Abstract: This study aimed to evaluate the long-term impact of paediatric dentistry programmes on children and adolescents to reduce oral health inequalities. It measures and assesses the improvement effects of paediatric dentistry programmes on the oral health of children and adolescents as part of the efforts to decrease oral health disparities in this age group. It included 406 individuals who participated in student and paediatric dentistry programmes between 2013 and 2019 at screening facilities in Gwangjin-gu, Seoul. Frequency analysis was conducted for demographic characteristics, and binary logistic regression analysis was performed to identify factors influencing the prevalence of dental caries as the dependent variable. Data were analysed using PASW Statistics with the statistical significance level set at α=0.05. Regarding oral health indicators based on the frequency of participation in paediatric dentistry programmes for children and adolescents, participants with seven or more sessions had lower prevalence rates of dental caries, malocclusion, and periodontal disease than those with only one session. Second, when comparing oral health indicators in paediatric dentistry programmes between primary and adolescent age groups, individuals under continuous management showed a decrease in permanent teeth affected by dental caries, dental caries prevalence, and malocclusion prevalence (excluding primary school age). Third, binary logistic regression analysis revealed significant influences (p

Lyme disease, the leading vector-borne ailment in the U.S., annually affects an estimated 476,000 individuals, predominantly in the Northeast and Upper Midwest. Despite its increasing incidence, the evaluation of risk within U.S. cities, including natural public lands, remains inadequate. This study focuses on blacklegged tick occurrences and Borrelia burgdorferi infection prevalence in 24 Staten Island parks, aiming to assess Lyme disease exposure risk. Monthly acarological risk index (ARI) calculations from 2019 to 2022 revealed elevated values (0.16-0.53) in specific parks, notably Wolfe’s Pond Park, High Rock Park, Clay Pit Pond Park, Clove Lake Park, and Fair View Park. June (0.36) and November (0.21) consistently exhibited heightened ARIs, aligning with peak tick collection months. Despite stable yearly infection rates at 28.97%, tick densities varied significantly between parks and years. Identifying a high transmission risk in specific parks in Staten Island, a highly urbanized part of New York City, emphasizes the continuous necessity for Lyme disease risk management, even within the greenspaces of large cities.

Many protein expression systems are primary utilised to produce a single, specific recombinant protein. In contrast, most biological processes such as virus assembly rely upon a complex of several interacting proteins rather than the activity of a sole protein. The high complexity of the baculovirus genome, coupled with a multiphase replication cycle incorporating distinct transcriptional steps, made it the ideal system to manipulate for high-level expression of a single or co-expression of multiple foreign proteins within a single cell. We have developed and utilised a series of recombinant baculovirus systems to unravel the sequential assembly process of a complex non-enveloped model virus, Bluetongue virus (BTV). The high protein yields expressed by the baculovirus system not only facilitated structure-function analysis of each viral proteins but were also advantageous to crystallography studies and supported the first atomic level resolution of a recombinant viral protein, the major BTV capsid protein. Further, the formation of recombinant double-shelled virus-like particles (VLPs) provided insights into the structure-function relationships among the four major structural proteins of the BTV whilst also representing a potential candidate for a viral vaccine. The baculovirus multi-gene expression system facilitated the study of structurally complex viruses (both non-enveloped and enveloped viruses) and heralded in a new generation of viral vaccines.

Wastewater-Based Epidemiology (WBE) is currently used to monitor not only the spread of the pandemic virus SARS-CoV-2 but also for other viruses in endemic conditions, particularly in the absence of syndromic surveillance. Continuous monitoring of sewage requires high costs and significant time investment, highlighting the need for standardized methods and structured monitoring strategies. In this context, we conducted weekly wastewater monitoring in northwestern Italy, targeting Human Adenovirus (HAdV), Norovirus Genogroup II (NoVggII), Enterovirus (EV), and SARS-CoV-2. Samples collected at the entrance of treatment plants were concentrated using PEG/NaCl precipitation and viral nucleic acids were extracted and detected by real-time (RT-)qPCR. NoVggII resulted the most identified target (84.4%), followed by HAdV, SARS-CoV-2, and EV. Only HAdV and EV exhibited seasonal peaks in spring and summer. SARS-CoV-2 results compared with data previously collected in the same study area (February 2021 to September 2021) revealed a shift from an epidemic to a pandemic status, likely due to the evolution of variants. In conclusion, WBE, using standardized methods and an efficient monitoring strategy, proves valuable for virus surveillance in pandemic and epidemic scenarios, enabling the identification of temporal-local distribution patterns that are useful for making informed public health decision.

Malocclusions have a continuously increasing prevalence from a generation to another as a result of climate changes, soil, atmosphere and water pollution. All of these aspects have unfavorable consequences on the nutritional scheme. Thus, nutrition together with other etiopathogenic factors contribute to complex alterations in the somatic development of the entire organism and, implicitly, of the cephalic extremity. The study group included 4147 children from randomly selected schools from Vâlcea County, Romania. The aim of this study is to determine the prevalence of malocclusions in schoolchildren from Vâlcea County, Romania, according to the three main classes of malocclusions (according to Angle’s classification), age groups (from 6 to 10 years old and from 11 to 14 years old), gender (male and female) and place of origin (rural and urban). For Angle class I malocclusions we recorded the highest prevalence (48,78% from the total number of schoolchildren with malocclusions), followed by Angle class II malocclusions (45,85% from the total number of schoolchildren with malocclusions) and for Angle class III malocclusions we found the lowest prevalence (5,37% from the total number of schoolchildren with malocclusions).According to gender, we found the highest prevalence in female gender (29,90% from the total number of female subjects), while in male gender we recorded a prevalence of 27,70% from the total number of male subjects. Regarding the place of origin, there is a higher prevalence of malocclusions in the urban areas (29,16%). The study subgroup included 140 children randomly selected from the total number of subjects from the study group. They were included in a more advanced study. The aim is to find potential associations between the presence of malocclusions and various oral variables. Categorical variables were expressed as numerical values and percentages, and their association was evaluated with either the Chi-square test of association or homogeneity, or the Fisher Exact test. The acquired data were incorporated into a binomial logistic regression model to assess the likelihood of developing malocclusions in relation to the following variables: defective phonation, bruxism, frequency of teeth brushing, onychophagia, oral respiration, infantile deglutition, placing objects between the maxillaries, thumb sucking and salivary aspects. It is also aimed to compare the results obtained with similar ones from the specialized literature.

Safe water is a global public health concern amid increasing scarcity and pollution. Bottled water production and consumption contribute to these problems. This study examines tap water consumption in Italy, assessing associated sociodemographic factors and related health outcomes such as obesity and self-perceived health status. Data from the Italian National Statistics Institute's "Aspects of daily life" survey (N=45,597) were analyzed. Covariates included education, age, gender, economic status, region, concerns about waste and climate change, consumption of carbonated drinks excluding water, alcohol consumption, consumption of vegetables, consumption of snacks, body mass index, and self-perceived health status. Bivariate analyses and mixed-effect logistic regression models explored the associations. People who drink tap water were 19,674 with a higher prevalence in people aged 45 to 59 old, people with a graduate/post-graduate degree diploma, with optimal economic resources, and concerned about waste production and climate change, coming from the North-East regions of Italy. Underweight people showed a higher prevalence of TW assumption as well as those who drink less than occasionally carbonated drinks, drink alcohol, consume vegetables more than once a day, and snacks less than once a week with a satisfying level perceived health status. Regressions showed that all age classes are less likely to drink tap water than people younger than 20 years old. The category with “inadequate” economic resources is more likely to consume tap water. Low educational classes show a low likelihood of consuming tap water as well as Islands. A concern about waste production and climate change is associated with an increased likelihood of assuming tap water. Tap water consumption was negatively associate with obesity but not with a satisfactory Self-perceived health status. Insights from this study can inform public health strategies.

Diabetes mellitus (DM) poses a significant challenge to global health, with its prevalence projected to rise dramatically by 2045. This narrative review explores the bidirectional relationship between periodontitis (PD) and type 1 diabetes mellitus (T1DM), focusing on cellular and molecular mechanisms derived by the interplay between oral microbiota and the host immune response. A comprehensive search of literature published between 2008 and 2023 was conducted to elucidate the association between these two diseases. Preclinical and clinical evidence suggests a bidirectional relationship, with individuals with T1DM exhibiting heightened susceptibility to periodontitis, and vice versa. The review includes recent findings from human clinical studies, revealing variations in oral microbiota composition in T1DM patients, including increases in certain pathogenic species such as Porphyromonas gingivalis, Prevotella intermedia, and Aggregatibacter actinomycetemcomitans, along with shifts in microbial diversity and abundance. Molecular mechanisms underlying this association involve oxidative stress and dysregulated host immune responses, mediated by inflammatory cytokines such as IL-6, IL-8, and MMPs. Furthermore, disruptions in bone turnover markers, such as RANKL and OPG, contribute to periodontal complications in T1DM patients. While preventive measures to manage periodontal complications in T1DM patients may improve overall health outcomes, further research is needed to understand the intricate interactions between oral microbiota, host response, periodontal disease, and systemic health in this population.

Severe early childhood caries remains the most common chronic disease affecting children. Its multifactorial etiology has established a controversy about which risk factors were more significant to its development. Therefore our study aimed through meticulous statistical analysis to arrange the “well agreed upon” common risk factors in order of significance, to aid the clinician in tailoring an adequate preventive program for this affected age group. The study reshuffled the risk factors contributing to severe early childhood caries and placed them in the order of their significance as follows: snacking of sugary food several times a day, increased number of siblings to 3 or more, night feeding, child self-employed brushing, mother caries experience, 2 siblings, on demand feeding, once/day sugary food, sharing utensils, 1 Sibling, male gender, father’s education, late first child dental visit, brushing time, mother’s education, no dental visit, decreased brushing frequency & no night brushing.

Dental agenesis is one of the most common developmental anomaly in humans and it is frequently as-sociated with several other oral abnormalities. The present case describes nonfamilial agenesis of per-manent teeth in a twenty-one-year-old boy, with no apparent systemic abnormalities. The treatment in-cluded a personalized and interdisciplinary approach by the means of endodontics, orthodontics, im-plants supported restorations and prosthetic treatments. The treatment plan was thoroughly elaborated using photographic analysis, study models, orthopantomogram, CBCT and cephalograms. Virtual smile design, diagnostic waxing, and mock-up previsualized the treatment objectives. The edentulous spaces were reconstructed by inserting dental implants, and monolithic Zirconia implant supported restorations. The final results showed a highly aesthetic and functional rehabilitation. Periodic checkups have shown that the stability of the result is well maintained and that the implant supported restorations are an op-timal solution for patients with multiple anodontia.

Background Gingivitis can develop without mechanical cleaning within three weeks. The first clinical sign is bleeding on positive probing. The accumulation of dental biofilm generates an inflammatory gingival response. In the past decade, attention has focused mainly on the interproximal areas and the use of customsized interproximal toothbrushes.The aim of the study was to evaluate the effectiveness of individualized oral hygiene education and its role in dental prevention among patients with dental problems. Methods Before treatment, patients were clinically and radiologically examined, full mouth plaque score (FMPS), full mouth bleeding score (FMBS), and bleeding on brushing (BOB) were recorded, and matrix-metalloproteinase-8 (MMP-8) was measured by using a chair-side MMP-8 measuring system. Patients in group A had gingivitis, but no periodontal damage and patients in group B had periodontal damage. Patients in both groups A and B were identified in to four subgroups based on their toothbrushing habits and the oral health education they received. The three months after initial examination, each patient was examined three more times (2, 4 and 12 weeks later). Results It was concluded that subjects in groups A1 and B1 showed significant reduction in BOB, MMP-8, FMBS and FMPS levels after two weeks. Solo Prophylaxis (A1and B1) remained as a well-constructed protocol with hte complete resolution of interdental inflammation after two weeks. Other subgroups achieved significant reductions only after 12 weeks. Conclusions BOB and MMP-8 are valuable complements in preventive dentistry, and are able to detect potential pathological processes in interproximal spaces. The clinical relevance of BOB, in addition to FMBS, FMPS and gingival inflammation can be demonstrated to patients, which may increase compliance.

Although the universal health coverage (UHC) is pursued by many countries, not all countries with UHC include dental care as their benefits. Japan, with its long-held tradition of UHC, has covered dental care as essential benefit and majority of dental care services are provided to all patients with minimal copayment. Being under the UHC, the scope of services as well as prices are regulated by the uniform fee schedule and dentists submit claims according to the uniform format and fee schedule. The author analyzes the publicly available dental health insurance claims data as well as a sampling survey on dental hygiene and illustrates how Japan’s dental care is responding to the challenges of the population ageing.

ABSTRACT Background: To date, the COVID-19 pandemic has been the foremost health concern for humankind in the new millennia. This paper aims to describe the related hospitalizations in Italy during the first two years of the health emergency. Design and methods: This is a retrospective, population-based study of Italian hospitalizations for patients diagnosed with COVID-19 during the 2020-2021 period, extracted from the National Hospital Discharge Registry. The outcome variables considered include hospital admissions, costs, and length of stay, among other hospitalization-level variables. Costs were estimated through the charges associated with the Diagnosis-Related Group and Major Diagnostic Categories coding system, plus an additional cost attributed to COVID-19 admissions. To these charges was added an extra cost defined by the ministry of health. Results: In Italy, there were 357,354 hospitalizations for COVID-19 attributed to 298,856 patients in 2020 and 399,043 hospitalizations for COVID-19 attributed to 333,447 patients in 2021. COVID-19 patients faced a transfer rate thrice that of other patients. Hospitalizations were concentrated predominantly in the northern regions, particularly in the first year. Hospitalization rates varied by age in a sine wave pattern, peaking in the youngest and oldest age groups, with mortality rates escalating with age— tending to remain below 3% for those under 44 but surging to 40% in individuals over 75. The financial impact of COVID-19 hospitalizations was substantial, with total costs reaching €3.97 billion in 2020 and €4.99 billion in 2021. Costs per admission and per day also rose, from €11,112 and €807 in 2020 to €12,503 and €844 in 2021, respectively. Excluding the added financial burden of COVID-19, costs would have been notably lower. Hospitalizations involving continuous invasive mechanical ventilation were particularly costly (about 24.000 euros x admission), reflecting the significant resources required for these treatments. Conclusion: Implementing a protective pad around the entire health system that leverages networks of family doctors and nurses, connected in real time to the entire health system, can be crucial. Such a network, tasked with monitoring the local epidemiological situation, protecting vulnerable individuals also through telehealth visits, and establishing a triage system for infections in the initial phase, may effectively help in managing virus spread and protecting hospitals from unpredictable waves of admission demand. Strengthening primary health care could be a decisive factor for the future and enhance the system's resilience in facing new challenges.

This research addresses a gap in the literature by conducting a comprehensive analysis of patients’ level of satisfaction with dental care. Methods: By combining quantitative and qualitative survey methods with the PSQ questionnaire this study aims to augment ongoing initiatives to enhance dental patients’ experiences by painting a more comprehensive depiction of patients' level of satisfaction; Results: When asked about their overall level of satisfaction 77,1% of the patients said they received excellent services from the office personnel and 72,2% said they trust their doctors; Conclusions: Assessing patient satisfaction in the realm of dental services quality is crucial for enhancing service quality and accuracy, benefiting both patients and dentists, and ultimately improving public health.

Several pathotypes of enteric E. coli have been identified. The group represented by Shiga toxin-producing E. coli (STEC) is of particular interest. Raw milk and raw milk products are significant sources of STEC infection in humans; therefore, identifying pathogens at the herd level is crucial for public health. Most national surveillance programs focus solely on raw milk and raw milk cheeses that are ready for retail sale, neglecting the possibility of evaluating the source of contamination directly at the beginning of the dairy chain. In order to assess the viability of new molecular methodologies applied to raw milk filters enabling the identification of the presence of STEC serotypes in milk production and apply the same methods to identify the presence of these pathogens in calf feces we analyzed, through a commercial real-time PCR assay, a total of 290 samples coming from 18 different dairy herds; 88 bulk tank milk (BTM), 104 raw milk filters (RMF) and 98 calves’ feces samples. In total 3.4% of BTM, 41.4% of RMF and 73.4% of calves’ feces tested positive for stx presence, supporting our hypothesis that BTM is not a suitable matrix to assess the STEC presence at herd level, underestimating it. Our conclusion is that the surveillance program needs critical and extensive improvements such as RMF and calves’ feces analysis implementation in order to be more efficient in detecting and preventing STEC infections. The epidemiology of these infections and the characteristics of the pathogen clearly show how a One Health approach will be pivotal to improve our capabilities to control the spread of these infections.

Active participation of students is paramount not only for their learning experiences but also for their academic performance. Therefore, various methods have been developed and proven to help students achieve active learning. However, several shortcomings in these methods have been indicated as increasing students’ sense of burden and discomfort, eventually preventing them from benefiting sufficiently. This study aimed to determine the efficiency of a low-load web-based review quiz built by the researchers on Google Forms to enhance students’ reviewing habits and active class participation. Participants in this study were 53 first-year dental hygiene students in a 10-class microbiology course. After each class, all students were given the web-based quiz to prepare for a paper-based review test, which assessed the learning of the content covered in the previous classes. We analyzed the correlations between frequency of participation in the web-based quiz and the average scores of the weekly review tests or the final examination scores. Consequently, voluntary participation in the web-based quiz positively correlated with both short-term and long-term students’ learning outcomes. Through this web-based quiz during the first year of the dental hygiene program, students can develop the “self-learning attitude” needed to pass the national examination.

The present study was performed to examine that transforming growth factor beta (TGF-β) in root-surrounding tissues on deciduous teeth during the physiological root resorption regulates the differentiation induction into odontoclast. We prepared root-surrounding tissues with (R) or without (N) physiological root resorption scraped off at three regions (R1-R3 or N1-N3) from the cervical area to the apical area of the tooth and measured both TGF-β and the tartrate-resistant acid phosphatase (TRAP) activities. The TGF-β activity level was increased in N1-N3, whereas the TRAP activity was increased in R2 and R3. In vitro experiments for RANKL-mediated osteoclast differentiation revealed that TGF-β in N1-N3 and R1-R3 enhanced the TRAP activity in RAW264 cells. A genetic study indicated that the mRNA level of TGF-β1 in N1 and N2 was significantly increased, and corresponded with that of osteoprotegerin (OPG). In contrast, the expression level of receptor activator of NF-κB ligand (RANKL) was increased in R2 and R3. Our findings suggest that TGF-β is closely related to the regulation of OPG induction and RANKL-mediated odontoclast differentiation depending on the timing of RANKL and OPG mRNA expression in the root-surrounding tissues of deciduous teeth during physiological root resorption.

Background: Educating college students about the importance of good sleep habits could lead to the adoption of healthier sleep routines, including sufficient sleep duration and sleep quality. The current pre-post study examines the impact of completing a sleep education program called “Sleep 101” on (1) sleep hygiene practices, (2) sleep quality, and (3) weekday and weekend sleep behaviors among college students. “Sleep 101” is an interactive online course developed to educate college students about the importance of sleep by addressing basic sleep physiology, the impact of sleep on mood, academic and physical performance, the interactions between sleep and various substances, and common sleep disorders. Methods: 338 college students were recruited from a midsized public university in the US and invited to participate in “Sleep 101”, of which 25 participants completed the baseline and post-intervention questionnaire. The Sleep Hygiene Index (SHI) was utilized to evaluate sleep hygiene practices, while standard questions were employed to assess weekday and weekend sleep behaviors and overall sleep quality. Results: Those who completed the study demonstrated a significant increase in weekday sleep duration and were less likely to engage in negative prior bedtime activities. In addition, 40% of those who completed baseline and post-intervention assessments noticed improvements in their sleep quality. Conclusion: These findings suggest that a brief online program is beneficial in improving sleep behaviors among college and could be a scalable approach to addressing current sleep issues and preventing future sleep problems in college students.

(1) Background: Tooth extraction is one of the oldest and most well-known surgical procedures in dental medicine. It is still routinely performed to date by both general practitioners, oral surgeons, and dental undergraduates. The Benex extraction system allows for the extraction of teeth in vertical direction, which avoids most trauma against the surrounding alveolar bone and soft tissues; (2) Methods: The study included 56 patients who were recruited from the department of Oral Surgery at the Faculty of Dental Medicine, Medical University – Plovdiv. Patients were divided into two groups of 28 patients – Group I (control group) and Group II (study group). For each group the success of the extraction, buccal cortical plate preservation, pain experience and early wound healing were assessed; (3) Results: There was no statistical significance between the success of the extractions in both groups. The Benex extractions preserved the buccal cortical plate in 95% of the cases, whereas the forceps extractions only in 71.8%, which shows a statistical significance. On the seventh day patients in group II reported less pain, without a significant difference. There was a significantly bigger number of completely healed extraction wounds on the 10th day; (4) Conclusions: Atraumatic extractions allow for more hard and soft tissues to be preserved in the extraction site. This is all crucial for the successful outcome and aesthetically pleasing results of a following prosthetic or implant restoration.

Honey is a sweet substance extensively consumed in the world for its nutritional and healthy properties. However, residues of pesticides and environmental contaminants can compromise its quality. For this reason, the physicochemical parameters, and the organic contamination of monofloral and multifloral honeys from three regions of Algeria (Tiaret, Laghouat and Tindouf) were monitored to evaluate the quality of honey and the safety for consumers. In general, the results obtained from the physicochemical analyses were in line with the EU standards. In terms of contamination, pesticides authorised and used in Algerian agriculture (matalaxyl-M and cyromazine), as well as banned pesticide (carbaryl), were found in almost all the samples. However, only the concentration of cyromazine was higher than the relative EU maximum residue levels. PCB 180, PCB 189, anthracene, fluorene and phenanthrene were mainly detected. All the honeys show traces of DiBP, DBP, DEHP and DEHT, but no traces of bisphenols were found. Moreover, the dietary exposure assessment shows that a small amount of Algerian honey can be safely consumed. Overall, data from this study should motivate the Algerian government to enhance their monitoring activities in beekeeping and to find solutions for implementing more sustainable agricultural practices harmonizing with the international legislation.

Tooth decay, also known as caries, is a significant medical problem that harms teeth. Treatment is based on the removal of the carious material and then filling the cavity left in the tooth, most commonly with amalgam or composite resin. The consequences of filling failure include repeating the filling, or performing another treatment, such as a root canal, or extraction. Dental amalgam contains mercury, and there is a global effort to reduce its use. However, no consensus has been reached using randomized clinical trials, regarding whether amalgam or composite resin materials are more durable, and which is the best restorative material. To determine which material is superior, we performed a retrospective cohort study using a large database where members of the 58 dental clinics with 440 dental units were treated. The number of failures of the amalgam compared to composite resin restorations between 2014 and 2021 were compared. Our data included information from over 650,000 patients. Between 2014 - 2021, 260,905 patients were treated. 19,692 out of 113,281 first amalgam restorations failed (17.49%), whereas significantly fewer composite restorations failed (11.98%) 65,943 out of 555,671. This study indicates that composite is superior to amalgam and therefore it is reasonable to cease using mercury containing amalgam.

Background: Dental education blends theoretical and practical training to prepare students for independent patient care. This study examines the confidence levels of dental students in Umeå regarding independent performance of general dentistry tasks, and whether this confidence changes after clinical training. Methods: Surveys were conducted before and after a summer clinical internship, with s tudents rating their comfort levels on a scale from 0 to 10 for various procedures. Results: Results from 64 initial surveys and 54 follow-up surveys showed no significant difference in confidence before and after the internship. However, confidence levels varied based on whether students had practiced specific tasks during the internship. Students felt least confident in managing acute dental trauma and treating cavities in young children, while they were most confident in tasks like obtaining radiographic surveys and debriding periodontally compromised dentition. Tooth extraction and dental fillings were the most practiced procedures during the internship. Conclusions: The study concludes that the internship between the ninth and tenth semesters does not notably boost students' confidence in specific dental procedures, possibly due to the short duration of the training. Further exploration, including input from clinical supervisors, is suggested to optimize clinical training in dental education.

In the area of dental healthcare services, where patients and professionals deal with multiple auditory stimuli, this cross-sectional study reports on the intricate dynamics of sound preferences, noise obstacles, and the profound impact of music on anxiety reduction within dental office set-tings. The sample comprises of 134 dental patients, primarily females (56.7%), with varying age groups, education levels, and therapy durations in the university clinics of the department of Dentistry, National and Kapodistrian University of Athens and four private dental offices at the metropolitan area of Athens, Greece. Notably, 92.5% of the participants report no hearing loss, and 56.7% exhibit some level of noise sensitivity. The study reveals a moderate to good perceived health status (M=3.84, SD=0.95) among participants, with low perceived noise disturbance in university dental clinics. Preferences for instrumental music, foreign pop, and classical music are prominent during waiting times. Potential irritations include impersonal treatment (44%) and staff behavior (41.8%). Music player usage within the settings of the dental clinic involves radios (49.3%) and headphones (41.0%). Correlations and predictors indicate associations between health status, music preferences, and noise disturbances. More specifically, visiting the university dental clinics (β = .300, p = .005) as well as younger age (β = .300, p = .034) were significant predictors of better perceived health status. Clearer perception of external sounds while using the music player (β = .190, p = .039) was a significant predictor of better perceived health status, while poorer health was predicted by the preference of Greek folk songs (β = -.200, p = .030). Also, the use of smartphones for playing music was related to poorer health (β = -.370, p < .001). Following, younger age (β = -.270, p = .015), lower education (β = -.210, p = .035), higher noise sensitivity (β = .190, p = .027), as well as feelings of anxiety and nervousness due to ambient noise from people and machines (β = .510, p = .027) were significant predictors of noise disturbance from machines. Also, visiting private clinics (β = .240, p = .018), preferences of specific playlist (β = .310, p = .012), no music (β = .280, p = .016) and use of smartphones to play music (β = .230, p = .029) were significant predictors of noise disturbance from patients or staff. Finally, the preference of listening to a specific playlist was related to better health status (r = .190, p < .05). Findings aim to optimize eco-soundscapes in dental offices, con-tributing to enhanced patient well-being. The research underscores the potential of music inter-ventions to alleviate dental anxiety and improve the overall dental experience and quality care.

The integration of three-dimensional (3D) printed resin denture teeth represents a significant ad-vancement in digital dentistry. This study aimed to assess their ability to withstand chipping and indirect tensile fractures, comparing them with conventionally manufactured resin denture teeth. Four groups, each comprising 30 specimens, were examined: Group 1 featured 3D printed denture teeth (NextDent, 3D Systems, Soesterberg, The Netherlands), while the others included commer-cially obtained Ivostar Shade, SpofaDent Plus, and Major Super Lux teeth. Stereolithography 3D printing was utilized to produce methacrylate-based photopolymerized resin teeth models for Group 1, while the remaining groups were commercially sourced. Chipping and indirect tensile fracture tests were performed at a speed of 1 mm/min until fracture occurred. Statistical analysis was conducted using one-way analysis of variance (ANOVA) with Tukey's honestly significant difference multiple comparisons test (p < 0.05). Results indicated that 3D-printed teeth exhibited higher indirect tensile fracture resistance than Major Super Lux and Ivostar Shade but lower than SpofaDent Plus. Additionally, in the chipping test, buccal chipping occurred in 3D-printed resin teeth without distortion. In the indirect tensile test, the fracture line emerged near the loading point, extending cervically from the inner incline of both cusps. Overall, denture teeth produced via 3D printing with printable resin materials demonstrated sufficient fracture resistance, making them suitable for prosthetic applications.

The primary objective of this current study is to conduct a comprehensive review of existing literature that discusses research on post and core restorations, covering aspects such as their composition, manufacturing methods, and clinical effectiveness. The methodology employed in this review encompasses the implementation of a well-defined search strategy, the establishment of criteria for inclusion and exclusion, and the selection of relevant studies to summarize their findings. To gather relevant literature published between 1993 and 2023, the research team conducted separate searches on PubMed, Scopus, and Embase databases. In total, 165 titles were initially retrieved from these electronic databases. By applying the predefined exclusion criteria, the researchers identified 73 articles that specifically address the conventional and computer-aided design/computer-aided manufacturing (CAD/CAM) technologies employed in post and core restorations. These restorations are frequently utilized procedures for repairing teeth that have undergone endodontic treatment and subsequently lost dental structure. The development of computerized technology for the creation of customized posts and cores has emerged as a straightforward and efficient alternative to traditional methods. The review encompasses a synthesis of papers discussing the various techniques and materials employed in constructing post and cores using CAD/CAM technology. Notably, different strategies for restoring endodontically treated teeth through CAD/CAM post and cores have been documented, revealing both direct and indirect approaches. The most mentioned materials for these restorations include zirconia, composite resin, and hybrid ceramics. While the available literature on CAD/CAM post and core procedures is somewhat limited, the review underscores the need for further research to explore the long-term outcomes and efficacy of this treatment approach.

Background: Patients with thromboembolic disease, prosthetic valves, or coagulation issues are commonly prescribed anticoagulants and antiplatelets. Although common professional oral hygiene might not represent a health concern for these patients, anticoagulant and antiplatelet medication might constitute a challenge for dentists and dental hygienists since possible prolonged bleeding might interfere with dental procedures. The aim of the present study was to investigate the bleeding time of different anticoagulants and antiplatelets during a professional hygiene session adapting the Ivy test to the oral environment; Methods: 93 consecutive patients undergoing professional oral hygiene were recruited. Debridement during oral hygiene was performed using ultrasonic mechanical instrumentation, and bleeding sites were assessed and treated with gentle pressure using sterile gauzes. The time for bleeding cessation was recorded. Patients were categorized into six groups based on their drug intake, Control: no anticoagulants or antiplatelets DTI: direct thrombin inhibitors (dabigatran) AntiXa: directa factor Xa inhibitors (endoxaban, apixaban, rivaroxaban) VKA: vitamin K antagonists (warfarin, acenocoumarol) SAPT: single anti-platelet therapy (acetylsalicylic acid or clopidogrel) DAPT: dual anti-platelet therapy (acetylsalicylic acid and clopidogrel). Bleeding time was measured in seconds and mean values were assessed among the different groups. Differences between groups were investigated with Kruskal-Wallis test followed by Dunn’s post-hoc correction for multiple comparisons or two-way ANOVA followed by Dunnett post-hoc; Results: Control patients presented the lowest bleeding time 50 sec, followed by AntiXa (98), SAPT (105), DTI (120), DAPT (190) and VKA (203). A statistically significant difference was present among control and DTI (p=0.004), VKA (p&lt;0.001), DAPT (p&lt;0.001). Conclusions: Based on the present outcomes, an increased risk of prolonged bleeding emerged in patients taking VKA and DAPT. However, bleeding did not interfere with the oral hygiene ses-sion The optimal period for dental treatment of these patients should be 2-3 hours before the next dose, without the need to temporarily suspend the medication.

The objective of this study was to detail the monomer composition of resin-based dental materials sold in the market in 2023 and to evaluate the proportion of BPA derivatives in relation with their applications. A search on manufacturers’ websites was performed to reference resin-based dental materials currently on the market. Their monomer composition was determined from material safety data sheets and completed with a search on PubMed database. Among the 543 material compositions exploitable, 382 (70.3%) contained BPA derivatives. Among them, 56.2% contained BisGMA, 28% BisEMA, the most frequently reported. A total of 59 monomers of which 6 BPA-derivatives were found. 309 materials (56.9%) contained UDMA and 292 (53.8%) TEGDMA. Less than one third of materials identified contained no BPA derivatives. These proportions vary a lot depending on their applications with materials dedicated to dental care of young populations containing the highest proportions of BPA-derivatives monomers. The long-term effects on human health of the different monomers identified including BPA-derivatives monomers is a source of concern. For children and pregnant or lactating women arises the question to take a precautionary principle and avoid the use of resin-based dental materials likely to release BPA by opting for alternative materials.

Ensuring access to water, sanitation, and hygiene (WASH) facilities, coupled with behavior change education in schools, is fundamental for fostering a conducive learning environment and promoting principles of inclusion, dignity, and equality. This study focuses on 12 primary schools in Anápolis, Brazil, encompassing 4,394 students and 248 teachers. WASH assessments were conducted through a questionnaire, observation of water and sanitation facilities and structures, and microbiological analysis. Over the period 2018 to 2020, the proportion of schools with safely managed drinking water surged from 42% to 92%. However, sanitation conditions in the schools were categorized as a basic level, with hygiene services rated as limited in 92% of the schools due to the absence of soap. While this study reveals that Anápolis schools generally align with WASH guidelines for basic/advanced drinking water services, there is a crucial need for enhancements in both hardware and software facilities to address sanitation and hygiene challenges.

Patients with predominantly antibody deficiencies (PAD) display hypogammaglobulinemia with a high prevalence of infections, along with autoimmune manifestations, benign and malignant lymphoproliferation and granulomatous disease. It is noteworthy that PAD patients, even those with defects in the same causative genes display a variable clinical phenotype, suggesting that additional genetic polymorphisms, located in either immune-related or non-immune-related genes, may affect their clinical and laboratory phenotype. In this context, we analyzed 80 PAD patients, including 70 with common variable immunodeficiency (CVID) for SERPINA1 defects, in order to investigate their possible contribution to PAD clinical phenotype. Eight CVID patients carried heterozygous pathogenic SERPINA1 defects with normal alpha-1 antitrypsin levels. Interestingly, the presence of the Z allele (rs28929474) which was found in three patients, was significantly associated with liver disease; hepatic complications were also observed in patients carrying the p.Leu23Gln (rs1379209512) and the p.Phe76del (rs775982338) alleles. Conversely, no correlation of SERPINA1 defective variants with respiratory complications was observed, although patients with pathogenic variants exhibit a reduced probability of developing autoimmune diseases. Therefore, we recommend SERPINA1 genetic analysis in PAD, in order to identify patients with a higher risk for liver disease.

In polymer-based dental composites, wear is a three-body wear system mainly abrasive, because of the food particles and wear products suspended in the oral cavity, which are transferred to the microcavities of the surface of the replacements. Due to this fact, the incorporation of nanodiamond as reinforcement in these polymer matrix composites, which promotes the creation of a solid lubricant tribofilm surface could be advantageous. When nanodiamond is added in contents of 0.8, 1.6 and 3.2 wt %, an increase in microhardness from 95 up to 420 %, compared to the one of neat BisGMA/TEGDMA, is observed. Additionally, the incorporation of a content of 1.6 wt % is enough to cause a diminution of ~78 % in the friction coefficient and a reduction of the specific wear rate and Archard’s coefficient of ~50 %. Nevertheless, the addition of relatively high contents reduces the effectiveness of photoinitiation and UV-curing, which is related to the scattering and absorption of UV radiation by ND.

Objective: The aim of this in vitro study was to evaluate the accuracy of resin-based fixed dental restorations, namely veneers, single crowns, and four-unit fixed partial dental prosthesis (FPDs) using two different 3D printers and polymer-based materials. Materials and Methods: A standard maxillary polyurethane jaw model containing prepared teeth was scanned using an intraoral scanner. The generated STL data were used to design the restorations virtually using CAD software. Two 3D printers were utilized for the provisional digital light processing and stereolithography for the castable resin patterns. Each printer produced 10 specimens of each type of restoration, for a total of 80 restorations. The 3d-printed restorations were then 3D scanned using the same intraoral scanner and evaluated for external and internal dimensional accuracy in terms of trueness and precision. A one-way ANOVA and Two-sample T-Test were implemented to compute the precision (variability between groups) and trueness (with the designed CAD model). A level of statistical significance of p-Value

Interrelationships between traditional dental variables are becoming more evident in far reaching aspects of life such as psychosocial interaction, self-esteem, overall health and even occupational performance. This study compares quality of life (QoL) in postmenopausal women (PMW) with poor oral health (POH) with QoL in PMW with good oral health. 200 randomly recruited PMW received a dental evaluation and completed Utian Quality of Life Survey. The participants were divided into POH and healthy groups based on dental exam. Mean scores were calculated for each QoL item, domain and the overall summary score. For each of the four parameters for periodontitis diagnosis, periodontitis patients’ QoL outcomes were compared to those of healthy patients using T-test with threshold of significance at p<0.05. QoL in all fields measured were significantly poorer in the POH compared to the healthy patients, occupational (19.95±5.35vs. 27.56±6.13), health (18.02±8.23 vs. 26.59 ±6.45), emotional (15.68±10.22vs. 21.15±9.15), sexual (6.2±5.98vs. 10.02±5.35), and total score (60.21±25.85 vs. 84.26±22.35). This study finds that PMW with POH, report significantly poorer quality of life. Clinicians caring for PMW should be aware of that oral health impacts QoL and make appropriate referral decisions for patients’ dental care. Keywords: Quality of Life, Oral Health, Post-menopause, Women

Dental anxiety (DA) negatively affects patients’ oral and overall health. This study explored attitudes and clinical practices of licensed Ohio general dentists who treat patients with DA. Methods: An anonymous self-administered mail survey was sent to 500 general dentists licensed and practicing in Ohio. Responses to 21 pre-coded questions were analyzed. Frequencies were examined; cross-tabs, Chi-Square, and Fischer’s Exact Test were calculated for statements according to dentists’ gender. Alpha was set at p = 0.05. Results: Nearly all respondents treated anxious patients; males were more likely to find it challenging than females. Dentists were most familiar with distraction, although half found nitrous oxide to be an effective tool. Female dentists were more likely than males to be familiar with anxiolytics and find them effective. Conclusion: Overall, Ohio general dentists are most familiar with using distraction and nitrous oxide during appointments for anxious patients. Gender differences exist in attitudes towards anxiolytic use for patients with DA. Practice Implications: By identifying techniques that are comfortable for patient and practitioner, oral health disparities associated with DA may be reduced.

The human mandible's cancellous bone, which is characterized by its unique porosity and directional sensitivity to external forces, is crucial for sustaining biting stress. Traditional CAD models fail to fully represent bone's anisotropic structure and thus depend on simple isotropic assumptions. For our research, we use the latest versions of nTopology and Creo Parametric software to make biomimetic Voronoi lattice models that accurately reflect the complex geometry and mechanical properties of trabecular bone. The porosity of human cancellous bone is accurately modeled in this work using biomimetic Voronoi lattice models. The porosities range from 70% to 95%, which can be achieved by changing the pore sizes to 1.0 mm, 1.5 mm, 2.0 mm, and 2.5 mm. Finite element analysis (FEA) was used to examine the displacements, stresses, and strains acting on dental implants with a buttress thread, abutment, retaining screw, and biting load surface. The results show that the Voronoi model accurately depicts the complex anatomy of the trabecular bone in the human jaw, compared to standard solid block models. The ideal pore size for biomimetic Voronoi lattice trabecular bone models is 2 mm, taking into account both the von Mises stress distribution over the dental implant, screw retention, cortical bone, cancellous bone, and micromotions. This pore size displayed balanced performance by successfully matching natural bone's mechanical characteristics. Advanced finite element analysis (FEA) improves biomechanical understanding of how bones and implants interact by creating more accurate models of biological problems and dynamic loading situations. This makes biomechanical engineering better.

This study aimed to review the dietary risk factors for root caries prevalence in older adults, from socially active people to frail patients. A comprehensive search strategy was used to select studies from PubMed and Scopus databases. Two evalua-tors performed data extraction, screening, and quality assessment independently. Only studies written in English were included. Caries is very common in the elderly, as there are several aggravating factors such as the decrease of the ability to self-care and, by extension, insufficient oral hygiene, a carious diet, limited exposure to fluoride, xero-stomia, gingival recession, limited access to dental care. Root caries is prevalent in the elderly due to gingival recession and root exposure to the oral environment. Dietary risk factors significantly affect root caries prevalence in older adults, including high intake of sugars and an alteration of their composition preference in this age group. Caries risk appears more significant in frail, standardized patients who feed with even softer food or supplements.

Objectives (Purpose) This study aims to evaluate the outcomes of the Subcrestally Placed Implant (SPI) technique in single molar cases, focusing on biological stability and aesthetics. It proposes a schematic model to elucidate the interplay between the biological stability of soft tissues and bone around the SPI and the morphological requisites that Implant Abutment Prostheses (IAP) must fulfill to effectively replace natural teeth. Materials and methods I examined 20 cases using the SPI technique with Internal Platform Switching (IPS) design implants for single molar replacements to assess their stability. Routine check-ups utilized plain panoramic X-rays to measure changes in crestal bone on the mesial and distal sides. Additionally, 10 cases with CBCT X-rays taken more than one year after the initial surgery underwent a novel 3-dimensional soft tissue analysis (3DSTA). Measurements included placement depths (PD), soft tissue thickness (STT) at central (cPD, cSTT) and peripheral areas (pPD, pSTT), the length of the Transitional Zone (TZ) on mesial, distal, facial, and lingual aspects, and crestal bone thickness (CBT) at buccal and lingual sites. Results Panoramic analyses showed minimal changes in crestal bone (mean changes of pPD were less than 0.1 mm) over an average period of 3.3 years. Average measurements were as follows: cPD was 1.7 mm, pPD was 2.7 mm, cSTT was 0.2 mm, pSTT was 0.6 mm, TZ length was 3.8 mm, buccal CBT was 3.0 mm, and lingual CBT was 3.7 mm. Conclusions CBCT analyses of the topographical relationships between soft tissue and crestal bone with IAP for SPIs demonstrated stable results over an average 3-year period. The consistency in the relationship between crestal bone and surrounding soft tissue can be ascribed to biological structural integrity. The study classified peri-implant soft tissues into subcrestal and supracrestal (transitional zone – TZ) segments, exploring their characteristics through dimensional measurements and assessing mechanical resistance. Further histological study is needed to identify specific features of each segment.

Introduction The placement of implants is often hindered by a severely atrophic mandibular edentulous ridge. A sufficient volume of bone graft is crucial for successful implant restoration. The required bone graft volume directly correlates with the deficiency present in the edentulous ridge. If the residual crestal bone height is so low that the distance between the crestal ridge and the inferior alveolar nerve is less than 2 mm, a significant bone augmentation procedure is necessary. This procedure must ensure the implants are surrounded by a sufficient margin of bone, aiming for a final height of more than 8 mm and a width of more than 7 mm. Achieving primary closure with adequate soft tissue is vital for the success of the bone graft procedure. The key to successful bone grafting lies in the effective management of the soft tissue covering. Case Report This case report details the treatment of a patient with severely atrophic edentulous ridges on both sides, addressed using Self Inflating Tissue Expanders (SITEs) to facilitate bone grafting and implant placement. Following soft tissue expansion, bone grafting and implant placement were successfully performed. The implants supported a fixed restoration, which remained stable and complication-free over a seven-year observation period. Conclusion The SITE (Self-Inflating Tissue Expander) proved effective in obtaining a substantial amount of bone graft needed for implant installation. A seven-year follow-up confirmed the implants were well-functioning with stable bone support, healthy soft tissue coverage, and adequate vestibular depth.

The increase in the rate and prevalence of diseases associated with the localized and general loss of bone mass calls for an investigation into therapeutic alternatives that largely involve the de-velopment of new biomaterials and cell therapy, converting tissue bioengineering into a prom-ising option. An experimental model of a critical mandibular lesion in rats has been used to study bone re-generation by treating the ostectomy with the biomaterials Evolution® and Gen-Os® (OsteoBiol®, Italy) combined, or not, with dental pulp stem cells (DP-MSC). The results obtained through the Micro-CT and histological study reveal the almost complete re-covery of the lesion in the group with DP-MSC. These results are supported by increases in endoglin, TGF-β, protocollagen I, parathormone, and calcitonin, generating an environment of bone generation and development when combining Evolution® and Gen-Os® (OsteoBiol®, Italy) with DP-MSC. These promising results confirm the transcendental role of DP-MSC in combina-tion with osteogenic biomaterials for bone regeneration, and warrant further studies, including its assessment in clinical trials.

Academic stress affects students' psychological and physiological well-being. Dental undergraduate programs are known for their demanding curriculum, leading to significant stress symptoms. Objective was to determine if salivary cortisol levels were higher in students exposed to academic stress, assess the relationship between stress severity/temperament and cortisol values, and explore relaxation technique effects. Salivary cortisol was measured at two time points for all participants: before exams and during a relaxation period after summer break. A third measurement was conducted for students with high pre-test cortisol levels who received instructions on progressive muscle relaxation(PMR) before subsequent exams. Additionally, participants completed two questionnaires: Perceived Stress Scale(PSS) and Fisher's Temperament Questionnaire. The group analysis based on the PSS indicated that 39 participants reported high stress. Women demonstrated significantly higher stress than men(p=0.042054). A significant difference in stress levels was observed between Director and Builder temperament types(p=0.029276). Cortisol levels showed a significant decrease from the first measurement to the second measurement, and the third measurement after implementing PMR. The grade in the "Dermatovenereology" course correlated with stress level according to the PSS(k=0.578467). Pre-test cortisol levels correlated with the frequency of using PMR guidelines during winter test periods(k=0.416138). Stress negatively affects the immune system and poses health risks. Implementing stress reduction techniques in dental/medical education could benefit students and the healthcare system.

This work explores the significance of toothbrushing in maintaining optimal oral health, delving into its benefits, proper techniques, and types of toothbrushes. The primary cause of caries, periodontal diseases, and halitosis is oral biofilm development. One of the most fundamental practices in maintaining oral health is toothbrushing. Studies have confirmed that mechanical procedures for controlling plaque and toothbrushing, in particular, significantly decrease plaque accumulation. The significance of teeth brushing in preventing dental caries has been well-acknowledged for a considerable period. Dentists recommend brushing twice daily for at least two min to ensure thorough cleaning. Unfortunately, precise guidelines from dental associations are often missing. Authors mention that two min of brushing are insufficient for significant plaque removal; plaque removal increases with augmented brushing time, with maximum removal at 180 s. Multiple studies have documented that engaging in the practice of brushing one’s teeth twice a day has a preventive impact. Various toothbrush designs, including both manual and electric options, have been created to improve the elimination of dental biofilm and reduce the accumulation and persistence of bacteria. In conclusion, toothbrushing is a simple yet incredibly important practice for maintaining oral health. The benefits extend beyond just a bright smile, encompassing caries, gum disease, halitosis prevention, and the preservation of tooth enamel. Adhering to proper toothbrushing techniques, selecting the right toothbrush, and understanding the connection between oral health and overall well-being can lead to a healthier life. To foster favorable toothbrushing behaviors among the population, dental practitioners and public health experts must know the factors that influence toothbrushing habits.

Fish and fish products are very appreciated in the human diet because of high quality proteins and other important nutrients, such as minerals and polyunsaturated fatty acids. Maintaining freshness, quality and safety is essential in the fish supply chain, starting from on board vessels where the product must be carefully checked and protected from any source of contamination. Safe fishing and handling of fish are very important to reduce the risk of foodborne diseases caused by pathogenic microorganisms such as Salmonella spp., Vibrio spp., Listeria monocytogenes, Clostridium botulinum type E, viruses, and parasites. The inspection of raw material, use of good quality ice and water, high standards of personnel hygiene and cleanliness of equipment and fa-cilities as well as proper storage temperature are the most effective measures to ensure safety of fish and fish products for consumers. This review describes the good hygiene practice to be ap-plied on ships to preserve both fish products and public health.

Aim: This study aimed to investigate the relationship between dental caries, dental anxiety, and salivary cortisol levels in children visiting pediatric dental clinics and their implications on pediatric oral health. Materials and Methods: A cross-sectional study was conducted at a dental university in the UAE. A total of 60 children, aged 4-12 years, were included. Salivary cortisol levels were measured using an Enzyme-Linked Immunosorbent Assay (ELISA) kit. Dental caries status was evaluated, and dental anxiety levels were assessed using the Modified Dental Anxiety Scale (MDAS). Statistical analyses, including Mann-Whitney U test and Pearson's correlation coefficient, were performed to determine significant differences and associations. Results: The study group showed significantly higher salivary cortisol levels compared to the control group (p<0.0001). A strong positive correlation was found between salivary cortisol levels and dental caries status (p<0.001). However, no significant difference in dental anxiety levels was observed between the study and control groups (p=0.85). A strong positive correlation was found between dental anxiety levels and dental caries status (p<0.001). Conclusion: The findings indicate a significant association between salivary cortisol levels and dental caries, suggesting that higher cortisol levels are associated with active caries. Dental anxiety levels were positively correlated with dental caries. Understanding the relationship between these variables can contribute to better oral health strategies and interventions for children, emphasizing the importance of managing dental anxiety and stress in pediatric dental care. Clinical Significance: This study highlights the potential of salivary cortisol as a biomarker for assessing stress and its impact on oral health in children. By addressing dental anxiety and stress, dental professionals can provide child-friendly dental care, enhance preventive measures, and improve oral health outcomes in pediatric patients.

There is a considerable increase in the use of substances and medical procedures aimed at changing the esthetics of the face, particularly the appearance of the lips. Permanent fillers such as polydimethylsiloxane, also called liquid silicone, are widely used, but their application for facial esthetics is currently obsolete. However, the long-term complications remain a reality, as they can occur decades after the application. Thus, the goal of this case report was to present a complication after 16 years of treatment using liquid silicone. This case report involved a 52-year-old male with a complication of bilateral permanent filler in the upper lip performed 16 years ago, its surgical removal, and histological analysis. Histologically, it was possible to identify a chronic inflammatory, lymphoplasmacytic, and granulomatous reaction, with foreign body giant cells’ reaction, in relation to non-polarizable exogenous material due to the reaction to silicone. The most common complications are granulomas' appearance and material displacement. The case report shows these granulomas are characterized as chronic low-caliber inflammation around the silicone. They have an unknown etiology but are probably multifactorial, from continuous trauma, friction or irritation, iatrogenic factors, infection, immunological mechanisms, and genetic and molecular variations, and can be highly related to the impurity of the injected material.

Bioelectric effect is known as combinatorial biofilm treatment with low dose of antibiotics with small electricity. When external electric field or current are applied, biofilms can be affected by the electrostatic force, non-uniform distribution of essential electrolytes, induction of low activity of enzyme, and increase of permeability of biofilms. In this work, we have focused on the reduction of applied electric power consumption that could avoid water electrolysis which was one of major challenges for biomedical applications. We have developed a new type of electrical signal that enhances the efficacy of biofilm removal. The results show combination of alternating and direct current remove biofilm effectively without causing electrolysis. We further developed an oral healthcare device as a bioelectric toothbrush and tested in dental clinic. The results demonstrated 75% reduction of gingivitis. In addition, we have tested a mimicked air conditioner biofilms that are root causes of aerobic hygiene infection. The result demonstrates 81.8% increased biofilm removal. In conclusion, a new bioelectric technology has been developed and demonstrated the biofilm removal efficacy without the electrolysis.

There has been a steady rise in the recognition of menstrual hygiene management (MHM) as a pressing public health issue due to several advocacy campaigns against its high cost. However, not much of such recognition has been given to it outside the non-profit sector in Nigeria. This is paradoxical considering that most menstruators in Nigeria cannot afford MHM whose cost is considered high even in developed countries. We estimated that the average lifetime cost of MHM in Nigeria is US$1,122.3 per menstruator and US$113.58 billion for the entire menstruating population. Although this cost is relatively lower than in other countries, Nigeria’s low-income level explains why there is a high prevalence of period poverty among menstruators in Nigeria. This commentary highlights the intersected impacts of the cost of MHM and period poverty on the average Nigerian menstruator, his/her family, the economy, the environment and the United Nations Sustainable Development Goals. To alleviate the discussed negative effects, we suggested, as a key recommendation, the national shift from the use of disposable MHM products to that of reusable ones.

The oral mucosa represents a defense between the external environment and the rest of the body and encompasses several antimicrobial and antiviral mechanisms. Oral mucosal cells are constantly bathed in hypotonic saliva (normally one-third tonicity compared to plasma) and are repeatedly exposed to environmental stresses of tonicity, temperature and pH by the drinks we imbibe (e.g. hypotonic: water, tea, coffee; hypertonic: assorted fruit juices, red wines), as well as of diverse microbial and viral flora. In the mouth, the broad-spectrum antiviral mediator MxA (a dynamin-family large GTPase) is constitutively expressed in healthy periodontal tissues, and also induced by Type III interferons (e.g. IFN-λ1). Endogenously induced human MxA and exogenously expressed human GFP-MxA formed membraneless biomolecular condensates in the cytoplasm of oral carcinoma cells (OECM1 cell line). These condensates likely represent storage granules in equilibrium with antivirally active dispersed MxA. Remarkably, cytoplasmic MxA condensates were exquisitely sensitive sensors of hypotonicity – the condensates in oral epithelium disassembled within 1-2 min of exposure of cells to saliva-like one-third hypotonicity, and spontaneously reassembled in the next 4-7 min. OECM1 cells preloaded with calcein-AM (a reporter of cytosolic “macromolecular crowding”) confirmed unquenching and then requenching of calcein fluorescence during this process. Hypertonicity had little effect on MxA condensates. The spontaneous reassembly of GFP-MxA condensates in oral epithelial cells even under continuous saliva-like hypotonicity was slowed by the protein phosphatase inhibitor cyclosporin A (CsA) and by the K-channel blocker tetraethylammonium chloride (TEA) suggestive of the involvement of the volume-sensitive WNK kinase-protein phosphatase (PTP)-K-Cl cotransporter (KCC) pathway in the regulated volume decrease (RVD) during condensate reassembly in oral cells. Thus, physiologically, hypotonic drinks (water, tea, coffee) trigger a rapid deployment of antiviral MxA throughout the cytoplasm of oral epithelial cells, with subsequent salvage of MxA back into storage granules/condensates.

Despite the success of recent efforts to increase access to improved water, sanitation, and hygiene (WASH) globally, approximately one-third of schools around the world still lack adequate WASH services. A lack of WASH in schools can lead to the spread of preventable disease and increase school absences, especially among women. Inadequate financing and budgeting has been named as a key barrier for integrating successful and sustainable WASH programs into school settings. For this reason, the purpose of this review is to describe the current knowledge around the costs of WASH components as well as financing models that could be applied to WASH in schools. Results show a lack of information around WASH costing, particularly around software elements as well as there is a lack of data overall for WASH in school settings as compared to community WASH. This review also identifies several key considerations when designing WASH budgets or selecting financing mechanisms. Findings may be used to advise future WASH in school programs.

Introduction Menstrual hygiene is a critical issue encountered by women and girls of the reproductive age, which negatively affects their health and empowerment. It is still deemed a taboo in several parts of the world and girls hesitate to discuss menstruation with their family members, friends, or schoolteachers, which creates hurdles when they attain their menarche. Girls residing in rural areas encounter more problems, since they lack proper resources, and knowledge to manage their menstruation in school as well as at home. Methods The descriptive cross-sectional design was used to assess the study questions. The consecutive sampling techniques was applied to recruit 300 female participants from remote area of Gilgit, Pakistan, who were 13- to 22-year-old. A pre-tested questionnaire was utilized to collect the data, and to analyze the data the SPSS version 21.0 was used. Results The study found that more than half of the participants had poor level of knowledge, practices, and negative attitude towards menstrual hygiene. This could be because of many cultural and social taboos attached to menstrual hygiene. Conclusions The study concluded that the study participants were not knowledgeable about menstrual hygiene. They had poor practices and attitude regarding menstrual hygiene. Hence, it is recommended that frequent sessions should be conducted by health care workers to enhance the knowledge of parents, teachers, and young girls, to increase the positive attitude and practices regarding menstrual hygiene. Keywords menstruation, knowledge, attitude, practices, Adolescents

Background: Bleeding disorders can be divided into three categories: congenital coagulation disorders (CCDs), antiplatelet induced bleeding disorders (APBDs) and anticoagulant induced bleeding disorders (ACBDs). Implant placement can be challenging in this kind of patients. The aim of this study is to provide evidence on implant surgery in patient with bleeding disorders and to generate some practical recommendations for clinicians. Material &amp; Methods: Pubmed/MEDLINE, Scopus, Web of Science and Cochrane Library databases were screened. The latest search was performed in July 2022. Case Reports, Case Series, Cohort Studies, Cross-Sectional Studies, Case Control Studies, Reviews, Consensus Reports, Surveys and Animal Studies were included in the analysis. Results: Seventeen articles on CCDs were found, fourteen on APBDs, twenty-six on ACBDs. Most of these articles were case report or case series. Patients with CCDs can be treated after the infusion of the missing coagulation factor. Patients with APBDs can be treated without withdrawing the therapy. Patients with ACBDs should be treated depending on the anti-coagulative medication. Conclusion: Despite the low level of evidence, dental implants can be safely placed in patients with bleeding disorders. However, careful preoperative evaluation and the adoption of local and post-operative bleeding control measures are mandatory.

Molecular analysis of growing teratoma syndrome has not been extensively studied. Here, we report a 14-year-old boy with a growing mass during treatment for a mixed germ cell tumor of the pineal region. Tumor markers were negative; thus, growing teratoma syndrome was suspected. A radical resection via the occipital transtentorial approach was performed, and histopathological examination revealed a teratoma with malignant features. Methylation classifier analysis confirmed the diagnosis of teratoma, and DMRT1 loss and 12p gain were identified by copy number variation analysis, potentially elucidating the cause of growth and malignant transformation of the teratoma. The patient remains in remission after intense chemoradiation treatment as a high-risk germ cell tumor.

Providing safely-managed sanitation/hygiene requires key competencies for education, training, service delivery, enterprise development and management, product and infrastructure design and development, construction and installation, governance, financing, research, etc. These strategic sanitation capacities will have to be built from higher education’s academic and professional programmes structured and designed to produce skilled and knowledgeable professionals and practitioners. This study aims to investigate the quality of the sanitation/hygiene management content of Environmental Health programmes; the adequacy of the existing central curricula; and the perception of environmental health sanitation/hygiene-trained professionals to determine the next phase for building knowledge and capacity of sanitation professionals in Nigeria through higher education institutions. A multilevel mixed method concurrent study was used for sampling and data collection with a multilevel perception analysis to examine the perceptions of students, lecturers and graduate alumni as well as employers/supervisors and clients/service-users of sanitation/hygiene related graduates. The main findings of this paper show limited understanding of the concepts of contemporary issues of sanitation/hygiene management; the central/national teaching and curricula were found to be seriously out of date; and clients/service-users were dissatisfied with the skills and knowledge levels of the graduates. The study concludes by recommending a national sanitation management higher education pathway to guide the provision of integrated sanitation/hygiene management education at higher education institutions (HEIs), to build effective, efficient, competent, and sufficient workforce for the country.

Disposable absorbent hygiene products have evolved for superior performance, enhancing the convenience of daily lives. Yet the use of disposable hygiene pads has brought safety concerns on chemical exposure, and significant efforts have been made to assess the potential risks associated with use of hygiene pads. This article intends to overview the safety assessment framework of diapers and feminine pads, which includes hazard identification, hazard characterization, exposure assessment, risk characterization, and postmarket risk management. Risk assessment of various constituents are reviewed for quantification methods and conservative estimation of exposure parameters. By reviewing the up-to-date considerations in risk assessment, we aim to provide insightful discussion on safety evaluation of current versions of disposable absorbent products. More clinical testing and postmarket surveillance are needed for continuous monitoring of potential health impacts of advanced products and constituents.

The Brazilian economy, the rural in particular, was until the end of the 19th century based on slave labour. In this research, it was intended to obtain, through a review of historical descriptive studies, a detailed picture of the occupational hygiene conditions related to the slaves’ work and their interactions with climatic and environmental conditions. The search was done in the following databases: Science Direct, Scopus, Web of Science, Criminal Justice, Ebsco, Business Source Supplement, as well as original historical documents. Descriptive studies, without the restriction of language, were selected that involved the rural work of slaves in colonial and imperial Brazil. Working environmental conditions have been evaluated: environmental and occupational hygiene conditions to which the captive workers were exposed, as well as their accommodation and clothing. The analysed studies registered the existence of accommodation and similar dresses all over Brazil, regardless of the region's climate. In addition to these accommodation conditions, slaves were still exposed in a similar way to physical, chemical and biological agents throughout the country. Finally, it was also possible to identify a clear similarity with the occupational exposure conditions of the modern slaves in the 21^st century.

A new Mg-Zn-Zr-Ca alloy in powder state was obtained via mechanical alloying method, from pure elemental powder. Further, the obtained powder-alloy was processed by selective laser melting (SLM) procedure to obtain 3D printed samples for small biodegradable implants. A series of microstructural, mechanical and corrosion analysis were performed. The SEM analysis of powder-alloy reveal a good dimensional homogeneity, with uniform colored, no agglutinated and almost rounded particles, suitable for selective laser melting procedure. Further, the SLM samples reveal a robust and unbreakable morphology, with a suitable porosity and without undesirable balling effect. The tested Young’s modulus of the SLM samples, of 42 GPa, is close to cortical bone one, of 30 GPa. The corrosion tests performed in PBS (Phosphate-buffered saline) solution show that the corrosion parameters have a satisfactory evolution.

Superstition is a belief that is not based on scientific knowledge. Traditional healers usually use superstition in their practices to manage human health problems and diseases; such practices create a conflict with the medical profession and its evidence-based practices. Medical professionals confirm that this kind of practice is not safe to human health as it is done by untrained people (e.g., tradition healers) utilizing unsterilized instruments within unhygienic environments. Most of the cases eventually develop a variety of complications, which are sometimes fatal. Female genital mutilation, uvulectomy, oral mutilation (tooth bud extraction to cure “Ibyinyo”), and eyebrow incisions are examples of the many different types of superstitious practices which occur commonly in different parts of the world. We described how these traditional practices of superstition have been and continue to be performed in various parts of the world, their complications on oral and general health, and the ways such practices hinder modern medical practices. This paper aims to increase the awareness of these superstition-driven traditional and potentially harmful practices by promoting the importance of evidence-based medical practices.

As in every workplace, human sustainability in dental enterprises is connected to air and water quality, eco-friendly and naturally designed working spaces and 4R’s culture. Purpose of this study is to access the preferences and knowledge on circular economy and green building construction in a sample of students and dentists in Greece. Students (N1=93) and dentists (N2= 126) filled in e-questionnaires from April to December 2022. The response rate was 17,88% for N1 and 1.94% for N2. Data revealed that both students and dentists lack knowledge on circular economy (N1=67.7%, N2=68,25%), EU regulations on amalgam disposal (N1=64.5%, N2=58.73%) and plastic recycling (N1=76.34%, N2=76,98) while they do recycle at home (N1= 80.6%, N2=82.54%) and have participated in voluntary environmental actions (N1=58.1%, N2=66.67%). Gender influences the importance of factors related to green dental practices, with women students being more prone to answer positively as important for increase costs for network changes (p=0.02), lack of environmental awareness of manufacturers (p=0.057), and poor wastewater management (p=0.01). Students from urban areas are more prone to answer positively for lack of state financial support (p=0.02), low level of green design in the building (p=0.03), low direct financial benefit of a green dental office (p=0.04), low benefit to the reputation of the green dental office (p=0.02), lack of continuing education training seminars on green dentistry (p=0.05). For dentists, no significant relationships were observed except of a weak positive relationship in increase in costs for changes related to utility networks (p=0.08) while increased wasteful energy (p=0.12) and waste of dental materials (p=0.19) seemed important only for dentists in urban areas. Women dentists were more prone to answer positively on wasting energy (p=0.024) and use of unapproved disinfection products (p=0.036). The findings contribute ideas and solutions on green dental office buildings and sustainable behaviors through educational activities and social perspective of factors such as age, experience in dentistry, gender, and urbanism. It also inspires future multi-disciplinary research on dental quality assurance, psychology of environmentalism, economics, and behavioral science in dentistry.

The study assessed the trapping efficacy of locally-modified 1) Gravid Aedes Trap(GAT) lined with insecticide-treated net (ITN) as a killing agent, 2) Autocidal Gravid Ovitrap(AGO) with sticky board in the semi-field system (SFS) and field setting. Fully-balanced Latin square experiments were conducted to compare GAT lined with ITN vs AGO, both with either yeast or grass infusion. Biogents-Sentinel (BGS) with BG-Lure and no CO2 was used as standard trap for Aedes mosquitoes. In the SFS, GAT outperformed AGO in collecting both nulliparous (65% vs 49%,OR=2.22,[95%CI:1.89-2.60],p

(1) Background: The compound ytterbium trifluoride is used as a component of several dental materials, and this is reviewed in the current article. (2) Methods: Published articles on this substance were identified from PubMed, and showed that it has been included in a variety of dental restorative materials, including composite resins, glass polyalkenoate cements and calcium trisilicate cements. (3) Results: Ytterbium trifluoride is reported to be insoluble in water. Despite this, its presence is associated with fluoride release from dental materials. There is evidence that it reacts with the components of calcium trisilicate cements to form small amounts of a variety of compounds, including ytterbium oxide, Yb2O3, and calcium-ytterbium fluoride, CaYbF5. In nanoparticulate form, it has been shown to reinforce glass polyalkenoates and it also provides high contrast in X-ray images. (4) Conclusions: Ytterbium trifluoride is a useful component of dental materials, though some of the published findings suggest that there are aspects of its chemistry which are poorly understood.

Anemia is a condition of decreased red blood cell number or hemoglobin concentration, or of disturbance in their function, ultimately leading to decreased oxygen transport to tissues. Many factors and diseases may lead to anemia, with wide manifestations systemically as well as orally. Therefore, a sound understanding of this condition is essential for the dental practitioner, with emphasis on alerting signs, dental management and proper communication with patient’s physician.

This paper aims to investigate the usage of waste from Absorbent Hygienic Products (AHP) as a fuel for gasification or pyrolysis, two attractive routes to obtain valuable products and dispose of this kind of waste. The study experimentally investigated the devolatilization of coarsely shred-ded materials from diapers, in a laboratory-scale bubbling fluidized bed made of sand, as a rep-resentative preparatory step of above-mentioned thermochemical conversions. Two versions of shredded materials were considered: as-manufactured diapers (AHPam, as a reference), and the cellulosic fraction of sterilized used diapers (AHPus). Results were presented, obtained from physic-chemical characterization of AHPam and AHPus (TGA, CHNS/O, proximate and ultimate analysis, XRF, ICP-AES, SEM-EDS) and their devolatilizations at 500-600-700-800°C, under two different atmospheres (air plus nitrogen, or pure nitrogen as a reference). Generally, temperature had most influenced syngas composition, with better performances under pure nitrogen. At 700-800 °C under pure nitrogen, the highest syngas quality and yield were obtained. For AHPam and AHPus, respectively: (i) H2 richness equaled 29.5 vol% and 23.7 vol%, while hydrocarbons poorness equaled 14.8 vol% and 7.4 vol% on dry, dilution-free basis; (ii) 53.7 Nl 100 gfuel-1 and 46.0 Nl 100 gfuel-1 were produced. Overall, AHP emerged as an interesting fuel for thermochemical conversions.

The onset of the Coronavirus 2019 (COVID-19) pandemic has challenged the worldwide healthcare sector, including dentistry. The highly infectious nature of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus and risk of transmission through aerosol generating procedures has profoundly impacted the delivery of dental care services globally for months causing prioritization of critical dental needs and suspension of routine dental procedures. As dental practices with strengthened infection control strategies and preventive measures are re-opening in the “new normal” period, it is the responsibility of healthcare professionals to constantly analyze new data and limit the spread of COVID-19 in dental care settings. With the new variants of SARS-CoV-2 rapidly emerging in different geographic locations, a definite need to comply more than ever with the rigorous public health measures to mitigate COVID -19 transmission exists. The aim of this article is to provide dental clinicians with essential information regarding both the spread of SARS-CoV-2 virus and protective measures against COVID-19 transmission in dental facilities. By compiling guidance and standard protocols recommended by credible national and international organizations, this article serves as an aid to navigating through this unprecedented time with ease. Much to learn about COVID-19 exists and because of constant ongoing research, we are not aware of all of the newly found information. However, in this paper, we reviewed the available literature recommended for the best current practices that must be taken for a dental office to function safely and successfully.

A review of the surface ablation of hominin teeth by attrition, abrasion and erosive wear. The occurrence of these lesions is explored in a sample of South African fossil australopithecine dentitions revealing excessive wear. Interpretation of the nature of the dietary components causing such wear in the absence of carious erosion provides insight into the ecology of the Plio-pleistocene epoch (1-2 million years ago). Fossil teeth inform much of the living past by their retained evidence after death. Tooth wear is the ultimate forensic evidence of lives lived.

Abstract: Background: The practice of menstrual hygiene(MH) is a public health issue and depends on various factors. Taboos and incorrect MH practices can lead to health hazards. This study aimed at assessing the Knowledge, Attitude, and Practice of MH among the female students and faculty of Medical and Health Sciences University. Materials and methods: This cross-sectional questionnaire survey between February and June 2023 using consecutive sampling. Univariate analysis and comparisons were done with a significant p-value <.05. Results: A total of 253 women participated in the study. The knowledge and practices of MH were good. There were significantly more irregular and painful periods in younger females (p=.005,.0001). 89% of women used disposable pads and least used menstrual cups. Younger women were unaware of menstrual cloth. The attitude towards menses varied, with younger females feeling annoyed (p=.002), and older females embarrassed (p=.0001) at menarche. About 1/3rd of participants perceived menstrual blood as unhygienic. Younger women were more open about talking about menses (p=.005). Conclusion: There was good knowledge and practices of MH among participants. There were differences in menstrual history and attitude among older and younger women. The attitude and beliefs vary among the participants, due to sociocultural factors and age differences.

: Background: The aim of this study was to evaluate Phenylketonuria (PKU) patients’ oral health habits and the efficiency of tailored recommendations for PKU patients in Latvia on the correct management of oral hygiene. The-free amino acid formula can negatively impact PKU patient’s oral health as it contains a high amount of complex carbohydrates. Materials and methods: In this study with a one-month interval pre and post implementation of oral hygiene recommendations, two questionnaires regarding oral hygiene habits and knowledge were prepared and provided by trained medical personnel to be filled in for all diagnosed PKU patients in Latvia who were not lost to follow-up. Results: Based on the questionnaires among the PKU patients under 18 years of age, 27% cleaned their teeth once a day. However, 6% of patients did not engage in regular teeth brushing at all. Among PKU patients over and 18 years of age, 26% brushed their teeth only once a day. Additionally, a mere 39% of PKU patients ≥18 years of age and 17% &lt; 18 years of age incorporated flossing into their oral hygiene routine. In total, 45% of PKU patients ≥18 years of age and 44% &lt; 18 years of age visited a dentist once a year, but 40% ≥18 years of age and 39% &lt;18 years of age visited a dentist less often than once per year. After reading the recommendations, a remarkable number of PKU patients &lt; 18 years of age had improved their daily oral hygiene routine, including toothbrushing (25%) and flossing (23%). Conclusion: Given the unique dietary requirements and the implementation of these daily at-home oral health practices, motivation and regular reminders should result in better oral health of PKU patients and cooperation with clinicians.

In the face of 21st-century environmental challenges, including climate change, migration pressures, and waste disposal issues, certain healthcare sectors, notably dentistry, pose a significant global environmental footprint with concerns about carbon emissions and waste production. This scoping review delves into the paradox that healthcare, while dedicated to safeguarding health, inadvertently contributes to environmental degradation through waste accumulation and disposal. The analysis of relevant pertinent literature emphasizes the imperative for an environmentally sustainable approach to dental waste measurement, disposal methods, and comprehensive education for stakeholders. Aligned with the World Conference on Sustainable Development and the United Nations' 2030 Agenda, the study adhered to PRISMA-ScR scoping review guidelines and Institute of Medicine's recommendations. The study utilized Medline/PubMed and international organization websites for data retrieval, employing Boolean operator queries in Medline. A systematic literature analysis identified six cross-sectional studies (2004-2018) highlighting variations in dental waste composition due to the lack of standardized identification methods. This heterogeneity underscores the need for a proposed research model, emphasizing comprehensive methodologies and healthcare staff training in waste management. The study advocates for environmentally conscious dental practices, contributing to broader sustainable healthcare goals through sharing of a research protocol for dental solid waste management.

This study sought to evaluate the awareness, comprehension, and practices concerning Forensic Odontology among dental students and faculty at a Dental School in Cyprus. An online, cross-sectional, descriptive survey was disseminated to the entirety of dental students and faculty of the School of Dentistry, European University Cyprus, in November 2022. Of those surveyed, 47 faculty members and 304 students responded, yielding response rates of 66.2% and 80%, respectively. The survey revealed that 87% of faculty and 65% of students were familiar with Forensic Odontology. A noteworthy 94% of faculty and 85% of students recognized teeth as DNA repositories. A high percentage, 98% of faculty and 89% of students, acknowledged the role of Forensic Odontology in the identification of criminals and deceased individuals. Awareness of age estimation through dental eruption patterns was evident in 85% of faculty and 81.6% of students. A substantial proportion (80% of faculty) maintained dental records, while 78% of students recognized the importance of dental record-keeping in ensuring quality care. Interestingly, 57% of students and 64% of faculty were aware of the possibility of dentists testifying as expert witnesses. The majority, 95.7% of faculty and 85% of students, concurred that physical harm, scars, and behavioral alterations predominantly indicate child abuse. The survey underscored a robust awareness of Forensic Odontology among respondents. Despite faculty's comprehensive understanding, there's a pronounced need to bolster their inclination towards attending relevant seminars. Emphasis on improved record-keeping practices for potential forensic applications is paramount.

Chat generative pre-trained transformer (ChatGPT) is a developed language model and a subgroup of artificial intelligence (AI) which has demonstrated noticeable innovation in interactions between computer models and human studies. The release of ChatGPT in November 2022 attracted over 100 million users in a short time. It has unlimited applications in different fields of studies such as technology and science. ChatGPT utilizes deep learning and internet text to produce responses that resemble human language, although their accuracy is not always guaranteed. ChatGPT and GPT-4 can make a huge revolution in biology, medical, dental research, and health care. However, it's important to acknowledge the limitations of ChatGPT such as limitation in accessing the latest data. ChatGPT has generated both excitement and concern regarding its potential misuse. Its utilization in scientific publications has sparked debates and prompted the development of policies to govern the use of it. Although ChatGPT has certain limitations, it could impact on many different fields of study. There are challenges associated with using ChatGPT in the field of laboratory medicine and biology, particularly in the interpretation of test results. In this article, we review some of the applications of ChatGPT and GPT-4 in biology, dental and medical studies, and concerns about ChatGPT. Despite ChatGPT's conversational abilities are impressive, there are important considerations regarding its use in different fields of research and academic public.

Background: Acceleration of mass vaccination strategies is the only pathway to overcome the COVID-19 pandemic. Healthcare professionals and students have a key role in shaping public opinion about vaccines. This study aimed to evaluate the attitudes of dental students globally towards COVID-19 vaccines and explore the potential drivers for students' acceptance levels; Methods: A global cross-sectional study was carried out in February 2021 using an online ques-tionnaire. The study was liaised by the scientific committee of the International Association of Dental Students (IADS), and data was collected through the national and local coordinators of IADS member organizations. The dependent variable was the willingness to take the COVID-19 vaccine, and the independent variables included demographic characteristics, COVID-19-related experi-ence, and the drivers of COVID-19 vaccine-related attitude suggested by the WHO-SAGE; Results: A total of 6639 students from 22 countries representing all world regions responded to the ques-tionnaire properly. Their mean age was 22.06 ± 2.79 (17-40) years, and the majority were females (70.5%), in clinical years (66.8%), and from upper-middle-income economies (45.7%). In general, 22.5% of dental students worldwide were hesitant, and 13.9% rejected COVID-19 vaccines. The students in low- and lower-middle-income (LLMI) economies had significantly higher levels of vaccine hesitancy compared to their peers in upper-middle- and high-income (UMHI) economies (30.4% vs 19.8%; p < 0.001); Conclusions: The global acceptance level of dental students for COVID-19 vaccines was suboptimal, and their worrisome level of vaccine hesitancy was influenced by the socioeconomic context where the dental students live and study. The media and social media, public figures, insufficient knowledge about vaccines, and mistrust of governments and the pharmaceutical industry were barriers to vaccination. The findings of this study call for further implementation of epidemiology (infectious diseases) education within undergraduate dental curricula.

There are few published studies assessing dental students' and faculty's perception regarding environmental sustainability in dentistry (ESD), its existence within the dental curricula, along with barriers and enablers for its integration. As far as the authors know, no published study looked into this in Saudi Arabia, and this is what the current study aims to explore. A cross-sectional survey using validated online questionnaires for dental students and faculty was carried out in 26 dental schools in Saudi Arabia. The validated questionnaire utilized 25 questions using Qualtrics (XM) software. Both descriptive statistics and thematic analysis were included in the data analysis. ESD content is not formally embedded within the dental curricula in all 26 included universities in Saudi Arabia. Although the majority of students and faculty members agreed or strongly agreed on the importance of ESD as a whole and the importance of teaching it, more than 82% and 81% of students and faculty, respectively, demonstrated a lack of basic knowledge concerning ESD. There is a high demand for incorporating ESD content in dental education in Saudi Arabia. To achieve this, resources and policy changes are necessary. A top-down approach is needed, including incorporating ESD into dental education standards, using evidence-based practices in revising infection control regulations and providing institutional support through training, materials, and incentives. National dental associations and governments should provide practical solutions and actively support dental professionals in implementing ESD.

The study aimed to estimate the prevalence and correlates of oral hygiene (OH) and hand hygiene (HH) behaviour among school adolescents in three Caribbean countries. In all, 7,476 school adolescents (median age 14 years), from Dominican Republic, Suriname and Trinidad and Tobago responded the cross-sectional “Global School-based Student Health Survey” (GSHS) in 2016-2017. The prevalence poor OH (tooth brushing <2 times/day) was 16.9%, poor HH (not always before meals) was 68.2%, poor HH (not always after toilet) was 28.4% and poor HH (not always with soap) was 52.7%. In adjusted logistic regression analysis, current cannabis use, inadequate fruit and vegetable intake, poor mental health and low parental support increased the odds for poor OH. Rarely or sometimes experiencing hunger, trouble from alcohol use, inadequate fruit and vegetable intake, poor mental health, and low parental support were associated with poor HH (before meals, and/or after toilet, and/or with soap). The survey showed poor OH and HH behaviour practices. Several sociodemographic factors, health risk behaviours, poor mental health and low parental support were found associated with poor OH and/or HH behaviour that can assist with tailoring OH and HH health promotion.

The study conducts a comparative life cycle assessment (LCA) analysis to assess the environmental impact of two different manufacturing processes used to produce transparent dental aligners. The former method consists of thermoforming a polymeric disc over 3D printed, customized models, while the second, more innovative approach involves the direct printing of aligners using additive manufacturing (AM), specifically applying digital light processing (DLP) technology. The analysis results highlight how adopting direct printing through AM brings significant advantages in terms of environmental sustainability, thanks to the substantial reduction in raw materials and electricity consumption. These drops translate into decreased potential environmental impacts across all impact categories considered within the EF 3.1 method. Furthermore, lowering the amount of raw materials needed in the direct printing process contributes to a notable decrease in the overall volume of waste generated, emphasising the environmental benefits of this innovative technique.

IntroductionDiversity is known to be important but diversity of staff working in dental schools in the UK and Ireland is low in comparison with the dental profession and the overall population. AimsTo provide a detailed snapshot of the diversity of dental academic staff in 2021 including staff working in academic and clinical roles.MethodsAn online survey was circulated to dental schools by Dental Schools Council. Questions included dates of graduation and key career milestones, demographics and indicators of esteem. Free text questions were also included.ResultsThere was a high degree of variability in dental academic careers which made direct comparisons difficult. Neither gender nor race appeared to be associated with a faster career progression. Females and those of racialised minority were less represented at the most senior grades. For those who had completed specialty training, racialised minority staff were far less likely to be working at consultant grade than their White equivalents.ConclusionThere are differences in career progression between staff in dental schools. The high amount of individual variability makes these difficult to quantify except at the most senior positions. Qualitative information is needed to contextualise the results and provide additional information.

The aim of this study was to compare the effect of using L-PRF in patients undergoing impacted lower third molar surgery with either primary or secondary closure techniques. Methods: This prospective, randomised, double-blind, split-mouth clinical trial was conducted in patients with bilateral lower impacted third molars of similar position. Primary closure was performed in group 1 and secondary closure in group 2. Group 1 closure technique was applied to one side of the patients and group 2 closure technique was applied to the other side at different times. Nine pa-tients were excluded from the study due to alveolitis and failure to attend regular control visits out of the 45 patients evaluated. Results: Of the 36 patients included in the study, 23 were female and 13 were male and the mean age was 22.42±3.36 years. The secondary closure group had lower VAS scores at hour 6 (p

Teeth include mesenchymal stem cells (MSCs), which are multipotent cells that promote tooth growth and repair. Dental tissues, specifically the dental pulp and the dental bud, constitute a relevant source of multipotent stem cells, known as dental-derived stem cells (d-DSCs): dental pulp stem cells (DPSCs) and dental bud stem cells (DBSCs). Cell treatment with bone-associated factors and stimulation with small molecule compounds are, among the available methods, the ones who show excellent advantages promoting stem cell differentiation and osteogenesis. Recently, attention has been paid to studies on natural and non-natural compounds. Many fruits, vegetables and some drugs contain molecules that can enhance MSC osteogenic differentiation and therefore bone formation. The purpose of this review is to examine research work over the past 7 years that has investigated two different types of MSCs from dental tissues that are attractive targets for bone tissue engineering: DPSCs and DBSCs. We focused on articles hypothesizing the identification and study of compounds that induce proliferation and osteogenic differentiation of the two d-DSC populations, representing an interesting issue for regenerative medicine. The reconstruction of bone defects in fact is still a challenge for personalized medicine.

(1) Introduction: External high volume extraction devices may offer a way to reduce any aerosol particulate generated. The aim of this study was to measure the particle count during dental aerosol procedures and compare the results to when a High Volume Extraction device is used; (2) Methods: A comparative clinical study measuring the amount of PM1, PM2.5 and PM10 aerosol particulate with and without the use of an external High Volume Extraction device was undertaken. In total, 10 restorative procedures were monitored with an an industrial Trotec PC220 particle counter. The air sampler was placed at the average working distance of the clinicians involved in the study - 420mm.; (3) Results: In the present study aerosol particulate was recorded at statistically significantly increased levels during dental procedures without an external high volume extraction device versus with the device. The null hypothesis was rejected, in that significant differences were found between the results of the amount of aerosol particle count with and without a High Volume Extraction device.; (4) Conclusion: If the results of the present study are repeated in an in vivo setting, an external high volume suction device may potentially lower the risk of transmission of viral particulate.

Purpose: to assess any differences on marginal bone loss between bone-level or tissue-level dental implants through a review of literature until September 2019. Materials and methods: MEDLINE, Embase and other database were searched by two independent authors. The search was limited to articles in English. Results: The search provided 1028 records and, after removing the duplicates through titles and abstracts screening, 45 full-text articles were assessed for eligibility. For qualitative analysis 20 articles were included, 17 articles of them for quantitative analysis. A total of 1161 patients (mean age 54,4 years) and 2933 implants were observed, 1427 (Tissue-level) and 1506 (Bone-level). The survival rate and the success rate were more than 90%, except for 2 studies with a success rate of 88% and 86.2%. No studies reported any differences between groups in term of success and survival rates. Three studies showed that BL-implants had statistically less marginal bone loss (P< 0.05). Only one study reported statistically less marginal bone loss in TL-implants (P< 0.05). In the most part of the studies, differences between implant types in marginal bone loss were not statistically significant. Conclusion: Despite to the peri-implant tissue around transmucosal implants has been reported to be inflammation-free because of the absence of bacterial infiltration in the micro-gap between the fixture and abutment, no clinical and radiological differences were highlighted between groups from the included studies after a variable period of follow-up ranged between 1 to 5 years.

Governments all over the world are currently grappling with the COVID-19 pandemic. While some countries were very hard hit, others were only mildly hit but all are still taking measures to mitigate the consequences. The virus emerged in December 2019 in Wuhan, China and spread to most continents by the beginning of March 2020, which led to the World Health Organization declaring it as a pandemic on the 11^th of March 2020. Since it was a novel disease, there was limited information on the virus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) belongs to the same family as the Severe Acute Respiratory Syndrome Coronavirus 1 (SARS-CoV-1) and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Researchers all over the world started working simultaneously to understand the virus to provide the necessary treatment regime or vaccine in order to reduce the impact of the virus on its victims. Africa and other developing countries with limited resources and poor planning and management are expected to be among the worst hit in the long run. The implications of the COVID-19 on food, water, hygiene, sanitation, and the environment in Africa have been reviewed in this paper, as well as possible implications they may pose to the population, based on the existing common practices and their immediate impacts. This information can assist policymakers in Africa to adequately plan the management of the COVID-19 in order to lessen its impact on the population.

To identify gender- and age-related associations between adult dental checkups and unmet dental care needs, we analyzed data of 14,000 participants, ages ≥ 19, from the 7th Korea National Health and Nutrition Examination Survey (2016–2018) (KNHANES VII). Data was collected via self-report questionnaires and interviews. Complex sample chi-square test and multiple logistic regression analysis indicated 31.7% of participants had unmet dental care needs; in the prior 12months, 67.1% had not utilized dental services, and 43.3% had not received dental checkups. Odds ratios (ORs) for dental checkups and unmet dental needs were 8.87 (CI:7.80–10.09, p < 0.001) for those who used dental services and 1.28 (CI: 1.13–1.44, p < 0.001) for those who had not. Significant age-dependent associations between those not receiving dental checkups and the rate of unmet dental care include men and women aged 50–59 years (OR: 1.77; CI = 1.22–2.58 and OR: 1.43; CI: 1.02–2.02; p = 0.040, respectively) and women ≥ 70 years (OR = 1.79, CI = 1.20–2.66, p = 0.004). Reducing unmet dental care needs requires greater public health promotion and education regarding regular dental checkups; additional practical strategies could enhance dental checkup compliance.

The non-therapeutic use of antimicrobials in poultry production contribute to the spread of drug-resistant pathogens in both birds and humans. Antibiotics are known to enhance feed effi-ciency and promote growth and weight gain of poultry. New regulatory requirements and con-sumer preferences have led to a reduced use of antibiotics in poultry production and discover natural alternatives to the antibiotic growth promoters. This interest is not just focused on the di-rect removal or inhibition of the causative microorganisms but also the prevention diseases caused by enteric pathogens using a range of feed additives. A group of promising feed additives is short- and medium-chain fatty acids and their derivatives. MCFAs possess antibacterial, anticoccidial and antiviral effects. Also, it has been proven that these acids act synergistically if they are used together with organic acids, essential oils, or probiotics. These fatty acids also benefit intestinal health integrity and homeostasis in broilers. Other effects have also been documented, including increases in intestinal angiogenesis and gene expression of tight junctions. The aim of this review is to give an overview of SCFA, MCFA as alternatives of antibiotic growth promoters and by sum-marizing the current finding in the literature, to show their possible benefits on production, meat quality and gut health in poultry.

Little has been written in literature about the clinical comparison of the single use of chlorhexidine (CHX) rather than its combination with cetylpyridinium chloride (CPC). The purpose of this study was to compare the clinical effectiveness of two at-home antiseptic regimens. Healthy subjects scheduled for dental surgery were enrolled. After the surgery, patients were randomly allocated in a first group (Group A) which received a manual ultra soft toothbrush (Mentadent Professional®), an antiseptic toothpaste with 0,12% CHX and Vitamin B3 (Mentadent Professional Azione Intensiva Gengive®) and an antiseptic mouthwash with 0,12% CHX and 0,07% CPC. The second group (Group B) received solely an antiseptic mouthwash with 0,2% in conjunction with Anti Discoloration System (Curasept ADS/DNA®) and were encouraged to use their usual toothbrush and toothpaste. Patients were instructed to use the products twice a day and to rinse for 30 seconds. On day 7, patients were examined for the Early Healing Score, Visual Plaque Index of the sutures, Numerical Rating Scale and mouthwash taste. Group A showed a statistically significant levels of EHS and taste satisfaction. The regimen based on CHX associate with vitamin B3 in the toothpaste and CPC in the mouthwash resulted in superior clinical outcomes and satisfaction compared to solely CHX.

Objective: To investigate commonalities and variations in the learning outcomes, curriculum content, assessment methods and competencies in undergraduate orthodontic curricula globally. Methods: This scoping review followed the updated methodological guidance proposed by the Joanna Briggs Institute and reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A search on electronic databases PubMed, Scopus and Embase was conducted for the last 25 years. Google Scholar was used to identify eligible unpublished and grey literature. Results: The total number of reports identified was 231. After removal of 62 duplicates, 169 reports were included in the title and abstract screening. Finally, 17 studies were included in the review which included 13 cross-sectional surveys, three expert panel proceedings and one discussion paper. Marked variations were reported in undergraduate orthodontic curricula and competency assessments at the level of individual countries, regionally as well as globally. The challenges of imparting competency in orthodontic treatment during undergraduate dental education are also acknowledged. Conclusion: Lack of consistency in undergraduate orthodontic education is evidenced by several Delphi studies to develop consensus on orthodontic teaching in undergraduate programs. A common message emanating from the available studies on undergraduate orthodontic education seems to emphasize a focus on assessment and diagnosis of orthodontic treatment needs of patients and a basic understanding of contemporary treatment options to facilitate patient referral.

More than 15,000 prescriptions and over the counter drugs are available according to the US Food and Drug Administration website. Moreover, several herbal medicines and dietary supplements are readily available to add to the list of possible drugs, which can potentially cause adverse drug interactions. These are a pressing concern for all as they can interfere with many dental procedures. Additionally, the number of geriatric patients seen in routine dental practice has increased over time. This implies that there are more patients with multiple diseases and health conditions like hypertension, diabetes, problems associated with the cardiovascular, renal and gastrointestinal systems, arthritis, osteoporosis, etc. All these require patients to be on certain medications. Furthermore, advancement in the dental field has led to more complex dental procedures (implants, grafts) being carried out in a general dental practice. These advanced and slightly more invasive treatments require the use of certain drugs before, during and after the treatment like local anesthetics, vasoconstrictors, anxiolytics, analgesics and antibiotics. All of these can possibly interact with medications a patient is already taking and can also interfere with the current dental treatment and create complications. This article aims to provide necessary information about commonly encountered systemic diseases and associated treating medications, their mechanism of action, possible complications and their management. The classes of drugs discussed include anti-platelet agents, vitamin K antagonists, novel oral anticoagulants, bisphosphonates, disease-modifying anti-rheumatic drugs and oral contraceptives.

Enamel erosion is a process which happens every time we eat and it may be accelerated by some particular acid foods, drinks or other agents. Dental enamel when damaged by low pH substances becomes chalky, rough, opaque, yellowed and it can be related to dentinal hypersensitivity. To the present day, several possible solutions are available, therefore the aim of this study was to evaluate the effect of a biocompatible minerals serum based on calcium silicate, sodium phosphate and fluoride (Regenerate™) on the damaged enamel by four different acid liquids. 135 ovine teeth were equally divided into 5 groups and submerged for one week into lemon juice, energy drink, coffee, tea and physiologic solution for the negative control. The first 4 groups were evaluated for their color with an analogical color scale (Vita® Scale) and for their surface assigning a qualitative aspect among opaque, rough, chalky or smooth. Then they were treated with hydroxyapatite gels and re-evaluated for the same parameters. Data were checked for the normal distribution with Shapiro-Wilk test and analyzed with dependent t-test or Wilcoxon Signed Rank test, every test with a p≤0.05. Both color and surface aspect showed a strongly significant improvement after the treatment. Biocompatible minerals serum based on hydroxyapatite is able to reverse teeth erosion, improve the color and restore the smoothness of the dental enamel.

Although researchers have proposed various indentation size effect (ISE) models, these models often involve different form and number of parameters that can make our wonder which is the best in existed ISE models. Three types of ISE test data, namely, normal ISE, reverse ISE and transition of normal to reverse ISE, are used to evaluate the sixteen ISE models. The comparatively study indicates that H-J, N-G-Fs, N-G-H, N-G-A and N-G-Qs models can accurately predict the normal ISE. The reason for this is that the friction stress that is not related to dislocation activities or the indentation size effect of plastic zone has been introduced into these models. Therefore, these two factors should be considered in future ISE models. The sixteen ISE models are originally proposed to describe the normal ISE of different materials. However, to our surprise, some of these models are able to capture the reverse ISE and the transition of normal to reverse ISE of different materials. The determination coefficients (DC) of the sixteen ISE models are also determined for different materials. For reverse ISE, the highest DC value for NiCSi, TC4 and PED Ni are given by the EXP, N-G-Fs and N-G-A models, respectively. For the transition of normal to reverse ISE, the N-G-YC, N-G-Fs, and N-G-H models produce the maximum DC for ZrO2, Cu and Y2O3-ZrO2, respectively. Moreover, the mean DC of the N-G-Fs model is the maximum among the sixteen ISE models, followed by the N-G-H model, but they cannot accurately predict the reverse ISE. Therefore, the N-G-Fs and N-G-H models should be further modified to accurately predict the reverse ISE.

The paper analyzes the phenomenon that condition the durability and reliability of a type of dental bur based on the wear of the active part and with effect on its quality. For the experimental study, a conical-cylindrical dental bur and a sample dental material in cobalt-chromium alloy, cylindrical shape, tested on a specially made experimental installation were used. The paper was limited to the consideration of a single parameter (loss of mass, mw by wear of the active part of the dental bur tested) for the establishment the durability and reliability, useful for the extension of the lifetime or even optimization of its operation. The wear phenomenon of the active part of dental bur is studied based on the results and experimental data obtained in the work process that was validated by interpolation and led to polynomial functions which approximate very well the dependent parameter, mw, considered in the experimental program. The results of the interpolation showed that in the first 11 h of work, the dental bur works with high efficiency, after which it can be easily decommissioned (optimizing operation, possibly constructive solutions); i.e., it should be replaced with a new one (criterion for replacing of worn dental bur).

Background and Purpose: Open-source Artificial intelligence (AI) applications are fast transforming access to information and allow students to prepare assignments and offer quite accurate responses to a wide range of exam questions which are routinely used in assessments of students across the board including undergraduate dental students. This study aims to evaluate the performance ChatGPT, an AI-based application, on a wide range of dental assessments and discusses the implications for undergraduate dental education. Methods: This was an exploratory study investigating the accuracy of ChatGPT to attempt a range of recognized assessments in undergraduate dental curricula. ChatGPT was used to attempt ten items based on each of the five commonly used question formats including single-best answer (SBA) multiple-choice questions (MCQs); short answer questions (SAQs); short essay questions (SEQs); True/False questions and fill in the blanks items. In addition, ChatGPT was used to generate reflective reports based on multisource feedback (MSF); research methodology; critical appraisal of the literature. Results: ChatGPT application provided accurate responses to majority of knowledge-based assessments based on MCQs, SAQs, SEQs, Tue/False and fill in the blanks items. However, it was only able to answer text-based questions and did not allow processing of questions based on images. Responses generated to written assignments were also of good quality apart from those for critical appraisal of literature. Word count was the key limitation observed in outputs by ChatGPT as it was only able to produce reports limited to approximately 650 words. Conclusion: Notwithstanding their current limitations, AI-based applications have the potential to revolutionize virtual learning. Instead of treating it as a threat, dental educators need to adapt teaching and assessments in dental education to the benefits of the learners whilst mitigating against dishonest use of AI-based applications.

Fatigue analysis plays a vital role in determining the structural integrity and life of a dental implant. With the use of such implants on the rise, there is a corresponding increase in the number of implant failures. As such, the aim of this research paper is to investigate the life of 3D-printed dental implants. The dental implants considered in this study were 3D printed according to the direct metal laser sintering (DMLS) method. Additionally, a finite element model was developed to study their performance, while fatigue life was predicted using Fe-Safe software®. The model was validated experimentally by performing fatigue tests. The life of the dental implants was analysed based on Normal strain and the Brown-Miller with Morrow mean correction factor algorithm. The model revealed that there was a strong correlation between the FEA and the experimental results. The clinical success of 3D-printed dental implant experimentally is 20.51 years and computationally under Normal strain is 19.89 years and Brown-Miller with Morrow mean correction factor is 26.82 years.

Malnutrition and dental caries in early childhood remain persistent and intertwined global health challenges, particularly for indigenous and geographically-remote populations. To examine the prevalence and associations between early childhood dental caries, parent-reported mouth pain and malnutrition in the Amazonian region of Ecuador, we conducted a cross-sectional study of the oral health and nutrition status of 1,407 children from birth through age 6 in the “Alli Kiru” program (2011-2013). We used multivariate regression analysis to examine relationships between severe caries, parent-reported mouth pain measures, and nutritional status. The prevalence of dental caries was 65.4%, with 44.7% of children having deep or severe caries, and 33.8% reporting mouth pain. The number of decayed, missing and filled teeth dmft) increased dramatically with age. Malnutrition was prevalent, with 35.9% of children stunted, 1.1% wasted, 7.4% underweight, and 6.8% overweight. As mouth pain increased in frequency, odds for severe caries increased. For each unit increase in mouth pain frequency interfering with sleeping, children had increased odds for underweight (AOR: 1.27; 95% CI: 1.02 – 1.54) and decreased odds for overweight (AOR: 0.76; 95% CI: 0.58 – 0.97). This relationship was most pronounced among 3-6 year-olds. Early childhood caries, mouth pain and malnutrition were prevalent in this sample of young children. Parent-reported mouth pain was associated with severe caries, and mouth pain interfering with sleeping was predictive of poor nutritional status. We demonstrate the utility of a parsimonious parent-reported measure of mouth pain to predict young children’s risk for severe early childhood caries and malnutrition, which has implications for community health interventions.

Abstract: With a resurgence in ITRT (Immediate Tooth Replacement Therapy) as a method of preserving both hard and thus soft tissues for improved aesthetic outcomes, this multi-centre, retrospective study will look at two novel products and their effect on these outcomes. A new synthetic particulate graft material along with a novel Implant design was utilized in the study and a 1 year follow up assessment, analysed for hard and soft tissue regeneration.

In this pilot study, 84 subjects with a history of poor oral hygiene were enrolled in an interventional, randomized, prospective, open-label controlled trial. The aim was to provide preliminary clinical data on the products, the recruitment monthly rate, and patient satisfaction to estimate resources for the main study, as well as descriptive data on oral microbiota rebalancing. The population was divided into five groups: 20 participants received delicate mint toothpaste, 12 mint toothpaste, 20 mint mouthwash, and 20 delicate mint toothpaste and mint mouthwash using a specifically custom-designed toothbrush. The 12 subjects in the control group continued to use their oral care products without changing their normal routine. The study duration was 28 days.All subjects tolerated the products well, and there were no adverse events. Recruitment capability and procedures allowed a realistic estimation for the future main trial. The products did not cause any changes in tooth color. The participants who completed the treatment consisting of delicate mint toothpaste, mint mouthwash, and the specifically custom-designed toothbrush showed the gingival sensitivity best results (p≤0.000). The products induced a statistically significant decrease in plaque in all treated groups (p≤0.000) and an improvement of gingival sensitivity (delicate mint toothpaste, p≤0.005; mint toothpaste, p≤0.015; and mint mouthwash, p≤0.015). All the products were effective in stabilizing the oral microbiota.The tested products showed an optimal safety profile. They also stabilized the biodiversity of the oral microbiota, making it less susceptible to microbial fluctuations than the control group.

Objective: The purpose of this study was to evaluate the surface texture and biofilm adhesion of veneered or CAD/CAM milled zirconia (partially stabilized with yttrium) after professional oral hygiene procedures. Samples (4x4 mm, thickness 2 mm; n = 72) were separated from zirconia blanks (3Y-TZP-LA). One group was veenired with ceramics and the other group of samples was CAD/CAM milled. Each group had 2 subgroups: polished and glazed. The samples were subjected to simulated strokes of professional brushing using abrasive paste and ultrasonic scaling. Parameters of surface micromorphology and receptivity to biofilm were calculated before and after simulating the given methods of professional maintenance of oral hygiene. The characteristics of zirconia surface were evaluated by scanning electron microscopy (SEM). Microbial bacterial/fungal species (Staphylococcus aureus, Streptococcus sanguinis and Candida albicans) were used and cultured on the respective sterilized zirconia surfaces. The amount of biofilm formation on zirconia surface was quantified by colony forming unit (CFU) counts. Results: SEM analysis showed the greatest change in surface microtopography after the use of ultrasonic scaling, in glazed zirconia samples. Less formation of colonies on the surface CAD/CAM milled zirconia restorations was observed. Conclusion: Routine methods of professional maintenance of oral hygiene can damage the surface of glazed zirconia restorations.

Background: One challenge in implant dentistry is to reduce marginal bone resorption to avoid long-term esthetic and biological complications. Sub-gingival implant placement has been suggested as a suitable strategy. Methods: 38 healthy patients were enrolled to receive bone level (BL – Control group) or 2 mm sub-crestal (SC - Test group) conical connection, platform-switched implants. An immediate tissue level abutment was used in the Test group by following a One Time Abutment (OTA) restorative procedure. Marginal Bone Modification (MBM) was calcu-latied on standardized radiographs at surgery (T0), loading (T1), and 6 months (T2) and 12 months after loading (T3), and cathegorised in Bone Loss (BL) if the resorption occurred below the implant neck and Bone Remodeling (BR) if above. Pocket probing depth (PPD), Bleeding on probing (BoP) and Plaque Index (PI) were also collected. Results: The mean MBM in the test group after 12 months was 0.61mm, compared to 0.52mm in the control group. However, no BL was observed in the test group, as the MBM completely occurred above the implant neck as BR, whilst in the control group MBM corresponded in total to BL. The average PPD was 2.38mm in the test group and 3.04mm in the control group after 12 months, BoP 50% and 43%, PI 33% and 19.44% respectively. Conclusions: Sub-crestal conical connection, platform-switched implants could be a suitable clinical choice to avoid BL with exposure of the treated implants surfaces.

Background: clubfoot is a common congenital deformity. The Ponseti technique, involving early corrective manipulations followed by the application of long leg casts and Achilles tenotomy, is widely accepted as the preferred treatment. Rapid healing of the tendon after surgery has been documented, but the aspect regarding tendon structure and properties is not known. Three cases of Achilles tendon rupture in adolescent previously treated for clubfoot have been described in the literature. Since rupture is a rare event in this age group a possible correlation with previous surgery has been hypothesized. The primary aim of the study was to compare the ultrasound findings of the Achilles tendon, in patients treated for clubfoot, between patients treated with casting alone and the ones who underwent surgery (percutaneous tenotomy or Z-plasty lengthening). Methods: 22 asymptomatic patients, (34 feet) median age 12 years, previously treated for clubfoot, were recruited for this study; the patients underwent an Achilles tendon ultrasound examination during a follow-up outpatient visit. Results: a greater thickness and structural alterations with presence of hypoechoic areas of the operated tendons compared to those treated with plaster alone were observed (p value: 0.0498 and

Dental healthcare providers, staff and patients are constantly exposed to the risk of infection or cross-infection in the dental office, particularly due to the formation of biofilms within Dental Unit Waterlines (DUWLs). Good water quality, achieved with environmentally friendly means, is essential in ensuring the safe operation of the clinic. The aim of this study was to evaluate the practices and protocols used in dental offices of Metropolitan Athens in Greece with regards to water quality in DUWLs. The questionnaire about water quality was distributed to dental practitioners in 2022 and was completed by 206 dentists. Water supplied to dental units was mainly from the public network (65.0%), with 55.8% using in-office filtration. Most dentists (71.8%) do not know the active substance of the antiseptic used for the DUWLs, while 96.1% reported having an antiseptic reservoir embedded in the dental unit. Daily flushing with a small and a large amount of fluid was practiced in approximately 83% and 61% of dental offices, respectively. Dental associations should raise awareness regarding water quality and maintenance of DUWLs in dental offices, investing in lifelong learning, while implementing protocols and green strategies.

Background: Dental professions are at high risk of contracting novel corona virus (COVID-19) infections during the dental procedure due to the droplets and aerosols generated during various dental procedures on infected patients. To prevent and avoid the cross-infection of the infection to dental professionals or the patients attending the dental clinic, good knowledge of the infection and its prevention mechanisms is mandatory among the professionals. Until to date, there is no pooled estimate on the knowledge,attitude and practice (KAP) of dental professionals to COVID-19 in the globe. Hence, this study aimed to determine the pooled estimate of KAP of dental professionals in this pandemic disease. Methods: Article search was done electronically using Medline, Scopus, Web of Science, EMBASE, SciELO and Google Scholar from June 1, 2020 to August 20, 2020. All studies that assessed the KAP of dental professionals to COVID-19 were searched and included in this review after passing the inclusion criteria. The pooled analysis of their knowledge (sign and symptom, mode of transmission and prevention mechanisms), attitude (their concern, intention to treat suspected patients) and practice (face mask usage, hand washing and alcohol based hand rub usage, handshaking practice, deferred procedures and checkup of patients temperature) was computed using RevMan 5.3 and random effect model was used. The presence of publication bias was assessed using the funnel plot. Results: Twelve articles with a total of 5,362 study participants were included in this study. The pooled estimate revealed that 59.91% of the dental professionals had good knowledge of the signs and symptoms of COVID-19. Two-third of dental professionals know the prevention mechanisms of the infection, and 70.13% had enough knowledge of the transmission modalities of the infection. The professional attitude revealed that only 36.43% of the participants had intention to treat a patient with cough or suspected COVID-19 (36.43%, 95%CI: 8.57, 64.29). Moreover, 47.85% of the dentists were concerned about their life, and the fate of their profession due to this pandemic disease (47.85%, 95%CI: 26.74, 68.97). The pooled analysis showed only 50.86% (95%CI: 18.64, 83.09) of the study participants worn face mask and 52.63% (95%CI: 10.54, 94.71) had avoided handshaking practice during this pandemic period. Non-emergency dental procedures were canceled by 83.98%. Conclusion: The dental professional KAP is not optimal. Thus, dental professionals should be aware of the recently updated knowledge about COVID-19 and practice according to the standards of treatment guidelines, and the recommended infection control measures in dental settings. Moreover, as saliva and droplets are the major sources of infection, dentists should follow essential protocols to regulate droplet and aerosol contamination in the dental practice

Candida albicans is an opportunistic fungus that becomes pathogenic and problematic under certain biological conditions. C.albicans may cause painful and uncomfortable symptoms, as well as deaths in immunocompromised patients. Therefore, early detection of c.albicans is essential. However, conventional detection methods are costly, slow and inaccessible to women in remote or developing areas. To address these concerns, we have developed a wearable and discrete naked-eye detectable, colorimetric platform for c.albicans detection. With some modification, this platform is designed to be directly adhered to existing feminine hygiene pads. Our platform is rapid, inexpensive, user-friendly, disposable and only requires three steps: i) addition of vaginal fluid onto sample pads; ii) addition of gold nanoparticle gel and running buffer, and iii) naked eye detection. Our platform is underpinned by selective thiolated aptamer-based recognition of 1,3-β-D glucan molecules- a hallmark of c.albicans cell walls. In the absence of c.albicans, wearable sample pads turn bright pink. In the presence of c. albicans, the wearable pads turn dark blue due to significant nanoparticle target-induced aggregation. We demonstrate naked eye colorimetric detection of 4.4 ×106 c.albicans cells per ml. We believe that this proof-of-concept platform has the potential to have a significant impact on women’s health, globally.

Introduction: Dental students’ use of online material to supplement learning has been studied, but educator awareness and reaction to the findings of this research is unknown. This small local study aimed to investigate dental students’ use of online content as a learning tool from an educator’s perspective.Methods: Educators at an Irish dental school completed a survey based on dental students’ use of online learning. Quantitative descriptive analyses were carried out as appropriate on the data collected, and a subsequent focus group was held to gain deeper insight into survey results. Data were analysed for themes by deductive and inductive coding methods.Results: This study found a sample of educators were aware of some student behaviours around online videos. Most educators correctly thought that students are likely to refer to online videos to prepare for dental procedures. Several educators believed that teachers should incorporate videos into their learning, but do not themselves upload or recommend online videos. Most recalled discussing accuracy and/or relevancy of online content with their students. Fewer thought that students would discuss contradictory videos with them. Focus group participants expressed concern over the accuracy of online content. This along with a lack of time were some reasons deterring them from referring students to online videos. Conclusions: An opportunity exists for dental educators and their students to have local dialogue around (1) student use, critical appraisal, and sharing of dental procedural video material; and (2) perceived benefits and challenges of incorporating both school-produced and online videos into teaching and learning. Although arguably non-generalizable beyond this context, this study may inform future research and serve to spark conversations within schools regarding video use for teaching clinical dental procedures.

Tooth bud removal called Ibyinyo is the practice of removing the developing tooth buds, usually done on an infant, typically performed by traditional healers who believe that this practice will reduce fever and diarrhea in children. This practice is most prevalent in East-African countries, including Rwanda. These procedures are mostly performed in non-sterile conditions using basic sharp instruments. We will discuss the case of a 10-year-old female patient who was presented at the dental clinic, with two malformed permanent canine teeth. Clinical examination revealed malformed enamel and elongated permanent right maxillary canine tooth left mandibular canine tooth with crown malformation. She was also presented with retained (primary) left maxillary lateral incisor tooth and missing left maxillary canine tooth. In addition, the ectopic eruption of left maxillary central incisor tooth and missing permanent right mandibular canine tooth were noted. All these complications resulted from tooth bud removal that the patient had experienced in her early childhood. Her malformed right maxillary and left lower mandibular canine teeth were reshaped, using composite filling materials, to improve her appearance aesthetically. Ibyinyo is preventable damage, done out of ignorance and superstitious practices that can be stopped by growing social awareness. Therefore, educating parents through community-based campaigns on the detrimental consequences of early childhood tooth bud removal through Ibyinyo practice might be helpful to eradicate this harmful and unnecessary practice.

Pre-diabetes is a serious health condition where blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. Pre-diabetes puts one at an increased risk of developing type 2 diabetes and heart disease Methodology: A cross-sectional study was carried out on 384 patients aged 20-70 years old, attending the dental clinics to assess the risk for diabetes, using the FINDRISC questionnaire, HbA1c blood test and a periodontal examination. Results: The mean age of participants was 38.90±10.74. 32.3% were categorized as no risk, 46.6% low risk, while 19% and 2.1% moderate and high risk of developing diabetes respectively. Tests for serum HbA1c Level showed 46.1 % had normal HbA1c followed by 18.0% and 3.6 % were pre-diabetic and diabetic respectively. 19.3% of participants had periodontal pockets measuring more than 4mm and 15.9% measuring more than 6mm. Conclusion: The study has proven to be useful in identifying patients at high-risk of developing diabetes. Controlling and managing periodontal disease could be a new aspect to include in the standards for diabetes care. Dental settings could be a successful platform to carry out the screening and risk stratification of pre-diabetic patients.

Background and Objectives: The purpose of this study was to investigate whether early surfactant administration affects the status of ductus arteriosus (DA) in preterm infants ≤32 weeks of gestational age (GA) within 24 hours of birth. Materials and Methods: It is a prospective study conducted from March 15, 2022, to November 15, 2023, in a tertiary academic center. In-born infants ≤ 32 weeks of gestation (n = 88) were enrolled. The study group was further divided into surfactant (n=44) and non-surfactant (n=44) subgroups. Results: 76% of the preterm infants who received surfactant therapy (RRR = 0.839) recorded an increase in Kindler Score at 24 hours of life (1-RR = 1-0.24 = 76%). Surfactant administration was significantly associated with decreased pre-ductal diastolic pressure (29.9 mmHg vs. 34.8 mmHg, p=0.0231), post-ductal diastolic pressure (28.7 mmHg vs. 32.2 mmHg, p=0.0178) pre-ductal MAP (41.6 mmHg vs. 46.5 mmHg, p=0.0210) post-ductal MAP (41.0 mmHg vs. 45.3 mmHg, p=0.0336). There were no significant changes in ductus arteriosus parameters at 24 hours of life. Conclusions: Early surfactant administration does not affect the status of ductus arteriosus in preterm infants ≤32 weeks of gestational age at 24 hours of life.

Background: Globally, infections are the third leading cause of neonatal mortality. Predominant risk factors for facility-born newborns are poor hygiene practices that span both the facility and home environments. Current improvement interventions focus on only one environment and tar-get limited caregivers, primarily birth attendants and mothers. To inform the design of a hand hygiene behaviour change intervention in rural Cambodia, a formative mixed-methods research study was conducted to investigate the context specific behaviours and determinants of hand-washing among healthcare workers, maternal and non-maternal caregivers along the early new-born care continuum. Methods: Direct observations of hygiene practices of all individuals providing care to 46 newborns across eight facilities and associated communities were completed and hand hygiene compliance assessed in analysis. Semi structured interactive interviews were subsequently conducted with 35 midwives and household members to explore the corresponding cognitive, emotional, and environmental factors influencing the observed key hand hygiene behaviours. Results: Hand hygiene opportunities during newborn care were frequent in both set-tings (n = 1319) and predominantly performed by mothers, fathers and non-parental caregivers. Compliance to hand hygiene protocol across all caregivers, including midwives, was inadequate (0%). Practices were influenced by the lack of accessible physical infrastructure, time, increased workload, low infection risk perception, nurture-related motives, norms and inadequate knowledge. Conclusion: Our findings indicate that an effective intervention in this context should be multi-modal to address the different key behaviour determinants and target a wide range of caregivers.