A Multicultural Demographic Study to Analyze Antibiotic Prescription Practices and the Need for Continuing Education in Dentistry.

OBJECTIVES: The objective of the study was to understand and analyze the prescription patterns of dentists across various demographic locations for managing oral infections and pain with antibiotics and explore the evidence-based practices by clinicians as well as the need for further education. Materials and methods. This cross-sectional study was carried out using an online questionnaire framed to explore the knowledge, attitude, and practices among dentists with varying levels of experience and qualifications, regarding antimicrobial prescription. The questions were validated from previous published studies that explored the knowledge, attitude, and practice (KAP) with respect to antimicrobial prescription. In total, N = 300 of dentists from four different countries responded to the online questionnaire out of which 53% were specialists while 47% were general dentists. After data collection, descriptive analysis was carried out along with a one-sided hypothesis test to depict the power of the sample. RESULTS: It was seen from the results of the study that the first-choice antibiotics for 67.8% of dentists were found to be the ß-lactam group while sulfonamides and tetracyclines at 20% were the second most prescribed group. Another important finding was that 45.6% of dentists ignored hypersensitivity testing before prescription of antibiotics even though 83.3% of the total dentists interviewed were aware of the increase in antibiotic resistance. CONCLUSION: In conclusion, the dentists are partially aware of the guidelines but need further training and education on antimicrobial prescription that enables evidence-based decision-making for better practices and outcomes.

Effect of increasing the vertical intrusive force to obtain torque control in lingual orthodontics: A three-dimensional finite element method study.

CONTEXT: Biomechanical differences between lingual and labial orthodontics (LiO and LaO). AIMS: To investigate the effects of intrusive forces in lingual technique during retraction treatment mechanics. SETTINGS AND DESIGN: Intrusive forces act differently in both techniques because of the different location of force vectors in relation to the center of resistance. Increasing the vertical intrusive force is one of the methods routinely used to prevent the uncontrolled tipping and obtain bodily tooth movement in LaO. However, its effects in lingual technique need to be investigated to derive at an optimal treatment mechanics. SUBJECTS AND METHODS: Finite element method which has been successfully used to simulate tooth movement and optimize orthodontic mechanics effectively was used in this study. An accurate model of the upper central and lateral incisors with the surrounding structures was developed, and the "ANSYS" version 7.0 software was used for analysis. RESULTS: Intrusive forces as high as 3.6N was required to obtain translation in LiO that too in an undesirable direction. Efforts to obtain torque control by increasing the intrusive force only would not be successful. CONCLUSION: Forces that produce a translation in LaO tends to produce uncontrolled tipping in lingual technique. To obtain adequate torque control in lingual technique, a combination of the reduction in horizontal retraction forces, increased lingual root torque application, and increase in vertical intrusive forces is desirable.

Comparison of the dental arch changes in patients with different malocclusions.

AIMS AND OBJECTIVES: To evaluate the pre-treatment and post-treatment dental arch changes in both upper and lower arches in orthodontic patients treated with extraction of first premolar teeth. SUBJECTS AND METHODS: Measurements were made on casts of 50 post treated cases in the age group of 12-30 years for individual tooth measurements, width of the arches (inter-incisal, inter-canine, inter-premolar and inter-molar) arch length (both right and left sides, anterior segment, posterior segment and total arch length for both for the maxillary and mandibular dental casts. STATISTICAL ANALYSIS USED: Kolmogorov-Smirnov test for Normality, Regression Analysis was done as variables were tested and proved to follow normality. Statistical software  Statistical Package for the Social Sciences version 18 (SPSS Inc.; Chicago, Illinois, USA) was used for data analysis. Descriptive statistics and paired t-tests were used to compare the changes in the Class I and Class II div 1 groups. RESULTS: There was a significant increase in the inter-incisor and inter-canine width post-treatment in the Class I and Class II div 1 subjects in the upper arch but no significant change in inter-incisor width in the lower arch in class I subjects. A significant decline in the inter-molar arch width in both the groups were seen. The inter-premolar arch width declined significantly in Class I cases while it increased significantly in Class II div 1 subjects. There was a significant increase in anterior arch length and a significant decrease in posterior arch length in all subjects. CONCLUSIONS: The findings of this original clinical research should significantly help the orthodontists in orthodontic treatment planning in patients requiring extractions of premolars.

Effect of prostaglandin E1 versus corticotomy on orthodontic tooth movement: an in vivo study.

BACKGROUND AND AIM: The aim of the present study is to compare the effect of corticotomy versus prostaglandin E1 injection in human subjects on rate of tooth movement, anchorage loss and their effect on crest bone height and root length. SETTINGS AND DESIGN: Clinical interventional study. Split mouth design was used. MATERIALS AND METHODS: Study was done on 32 regular orthodontic patients. A volume of 100 mcg of prostaglandin E1 was injected on the right side once in 2 weeks and on the left side corticotomy was performed, and canine retraction was started on both sides simultaneously. The rate of space closure and anchorage loss was assessed with casts. The root length and crestal bone height changes were assed with IOPAs. The comparison of rate of tooth movement, anchorage loss, crestal bone height and root length changes between the sides were statistically analyzed using paired t-test. RESULTS: The average rate of space closure on right side was 0.36 mm/week with a standard deviation of 0.05 mm/week and on the left side average rate of space closure was 0.40 mm/week with a standard deviation of 0.04 mm/week. The difference between the rate of closure between the right side and left where found to be statistically significant (P=0.003). The anchorage loss, the crestal bone height changes and root length changes were not statistically significant. CONCLUSION: The rate of tooth movement was significantly more with corticotomies when compared with given dose of prostaglandin injection.

Treatment of division II malocclusion in young adult with Forsus fatigue-resistant device.

The traditional technique for correcting class II malocclusion - involving the use of class II elastics and headgear - has been problematic due to its dependence on patient compliance. Functional orthopedic treatment seeks to correct malocclusions and harmonize the shape of the dental arch and orofacial functions. Removable functional appliances are normally very large in size, have unstable fixation, cause discomfort, exert pressure on the mucosa, reduce space for the tongue, cause difficulties in deglutition and speech, and very often affect esthetic appearance. With a fixed appliance like the Forsus fatigue-resistant device (FRD), as the appliance is fixed, there is less dependence on patient compliance and the remaining growth after the pubertal growth spurt can be harbored effectively. The Forsus FRD is not as rigid as the previous fixed functional appliances and hence is comfortable for the patients. In this case report we describe a patient at the end of the growth stage who had mandibular retrognathia and was successfully treated with the Forsus FRD.