Relationship between radiological (X-ray/HRCT), spirometric and clinical findings in dental technicians' pneumoconiosis

The application of lasers in vital pulp therapy: clinical and radiographic outcomes

The main purpose of vital pulp therapy (VPT) is to preserve the integrity and function of the pulp. A wide variety of materials and techniques have been proposed to improve treatment outcomes, and among them, the utilization of lasers has gained significant attention. The application of lasers in different stages of VPT has witnessed remarkable growth in recent years, surpassing previous approaches.This study aimed to review the applications of lasers in different steps of VPT and evaluate associated clinical and radiographic outcomes. An electronic search using Scopus, MEDLINE, Web of Science and Google Scholar databases from 2000 to 2023 was carried out by two independent researchers. The focus was on human studies that examined the clinical and/or radiographic effects of different laser types in VPT. A total of 4243 studies were included in this narrative review article. Based on the compiled data, it can be concluded that although current literature suggests laser may be proposed as an adjunct modality for some procedural steps in VPT, more research with standardized methodologies and criteria is needed to obtain more reliable and conclusive results.

Evaluation of the marginal adaptation and debonding strength of two types of CAD-CAM implant-supported cement-retained crowns

BACKGROUND

In-vitro data from a clinically well-known lithium disilicate ceramic reference was used to assess the expected performance of resin-based materials in implant dentistry. The purpose of the study was to compare the bond strength and marginal adaptation of nano-ceramic hybrid composite crowns cemented to stock cement-retained abutments to lithium disilicate crowns.

METHODS

Twenty abutment analogs were embedded into auto-polymerizing acrylic resin blocks. The blocks were divided into 2 groups according to the restorative crown material. The 2 groups were divided as follows: Resin nano-ceramic group and lithium disilicate group. Abutment analogs in both groups were scanned using a laboratory scanner, and the restorations were designed, manufactured, and cemented with resin cement over the corresponding group. All samples were tested for marginal adaptation and bond strength after storage for 24 hours at 37 °C in 100% humidity. Data were collected, tabulated, and statistically analysed using the appropriate tests. Normality was checked using Shapiro Wilk test and Q-Q plots. Data were normally distributed. Variables were presented using mean, 95% Confidence Interval (CI) and standard deviation in addition to median and Inter Quartile Range (IQR). Differences between groups regarding debonding forces was assessed using independent t test. Two Way ANOVA was performed to assess the effect of material and bonding on marginal gap. All tests were two tailed and p value was set at < 0.05.

RESULTS

Marginal gap and debonding force values were significantly different according to the type of material used (P < .05). Resin nano-ceramic crowns presented lower marginal gap values before (20.80 ± 8.87 μm) and after (52.11 ± 22.92 μm) bonding than lithium disilicate crowns. The debonding force value for resin nano-ceramic crowns (284.30 ± 26.44 N) was significantly higher than that for lithium disilicate crowns (253.30 ± 33.26 N). Adhesive failure mode was detected in all the specimens in both groups.

CONCLUSIONS

The type of material used for implant-supported cement-retained crowns had a statistically significant effect on marginal adaptation and bond strength. Resin nano-ceramic implant-supported cement-retained crowns had better marginal adaptation and higher bond strength than those manufactured using lithium disilicate.

The comparison of calcium hydroxide + biostimulation, calcium hydroxide, formocresol, and MTA pulpotomies without biostimulation in primary teeth: 12-months clinical and radiographic follow-up

This study has aimed to evaluate the clinical and radiographic success rates of calcium hydroxide pulpotomy (CH) with biostimulation (PBMT) and compare them to that of CH, formocresol (FC), mineral trioxide aggregate (MTA) pulpotomies without PBMT in primary molars. A total of 172 pulpotomies were performed on primary first or second mandibular molars in 94 children who were 5-8 years old. The pulpotomy procedure was performed with four different techniques. In the PBMT group, before the CH placement, 820-nm diode laser radiation was applied to each pulp-stump for 12 s (10 mW, 2.5 J/cm²). The clinical (lack of spontaneous pain, abscess or fistula, and pathological mobility) and radiographic success (lack of periapical/furcal lesions and internal/external resorption) were recorded at 6 and 12 months. The data was statistically evaluated. p value < 0.05 was considered as significant. After 12 months, the clinical and radiographic success rate (a tooth with at least one of the findings was considered unsuccessful) was 97%/92% for FC and 97%/95%, 87%/73%, and 71%/45% for MTA, CH + PBMT, and CH, respectively. There was no significant difference between the CH + PBMT and the other groups in clinical success, while a significant difference was found between CH and FC, MTA groups. In radiographic success, there was a significant difference between the CH and the other groups. No significant difference was found between the 6th- and 12th-month results in clinical success for all the groups. A decrease in success over time was seen only in the CH group for radiographic results. CH without PBMT showed the worst clinical and radiographic results among the groups. CH + PBMT showed similar clinical success compared to the MTA and FC groups. In radiographic success, CH + PBMT showed higher success compared to CH, but this success was not high as compared to MTA and FC.

Intelligent Image Diagnosis of Pneumoconiosis Based on Wavelet Transform-Derived Texture Features

Objective. Early diagnosis and treatment of occupational pneumoconiosis can delay the development of the disease. This study is aimed at investigating the intelligent diagnosis of occupational pneumoconiosis by wavelet transform-derived entropy. Method. From June 2013 to June 2020, the high KV digital radiographs (DR) and computed tomography (CT) images from a total of 60 patients with occupational pneumoconiosis in our department were selected. The wavelet transform-derived texture features were extracted from all images, and the decision tree was used for feature selection. The support vector machines (SVM) with three kernel functions were selected to classify the two kinds of images, and their diagnostic efficiency was compared. Result. After eight times of wavelet decomposition, eight wavelet entropy texture features (feature set) were extracted, and six were selected to form the feature subset. The classification effect of linear kernel function SVM is better than those of other functions, with an accuracy of 84.2%. The diagnostic values of DR and CT for occupational pneumoconiosis were the same ( $\text{kappa}=0.737,P<0.001$ ). The detection rate of CT for stage I of occupational pneumoconiosis was significantly higher than that of DR ( $P=0.031$ ). Conclusion. It is helpful to improve the early diagnosis level of pneumoconiosis by using SVM to make an intelligent diagnosis based on the wavelet entropy.

A Comprehensive Systematic Review In Search Of Evidence for Pragmatic Altercations in Simplified Denture

Aim:

To explore the evidence available to evaluate if simplified dentures could be as effective as the conventional complete dentures.

Materials and Methods:

A total of 1,482 articles were obtained using keywords in a Boolean search operator in the PubMed search engine, Google Scholar and Cochrane Library. Duplicates were removed and the remaining articles were subjected to a title analysis which yielded a total of 20. Further analysis of the article abstracts led to an exclusion of four articles. The remaining 16 articles were subjected to full text analysis which finally yielded a total of 11 articles.

Results:

The cumulative results of the meta-analysis for oral health-related quality of life, patient satisfaction and professional quality of denture show no significant difference ( P > .05) between conventional and simplified dentures.

Conclusion:

Based on the available evidence adjusted for the potential literature/geographic bias, we conclude that the conventional procedures in complete denture fabrication such as facebow and gothic arch tracing do not improve the quality of the denture outcome from patients’ perspective and simplified dentures are equally effective as conventional complete dentures.

Lip print enhancement: review

Lip print (LP) evidence can be an essential tool for human forensics. LPs have conventionally been developed using substances such as lysochrome dyes, fluorescent dyes, indigo dye, aluminium powder, and silver metallic powder. However, techniques for LP enhancement from various substrates are currently inconsistent and lack standardisation in practice. This review summarises current knowledge on the physical and chemical techniques of LP enhancement, identifies limitations, and provides suggestions for future research on practical applications of cheiloscopy as a forensic tool in criminal justice.Key pointsThe grooves and wrinkles of the human lip establish unique patterns that persist throughout life.Cheiloscopic patterns exhibit discriminatory individual characteristics that may constitute circumstantial forensic evidence.Enhancement techniques for latent lip prints on porous and nonporous substrates can be classified as physical or chemical.Unlike fingerprint, there is a current lack of consistency and/or standardisation on latent lip print enhancement methods in frontline forensic practice.

ACR Appropriateness Criteria® Occupational Lung Diseases

Ordering the appropriate diagnostic imaging for occupational lung disease requires a firm understanding of the relationship between occupational exposure and expected lower respiratory track manifestation. Where particular inorganic dust exposures typically lead to nodular and interstitial lung disease, other occupational exposures may lead to isolated small airway obstruction. Certain workplace exposures, like asbestos, increase the risk of malignancy, but also produce pulmonary findings that mimic malignancy. This publication aims to delineate the common and special considerations associated with occupational lung disease to assist the ordering physician in selecting the most appropriate imaging study, while still stressing the importance of a multidisciplinary approach. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

Silicosis in Turkey: Is it an Endless Nightmare or is There Still Hope?

Silicosis is an ancient but still life-threatening occupational lung disease because of its incurable nature. Although its risks are known in many occupational settings and effective control strategies are well established, new cases, even epidemics, continue to occur in different sectors of Turkey. Before taking action, defining the magnitude of the problem is essential. In this concise review, we aimed to present the current situation of silicosis in Turkey. According to the data available to date, silicosis continues to be a major health problem in different sectors. Sandblasting seems to have the highest risk for the development of silicosis. Disease onset at early age and history of short exposure duration may indicate intense silica exposure. After denim sandblasters, dental technicians seem to be the new and recently recognized high-risk occupation group as per the increasing reports. Because of the lack of a definite treatment of silicosis, prevention of the disease should be the main target. Better occupational disease registry systems would be useful to assess the magnitude of the problem. In addition to implementing the necessary regulations, a close inspection of the workplaces for potential risks is essential. Other social and economic factors related with the occurrence of disease, such as unregistered employment rate and unlicensed and uninsured work, should also be considered. Finally, optimal healthcare and better living conditions for patients with silicosis should be ensured.

Dental Technicians' Pneumoconiosis; Illness Behind a Healthy Smile - Case Series of a Reference Center in Turkey

BACKGROUND

Dental laboratories include many hazards and risks. Dental technicians working in an unfavorable work environment in Turkey and other parts of the world may develop pneumoconiosis as a result of exposure to dust, depending on exposure time. In this study, we aimed to investigate the clinical and laboratory findings of dental technicians.

MATERIALS AND METHODS

The study consists of a case series. Between 2013 and 2016, a total of 70 who were working as a dental technician and referred to our clinic with suspicion of occupational disease were evaluated. Comprehensive work-history, physical examination complaints, functional status, chest X-ray, and high-resolution computed lung tomography (HRCT) findings were evaluated.

RESULTS

In all, 46 (65.7%) of the 70 dental technicians were diagnosed with pneumoconiosis. About 45 (97.8%) subjects were male and 1 (2.2%) was female. The mean age of starting to work was 15.89 ± 2.79 (11-23) years. The mix dust exposure time was 176.13 ± 73.97 (18-384) months. Small round opacities were most common finding. In 16 patients, high profusion being 2/3 and above were identified, and large opacity was detected in 11 patients. The radiological profusion had a weak negative correlation with FEV 1 and FVC (correlation coefficient - 0.18, P = 0.210 and - 0.058, P = 0704) and moderate negative correlation between radiological profusion and FEV1/FVC (correlation coefficient - 0.377, P = 0.010). In addition, no correlation was observed between the age at start of work and the duration of exposure.

CONCLUSION

The presence of pneumoconiosis continues in dental technicians in Turkey, especially because there is an early childhood apprenticeship culture and almost all workers in this period have the history of sandblasting.

Dental Technicians' Pneumoconiosis

A 40-year-old female dental technician visited our hospital for the investigation of a chest X-ray abnormality. Chest computed tomography demonstrated centrilobular nodules and lung volume reduction, and her serum KL-6 level was elevated. A histological analysis of the specimens obtained on a surgical lung biopsy showed peribronchiolar fibrosis with pigmented macrophages and cholesterol clefts. An energy-dispersive X-ray analysis showed that these lung tissues contained some metals, including indium. The serum indium level was also elevated. We diagnosed this patient with pneumoconiosis caused by exposure to sandblasting certain dental metals. This is the first reported case of pneumoconiosis in a dental technician associated with exposure to indium.

Dental technician pneumoconiosis mimicking pulmonary tuberculosis: a case report

Background

Dental laboratory technicians are at risk of developing occupational respiratory diseases due to exposure to various potentially toxic substances in their working environment. Since 1939, few cases of silicosis among dental technician have been reported.

Case presentation

We illustrate a 38 year-old female, who worked in a dental laboratory for 20 years, initially treated as pulmonary tuberculosis and chronic necrotising aspergillosis without much improvement. Computed tomography guided lung biopsy and bronchoscopic transbronchial lung biopsy were performed. Lung tissue biopsies showed presence of refractile dental materials within the areas of histiocyte proliferation. The diagnosis of dental technician pneumoconiosis was obtained and our patient underwent pulmonary rehabilitation.

Conclusions

This case highlights the importance of obtaining a detailed occupational history in tuberculosis endemic area, as pulmonary tuberculosis is a great mimicker of other respiratory diseases.

Dental technician pneumoconiosis mimicking lung cancer

A 47-year-old man was referred for assessment of bilateral lymph node enlargement identified on a routine chest radiograph. Positron emission tomography showed high standardized uptake values (SUVmax: 20.5) in right supraclavicular, right intercostal, and multiple mediastinal lymph nodes. Biopsy samples obtained from the right upper and left lower paratracheal nodes by mediastinoscopy revealed granulomatous inflammation. Clinical and laboratory findings indicated a diagnosis of dental technician pneumoconiosis. The patient is alive and well 3 years after diagnosis. This case highlights the importance of obtaining an occupational history.

Role of chest computed tomography in prevention of occupational respiratory disease: review of recent literature

This review provides an update on literature published over the past 5 years that is relevant to using chest computed tomography (CT) as a tool for preventing occupational respiratory disease. An important area of investigation has been in the use of low-dose CT (LDCT) to screen asbestos-exposed populations for lung cancer. Two recent systematic reviews have reached conclusions in support of screening. Based on the limited evidence that is currently available, the Finnish Institute of Occupational Health has recommended LDCT screening in asbestos-exposed individuals if their personal combination of risk factors yields a risk for lung cancer equal to that needed for entry into the National Lung Screening Trial. It has also recommended further research, such as to document the optimal frequency of screening and the effectiveness of screening. Recent literature continues to support high-resolution CT (HRCT) as being more sensitive than chest radiography in detecting pneumoconiosis. However, there are insufficient data to determine the effectiveness of HRCT screening in improving individual outcomes if used in screening for pneumoconiosis and its routine use for this purpose cannot be recommended. However, if HRCT is used to evaluate populations, recent literature shows that the International Classification of HRCT for Occupational and Environmental Respiratory Diseases provides an important tool for reproducible evaluation and recording of findings. HRCT is an important tool for individual patient management and recent literature has documented that chest HRCT findings are significantly associated with outcomes such as pulmonary function and mortality.