Frequency of Four-dimensional Oral Health Problems across Dental Fields - a Comparative Survey of Slovenian and International Dentists.

OBJECTIVES: To compare the frequency of patients' oral health problems and prevention needs among Slovenian and international dentists with the aim to validate the four oral health-related quality of life (OHRQoL) dimensions across six clinical dental fields in all World Health Organization (WHO) regions. METHODS: An anonymous electronic survey in the English language was designed using Qualtrics software. A probability sampling for Slovenia and a convenience sampling strategy for dentist recruitment was applied for 31 countries. Dentists engaged in six dental fields were asked to categorize their patients' oral health problems and prevention needs into the four OHRQoL dimensions (Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact). Proportions of patients' problems and prevention needs were calculated together with the significance of Slovenian and international dentists' differences based on dental fields and WHO regions. RESULTS: Dentists (n=1,580) from 32 countries completed the survey. There were 223 Slovenian dentists (females: 68%) with a mean age (SD) of 41 (10.6) years and 1,358 international dentists (females: 51%) with a mean age (SD) of 38 (10.4). Pain-related problems and prevention needs were the most prevalent among all six dental fields reported by dentists; Slovenian (37%) and 31 countries (45%). According to Cohen, differences between Slovenia, the broader European Region, and 31 countries were considered non-significant (<0.1). CONCLUSION: According to the dentists' responses, the frequency of patients' oral health problems and prevention needs are proportionate between Slovenia and 31 countries, regionally and globally. The four OHRQoL dimensions can be considered universal across all dental fields.

Pediatric patients' reasons for visiting dentists in all WHO regions.

BACKGROUND: Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the four oral health-related quality of life (OHRQoL) dimensions (4D) or areas in which oral disorders impact pediatric patients. Using their dentists' assessment, the study aimed to evaluate whether pediatric dental patients' oral health concerns fit into the 4D of the Oral Health-Related Quality of Life (OHRQoL) construct. METHODS: Dentists who treat children from 32 countries and all WHO regions were selected from a web-based survey of 1580 international dentists. Dentists were asked if their pediatric patients with current or future oral health concerns fit into the 4D of the Oral Health-Related Quality of Life (OHRQoL) construct. Proportions of all pediatric patients' oral health problems and prevention needs were computed. FINDINGS: Data from 101 dentists treating children only and 523 dentists treating children and adults were included. For 90% of pediatric patients, their current oral health problems fit well in the four OHRQoL dimensions. For 91% of oral health problems they intended to prevent in the future were related to these dimensions as well. Both numbers increased to at least 96% when experts analyzed dentists´ explanations of why some oral health problems would not fit these four categories. CONCLUSIONS: The study revealed the four fundamental components of dental patients, i.e., the four OHRQoL dimensions (Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact) are also applicable for pediatric patients, regardless of whether they have current or future oral health concerns, and should be considered when measuring OHRQoL in the pediatric dental patient population.

The methodological quality is insufficient in clinical practice guidelines in the context of COVID-19: systematic review.

OBJECTIVES: The number of published clinical practice guidelines related to COVID-19 has rapidly increased. This study explored if basic methodological standards of guideline development have been met in the published clinical practice guidelines related to COVID-19. STUDY DESIGN AND SETTING: Rapid systematic review from February 1 until April 27, 2020 using MEDLINE [PubMed], CINAHL [Ebsco], Trip and manual search, including all types of healthcare workers providing any kind of healthcare to any patient population in any setting. RESULTS: There were 1342 titles screened and 188 guidelines included. The highest average AGREE II domain score was 89% for scope and purpose, the lowest for rigor of development (25%). Only eight guidelines (4%) were based on a systematic literature search and a structured consensus process by representative experts (classified as the highest methodological quality). The majority (156; 83%) was solely built on an informal expert consensus. A process for regular updates was described in 27 guidelines (14%). Patients were included in the development of only one guideline. CONCLUSION: Despite clear scope, most publications fell short of basic methodological standards of guideline development. Clinicians should use guidelines that include up-to-date information, were informed by stakeholder involvement, and employed rigorous methodologies.

Why Patients Visit Dentists - A Study in all World Health Organization Regions.

OBJECTIVE: The dimensions of oral health-related quality of life (OHRQoL) Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the major areas where patients are impacted by oral diseases and dental interventions. The aim of this study was to evaluate whether dental patients' reasons to visit the dentist fit the 4 OHRQoL dimensions. METHODS: Dentists (N = 1580) from 32 countries participated in a web-based survey. For their patients with current oral health problems, dentists were asked whether these problems were related to teeth, mouth, and jaws' function, pain, appearance, or psychosocial impact or whether they do not fit the aforementioned 4 categories. Dentists were also asked about their patients who intended to prevent future oral health problems. For both patient groups, the proportions of oral health problems falling into the 4 OHRQoL dimensions were calculated. RESULTS: For every 100 dental patients with current oral health problems, 96 had problems related to teeth, mouth, and jaws' function, pain, appearance, or psychosocial impact. For every 100 dental patients who wanted to prevent future oral health problems, 92 wanted to prevent problems related to these 4 OHRQoL dimensions. Both numbers increased to at least 98 of 100 patients when experts analyzed dentists' explanations of why some oral health problems would not fit the four dimension. For the remaining 2 of 100 patients, none of the dentist-provided explanations suggested evidence against the OHRQoL dimensions as the concepts that capture dental patients' suffering. CONCLUSION: Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact capture dental patients' oral health problems worldwide. These 4 OHRQoL dimensions offer a psychometrically sound and practical framework for patient care and research, identifying what is important to dental patients.

Successful Management of Peri-Implantitis around Short and Ultrashort Single-Crown Implants: A Case Series with a 3-Year Follow-Up.

INTRODUCTION AND AIM: In case of peri-implantitis, resective surgery is contraindicated for short and ultrashort implants, limiting the treatment options to regenerative surgery or to implant removal. This retrospective case series presents the clinical and radiographic outcomes of a surgical regenerative procedure to treat peri-implantitis around short and ultrashort implants. MATERIALS AND METHODS: The study is a retrospective evaluation of patients suffering from peri-implantitis and those who underwent access flap surgery, concomitant chemical and mechanical decontamination of implant surface, and bone grafting using a self-hardening mixture of bone substitutes and biphasic calcium sulfate. No membranes were applied to cover the grafting material, and primary tension-free closure was achieved. The retrospective protocol was reviewed and approved by the Ethics Committee for Clinical Sperimentation (CESC) of Verona and Rovigo, Italy (based in the University of Verona) (Prog. 1863CESC. Date of approval: 2018-07-04). RESULTS: 15 patients (17 implants) have been diagnosed with peri-implantitis after a mean follow-up of 24 months after loading. Implant length was between 5 and 8 mm. 8 patients (10 implants) had a history of periodontitis. At baseline, the mean PD (probing pocket dept) at the deepest site was 8.12 mm, with an average mBI (modified bleeding index) of 2.35 and a mean BD (bone defect depth) of 3.04 mm. At the 3-year follow-up, the CSR was 100%, the mean mBI was 0.88 (average reduction: -1.47), the mean PD was 3.35 mm (mean PD reduction: 4.77 mm), and the mean bone defect was reduced by 1.74 mm, with a mean bone fill of 55%. CONCLUSIONS: The results of the present case series suggest that if accurate surface decontamination is achieved, high survival rate and good clinical and radiographic results can be obtained after 3 years. However, only the histological examination could confirm the growth of new bone in direct contact with the implant surface or if the grafted material only fills the space left by the peri-implant defect.

Validity and internal consistency of the Maslach Burnout Inventory in dental students from Cartagena, Colombia / Validez y consistencia interna del Inventario Maslach para burnout en estudiantes de Odontología de Cartagena, Colombia

Abstract Objective: To determine the internal consistency and content validity of the Maslach Burnout Inventory-Student Survey (MBI-SS) in dental students from Cartagena, Colombia. Materials and methods: Scale validation study in 886 dental students from Cartagena, Colombia. Factor structure was determined through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Internal consistency was measured using the Cronbach's alpha coefficient. Analyses were performed using the Stata v.13.2 for Windows (Statacorp., USA) and Mplus v.7.31 for Windows (Muthén & Muthén, USA) software. Results: Internal consistency was α = 0.806. The factor structure showed three that accounted for the 56.6% of the variance. CFA revealed: x 2 = 926.036; df=85; RMSEA = 0.106 (90% CI, 0.100-0.112); CFI = 0.947; TLI = 0.934. Conclusions: The MBI showed an adequate internal consistency and a factor structure being consistent with the original proposed structure with a poor fit, which does not reflect adequate content validity in this sample.

Resumen Objetivo: Determinar la consistencia interna y la validez de contenido del Inventario Maslach para burnout-Encuesta para estudiantes (IMB-EE) en estudiantes de Odontología de Cartagena, Colombia. Material y métodos: Estudio de validación de una escala en 886 estudiantes de Odontología de Cartagena (Colombia). Se determinó la estructura de factores a través de análisis factorial exploratorio y confirmatorio, y la consistencia interna, con el coeficiente alfa de Cronbach. El análisis estadístico se realizó empleando Stata v.13.2 para Windows (StataCorp., Estados Unidos) y Mplus v.7.31 (Muthén & Muthén, Estados Unidos). Resultados: La consistencia interna general fue α = 0,806. La solución factorial mostró tres factores que explican el 56,6% de la varianza. El análisis factorial confirmatorio mostró: X 2 =926,036; gl = 85; RCEMA = 0,106 (intervalo de confianza del 90%, 0,100-0,112); ICA = 0,947; ITL = 0,934. Conclusiones: El IMB muestra adecuada consistencia interna y una estructura factorial coherente con la propuesta original, pero con ajuste pobre, lo cual no refleja adecuada validez de contenido en esta muestra.

[Validity and internal consistency of the Maslach Burnout Inventory in Dental Students from Cartagena, Colombia]. / Validez y consistencia interna del Inventario Maslach para burnout en estudiantes de Odontología de Cartagena, Colombia.

OBJECTIVE: To determine the internal consistency and content validity of the Maslach Burnout Inventory-Student Survey (MBI-SS) in dental students from Cartagena, Colombia. MATERIALS AND METHODS: Scale validation study in 886 dental students from Cartagena, Colombia. Factor structure was determined through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Internal consistency was measured using the Cronbach's alpha coefficient. Analyses were performed using the Stata v.13.2 for Windows (Statacorp., USA) and Mplus v.7.31 for Windows (Muthén & Muthén, USA) software. RESULTS: Internal consistency was α=.806. The factor structure showed three that accounted for the 56.6% of the variance. CFA revealed: χ2=926.036; df=85; RMSEA=.106 (90%CI, .100-.112); CFI=.947; TLI=.934. CONCLUSIONS: The MBI showed an adequate internal consistency and a factor structure being consistent with the original proposed structure with a poor fit, which does not reflect adequate content validity in this sample.

Psychological distress and its correlates among dental students: a survey of 17 Colombian dental schools.

BACKGROUND: Links between the demanding nature of studies in the health sciences, students' personality traits and psychological distress have been well-established. While considerable amount of work has been done in medicine, evidence from the dental education arena is sparse and data from Latin America are lacking. The authors conducted a large-scale investigation of psychological distress among dental students in Colombia and sought to determine its curriculum and student-level correlates. METHODS: The Spanish version of the Derogatis' Symptoms Checklist Revised (SCL-90-R) was administered to all students officially registered and attending classes or clinics in 17 dental schools in 4 geographic districts of Colombia between January and April 2012. Additional information was collected on participants' socio-demographic information and first career choice, as well as school's characteristics such as class size. The Global Severity Index (GSI) score, a measure of overall psychological distress, served as the primary analytical endpoint. Analyses relied on multilevel mixed-effects linear and log-binomial regression, accounting for study design and sample characteristics. RESULTS: A total of 5700 dental students completed the survey, a response rate of 67%. Pronounced gradients were noted in the association between socio-economic status and psychological distress, with students in higher strata reporting fewer problems. After adjustment for all important covariates, there was an evident pattern of increasing psychological distress corresponding to the transition from the didactic, to the preclinical and clinical phases of training, with few differences between male and female students. Independent of other factors, reliance on own funds for education and having dentistry as the first career choice were associated with lower psychological distress. CONCLUSIONS: Levels of psychological distress correlated with students' socio-economic and study-level characteristics. Above and beyond the influence of person-level factors, variations in levels of distress paralleled specific transitional stages of the 5-year dental curriculum, providing opportunities for targeted interventions.

Aumento del reborde alveolar residual mediante técnica de rollo / Increase of residual alveolar ridge using roll technique

La pérdida dentaria, asociada a factores sistémicos, patológicos y traumáticos, promueve el proceso de reabsorción ósea de los rebordes residuales y genera problemas funcionales, como la falta de estabilidad y retención de las prótesis dentarias removibles, y disturbios estéticos y psicológicos. Estos defectos varían en dependencia de la cantidad de pérdida ósea y de tejidos blandos que hayan alcanzado. En la actualidad son descritas diversas técnicas que permiten corregir estos defectos. Una de ellas es la técnica del rollo, la cual demuestra muy buenos resultados al aumentar el tamaño del reborde alveolar y disminuir los defectos estéticos que causa sobre todo en el sector anterior. El objetivo del presente artículo es describir el caso clínico de un paciente con pérdida ósea en el sector anterior, tipo III según Seibert, rehabilitado con prótesis parcial fija y sometido a un procedimiento quirúrgico con la técnica del rollo. Se alcanzaron los objetivos planteados y proporciona una mejoría estética así como una mejora en su calidad de vida. Se demostró que con esta técnica se obtienen resultados predecibles que devuelven la estética en zonas de alta exigencia por parte de los pacientes(AU)

Tooth loss associated with systemic factors, pathological and traumatic conditions, promotes the bone resorption of residual ridges, this, creates functional problems such as lack of stability and retention of removable dentures as well as aesthetic and psychological disturbances. These defects vary depending on the amount of bone loss and soft tissue they reach. At present there are described various techniques that can correct these defects. One of these is the roll technique which shows very good results by increasing the size of the alveolar ridge and decrease aesthetic defects in the anterior area of the maxilla. The aim of this article is to describe a case of a patient with Seibert bone loss type III, rehabilitated with fixed partial denture after undergoing a surgical procedure with the roll technique achieving the stated objectives and providing aesthetic improvement to the patient and an improvement in their quality of life. It is shown that the technique can be achieved with predictable results that return aesthetics in areas of high demand from patients(AU)

Mineral trioxide aggregate in primary teeth pulpotomy. A systematic literature review.

UNLABELLED: Evidence-based dentistry is a critical evaluation, awareness of the available evidence to improve decision making about the care of individual patients and/or communities. OBJECTIVE: To systematically analyze the available scientific literature on clinical and radiographic results of two materials used in pulpotomy in primary teeth: formocresol and mineral trioxide aggregate. MATERIALS AND METHODS: It was identified relevant publications through a search of electronic databases such as MEDLINE (Ovid) and The Cochrane Library. To be included in the review, studies had to define the material used in child patients with pulp exposure by caries or tooth-alveolar trauma. RESULTS: Of the 21 articles obtained in the initial phase of the review, only 19 were available in full text and of these only met the requirements for inclusion 6 items, which were confronted, analyzed and discussed later. CONCLUSIONS: The clinical evidence available showed significant differences regarding the use of a material or another. In addition to the findings of clinical follow--radiographic and taking into account the potential toxicity of formocresol suggest the use of mineral trioxide aggregate pulpotomy of primary teeth.