The frequency of periodontitis in end-stage renal disease on hemodialysis in a sample of Egyptian population: multi-center clinical cross-sectional study

Development and validation of a healthy diet and physical activity tool based on health action process approach among patients undergone bariatric surgery

Background

The purpose of this study was to develop and evaluate the validity and reliability of a healthy diet and physical activity assessment tool among patients one year after bariatric surgery based on Health Action Process Approach.

Methods

We compiled 53 items based on healthy diet and physical activity behaviors among patients undergone bariatric surgery through reviewing the literature. Using quantitative and qualitative methods, and a panel of experts, we evaluated the face and content validities of the tool. The reliability was evaluated by Intra-class correlation coefficient and Cronbach's alpha.

Results

The content validity ratio and the content validity index were 0.62 and 0.79, respectively. Exploratory factor analysis showed seven factors, including risk perception, outcome expectations, task self-efficacy, coping, recovery self-efficacy, action planning, coping planning, and behavioral intentions. The Intra-class correlation coefficient was between 0.8 and 0.91; and Cronbach's alpha for different constructs was between 0.8 and 0.95.

Conclusion

The findings showed that the constructs of the Health Action Process Approach tool regarding healthy diet and physical activity had adequate validity and reliability in bariatric surgery patients.

Preventive dental care reduces risk of cardiovascular disease and pneumonia in hemodialysis population: a nationwide claims database analysis

This study aims to investigate the impact of dental care utilization status on the occurrence of fatal complications such as cerebral/cardiovascular disease (CVD) and infectious diseases in patients with end-stage renal disease (ESRD) undergoing hemodialysis. This retrospective cohort study was performed using the Japanese claims database and included patients who first underwent hemodialysis between April 2014 and September 2020. The exposure variable of interest was the pattern of dental utilization, which was categorized into three groups, "dental treatment group", "preventive dental care group", and "no-dental visit group". The primary outcomes were the time interval until a composite end point of first major cardiovascular event (acute myocardial infarction, heart failure, or cerebral infarction) of infectious disease (pneumonia and sepsis). The secondary outcomes were the time interval until the incidence of each component of primary outcomes. Survival analyses, including log-rank tests and Cox proportional hazards regression analyses, were performed. Among the 10,873 patients who underwent the first dialysis treatment, 6152 were assigned to the no-dental visit group, 2221 to the dental treatment group, and 2500 to the preventive dental care group. The preventive dental care group had significantly lower hazard ratios (HRs) of the incidence of CVD (adjusted hazard ratio [aHR]: 0.86, 95% confidence interval [CI]: 0.77-0.96) and infectious diseases (aHR: 0.86, 95% CI: 0.76-0.97). As for pneumonia, preventive dental care and dental treatment groups had significantly lower HRs (aHR: 0.74 and 0.80, 95% CI: 0.61-0.88, 0.66-0.96) than the no-dental visit group. This study demonstrated that dental visits for preventive dental care were associated with a significant risk reduction in CVD and infectious complications in patients with ESRD undergoing hemodialysis.

Barriers to routine screening for intimate partner violence during pregnancy in Nigeria

Background

The benefits of routine screening for intimate partner violence (IPV) among pregnant women include early identification, prompt management, referral of IPV victims, and creating awareness about IPV. Despite these benefits, the practice of routine screening of IPV remains limited in midwifery settings in low-income countries. The purpose of this study is to identify and describe midwives' perspectives of the barriers in conducting routine screening of IPV for pregnant women in northern Nigeria.

Methods

A case study qualitative descriptive design was used to collect data from ten midwives in the antenatal clinic of a tertiary hospital. Non-participant observation and individual face-to-face semi-structured interviews were used as data collection methods. Thematic data analysis was carried out using Yin's five stage analytical cycle.

Findings

Three themes, with related subthemes, emerged from the data: (i) The theme of "Internal" barriers to IPV screening has four subthemes; midwives' personal discomfort in asking IPV- related questions, perceived mistrust of midwives by pregnant women, midwives' own perceptions of IPV as a personal matter, and midwives' lack of skills to screen for IPV. (ii) "External" barriers to IPV screening subsumes three subthemes: antenatal card related barriers, workload related barriers, and protocol barriers. (iii) "Structural" barriers to IPV screening have two subthemes: lack of space for privacy and lack of resources for managing pregnant women who have experienced IPV.

Conclusion

Knowing the barriers to midwives' screening practices is important because it may help in the development of contextually relevant and acceptable screening guidelines for midwives in Nigeria. Education and training of midwives will eliminate the internal barriers while the external barriers will need the intervention of hospital authorities and government to eliminate their effects on screening.

Caries in orphan children: prevalence and determinants-a systematic review and meta-analysis

BACKGROUND

Orphan children represent a category of children who lost their family support. Their health status is poorer when compared to their parented counterparts. As the most prevalent disease in the world, dental caries is expected to affect orphans greatly. Being vulnerable, health status of orphan children must be monitored and studied; so that health improvement plans would be formulated. Therefore, this systematic review focuses on the extent of the dental caries problem among institutionalized orphan children and its determinants.

METHODS

The review has two outcomes: comparing caries experience of institutionalized children to their parented counterparts, and reviewing the determinants of caries in the exposure group. Two systematic searches (one for each outcome) were run on MedLine via PubMed, Cochrane library, LILACS, Egyptian knowledge bank (EKB) and Google Scholar; beside hand search and searching grey literature.

RESULTS

The searches yielded 17,760, followed by 16,242 records for the first and second outcomes respectively. The full text was screened for 33 and 103 records for the two outcomes respectively; after translating non-English reports. Finally, the review included 9 records to address the first outcome and 21 records for the second. The pooled results showed that the exposure group may show slightly poorer caries experience regarding permanent teeth (pooled mean difference of DMF = 0.09 (-0.36, 0.55)); but they have a much poorer caries experience regarding primary teeth health (pooled mean difference of dmf = (0.64 (-0.74, 2.01)). Meta-analysis of the caries determinants showed that institutionalization increases the risk of caries by 19%. Gender showed slight effect on caries risk with males being more affected; while primary teeth revealed higher risk of caries when compared to permanent teeth.

CONCLUSION

Limited by the heterogeneity and risk of bias of the included studies, meta-analyses concluded that institutionalized orphan children have higher risk of caries. Yet, the institutionalization circumstances were not well-documented in all the included studies. So, the complete picture of the children's condition was not possibly sketched.

TRIAL REGISTRATION

Protocol has been registered online on the PROSPERO database with an ID CRD42023443582 on 24/07/2023.

Current trends in placing posterior composite restorations: Perspectives from Palestinian general dentists: A questionnair study

Aim

The success of composite restorations relies on material selection and practitioner-related factors that shape the overall outcome. This study explores the practices of Palestinian general dental practitioners in placing posterior composites, examining the impact of work sector, experience, and gender on their choices.

Materials and Methods

The study was conducted as an online cross-sectional questionnaire and involved 351 participants, with a response rate of 69.8%. The survey comprised 18 closed-ended questions covering demographics, material selection, and composite placement in special cases, techniques, and factors influencing the choices. Statistical analyses included descriptive statistics, chi-squared tests, and Fisher's exact tests.

Results

Composite was the predominant choice for small-size (83.7%) and large-size posterior cavities (60.4%). Practitioners commonly opted for composite restorations in cases involving occlusal parafunctional activity (60%), poor oral hygiene (78%), and subgingival cavities (72.2%). Only 19.6% and 5.3% reported occlusal and gingival beveling, respectively. Rubber dams for isolation stood at 30%, one-step self-etch adhesives at 44.9%, and the oblique layering technique at 51%. Light-emitting diode curing units were popular (97.55%), but monitoring output with a radiometer was infrequent (93.5%). Tofflemire metal matrix usage was 46.1%, whereas a sectional matrix system was employed by 29.8%. A 2 mm layer exposure to light curing for 20 s was reported by 62%, and 27.75% utilized additional light-curing postmatrix band removal.

Conclusion

The study highlights the need for Palestinian dental professionals to update their clinical approaches in placing composite restorations in posterior teeth. Gender, work sector, and experience influence practitioners' choices, emphasizing the importance of tailored continuing education programs for improving clinical practices.

Meta-analysis with systematic review to synthesize associations between oral health related quality of life and anxiety and depression

OBJECTIVES

The present systematic review aimed to investigate how oral health related quality of life (OHQOL) associates with anxiety and depression. The study protocol was registered prospectively in the PROSPERO database (CRD42023389372).

MATERIALS AND METHODS

Studies investigating associations between OHQOL and depression and/or anxiety were included. Fisher's Z scores were used to summarize associations between OHQOL and depression/anxiety. Funnel plots and Begg's Tests were used to assess publication bias. Meta-regression was conducted to examine potential moderator effects in the associations. Academic databases including the ISI Web of Knowledge, Scopus, ProQuest and PubMed were systematically searched. The quality of included studies was checked with the Newcastle Ottawa Scale (NOS).

RESULTS

All 15 included studies were cross-sectional (14,419 participants from nine countries; mean age=43.74 years). The pooled estimates showed weak associations between OHQOL and depression (Fisher's z-score of 0.26 [95% CI = 0.17, 0.35; I2 = 96.2%; τ2 = 0.03]) and anxiety (Fisher's z-score of 0.22 [95% CI = 0.001, 0.43; I2 = 97.9%; τ2 = 0.06]). No severe problems in methodology quality, publication biases, or moderator effects were observed.

CONCLUSION

Both depression and anxiety were weakly associated with individuals' OHQOL. Although the synthesized associations were not strong, they were significant, indicating that depression and anxiety are potential factors influencing individuals' OHQOL.

A narrative review of minimally invasive techniques in restorative dentistry

This narrative review aimed to provide a comprehensive overview of minimal invasive dentistry (MID) by synthesizing relevant articles obtained from various sources, including electronic databases such as PubMed, SCOPUS, EMBASE, the COCHRANE library, and Science Direct, as well as through manual searches of cross-references and textbooks. The search employed MeSH terms and keywords related to MID, such as "minimally invasive dentistry," "atraumatic restorative treatment (ART)," "MID," and "minimum intervention dentistry." The inclusion criterion was English-language articles published between the years 2000 and June 2023 that aligned with the study objectives. After a thorough assessment of the included articles, 34 high-quality articles were selected for this review. The selected articles elucidate the characteristics of MID, the application of the ART, and the principles of minimum intervention in dentistry. Animal-based studies and narrative reviews on MID were excluded from the analysis. This narrative review serves as a valuable resource for dental professionals, researchers, and educators interested in staying abreast of the latest developments and evidence in the field of MID.

Validity of self-reported number of teeth among Saudi older adults: A public health perspective

Objectives

This study aimed to evaluate the agreement between self-reported and clinically measured numbers of teeth in older adults from Almadinah Almunawwarah, KSA, and to identify factors associated with self-reporting accuracy.

Methods

This study included 337 older adults (≥60 years). Participants completed a survey assessing sociodemographic characteristics, self-rated oral and general health, and the self-reported number of teeth. Clinical examination was conducted using the 2013 criteria published by the World Health Organization. Bland-Altman plots and correlation coefficients were used to assess the agreement between self-reported and clinically measured teeth.

Results

The mean age of the study participants was 67.1 (SD = 6.5) years, and the majority were males (71.2%). The self-reported teeth count was higher than the clinically measured number, and only 47.7% (n = 161) of the sample showed complete agreement between the two measures. The mean difference between the self-reported and clinically recorded number of teeth was 0.41 teeth, and almost two-thirds of the study participants reported their number of teeth within an error margin of two teeth (p < 0.001). Both Spearman's and Pearson's correlation methods revealed a significant positive correlation between the two measures. Specifically, the Spearman's rho was 0.91, while Pearson's r coefficient was 0.96.

Conclusion

Among Saudi older adults, the self-reported number of teeth correlated with the clinically measured numbers of teeth. This suggests that self-reports can be a reliable and cost-effective method for assessing oral health in large-scale surveys, potentially guiding health policies and interventions for older adults.

Assessing dental surgeons' understanding of bisphosphonates: Implications for patient health in oral surgery

Objectives

This study aimed to analyze the knowledge of dental surgeons concerning the pharmacological effects of bisphosphonates (BP) and their impact on the health of patients undergoing oral surgery treatment.

Materials and methods

A quantitative study was conducted with professionals in the Cariri region of Ceará, Brazil. The data were collected using a semi-structured questionnaire to interview the dental surgeons who met the inclusion criteria. The data were analyzed by Chi-square and Fischer's Exact tests using the SPSS program version 22.0.

Results

The results indicated that most interviewed subjects have no experience with the dental treatment of individuals under treatment with bisphosphonates. When a sample of the medication was presented, a significant number of the participants (65.3%) did not recognize the drug. Among those who recognized it, 66.5% did not know how to treat bisphosphonate-using patients in the clinical routine. However, 95.1% of the professionals who recognized the need to discontinue these drugs admitted contacting the prescriber to establish the best dental conduct. Our results also showed that recently graduated professionals better understood the need to stop BP use before invasive treatment, although they did not know the protocol.

Conclusion

In conclusion, a better knowledge of the pharmacological effects of BP is crucial for conducting adequate anamnesis, requesting additional tests, and performing medical monitoring, which has a significant impact on the clinical practice of dental surgeons.

Perceptions of Schoolteachers About Teledentistry Use in Makkah City

OBJECTIVES

Teledentistry is a combination of communication technology and dentistry. Teledentistry is an alternative and useful way to remotely provide advisory, preventive, and emergency services in places with poor access to dental care. Few studies in Saudi have investigated the implementation of teledentistry at schools or assessed the perceptions of school personnel. This research aimed to evaluate teachers' perceptions about the use of teledentistry to examine schoolchildren in Makkah city.

METHODS

 The study was conducted on 20 intermediate schools randomly selected from different regions of Makkah city using a multistage cluster sampling method. Two data collectors visited the schools to administer the study questionnaire, exploring teachers' perceptions of teledentistry. The questionnaire was adapted from a validated survey based on the technology acceptance model (TAM). Descriptive statistics, analysis of variance, Mann-Whitney U test, and the Kruskal-Wallis tests were conducted to compare the mean differences in participants' perceptions of teledentistry based on their demographics.

RESULTS

 A total of 241 teachers completed the survey, 131 of whom were females (54.4%), and the mean age of participants was 42.5±7 years. Over 80% of participants taught ≥16 classes a week, and their experience ranged from less than a year to more than 31 years. Sixty participants (25%) knew teledentistry before watching the study video. The results revealed a significant difference between male and female teachers regarding perceptions of teledentistry. Female participants had higher scores in TAM dimensions than males.

CONCLUSION

 This survey revealed a generally favorable attitude toward teledentistry utilization in schools. Including non-dental employees, such as teachers to provide such a service will assist in alleviating the shortage or unavailability of dentists at schools. This goes in line with the government's plans to promote telehealth as part of the Saudi Vision 2030.

Phytochemical, antioxidant, and antibacterial activity of Moringa oleifera nanosuspension against peri-implantitis bacteria: An in vitro study

Objective

the Moringa oleifera leaf (MO) has active compounds that may be beneficial for peri-implantitis therapy. This research aims to analyze the phytochemical, antioxidant, and antibacterial properties of Moringa oleifera L. nanosuspension (MON) extract in peri-implantitis-related bacteria.

Methods

MON extract phytochemical analysis was conducted to examine active compounds such as flavonoids, saponins, quinones, alkaloids, tannins, terpenoids, and steroids. The 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay for antioxidant capacity was evaluated, and gas chromatography-mass spectrometry for the detection of volatile active compounds in MON extract was performed. Turax was used to create MON extract at concentrations of 1% and 2%, and then a particle size analysis was carried out. Prevotella intermedia (Pi), Porphyromonas gingivalis (Pg), Aggregatibacter actinomycetemcomitans (Aa), and Fusobacterium nucleatum (Fn) were tested for antibacterial activity of MON extract, comparing them with doxycycline as the reference drug and using the minimal inhibitory concentration (MIC), minimal bactericidal concentration (MBC), and diffusion zone methods.

Results

MON extract has lower antioxidant capacity than vitamin C. Flavonoids, saponins, quinones, alkaloids, tannins, terpenoids, and steroids were found in MON extract. 1% and 2% of MON extract has 10-40 d nm particle size. MIC, MBC and diffusion examination of 1% and 2% MON extract on Aa, Pg, Pi, and Fn were seen at concentrations of 25% and 12.5% with significantly different (p < 0.05) in vitro.

Conclusion

MON extract has potential antioxidant activity, and 1% or 2% of MON extract has antibacterial properties toward Aa, Pg, Pi, and Fn at concentrations of 25% and 12.5%, with significant differences.

Assessment of mandibular asymmetry in different skeletal malocclusions and vertical patterns in adult individuals: A cone-beam computed tomography study

OBJECTIVES

The study aims to measure the mandibular condylar height (CH), ramus height (RH), total height (CH+RH), asymmetry index, and condylar volume (Cvol) in individuals with different anteroposterior and vertical skeletal discrepancies.

MATERIALS AND METHODS

The study sample consisted of 131 subjects (60 females and 71 males) with a mean age of 35.06 ± 12.79 years. Pre-existing CBCT images were divided into groups according to the anteroposterior and vertical skeletal discrepancies. The investigator analyzed the data using t-tests to assess the mandibular bilateral sides of the individuals and gender differences. The mean difference between groups was determined using a one-way analysis of variance (ANOVA). The Chi-square test was used to study the association between the asymmetry index and groups.

RESULTS

Each individual's bilateral sides exhibited statistically significant differences in CH, RH, and Cvol (P = 0.033, P = 0.039, P = 0.005, respectively), but not in CH+RH (P = 0.458). There were, however, statistically significant gender differences in CH+RH (P < 0.001). Skeletal Class III and hypodivergent groups revealed the highest linear and volumetric values compared to other groups. The asymmetry index was increased in CH (P = 0.006) and Cvol (P = 0.002) in skeletal Class II subjects.

CONCLUSIONS

Significant differences in CH, RH, and Cvol were found on the right and left sides of the same individual. This study found increased linear and volumetric values in males, skeletal Class III, and hypodivergent subjects. Class II individuals had an increased CH and Cvol asymmetry index. This study highlights in-depth knowledge of mandibular asymmetry, which is extremely important to achieve an accurate diagnosis and provide the best treatment outcome.

Assessing the Self-reported After Events Following Immunization of COVID-19 Vaccines in Turkey and Bangladesh

Though mass vaccination programs helped to reduce the severity of the ongoing pandemic, various unwanted effects were reported in Turkey and Bangladesh after taking vaccines. The purpose of this study was to evaluate and compare the adverse effects of several vaccines in Turkey and Bangladesh and how the population of both countries prioritizes the continuation of vaccination compared to the side effects. An online survey with a pretest was conducted to gather data over the research period from July 10, 2021 to December 10, 2021. Finally, the questionnaire was shared with the mass population of Turkey and Bangladesh who have received at least one or two doses of the COVID-19 vaccines. The quality of the questionnaire was evaluated with Cronbach's alpha test. The study consisted of 1508 respondents from Bangladesh and 602 respondents from Turkey. Among the total 2110 respondents, 50.0% were male 66.8% were from the 18-30 years age range, and 77.5% reported living in the city area. Among all the respondents, 64.99% of those vaccinated in Bangladesh and 67.28% of those vaccinated in Turkey reported side effects after vaccinations. Participants receiving mRNA vaccines (Pfizer and Moderna) experienced the most side effects, with many reporting pain at the injection site in both nations. Following that, fever, body pain, and headache were common in Bangladesh, whereas body pain, fatigue, and arm numbness were common in Turkey. The study found no significant adverse events reported in Turkey and Bangladesh following the first and second doses of COVID-19 vaccination. These COVID-19 vaccines showed similar patterns of efficacy and safety during the short period of analysis. Vaccines from different manufacturers showed a non-significant level of adverse events during this binational AEFI approach to COVID-19 vaccines. More studies are recommended on the efficacy and safety of several vaccines to discover unexpected effects.

Periodontitis is associated with the development of fungal sinusitis: A nationwide 12-year follow-up study

AIM

The incidence of fungal sinusitis is increasing; however, its pathophysiology has not been investigated previously. We investigate the effect of periodontitis on the incidence of fungal sinusitis over a 12-year follow-up period using nationwide population-based data.

MATERIALS AND METHODS

The periodontitis group was randomly selected from the National Health Insurance Service database. The non-periodontitis group was obtained by propensity score matching considering several variables. The primary end point was the diagnosis of sinonasal fungal balls (SFBs) and invasive fungal sinusitis (IFS).

RESULTS

The periodontitis and non-periodontitis groups included 12,442 and 12,442 individuals, respectively. The overall adjusted hazard ratio (aHR) for SFBs in the periodontitis group was 1.46 (p = .002). In subgroup analysis, the aHR for SFBs was 1.59 (p = 0.008) for those with underlying chronic kidney disease (CKD), 1.58 (p = .022) for those with underlying atopic dermatitis, 1.48 (p = .019) for those with chronic obstructive pulmonary disease (COPD), and 1.36 (p = .030) for those with diabetes mellitus (DM), but these values are applicable only when considering the relationship between periodontitis and SFB. The aHR for IFS in the periodontitis group was higher than in the non-periodontitis group (2.80; p = .004).

CONCLUSIONS

The risk of SFBs and IFS increased after diagnosis of periodontitis. This trend is often more severe in patients with DM, COPD, or CKD, but this association with underlying diseases is applicable only when considering the association between periodontitis and fungal sinusitis.

A micro-computed tomographic analysis of the root canal systems in the permanent mandibular incisors in a Chinese population

BACKGROUND

Comprehensive understanding of the root canal system complexity is critical important for successful root canal therapy. A double root canal system may be present in permanent mandibular incisors with a variable incidence in different ethnic populations. Ignorance or improper management of this canal variation can lead to treatment failure. This in vitro study aimed to identify the anatomic features of root canal systems in the mandibular incisors in a Chinese population by using micro-CT.

METHODS

A total of 106 permanent mandibular incisors (53 central incisors and 53 lateral incisors) were collected from a native Chinese population. The teeth were scanned by a micro-CT scanner and then reconstructed three-dimensionally. The canal configurations were detected by Vertucci's classification, and the number and location of the accessory canals were also identified. The long (D) and short diameters (d) of the main and accessory canals were measured and D/d ratio was calculated at different root levels (cemento-enamel junction [CEJ] level, mid-root level and 1, 2, 3 and 4 mm from the apex). The root canal curvatures in the double-canaled mandibular incisors were measured at the proximal view by using modified Schneider's method. Chi-square test or Fisher's exact test was used for comparison of occurrence rates. Comparison of means from multiple groups was performed by using one-way ANOVA and LSD post-hoc test.

RESULTS

In regard to the occurrence of double root canals, gender difference was neither detected in the mandibular central (16.0% [male] vs 14.3% [female]; p = 0.862), nor in the mandibular lateral incisors (26.9% [male] vs 33.3% [female]; p = 0.611). Age group difference was also not detected in the mandibular central (p = 0.717) and lateral incisors (p = 0.521). The incidence of double root canals was 15.1% (8/53) in the central incisors, and 30.2% (16/53) in the lateral incisors, but the difference did not reach statistical significance (p = 0.063). The most frequent non-single canal type was the type III (1-2-1) (18.9% [20/106]), and the other types identified included 1 case of type II (2-1) and 3 cases of type V (1-2). The incidence of accessory canals was 17.9% (19/106), with a mean level of 1.92 ± 1.19 mm from the apex. The frequency of long-oval (2 ≤ D/d < 4) and flattened canals (D/d ≥ 4), as well as the mean value of D, d and D/d ratio increased from the apical 1 mm to the apical 4 mm level (the D/d ratio increased from 1.9 to 2.9 for the single canals, from 1.4 to 3.3 for the buccal canals and from 1.2 to 2.3 for the lingual canals), and the D/d ratio reached the peak at the mid-root level. Double curvatures were detected in 33.3% (8/24) of the buccal canals and 37.5% (9/24) of the lingual canals, and the difference has no statistical significance (p = 0.063). The degrees of the primary curvatures were 21.5 ± 7.1 degrees for the buccal and 30.1 ± 9.2 degrees for the lingual canals, and the degrees of secondary curvatures were 27.0 ± 11.4 degrees for the buccal and 30.5 ± 12.5 degrees for the lingual canals in the double curvatures. The degrees of the single curvatures were 14.2 ± 6.3 degrees for the buccal and 15.6 ± 6.0 degrees for the lingual canals. Significant difference was detected among above 6 groups of canal curvatures (p = 0.000), and severe curvatures (≥ 20 degrees) were more frequently detected in the double curved canals.

CONCLUSIONS

Double-canaled mandibular incisors were not uncommon in the Chinese population, and type 1-2-1 was the most frequent non-single canal type. Gender and age did not significantly impact the occurrence of a second canal in mandibular incisors. Long-oval and flattened canals were very common at different root levels and their incidence increased from apex to the mid-root level. Severe curvatures were frequently detected in the double canal systems, especially in those canals with double curvatures.

Dentists' attitudes toward patient-centered care and its predictors: a cross-sectional study in South Korea

BACKGROUND

Patient-centered care (PCC) has been one of medical practice's most frequently discussed principles. However, attitudes toward PCC among dentists remain underexplored. This study focuses on examining dentists' patient-centered attitudes and investigating their predictors.

METHODS

The Patient-Practitioner Orientation Scale which consists of Sharing and Caring subscales was used to assess patient-centered attitudes. The statistical analysis included 217 dentists from South Korea. Hierarchical linear regression analysis was performed to examine the predictors such as sociodemographic aspects, academic factors, work-related factors, and empathy.

RESULTS

A patient-centered attitude of Caring subscale (M = 4.29, SD = 0.56) emerged, but the provider-centered attitude was higher in Sharing subscale (M = 3.40, SD = 0.48). Work year, academic track, and empathy were associated significantly with an overall caring aspect of patient-centered attitude, while the gender effect remained insignificant. Empathy had a critical and significant impact on the patient-centered attitude.

CONCLUSIONS

Efforts to enhance patient-centeredness in Sharing are needed; post-graduate education and transition to a more patient-centered health system are recommended. Moreover, empathy still matters as it was found to be a significant predictor of patient-centered attitudes. The findings of this study support the need for efforts to enhance patient-centered attitudes among dentists, which will help generate discussion on improving the curriculum of post-graduate education and health system reform.

Periodontitis: An Oral Disease with Severe Consequences

Periodontitis, being a multifactorial disorder is found to be the most common oral disease denoted by the inflammation of gingiva and resorption of tooth supporting alveolar bone. The disease being closely linked with fast life style and determined by unhygienic behavioural factors, the internal milieu of oral cavity and formation of plaque biofilm on the dental and gingival surfaces. Porphyromonas gingivalis, being the major keystone pathogen of the periodontal biofilm evokes host immune responses that causes damage of gingival tissues and resorption of bones. The biofilm associated microbial community progressively aggravates the condition resulting in chronic inflammation and finally tooth loss. The disease often maintains bidirectional relationship with different systemic, genetic, autoimmune, immunodeficiency diseases and even psychological disorders. The disease can be diagnosed and predicted by various genetic, radiographic and computer-aided design (CAD) & computer-aided engineering (CAE) and artificial neural network (ANN). The elucidation of genetic background explains the inheritance of the disease. The therapeutic approaches commonly followed include mechanical removal of dental plaque with the use of systemic antibiotics. Awareness generation amongst local people, adoption of good practice of timely tooth brushing preferably with fluoride paste or with nanoconjugate pastes will reduce the chance of periodontal plaque formation. Modern tissue engineering technology like 3D bioprinting of periodontal tissue may help in patient specific flawless regeneration of tooth structures and associated bones.

Personality and oral health-related quality of life. Results from an online survey

BACKGROUND

To investigate the association between personality factors and oral health-related quality of life.

METHODS

Data were taken from an online survey (representative for the general adult population in Germany in terms of region, sex and age group; n = 3,075) performed in late summer 2021. The well-established Oral Health Impact Profile (OHIP-G5) was used to measure oral health-related quality of life. Moreover, the established 10 Item Big Five Inventory (BFI-10) was used to quantify personality factors (in terms of agreeableness, conscientiousness, extraversion, neuroticism, and openness to experience). Sex, age, family status, educational level, smoking status, alcohol consumption, sports activities, presence of chronic diseases and self-rated health were adjusted for in multiple linear regression analysis.

RESULTS

Pearson correlations between oral health-related quality of life and personality factors ranged from r =- 0.17 (conscientiousness) to r = 0.17 (neuroticism). Regressions revealed that low oral health-related quality of life is associated with higher neuroticism (β = 0.39, p < 0.001) and lower conscientiousness (β=-0.51, p < 0.001).

CONCLUSION

This study revealed an association between personality factors (higher neuroticism and lower conscientiousness) and low oral health-related quality of life. Before dental treatment, it may be helpful to measure personality traits of patients in order to predict the expectations of patients, as well as their responses to intended treatments. This may support the identification of the most appropriate method of treatment.

Pathogenic Connections in Post-COVID Conditions: What Do We Know in the Large Unknown? A Narrative Review

The coronavirus 2019 (COVID-19) disease has long-term effects, known as post-COVID conditions (PCC) or long-COVID. Post-COVID-19 syndrome is defined by signs and symptoms that occur during or after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection which persist for more than 12 weeks and cannot be supported by an alternative diagnosis. The cardiovascular damage caused by COVID-19 in the severe forms of the disease is induced by severe systemic inflammation, considered to be one of the causes of myocardial lesions, with increased levels of circulating cytokines and toxic response mediators. We have focused on conditions that can induce long-COVID-19, or multisystem inflammatory syndrome in adults or children (MIS-C/MIS-A), with an emphasis on endocrinological and metabolic disorders. Although described less frequently in children than in adults, long-COVID syndrome should not be confused with MIS-C, which is an acute condition characterized by multisystem involvement and paraclinical evidence of inflammation in a pediatric patient who tested positive for SARS-CoV-2. At the same time, we mention that the MIS-A symptoms remit within a few weeks, while the duration of long-COVID is measured in months. Long-COVID syndrome, along with its complications, MIS-A and MIS-C, represents an important challenge in the medical community. Underlying comorbidities can expose both COVID-19 adult and pediatric patients to a higher risk of negative outcomes not only during, but in the aftermath of the SARS-CoV-2 infection as well.

Mandibular Second Premolar with Four Canals: A Case Report

The mandibular second premolar can be considered one of the most challenging teeth to treat endodontically; due to the complexity of its root canal morphology and increased incidence of multiple canals. The knowledge of internal anatomy of root canals and their possible variations as well as use of magnification, e.g. operating microscope, radiographic examination and illumination, can increase the chances of finding additional canals and contribute to the success of endodontic treatment. The purpose of the current investigation is to report the successful endodontic treatment of a mandibular second premolar with 4 canals; all of them in one single root.

Is Antifibrinolytic Therapy Effective for Preventing Hemorrhage in Patients with Hemophilia Undergoing Dental Extractions? A Systematic Review and Meta-Analysis

Objectives

This systematic review aims to analyze the systemic administration of antifibrinolytics (tranexamic acid and aminocaproic acid) to prevent postoperative bleeding in patients with hemophilia.

Methods

This systematic review was conducted adhering to PRISMA guidelines. Only randomized controlled trials that assessed human subjects of any age or gender with any severity of hemophilia undergoing dental extractions, and systemically administered antifibrinolytic therapy compared to placebo were included. Post-operative bleeding episodes and adverse events were presented. PubMed, Cochrane, Embase, CINAHL, Web of Science, and Scopus were searched through April 15, 2022. The risk ratio (RR) and odds ratio (OR) applying 95% confidence intervals (CI) were computed using RevMan 5.4.1 (Cochrane).

Results

Two randomized, placebo-controlled trials pooling in a total of 59 patients were pooled in this analysis. Among patients administered antifibrinolytic therapy, 84% reduced risk of post-operative bleeding was reported (RR = 0.16, 95% CI = 0.05–0.47, P = 0.0009). The chances of post-operative bleeding were reduced by 95% among the antifibrotics group (OR = 0.05, 95% CI = 0.01–0.22, P < 0.0001).

Conclusion

This review finds favorable outcomes for the routine use of antifibrinolytic therapy for dental extractions in hemophiliacs. Further trials are required to rationalize existing evidence.