring tissues,such as lymphatic and blood arteries,due to the tumor cells'capacity to break down the extracellular matrix(ECM).Matrix metalloproteinases(MMPs)constitute a family of proteolytic enzymes that facilitate tissue remo-deling and the degradation of the ECM.MMP-9 and MMP-13 belong to the group of extracellular matrix degrading enzymes and their expression has been studied in OSCC because of their specific functions.MMP-13,a collagenase family member,is thought to play an essential role in the MMP activation cascade by breaking down the fibrillar collagens,whereas MMP-9 is thought to accelerate the growth of tumors.Elevated MMP-13 expression has been associated with tumor behavior and patient prognosis in a number of malignant cases.The authors wish to thank Jadhav KB for his valuable opinion during the preparation of the manuscript.

Relationship of Periodontal Status and Dental Caries Status with Oral Health Knowledge, Attitude and Behavior among Professional Students in India

Aim To find the relationship of periodontal status and dental caries status with oral health knowledge, attitude, behavior, among professional students in India. Methodology In a cross sectional study, a total of 825 students （males： 577, females： 248） fi＇om six professions were surveyed using a self administered structured questionnaire including 41 multiple choice questions and the WHO Oral Health Assessment Form （1997）. The data was analyzed using the SPSS version 13.0 to perform the Student＇s t-test, ANOVA test, Scheffe＇s test and Chi-square test, linear regression analysis. Results The mean percentage scores of the students for knowledge were 53.25 ±15.05; for attitude 74.97±20.48; and for behavior 59.09 ±18.77. The percentage of students with calculus score was found to be significantly high （43.8%）. The percentage of professional students with DMFT〉4 was 14.1% and the percentage of students with decayed teeth was 46.2%. The regression analysis showed that the oral health behavior of the students was dependent on the attitude （P〈0.001）, but showed no significant linear relation with the knowledge. Also, that the mean DMFT score was dependent on the oral health behavior （P〈0.05）, but showed no significant relationship with the knowledge and attitude of the students. The periodontal status was independent on the knowledge, but showed a significant relationship with attitude and behavior of the students. Conclusion A positive attitude and adherence to good oral hygiene behaviors is associated with better oral health.

Corrosion aspect of dental implants—An overview and literature review

The use of metals and their alloys in restorative and implant dentistry dates back to centuries. Titanium (Ti) is one of the most widely used biomaterial for medical implants because of its excellent mechanical properties and exceptional biocompatibility. The good biocompatibility of Ti is related to the thin oxide layer formed on Ti surface. TiO2 is inactive with the surrounding biological environment and quite compatible with living tissues. However, TiO2 layer can be destroyed during movements between implant and bone tissue under loading condition. The localized destruction causes corrosion of the implant, thus, weakening it;and can induce the leak of small metallic particles or ions into living tissues. This article highlights a review of the various aspects of corrosion and biocompatibility of dental titanium implants as well as suprastructures, and the methods to prevent it.

Accidental Entry of Foreign Body in Maxillary Sinus—A Case Report

Extraction of the first molar or premolar is the commonest cause of oro-antral fistula. Management involves identification of the same, removal of any foreign body from the maxillary sinus, if present, followed by appropriate flap for closer. A case is presented when a gutta percha (GP) point was accidentally dislodged into the right maxillary sinus during preliminary diagnosis of the oro-antral fistula. The surgical management of the case is described and is the appropriate treatment plan.

Knowledge,attitude and anxiety pertaining to basic life support and medical emergencies among dental interns in Mangalore City,India

BACKGROUND: This cross-sectional study aimed to assess the knowledge, attitude and anxiety pertaining to basic life support(BLS) and medical emergencies among interns in dental colleges of Mangalore city, Karnataka, India.METHODS: The study subjects comprised of interns who volunteered from the four dental colleges. The knowledge and attitude of interns were assessed using a 30-item questionnaire prepared based on the Basic Life Support Manual from American Heart Association and the anxiety of interns pertaining to BLS and medical emergencies were assessed using a State-Trait Anxiety Inventory(STAI) Questionnaire. Chi-square test was performed on SPSS 21.0(IBM Statistics, 2012) to determine statistically signifi cant differences(P<0.05) between assessed knowledge and anxiety.RESULTS: Out of 183 interns, 39.89% had below average knowledge. A total of 123(67.21%) reported unavailability of professional training. The majority(180, 98.36%) felt the urgent need of training in basic life support procedures. Assessment of stress showed a total of 27.1% participants to be above highstress level. Comparison of assessed knowledge and stress was found to be insignifi cant(P=0.983).CONCLUSION: There was an evident lack of knowledge pertaining to the management of medical emergencies among the interns. As oral health care providers moving out to the society, a focus should be placed on the training of dental interns with respect to Basic Life Support procedures.

Dental knowledge and awareness among grandparents

AIM: To investigate grandparent's knowledge and awareness about the oral health of their grandchildren. METHODS: Grandparents accompanying patients aged 4-8 years, who were living with their grandchildren and caring for them for a major part of the day, when both their parents were at work were included in the study. A 20-item questionnaire covering socio-demographic characteristics, dietary and oral hygiene practices was distributed to them. The sample comprised of 200 grandparents(59 males, 141 females). χ2 analysis and Gamma test of symmetrical measures were applied to assess responses across respondent gender and level of education.RESULTS: Oral health related awareness was found to be low among grandparents. In most questions asked, grandparents with a higher level of education exhibited a better knowledge about children's oral health. Level of awareness was not related to their gender. CONCLUSION: Oral hygiene and dietary habits are established during childhood. There is a great need for dental education of grandparents as they serve as role models for young children.

Comparison of skeletal, dental and soft tissue changes in young adults with Class II malocclusion, treated either by camouflage, fixed functional appliance or orthognathic surgery—A prospective study on Indian subjects

Introduction: Borderline Class II malocclusion due to deficient mandible can be treated either by orthodontic camouflage, fixed functional appliances or by orthodontics followed by surgical mandibular advancement. Methodology: A prospective study was designed on young adults with Class II malocclusion on account of a deficient mandible. A total of 45 subjects were divided into three groups of 15 individuals each. The patients were treated either by camouflage, fixed functional appliances or by orthognathic surgery. Pre and post treatment cephalograms were used to assess the skeletal, dental and soft tissue changes. Pre and post treatment profile photographs were assessed on a Visual Analogue Scale (VAS) by orthodontists, oral surgeons and laypersons. Results: Each group achieved a reduction in facial convexity, but the results obtained from the surgical group were more pronounced than the camouflage and the fixed functional group. Conclusion: The reduction in convexity in the camouflage group was by retracting the upper anteriors, which increases the nasolabial angle. In the fixed functional appliance a combination of skeletal and dentoalveolar changes can be observed. However the most appropriate reduction in profile convexity can be obtained by combined orthodontic and surgical treatment of malocclusion.

Proteomic profiling of various human dental stem cells-a systematic review

BACKGROUND The proteomic signature or profile best describes the functional component of a cell during its routine metabolic and survival activities.Additional complexity in differentiation and maturation is observed in stem/progenitor cells.The role of functional proteins at the cellular level has long been attributed to anatomical niches,and stem cells do not deflect from this attribution.Human dental stem cells(hDSCs),on the whole,are a combination of mesenchymal and epithelial coordinates observed throughout craniofacial bones to pulp.AIM To specify the proteomic profile and compare each type of hDSC with other mesenchymal stem cells(MSCs)of various niches.Furthermore,we analyzed the characteristics of the microenvironment and preconditioning changes associated with the proteomic profile of hDSCs and their influence on committed lineage differentiation.METHODS Literature searches were performed in PubMed,EMBASE,Scopus,and Web of Science databases,from January 1990 to December 2018.An extra inquiry of the grey literature was completed on Google Scholar,ProQuest,and OpenGrey.Relevant MeSH terms(PubMed)and keywords related to dental stem cells were used independently and in combination.RESULTS The initial search resulted in 134 articles.Of the 134 full-texts assessed,96 articles were excluded and 38 articles that met the eligibility criteria were reviewed.The overall assessment of hDSCs and other MSCs suggests that differences in the proteomic profile can be due to stem cellular complexity acquired from varied tissue sources during embryonic development.However,our comparison of the proteomic profile suffered inconsistencies due to the heterogeneity of various hDSCs.We believe that the existence of a heterogeneous population of stem cells at a given niche determines the modalities of regeneration or tissue repair.Added prominences to the differences present between various hDSCs have been reasoned out.CONCLUSION Systematic review on proteomic studies of various hDSCs are promising as an eye-opener for revisiting the proteomic profile and in-depth analysis to elucidate more refined mechanisms of hDSC functionalities.

Complete oral rehabilitation in a case with severe dental fluorosis

The authors have presented a technique of full occlusal rehabilitation in a case of severe dental fluorosis. In this technique, maxillary and mandibular anterior teeth were simultaneously prepared and restored first. This was followed by simultaneous preparation of maxillary and mandibular posterior teeth that were restored in canine guided occlusion. The technique and sequence followed here is unique and is not available in dental literature. This technique reduces number of appointments while fulfilling all objectives. Periodontal followup over 3 years was satisfactory. A restorative treatment protocol has been devised for fluorosis which will act as a guide for the dental practitioners.

To explore and develop a model to maintain and build upon a dental clinic open for all in developing regions, with a primary focus on India

AIM: To study a service model that enables a clinic to be open to all members of the community, irrespective of their ability to pay.METHODS: Sampling methodology was used to gather information in two phases, with the city of Indore as the target region. In the first phase, dental professionals were surveyed to gather the cost of the facility, land and equipment and the cost of sustaining the practice. In the second phase, the residents of Indore were surveyed to collect information regarding their oral health problems and their expenditure for the same. Assessing the current situation, the questions to answer are related to the issues of dental health care access problems and the resources required, human and financial.RESULTS:(1) People younger than 20 years of age form a large proportion(43%) of the population of the city and also a large proportion(54%) of people who visit dental clinics;(2) Dental caries are commonlyfound in the population younger than 20 years of age and mobile teeth in those older than 50 years of age;(3) Dental caries and mobile teeth are almost equally found in people of the age group 20-50 years old;(4) A significantly large proportion of those older than 50 years old have had all their teeth extracted; and(5) A significantly large proportion of the 20-30 years of age group has had no teeth extracted.CONCLUSION: The model which we propose works well for low income patients; however, it places a lot of extra burden on the higher income group. A lot of effort can be put into generating revenue from other sources, including events and donations.

Effect of westernization on oral health among college students of Udaipur City,India

Background:There is overwhelming evidence that periodontal disease and dental caries affect the majority of populations and that western culture and lifestyle may have a profound influence on oral health,especially in adults.The present study was performed to determine the effect of westernization on the oral health of college students of Udaipur City,Rajasthan.Methods:A descriptive cross-sectional study was conducted among students attending various professional and non-professional bachelor's degree colleges of Udaipur City,Rajasthan,India,from March 2013 to May 2013.Eight hundred students were selected based on a two-stage random sampling procedure.Westernization was assessed by a self-administered structured questionnaire.Periodontal status,dental caries status and malocclusion were assessed according to World Health Organization(WHO) criteria(1997).Statistical analysis was performed using Chi-square and Multivariate logistic regression.The confidence level and level of significance were set at 95% and 5%,respectively.Results:The present study suggested that adverse habits,listening to English music and preferring English food had a significant association with dental caries and periodontal diseases.Malocclusion also showed a significant relationship with consuming English food for snacks and desserts.Multivariate analysis revealed a significantly greater odds ratio(OR) for periodontal disease and dental caries among those who preferred English food for lunch.Conclusion:Based on the results of the present study,there is an association between westernization and oral health.

Dental pulp stem cells and banking of teeth as a lifesaving therapeutic vista

Exfoliated deciduous or an extracted healthy adult tooth can be used to harvest,process,and cryogenically preserve dental pulp stem cells.Future stem cell-based regenerative medicine methods could benefit significantly from these mesenchymal stem cells.Teeth serve as a substantial source of mesenchymal stem cells,otherwise disposed of as medical waste.Care should be taken to store this treasure trove of stem cells.Collective responsibility of patients,dentists,and physicians is necessary to ensure that this valuable resource is not wasted and that every possible dental pulp stem cell is available for use in the future.The dental pulp stem cells(DPSC)inside teeth represent a significant future source of stem cells for regenerative medicine procedures.This review describes the ontogeny,the laboratory processing and collection,and isolation methods of DPSC.This review also discusses currently available stem cell banking facilities and their potential use in regenerative medicine procedures in dental and general medical applications in the future.

Assessment of Relationship between Pain and Anxiety Following Dental Extraction—A Prospective Study

Objective—Anxiety and expected dental pain are the main reasons for avoiding any dental treatment by general population. In this study, we aimed to evaluate the various factors which can in-crease the anxiety and its association with pain perception of patients following dental extraction. Material and Methods—We had included 100 patients in our study who were undergoing orthodontic treatment and required extraction of either 34 or 44. Pain and anxiety levels after extraction were assessed with a visual analog scale (VAS) and an anxiety questionnaire consisting of eleven questions. Results—The mean VAS score for the entire study group was 16.23 ± 1.28 with statistically significant differences between genders, and was high in females and no statistically significant differences between different age groups. The mean anxiety score was 10.64 ± 3.12. This was significantly higher in women (P = 0.005), but there was no statistically significant differences between different age groups. There was a statistically significant correlation between VAS and total anxiety score (P < 0.001) as well as each question, except for question number 4, 8 and 9 in men. Conclusion—Although most patients had experienced limited pain, there was a significant gender difference in pain and anxiety level. They were anxious because they expected pain, women being more anxious than men. The most provoking factor for anxiety and pain while going for extraction in females was “being seated in dental chair”, while in men the most provoking factor was “uncertainty about proper numbness before extraction”.

Advances in Dental Implant Positioning Techniques and Their Clinical Implications

Background: Advancing surgical reconstructive methods and demanding prosthetics need accurate and precise implant placements. Positioning dental implant is vital in both prosthetic and aesthetic perspectives. The optimal three-dimensional placement not only reduces biomechanical complications but also imprecates the odds of implant failure. Materials & Methods: By using robust text mining, searching and retrieval tools, 350 relevant articles were found and then out of them 161 articles were short listed for our review. They included systematic reviews, meta-analyses, case series and experimental studies. Conclusions & Results: Conventional freehand implant placement techniques remain experts’ favorite for uncompromised cases. However, for compromised cases that demand accuracy and predictability, various computer-based methods are in use. While computerized tomography techniques and use of interactive software prevalent in treatment planning, computer-aided design or computer-aided manufacturing (CAD/ CAM) fabricated surgical guides enable implantologists for more successful implantations.

Expression of pain and distress in children during dental extractions through drawings as a projective measure: A clinical study

AIM: To evaluate the efficacy of drawings as a projective measure of pain and distress in children undergoing dental extractions.METHODS: Children in the age range of 4-13 years with existence of untreatable caries or over-retained primary teeth, indicated for extractions were included. Pain was assessed using one behavioral, faces, legs, activity, cry and consolability(FLACC) scale; and a self report measure; faces pain scale-revised(FPS-R), at two points of time, after completion of local anesthetic administration and after extraction. The general behavior of children was assessed with Wright's modification of Frankl rating scale. At the end of the session, children were instructed to represent, themselves along with the dentist and their experiences of the dental treatment through drawing. The drawings were scored utilizing Child drawing: Hospital scale(CD: H) manual and correlated with FLACC, FPS-R and Frankl using Pearson correlation test.RESULTS: A positive correlation, though statistically not significant, was observed between CD: H scores and all other considered parameters(Frankl, FPS-R and FLACC) in the present study.CONCLUSION: Drawings could not act as surrogate measure of child's pain; however, they acted as a narrative of his/her experiences and reflection of inner emotions. Hence, drawings can be used as an additional dental armamentarium.

Evaluation of xerostomia closely associated with systemic diseases using a dental approach

Based on the findings of epidemiological surveys in western countries, the number of person with suspected xerostomia in Japan is estimated to be 30,000,000. Xerostomia is caused by: 1) Systemic diseases;2) Medications;3) Tumors or trauma;4) Radiotherapy;and 5) Neurological factors. Its symptoms can be alleviated, and its progression can be stopped by close cooperation between the dental and medical departments. However, at present, symptomatic treatment methods such as water drinking, oral rinsing with water, and administration of Kampo medicines or parasymptomimetic drugs are mainly used, and a standard treatment has not been established. On the other hand, previous studies on xerostomia have reported improvement in dry mouth symptoms using dental approaches or a relationship between the development of candidiasis and the salivary flow rate. Therefore, in this study, to establish a dental method useful for improving xerostomia associated with systemic diseases and medications for them, we restored occlusal function, and as a result, increased the salivary flow rate, and evaluated changes in oral findings.