The objective of the study was to investigate the dynamics of collaborative learning in TBL through students’ reflections and feedback. The study utilized a mixed-methods approach. Quantitative data collection was done via feedback structured questionnaire. Qualitative data were collected from reflections submitted by 107 first-year MBBS students at the end of TBL session. We found five main themes related to students’ engagement with the session i.e. ( 1) conceptual clarity as the foundation, (2) collaborative learning culture, (3) communication skills, (4) informative and useful team discussions and (5) interactive learning for team development. The majority of the respondents (93%) listened to classmates and coordinated with group members in discussion, (77%) were willing to learn from other group members and contributed ideas to them, (79%) came prepared for session, (75%) found learning material assigned to them as appropriate. Respondents had positive perceptions regarding their participation in group work with a strong inclination towards agreement with the statements provided. The study highlights the positive effects of TBL in promoting peer to peer engagement, active engagement, teamwork skills, and knowledge sharing among undergraduate medical students, ultimately contributing to an effective learning experience.

Since December 2019, the COVID-19 virus has rapidly spread worldwide, prompting the World Health Organization (WHO) to declare it a pandemic and advocate for the widespread use of face masks to mitigate transmission. In this review, we delve into the potential impact of prolonged face mask use on temporomandibular joint (TMJ) health, an area that has garnered limited attention amidst COVID-19 research. Research has revealed that improper mask fit, and constant readjustment can lead to TMJ abnormalities. Similarly, there is a demonstrated correlation between continuous mask usage and increased incidence of headaches, temporomandibular pain, and diminished quality of life. Many studies have highlighted discomfort in the preauricular area, headaches, TMJ noises, headache, jaw pain, and muscle fatigue, as well as dermatological disorders that have been attributed to prolonged mask wear and its impact on TMJ. Our study catalyzes future research endeavors, urging a deeper exploration of the implications of long-term mask wear, not only in the context of the COVID-19 pandemic but also among occupational groups regularly exposed to extended mask use. By unraveling the complexities of TMJ health in the face of evolving preventive measures, we aim to enhance our understanding and safeguard the well-being of mask-wearers worldwide.

Abstract: Aim: This study aimed to evaluate the antibiotic-prescribing attitudes of dental students during the management of pulpal and periapical pathologies. Material and methods: This cross-sectional descriptive study concerned all the students in clinical training registered the 5 faculties of dental medicine in Morocco. A self-administered questionnaire was used, and completed via email addresses. Data were analyzed with Jamovi software. Quantitative variables are expressed as mean and standard deviation and qualitative variables as numbers and percentages. X2 and ANOVA tests were performed. The significance level was set at p < 0.05. Results: Three sixty-five students participated in this study. The average duration was 5.87 ±1.45 No statistical difference was found between the different universities p >0.05. Of most students 83.8% prescribe Amoxicillin first ; Amoxcilin in combination with clavulanic acid is prescribed by 9.2%. For patients with penicillin allergy, clindamycin was the most prescribed 53.9%, after followed by azitromycin at 20.9%. Antibiotics are prescribed for all pulp and periapical pathologies, whether acute or chronic. For acute pulpitis, a difference was statistically significant (P=0.01). Regarding acute apical periodontitis, a statistically significant difference between the different faculties was noted (P= 0.03). For the apical abscess, the antibiotic prescription was higher at the public faculty of Casablanca 92.8% than in the other faculties (P = 0.02) Conclusion: It appears from this study the need for faculties of dentistry to develop innovative teaching models to improve the level of knowledge of students on antibiotics and their indications in endodontics.

Ovarian cancer (OC) represents a significant challenge in the realm of gynecological cancers, characterized by poor survival rates and complex etiology. In this review, we delve into the se-lected genetic, environmental, and hormonal factors underpinning OC development. We have reviewed scientific databases searching for ovarian cancer genetic and epigenetic factors. We have included studies based on their relevancy. As a result of exploring ovarian carcinogen-esis, this systematic review contains data collected from 126 various works. The role of prominent genetic players such as BRCA mutations, DNA repair mechanisms, un-derscores the intricate landscape of OC susceptibility. We explore Li-Fraumeni and Lynch syn-drome, which impart a heightened predisposition to OC development. Hormonal factors such as estrogen, progesterone, and androgens are also discussed. Environmental alterations, ranging from lifestyle influences on OC to microbiome dysbiosis and lifestyle factors such as obesity, al-cohol consumption, and physical activity intersect with genetic and epigenetic pathways, shaping the risk landscape for OC. Through a meticulous examination of current literature, this review provides a nuanced under-standing of the multifactorial nature of OC, emphasizing the need for holistic approaches to prevention, diagnosis, and treatment.

Background: Our study investigates the prevalence and causes of injuries among undergraduate dental students during clinical sessions. Methods: The study was conducted at the Department of Dentistry, National and Kapodistrian University of Athens, focusing on injuries reported from 2021 to 2024. Data were collected through self-reported questionnaires and clinical records. The primary variables assessed included the type of injury, the instrument involved, the clinical procedure being performed, and the immediate actions taken post-injury. Serological testing was conducted on both students and patients to assess the risk of bloodborne pathogen transmission. Results: The findings revealed a high prevalence of injuries, with needles being the most common cause, followed by burs and dental probes. The most frequent injury type was piercing, primarily affecting the fingers. Periodontal treatments, restorative procedures, and endodontic treatments were the main activities leading to injuries. Despite normal medical records for most patients treated by injured students, serological testing showed significant positivity rates for HCV and HBV. It is noteworthy that most injured students demonstrated their commitment to safety by adhering to recommended post-exposure protocols, including wound cleaning, disinfecting, and serological testing. Our study highlights the critical need for enhanced biosafety awareness and training among dental students to reduce injury risks. Conclusions: These findings underline the necessity for integrated safety protocols and continuous education to improve clinical practices and ensure student safety.

Students studying dentistry and nursing experience anxiety daily, which affects both their general well-being and academic achievement. Anxiety is exacerbated by several circumstances, such as stressors in one's personal life, clinical environment exposure, and academic expectations. To effectively regulate anxiety and support students' achievement, treatments that take these elements into account must be designed. In this study, 271 students from the National and Kapodistrian University of Athens, Greece's departments of dentistry and nursing were polled. Being the following resources, participants filled out an electronic questionnaire that was uploaded to Google Forms and assessed their levels of stress, anxiety, depression, resilience, hope, and spiritual well-being: a) the Depression, Anxiety, Stress Scale (DASS-21), b) the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-12), c) the Adult Hope Scale (AHS), d) the Resilience Assessment Questionnaire (RAQ8), and e) the Brief Resilience Scale (BRS). Additionally, demographic data was gathered, such as gender, educational attainment, family income, and country of origin. Statistical analyses were performed to investigate the relationships between the variables, including hierarchical multiple linear regression and t-tests. The sample consisted of 271 students from the Department of Nursing (n=126, 46.5%) and Dentistry (n=145, 53.5%), with 68.60% of them being female, 80.10% being undergraduate students, and 48.30% being from Athens, the country's capital. Comparatively speaking, 74.50 percent of nursing students were female, while 62.80% of dental students were. Compared to dental students (2.10%), nurses (40.50%) participated in postgraduate studies at a higher rate. Compared to dental students (44.80%), nursing students reported a household income of just 13.90%, which is much less than €35,000. Anxiety was reported by 51.30% of participants overall, with dental students reporting higher anxiety than nursing students. Higher family wealth was associated with reduced stress levels, while female undergraduate students reported higher levels of anxiety than their male counterparts. Hope was a strong predictor of resilience, but stress and worry had a negative correlation. Promoting students' well-being and academic success requires effective stress-reduction and resilience-building techniques aimed to not only improve student performance but also support future healthcare professionals' personal sustainability and holistic growth.

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 purpose of this review is to elucidate the actual threat of the most prevalent mycotoxins in agricultural commodities and human/animal food/feed for appearance of foodborne ailments and diseases. The underestimated hazard of joint mycotoxin uptake of animals or humans is critically discussed with regards to synergistic or additive interaction between some target mycotoxins. The real toxicity of target mycotoxin combinations as it happens in practice is evaluated and possible lower limit values or control measures are suggested in such cases. Some critical points in adequate risk assessment, hygiene control and regulation of mycotoxns are discussed. The efficiency of current mycotoxin regulations and control measures is evaluated in regards to human/animal health hazard. The risk assessment in the case of multiple mycotoxin exposure of humans/animals via the food/feed or agricultural commodities is evaluated and some suggestions are proposed in such cases. Appropriate control measures and food safety issues throughout the food supply chain are proposed in order to prevent target foodborne diseases. Some preventive measures and possible veterinary hygiene control or risk assessment are proposed in some practical cases of foodborne diseases for preventing mycotoxin contamination of animal products designed for human consumption and to avoid possible public health issues.

Multimedia resources, such as instructional videos, are currently enjoying a certain popularity in training programmes for medical and dental students. The major challenge is to create such resources that have quality content and are acceptable to students. We investigated the opinions of a sample of 551 students from 4 medical universities in Romania in order to identify the characteristics of the instructional videos that students prefer and we comparatively analysed these characteristics according to gender, age group, but also according to their general preferences for using Internet services. We used univariate (hypothesis testing) and multivariate (Two-Step Clustering) data analysis techniques and revealed three clusters of students, primarily determined by perceptions of the visual appearance of instructional videos. The structure of the clusters by gender and age group is relatively similar, but we recorded differences between them associated with students' expressed preferences for certain Internet services compared to others. Students who prefer instructional videos to contain images used only for aesthetic purposes, to fill in breaks, use Internet services mainly for communication, while students who prefer in videos the use of already drawn explanatory diagrams are slightly younger than the others and use Internet services mainly for information and communication.

Surgical site infections (SSIs) are a major concern in public healthcare, leading to increased morbidity, pro-longed hospital stays length, and significant economic costs. Understanding the epidemiology and risk fac-tors of SSIs is crucial for developing effective prevention and management strategies. In the last century, CDC ‘s HICPAC improved a bundle for prevention of HAIs based on the use of aseptic procedures, disin-fection of the skin and correct use of antibiotics for SSIs. In our country, Gelli-Bianco law introduced the national health guidelines system that include the prophylaxis antibiotic therapy pre- and post-surgery. The aim of our study is to evaluate adherence and appropriateness of the use of antibiotic-preoperative prophylaxis in a province of southern Italy and to identify risk factors that may influence the development of an SSI. The study found many statistically significant associations among the factors examined, i.e. the timing of administration adherent to guidelines, with 47% of the analyzed files administering antibiotics within 60 min before the intervention and 62.7% using intravenous administration.

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 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.

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.

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.

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.

Background: Removable prostheses have seen a fundamental change recently because of advances in polymer materials, allowing improved durability and performance. Despite these advancements, notable differences still occur amongst various polymer materials and processing technologies, requiring a thorough grasp of their mechanical, physical, and therapeutic implications. Methods: Fours different processing techniques, all utilizing Polymethyl methacrylate (PMMA) as the main material, were used to construct complete dentures. The specimens underwent a mechanical test. Results: All the specimens broke under the influence of a certain force, rather than yielding through flow, as is characteristic for plastic materials. For each specimen, the maximum force (N) was recorded (figure 4), as well as the breaking energy, Conclusions: The best results were obtained in the case of the thermoplastic injection system and, surprisingly and contrary to those in the specialized literature, the worst results were recorded in the case of 3D printed samples.

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.

Treating central giant cell granuloma (CGCG) is challenging due to high recurrence rates and variable therapy responses. This study examines the efficacy of various treatments in reducing CGCG recurrence. A literature review explored outcomes of surgical excision, curettage, intralesional corticosteroid injection, and adjuvant therapy, considering factors like lesion location, size, and histological features. Aggressive surgical techniques such as en bloc resection were found to potentially lower recurrence rates compared to conservative approaches. However, treatment should be tailored to individual patient needs. Further research is needed to confirm these findings and improve treatment strategies. A concise literature review was conducted using PubMed, MEDLINE, and Google Scholar, focusing on papers published from 1986 to 2024. Search terms included "central giant cell granuloma," "recurrence," "treatment modalities," and "surgical excision". Studies reporting recurrence rates and treatment outcomes for CGCG were analyzed. Twenty-nine studies were reviewed, including six studies on surgical excision and curettage, eight studies on intralesional corticosteroid injections, six studies on calcitonin therapy, five studies on interferon alpha therapy and four studies on the therapy with denosumab. Analysis indicated that aggressive surgical treatments like en bloc resection were associated with lower recurrence rates compared to conservative methods. Predictors of recurrence included lesion size (&gt;3 cm), location (mandible), and aggressive histopathological features. Aggressive surgical excision combined with nonsurgical methods may lower recurrence rates, while conservative techniques remain viable in some cases. Further prospective research is needed to validate these findings and enhance CGCG treatment options.

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.

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.

Introduction: Caries is a public health problem in Kosovo among children, Caries is a multifactorial microbial disease and connection of this disease with soft drinks and food habits between children and their poor oral health is very strong. Aim: The aim of present study is to evaluate prevalence of caries among 12 to 16 years old students in municipality of Suhareka and to analyze related risk factors that contribute in occurrence of caries. Material and methods: To observe parameters of soft drink we used experimental method and a cross-sectional study was carried out among 120 adolescents in “Sadri Duhla” elementary school in Duhel and “7 Marsi” elementary school in city of Suhareka. Oral clinical examination and self administered questionnaire were used to collect information about dental caries and its correlation to soft drinks and food habits. Examination was done between May and October in the year 2023. Impact of soft drink in caries was assessed through DMFT index and frequency of consumption of soft drinks. The data were collected statistically using SPSS version 26 and presented in tables and graphs. Results: The highest result of DMFT (4.36) with standard deviation 1.23 was noted in the group consuming more than 16 cans per week also the highest score in adolescent compared to frequency of consumed cans per week. Soft drinks found in Kosovo’s mar-kets are acidic with low pH, 93.75% of them had a pH below 4 which are considered erosive and only 6.25% are minimally erosive with a pH > 4, in terms of buffer capacity soft drinks can be ordered like this energy drinks >soda >100% fruit juice > fruit drinks. Improper tooth-brushing, dental visits only in case of pain and not preventive visits were significantly related to dental caries. Conclusion: The results of the research awarned us for high frequency consumption of soft drinks related to dental caries. It is recommended to be aware of the use of soft drinks, regular visits to the doctor, higher maintenance of oral health by using paste with sufficient fluoride content also brushing teeth 1 hour after consuming acidic food.

This Systematic Review examines studies focusing on tooth bleaching and its effect on healthy enamel or incipient caries and bacterial adhesion. The aim is to explore the impact of different bleaching agents on incipient caries lesions and healthy enamel. Randomized controlled trials, clinical trials, observational studies, and in vitro studies that compared at least two groups were included. A comprehensive search strategy was used to select studies from Pubmed and Scopus databases. Two evaluators performed data extraction, screening, and quality assessment independently. Only studies written in English were included. From 968 initial records, 28 studies were selected for a full-text evaluation. 7 studies were classified as cluster 1 (bacterial adherence on teeth), 12 studies as cluster 2 (no bacteria involved), 4 studies as cluster 3 (no teeth deployment), and 5 clinical studies were cluster 4. Of the selected studies, 6 (21.43%) supported increased bacterial attachment capacity and cariogenic dynamics, 4 (14.29%) decreased adhesion and cariogenic activity, 7 (25%) no difference, and 11 (39.28%) followed a differentiated methodological approach and could not be categorized. Due to different methodology strategies used in the studies of all clusters, the risk of bias was high. Thus, we cannot reach a confident conclusion.

Staphylococcus aureus, found in the oral cavity as an opportunistic bacterium, has been reported as a cause of infective endocarditis and pneumonia. Salt is an essential mineral component for maintaining human body cells and has attracted attention as a promoter of S. aureus biofilms. This study was conducted to clarify how salt affects biofilm formation by S. aureus and S. mutans, which is a pathogen implicated in the dental caries. Bacteria were cultivated with various concentration of sodium chloride (NaCl) in Toryptic Soy Broth with 0.25% sucrose and 0.25% glucose (TSBs and TSBg) for 16 hours. Contribution of GTF on the membrane vesicles (MVs) from S. mutans and extracellular DNA (eDNA) was also analyzed in the biofilm formation. S. aureus biofilms were induced by the addition of 0.004–0.25 M NaCl but decreased by NaCl concentrations greater than 0.25 M, in TSBs. The biofilm formation of mixed bacteria (S. aureus and S. mutans) gradually increased in a NaCl concentration-dependent manner in TSBs and TSBg. Moreover, the biofilm was dependent on glucan formation by GTF in MVs at high salinity. The mixed-species biofilm of S. aureus and S. mutans was upregulated by the collaboration of eDNA and MVs. Therefore, eDNA and MVs are developmental factors for S. aureus biofilm formation under harsh conditions. The intake of sucrose and glucose may be a risk factor for infection by opportunistic pathogens such as S. aureus in persons who consume high concentrations of salt in foods and drinks in custom-type foods.

Background: Psychological sufferings are observed among dental students during their academic years, which had been intensified during the COVID-19 pandemic. Objectives: This study assessed the levels and identified factors associated with psychological distress, fear and coping experienced by dental undergraduate students in Bangladesh. Methods: A cross sectional online survey was conducted during October-November, 2021. The Kessler Psychological Distress Scale (K-10), Fear of COVID-19 Scale (FCV-19S) and Brief Resilient Coping Scale (BRCS) were used in order to assess psychological distress, fear and coping strategies respectively. Results: A total of 327 students participated; the majority (72%) were 19-23 years old and females (75%). One in five participants were infected with COVID-19 and 15% reported contact with COVID-19 cases. Negative financial impact (AOR 3.72, 95%CIs 1.28-10.8), recent or past COVID-19 infection, contact with COVID-19 cases were associated with higher levels of psychological distress; but being a 3rd year student (0.14, 0.04-0.55) and being satisfied about current social life (0.11, 0.03-0.33) were associated with lower levels of psychological distress. Being a 3rd year (0.17, 0.08-0.39) and a 4th year student (0.29, 0.12-0.71) were associated with lower levels of fear. Health care service use and feeling positive about life were associated with medium to high resilience coping. Conclusions: This study iden-tified dental students in Bangladesh who were at higher risk of psychological distress, fear and coping during the ongoing pandemic. Development of mental health support system within dental institution should be considered in addition to the academic and clinical teaching.

Background: Although several studies have been conducted on the use of Artificial Intelligence (AI) in mammography (MG), research focusing on the diagnosis of metachronous bilateral breast cancer (BC), which is typically more challenging to diagnose, remains limited. This study assessed whether AI could enhance the detection of BC, achieving earlier or more accurate diagnoses than radiologists in cases of metachronous contralateral BC. Methods: The study included patients who underwent unilateral BC surgery and subsequently developed contralateral BC during follow-up. We evaluated the capability of the AI-supported MG diagnostic system FxMammo™ (FathomX Pte Ltd, Singapore) to diagnose BC more accurately or earlier than radiologists' assessments. This evaluation was supplemented by reviewing MG readings by radiologists. Results: Out of 1,101 patients who underwent surgery, 10 patients who had initially received a partial mastectomy and later developed contralateral BC were analyzed. The AI system identified malignancies in 6 cases (60%), while radiologists identified 5 cases (50%). Notably, two cases (20%) were diagnosed solely by the AI system. Additionally, for these cases, the AI system had identified malignancies a year prior to the conventional diagnosis. Conclusions: This study highlights the AI system's effectiveness in diagnosing metachronous contralateral BC via MG. In some cases, the AI system consistently diagnosed cancer at earlier than radiological assessments.

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.

The SWOT analysis, pivotal in the competitive healthcare sector, aids dentists in identifying and analyzing internal strengths and weaknesses, as well as external opportunities and threats. This study focuses on senior dental students, aiming to scrutinize their use of SWOT analysis and evaluate its efficacy as an educational tool for career decision-making in dental entrepreneurship. The research sample comprises 116 senior dental students in the final stages of their dental education, with data collection accomplished through the administration of an e-questionnaire. The data extracted from the SWOT analysis encompass internal and external factors, gender distinctions, and outcomes derived from Stepwise Binary Logistic Regression concerning predictor markers. The results from the SWOT analysis of 114 questionnaires, revealed that participants identified communication skills (50%) and organization skills (49.10%) as their primary strengths, followed by favorable personal traits contributing to goal success (36%). Weaknesses predominantly centered around emotional and personal traits like anxiety (41.20%) and other characteristics, alongside practical challenges such as lack of initial capital (24.60%). Main opportunities included collaboration with experienced dentists (33.30%) and access to training programs (27.20%), while economic instability in Greece (77.20%) and the saturated dentist profession (26.30%) were perceived as significant threats. Gender differences were notable, with female dentists more likely to report organization skills as a strength and anxiety as a weakness. Values such as industriousness, persistence, and ethics were commonly shared, with actions focusing on training programs (57.9%) and gaining experience with experienced dentists (29.8%). Cluster analysis identified two subgroups, with one emphasizing on utilizing all available options (n=49) and the other prioritizing on gaining professional skills and experience (n=65). Logistic regression indicated that participants valuing industriousness were less likely to explore all available options, while those recognizing personal traits were more likely to do so. The study's outcomes highlight key predictor factors linked to a proactive orientation in career decision-making among senior dental students. These insights offer valuable implications for educational institutions and career counselors.

In 2020, students of Pakistan had to adapt to the online environment for the very first time. This study aims to analyze the perceptions of medical, dental, and allied health students about online education in Pakistan. A descriptive, cross-sectional study was done to assess the level of acceptance of undergraduate students. A pre-validated questionnaire regarding demographics, past-experience of e-learning, advantages disadvantages of e-learning, and general perception of students towards e-learning was distributed. Descriptive statistics were computed for demographics, Mann-Witney-U test was used to compare the differences of perceptions between pre-clinical year and clinical years students. Kruskal-Wallis test was applied to compare the results of three specialties of students. Chi-square was used to compare overall category-wise positive and negative responses of students. 1200 students participated in the study. The major advantage identified by all students was the ‘comfortable environment’ in which they studied online. The major disadvantage selected by preclinical year students was ‘anxiety due to social isolation’ and that chosen by clinical year students was ‘lack of patient interaction’. Overall, 72% of students had a negative perception of e-learning. Student-teacher training, student counselling sessions, and innovative techniques need to be introduced to enhance student engagement and reduce pandemic stress.

The purpose of this study is to evaluate the amounts of apically extruded 3% sodium hypochlorite using two modes of Er:YAG laser-activated irrigation (LAI), super short pulse (SSP) and shock wave enhanced emission photoacoustic streaming (SWEEPS®), combining three types of laser tips (FT) and conventional syringe needle irrigation (SNI). Methods: Twenty extracted human maxillary central incisors prepared using Reciproc® instruments (size 40, taper 0.06). Irrigant volumetric flow (IVF) was accurately standardized using a precision syringe pump with constant irrigant delivery through the 27G needle. The tested irrigation protocols (60 s) were groups 1: 27-G SNI with 0.05 ml/s constant IVF; group 2: SSP (10 mJ, 15 Hz, pulse duration 50 μs) + Radial SWEEPS FT; group 3: SSP + photon-induced photoacoustic streaming (PIPS) FT; group 4: SSP+SWEEPS FT; group 5: AutoSWEEPS (20 mJ, 15 Hz, pulse duration 25 µs) + Radial SWEEPS FT; group 6: AutoSWEEPS+PIPS FT; group 7: AutoSWEEPS+SWEEPS FT. Each protocol was evaluated in 10 repetitions each. Apically extruded irrigant was collected, and the net weighted. Results: There were significantly lower amounts of extruded irrigant with SNI and SSP using radial SWEEPS and PIPS FTs compared to the other tested laser protocols (p&lt;0.05). In the AutoSWEEPS groups, all three FTs had similar amounts of extruded irrigant (p&gt;0.05). Conclusion: In straight root canals, the use of various fiber FTs in the AutoSWEEPS mode exhibited a higher potential for irrigant extrusion.

Economic, social, and environmental sustainability are the results of efforts aiming to improve all aspects of milk production, respecting animal welfare and improving herd health. An epidemi-ological study was designed to assess the role of contagious pathogens (S. aureus and S.agalactiae) in a cohort of 120 dairy herds located in the southern regions of Italy. Milk quality was assessed using certified methods, and the prevalence of mastitis pathogens in bulk tank milk was determined using quantitative polymerase chain reaction. Welfare scores were assessed using a scoring card that have more than 100 items, including animal-based measurements. Statistical analyses were performed using general lineal model and logistic regression procedures. The results showed that S. aureus had a significant negative effect on the amount of milk components delivered to the dairy plant, and on the level of welfare. Whereas, the presence of S.agalactiae did not show any significant association. The major risk factors associated with the presence of S.aureus were also identified to help prioritise control programs. These results support the “One Sustainability” approach im-plying that an increase of animal productivity is related to the improvement of animal health and welfare and potentially leading to the mitigation of greenhouse gas emissions.Economic, social, and environmental sustainability are the results of efforts aiming to improve all aspects of milk production, respecting animal welfare and improving herd health. An epidemi-ological study was designed to assess the role of contagious pathogens (S. aureus and S.agalactiae) in a cohort of 120 dairy herds located in the southern regions of Italy. Milk quality was assessed using certified methods, and the prevalence of mastitis pathogens in bulk tank milk was determined using quantitative polymerase chain reaction. Welfare scores were assessed using a scoring card that have more than 100 items, including animal-based measurements. Statistical analyses were performed using general lineal model and logistic regression procedures. The results showed that S. aureus had a significant negative effect on the amount of milk components delivered to the dairy plant, and on the level of welfare. Whereas, the presence of S.agalactiae did not show any significant association. The major risk factors associated with the presence of S.aureus were also identified to help prioritise control programs. These results support the “One Sustainability” approach im-plying that an increase of animal productivity is related to the improvement of animal health and welfare and potentially leading to the mitigation of greenhouse gas emissions.

Background: developmental dysplasia of the hip (DDH) is a condition characterized by abnormal hip development in infancy. Early diagnosis allows for effective treatment, while late presentation often necessitates complex surgical interventions. Current recommendations advise screening between the 6th and 8th week postnatal using ultrasound, typically employing the Graf method. However, there's no universal consensus on whether ultrasound screening significantly increases treatment compared to clinical examination-guided ultrasound. This study aims to explore the feasibility of prenatal ultrasound for early identification of DDH risk. Methods: This prospective observational study involved 100 pregnant women undergoing fetal hip ultrasound during the second and third trimesters. Using the modified Graf method, alpha and beta angles were calculated on the fetus. Postnatally, alpha and beta angles were compared with prenatal values. Results: Prenatal ultrasound at 24th week showed inconclusive results because of the difficulty in identification of Graf landmarks, while ultrasound at 34th week has proved to be a reliable and safe method for quantitative determination of alpha and beta angles. Significant correlations were found between prenatal and postnatal alpha and beta angles. Moreover, significant differences in prenatal alpha and beta values were observed in patients developing mature/immature hips postnatally. Conclusions: Prenatal diagnostics show promise for predicting infant hip development. Further research is warranted to validate correlation strength and clinical applicability.

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 transition from undergraduate dental student to the actual practicing dentist is a crucial phase and ensuring the preparedness of graduates for the complexity and demands of contempo-rary dental practice is a challenging task. This study aimed to evaluate the self-perceived prepar-edness of undergraduate dental students and house officers in the dental colleges of Pakistan. Cross-sectional national study was planned to collect the information from dental students and new graduates in Pakistan. The pre-validated Dental Undergraduates Preparedness Assessment Scale (DU-PAS) was used. Purposive sampling technique was utilized to recruit house officers and undergraduate dental students from 27 dental schools in Pakistan. The data analysis was car-ried out using the R statistical environment for Windows (R Core Team, 2015). The total of 862 responses with 642 females and 219 males were analyzed in the study. Overall, clinical skills score was 30.56+9.08 and score for soft skills was 30.54+10.6. The mean age of the participants was 23.42+1.28. Deficiencies were reported in various soft skills and clinical skills attributes.The results highlighted the strengths and weaknesses of dental students and new graduates in Pakistani den-tal institutions. The findings may be used to further develop and strengthen teaching and training of dental students in Pakistan.

We evaluated the dentofacial characteristics and temporomandibular disorder (TMD) symptomatology of patients with orthopedic instability before and after deprogramming with a stabilization splint. Sixty patients with the signs and symptoms of TMD were assessed using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and underwent stabilization splint therapy to place the condyles in a more stable musculoskeletal position. The amount of condylar displacement was evaluated using the condylar position indicator (CPI). Six-teen angular and linear hard tissue landmarks were traced and compared from lateral cephalo-grams taken in the maximum intercuspation (MI) position before and in the centric relation (CR) position after the splint therapy. Following the splint therapy, the signs and symptoms of TMD were significantly reduced or completely eliminated in more than 90% of the patients. Compared with the values registered before the splint therapy, a significant reduction in the mean values of condylar displacement was observed on both sides of the vertical, horizontal, and transverse planes of space after the splint therapy. A comparison of pre- and post-splint lateral cephalograms revealed that, following the splint therapy, the mandible moved more posteriorly and rotated more in a clockwise direction. In patients with orthopedic instability and signs and symptoms of TMD, deprogramming of the neuromuscular system with a stabilization splint is highly recommended to provide a correct orthodontic diagnosis and improve the health of temporomandibular joint structures.

Background: The incidence of metabolic dysfunction-associated steatohepatitis (MASH)-related hepatocellular carcinoma (HCC) is increasing annually with a rise in the incidence of obesity and metabolic syndrome. Based on preliminary reports regarding the potential association of HCC and periodontitis, this study aimed to analyze the involvement of periodontal bacteria as well as the oral and intestinal bacterial flora in MASH-related HCC (MASH-HCC). Methods: Forty-one patients with MASH and 19 with MASH-HCC who completed survey questionnaires, underwent periodontal examinations, and subjected to sample collection (saliva, mouth-rinsed water, feces, and peripheral blood) participated in the study. Bayesian network analysis was used to analyze the causation between various factors, including MASH-HCC, examinations, and bacteria. Results: The occupancy rate of the genus Fusobacterium in the intestinal bacterial flora was significantly higher in in the MASH-HCC group than in the MASH group (p = 0.002), whereas that of Butyricicoccus (p = 0.022) and Roseburia (p &lt; 0.05) was significantly lower. Bayesian network analysis revealed the absence of periodontal pathogenic bacteria and enteric bacteria affecting HCC. However, HCC directly affected the periodontal bacterial species Porphyromonas gingivalis, Tannerella forsythia, Fusobacterium nucleatum, and Prevotella intermedia in the saliva, as well as the genera Lactobacillus, Roseburia, Fusobacterium, Prevotella, Clostridium, Ruminococcus, Trabulsiella, and SMB53 in the intestine. Furthermore, P. gingivalis in the oral cavity directly affected the genera Lactobacillus and Streptococcus in the intestine. Conclusion: MASH-HCC directly affects periodontal pathogenic and intestinal bacteria, and P. gingivalis may affect the intestinal bacteria associated with gastrointestinal cancer.

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.

: The objetive of this study was to evaluated the quality of sleep, degree of drowsiness, and stress index of dentistry students during the COVID-19 pandemic. Methods: This study was conducted among dentistry students from two universities, obtaining data at baseline and 10 months after the pandemic. The Pittsburgh questionnaire, Epworth sleepiness scale, and Cohen perceived stress scale were used to assess sleep quality, sleepiness index, and stress level, respectively. Statistical analyses were performed using Generalized Estimating Equations, with binary, ordinal, and linear logistic regression. Results: Baseline sleep quality had a positive influence on sleep quality compared with the assessment after 10 months. Drowsiness is influenced by factors, such as the time of assessment, income of up to one salary, and physical activity. There was greater drowsiness 10 months after the pandemic. High stress levels were observed during both assessments. Female sex, deteriorated family relationships, and lack of physical activity increase the risk of stress. Conclusion: The quality of sleep was positively affected during the pandemic period, remaining high, and drowsiness increased.

Stage IV grade C localized periodontitis (pre-puberal localized aggressive periodontitis/LPP), an extremely rare form of periodontal disease, occurs in otherwise healthy individuals (no signs of dental plaque/calculus) due a hyper-aggressive auto-immune response to high periodontopathic bacteria levels. Methods: A 4-year-old Caucasian girl with unusual high mobility of temporary lower left canine and localized gingival inflammation was misrecognized by multiple clinicians (initially diagnosed with hypophosphatasia, genetic and metabolic disorders, all turning negative), over a period of 4-6 month, despite initial radiographs showing clear pathognomonic signs. LPP diagnostic was made by the last clinician, but by now the tooth was lost. Similar inflammation signs appeared around the lower temporary right canine. X-ray examination showed similar bone and periodontal loss as previously seen, while periodontopathic bacteria tested highly positive. The patient received both mechanical cleaning and ten days systemic antibiotic treatment (Augmentin and Metronidazole). Results: Two months after, inflammation signs disappeared, with periodontal regeneration radiologically present, and only small periodontopathic bacteria precursors concentrations. Conclusions: Despite initial periodontal loss, an adequate treatment can keep under control an LPP disease. Moreover, bone and periodontal regeneration appears if periodontopathic bacteria scores are kept lower, showing the importance of fast adequate diagnostic and treatment.

The goal was to assess dental students' perception of digital technologies after participating in a CAD/CAM exercise for scanning, designing, and manufacturing computer-aided provisional fixed dental restorations. A survey was conducted among second-year dental students (pre-D2 and post-D2), first- (D1, negative control), third-, and fourth-year dental students (D3 and D4, positive controls). Only OSU College of Dentistry students who completed the activity and completed the surveys were included. Seven questions were rated, which evaluated changes in knowledge, skill, interest, the importance of technology availability in an office, patients' perception of technology, the importance of having the technology, and the expected frequency of clinics utilizing the technology. Statistical analysis was performed with a significance level of 0.05. A total of 74 pre-D2 and 77 post-D2 questionnaires were completed. Additionally, 63 D1, 43 D3, and 39 D4 responded to the survey. Significant differences were found for "knowledge" and "skill" between pre-D2 and post-D2, and pre-D2 and control groups (p<0.001). There was a significant difference between post-D2 and all controls for “interest” (p=0.0127) and on practice preference for technology availability (p<0.05). There were significant results between post-D2 and all controls regarding the importance of technology availability in an office (p<0.001) and the expected frequency of clinics utilizing the technology (p=0.01). No significance was found for "patient's value of technology" and "the importance of having the technology". The presence of technology in the practice and educational academic environments significantly improved students’ interest and perception of knowledge and skill.

(1) Background: This retrospective cohort study aimed to investigate the cephalometric evaluation of facial height ratio (FHR) and growth patterns. (2) Methods: We assessed facial height ratios, Y-axis to SN angle, and growth patterns in 94 participants from Timis county using digital cephalograms. Participants were categorized based on Angle’s classification. Cephalograms were digitally traced and analyzed using WebCeph imaging software. Statistical analysis was conducted using Python version 3.11.9. (3) Results: Significant correlations were observed between FHR and craniofacial development, particularly regarding hypodivergent growth patterns. In a sample of 94, molar classes showed varying patterns: Class I—33.3% hyperdivergent, 61.5% normodivergent, 33.3% hypodivergent. Class II—50% hyperdivergent, 30.8% normodivergent, 52% hypodivergent. Class III—16.7% hyperdivergent, 7.7% normodivergent, 14.7% hypodivergent. Y-axis to SN angle values were within normal limits across groups (Group I: 65.0 (IQR: 61.2-69.0), Group II: 65.0 (IQR: 62.0-69.0), Group III: 67.0 (IQR: 59.7- 69.0). A strong negative correlation was found between Y-axis to SN angle and Jarabak’s ratio (r = -0.72, p &lt; 0.001), highlighting the need for holistic assessment methods in orthodontic practice. (4) Conclusion: Patients from Timis county predominantly exhibit a hypodivergent growth pattern across all malocclusion types. Understanding these patterns is essential for comprehensive orthodontic treatment planning. Further research is needed to explore the implications of these findings on treatment outcomes and patient care.

This study examines HIV/AIDS-associated knowledge and attitudes towards treating disadvantaged communities among predoctoral dental students in U.S. dental schools who had not yet commenced their Community-Based Dental Education (CBDE) training. It also compares the difference in knowledge and attitudes between students with reported community engagement with PLWHA, and those without. Our study comprised 89 predoctoral dental students within their D1-D3 years of dental school who had not yet initiated their Community-Based Dental Education (referred to as pre-CBDE dental students). Responses were collected via an online survey. Participants were 68% females, 94% heterosexual, of mean age (years): 25.9 ± 3.5 SD. The majority (62%) were in their first (D1) and second (D2) years of dental education. Of the thirty knowledge questions, only five received a minimum of 90% correct responses. Similarly, we found no statistical differences in most of the knowledge/attitude sections, between those with and without prior PLWHA exposure. Encouragingly, 90% of our participants reported prior experience working with disadvantaged communities. Early community engagement fosters a sense of professional responsibility towards administering dental care to disadvantaged communities and we propose that it must be encouraged among aspiring dental school students.

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.

(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.

This investigation pioneers an examination of the scarcely explored terrain of social diversity in medical education, assessing the complex impacts of socioeconomic status (SES), prior working experiences, and completed apprenticeships on a spectrum of psychological and academic facets among first-year medical students (n = 336) in an urban university setting. By utilizing a systematic and detailed approach, the study illuminates prior anatomical knowledge and various psycholog-ical constructs, marking a significant stride into a domain where knowledge remains profoundly limited. Analyses indicated that SES significantly affects financial anxiety (F(4, 331) = 17.391, p < .001) and academic behavioral confidence (F(4, 331) = 4.323, p = 0.002). Students with prior working experience reported higher self-perceived clinical experience but lower A-level grades (t(279.459) = -6.690, p < .001), competence in natural sciences (t(321.045) = -3.178, p = 0.002), and online competence (t(319.429) = -2.026, p = 0.044). Those who completed an apprenticeship showed higher resilience, academic confidence, self-efficacy, and greater concerns about balancing studies and work (t values ranging from 2.020 to 3.158, p < 0.05). Correlation analysis revealed a positive relationship between resilience (RQS) and coping with academic stress (CAS) (r = 0.632, p < .001), as well as between resilience and academic behavioral confidence (ABC) (r = 0.608, p < .001). Negative correlations were observed between resilience, coping with academic stress, academic confidence, and cognitive test anxiety (CTA) (r values from -0.235 to -0.404, p < .001). The findings emphasize the need for tailored support for students from diverse SES backgrounds and with varying expe-riences. The study highlights the value of a comprehensive approach in medical education, con-sidering the diverse backgrounds and experiences of students. Future research should explore the long-term impact of these factors on professional competencies and patient care, leveraging the diversity of the student body for a holistic educational experience.

The aim of this research is to investigate the influence of model height employed in the deep drawing of orthodontic aligner sheets on force transmission and aligner thickness. Forty sheets (Zendura FLX) were thermoformed over four models of varying heights (15, 20, 25, and 30 mm). Normal contact force generated on the facial surface of the upper right central incisor (Tooth 11) was measured using pressure-sensitive films. Aligner thickness around Tooth 11 was measured at five points. A digital caliper and a micro-computed tomography (µ-CT) were employed for thickness measurements. The normal contact force exhibited an uneven distribution across the facial surface of Tooth 11. Model 15 displayed the highest force (88.9±23.2 N), while Model 30 exhibited the lowest (45.7±15.8 N). The force distribution was more favorable for bodily movement with Model 15. Thickness measurements, conducted using a digital caliper and µ-CT, revealed substantial thinning of the aligner after thermoforming. This thinning was most pronounced at the incisal edge (50% of the original thickness) and least at the gingivo-facial part (85%). Additionally, there was a progressive reduction in aligner thickness with increasing model height, which was most significant on the facial tooth surfaces. We conclude that the thermoplastic aligner sheets undergo substantial thinning during the thermoforming process, which becomes more pronounced as the height of the model increases. As a result, there is a decrease in both overall and localized force transmission, which could lead to increased tipping by the aligner and a diminished ability to achieve bodily movement.

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.

Antimicrobial peptides represent a promising alternative to traditional drugs in relation to cost, toxicity and, primarily, the growing problem of drug resistance. Here we report on the activity against HSV-1 and HSV-2 of a previously described wide-spectrum synthetic decapeptide, Killer Peptide (KP). As determined by plaque reduction assays, treatment with KP at 100 μg/mL resulted in a reduction in the viral yield titer of 3.5 Logs for HSV-1 and 4.1 Logs for HSV-2. Further evaluation of KP antiviral activity focused on the early stages of virus replicative cycle, including the determination of the residual infectivity of viral suspensions treated with KP. A direct effect of the peptide on viral particles, impairing virus absorption and penetration, was shown. The toxicity profile proved to be extremely good with a selectivity index of 29.6 for HSV-1 and 156 for HSV-2. KP was also active against an acyclovir (ACV)-resistant HSV-1 strain, while HSV-1 subcultures in the presence of sub-inhibitory doses of KP did not lead to the emergence of resistant strains. Finally, the antiviral action of KP proved to be synergistic with that of ACV. Overall, these results demonstrate that KP could represent an interesting addition/alternative to acyclovir for antiviral treatment.

Automatic Milking Systems (AMS) are revolutionizing the dairy industry by boosting herd effi-ciency, primarily through increased milk yield per cow and reduced labor costs. The performance of milking machines, whether traditional or automated, can be evaluated using advanced vacuum meters through dynamic testing. This process involves scrutinizing the system and milking rou-tine to identify critical points, utilizing the VaDia™ logger (BioControl AS, Rakkestad, NO). Vacuum recordings were downloaded and analyzed using the VaDia Suite™ software under the guidance of a milking specialist. Access to data from AMS across various manufacturers and herds facilitated a retrospective study aimed at describing and comparing key milk emission parameters for different AMS brands while identifying potential mastitis risk factors. Using proper statistical procedures of SPSS 29.1 (IBM Corp, USA), researchers analyzed data from 4,878 individual quarter milkings from cows in 48 dairy herds. Results indicated significant variability in milking pa-rameters associated to quarter milk yield and AMS brand. Notably, despite AMS standardizing teat preparation and stimulation, the study revealed a surprisingly high frequency of two major mastitis risk factors—bimodality and irregular vacuum fluctuations—occurring more frequently than in conventional milking systems. This study, one of the few comparing different AMS brands and their performance, highlights the crucial role of dynamic testing in evaluating AMS perfor-mance under real-world conditions.

Introduction: Dental health care workers, particularly dental medicine students (DMS), are at an increased risk of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. The aim of our study was to assess the level of knowledge on HBV and HCV, estimate needlestick injury (NSI) prevalence and reporting practice in DMS at the University of Zagreb and analyze how enrolment in obligatory and supplemental courses affects knowledge and needlestick injury reporting practice. Materials and methods: The knowledge was assessed by our questionnaires based on Centers for Disease Control general handouts. Additional information was collected to examine the prevalence and reporting practice of NSI. Data was analyzed by descriptive statistical analysis, independent-samples t-tests, proportion analyses and combined factor analyses of categorical and quantitative variables in SPSS and R. Results: In total, 206 students participated. The overall level of HBV and HCV-related knowledge was poor with average scores being 61.90% and 51.35% respectively. Moreover, students enrolled in the first year demonstrated significantly lower levels of knowledge in comparison with their older peers. Of all participants 18.2% sustained a needlestick injury, and majority of them (78.95%) never reported the injury. Conclusion: In conclusion, DMS have low levels of knowledge on important occupational pathogens and poor NSI reporting practice. Moreover, formal education in the current form failed to significantly improve competence of students and theoretical knowledge translates poorly into more conscientious injury reporting practice. We should look for a better way to increase student awareness and level of knowledge on this topic.

The nuclear magnetic resonance (NMR) metabolomic analysis was applied to investigate the differences within nineteen Sicilian Nocellara del Belice mono varietal Extra Virgin Olive Oils (EVOO), grown in two zones different for altitude and soil composition. Several classes of endogenous olive oil metabolites were quantified through a nuclear magnetic resonance (NMR) three-experiment protocol coupled with a yet developed data-processing called MARA-NMR. This method, taking around one-hour experimental time per sample, faces the possible quantification of different class of compounds at different concentration’s range which would require at least three alternative traditional methods. NMR results were compared with the data of traditional analytical methods to quantify free fatty acidity (FFA), fatty acid methyl esters (FAMEs), and total phenol content. The presented NMR methodology is compared with traditional analytical practices and its consistency is also tested through slightly different data treatment. Despite the rich literature about the NMR of EVOOs, the paper points out that there are still several advances potentially improving this general analysis and overcoming the other cumbersome and multi-devices analytical strategies. Monovarietal EVOO’s composition is mainly affected by pedoclimatic conditions in turn relaying upon the nutritional properties, quality, and authenticity. Data collection, analysis and statistical processing are discussed touching the important issues related to the climate changes in Sicily and to the specific influence of pedoclimatic conditions.

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 recent years, the utilization of machine learning algorithms and advancements in Unmanned Aerial Vehicle (UAV) technology have marked significant shifts in remote sensing practices. In particular, the integration of machine learning with physical models and their application in UAV-satellite data fusion have emerged as two prominent approaches for estimating vegetation biochemistry. This study evaluates the performance of five machine learning regression algorithms (MLRAs) for mapping crop canopy chlorophyll at the Kellogg Biological Station (KBS) in Michigan, USA, across three scenarios: (1) application to Landsat 7, RapidEye, and PlanetScope satellite images; (2) application to UAV-satellite data fusion; and (3) integration with the PROSAIL radiative transfer model (hybrid methods PROSAIL + MLRAs). The results indicate that the majority of the five MLRAs utilized in UAV-satellite data fusion perform better than the five PROSAIL + MLRAs. The general trend suggests that the integration of satellite data with UAV-derived information, including the normalized difference red-edge index (NDRE), canopy height model, and leaf area index (LAI), significantly enhances the performance of MLRAs. The UAV-RapidEye dataset exhibits the highest coefficient of determination (R2) and the lowest root-mean-square errors (RMSE) when employing kernel ridge regression (KRR) and Gaussian processes regression (GPR) (R2 = 0.89 and 0.89 and RMSE = 8.99 µg/cm2 and 9.65 µg/cm2, respectively). Similar performance is closely observed for the UAV-Landsat and UAV-PlanetScope datasets (R2 = 0.86 and 0.87 for KRR, respectively). For the hybrid models, maximum performance is attained with Landsat data using KRR and GPR (R2 = 0.77 and 0.51 and RMSE = 33.10 µg/cm2 and 42.91 µg/cm2, respectively), followed by R2 = 0.75 and RMSE = 39.78 µg/cm2 for PlanetScope data upon integrating partial least squares regression (PLSR) into the hybrid model. Across all hybrid models, RapidEye data yielded the most stable performance, with R2 ranging from 0.45 to 0.71 and RMSE ranging from 19.16 µg/cm2 to 33.07 µg/cm2. The study highlights the importance of synergizing UAV and satellite data which enables effective monitoring of canopy chlorophyll in small agricultural lands.

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.

Keywords: Endodontic microsurgery; Root canal treatment; Isthmus preparation; Short-term outcomes

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.

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.

This paper explores innovative approaches to determining eigenvalues and eigenvectors through the combination of neural networks and traditional numerical methods. Traditional methods like the Newton-Raphson and Durand-Kerner algorithms are proven effective but often require good initial approximations and can be sensitive to the choice of starting points. In this study, we propose a hybrid approach that uses neural networks to generate better initial approximations, which are then iteratively refined using traditional methods. By combining the pattern recognition power of neural networks with the adaptability of traditional numerical methods, we demonstrate faster convergence and higher accuracy in determining eigenvalues and eigenvectors. Experimental results on various polynomials of different degrees and characteristics show that our hybrid approach outperforms individual methods, providing a more robust and efficient solution.

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.

(1) Background : When placing implants in the maxillary posterior region with insufficient alveolar bone, a maxillary sinus elevation is necessary. Autogenous bone, though biologically ideal, poses risks and discomfort due to donor site harvesting. Block-type autogenous tooth bone graft material, made from the patient’s own extracted tooth, offers similar biological stability without these drawbacks; (2) Methods : This study observed the progress of 19 implant patients who were treated with maxillary sinus elevation procedures using block-type autogenous tooth bone graft material at the Daegu Catholic University Medical Center. Extracted teeth were processed into demineralized tooth block bone. After elevating the sinus membrane, implants and the tooth bone graft material were placed in the space, and the bony window was repositioned. Postoperative evaluations through clinical observation and radiographic imaging assessed sinus membrane elevation, alveolar bone height increase, and implant osseointegration; (3) Results : Results showed proportional increases in alveolar bone height to the graft material size, with long-term stability. No postoperative complications occurred, even with sinus membrane perforation, and implants remained stable; (4) Conclusions : The study concludes that maxillary sinus lifts using block-type autogenous tooth bone graft material provide excellent bone induction and biocompatibility, making it a highly beneficial method for both dentists and patients.

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

The development of the finite element method (FEM) combined block polynomial interpolation with the concepts of finite difference formats and the variation principle. Because of this combination, FEM overcomes the shortcomings of traditional variation methods while maintaining the benefits of current variation methods and the flexibility of the finite difference method. As a result, FEM is an advancement above the traditional variation methods. The aim of the study is to experimentally determine the thermal behavior of two stomatognathic systems, one control and the other presenting orthodontic treatment by means of a fixed metallic orthodontic appliance, both being subjected to several thermal regimes. In order to carry out this experimental study, we examined the case of a female subject, who was diagnosed with Angle class I malocclusion. The patient underwent a bimaxillary CBCT investigation before initiating the orthodontic treatment. A three-dimensional model with fully closed surfaces was obtained by using the InVesalius and Geomagic programs. Like the tissues examined in the patient, bracket and tube-like components, as well as orthodontic wires, can be included to these models. Once it is finished and geometrically accurate, the model is exported to a FEM-using program, such as Ansys Workbench. The intention was to study the behavior of two stomatognathic systems (with and without a fixed metallic orthodontic appliance) subjected to very hot food (70 ⁰C) and very cold food (-18 ⁰C). From the analysis of the obtained data, it was concluded that, following the simulations carried out in the presence of the fixed metallic orthodontic appliance, significantly higher temperatures were generated in the dental pulp.

During pregnancy, profound physiological changes occur in the maternal body, including those affecting oral health. Dental stem cells (DSCs) have emerged as promising candidates for regenerative therapies in dentistry. This manuscript delves into the intricate interplay between DSC behavior and maternal oral health during pregnancy. We provide an overview of current knowledge concerning the impact of pregnancy on DSCs, highlighting their potential roles in maintaining oral homeostasis and responding to pathological conditions. Additionally, we identify key research gaps and propose future directions for investigating novel therapeutic strategies leveraging DSCs to improve maternal and fetal oral health outcomes. By elucidating this relationship, we aim to pave the way for innovative approaches in preventive and regenerative dentistry tailored to the unique needs of pregnant women.

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.

Students have historically fared poorly on the West African Examinations Council’s (WAEC) mathematics exam. This study investigated senior high school students’ difficulties with studying Geometry in the Cape Coast Metropolis, Central Region, Ghana. Using the descriptive survey design, data were collected from 300 Senior High School Two (SHS 2) students using simple random sampling. Students responded to the questionnaire and a 30-item multiple-choice achievement test on geometry. Four geometry concepts students perceived difficult to study are Circle theorems, Perpendicularity of Tangent and radius of a circle, Angle between Tangent and a chord and Tangents from an external point. The reasons for the difficulty in studying geometry topics are the unavailability of instructional materials, the geometry topics being complex, and teachers not teaching geometry concepts to the students’ understanding. Students’ gender did not influence the learning of concepts in geometry at a 0.05 level of significance. There was an insignificantly weak positive correlation between the students’ performance and their perceived difficult geometry concepts. It was concluded that the Ministry of Education does not provide relevant instructional materials to the various schools to teach geometry concepts. Schools do not organise workshops and seminars for teachers on effectively teaching geometry concepts in mathematics.

This study investigates the diversity and evolution of research topics within the dental sciences from 1994 to 2023 using topic modeling and Shannon's entropy as a measure of research diversity. We analyzed a dataset of 412036 scientific articles across six dental disciplines: Orthodontics, Pros-thodontics, Periodontics, Implant Dentistry, Oral Surgery, and Restorative Dentistry. This research relies on BERTopic to identify distinct topics within each field. The study revealed significant shifts in research focus over time, with some disciplines exhibiting robust growth in article numbers such as Periodontics and Prosthodontics. The application of Shannon's entropy revealed an increasing diversification of research efforts in disciplines such as Restorative Dentistry, while others, like Prosthodontics, in spite of their size and their high number of research topics, maintain a more specialized research focus. Taken together, our findings describe the dynamic nature of dental re-search and highlight the balance shifts in research focus across several key areas of Dentistry.

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

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.

The aim of the study was to investigate the effects of Botox injection therapy, with or without wearing thermoformed occlusal splints, in patients with sleep apnea and nocturnal bruxism and to determine their degree of satisfaction after completing the therapy. The selected patients (n = 36, 24 female and 12 male) with sleep apnea and nocturnal bruxism were divided into two groups. The first group of 18 patients (G1) was treated by injecting Botox (Allergan) into the masseter muscle. The 18 patients in the second group (G2) benefited from associated therapy represented by Botox injections in masseter muscle and the wear of thermoformed occlusal splints. Four monitoring sessions were realized: at baseline, at three weeks, at three months, and at six months after the effectuation of treatments. The associated therapy (Botox and thermoformed occlusal splints) presented much better results over time in decreasing the sleep apnea and nocturnal bruxism symptoms than the one represented only by injections with Botox, but Botox injections presented a rapid relief of both disease signs. Patient satisfaction after the applied treatments was very good, but in patients with associated therapy, it was better after six months than in first-group patients.

Predictive factors associated with a decline in swallowing function after 2 years were examined in 3,409 Japanese older people aged ≥ 75 years who had undergone a dental checkup in Gifu Prefecture, Japan. Participants with normal swallowing function in a baseline survey in April 2018 were followed for 2 years. Swallowing function was assessed by a repetitive saliva swallowing test. After 2 years, 429 participants (13%) who could not swallow at least three times in 30 seconds were diagnosed as having a decline in swallowing function. Multivariate logistic regression analyses showed the decline in swallowing function after 2 years was associated with male gender (odds ratio [ORs]: 0.772; 95% confidence interval [CIs]: 0.615–0.969), age ≥ 81 years (presence; ORs: 1.523; 95% CIs: 1.224–1.895), support/care-need certification (presence; ORs: 1.815; 95% CIs: 1.361–2.394), periodontal pocket depth (PPD) ≥ 4 mm (presence; ORs: 1.469; 95% CIs: 1.163–1.856), difficulty in biting hard food (yes; ORs: 1.439; 95% CIs: 1.145–1.808), choking on tea and water (yes; ORs: 2.543; 95% CIs: 2.025–3.193), and dry mouth (yes; ORs: 1.316; 95% CIs: 1.052–1.646) at baseline. Therefore, the dental checkup items associated with a decline in swallowing function after 2 years were a PPD ≥ 4 mm, difficulty in biting hard food, choking on tea and water, and dry mouth. PPD status and confirming to the self-administered questionnaire about biting, choking, and dry mouth may be useful in predicting future decline in swallowing function.

Achieving effective haemostasis is crucial for successful outcomes and optimal patient care in contemporary oral surgery. Control of bleeding is essential in procedures like extractions, implant placements, periodontal surgeries, and soft tissue interventions. Efficient management ensures a clear surgical field, reduces post-operative complications, and promotes healing. Local haemostatic agents are essential tools for oral surgeons, offering targeted and controlled methods to achieve haemostasis. These agents include diverse materials and technologies, each with unique mechanisms of action suited to specific surgical scenarios. This review explores the spectrum of local haemostatic agents in contemporary oral surgery, focusing on their efficacy, safety, and practical utility. By examining the characteristics and clinical performance of various haemostatic agents, this review provides valuable insights to guide dentists and oral surgeons in selecting the most appropriate agent for specific situations. A literature search in electronic databases such as Medscape, PubMed-Medline, Science Direct, and EBSCO Host identified 46 publications from 1990 to 2023. This comprehensive examination aims to enhance understanding of local haemostatic agents and their role in advancing the standards of care in contemporary oral surgery.

Objectives: Aim to assess the perceptions of virtual learning among dental residents and faculty and employ Regulatory Focus Theory (RFT) to understand the impact of motivational orientations on virtual learning during COVID pandemic. Methods: 46 dental residents and 10 faculty in Upstate New York participated in the study (June -August 2021). Questionnaires were used to collect demographics, perceptions of virtual learning, burnout, and RFT types (promotion and prevention focus). Multiple regression analyses were used to examine factors associated with perceptions of virtual learning and burnout. Results: Overall, 70% of residents and 44% of faculty found virtual learning effective. Younger residents with less experience preferred virtual learning more than their older, experienced peers. Residents trained outside the U.S. and Canada favored in-person learning more than those trained within. Furthermore, residents with a higher promotion focus score found virtual learning more interactive for didactic courses. Additionally, 52% of residents experienced burnout, with a higher incidence among females (p=0.044). Conclusions: Virtual learning is well-received by dental residents and faculty, with potential for continued use post-pandemic. Future efforts should focus on creating an inclusive and supportive educational environment that meets the motivational and well-being needs of dental residents and faculty.

Probiotics are living microbes that provide benefits to the host. The increasing data on health promotion following probiotics administration triggered growing interest among researchers and pharmaceutical companies looking for novel therapeutic or preventive tools. Infections of the lower genital tract in females are caused by a wide range of pathogens, they are widespread, and represent one of the main areas for the use of probiotics and postbiotics. Vulvovaginal candidiasis (VVC) affects 75% of women in their reproductive age at least once during their lifetime. Of these women 5-8% develop the recurrent form (RVVC). The disease onset is triggered by the overgrowth of Candida species on the vaginal mucosa. Here, we evaluated the beneficial properties of the Bacillus coagulans spore-producing LMG S-24828 against C. albicans and C. parapsilosis. Our results show that both alive B. coagulans and its Cell-Free-Supernatant (CFS) exerted antifungal activity against both fungi. Moreover, alive B. coagulans reduced hyphal formation, inhibited C. albicans adhesion to vaginal epithelial cells and showed co-aggregation capacity. Overall, B. coagulans LMG S-24828 exerted a protective effect on vaginal epithelial cells infected with C. albicans. These data suggest that B. coagulans LMG S-24828 may provide benefits in the context of Candida vaginal infections.

Some evidence supports the influence of the implant macro-design and primary stability. Additionally, tactile perception can be used to assess implant stability when placing the implant. This research aimed to quantify the primary and secondary stability of three implant systems with two different macro geometries (cylindrical and conical) determined through the insertion torque and the implant stability quotient (ISQ) at the moment of implant placement as a function of implant-related factors (length, width, dental arch, and implant location in the arch), intraoperative factors (bone density determined subjectively by the clinician's tactile perception), and patient-related factors (age, gender and bone density determined objectively in the cone beam computed tomography (CBCT). Methods: 102 implants of three implant systems with two different macro geometries (conical and cylindrical) were placed in 53 patients. The insertion torque, the ISQ at the implant placement (ISQ0), and bone quality according to the clinician's tactile sensation were recorded on the day of the surgery. After a three-month healing period, the ISQ was re-evaluated (ISQ3). Results: Cylindrical implants exhibited significantly higher insertion torque and ISQ at the moment of the surgery and after three months than conical implants. Cylindrical implants also showed significantly lower indices of tactile evaluation of bone quality during the implant placement surgery. However, no differences were demonstrated in the bone density measured objectively in the CBCT. (4) Conclusions: The cylindrical implants achieved the highest values for primary stability (Ncm and ISQ) and secondary stability (ISQ after three months). Insertion torque was the variable that most influenced ISQ on the day of the surgery. Implant location (incisors-canines, bicuspids-molars) and the implant macro geometry were the variables that most influenced the secondary stability (ISQ at three months).

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.

Purpose: This integrated review aims to identify and analyze the multifactorial contributors to the longevity of direct restorations, focusing on tooth-, patient-, and dentist-related factors. Materials and Methods: A literature search was performed using an electronic database, PubMed/Medline, Web of Science, and Scopus, between 1980 and 2024. Titles and abstracts of papers that evaluated aspects categorized into tooth-related, patient-related, and dentist-related factors influencing restoration failure were selected and screened. Full-text assessments were conducted, and the extracted data were compiled, summarized, and synthesized. The reference lists of the collected papers were also screened, and relevant citations were included in this review. Data were gathered from clinical and laboratorial studies, systematic reviews, and meta-analyses to provide a comprehensive understanding of restoration longevity. Results: Among the tooth-related factors, multiple-surface restorations, deep margins, tooth location, and tooth vitality significantly impact restoration survival. Patient-related factors such as medical conditions, risk predictors of caries, age, sex, parafunctional habits, smoking, periodontal health, number of restorations, and socioeconomic status all play crucial roles. Regarding dentist-related factors, the decision-making process, age, experience, and dentist manual dexterity are vital aspects. Furthermore, the technique used, including isolation methods for moisture control, as well as the type of dental practice (large group vs. small practice), notably influenced the restoration survival. Conclusions: The longevity of dental restorations is influenced by a complex interplay of tooth-related, patient-related, and dentist-related factors. Strategies to improve restoration outcomes should consider all these multifactorial contributors. Continuing professional education, diligent patient guidance on the factors that influence restoration survival, careful material selection and restorative technique, and tailored individual treatment are crucial factors to reduce failure rates and improve the lifespan of restorations.

The paper presents theoretical notions with practical applications for establishing of one dental bur lifetime (durability and reliability based on the active part wear considering a series of statistical indicators. For the justification application of theoretical notions in practice, a conical-cylindrical dental bur was studied experimentally, to obtain a series of data in the work process, necessary for statistical calculation. The parameter taken into consideration in this paper is mass lost through the dental bur active part wear, tested. This is useful for the dental bur lifetime establishment and its extension or even optimization in operation. The loss of mass of the dental bur active part is analyzed in the work process by the results and experimental data obtained and validated by a numerical calculation statistical-mathematical. The numerical calculation approximates very well the mass lost through the wear at different rotation speeds and operation times, with those experimentally determined ones, based on which it was established lifetime. The results showed that the dental bur works with high yield in the first 20 hours of work, , after which it should be replaced with a new one.

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.

Dental implantology has evolved greatly as a result of the application of biomechanical engineering concepts, notably the utilization of additive manufacturing technologies that recreate the intricate architecture of real bone. This technique intends to improve functional compatibility with bone tissue while also addressing continuing problems of stress distribution inside dental implants. The research examines two types of dental implants: fully gyroid latticed and hybrid gyroid latticed with a solid neck, comprising three different cell sizes—FI-111, FI-222, FI-333, and their hybrid equivalents HI-111, HI-222, and HI-333. Traditional solid implants often cause stress shielding, which reduces long-term osseointegration and implant durability. Developed using nTopology for lattice configuration and meshing, this design undergoes a comprehensive stress analysis using finite element analysis (FEA). The study seeks to determine the most efficient implant design by maximizing stress distribution and mechanical stiffness. Analyses suggest that hybrid latticed implants, notably the HI-222 type, possess superior mechanical characteristics. These implants successfully balance stiffness and flexibility, reducing stress concentrations and improving stress distribution throughout the implant structure. This balance is critical for decreasing micromotions at the bone-implant interface, boosting osseointegration, and, ultimately, increasing implant longevity and success rates in clinical settings. The paper describes a substantial redesign of dental implants by combining biomechanical engineering and modern additive manufacturing. The novel proposed hybrid structure not only addresses typical challenges such as stress shielding, but it also establishes new standards in implantology, potentially leading to better clinical results and patient quality of life. This complete approach emphasizes the ability of personalized implant designs to fulfill individual clinical demands, indicating a significant improvement in dental treatment technology.

Adolescence is a central phase for the development of a person’s identity involving complex multidimensional changes and increasing vulnerability to distress. The aim of this study was to investigate the psychological well-being of adolescent students in Brescia (Northern Italy), two years after the beginning of the Covid-19 pandemic. An online survey investigated the extent and the reasons reported by high school students for their emotional distress (ED), also considering other factors such as physical activity, diet, sleep and smartphone overuse. The main reasons for ED were classified through a qualitative analysis of the freetext answers. 1686 students agreed to participate, 50% showed a presence of ED. According to a multiple logistic analysis, the main factors associated to ED were female gender (AdjOR 2.3, p<0.0001), age (AdjOR 1.6, p<0.0001), sleep duration <8 hours (AdjOR 1.5, p=0.0003), anxiety perception (AdjOR 3.4, p<0.0001), and certain eating behaviors, e.g. comfort food consumption (AdjOR 2.0, p<0.0001). According to free-text answers, the main reasons for ED were: “school pressure”, “ relationships with family and peers”, “negative emotional states” and “the pandemic”. The results show a high level of ED among adolescents and the reported reasons may help to better address their psychological needs after the pandemic.

The nuclear hormone family of receptors regulates gene expression. The androgen receptor (AR) shuttles upon ligand binding and homodimerization from the cytosol into the nucleus to activate gene expression. Thyroid hormone receptors(TR), retinoic acid receptors (RAR), and the vitamin D receptor (VDR) are present in the nucleus bound to chromatin as a heterodimer with the retinoid X receptors (RXR) and repress gene expression. Ligand binding leads to transcription activation. The hormonal ligands for these receptors play crucial roles to ensure the proper conduct of very many tissues and exert effects on prostate cancer (PCa) cells. Androgens support PCa proliferation and deprivation alone or with chemotherapy is the standard therapy for PCa. RAR activation and 3,5,3'-triiodo-L-thyronine (T3) stimulation of TR support the growth of PCa cells. Ligand stimulation of VDR drives growth arrest, differentiation, and apoptosis of PCa cells. Often these receptors are explored as separate avenues to find treatments for PCa and other cancers. However, there is accumulating evidence to support receptor interactions and crosstalk of regulatory events whereby a better understanding might lead to new combinatorial treatments.

Thermomechanical, biocompatibility, durability, workability and economic characteristics are the main criteria for development of dental alloys. In an attempt to provide a noble metal dental alloy without the known adverse metallic elements, a novel alloy was produced with the addition of Germanium (Ge), as a more cost-effective alternative to other precious alloying metals. The objective of this investigation was to analyse the thermomechanical and biocompatibility properties of a high noble Au-Pt-Ge porcelain-fused-to-metal (PFM) alloy. These properties were investigated with DSC analysis, hardness, density and coefficient of thermal expansion (CTE) measurements, as well as with metallographic and SEM/EDX microstructure investigations, with the production of a test PFM dental bridge, static immersion testing for metal ion release, and an in vitro primary biocompatibility testing on human gingival cells. The results of the thermomechanical testing showed alloy properties suitable for dental restorations and clinical use, with somewhat lower hardness, making the alloy not suitable for extensive multiunit fixed restorations. The microstructure investigations showed segregations of Ge in a homogeneous alloy matrix, which reduce the alloy’s mechanical properties. The produced PFM dental bridge shows excellent workability of the alloy in a dental laboratory setting, as well as a high standard of the final dental restoration. The ion release was negligible, well below any harmful quantities, while the cell viability examination showed significantly higher viability ratings on polished alloy samples as compared to as-cast samples. The results showed that a dental substructure in direct contact with oral tissue and fluids should be highly polished.

(1) Background: This study aimed to compare the effect of polyetheretherketone (PEEK) and titanium abutments on implant prosthetic systems and supporting bone using three-dimensional finite element analysis (FEA); (2) Methods: A three-dimensional finite element analysis was conducted using CATIA and Abaqus software to model mandibular first molar implant systems with titanium and PEEK abutments. Under external loading conditions, finite element analysis was conducted for the stresses in implant components and surrounding bones of each group; (3) Results: The implant fixture of the PEEK model exhibited the highest von Mises stress (VMS). The lowest VMS was observed in the abutment screw of the titanium model. Both implant systems demonstrated similar stress distribution and magnitudes in cortical and cancellous bones; (4) Conclusion: PEEK abutments show similar stress distribution in surrounding bone compared to titanium. However, PEEK absorbs the stresses within the implant system and exhibits the highest VMS values due to its low mechanical and physical properties. Therefore, PEEK abutments need improved mechanical properties for better clinical application.

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.

In the dynamic landscape of modern education, characterized by an increasingly active involvement of IT technologies in learning, the imperative to transfer to students the skills necessary to integrate Artificial Intelligence (AI) into the process represents an important goal. This paper presents a novel framework for knowledge transfer, diverging from traditional programming language-centric approaches by integrating PSoC 6 microcontroller technology. This framework establishes a cyclical learning cycle encompassing theoretical fundamentals and practical experimentation, fostering AI literacy at the edge. Through a structured combination of theoretical instruction and hands-on experimentation, students develop proficiency in understanding and harnessing AI capabilities. Emphasizing critical thinking, problem-solving, and creativity, this approach equips students with the tools to navigate the complexities of real-world AI applications effectively. By leveraging PSoC 6 as an educational tool, a new generation of individuals is efficiently cultivated with essential AI skills. These individuals are adept at leveraging AI technologies to address societal challenges and drive innovation, thereby contributing to long-term sustainability initiatives. Specific strategies for experiential learning, curriculum recommendations, and results of knowledge application are presented, aimed at preparing students to excel in a future where AI will be omnipresent and indispensable.

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.

Candida albicans is present in oral health and has been linked with dental caries. So far, the behavior of the yeast in the presence of Streptococcus sanguinis has not been tested. The aim was to determine the effect of excess sugar as a cariogenic environment on the biological and physico-chemical parameters of single-species (C. albicans) and dual-species biofilms of C. albicans and S. sanguinis. An in vitro caries model was used. The biofilms were exposed to 10% sucrose or 0.9% NaCl for 5 min 3x/day/5 days. Viable cells, hyphal quantification, SEM, biofilm pH, H2O2 quantification and surface microhardness of enamel slabs were determined. Microbial viability and the number of hyphae were higher for sucrose exposure, in the dual-species biofilms induced by excess sugar and coexistence between the two microorganisms. Sucrose-exposed biofilms showed a progressive pH drop over the time course. H2O2 production was about 6 times higher for the dual-species biofilms. Enamel demineralization was higher in the single-species, suggesting an inhibitory effect due to S. sanguinis. Excess sugar increases the pathogenic potential of C. albicans biofilm. In dual-species biofilms, S. sanguinis prevents pronounced drops in pH, decreasing demineralization and stimulates the development of hyphae in the yeast.

With around one billion of the world's population affected, the era of Metabolic-associated fatty liver disease (MAFLD) pandemic has entered the global stage. MAFLD is a chronic progressive liver disease with accompanying metabolic disorders such as type 2 diabetes mellitus and obesity which can progress asymptomatically to liver cirrhosis and subsequently to hepatocellular carcinoma (HCC), and for which, to date there is almost no approved pharmacologic options. Because MAFLD has a very complex etiology and it affects also extrahepatic organs, a multidisciplinary approach is required when it comes to finding an effective and safe active substance for MAFLD treatment. The optimal drug for MAFLD should diminish steatosis, fibrosis and inflammation in the liver, and the winner for MAFLD drug authorisation seems to be the one that significantly improves liver histology. Saroglitazar (Lipaglyn®) was approved for Metabolic dysfunction associated steatohepatitis (MASH) in India in 2020; however, the drug is still being investigated in other countries. Despite that a pharmaceutical industry is still lagging behind to develop an ap-proved pharmacologic therapy for MAFLD, research has been recently intensified and many molecules which are underway in the final stages of clinical trials are expected to be approved in the coming few years. Already this year, the first drug (Rezdiffra™) in the United States was ap-proved via accelerated procedure for treatment of MAFLD, i.e. of MASH in adults. This review underscores the most recent information related to the development of drugs for MAFLD treatment, focusing on the molecules that have come furthest towards approval.

Background/Objectives: Dental implants have become a cornerstone of restorative dentistry, providing a long-lasting method for tooth replacement. The level of osseointegration has a big impact on the biomechanical stability at the bone-implant contact (BIC), which determines how long these implants will work. However, the exact consequences of changing osseointegration levels on different implant designs, especially in bones with variable densities, are not well known. Three short dental implants were tested in this study: BioMet 3iT3, Straumann® Standard Plus Short Regular Neck (SPS-RN), and Straumann® Standard Plus Short-Wide Neck (SPS-WN). 3D finite element analysis (FEA) was used to look at how well they worked biomechanically. This paper tests the implants at four stages of osseointegration: 25%, 50%, 75%, and 100% in both high-density (Bone Type III) and low-density (Bone Type IV) cancellous bone. It also created and examined realistic CAD models under static occlusal loading conditions to assess stress distribution and major strains at the bone-implant contact.; Results: The study discovered that as osteointegration increases, von Mises stress and principal strains go down significantly for all implant types. The SPS-WN implant had the lowest strain values, especially for bone with low density. These reductions demonstrate increased mechanical stability as the bone-implant inter-face becomes more capable of dispersing mechanical stresses, minimizing the potential for localized deformation and bone resorption.; Conclusions: The results highlight the importance of achieving optimum osseointegration to reduce mechanical stress and increase the lifespan of dental implants. The SPS-WN type implant performed better in biomechanical tests than the others, especially when bone conditions were not ideal. This makes it a great choice for clinical applications that need long-term implant success.

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.

Acrylates and methacrylates are widely used, especially in the dental industry, but can cause adverse skin reactions. These compounds, including 2-hydroxyethyl methacrylate, triethylene glycol dimethacrylate, and bisphenol A-glycidyl methacrylate, are strong contact irritants or allergens. Found in dental prostheses, composite resins, dentin bonding materials, and glass ionomers, they pose a higher risk of exposure for dental personnel. Clinically, acrylate allergies manifest as facial rashes, eczema with cracked skin on fingers (pulpitis), nail dystrophy, and periungual dermatitis. Recently, the highest frequency of allergic reactions to acrylates has shifted from dentistry to the beauty industry due to increased use in artificial nails, eyelashes, and hair extensions. This has led to greater sensitization. Acrylates are also used in medical applications, such as bone cement for orthopedic endoprostheses, soft contact lenses, hearing aids, histological preparations, and wound dressings, which can also cause allergic reactions. Severe dermatitis from surgical glue containing acrylates has been documented, and diabetic medical devices are potential sources of allergic contact dermatitis. Given the extensive use and prolonged skin contact of products containing acrylates and methacrylates, this review aims to present current knowledge and literature on reactions to these compounds across different industries.

High Education Institutions (HEI) play a key role in fostering sustainability since students will be future active society members. By providing them with the knowledge, skills, and mindset needed to address environmental challenges, they can contribute to increase sustainability in a long-term approach. With the effects of climate change strongly affecting water availability across planet, it is increasingly relevant to understand if higher education students are aware of this situation, to develop adequate measures to promote sustainable behaviors regarding water uses. This study aimed to assess students’ perceptions regarding water efficiency through a questionnaire submitted in 7 HEI in Portugal. Students recognized the importance of water with older students, women and science students demonstrating a greater awareness. Inspite of this 27% students do not know what the average water consumption in Portugal is and only 18% accurately reported the consumption range in Portugal. There is also a lack of knowledge (&gt;50% students) if common water efficiency measures are applied in their HEI. The main information sources identified by the students were “social communication” and “internet/social media”, revealing that water efficiency knowledge transfer in high education can be improved.

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.

This study investigates stress perceptions, somatization, and coping strategies among 271 nursing and dentistry (n=126 and n=145, respectively), undergraduate and postgraduate students. For the study, an e-questionnaire was designed in a two-step process, uploaded in Google Forms and staying open for submissions during February 2024 in the School of Health Sciences, National and Kapodistrian University of Athens. In our sample, predominantly female (68.60%), the majority were undergraduates (80.10%). Females reported higher stress somatization (M=10.22, SD=5.23) compared to males (M=7.94, SD=6.14), with a moderate effect size (Cohen’s d=0.412, p

The definition of patients with Special Needs (SN) is used in the literature to refer to individuals with mental and physical disorders for whom the usual perioperative pathways are not applicable due to lack of cooperation, regardless of age. Studies in the literature recognize the appropriateness of general anesthesia for performing day surgery dental care in this type of patient. The present retrospective, single-center, observational study involved 41 uncooperative patients aged between 3 and 17 undergoing dental surgery under general anesthesia. The main objective was to assess the possible incidence of difficult airway management, understood as difficulty ventilating and/or intubating the patient. A secondary objective was to highlight the influence of general anesthesia on patient outcomes by testing the incidence of perioperative complications. Tracheal intubation was successfully completed in all of the patients considered, and in no case did the patient have to be woken up because of difficulty in airway management. No perioperative complications attributable to anesthesia were found in any patients. From the present experience, it can be concluded that general anesthesia is a suitable option for performing dental care in pediatric subjects with special needs, and that although the peculiar peri-operative management of these patients might increase the risk of possible anesthesia-related side effects, no complications have been encountered in any case.

Rheumatoid arthritis (RA) is an autoimmune disease characterized by immune cell-mediated joint inflammation and subsequent osteoclast-dependent bone destruction. Collagen antibody-induced arthritis (CAIA) is a useful mouse model for examining the inflammatory mechanisms in human RA. Previously, we identified the novel gene Rab44, which is a member of the large Rab GTPase family and is highly expressed in immune-related cells and osteoclasts. In this study, we induced CAIA in Rab44-knockout (KO) mice to investigate the effects of Rab44 on inflammation, cell filtration, and bone destruction. Compared with wild-type (WT) mice, Rab44 KO mice showed reduced inflammation in arthritis under CAIA-inducing conditions. Rab44 KO CAIA mice exhibited reduced cell filtration in the radiocarpal joints. Consistent with these findings, Rab44-KO CAIA mice showed decreased mRNA levels of arthritis-related marker genes including inflammation, cartilage turnover, bone formation, and bone absorption markers. Rab44-KO CAIA mice exhibited predominant infiltration of M2-type macrophages at inflammatory sites and reduced bone loss compared to WT CAIA mice. These results indicate that Rab44 deficiency reduces the progression of inflammation in CAIA in mice.

In the context of restorative dentistry and the use of different techniques and dental adhesive systems, this study was to designed to assess the degree of adhesive absorption and wetting for each dental micro applicator; and also quantify the amount of lost fiber flocks after three applications of dental adhesive on the inside surface of a plastic veneer tooth in order to reveal a potential contaminating factor at the adhesive interface. Initially, one drop of dental adhesive was dispensed into a glass dental mixing well. The dental adhesive was then applied onto the inside surface of the veneer restoration for 30s using a dental micro applicator which was weighed afterwards. For each dental micro applicator, this sequence was repeated three times and measured again by the same operator. Each adhesive application was analyzed separately, to show the values independently and compare them to the initial weight. The samples of Fiber-Free Elastomer Bristle Micro Applicators (FEBM) demonstrated the best performance with a good degree of absorption and wetting of the dental adhesive without the loss fiber flocks and release-induced weight loss. The samples of Conventional Fiber Flocked Micro Applicators (CFFM) demonstrated good initial absorption and wetting of the dental adhesive, but visually shed several fiber flocks which resulted in significant weight loss and can also be considered a contaminating factor at the adhesive interface.

Electrolyzed water, which mainly contains hypochlorous acid, is widely used because of its strong microbicidal effects, biosafety, and eco-friendliness. For frequent use in intraoral treatments, we focused on neutral electrolyzed water (NW) produced using two-stage electrolysis and investigated its storage stability. For standard-concentration NWs with free available chlorine concentration (ACC) of 25, 35, and 50 mg/L and high-concentration NWs (100, 200, 300, 500, and 1000 mg/L), changes in the pH, oxidation-reduction potential, and ACC during 126 days of storage and the bactericidal efficacies were examined. Storage under non-shaded conditions at room temperature (LRT) and a higher ACC substantially altered the properties of the NW. NW (≤ 300 mg/L) had a pH of 5.9–7.3 even after storage under LRT; however, NW with higher ACC (500 and 1000 mg/L) had a pH ˂ 5.5, critical for human enamel), even under shaded and refrigerated conditions (SLW). Only NW (25 mg/L) stored under LRT exhibited the lowest ACC (5 mg/L), indicating a decreased bactericidal effect. When stored for use in intraoral treatments, NWs should be prepared with an ACC of 25–300 mg/L and stored in SLW. If diluted NW is used, the ACC should be checked and appropriately diluted every time.