Testing a Consumer Wearables Program to Promote the Use of Positive Airway Pressure Therapy in Patients With Obstructive Sleep Apnea: Protocol for a Pilot Randomized Controlled Trial.

BACKGROUND: Although positive airway pressure (PAP) therapy is considered first-line treatment for obstructive sleep apnea (OSA), nonadherence is common. Numerous factors influence PAP use, including a belief that the therapy is important and effective. In theory, providing information to patients about their blood oxygen levels during sleep (which may be low when PAP is not used), juxtaposed to information about their PAP use, may influence a patient's beliefs about therapy and increase PAP use. With the advent of consumer wearable smartwatches' blood oxygen saturation monitoring capability (and the existing routine availability of PAP use data transmitted via modem to clinical dashboards), there is an opportunity to provide this combination of information to patients. OBJECTIVE: This study aims to test the feasibility, acceptability, and preliminary efficacy of the Chronic Care Management With Wearable Devices in Patients Prescribed Positive Airway Pressure Therapy (mPAP), a program that augments current PAP therapy data with consumer-grade wearable device to promote self-management of PAP therapy for OSA in a pilot randomized waitlist-controlled clinical trial. METHODS: This is a single-blinded randomized controlled trial. We will randomize 50 individuals with a history of OSA, who receive care from a Department of Veterans Affairs medical center in the Los Angeles area and are nonadherent to prescribed PAP therapy, into either an immediate intervention group or a waitlist control group. During a 28-day intervention, the participants will wear a study-provided consumer wearable device and complete a weekly survey about their OSA symptoms. A report that summarizes consumer wearable-provided oxygen saturation values, PAP use derived from modem data, and patient-reported OSA symptoms will be prepared weekly and shared with the patient. The immediate intervention group will begin intervention immediately after randomization (T1). Assessments will occur at week 5 (T3; 1 week after treatment for the immediate intervention group and repeat baseline for the waitlist control group) and week 11 (T5; follow-up for the immediate intervention group and 1 week after treatment for the waitlist control group). The primary outcome will be the change in 7-day PAP adherence (average minutes per night) from T1 to T3. The primary analysis will be a comparison of the primary outcome between the immediate intervention and the waitlist control groups (intention-to-treat design), using a 2-sample, 2-sided t test on change scores (unadjusted). RESULTS: Recruitment began in October 2023. Data analysis is expected to begin in October 2024 when all follow-ups are complete, and a manuscript summarizing trial results will be submitted following completion of data analysis. CONCLUSIONS: Findings from the study may provide additional insights on how patients with OSA might use patient-generated health data collected by consumer wearables to inform self-management of OSA and possibly increase their use of PAP therapy. TRIAL REGISTRATION: ClinicalTrials.gov NCT06039865; https://clinicaltrials.gov/study/NCT06039865. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/60769.

The Prevalence and Correlates of Fissured Tongue Among Outpatients in Andkhoy City, Afghanistan: A Cross-Sectional Study.

BACKGROUND: Fissured tongue is a common manifestation of the tongue, marked by the presence of multiple prominent grooves or fissures on the dorsal surface of the tongue. However, there is a lack of studies focusing on the prevalence and factors associated with fissured tongue among patients attending an outpatient clinic in Afghanistan. AIM: The purpose of the current study was to determine the prevalence and factors associated with fissured tongue and its effects on the general health of adult outpatients in Afghanistan. PATIENTS AND METHODS: The cross-sectional survey was conducted among outpatient populations in Andkhoy City, Afghanistan, between September 2019 and December 2019. A convenience technique was applied by including 1182 patient aged 18-80 years. Socio-economic status, smoking, nass use (smokeless tobacco use) and medical data were collected using face-to-face interviews. We used logistic regression analysis to identify factors associated with fissured tongue. A convenience technique was applied by including patient aged 18-80 years. RESULTS: The studied population consisted of 1182 participants, of whom 573 (48.5%) were males and 609 (51.5%) females. The prevalence of fissured tongue was 27.2% (95% CI: 24.7-29.9%) with males having significantly higher prevalence than females (47.5%, 95% CI: 43.3-51.6% versus 8.2%, 95% CI: 6.2-10.7%, p<0.001). Male participants (OR=7.1, 95% CI: 4.8-10.3), diabetes mellitus (OR=1.6, 95% CI: 1.1-2.3) and smokeless tobacco use (OR=12.0, 95% CI: 8.1-17.6) were the only variables independently associated with fissured tongue. CONCLUSION: This study suggested that there was a high rate of fissured tongue among an outpatient clinic in Andkhoy, Afghanistan. Male gender, diabetes mellitus, and nass consumption were associated with fissured tongue. Therefore, these factors might usefully be targeted in local health promotion, prevention and early intervention programs.

Comparison of Microleakage of Pedo Jacket Crowns and Stainless Steel Crowns Cemented with Different Cements.

OBJECTIVES: This study aimed to assess the microleakage of Pedo Jacket crowns compared to stainless steel crowns (SSCs) cemented with different luting cements. MATERIALS AND METHODS: In this in-vitro experimental study, 80 primary molars were randomly divided into four groups of 20 each. Groups 1 and 2 were subjected to standard tooth preparation for SSC. Crowns in group 1 were cemented with glass ionomer (GI), and crowns in group 2 were cemented with a resin-modified glass ionomer (RMGI) cement. In groups 3 and 4, minimal tooth preparation was performed for Pedo Jacket crowns, and the crowns were cemented with RMGI and Panavia resin cement, respectively. Microleakage was measured at mesial and distal surfaces in micrometers (µm), and the mean value for each tooth was calculated. Oneway analysis of variance (ANOVA) was applied to compare the microleakage of the four groups. RESULTS: Group 3 (Pedo Jacket cemented with RMGI) showed the highest microleakage (1523.83±250.32 µm) with significant differences with the remaining three groups (P<0.001). Microleakage in group 4 (Pedo Jacket cemented with Panavia) was significantly lower than that in the other three groups (301.25±219.53 µm, P<0.001). Groups 1 (SSCs cemented with GI) and 2 (SSCs cemented with RMGI) were not significantly different in terms of microleakage (P=0.49) although group 1 showed slightly higher microleakage than group 2 (598.43±260.85 µm versus 500.25±124.74 µm). CONCLUSION: Pedo Jacket crowns can serve as an acceptable esthetic alternative to SSCs if cemented with resin cements.

Comparison of Canine Overlap in Pediatric Patients Requiring Stainless Steel Crown Placement under General Anesthesia before and after the Procedure.

OBJECTIVES: Despite the increasing popularity of pediatric dental treatments under general anesthesia, information is scarce regarding occlusal changes in patients receiving stainless steel crowns (SSCs) under general anesthesia. This study sought to compare canine overlap before and after general anesthesia in children receiving SSCs. In case of a change, the possibility of returning to the preoperative state and the time required for this process were also evaluated. MATERIALS AND METHODS: This interventional, before-and-after study was performed on 60 children between 2 to 7 years of age requiring dental treatment under general anesthesia. The contact point of the most prominent area of the maxillary primary canine and mandibular primary canine was marked before and immediately after general anesthesia and at one and two weeks postoperatively. The change in canine overlap was analyzed using repeated measures analysis of variance (ANOVA) and linear regression test. RESULTS: Canine overlap significantly decreased immediately after general anesthesia (P<0.05). The mean bite opening was 0.51±0.22 mm at the site of the right canine and 0.50±0.185 mm at the site of the left canine. These values returned to their normal preoperative state after one week (P<0.05). Repeated measures ANOVA showed significant differences in this respect between the time points (P=0.002). CONCLUSION: The occlusion and vertical dimension of pediatric patients may change following dental treatment under general anesthesia; the magnitude of change in canine overlap may vary depending on the class of occlusion and number of SSCs placed. These changes are temporary and often resolve within a week.

Comparison of Shear Bond Strength of Composite to Stainless Steel Crowns Using Two Mechanical Surface Treatments and Two Bonding Systems.

OBJECTIVES: This study aimed to compare the shear bond strength (SBS) of composite to stainless steel crowns (SSC) using two mechanical surface treatments (MSTs) and two bonding systems. MATERIALS AND METHODS: Eighty-four SSCs were divided into six groups of 14; Group1: No MST+Scotchbond Universal adhesive (N+U), Group 2: Surface roughening by a diamond bur+Scotchbond Universal adhesive (R+U), Group 3: Sandblasting+Scotchbond Universal adhesive (S+U), Group 4: No MST+Alloy Primer+Clearfil SE Primer and Bond (N+A), Group 5: Surface roughening by a diamond bur+Alloy Primer+Clearfil SE Primer and Bond (R+A), Group 6: Sandblasting+Alloy Primer+Clearfil SE Primer and Bond (S+A). After MST and bonding procedure, composite cylinders were bonded to the lingual surface of SSCs, then the SBS of composite to SSCs was measured using a universal testing machine following thermocycling. RESULTS: The SBS of groups R+U and S+U was significantly higher than that of group N+U. No significant difference was noted in SBS of groups R+U and S+U. The SBS of group S+A was significantly higher than that of groups N+A and R+A. No significant difference was noted in the SBS of groups N+A and R+A (P>0.05). CONCLUSIONS: In Scotchbond Universal adhesive groups, sandblasting and surface roughening by diamond bur significantly increased the SBS of composite to SSCs compared to no MST. In Alloy Primer groups, sandblasting significantly increased the SBS of composite to SSC compared to surface roughening with diamond bur and no MST.

Excision of epulis granulomatosa with diode laser in 8 years old boy.

INTRODUCTION: Epulis granulomatosa is a lesion which grows from an extraction socket. It can be misdiagnosed with lesions of the same clinical appearance such as: foreign body or pyogenic granuloma, or as a herniation of the maxillary sinus. The most common treatment is surgical excision. CASE REPORT: The present article reports an Epulis granulomatosa which was removed with diode laser (810 nm) due to child's fear related to traditional surgical instruments and bleeding. RESULTS AND CONCLUSION: Lasers are useful for soft tissue surgery in modern dentistry, especially in relation to pediatric patients due to the rapid and regular wound healing without sutures.

Treatment of Ankyloglossia with Carbon Dioxide (CO2) Laser in a Pediatric Patient.

INTRODUCTION: Laser surgery as an alternative for conventional surgical procedure has gained special attention. Using Carbon Dioxide (CO2) laser has some benefits like less post-operative pain, swelling and infection, decrease in risk of metastasis and edema, and less bleeding providing dry sites for surgery. CASE REPORT: A 12 years old boy with lingual frenum with indication for excision was referred to the laser department of Tehran University of medical sciences dental school.CO2 laser was used with 10600 nm wavelength, 1.5 W output power, 100 Hz frequency and 400 µsec pulse duration in non-contact mode. RESULTS: The result of using CO2 laser was dry and bloodless field during operation, no post operative swelling, no pain or discomfort, with normal healing process. CONCLUSION: We suggest and stimulate the use of CO2 laser for soft tissue surgery because of elimination of suture, convenient coagulation, time saving, patients' comfort and easy manipulation.

Microleakage of stainless steel crowns placed on intact and extensively destroyed primary first molars: an in vitro study.

PURPOSE: The purpose of this investigation was to evaluate the effect of residual tooth structure on the microleakage of stainless steel crowns cemented with glass ionomer on primary maxillary and mandibular first molars. METHODS: Thirty extracted primary molars were divided into 2 groups: group 1 included intact teeth; and group 2 included extensively carious samples. Each tooth received standard preparation, and each crown was luted with G-CEM on its specific specimen. Teeth were loaded vertically and transferred to distilled water. After thermocycling and immersing in methylene blue solution, the teeth were sectioned and examined microscopically for microleakage. Data were analyzed using Mann-Whitney U and Wilcoxon signed-rank tests. RESULTS: All specimens (intact and damaged teeth) had microleakage, although most of these presented only minimum microleakage. No statistically significant differences were found in the microleakage of sound and extensively carious teeth on either the buccal (P=.62) or lingual (P=.65) side. Buccal (P=.73) and lingual (P=.63) surfaces showed similar microleakage scores in primary maxillary and mandibular molars. CONCLUSIONS: There was no significant difference in the microleakage of sound or extensively carious teeth and primary maxillary or mandibular first molars.