The impact of the COVID-19 pandemic on 397 631 elective dental admissions among the under-25s in England: a retrospective study.

BACKGROUND: COVID-19 caused widespread disruptions to health services worldwide, including reductions in elective surgery. Tooth extractions are among the most common reasons for elective surgery among children and young people (CYP). It is unclear how COVID-19 affected elective dental surgeries in hospitals over multiple pandemic waves at a national level. METHODS: Elective dental tooth extraction admissions were selected using Hospital Episode Statistics. Admission trends for the first 14 pandemic months were compared with the previous five years and results were stratified by age (under-11s, 11-16s, 17-24s). RESULTS: The most socioeconomically deprived CYP comprised the largest proportion of elective dental tooth extraction admissions. In April 2020, admissions dropped by >95%. In absolute terms, the biggest reduction was in April (11-16s: -1339 admissions, 95% CI -1411 to -1267; 17-24s: -1600, -1678 to -1521) and May 2020 (under-11s: -2857, -2962 to -2752). Admissions differed by socioeconomic deprivation for the under-11s (P < 0.0001), driven by fewer admissions than expected by the most deprived and more by the most affluent during the pandemic. CONCLUSION: Elective tooth extractions dropped most in April 2020, remaining below pre-pandemic levels throughout the study. Despite being the most likely to be admitted, the most deprived under-11s had the largest reductions in admissions relative to other groups.

Oral health, dental treatment, and medication related osteonecrosis of the jaw in multiple myeloma - a longitudinal cohort study.

OBJECTIVE: The objective of the present study was to investigate oral health status, oral health related quality of life, and identify risk factors associated with invasive dental treatment and medication related osteonecrosis of the jaw in patients with multiple myeloma. MATERIAL AND METHODS: Patients newly diagnosed with multiple myeloma (n = 144) referred between January 2015 and September 2022 were retrospectively included. The patients underwent a thorough clinical and radiological oral examination and odontogenic infections were treated before the start of bisphosphonate treatment. The patients were followed annually, including clinical and radiological examinations. The oral health related quality of life was investigated by the OHIP-14 questionnaire. RESULTS: Dental treatment (RR = 7.75), receiving combination antineoplastic therapy≥3 (RR =4.13), periodontitis (RR = 4.21), and reduced number of teeth (RR = 2.87) were associated with an increased risk of medication related osteonecrosis of the jaw. The response rate of the OHIP-14 questionnaire was 70.2%. Oral pain or discomfort in the mouth related to the medical treatment was reported by 30.5%. CONCLUSION: Dental screening and treatment planning in patients with Multiple Myeloma may result in fewer oral infections and fewer interruptions of the medical treatment of myeloma.

Osteoinductive calcium phosphate with submicron topography as bone graft substitute for maxillary sinus floor augmentation: A translational study.

OBJECTIVES: The aim of this study was the preclinical and clinical evaluation of osteoinductive calcium phosphate with submicron surface topography as a bone graft substitute for maxillary sinus floor augmentation (MSFA). MATERIAL AND METHODS: A preclinical sheep model of MSFA was used to compare a calcium phosphate with submicron needle-shaped topography (BCPN , MagnetOs Granules, Kuros Biosciences BV) to a calcium phosphate with submicron grain-shaped topography (BCPG ) and autologous bone graft (ABG) as controls. Secondly, a 10-patient, prospective, randomized, controlled trial was performed to compare BCPN to ABG in MSFA with two-stage implant placement. RESULTS: The pre-clinical study demonstrated that both BCPN and BCPG were highly biocompatible, supported bony ingrowth with direct bone apposition against the material, and exhibited bone formation as early as 3 weeks post-implantation. However, BCPN demonstrated significantly more bone formation than BCPG at the study endpoint of 12 weeks. Only BCPN reached an equivalent amount of bone formation in the available space and a greater proportion of calcified material (bone + graft material) in the maxillary sinus compared to the "gold standard" ABG after 12 weeks. These results were validated in a small prospective clinical study, in which BCPN was found comparable to ABG in implant stability, bone height, new bone formation in trephine core biopsies, and overall clinical outcome. CONCLUSION: This translational work demonstrates that osteoinductive calcium phosphates are promising bone graft substitutes for MSFA, whereas their bone-forming potential depends on the design of their surface features. Netherlands Trial Register, NL6436.

Development of a Real-Time 6-DOF Motion-Tracking System for Robotic Computer-Assisted Implant Surgery.

In this paper, we investigate a motion-tracking system for robotic computer-assisted implant surgery. Failure of the accurate implant positioning may result in significant problems, thus an accurate real-time motion-tracking system is crucial for avoiding these issues in computer-assisted implant surgery. Essential features of the motion-tracking system are analyzed and classified into four categories: workspace, sampling rate, accuracy, and back-drivability. Based on this analysis, requirements for each category have been derived to ensure that the motion-tracking system meets the desired performance criteria. A novel 6-DOF motion-tracking system is proposed which demonstrates high accuracy and back-drivability, making it suitable for use in computer-assisted implant surgery. The results of the experiments confirm the effectiveness of the proposed system in achieving the essential features required for a motion-tracking system in robotic computer-assisted implant surgery.

Harnessing the Power of PAOO and Invisalign: An Interdisciplinary Approach to Orthodontic Care.

The present article explores the benefits of combining periodontally accelerated osteogenic orthodontics (PAOO) with Invisalign for optimal orthodontic treatment outcomes. PAOO is an interdisciplinary dental technique that minimizes complications and accelerates tooth movement while enhancing various orthodontic treatments. In conjunction with Invisalign, PAOO provides a discreet and comfortable solution for patients seeking to improve their smile. The study presents two challenging cases successfully treated using this combined approach, emphasizing the technique's potential to reduce treatment times and improve orthodontic outcomes. The interdisciplinary approach of PAOO ensures long-term success and stability by preserving periodontal structures and addressing potential bony defects. By incorporating bone grafting materials, PAOO helps prevent common concerns in traditional orthodontic treatments, such as bony defects and gingival recession. Furthermore, the combination with Invisalign offers a more aesthetically pleasing and comfortable treatment experience, allowing patients to maintain their self-esteem and confidence throughout the treatment. Despite the potential advantages, dental professionals must manage patient expectations and address potential complications to ensure the best possible results. Overall, the integration of PAOO and Invisalign demonstrates a viable alternative for patients who do not want to proceed with orthognathic surgery, enhancing patient satisfaction and overall treatment outcomes.

Should we be afraid of dental robots? / Faut-il avoir peur des robots-dentistes ?

As it seems likely that France, at the forefront in the use of surgical robotic platforms, will authorize the deployment of dental robots in the short term, the purpose of this article is to question what is at stake in this technological revolution, for dental professionals, regulators but also (and above all) for patients: what awareness-raising will the intervention of machines bring? How does robotics reshuffle the cards of the care relationship? What are the ethical and public health issues? After having defined dental robots as non-humanoid, automated surgical devices with exclusive restorative vocation, we will see how the field of dental robotics currently oscillates between hopes and illusions. We will describe the new responsibilities and ethical requirements related to the introduction of these AI-powered technical objects, as well as the necessary safeguards that have to be implemented in order to avoid any moral buffer and to protect patients from any robotization (literally or metaphorically in the sense of 'zombification'). Finally, we will show that ultimately the question of robot-dentists is the natural evolution of unreasonable application of industrial processes to the rationalization of health and ectopic, neo-liberal practices shifting healthcare into a commercial commodity. Patients can participate in reversing this trend, by recalling that the centrality of the human person is the cornerstone of health professions.

Comme il est vraisemblable que la France, à la pointe dans l'utilisation des plateformes robotiques chirugicales, autorise à court terme le déploiement de robots-dentistes sur son territoire, l'objectif de cet article est d'interroger ce qui se joue dans cette révolution technologique, pour les professionnels du dentaire, les régulateurs, mais aussi (et surtout) pour les patients : quelle(s) prise(s) de conscience l'intervention de la machine et les mutations qui lui sont associées peuvent-elles amener ? Comment la robotique rebat-elle les cartes de la relation de soin ? Pour quels enjeux éthiques et de santé publique ? Après avoir défini les robots-dentistes comme des dispositifs chirurgicaux automatisés à vocation réparatrice, pour l'instant non anthropomorphes, nous verrons comment le domaine de la robotique dentaire oscille entre espoirs et illusions. Nous décrirons les nouvelles responsabilités et exigences éthiques liées à l'introduction de ces objets techniques équipés d'intelligence artificielle, ainsi que les nécessaires garde-fous à implémenter pour éviter toute distanciation morale et pour protéger la patientèle de toute robotisation (au sens propre ou au sens métaphorique de « zombification ¼). Nous montrerons enfin que la question du robot-dentiste n'est finalement que l'évolution naturelle de l'application déraisonnée de procédés industriels à la rationalisation de la santé et de pratiques néolibérales ectopiques conduisant à sa marchandisation. Les patients peuvent participer à l'infléchissement de cette tendance, en rappelant que la centralité de la personne humaine constitue la pierre angulaire des métiers de la santé.

Surgical safety checklists for dental implant surgeries-a scoping review.

OBJECTIVES: In both elective surgeries and aviation, a reduction of complications can be expected by paying attention to the so-called human factors. Checklists are a well-known way to overcome some of these problems. We aimed to evaluate the current evidence regarding the use of checklists in implant dentistry. METHODS: An electronic literature search was conducted in the following databases: CINHAL, Medline, Web of Science, and Cochrane Library until March 2022. Based on the results and additional literature, a preliminary checklist for surgical implant therapy was designed. RESULTS: Three publications dealing with dental implants and checklists were identified. One dealt with the use of a checklist in implant dentistry and was described as a quality assessment study. The remaining two studies offered suggestions for checklists based on literature research and expert opinion. CONCLUSIONS: Based on our results, the evidence for the use of checklists in dental implantology is extremely low. Considering the great potential, it can be stated that there is a need to catch up. While creating a new implant checklist, we took care of meeting the criteria for high-quality checklists. Future controlled studies will help to place it on a broad foundation. CLINICAL RELEVANCE: Checklists are a well-known way to prevent complications. They are especially established in aviation, but many surgical specialties and anesthesia adopt this successful concept. As implantology has become one of the fastest-growing areas of dentistry, it is imperative that checklists become an integral part of it.

A qualitative analysis of caregiver perceptions of pediatric dental surgery under general anesthesia.

BACKGROUND: Dental surgery under general anesthesia (GA) is a common treatment for severe childhood caries and thus may serve as an event to motivate behavior change. The frequency of recurrent caries, however, indicates opportunities within current practice to change a child's oral health behaviors. AIM: To assess caregiver experiences related to their child's dental surgery to inform development of a behavioral intervention. DESIGN: Semi-structured interviews with caregivers of children receiving GA for dental surgery. Transcripts (n = 19) were analyzed using qualitative thematic methods. RESULTS: Children were 2-5 years of age, mean 3.8 years. Limited access to GA services was a source of caregiver frustration and a barrier to caries treatment. Surgical events elicited emotional reactions including guilt, anxiety, and a sense of caregiver accountability for development of severe caries. There was variation in caregiver awareness and/or motivation to change oral health behaviors. CONCLUSIONS: A child's dental surgery under GA is an emotionally challenging event yet may inspire hope and expectations for improvement. Surgery offers an opportunity to implement interventions at a time when caregivers may be open to assistance with behavior change, though stress and anxiety may create barriers. Behavioral interventions should be tailored to individual caregiver needs/barriers and stage of developmental readiness.

EFFECTIVENESS OF COMPOSED HERBAL EXTRACT IN THE TREATMENT OF GINGIVITIS AND ORAL AND PHARYNGEAL MUCOSA - REVIEW OF STUDIES.

Intensive studies on properties of synthetic compounds are simultaneously conducted with studies on the effectiveness and safety of drugs derived from natural compounds. These drugs have been effectively used for years in dentistry, in treatment of inflammatory conditions of the oral cavity and in laryngology, in treatment of pharyngeal inflammatory conditions. The subject of this article is a compilation of studies conducted on medicinal products containing composed ethanolic extract as an active substance, and obtained from: chamomile capitulum (Matricaria recutita L.), oak bark (Quercus spp.), sage leaf (Salvia officinalis L.), arnica herb (Arnica spp.), calamus rhizome (Acorus calamus L.), peppermint herb (Mentha piperita L.), thyme herb (Thymus spp.) Preclinical studies confirmed that a particular tested plant extract exhibits antimicrobial (antibacterial, antifungal and antiprotozoal) as well as anti-inflammatory, immunomodulatory and astringent properties. Under clinical conditions, it was confirmed that drugs containing the analysed extract used in periodontology, in prevention and complex treatment of gingivitis, periodontitis as well as diseases of oral mucosa (but also the throat) of viral, bacterial, fungal and protozoal aetiology significantly improved the effectiveness of therapy, shortened the treatment and improved the patients' quality of life. The above preparations used in dental surgery contributed to faster tissue regeneration, more quickly relieved pain and swelling after a surgery or difficult dentition. Furthermore, drugs containing the above-mentioned extract can also be successfully used for oral cavity decontamination in the case of various diseases of teeth or the oral and pharyngeal mucosa. The tested composed herbal extract (CHE), applied in the form of a mouthwash and in the form for topical application with benzocaine content (CHEB), is a component of drugs which are great alternatives to widely used synthetic drugs. They are characterised with high effectiveness, comparable to that of synthetic agents, and a higher safety profile. Results of pharmacological and clinical studies justify their use in both prevention and treatment of inflammatory diseases of the gums, periodontium, oral cavity and pharynx.

Early Dental Trade Card with Occupational Logo.

Merchants, trade and service people, professionals, and others sometimes used logos related to their businesses on advertising trade cards. Dr. Harry William Sale used a stock advertising trade card with his message on the reverse, containing a bright red detailed dentistry logo displaying a maxillary denture, extracted teeth, and multiple tools of the trade. This remarkably preserved card by Milton Wolf, copyrighted 1882, offers a perfect example of a Victorian Era trade/business card featuring an occupational logo.

The Anatomical Society's Core Anatomy Syllabus for Dental Undergraduates.

The Anatomical Society has developed a series of learning outcomes in consultation with dentists, dental educators and anatomists delivering anatomical content to undergraduate dental students. A modified Delphi methodology was adopted to select experts within the field that would recommend core anatomical content in undergraduate dental programmes throughout the UK. Utilising the extensive learning outcomes from two UK Dental Schools, and neuroanatomy learning outcomes that remained outside the Anatomical Society's Core Gross Anatomy Syllabus for Medical Students, a modified Delphi technique was utilised to develop dental anatomical learning outcomes relevant to dental graduates. The Delphi panel consisted of 62 individuals (n = 62) from a wide pool of educators associated with the majority of undergraduate dental schools in the UK, representing a broad spectrum of UK Higher Education Institutions. The output from this study was 147 anatomical learning outcomes deemed to be applicable to all dental undergraduate programmes in the UK. The new recommended core anatomy syllabus for dental undergraduates, grouped into body regions, offers a comprehensive anatomical framework with which to scaffold clinical practice. The syllabus, presented as a set of learning outcomes, may be used in a variety of pedagogic situations, including where anatomy teaching exists within an integrated dental curriculum (both horizontally in the basic sciences part of the curriculum and vertically within the clinical years).

Retropharyngeal abscess in a post-lung transplant cystic fibrosis patient with prior cervical fusion: a case study.

BACKGROUND: Cystic fibrosis (CF) is a chronic, genetic, incurable disease that affects primarily the respiratory and gastrointestinal systems. End-stage lung disease is the leading cause of death in people with CF, and lung transplant is required to preserve life. Anti-rejection medications are necessary post-transplant; however, these medications lower immune response and increase susceptibility to bacterial infections. Complications from infections post lung-transplant account for approximately 30% of CF-related deaths. Retropharyngeal abscess (RPA) is a rare deep neck infection that occurs most commonly in children. This is the case of a 45-year-old Caucasian male with CF who developed a retropharyngeal abscess post wisdom teeth extraction that seeded into hardware from a previous cervical disc fusion. CASE PRESENTATION: The patient presented to the emergency department with severe neck and shoulder pain, limited range of motion in his arm and neck, and dysphonia. He reported feeling pain for 10 days and suspected the pain was caused by a weightlifting injury. The patient reported low-grade fever 5 days prior, which responded to acetaminophen. He was afebrile upon admission and in no respiratory distress. Diagnostic labs revealed WBC 22,000/uL and CRP 211 mg/L. The CT scan showed a large abscess in the retropharyngeal space between C2-C7. The immediate concern was airway obstruction and need for possible intubation or tracheostomy. The patient was transferred to ENT service with neurosurgery and transplant consults. The RPA was drained and lavaged. The cervical hardware was discovered to be infected and was removed. The source of the RPA infection was determined to be from the patient's wisdom teeth extraction 6 months prior to RPA. The patient received 8 weeks of intravenous ceftriaxone for Streptococcus pneumoniae bacteremia and underwent revision of his cervical fusion 3 months after hardware removal. CONCLUSIONS: Clinicians should consider prophylactic antimicrobial therapy for immunocompromised patients when they are at increased risk for transient bacteremia such as following invasive procedures (e.g., tooth extraction). Prophylactic antimicrobial therapy could prevent potentially life-threatening infections such as RPA in immunocompromised patients.

Comparison of Aerosolized Hydrogen Peroxide Fogging with a Conventional Disinfection Product for a Dental Surgery.

AIM AND OBJECTIVE: The study aimed to determine the efficacy of adding a 12% hydrogen peroxide dry hydrogen peroxide vapor fogger system as an additional layer of infection control in a dental surgery. MATERIALS AND METHODS: A total number of agar plates from the five locations were used during the treatment of the 22 patients (n = 440). During the treatment of each patient, four agar plates (n = 4) were used per location [location 1: X-ray, location 2: the dental arm, location 3: left side desk, location 4: under the foot of the dental chair, location 5: ri ght side desk and (n = 20 for the five locations per patient)]. The control agar plates were incubated after the treatment of the patient was completed period. The test agar plate groups were sprayed with a 70% isopropanol surface disinfectant, or received exposure to an automated 12% hydrogen peroxide fog, or a 70% isopropanol surface disinfectant spray immediately followed by exposure to the automated 12% hydrogen peroxide. RESULTS: One-way ANOVA and Scheffé's method identified significant differences (p < 0.01). Between the control agar plates and the three disinfection methods used a significantly lower colony count was established for colonies recorded in the surgery assessed as a whole, the X-ray unit, and the ri ght side desk. CONCLUSION: The disinfection of dental surgery r equires sufficient time as it not only includes the working surfaces but also various inanimate objects. Surface disinfectant spray followed by hydrogen peroxide decontamination has potential for dental surgery, as the colony-forming units have been r educed further compared to spray alone and even just fog alone for all the various areas of the dental surgery that was assessed. CLINICAL SIGNIFICANCE: The infection control protocols with hydrogen peroxide vapor would ensure the maximum efficacy of the disinfection protocols.

[Clinical evaluation of the innovative concept of teeth saving]. / Klinicheskaia otsenka innovatsionnoi kontseptsii sokhraneniia zubov.

AIM: To evaluate the effectiveness of the innovative concept of dental medical technologies in patients with resected (amputated) roots of teeth with and without periodontal diseases. MATERIAL AND METHODS: Of the 516 examined patients with periapical destructive foci of infection of various genesis, 4 clinical groups of 24 people were randomly formed: (1) with a diagnosis of apical periodontitis of incisors, canines or premolars with individual milled transdental implants made of zirconium dioxide; (2) patients with a similar diagnosis and concomitant periodontitis of moderate severity with the same implants; (3) patients with periapical destructive process of molars without periodontitis with the same implants. Control group (4) included patients with similar diagnoses with resection of the root apex without implantation. Patients of the study groups were operated in accordance with the developed clinical protocols, including the manufacture and installation of individual transdental implants with fixation in the postoperative period, developed within the framework of tooth-preserving technologies of immobilizing structures. RESULTS: The reinforcement of teeth with resected roots with transdental implants together with immobilization of these teeth in the postoperative period restores the biomechanical characteristics of the tooth 2.7 times more effectively. However, there is a slight change in the mobility of the operated teeth in an earlier period (after 3 months), which is associated with the resorption of the bone-replacing agent used to fill the intraoperative defect and with the defective formation of bone tissue. The values of peritelomeric 6 months after the operation differ from the control by 1.4 units only.

Usefulness of a stool to stabilize dental chairs for cardiopulmonary resuscitation (CPR).

BACKGROUND: Cardiopulmonary resuscitation (CPR) requires immediate start of manual chest compression (MCC) and defibrillation as soon as possible. During dental surgery, CPR could be started in the dental chair considering difficulty to move the patient from the dental chair to the floor. However, all types of dental chairs are not stable for MCC. We previously developed a procedure to stabilize a dental chair by using a stool. EUROPEAN RESUSCITATION COUNCIL (ERC) guideline 2015 adopted our procedure when cardiac arrest during dental surgery. The objective of this study was to verify the efficacy of a stool as a stabilizer in different types of dental chairs. METHODS: Three health care providers participated in this study, and 8 kinds of dental chairs were examined. MCC were performed on a manikin that was laid on the backrest of a dental chair. A stool was placed under the backrest to stabilize the dental chair. The vertical displacement of the backrest by MCC was recorded by a camcorder and measured by millimeter. Next, the vertical displacement of the backrest by MCC were compared between with and without a stool. RESULTS: In all 8 dental chairs, the method by using a stool significantly reduced the vertical displacements of the backrest by during MCC. The reduction ratio (mean [interquartile range]) varied between nearly 27 [20] and 87 [5] %. In the largest stabilization case, the displacement was 3.5 [0.5] mm with a stool versus 26 [5.5] mm without a stool (p <  0.001). CONCLUSIONS: Our procedure to stabilize dental chairs by using a stool reduced the displacement of a backrest against MCC in all chairs. CLINICAL RELEVANCE: Effective MCC could be performed in dental chairs by using a stool when sudden cardiac arrest occurs during dental surgery.

Dr Guralnick's 'Secret' Mission.

Walter C. Guralnick, a major figure in Oral and Maxillofacial Surgery, educational innovator, master surgeon and mentor died, surrounded by family, on September 6, 2017 at Massachusetts General Hospital, the institution he loved and served for 65 years. Like others of his generation, Dr Guralnick served in the Armed Services in Europe during World War II. Little was known of his activities with the 7th General Hospital and of his contributions to the war effort. This paper brings together material from military, local and overseas archives to provide an insight into his life and work during those years.

Nasotracheal Intubation in Children for Outpatient Dental Surgery: Is Fiberoptic Bronchoscopy Useful?

BACKGROUND: The aim of our study was to compare the hemodynamic responses and adverse events associated with nasotracheal intubation (NTI) using a fiberoptic bronchoscope (FOB) and a direct laryngoscope (DLS) in children undergoing general anesthesia for outpatient dental surgery. METHODS: Eighty children (aged 5-15 years) were scheduled to undergo outpatient dental surgery under general anesthesia and of these children those who required NTI were included. RESULTS: NTI was significantly longer in the FOB group (P = 0.03). In both groups, systolic blood pressure (SBP) and heart rate (HR) significantly decreased after the induction of anesthesia when compared with the baseline values. SBP was significantly higher in both groups at intubation and 1 and 3 min after intubation when compared with postinduction. SBP significantly increased in the DLS group compared with the FOB group at intubation and 1 min after intubation. HR was significantly increased at intubation and 1 min after intubation in the DLS group compared with the FOB group. Nose bleeding after intubation was significantly more frequent in the DLS group (30%) than in the FOB group (7.5%) (P = 0.034). The incidence of sore throat 24 h after surgery was 20% (8/40) in the DLS group and 2.5% (1/40) in the FOB group (P = 0.014). CONCLUSIONS: There are fewer hemodynamic responses and adverse events in the FOB group than in the DLS group; therefore, FOB can be safely used for NTI in children undergoing outpatient dental surgery, and FOB may be more successful than DLS for NTI.

The assessment of accessory mental foramen in a selected polish population: a CBCT study.

BACKGROUND: Accessory mental foramen (AMF) is a rare anatomical variation. When accessory mental foramen is present, the nerves and vessels that go through the mental foramen (MF) must follow alternative courses and special care must be taken during dental treatment planning. The purpose of this study was to evaluate the occurrence and the location of AMF in a selected Polish population using cone-beam computed tomography (CBCT). METHODS: Two hundred CBCT (105 males and 95 females) examinations were evaluated for the presence of AMFs. The location and side of AMFs were reported. The mean distance between MF and AMF was also calculated. The vertical size of MF on the side with and without AMF was measured. The obtained variables were statistically analyzed. RESULTS: AMFs were observed in 7% of the patients. There was no statistically significant difference between the appearance of AMF and sex (p > 0.05). We found no significant difference in the vertical size of MF between individuals with and without AMFs (p < 0.05). CONCLUSION: Twenty-eight AMFs (7%) were observed from 400 sides of 200 patients. AMFs occurred more often in males (18 AMFs) than in females (10 AMFs). Twenty AMFs (71.4%) were located anteriorly, and eight (28.6%) - posteriorly. Fifteen AMFs (53.6%) were on the right side and thirteen (46.4%) - on the left.

A novel blue light laser system for surgical applications in dentistry: evaluation of specific laser-tissue interactions in monolayer cultures.

OBJECTIVES: The objective of this study was to examine a new blue light diode laser system (445 nm) for dental soft tissue surgery on cellular level. MATERIALS AND METHODS: An in vitro cell culture model was established to evaluate the effects of the 445-nm diode laser in comparison to an established infrared diode laser (IR). Monolayer cell cultures were irradiated and wound healing was morphometrically measured. Fluorescence staining was used for proof of potential DNA double-strand breaks as well as cytoskeleton alterations. Cellular live/dead discrimination was performed and temperature development during laser irradiation was measured with a thermographic infrared camera. RESULTS: A characteristic zone formation was detected after irradiation with both wavelengths. Despite a larger wound area after irradiation with 445 nm, due to its higher temperature development, this laser system showed a faster wound healing in comparison to the IR laser. No increase of devitalized cells was documented with higher distances between laser tip and cell layer and thus without thermal interaction. Neither cytoskeleton alteration nor DNA double-strand breaks could be recorded after irradiation in non-contact mode. CONCLUSIONS: The blue diode laser system demonstrated an excellent direct thermal coupling to cells and tissues without side effects even by reduced power settings. CLINICAL RELEVANCE: The blue diode laser seems to be a promising technology for clinical application due to high absorption of blue light without major side effects in adjacent tissues even by reduced power settings.

The effects of bispectral index monitoring on hemodynamics and recovery profile in developmentally delayed pediatric patients undergoing dental surgery.

BACKGROUND: General anesthesia is often preferred for dental surgery or rehabilitation in developmentally delayed pediatric patients. Bispectral index monitoring is used to monitor the depth of anesthesia and to ensure early recovery. However, studies on the topic in developmentally delayed pediatric patients are limited. AIM: To evaluate the effects of Bispectral Index Scale (BIS) on hemodynamics and recovery profile in developmentally delayed pediatric patients undergoing dental surgery. METHODS: Forty children between the ages of 6-16 years were studied in this prospective and randomized study. The children were randomized into two groups. In Group 1 (n = 20), general anesthesia was maintained with 1-2 minimum alveolar concentration (MAC) of sevoflurane in oxygen by standard practice. In Group 2 (n = 20), the depth of anesthesia was monitored by BIS. BIS values were continuously recorded from awake status to tracheal extubation. The duration of the surgical procedure, anesthesia, postanesthesia care unit (PACU) stay was noted. To evaluate recovery profile, time to spontaneous ventilation, extubation, open eyes, and PACU discharge were also noted. RESULTS: There were significant differences between recovery times and Non-communicating Children's Pain Checklist - Postoperative Version (NCCPC-PV) scores of two groups. Time to spontaneous ventilation [Difference in means (95% CI); 3.17 (1.79-4.54) P < 0.001], extubation [Difference in means (95% CI); 3.13 (1.66-4.60) P < 0.001], open eyes [Difference in means (95% CI); 3.97 (2.34-5.59) P < 0.001], and PACU stay time [Difference in means (95% CI); 23.55 (18.08-29.01) P < 0.001] were significantly shorter in Group 2. CONCLUSION: In conclusion, results suggest that routine BIS monitoring may be beneficial due to its favorable effects on the recovery profile in developmentally delayed pediatric patients.