Harnessing the power of collective intelligence in dentistry: a pilot study in Victoria, Australia.

BACKGROUND: In many dental settings, diagnosis and treatment planning is the responsibility of a single clinician, and this process is inevitably influenced by the clinician's own heuristics and biases. Our aim was to test whether collective intelligence increases the accuracy of individual diagnoses and treatment plans, and whether such systems have potential to improve patient outcomes in a dental setting. METHODS: This pilot project was carried out to assess the feasibility of the protocol and appropriateness of the study design. We used a questionnaire survey and pre-post study design in which dental practitioners were involved in the diagnosis and treatment planning of two simulated cases. Participants were provided the opportunity to amend their original diagnosis/treatment decisions after viewing a consensus report made to simulate a collaborative setting. RESULTS: Around half (55%, n = 17) of the respondents worked in group private practices, however most practitioners (74%, n = 23) did not collaborate when planning treatment. Overall, the average practitioners' self-confidence score in managing different dental disciplines was 7.22 (s.d. 2.20) on a 1-10 scale. Practitioners tended to change their mind after viewing the consensus response, particularly for the complex case compared to the simple case (61.5% vs 38.5%, respectively). Practitioners' confidence ratings were also significantly higher (p < 0.05) after viewing the consensus for complex case. CONCLUSION: Our pilot study shows that collective intelligence in the form of peers' opinion can lead to modifications in diagnosis and treatment planning by dentists. Our results lay the foundations for larger scale investigations on whether peer collaboration can improve diagnostic accuracy, treatment planning and, ultimately, oral health outcomes.

Study on the High Functional Contact Lens Material with Superior Oxygen Transmissibility and Antibacterial Properties.

The silicone monomer (SiH2) used in this study contains acrylate monomer, DMA (n,n-dimethylacrylamide). For the polymerization, PtOEP (platinum octaethylporphyrin) was added to the synthesized silicone, DMA (n,n-dimethyl acrylamide), HPMA (hydroxy propyl methacrylate), PEGMEMA [poly(ethylene glycol) methyl ether methylacrylate], EGDMA (ethylene glycol dimethacrylate) and the initiator AIBN (azobisisobutyronitrile) with various concentrations. Using the polymer produced through the thermal polymerization process, the optical and physical characteristics of high performance silicone hydrogel lenses were measured. The water content of sample containing PtOEP was in the range of 65.21∼66.56%. And also, oxygen permeability (Dk) of sample containing PtOEP was in the range of 30.20∼30.85 × 10-11 cm²/sec × mlO2/ml × mmHg. In case of the sample with nanoparticle, the oxygen permeability was higher than that of Ref. sample without nanoparticle. Silicone hydrogel monomer containing PtOEP was expected to be used usefully as a material for red tinted chromagen optical lens with high oxygen permeability for color amblyopia.

Preparation and Characterization of Novel Dental Material with High Shear Bond Strength.

HPMA (hydroxypropyl methacrylate) and Bis-GMA (bisphenol A glycerolate dimethacrylate), the main ingredients, and styrene, TEGDMA (triethylene glycol dimethacrylate), BPO (benzoyl peroxide) and camphoroquinone, the photo-initiators, and BHT (butylated hydroxytoluene), the photocatalyst were mixed by different ratios and stirred to investigate the compatibility of dental materials with photoinitiators. The degree of polymerization was checked and determination of the most ideal ratio for photopolymerization was followed by establishing the basic combination of styrene, HPMA, Bis-GMA, BHT, TEGDMA and HEMA. The mixture made in accordance to the predetermined ratio was stirred for 24 hours and was polymerized at a wavelength of 440 to 480 nm for 40 secs. The physical properties of each combination were also evaluated to analyze the functionality of the prepared resin cement. And also, the cytotoxicity of the samples was tested, and as a result, the cell lysis rate was 0% in negative control and 100% in positive control and 0% in S-1 combination which indicates that it does not possess cytotoxicity against cultured cells. It is considered suitable for commercializing and will be highly applicable as high quality dental resin cement.

Thermophysical properties and bonding with composite resin of premixed mineral trioxide aggregate for use as base material.

Dental bases require low thermal conductivity and good mechanical properties, such as bonding with composite resins. This study aims to elucidate the physicochemical properties of premixed mineral trioxide aggregate (MTA) for its suitability as a dental base and to explore the optimal adhesive strategy with composite resin. The thermal conductivity and compressive strength of this premixed MTA are 0.12 W/(m•K) and 93.76 MPa, respectively, Which are deemed adequate for its application as dental base. When bonded to composite resin, the use of 37% phosphoric acid etching before applying the Clearfil SE bond significantly reduced the bonding strength between composite resin and premixed MTA. This was because the compressive strength and Vickers hardness of premixed MTA decreased, and tricalcium silicate was dissolved from the surface during acid etching. Therefore, it is recommended to avoid using 37% phosphoric acid etching when bonding premixed MTA and composite resin as a dental base.

Hyperbranched double hydrophilic block copolymer micelles of poly(ethylene oxide) and polyglycerol for pH-responsive drug delivery.

We report the synthesis of a well-defined hyperbranched double hydrophilic block copolymer of poly(ethylene oxide)-hyperbranched-polyglycerol (PEO-hb-PG) to develop an efficient drug delivery system. In specific, we demonstrate the hyperbranched PEO-hb-PG can form a self-assembled micellar structure on conjugation with the hydrophobic anticancer agent doxorubicin, which is linked to the polymer by pH-sensitive hydrazone bonds, resulting in a pH-responsive controlled release of doxorubicin. Dynamic light scattering, atomic force microscopy, and transmission electron microscopy demonstrated successful formation of the spherical core-shell type micelles with an average size of about 200 nm. Moreover, the pH-responsive release of doxorubicin and in vitro cytotoxicity studies revealed the controlled stimuli-responsive drug delivery system desirable for enhanced efficiency. Benefiting from many desirable features of hyperbranched double hydrophilic block copolymers such as enhanced biocompatibility, increased water solubility, and drug loading efficiency as well as improved clearance of the polymer after drug release, we believe that double hydrophilic block copolymer will provide a versatile platform to develop excellent drug delivery systems for effective treatment of cancer.

Polyhedral Oligomeric Silsesquioxane Based Silicone Ophthalmic Contact Lens Material Containing Neodymium Nanoparticles.

This research was conducted to analyze the compatibility of used monomers and produce the high functional POSS-based ophthalmic polymer containing silicone monomers and neodymium nanoparticle. Synthesized silicone polymer (SiD), trimethylsilylmethacrylate (TSMA), N-vinyl-2-pyrrolidone (NVP) and neodymium nanoparticles were used as additives for the basic combination of polyhedral oligomeric silsesquioxane (POSS), and methyl methacrylate (DMA). And also, the materials were copolymerized with ethylene glycol dimethacrylate (EGDMA) as the cross-linking agent, azobisisobutyronitrile (AIBN) as the initiator. It is judged that the POSS-co-NVP polymer is optically good and thus have good compatibility. Especially copolymerization with TSMA showed high oxygen permeability, but with SID considered to be more stable judging by lens shape. Physical properties shows that the neodymium nanoparticle increases the wettability while maintaining water content. These materials are considered to make synergy effect each other, so it can be used in functional hydrogel ophthalmic lenses.

Effect of bone mineral with or without collagen membrane in ridge dehiscence defects following premolar extraction.

BACKGROUND: The purpose of this investigation was to evaluate the regenerative response to deproteinized porous bovine bone mineral (BM) when used alone or in combination with a bioresorbable porcine-derived bilayer collagen membrane (CM) for alveolar ridge augmentation in dogs. MATERIALS AND METHODS: The mandibular premolars were extracted unilaterally and three ridge defects were induced in six mongrel dogs. Each defect site was randomly assigned to one of the following treatment groups: BM alone (group A), BM in combination with CM (group B), or neither membrane nor bone graft, which served as a control (group C). No adverse events occurred during the experimental period. Dental computed tomography (CT) scans were taken after postoperative periods of 8 and 16 weeks. RESULTS: The percentage of CT-derived bone density in groups A and B was significantly different from that of group C (p < 0.01) at 8 and 16 weeks. The percentage of CT-derived bone density of the dogs in Group B was significantly higher than that of those in group A at 8 and 16 weeks (p < 0.01). Gross evaluation of the 3-dimensional CT reconstruction image of the canine mandibles after 16 weeks of implantation showed that group B had the greatest amount of bone augmentation and excellent thickness of the buccal aspect of the alveolar ridge. CONCLUSION: These results suggest that BM leads to more successful bone regeneration for guided bone regeneration procedures, especially in conjunction with the use of a CM as a barrier in order to promote the regeneration of canine alveolar ridge defects.

Tethered polymer nanoassemblies for sustained carfilzomib release and prolonged suppression of proteasome activity.

AIM: Proteasome inhibitors, such as carfilzomib (CFZ), have shown potential to treat various types of cancers in preclinical models, but clinical applications are limited likely due to formulation and delivery issues. Results & methodology: Tethered polymer nanoassemblies (TNAs) were synthesized by tethering hydrophilic polymers and hydrophobic groups to charged polymer scaffolds, and then end-capping remaining amines on scaffold. Drug entrapment and drug release half-lives increased as charge was removed from scaffold. TNAs with sustained CFZ release maintained drug efficacy after preincubation and increased duration of proteasome inhibition in cancer cells compared with free CFZ. CONCLUSION: TNAs fine-tuned CFZ release as charge was removed from polymer scaffold, which allowed for sustained proteasome inhibition in cancer cells and potentially enhanced anticancer efficacy.

Clinical evaluation of a biphasic calcium phosphate grafting material in the treatment of human periodontal intrabony defects.

PURPOSE: The aim of this study was to compare the clinical outcome of open flap debridement (OFD) with a biphasic calcium phosphate (BCP) graft to that of OFD without BCP graft for the treatment of intrabony periodontal defects (IBDs). METHODS: The study included 25 subjects that had at least one intrabony defect of 2- or 3-wall morphology and an intrabony component≥4 mm as detected radiographically. Subjects were randomly assigned to treatment with (BCP group, n=14) or without BCP (OFD group, n=11). Clinical parameters were recorded at baseline and 6 months after surgery and included the plaque index, gingival index, probing depth (PD), clinical attachment level (CAL), and gingival recession (REC). A stringent plaque control regimen was enforced for all of the patients during the 6-month observation period. RESULTS: In all of the treatment groups, significant PD reductions and CAL gains occurred during the study period (P<0.01). At 6 months, patients in the BCP group exhibited a mean PD reduction of 3.7±1.2 mm and a mean CAL gain of 3.0±1.1 mm compared to the baseline. Corresponding values for the patients treated with OFD were 2.5±0.8 mm and 1.4±1.0 mm, respectively. Compared to OFD group, the additional CAL gain was significantly greater in the patients in BCP group (P=0.028). The additional PD reduction was significant for the BCP group (P=0.048). The REC showed a significant increase in both groups, and the amount of recession was significantly smaller in the BCP group than OFD group (P=0.023). In radiographic evaluation, the height of the bone fill in the BCP group was significantly greater than OFD group. CONCLUSIONS: The clinical benefits of BCP found in this study indicate that BCP may be an appropriate alternative to conventional graft materials.