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Ahmad L, Aljoujou AA, Nadra R, Mashlah AM, Al Beesh FA, Alyafi A, Moulay Driss H. The Association Between Dental Caries and Salivary Buffering Capacity in Syrian Patients Diagnosed with Sickle Cell Disease. Cureus 2024; 16:e64887. [PMID: 39156342 PMCID: PMC11330576 DOI: 10.7759/cureus.64887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2024] [Indexed: 08/20/2024] Open
Abstract
Background Sickle cell disease (SCD) is a genetic disorder caused by mutations in the HBB gene, resulting in the abnormal shape of red blood cells. This condition is accompanied by various oral manifestations including salivary gland dysfunction leading to a heightened susceptibility to dental caries. This disorder is primarily treated with hydroxyurea. This study aims to assess dental caries utilizing the decay, missing, filling teeth (DMFT) index and evaluate salivary buffering capacity in patients diagnosed with SCD (HbSS type). The study also aims to assess the relationship between DMFT and salivary buffering capacity. Additionally, the study aimed to find a correlation between treatment with hydroxyurea and changes in both dental caries and salivary buffering capacity. Methods This case-control study enrolled a total of 100 participants aged between 20 and 50 years. The participants were divided into two groups: the study group, which comprised 70 individuals diagnosed with SCD (HbSS type), who were asked to report their current use of hydroxyurea, and the control group, which included 30 healthy individuals. Dental caries were assessed using the DMFT index, while salivary buffering capacity was measured using a pH meter model 420A device. Results The study group exhibited a mean DMFT index value of 6.39 compared to 5.20 in the control group. This difference was statistically significant (P-value=0.037), indicating higher DMFT values among patients with SCD. Salivary buffering capacity was significantly lower in the study group compared to the control group, with average values of 6.47 and 6.88, (P-value=.022). Interestingly, the administration of hydroxyurea impacted salivary buffering capacity, resulting in lower values for individuals using the drug (P-value=0.039). Conversely, hydroxyurea did not have a significant effect on DMFT values (P-value=0.317). Conclusion SCD increases susceptibility to dental caries and is associated with significant changes in salivary composition. At the same time, the potential negative impact of hydroxyurea is acknowledged.
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Affiliation(s)
- Lynn Ahmad
- Department of Oral Medicine and Radiology, University of Damascus, Faculty of Dentistry, Damascus, SYR
| | - Abeer A Aljoujou
- Department of Oral Medicine and Radiology, University of Damascus, Faculty of Dentistry, Damascus, SYR
| | - Reem Nadra
- Department of Biology, University of Damascus, Faculty of Dentistry, Damascus, SYR
| | - Ammar Mahmoud Mashlah
- Department of Oral Medicine and Radiology, University of Damascus, Faculty of Dentistry, Damascus, SYR
| | - Fatima AlZahraa Al Beesh
- Department of Oral Medicine and Radiology, University of Damascus, Faculty of Dentistry, Damascus, SYR
| | - Amr Alyafi
- Department of Oral Medicine and Radiology, University of Damascus, Faculty of Dentistry, Damascus, SYR
| | - Haina Moulay Driss
- Department of Dentistry, University of Damascus, Faculty of Dentistry, Damascus, SYR
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Silva LTD, Frusca-DO-Monte CM, Almeida GS, Silva VCD, Lorenzato CS, Bendo CB, Menezes JVNB, Torres-Pereira CC, Fraiz FC. Quality of life in children and adolescents with blood coagulation disorders and hemoglobinopathies. Braz Oral Res 2024; 38:e052. [PMID: 38922212 PMCID: PMC11376638 DOI: 10.1590/1807-3107bor-2024.vol38.0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/29/2024] [Indexed: 06/27/2024] Open
Abstract
The aim of this study was to evaluate the impact of oral conditions and health-related quality of life (HRQoL) on oral health-related quality of life (OHRQoL) in children and adolescents with blood coagulation disorders and hemoglobinopathies (BCDH). The study was cross-sectional and included 61 individuals aged 2 to 18 years with BCDH. Exams for dental caries (dmft/DMFT index), oral hygiene (simplified oral hygiene index - OHI-S), and gingival health (modified gingival index - MGI) were performed. The pediatric quality of life inventory™ (PedsQL™) generic core scale and oral health scale were used to measure HRQoL and OHRQoL. Spearman's correlation coefficient (ρ) and the Mann-Whitney test (α = 0.05) were conducted to assess the relationship between covariates and the PedsQL™ oral health scale. The mean PedsQL™ oral health scale score was 76.66 (SD = 21.36). Worse OHRQoL was correlated with poor oral hygiene (ρ = -0.383; p: 0.004), poor gingival health (ρ = -0.327; p = 0.014), and better HRQoL (ρ = 0.488; p < 0.001). Greater untreated dental caries experience was associated with worse OHRQoL (p = 0.009). Worse oral health status in children and adolescents with BCDH negatively impacts OHRQoL, and OHRQoL and quality of life analyzed from a generic perspective are positively correlated constructs in this population.
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Affiliation(s)
- Leandro Tavares da Silva
- Universidade Federal do Paraná - UFPR, School of Dentistry, Department of Stomatology, Curitiba, PR, Brazil
| | | | - Gabriela Silva Almeida
- Universidade Federal do Paraná - UFPR, School of Dentistry, Department of Stomatology, Curitiba, PR, Brazil
| | - Victor Cordeiro da Silva
- Universidade Federal do Paraná - UFPR, School of Dentistry, Department of Stomatology, Curitiba, PR, Brazil
| | | | - Cristiane Baccin Bendo
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Pediatric Dentistry, Belo Horizonte, MG, Brazil
| | | | | | - Fabian Calixto Fraiz
- Universidade Federal do Paraná - UFPR, School of Dentistry, Department of Stomatology, Curitiba, PR, Brazil
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3
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Yao B, Xu M, Cheng F, Peng M, Mao X. Knowledge, attitudes, and practices among patients with anemia towards disease management. Front Public Health 2024; 12:1380710. [PMID: 38835604 PMCID: PMC11149555 DOI: 10.3389/fpubh.2024.1380710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 05/06/2024] [Indexed: 06/06/2024] Open
Abstract
Objective This study aimed to assess the knowledge, attitudes and practices among anemia patients toward disease management. Methods This web-based cross-sectional study was conducted between September and December 2023 at The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine). A self-designed questionnaire was developed to collect demographic information of anemia patients, and assess their knowledge, attitudes and practices (KAP) toward disease management. Results A total of 396 valid questionnaires were collected. The mean age of the participants was 57.44 ± 16.80 years, and 52.02% were female. The mean knowledge, attitudes, and practices scores were 11.47 ± 1.73 (possible range: 0-14), 27.32 ± 2.96 (possible range: 7-35), and 40.49 ± 6.06 (possible range: 10-50), respectively. Multivariate analysis showed that bachelor's degree or above was independently associated with sufficient knowledge (OR = 2.372, 95%CI: 1.160-4.853, p = 0.018). Knowledge (OR = 1.350, 95%CI: 1.166-1.563, p < 0.001) and hemoglobin within 60-90 g/L (OR = 1.782, 95%CI: 1.090-2.912, p = 0.021) were independently associated with positive attitudes. Moreover, attitudes (OR = 1.618, 95%CI: 1.454-1.799, p < 0.001) and diagnosis ≥1 year (OR = 1.949, 95%CI: 1.171-3.243, p = 0.010) were independently associated with proactive practices. The path analysis demonstrated that knowledge was directly and positively correlated with attitudes (β = 0.484, 95% CI: 0.363-0.647, p = 0.008), and attitudes was directly and positively correlated with practices (β = 1.195, 95% CI: 1.062-1.332, p = 0.007). Moreover, knowledge was indirectly and positively correlated with practice (β = 0.579, 95% CI: 0.434-0.805, p = 0.004). Conclusion Anemia patients have sufficient knowledge, negative attitudes, but proactive practices toward the toward disease management Comprehensive training programs are needed to improve anemia patients practices in this area.
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Affiliation(s)
- Binlian Yao
- Department of Nursing, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
| | - Min Xu
- Department of Nursing, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
| | - Fang Cheng
- Department of Nursing, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
| | - Min Peng
- Department of Nursing, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
| | - Xiaopei Mao
- Department of Nursing, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
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Minja IK, Wilson EM, Machibya FM, Jonathan A, Cornel F, Ruggajo P, Makani J, Balandya E. Dental Caries in Children with Sickle Cell Disease and Its Association with the Use of Hydroxyurea and Penicillin Prophylaxis in Dar Es Salaam. Pediatric Health Med Ther 2024; 15:121-128. [PMID: 38533196 PMCID: PMC10964788 DOI: 10.2147/phmt.s443139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 02/08/2024] [Indexed: 03/28/2024] Open
Abstract
Purpose This comparative study sets out to report dental caries status among individuals with Sickle Cell Disease (HbSS) against those with sickle cell trait (HbSA) and those without the disease (HbAA) as controls. The study further assessed the impact of penicillin chemoprophylaxis and hydroxyurea use on dental caries among Sickle Cell Disease participants. Methods This was a comparative cross-sectional study in which 93 children aged 30 to 60 months were recruited. There were 60 participating children who had SCD (HbSS), 17 with SCD trait (HbAS) and 16 were without SCD or SC trait (HbAA). A questionnaire was used to record sociodemographic details including mean age in months and sex and on haemoglobin genotype for all the participants. Specifically, for the participants with HbSS, information on their whether they are taking hydroxyurea (HU), and penicillin chemoprophylaxis was recorded. To assess the prevalence of dental caries, clinical examination of all primary maxillary and mandibular teeth to determine the presence or absence of dental caries lesions was also recorded. Results A total of 1197 teeth from 93 children were examined, whereby, 45 (2.4%) of them had dental caries. The participating children with HbAA genotype (6.6%, N=21) had more dental caries than their HbSS counterparts (2.0%, N=24), while none of the participants with HbAS exhibited dental caries. Among the participants with HbSS, males and those who use HU were 3.79 and 3.07 times more likely to have dental caries than their counterparts, female and non-users of HU, respectively. Conclusion Dental caries was observed to be low among participants with HbSS when compared to those with HbAA. More research utilizing more robust methodologies is recommended.
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Affiliation(s)
- Irene Kida Minja
- Department of Restorative Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- The Sickle Pan African Research Consortium (SPARCO) – Tanzania Site Project, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Evarist Mulyahela Wilson
- Department of Restorative Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- The Sickle Pan African Research Consortium (SPARCO) – Tanzania Site Project, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Ferdinand M Machibya
- Department of Orthodontics, Pedodontics and Community Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Agnes Jonathan
- The Sickle Pan African Research Consortium (SPARCO) – Tanzania Site Project, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Fortunata Cornel
- Department of Restorative Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Paschal Ruggajo
- The Sickle Pan African Research Consortium (SPARCO) – Tanzania Site Project, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Julie Makani
- The Sickle Pan African Research Consortium (SPARCO) – Tanzania Site Project, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Department of Hematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Emmanuel Balandya
- The Sickle Pan African Research Consortium (SPARCO) – Tanzania Site Project, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Department of Physiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Sinkey RG, Ogunsile FJ, Kanter J, Bean C, Greenberg M. Society for Maternal-Fetal Medicine Consult Series #68: Sickle cell disease in pregnancy. Am J Obstet Gynecol 2024; 230:B17-B40. [PMID: 37866731 PMCID: PMC10961101 DOI: 10.1016/j.ajog.2023.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
Pregnant individuals with sickle cell disease have an increased risk of maternal and perinatal morbidity and mortality. However, prepregnancy counseling and multidisciplinary care can lead to favorable maternal and neonatal outcomes. In this consult series, we summarize what is known about sickle cell disease and provide guidance for sickle cell disease management during pregnancy. The following are Society for Maternal-Fetal Medicine recommendations.
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Abdullah HA, Ahmad HMA. Dental arch form in a sample of Iraqi adults with sickle cell anemia using 3D scanning technique: A cross-sectional study. J Orthod Sci 2023; 12:79. [PMID: 38234649 PMCID: PMC10793861 DOI: 10.4103/jos.jos_20_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/13/2023] [Accepted: 07/06/2023] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVE Sickle cell anemia (SCA) is a hematological condition that involves the synthesis of sickle-shaped, hemoglobin with a short lifespan. This study employed three-dimensional (3D) scanning to pinpoint the most common arch form in a sample of Iraqi adults with SCA. MATERIALS AND METHODS A cross-sectional study included maxillary and mandibular casts of 50 patients (25 male and 25 female) with SCA and 50 participants in a control group (25 male and 25 female). The facio-axial (FA) point was digitized on each tooth's labial or buccal surface using SolidWorks® 2020 software. The dimensions of the arch were calculated using two proportional measures and four linear measurements. The dental arch form was determined using 3M templates, and the arches were categorized as square, ovoid, or tapered to establish the most-common arch form. Chi-square was used to compare arch form distribution, and an independent t-test was used to calculate the difference between the control group and the SCA group. RESULTS The tapered arch was the predominant form in SCA males and females for the maxilla and the mandible. The molar vertical distance (upper and lower) was significantly higher in males in the SCA group than in males in the control group. There was no significant difference between females in the SCA group and females in the control group. CONCLUSION Most patients with SCA had tapered arches. Sagittal jaw dimensions in males with SCA were more affected by marrow hyperplasia. There was little if any to no effect on females with SCA.
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Affiliation(s)
- Hawraa Ali Abdullah
- Department of Orthodontics, College of Dentistry, Karbala University, Iraq
- Department of Orthodontics, College of Dentistry, University of Baghdad, Iraq
| | - Haider M. A. Ahmad
- Department of Orthodontics, College of Dentistry, University of Baghdad, Iraq
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Temur KT, Magat G, Yılmaz M, Ozcan S. Evaluation of the effect of sickle cell disease on the mandibular bone of children and adolescents by image texture and radiomorphometric analysis. Oral Radiol 2023; 39:792-801. [PMID: 37535233 DOI: 10.1007/s11282-023-00704-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 07/21/2023] [Indexed: 08/04/2023]
Abstract
OBJECTIVES Sickle cell disease (SCD) can cause osteoporotic changes in the jaw bones. In this study, it was aimed to evaluate possible bone changes using fractal analysis (FA) and morphometric analyses in dental panoramic radiographs of children and adolescents diagnosed with both homozygous and heterozygous forms of SCD. METHODS Sixty-five individuals (33 SCD, 32 controls) aged 6-17 years were included in the study. Four separate areas of interest (ROI) were selected for the right and left sides of all panoramic radiographs, and the FA value of the ROIs was calculated. Mandibular cortical width (MCW), panoramic mandibular index (PMI) and mandibular cortical index (MCI) and were evaluated. Data were statistically analyzed and p < 0.05 was accepted for statistical significance. RESULTS Fractal values of right and left ROI1 (the center of the mandibular angle.) and ROI4 (the cortical bone), and right ROI2 (the middle of the mandibular ramus) were statistically lower in the case group (p < 0.05). Right ROI2 and ROI4 fractal values of individuals in the case group were lower than those on the left side (p < 0.05). While MCI categories did not differ from the case-control group (p > 0.05), PMI and MCW values were lower in the case group (p < 0.05). All evaluated parameters did not differ according to age and gender (p > 0.05). CONCLUSION The results of this study showed that SCD affects the mandible. FA, MCW and PMI parameters can be used to detect early osteoporotic changes in the disease.
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Affiliation(s)
- Katibe Tugce Temur
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Niğde Ömer Halisdemir University, Niğde, Turkey.
| | - Guldane Magat
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - Melis Yılmaz
- Department of Endodontics, Faculty of Dentistry, Mersin University, Mersin, Turkey
| | - Sevgi Ozcan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Niğde Ömer Halisdemir University, Niğde, Turkey
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Katip Celebi University, İzmir, Turkey
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Hong WW, Kim IH, Dayo AF, Mupparapu M. A Patient Presents for Dental Extraction and Goes into Sickle Cell Crisis in the Dental Chair. Dent Clin North Am 2023; 67:679-682. [PMID: 37714623 DOI: 10.1016/j.cden.2023.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2023]
Abstract
Sickle Cell Disease is an inherited autosomal recessive hemoglobinopathy associated with multiorgan damage. This single gene disorder involves one DNA base pair alteration, producing HbS. The sickle-shaped cells form when deoxygenated in the capillaries. The resulting RBC stasis leads to ischemia and pain, and acute and chronic organ damage. Patients with SCD presenting to a dental office need careful examination to rule out any current infections, neurologic deficits, or other organ involvement before formulating a dental treatment plan to avoid prolonged and complicated procedures. Early intervention and dental anxiety management are key to the dental treatment of patients with SCD.
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Affiliation(s)
| | - Irene H Kim
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
| | - Adeyinka F Dayo
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
| | - Mel Mupparapu
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA.
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Cherry-Peppers G, Fryer C, Jackson AD, Gu X, Ford D, Glascoe A, Smith D, Liu M, Dunmore-Griffith J, Robinson-Warner G, McIntosh C, Sonnier J, Slade L, Rizkalla A, Mundey S, Dawson N, Fleurinord M, Edmonson B, Ford C, Griffith J, Peppers G, Muttanahally K, Mncube-Barnes F, Watkins-Bryant T. Sickle cell disease: Contributing factors and radiological assessments. J Natl Med Assoc 2023:S0027-9684(23)00064-0. [PMID: 37495445 DOI: 10.1016/j.jnma.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 03/09/2023] [Accepted: 05/13/2023] [Indexed: 07/28/2023]
Abstract
Sickle Cell Disease (SCD) is genetically described as an autosomal blood disorder resulting from the presence of a mutated form of hemoglobin. Morbidity, frequency of crisis, degree of anemia, and organ systems involved vary considerably per patient. Dental health professionals and other specialists commonly request comprehensive medical consultations prior to performing complex periodontal, endodontic, and surgical procedures. In order to have successful dental outcomes and minimize posttreatment dental complications, relevant disease indicators are noted. This review is to raise awareness of the impact of oral diseases in patients with sickle cell disease and to emphasize the importance of full medical disclosure, radiographic interpretation, and a well-documented medical history, and a well-written consultation which can guide treatment planning and greatly improve the course of dental treatment.
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Affiliation(s)
- Gail Cherry-Peppers
- Associate Professor, Director Oral Diagnosis and Radiology, Howard University College of Dentistry, Howard University College of Dentistry.
| | - Cheryl Fryer
- Associate Dean Academic Affairs, Howard University College of Dentistry.
| | | | - Xinbin Gu
- Associate Dean for Research, Chair, Research Committee, Howard University College of Dentistry.
| | - Debra Ford
- Senior Associate Dean for Academic Affairs, Howard University College of Medicine.
| | - Alison Glascoe
- Comprehensive Care, Chair, Howard University College of Dentistry.
| | - Dawn Smith
- Chair, Department of Dental Hygiene, Howard University College of Dentistry.
| | | | | | - Gillian Robinson-Warner
- Assistant Professor, Department of Restorative Dentistry, Howard University College of Dentistry.
| | - Crystal McIntosh
- Associate Professor, Chair, Department of Periodontics, Howard University College of Dentistry.
| | - Jezelle Sonnier
- Assistant Professor, Department of Restorative Dentistry, Howard University College of Dentistry.
| | - Lisa Slade
- Director, Department of Endodontics, Howard University College of Dentistry.
| | - Adel Rizkalla
- Assistant Professor, Department of Restorative Dentistry, Howard University College of Dentistry.
| | - Shakeya Mundey
- Assistant Professor, Comprehensive Care, Howard University College of Dentistry, Washington, DC.
| | - Nyree Dawson
- Assistant Professor, Department of Dental Hygiene, Howard University College of Dentistry.
| | - Manouchka Fleurinord
- Research Student Committee, Howard University College of Dentistry, Ashleigh Bellamy Research Student Committee, Howard University College of Dentistry.
| | - Baron Edmonson
- Research Student Committee, Howard University College of Dentistry.
| | - Courtney Ford
- Summer Research Project, Howard University College of Dentistry.
| | - Jillian Griffith
- Summer Research Project, Howard University College of Dentistry.
| | - Gretchen Peppers
- Research Committee Coordinator, Howard University College of Dentistry.
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