Evaluation of setting kinetics, mechanical strength, ion release, and cytotoxicity of high-strength glass ionomer cement contained elastomeric micelles.

BACKGROUND: Low mechanical properties are the main limitation of glass ionomer cements (GICs). The incorporation of elastomeric micelles is expected to enhance the strength of GICs without detrimentally affecting their physical properties and biocompatibility. This study compared the chemical and mechanical properties, as well as the cytotoxicity, of elastomeric micelles-containing glass ionomer cement (DeltaFil, DT) with commonly used materials, including EQUIA Forte Fil (EF), Fuji IX GP Extra (F9), and Ketac Molar (KT). METHOD: Powder particles of GICs were examined with SEM-EDX. Setting kinetics were assessed using ATR-FTIR. Biaxial flexural strength/modulus and Vickers surface microhardness were measured after immersion in water for 24 h and 4 weeks. The release of F, Al, Sr, and P in water over 8 weeks was analyzed using a fluoride-specific electrode and ICP-OES. The toxicity of the material extract on mouse fibroblasts was also evaluated. RESULTS: High fluoride levels in the powder were detected with EF and F9. DT demonstrated an initial delay followed by a faster acid reaction compared to other cements, suggesting an improved snap set. DT also exhibited superior flexural strength than other materials at both 24 h and 4 weeks but lower surface microhardness (p < 0.05). EF and F9 showed higher release of F, Al, and P than DT and KT. There was no statistically significant difference in fibroblast viability among the tested materials (p > 0.05). CONCLUSIONS: Elastomeric micelles-containing glass ionomer cement (DT) exhibited satisfactory mechanical properties and cytocompatibility compared with other materials. DT could, therefore, potentially be considered an alternative high-strength GIC for load-bearing restorations.

Knowledge of dental academics about the COVID-19 pandemic: a multi-country online survey.

BACKGROUND: COVID-19 is a global pandemic affecting all aspects of life in all countries. We assessed COVID-19 knowledge and associated factors among dental academics in 26 countries. METHODS: We invited dental academics to participate in a cross-sectional, multi-country, online survey from March to April 2020. The survey collected data on knowledge of COVID-19 regarding the mode of transmission, symptoms, diagnosis, treatment, protection, and dental treatment precautions as well as participants' background variables. Multilevel linear models were used to assess the association between dental academics' knowledge of COVID-19 and individual level (personal and professional) and country-level (number of COVID-19 cases/ million population) factors accounting for random variation among countries. RESULTS: Two thousand forty-five academics participated in the survey (response rate 14.3%, with 54.7% female and 67% younger than 46 years of age). The mean (SD) knowledge percent score was 73.2 (11.2) %, and the score of knowledge of symptoms was significantly lower than the score of knowledge of diagnostic methods (53.1 and 85.4%, P <  0.0001). Knowledge score was significantly higher among those living with a partner/spouse than among those living alone (regression coefficient (B) = 0.48); higher among those with PhD degrees than among those with Bachelor of Dental Science degrees (B = 0.48); higher among those seeing 21 to 30 patients daily than among those seeing no patients (B = 0.65); and higher among those from countries with a higher number of COVID-19 cases/million population (B = 0.0007). CONCLUSIONS: Dental academics had poorer knowledge of COVID-19 symptoms than of COVID-19 diagnostic methods. Living arrangements, academic degrees, patient load, and magnitude of the epidemic in the country were associated with COVD-19 knowledge among dental academics. Training of dental academics on COVID-19 can be designed using these findings to recruit those with the greatest need.

Fluoride-Releasing Effect of a Modified Resin Denture Containing S-PRG Fillers on Salivary Fluoride Retention: A Randomized Clinical Study.

This study aimed to evaluate the clinical effect of a resin denture base containing 20wt% surface prereacted glass ionomer (S-PRG) fillers on saliva fluoride concentrations as a surrogate evaluation of caries control. The study was a double-blind randomized clinical trial with a total of 110 participants aged 35-60 years who wore a removable partial resin denture for 1.5 years. Subjects were randomly assigned to receive a partial resin denture fabricated either with or without 20wt% S-PRG fillers (n = 55 per group). After 14 days of wearing the dentures, 5,000 ppm fluoride gel was applied nightly on both sides of the denture before storing it in a denture box overnight every night for 1.5 years. The salivary fluoride concentration was measured at baseline, on days 1, 14, and 15, and at 3 months and 1.5 years of wearing the denture. A significant increase in salivary fluoride concentration in the S-PRG denture group was observed from baseline to day 1, followed by a significant decrease to an approximate baseline level. After recharge with 5,000 ppm fluoride gel, salivary fluoride increased markedly on day 15 and remained elevated at month 3 through to 1.5 years. The resin denture base containing 20wt% S-PRG fillers demonstrated an initial fluoride release that increased saliva fluoride concentrations, but the fluoride release from within the material was short lived. The long-term effect of sustained fluoride release from the denture when combined with a regular fluoride recharge regimen may be beneficial for caries prevention.

Early childhood caries epidemiology, aetiology, risk assessment, societal burden, management, education, and policy: Global perspective.

BACKGROUND: This paper is a summary of the proceedings of the International Association of Paediatric Dentistry Bangkok Conference on early childhood caries (ECC) held in 3-4 November 2018. AIM: The paper aims to convey a global perspective of ECC definitions, aetiology, risk factors, societal costs, management, educational curriculum, and policy. DESIGN: This global perspective on ECC is the compilation of the state of science, current concepts, and literature regarding ECC from worldwide experts on ECC. RESULTS: Early childhood caries is related to frequent sugar consumption in an environment of enamel adherent, acid-producing bacteria in a complex biofilm, as well as developmental defects of enamel. The seriousness, societal costs, and impact on quality of life of dental caries in pre-school children are enormous. Worldwide data show that ECC continues to be highly prevalent, yet infrequently treated. Approaches to reduce the prevalence include interventions that start in the first year of a child's life, evidence-based and risk-based management, and reimbursement systems that foster preventive care. CONCLUSIONS: This global perspective on ECC epidemiology, aetiology, risk assessment, global impact, and management is aimed to foster improved worldwide understanding and management of ECC.

Effect of CPP-ACP Paste on Enamel Carious Lesion of Primary Upper Anterior Teeth Assessed by Quantitative Light-Induced Fluorescence: A One-Year Clinical Trial.

The purpose of this clinical trial was to evaluate the effect of 1 year of daily application of 10% w/v CPP-ACP (casein phosphopeptide-amorphous calcium phosphate) paste in addition to regular toothbrushing with fluoridated toothpaste on the remineralization of enamel carious lesions in preschool children using quantitative light-induced fluorescence (QLF). A total of 103 Thai children (aged 2(1)/2-3(1)/2 years) with high caries risk who had at least 1 enamel carious lesion (ICDAS 1-3) on the labial surface of the upper anterior teeth were assigned to receive either CPP-ACP paste (n = 53) or placebo control (n = 50) following toothbrushing with fluoridated toothpaste after lunch at school. QLF measurement was performed at baseline, 6 months and 1 year. At 1 year, a significant reduction in fluorescence loss (ΔF), lesion area and lesion volume (ΔQ; p ≤ 0.001) of the lesions were found over time in both groups. However, no significant difference was observed between the groups (p = 0.79, 0.98 and 0.88, respectively). There was no statistically significant difference between the odds of ΔQ transition to a stage of regression or arrest compared with progression from baseline to 1 year between the two groups (OR = 1.03, 95% CI 0.31-3.39). The daily application of 10% w/v CPP-ACP paste on a school day for 1 year resulted in no improvement of enamel carious lesion remineralization in the primary upper anterior teeth as assessed by QLF. The lesion improvement was not superior to remineralization from regular toothbrushing with fluoridated toothpaste alone in these children.

Periodontal Status and Potential Risk Factors in the Myanmar Population: Data from the First National Oral Health Survey in 2016-2017.

ABSTRACT: Periodontal disease is quite common in many developing countries, but no nationally representative data on periodontal disease is available in Myanmar until 2016. A nationwide cross-sectional survey with a stratified two-stage sampling method was conducted among 4668 participants aged 12-74 years. Periodontal assessments and self-administered questionnaire surveys were conducted to assess the periodontal status and risk factors in the Myanmar population using data from the first national oral health survey in 2016-2017. Descriptive statistics and logistic regression analysis were performed to assess the prevalence of periodontitis and its association with potential risk factors. The prevalence of gingivitis was 38.2%, 41.5%, 44.4%, and 43.7% in 12, 15-18, 35-44, and 60-74 year-olds, respectively. The prevalence of periodontitis in the latter three age groups was 2.3%, 16.3%, and 35.2%, respectively. After adjusting for other risk factors, younger participants aged 15-18 years (odds ratio [OR]: 0.1, 95% confidence interval [95% CI]: 0.0-0.2) and aged 35-44 years (OR: 0.4, 95% CI: 0.3-0.5) were less likely to have periodontitis. Moreover, participants educated upto junior high school level (OR: 1.6, 95% CI: 1.1-2.7), primary school and below level (OR: 1.9, 95% CI: 1.2-3.2), everyday smokers (OR: 1.6, 95% CI: 1.3-2.0), and everyday tobacco chewers (OR: 1.5, 95% CI: 1.2-1.8) were associated with increased risk of periodontitis. Periodontal complications were prevalent in Myanmar older adults. Prevention efforts should focus on tobacco control and oral hygiene.

Dental caries in the Myanmar population: Findings from the first national oral health survey in 2016-2017.

OBJECTIVES: This study aimed to investigate the dental caries status of indicator age groups as mentioned in the WHO pathfinder methodology, compare caries experiences among those age groups according to gender and geographical location, and assess the association between dental caries and related risk factors in primary and permanent dentition. METHODS: A sample of 5928 participants aged 6, 12, 15-18, 35-44 and 60-74 years were recruited from 21 selected townships in the first Myanmar national oral health survey. Clinical oral examinations and questionnaire-based surveys were conducted from December 2016 to January 2017. RESULTS: The prevalence of dental caries in primary teeth was 85.3% with a mean dmft of 5.7 at age 6 years. The prevalence of dental caries in permanent teeth and mean DMFT were 36.5% and 0.8 at 12 years, 43.8% and 1.1 at 15-18 years, 64.7% and 3.0 at 35-44 years, and 93.6% and 11.5 at 60-74 years. Missing teeth were higher in 60-74-year-olds, with 27 participants being fully edentulous. There were significant differences in caries experiences between males and females aged 15-18, 35-44 and 60-74 years. In the adjusted logistic regression, consumption of sweets or candies three times or more a day showed significantly higher risks of dental caries in primary teeth. Age, gender, consumption of sweets or candies and consumption of sweet drinks were associated factors for dental caries in permanent teeth. CONCLUSION: The findings from the first national oral health survey indicate that caries in primary teeth is an important oral health problem for Myanmar children. Tooth loss was also found to be a concern in the aging population. National oral health policies and strategies need to be developed to promote awareness and understanding of oral health, in particular the role of risk factors such as sugary foods and drinks in tooth decay in children and adults.

Prevalence and susceptibility profiles of oral yeast species isolated from a healthy adult Thai cohort.

OBJECTIVE: As the emerging resistance of Candida species to common antifungals is a major global concern, we assessed the antifungal susceptibility of oral yeast isolates from a healthy, Thai adult cohort, and correlated the yeast prevalence with oral disease indices. METHODS: Oral rinse samples collected from 100 Thai adults were concentrated and cultured on CHROMagar Candida. The yeasts were then isolated, identified and finally speciated using Matrix Assisted Laser Desorption ionization-time of flight mass spectrometry. Their antifungal sensitivity against fluconazole, itraconazole, voriconazole, and amphotericin B were investigated using standard Etest strips. The decayed, missing, filled teeth (DMFT) and the periodontal health were recorded and correlated with mycological data. RESULTS: The overall oral yeast prevalence was 25%. C. albicans was the commonest species isolated, followed by C. tropicalis and C. dubliniensis. Non-albicans-Candida was noted in approximately one-third, and included C. lusitaniae and C. nivariensis; Trichosporon asahii, was also detected in one subject. A majority of C. albicans isolates, (> 54%), exhibited resistance to fluconazole and voriconazole, while approximately a quarter (27%) were resistant to itraconazole. The vast majority (92%) however, were susceptible to amphotericin B. Those with oral yeasts had a significantly higher DMFT score (p < 0.05). CONCLUSION: The resistance of a majority of Candida spp. to common azoles, described here for the first time in a Thai cohort, is disconcerting, and appear to confirm the creeping emergence of antifungal resistance globally. An incidental finding was the positive correlation between oral yeast carriage and DMFT score in Thai subjects.

A 5-year Prospective validation of the Miller-McEntire Periodontal Prognostic Index.

Background: This 5-year prospective survival analysis study aimed to examine the prognostic validity of a periodontal prognostic score specific for diseased molars: Miller-McEntire Periodontal Prognostic Index (MMPPI). Materials and Methods: One thousand and twenty-three molars were evaluated from 129 patients. The MMPPI scoring factors included age, smoking, diabetes, probing depth, mobility, molar type, and furcation involvement. MMPPI was computed as the sum of scores for all seven prognostic factors. Appropriate periodontal treatment and supportive periodontal therapy were provided. All patients were evaluated at baseline and annually posttreatment up to 5 years. Hazard risk ratios (HR) were computed for each prognostic factor, MMPPI scores assigned. The MMPPI score were then analyzed using Kaplan-Meier survival analyses. Results: A total of 31/1023 (0.3%) molars were extracted over the 5-year follow-up duration. Significant and positive hazard risk ratio (HR = 1.9) was noted for the total MMPPI score, validating its prognostic value for molar survival at 5 years prospectively. Kaplan-Meier survival analysis showed a significantly lower probability of molar survival with increasing MMPPI scores, where total score >8 showed worse survival probability over time. The hazard risk ratio was significant for individual prognostic factors: mobility (HR = 1.63), smoking (HR = 1.61), diabetes mellitus (DM) (HR = 1.4), molar type (1.97), and furcation involvement (2.22). Conclusions: The findings of the current study demonstrate significant prognostic validity of MMPPI scores for molar loss for 5 years, and a score >8 showed markedly worse molar survival probability in a well-maintained, university-based, prospective cohort. Mobility, smoking, DM, molar type, and furcation were component factors that were significant individual predictors.

Strategic Management of Early Childhood Caries in Thailand: A Critical Overview.

The aim of this report was to advocate early childhood caries (ECC) and share strategic management in Thailand, despite over two decades of free Universal Health Coverage including oral healthcare. The recent Thai national oral health survey in 2017 indicates the very high prevalence of ECC, with an average of three carious teeth affected in 53% of 3-year-old children. This is despite the efforts of the Ministry of Public Health that has launched several interventional programs ranging from an upstream policy that prohibits sugar additions in baby formula milk to downstream remediations such as advocating and encouraging toothbrushing with fluoride toothpastes. Nevertheless, ECC is strongly predicated by other key factors including the family and community commitment and participation, as embodied in the current World Health Organization guidelines. These encompass three different tiers of community-level prevention: primary, secondary, and tertiary. Accordingly, the following strategies for ECC management in Thailand should be based at primary care clusters (PCC) in sub-district health centers, with the assistance of inter-professional health teams. These include community education on the importance of deciduous teeth and effective toothbrushing with fluoride toothpaste (primary prevention), regular examination and detection of ECC lesions and early intervention (secondary prevention), insertion of non-invasive preventive restorations using cost-effective atraumatic restorative treatment (ART) or simplified and modified ART (SMART) (tertiary prevention), and, finally, effective follow-up and monitoring systems. It is anticipated that this triple tier approach to ECC management will improve not only the oral health but also the overall children's health.

Effects of Different Application Times of Silver Diamine Fluoride on Mineral Precipitation in Demineralized Dentin.

Silver diamine fluoride (SDF) is a cost-effective method for arresting active dental caries. However, the limited cooperation of patients may lead to an SDF application time that is shorter than the recommended 1-3 min for carious lesions. Therefore, the aim of this study was to assess the effect of different application times of SDF on the degree of mineral precipitation in demineralized dentin. Demineralized dentin specimens from permanent maxillary molars were treated by applying 38% SDF for 30, 60, or 180 s. Water was applied in the control group. The specimens were immersed in simulated body fluid for 2 weeks, and the mineral precipitation in demineralized dentin was then analyzed using FTIR-ATR, SEM-EDX, and synchrotron radiation X-ray tomographic microscopy (SRXTM). The FTIR-ATR results showed a significant increase in mineral precipitation in the 180 s group after 1 week. However, after 2 weeks, the SRXTM images indicated comparable mineral density between the 30, 60, and 180 s groups. The precipitation of silver chloride and calcium phosphate crystals that occluded dentinal tubules was similar in all experimental groups. In conclusion, an application time of either 30, 60, or 180 s promoted a comparable degree of mineral precipitation in demineralized dentin.

Innovation of dental education during COVID-19 pandemic.

BACKGROUND/PURPOSE: The impact of the pandemic of COVID-19 has a certain influence on various walks of life around the world. Because of the pandemic of this novel coronavirus in terms of COVID-19, the social life global wide has been changed a lot. To keep the social distance between human being to prevent from being infected is the most important strategy for all the countries. Many dental schools have been locked down to minimize the spread out of this coronavirus infection. Close contact between human being are required for all those learning process in traditional dental education. Learning methods should be innovated to keep on the learning process but away from being infected for dental education during pandemic. The purpose of this manuscript is to exchange the information and experience of those dental educators from different countries to prepare for the future demand for dental education during pandemic. MATERIALS AND METHODS: By means of three online symposiums, dental educators from different countries were invited to give presentation and discussion regarding to the information and experience in the innovation of dental education during the pandemic. RESULTS: The results showed that the impact of the pandemic of COVID-19 affects the dental education a lot. Intelligent technology has certain benefit for the learning process of dental education during the pandemic. CONCLUSION: The impact of the pandemic of COVID-19 affects dental education a lot. The model of dental education should be innovated to suit different situations and novelty intelligent technology should be applied for future dental education.

Oral Health Policies to Tackle the Burden of Early Childhood Caries: A Review of 14 Countries/Regions.

Aim: Early childhood caries (ECC) has significant public health implications but has received inadequate global attention. There is limited information regarding the success of oral health policies implemented to address the challenges of ECC. This review aimed to summarize such policies to tackle ECC from different countries/regions. Method: Independent collaborators from 14 countries/regions (Australia, Brazil, Cambodia, China, Hong Kong, Egypt, India, Indonesia, Japan, Nigeria, Thailand, UK, USA, and Venezuela) collected the data. The ECC status, dental workforce, oral health policies on ECC prevention in different countries/regions were summarized by each country. Results: The findings indicated that ECC prevalence varied in different countries/regions. The lowest prevalence of ECC among 5-year-old children was found in Nigeria (7%), and the highest was found in Indonesia (90%). The existing dental workforce and resources are limited in most countries. The smallest dentist to population ratio was reported by Nigeria at 1:48,400, whereas the highest ratio was in Brazil (1:600). Out of 14, three (21%) countries namely India, Venezuela and Cambodia had no national oral health policies addressing ECC and four (29%) countries (Cambodia, China, India, Venezuela) had no publicly funded dental care program for 0-5-year-old children. Water fluoridation is available in four countries/regions (Australia, Brazil, Hong Kong, USA). Conclusion: ECC remains a global health challenge and dental workforce is limited. National/regional programs to tackle ECC are not yet prioritized in many countries/regions. Evidence to support demonstration projects is limited. Further research on the cost-effectiveness of interventions strategies is required for policymakers.

Perceived Preparedness of Dental Academic Institutions to Cope with the COVID-19 Pandemic: A Multi-Country Survey.

Dental academic institutions are affected by COVID-19. We assessed the perceived COVID-19 preparedness of these institutions and the characteristics of institutions with greater perceived preparedness. An international cross-sectional survey of dental academics was conducted from March to August 2020 to assess academics' and institutional attributes, perceived preparedness, and availability of infection prevention and control (IPC) equipment. Principal component analysis (PCA) identified perceived preparedness components. Multilevel linear regression analysis assessed the association between perceived preparedness and fixed effect factors (academics' and institutions' attributes) with countries as random effect variable. Of the 1820 dental academics from 28 countries, 78.4% worked in public institutions and 75.2% reported temporary closure. PCA showed five components: clinic apparel, measures before and after patient care, institutional policies, and availability of IPC equipment. Significantly less perceived preparedness was reported in lower-middle income (LMICs) (B = -1.31, p = 0.006) and upper-middle income (UMICs) (B = -0.98, p = 0.02) countries than in high-income countries (HICs), in teaching only (B = -0.55, p < 0.0001) and in research only (B = -1.22, p = 0.003) than teaching and research institutions and in institutions receiving ≤100 patients daily than those receiving >100 patients (B = -0.38, p < 0.0001). More perceived preparedness was reported by academics with administrative roles (B = 0.59, p < 0.0001). Academics from low-income countries (LICs) and LMICs reported less availability of clinic apparel, IPC equipment, measures before patient care, and institutional policies but more measures during patient care. There was greater perceived preparedness in HICs and institutions with greater involvement in teaching, research, and patient care.

Physical Properties of Glass Ionomer Cement Containing Pre-Reacted Spherical Glass Fillers.

The aim of this study was to assess the effect of different commercial liquid phases (Ketac, Riva, and Fuji IX) and the use of spherical pre-reacted glass (SPG) fillers on cement maturation, fluoride release, compressive (CS) and biaxial flexural strength (BFS) of experimental glass ionomer cements (GICs). The experimental GICs (Ketac_M, Riva_M, FujiIX_M) were prepared by mixing SPG fillers with commercial liquid phases using the powder to liquid mass ratio of 2.5:1. FTIR-ATR was used to assess the maturation of GICs. Diffusion coefficient of fluoride (DF) and cumulative fluoride release (CF) in deionized water was determined using the fluoride ion specific electrode (n=3). CS and BFS at 24 h were also tested (n=6). Commercial GICs were used as comparisons. Riva and Riva_M exhibited rapid polyacrylate salt formation. The highest DF and CF were observed with Riva_M (1.65x10-9 cm2/s) and Riva (77 ppm) respectively. Using SPG fillers enhanced DF of GICs on average from ~2.5x10-9 cm2/s to ~3.0x10-9 cm2/s but reduced CF of the materials on average from ~51 ppm to ~42 ppm. The CS and BFS of Ketac_M (144 and 22 MPa) and Fuji IX_M (123 and 30 MPa) were comparable to commercial materials. Using SPG with Riva significantly reduced CS and BFS from 123 MPa to 55 MPa and 42 MPa to 28 MPa respectively. The use of SPG fillers enhanced DF but reduced CF of GICs. Using SPG with Ketac or Fuji IX liquids provided comparable strength to the commercial materials.

Mitigating Global Oral Health Inequalities: Research Training Programs in Low- and Middle-Income Countries.

Although oral diseases are largely preventable, they are among the most non-communicable diseases globally, and they disproportionately burden disadvantaged communities, specially within low- and middle-income nations. The COVID-19 pandemic has highlighted the social, economic, and health inequalities in our society, including the existing global oral health inequalities. There is a shortage of dentist-scientist all around the world, especially in developing countries, such as Thailand. The National Institute of Dental and Craniofacial Research (NIDCR) and Fogarty International Center (FIC), joined efforts on creating research capacity in oral health in South East Asia through the Fogarty International Center Training Program in Clinical, Public Health and Behavioral Oral Health Research for Thailand (2006-2016). The University of Washington (USA), Thammasat University (Thailand) and Khon Kaen University (Thailand) partnered to conduct short-, medium- and long-term training programs to build regional oral health research capabilities. Investing in research has not only impacted trainees' career development but enhanced advancement of oral health research of South East Asia. The success of partnership calls for expanding oral health research training in other low-income countries.

Behavior change due to COVID-19 among dental academics-The theory of planned behavior: Stresses, worries, training, and pandemic severity.

OBJECTIVE: COVID-19 pandemic led to major life changes. We assessed the psychological impact of COVID-19 on dental academics globally and on changes in their behaviors. METHODS: We invited dental academics to complete a cross-sectional, online survey from March to May 2020. The survey was based on the Theory of Planned Behavior (TPB). The survey collected data on participants' stress levels (using the Impact of Event Scale), attitude (fears, and worries because of COVID-19 extracted by Principal Component Analysis (PCA), perceived control (resulting from training on public health emergencies), norms (country-level COVID-19 fatality rate), and personal and professional backgrounds. We used multilevel regression models to assess the association between the study outcome variables (frequent handwashing and avoidance of crowded places) and explanatory variables (stress, attitude, perceived control and norms). RESULTS: 1862 academics from 28 countries participated in the survey (response rate = 11.3%). Of those, 53.4% were female, 32.9% were <46 years old and 9.9% had severe stress. PCA extracted three main factors: fear of infection, worries because of professional responsibilities, and worries because of restricted mobility. These factors had significant dose-dependent association with stress and were significantly associated with more frequent handwashing by dental academics (B = 0.56, 0.33, and 0.34) and avoiding crowded places (B = 0.55, 0.30, and 0.28). Low country fatality rates were significantly associated with more handwashing (B = -2.82) and avoiding crowded places (B = -6.61). Training on public health emergencies was not significantly associated with behavior change (B = -0.01 and -0.11). CONCLUSIONS: COVID-19 had a considerable psychological impact on dental academics. There was a direct, dose-dependent association between change in behaviors and worries but no association between these changes and training on public health emergencies. More change in behaviors was associated with lower country COVID-19 fatality rates. Fears and stresses were associated with greater adoption of preventive measures against the pandemic.

Evaluation of periodontally diseased molars in diabetics with Miller-McEntire Periodontal Prognostic Index.

AIM AND OBJECTIVE: The aim of this study was to prospectively determine and establish the periodontal prognosis of diseased molars in diabetic patients using the Miller-McEntire Periodontal Prognostic Index (MMPPI) with an additional criterion for diabetes (changes in glycosylated hemoglobin levels), at 2-year postperiodontal therapy. MATERIALS AND METHODS: A sample of 200 molars in 25 patients with diabetes mellitus (DM) and chronic periodontitis were evaluated. The prognostic parameters evaluated include age, probing depth (PD), mobility, furcation involvement, diabetes, and molar type. The total score calculated from all parameters was used considered prognosis score for each molar. All patients were evaluated at baseline and 2-year posttreatment. RESULTS: The results of this study suggest that following prognostic factors, DM (hazard ratio [HR] =5.2), age (HR = 0.4), and molar type (HR = 0.6) were clinically significant at the end of the 2-year posttherapy from baseline. A total of 4 (2%) teeth were extracted from the 200 teeth with a mean of 0.02 for the tooth lost during 2-year posttreatment. Significant improvements (P < 0.05) in the frequency PD, furcation, and mobility scores were noted at 2 years. CONCLUSIONS: These findings demonstrate that score for DM as prognostic criterion is a valid addition to MMPPI. The factors such as DM, age, and molar type can impact the prognosis of molar survival. Studies with a larger sample size and longer follow-up are required to affirm the findings of this preliminary study.

Prospective evaluation of periodontally diseased molars in smokers using the Miller-McEntire Periodontal Prognostic Index.

BACKGROUND: The purpose of this 2-year prospective survival analysis study is to determine a statistically validated periodontal prognostic score for diseased molars in smokers using the Miller-McEntire Periodontal Prognostic Index (MMPPI). MATERIALS AND METHODS: Two hundred molars were evaluated from 25 patients who were smokers with moderate-to-severe chronic periodontitis. The factors evaluated included age, probing depth, mobility, furcation involvement, smoking, and molar type. A modified, 5 level, scoring criterion for smoking based on smoking-dose was adopted. MMPPI was computed as the sum of scores for all six prognostic factors. Appropriate periodontal treatment and supportive periodontal therapy were provided. All patients were evaluated at baseline and 2 years posttreatment. Hazard risk ratio (HR) was computed for each prognostic factor. RESULTS: A total of 3 (1.5%) teeth of the 200 molars were extracted over the 2-year follow-up duration, with a mean of 0.015 teeth lost. The HR was found as significantly higher for three individual prognostic factors: mobility (HR = 5.57, P = 0.02), smoking (HR = 3.35, P = 0.04), and furcation involvement (HR = 7.30, P = 0.01). Significant and positive HR (HR = 1.70, P = 0.01) was noted for the total MMPPI score, validating its prognostic value for molar survival at 2 years prospectively. CONCLUSIONS: The findings of the current study demonstrate the prognostic validity of MMPPI incorporating a more detailed smoking score criterion. The factors smoking, furcation involvement, and mobility significantly impacted the likelihood of survival of periodontally diseased molars. Further studies with a larger sample size and longer follow-up are required to confirm these findings.