A cross-sectional mental-health survey of Chinese postgraduate students majoring in stomatology post COVID-19 restrictions

Background

The psychological status of Chinese postgraduate students majoring in stomatology after the COVID-19 restrictions still remains unclear. The objective of this study is to evaluate the mental status through a cross-sectional survey and gather related theoretical evidence for psychological intervention on postgraduate students majoring in stomatology.

Methods

An online survey was administered, and subjective well-being, anxiety, stress and depression symptoms were assessed using the 5-item World Health Organization Well-Being Index (WHO-5), item Generalized Anxiety Disorder Scale (GAD-7), 10-item Perceived Stress Scale (PSS-10), and Patient Health Questionnaire-9 (PHQ-9), respectively, wherein suicidal ideation and sleep-related problems were measured with PHQ-9 and Insomnia Severity Index (ISI).

Results

A total of 208 participants who completed one questionnaire were considered as valid. It was found that female respondents generally exhibited significantly higher levels of PSS-10, PHQ-9, and GAD-7 scores and shorter physical activity hours than male students. Students from rural areas demonstrated significantly higher levels of PHQ-9, suicidal ideation, and less portion of good or fair family economic support. Additionally, individuals from only-child families reported increased levels of activity hours (1.78 ± 2.07, p = 0.045) and a higher portion (55.10%, p = 0.007) of having clear future plan as compared with multiple-child families. The risk factors for anxiety symptoms (GAD-7 score) were higher scores of PSS-10 (OR = 1.15, 95% CI = 1.09-1.22), PHQ-9 (OR = 1.35, 95% CI = 1.22-1.49), and ISI-7 (OR = 1.14, 95% CI = 1.06-1.23), while owning a clear graduation plan was the protective factor (OR = 0.55, 95% CI = 0.31-0.98). Moreover, the risk factors for depressive symptoms (PHQ-9) included PSS-10 (OR = 1.10, 95% CI = 1.04-1.16), GAD-7 (OR = 1.38, 95% CI = 1.25-1.52), suicidal ideation (OR = 5.66, 95% CI = 3.37-9.51), and ISI-7 (OR = 1.17, 95% CI = 1.09-1.25). Approximately 98.08% of Chinese postgraduates studying stomatology reported experiencing at least moderate stress after the COVID-19 restrictions.

Conclusion

Within the limitations of this study, senior students were more inclined to stress, while anxiety symptoms were related to severer levels of stress, depression, and insomnia. Depressive symptoms were associated with higher levels of stress, anxiety, insomnia, suicidal ideation, and lower levels of self-reported well-being. Thus, psychological interventions for postgraduates should be timely and appropriately implemented by strengthening well-being, reasonably planning for the future, and good physique, thereby mitigating the psychological issues after COVID-19 restrictions.

A Systematic Review of the Relationship between Serum Vitamin D Levels and Caries in the Permanent Teeth of Children and Adolescents

This systematic review critically evaluates the association between serum Vitamin D levels and dental caries incidence in the permanent teeth of children and adolescents. The search strategy comprised three databases (PubMed, Scopus, Embase), up to November 2023, targeting studies on the correlation between Vitamin D and dental caries in permanent dentition. The eligibility criteria focused on observational studies involving children and adolescents aged 12 to 19 years with permanent dentition. The screening process, guided by the PRISMA guidelines and the Newcastle-Ottawa Scale for quality assessment, resulted in the inclusion of eight studies conducted across various global regions from 2013 to 2023. The analysis revealed that Vitamin D insufficiency and deficiency were prevalent among the study populations, ranging from 17.3% to 69.4%. Specifically, children and adolescents with Vitamin D insufficiency (<50 nmol/L) were found to have significantly higher odds of developing caries, with odds ratios (ORs) ranging from 1.13 to 2.57. Conversely, two studies indicated a protective effect of higher Vitamin D levels, with an OR of 0.80 and 0.59, respectively, for caries among children and adolescents with serum levels ≥ 50 nmol/L, suggesting an inverse relationship between Vitamin D status and caries risk. The results indicate both the protective role of adequate serum levels of Vitamin D above 20 ng/mL and the increased risk associated with insufficient levels below this threshold. However, the variations in study quality, methodologies and geographic settings underscore the challenges in drawing universal conclusions. Despite these limitations, our review suggests that improving Vitamin D status could be a beneficial component of preventive strategies against dental caries in children and adolescents, warranting further research to clarify the clinical significance of our findings.

Literature review and prospect on oral cognition and disease diagnosis and treatment between Han and Tang dynasties

Chinese medicine entered a significant period from foundation to maturity between Han and Tang dynasties when the Chinese traditional stomatology was a key stage. Sorting and analysis of existing literature and research outcomes have showed that current research on stomatology between Han and Tang dynasties focuses on oral physiology, pathology, diagnosis and treatment, and health care. It also involves stomatology history and explanation of termino-logies related to mouth and teeth recorded in medical books, use of simple methods, and thinking with citation and analysis of literature simply listed and reasoning preliminarily deducted. From the macro perspective, current research has not unveiled the whole picture of stomatology between the two dynasties and left a series of key issues unresolved. Thus, new methods should be developed and employed to carry out medical research on stomatology between Han and Tang dynasties given that is has a prosperous future.

The risk profile of electronic nicotine delivery systems, compared to traditional cigarettes, on oral disease: a review

The use of electronic nicotine delivery systems (ENDS) has exploded, especially among teenagers and new smokers, amid widespread awareness of the dangers of traditional tobacco and restrictions on smoking. However, the risk effects of ENDS on physical health, especially oral health, are still ambiguous. The purpose of this study was to review the available evidence on risks of ENDS on oral health, and compares the differences between ENDS and traditional cigarettes. For heavy smokers, transferring the addiction of tobacco to ENDS can be less harmful to periodontal condition and physical health but is not completely without risk. The components of ENDS vapor have cytotoxic, genotoxic, and carcinogenic properties, and its usage may be associated with a wide range of oral health sequelae. The chemicals in ENDS increase the susceptibility to tooth decay, increase the risk of periodontal disease, peri-implant, and oral mucosal lesions. Nicotine aerosols from ENDS can be a potential risk factor for oral cancer due to the presence of carcinogenic components. Compared to smoking traditional cigarettes, the harm associated with ENDS use may be underestimated due to the reduced ability to control vaping behavior, ease of ENDS access, fewer vaping area restrictions, and better taste. Currently, the available evidence suggests that ENDS may be a safer alternative to traditional tobacco products. Though most oral symptoms experienced by ENDS users are relatively mild and temporary compared to traditional cigarettes, the dangers of ENDS still exist. However, further research with longer follow-up periods is required to establish the long-term safety of ENDS.

Graphene/hydroxyapatite coating deposit on titanium alloys for implant application

Titanium (Ti) implants are widely used in medicine. Meanwhile, surface modification of Ti can strengthen the osseointegration of implants. In this study, we modified Ti implant surfaces, which was coated with GO, HA, HA-2wt%GO and HA-5wt%GO via electrophoresis deposition, to investigate their mechanisms and biological activity. Uncoated Ti was used as the control. Further, we examined the biological behavior and osteogenic performance of mouse bone marrow mesenchymal stem cells (BMSCs) cultured on coatings in vitro. We found that the HA-GO nanocomposite coating improved the roughness and hydrophilicity of the Ti surface. Compared with the uncoated Ti or Ti modified by HA or GO alone, cell adhesion and diffusion were enhanced on HA-GO-modified Ti surfaces. In addition, the proliferation and osteogenic differentiation of BMSCs in vitro were significantly improved on HA-GO-modified surfaces, whereas osteogenesis-related gene expression and alkaline phosphatase activity were slightly enhanced. Furthermore, we noted that bone regeneration was improved in the HA-2wt%GO group in vivo. Thus, the HA-2wt%GO nanocomposite coating might have potential applications in the field of dental implants.

Relationship between Job Burnout, Depressive Symptoms, and Career Choice Regret among Chinese Postgraduates of Stomatology

A qualified Chinese dental postgraduate requires at least eight years of training. The huge academic burden, strict clinical requirements, and high workload increases the risk of job burnout, depression symptoms, and career choice regret of dental postgraduates, which may cause one to waver in their choice of a career as a doctor. Therefore, we aimed at assessing the relationship between job burnout, depressive symptoms, and career choice regret among Chinese dental postgraduates. The Chongqing Stomatological Association conducted an online cross-sectional study among 558 dental postgraduates in China, with an average age of 22.54 ± 2.44. Demographic information, the Maslach Burnout Inventory, the 2-item Primary Care Evaluation of Mental Disorders scale, and career choice regret scale were included in the questionnaire. About 41.0% of dental postgraduates experienced job burnout, 44.1% had depressive symptoms, and 41.6% reported career choice regret. Logistic regression analysis indicated the risk factors for job burnout were time worked/studied per week, depressive symptoms, and career choice regret. Job burnout and career choice regret was significantly related to depressive symptoms (p < 0.001). Risk factors for career choice regret were gender, postgraduate entrance examination score, daily hours of sleep, job burnout, and depressive symptoms. Such results suggest that job burnout, depressive symptoms, and career choice regrets are prevalent among dental postgraduates. Accurate measures should be taken to change this situation.

Severe oral mucositis relating to pain and worse oral condition among patients with solid tumors undergoing treatment with FOLFIRI and 5-FU: a retrospective study

BACKGROUND

There is a need for studies that correlate the severity of oral mucositis (OM) with chemotherapy protocols, transient myelosuppression and oral health.

OBJECTIVE

To analyze the severity of OM among individuals with solid tumors during hospitalization and its correlation with the type of chemotherapy, myelosuppression and oral health condition.

DESIGN AND SETTING

Retrospective study at a public hospital in Bauru, state of São Paulo, Brazil, that is a regional referral center.

METHODS

Individuals diagnosed with solid malignant tumors who received chemotherapy during hospitalization for completion of the antineoplastic treatment cycle or who presented complications resulting from this were assessed.

RESULTS

Twenty-eight individuals (24.3%) manifested some degree of OM. The most prevalent degrees of OM according to the World Health Organization (WHO) and modified WHO classification were grades 2 (11.3%) and 5 (4.3%), respectively. It was observed that the higher the OM-WHO (P < 0.001; r = 0.306) and modified OM-WHO (P < 0.001; r = 0.295) classifications were, the greater the oral pain reported by the individuals was. Presence of mucositis in the upper lip and buccal mucosa contributed to increased severity of OM and worsening of swallowing during hospitalization. Thus, severe OM was associated with use of the FOLFIRI protocol (folinic acid, fluorouracil and irinotecan).

CONCLUSION

Individuals with tumors who presented severe OM had greater severity of oral pain and worse oral health. Use of the FOLFIRI protocol was associated with higher prevalence of severe OM, while use of 5-fluorouracil (5-FU) was correlated with worse oral condition.

Novel Multifunctional Spherosilicate-Based Coupling Agents for Improved Bond Strength and Quality in Restorative Dentistry

The aim of this study was to investigate the restorative connections of composite materials after fracture, under controlled conditions of treating the materials with novel, spherosilicate-based (SS) primers bearing both methacryl (MA) and trimethoxysilyl (TMOS) groups. The chemistry of methacrylate group insertion and reactive groups hydrolysis has been studied with the aid of ¹H NMR (Nuclear Magnetic Resonance) spectroscopy. The light-cured resin composites were repaired by activating the connection site with the obtained primers and, for comparison, a silane (methacryloxypropyltrimethoxysilane, MATMOS) as a conventional coupling agent bearing the same reactive groups. The resistance of such a joint was tested in a three-point bending test after 24 h and 28 days period of sample conditioning. The effect of bond application was also studied, showing that spherosilicate-based primers may be used more effectively than MATMOS for two-step (primer-composite) restorative process, while for silane, the three-step process with bond application is crucial for satisfactory joint quality. The joint failure mode was determined by microscopic analysis and it was found that SS-4MA-4TMOS and SS-2MA-6TMOS application resulted in mostly composite, and not joint, failure. After 28 days of conditioning, the flexural strength of the joint repaired with SS-4MA-4TMOS was at 94% of the neat, solid material under the same procedure. However, the strength of the neat composite was observed to decline during the conditioning process by ~30%. The joint behavior was explained on the basis of the gradual hydrolysis effect (the greatest decrease being observed for silane).

The Oral Complications of COVID-19

Background: COVID-19 is a novel coronavirus infectious disease associated with the severe acute respiratory syndrome. More and more patients are being cured due to the development of clinical guidelines for COVID-19 pneumonia diagnosis, treatment, and vaccines. However, the long-term impact of COVID-19 on patients after recovery is unclear. Currently available reports have shown that patients recovered from COVID-19 continue to experience health problems in respiratory and other organ systems. Oral problem is one of the important complications which has serious impacts on the rehabilitation and future quality of life, such as ageusia and macroglossia, but the oral complication is often being neglected.

Aim of Review: From the perspective of stomatology, we summarized and elaborated in detail the types, pathogenesis of oral complications from COVID-19 patients after rehabilitation, and the reported prevention or treatment recommendations which may improve the COVID-19 patients associated oral diseases.

Key Scientific Concepts of Review: 1) To understand the common oral complications and the mechanisms of the development of oral complications after the COVID-19 recovery; 2) To summary the practical strategies to prevent the oral complications and construct the rehabilitation plans for patients with oral complications.

Rehabilitation of the Completely Edentulous Mandible by All-on-Four Treatment Concept: A Retrospective Cohort Study with Up to 10 Years Follow-Up

(1) Background and Objectives. Currently, there are no definitive long-term data about clinically significant difference in the failure of prosthesis and implant or marginal bone loss related to the rehabilitation of the completely edentulous mandible by all-on-four treatment concept. The main aim of present investigation was to report the long-term outcomes (10-years follow-up) of complete-arch mandibular rehabilitations based on the all-on-four concept. (2) Materials and Methods. Patients in need of extractions of teeth due to the occurrence of caries and/or severe periodontal disease and patients presented with edentulous mandibles were enrolled to the study. A total of 96 participants (mean follow-up period after intervention of 3185.2 days) were enrolled in the study. Participants were evaluated at the first visit, 10 days after intervention and every year after the intervention. Implant and prosthesis survival, bone loss and both local biological and mechanical complications were evaluated during the follow-up period. (3) Results. An implants’ survival rate of 97.9% was observed at the end of the follow-up period. Biological complications were reported in 19.8% of patients, whereas mechanical complications were reported in 27.1% of cases. The average marginal bone level at baseline was −0.03 mm. A significant marginal bone loss was observed after 10-years follow-up (2.5 mm). Binary logistic regression analysis showed significant association between smoke and both marginal bone loss and local biological complications. Lastly, a significant association was observed between bruxism and mechanical complications. (4) Conclusions. The high implant and prosthesis survival rate and the moderate incidence of biological and mechanical complications observed in present investigation can be associated to several factors such as high implant primary stability, prosthetic design, and control of the occlusal forces.

[The development of algorithm of preventive consideration of applications of citizen for stomatological polyclinics administrators]

The key priorities of the concept of development of health care in the Russian Federation is the population health support and increasing of availability and quality of medical care. The critical link in chain of interaction between medical organizations and residents is examination of applications of citizen. An appeal of citizen received by state authority, local self-government authority or by the official in accordance with their competence is to be a subject of mandatory proceeding. The service of non-staff chief stomatologist based on the organizational methodical office of Moscow Oblast Stomatological Polyclinic the comprehensive analysis of appeals of citizen appeals regarding provision of medical care in stomatological polyclinics of the Moscow Oblast was carried out. The analysis of summary of tasks demonstrated that in 2020, 107,511 appeals of citizens were received and 1002 tasks were related to stomatological care support that accounts 0.93% of total number of appeals. The results of analysis permitted to elaborate a set of recommendations for administrators of stomatological medical organizations to improve quality of examination of appeals of citizen.

Disinfectants Used in Stomatology and SARS-CoV-2 Infection

Effective disinfection is a basic procedure in medical facilities, including those conducting dental surgeries, where treatments for tissue discontinuity are also performed, as it is an important element of infection prevention. Disinfectants used in dentistry and dental and maxillofacial surgery include both inorganic (hydrogen peroxide, sodium chlorite-hypochlorite) and organic compounds (ethanol, isopropanol, peracetic acid, chlorhexidine, eugenol). Various mechanisms of action of disinfectants have been reported, which include destruction of the structure of bacterial and fungal cell membranes; damage of nucleic acids; denaturation of proteins, which in turn causes inhibition of enzyme activity; loss of cell membrane integrity; and decomposition of cell components. This article discusses the most important examples of substances used as disinfectants in dentistry and presents the mechanisms of their action with particular focus on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The search was conducted in ScienceDirect, PubMed, and Scopus databases. The interest of scientists in the use of disinfectants in dental practice is constantly growing, which results in the increasing number of publications on disinfection, sterilization, and asepsis. Many disinfectants often possess several of the abovementioned mechanisms of action. In addition, disinfectant preparations used in dental practice either contain one compound or are frequently a mixture of active compounds, which increases their range and effectiveness of antimicrobial action. Currently available information on disinfectants that can be used to prevent SARS-CoV-2 infection in dental practices was summarized.

Strontium-Substituted Dicalcium Silicate Bone Cements with Enhanced Osteogenesis Potential for Orthopaedic Applications

Incorporating Sr element in biomaterials for bone implants is an effective way to improve their biological performance, as Sr element has been proved to enhance bone regeneration and depress bone resorption activity. In the present study, we developed a Sr-incorporated dicalcium silicate (C2S) bone cement as a potential candidate for bioactive self-setting bone cement in orthopaedics and stomatology. The Sr-C2S powders containing 0.3–6.8% Sr in molar ratio were prepared by means of chemical co-precipitation, and the results of XRD analysis indicated the incorporation of Sr element into the lattice of C2S. Sr-C2S bone cements, as prepared by mixing the powders with water, have a final setting time of 570 to 594 min, and compressive strength higher than that of C2S bone cement within certain incorporation range. The Sr-C2S bone cements possessed good in vitro bioactivity by inducing apatite formation in simulated body fluid (SBF) within 7 days. Moreover, the proliferation activity of human bone marrow mesenchymal stem cells (hBMSCs) with Sr-C2S bone cements was significantly higher than that with C2S bone cement, and the alkaline phosphatase (ALP) activity of hBMSCs was also enhanced with addition of Sr element in Sr-C2S groups. The Sr-C2S might therefore be a bioactive self-setting material with enhanced biological performance and holds the prospect for application in the bone regeneration area.

[Dental-craniofacial manifestation and treatment of rare diseases in China]

Rare diseases are genetic, chronic, and incurable disorders with relatively low prevalence. Thus, diagnosis and management strategies for such diseases are currently limited. This situation is exacerbated by insufficient medical sources for these diseases. The National Health and Health Committee of China recently first provided a clear definition of 121 rare diseases in the Chinese population. In this study, we summarize several dental-craniofacial manifestations associated with some rare diseases to provide a reference for dentists and oral maxillofacial surgeons aiming at fast-tracking diagnosis for the management of these rare diseases.

Application of robotics in stomatology

The application of robots in oral treatment can not only reduce the work intensity of clinicians but also improve the accuracy of treatment. In this article, the application and research status of robots in stomatology are reviewed.

[Application of artificial intelligence in stomatology treatment and nursing]

Currently, artificial intelligence technology is being developed rapidly and is used in many clinical areas, especially in stomatology. The application of artificial intelligence technology in stomatology is a new technological revolution. This study focuses on artificial intelligence and its application status. The advantages, current situation, and development prospect of the application of artificial intelligence technology in stomatology treatment and nursing, such as oral and maxillofacial surgery, implant, prosthetics, orthodontics, oral medicine therapy, guidance, and teaching, are provided.

The oral cavity - potential source of stem cells

The purpose of this review is to present the current knowledge regarding the hierarchy of stem cells originating from the oral cavity, which could have a potential value when applied to regenerative stomatology. It must be particularly emphasized that the heterogenous nature of its biology and function within oral compartment may predispose them to different types of applications. Stem cells can be perceived as immature, primitive and unspecialized types of cells with the ability to proliferate, self-renew and differentiate into specialized progeny according to the compartmental signaling. Their presence in tissue reservoirs was already discovered in many organs and tissues as well as in the stomatognathic system. The oral cavity appears to be an exceptionally attractive site to acquire stem cells. The common presence and easy access to these cells in dental and peridental tissues provides a real chance to apply them for therapeutic purposes. Such an opportunity would also be neutral to bioethical and moral issues, assuming autologous stem cells employment. Many authors suspect that stem cells have epigenetic memory, so some of their features can be inherited through generations. They are not connected, however, with DNA sequence modifications. It is, therefore, justified to apply the cells, which have the oral cavity as their natural reservoir, in interventions associated with tissue engineering within the stomatognathic system. An increasing number of clinical trials, among which the number of randomized studies with large group of patients is progressively carried out, allows for a prediction that shortly therapeutic methods based on stem cells of dental origin may be implemented to the routine repertoire of clinical practice.

[Application of Raman spectroscopy in the stomatology]

Raman spectroscopy is an optical technology based on the theory of Raman scattering, which is generally used in the research of medical and biological science. Raman spectroscopy can be used to detect the molecular structures and components of proteins, lipids, DNA, and other biological molecules, and provide substantial information about molecules. Thus, Raman spectroscopy is generally considered a "molecular fingerprint", and it has exceptional advantages in medical research. Moreover, this technique can reflect the changes in molecular structures and detect the alterations of chemical constituents in the samples. Raman spectroscopy, given its high sensitivity and specificity in the detection of the biological samples, has been successfully used to detect and diagnose diseases in numerous sites, such as skin, oral mucosa, breast, head, and neck. In this paper, we introduce the application of Raman spectroscopy in stomatology by conducting a review of the literature.

[Application of Raman spectroscopy in the stomatology]

Raman spectroscopy is an optical technology based on the theory of Raman scattering, which is generally used in the research of medical and biological science. Raman spectroscopy can be used to detect the molecular structures and components of proteins, lipids, DNA, and other biological molecules, and provide substantial information about molecules. Thus, Raman spectroscopy is generally considered a "molecular fingerprint", and it has exceptional advantages in medical research. Moreover, this technique can reflect the changes in molecular structures and detect the alterations of chemical constituents in the samples. Raman spectroscopy, given its high sensitivity and specificity in the detection of the biological samples, has been successfully used to detect and diagnose diseases in numerous sites, such as skin, oral mucosa, breast, head, and neck. In this paper, we introduce the application of Raman spectroscopy in stomatology by conducting a review of the literature.

[Evidence-based medicine in stomatology]

Evidence-based medicine (EBM) has rapidly developed in recent years and is currently a hotspot in international medicine. The guiding principle behind EBM is that any medical decision should be determined based on objective clinical and scientific evidence, doctor's professional skills and experience, and patient's needs and desires. This paper introduces the concept and practice of EBM and explains how it can be used to solve the issues in stomatology.

An introduction to clinical practice guideline for Chinese undergraduates in stomatology

The Society of Dental Education, Chinese Stomatological Association has formulated the Standards of Clinical Practice for Chinese Undergraduate Students Majoring in Stomatology, on the basis of extensively soliciting the views of experts in various fields. The aim of this standard is to guide clinical teaching and improve teaching quality in schools of stomatology in China. The standards include eight parts: the standard of clinical practice for oral and maxillofacial surgery, for cariology and endodontics, for periodontics, for the oral mucosa diseases, for preventive dentistry, for pedodontology, for prosthodontics and for oral imageology. Each part includes introduction to subjects, the clinical practice time period, the purpose and requirements of practice, the disease types of practice and items of clinical operation, the index of the lowest workload of practice and the major methods of assessment. These standards are not only the basic requirements and guiding principles for clinical teaching, but also the major criteria for assessing the clinical teaching quality of stomatological colleges/schools of China.

Disciplinary competitiveness analysis in international stomatology education

With economic and cultural globalization, the trend of globalization of higher education becomes inevitable. Using the concept of competitiveness, the authors established a principal component analysis (PCA) model to examine disciplinary competitiveness in stomatology of various higher education institutions worldwide. A total of forty-four universities entered the final list according to these calculations. Possible reasons for their selection were explored and explained at macro and micro levels. The authors further accessed various sources of data and summarized several suggestions for enhancing disciplinary competitiveness for other universities in pursuit of promoting their position in the global spectrum.