Acceptability of fully guided virtual implant planning software among dental undergraduate students.

BACKGROUND: Fully guided implant surgery as a technique is gaining popularity. It has been observed that use of surgical guides improves precision and predictability for dental implant placement. However, like any other newer technology, the acceptance of fully guided dental implant technology among users is based upon its perceived usability. This study aimed at evaluating the perception about using Virtual Implant Planning Software (VIPS) among undergraduate dental students at the university of Sharjah. METHODS: Ninety-Six dental surgery students from the University of Sharjah were included in the study. One week after the Virtual Implant Planning Software (Planmeca Romexis version 6.2 procedure, students were asked to complete a Combined technology acceptance model and the theory of planned behaviour (C-TAM TPB) questionnaire. Sixty-six students responded to the questionnaire. RESULTS: Cronbach's alpha surpassed 0.7 for perceived usefulness, perceived ease of use, perceived behavioral control, and subjective norm. Attitude and behavioural intention reported Cronbach's alpha values less than 0.7. Spearman's correlation coefficient was significant for all the constructs. Perceived ease of use explained 49%, 33%, and 42% of the variance of perceived usefulness (R2 = 0.49), attitude (R2 = 0.33), and perceived behavioral control (R2 = 0.42) respectively. Perceived usefulness explained 25%, 18%, and 23% of the variance of attitude (R2 = 0.25), behavioral intention (R2 = 0.18), and perceived behavioral control (R2 = 0.23) respectively. Attitude accounted for 25%, 33%, and 29% of the variance of behavioral intention (R2 = 0.25), perceived behavioral control (R = 0.33), and subjective norm (R = 0.29) respectively. CONCLUSION: The fully guided VIPS was acceptable by dental students specifically because of its usability. This makes VIPS a very effective tool for teaching implantology for dental students. VIPS also allows students to perform multiple repetitions of the implant planning procedure which enhances understanding and content retention.

Comparison of clinical outcomes of non-surgical adjunctive use of the 980-nm diode laser to conventional periodontal flap procedure-a randomised controlled split-mouth clinical trial.

Lasers have been found to be effective as an adjunctive in periodontal therapy. The objective of the study was to compare the outcomes of non-surgical adjunctive use of 980-nm diode laser to that of conventional flap surgery in terms of clinical outcome measures and radiographic osseous defect depths. This study was designed as a double-blinded split-mouth randomised controlled clinical trial. A total of fifteen patients (30 quadrants) with generalised periodontitis stage III grade B were randomly assigned test group (diode laser) and control group (conventional flap surgery). Both test and control groups had 15 quadrants each. At 3 months, the probing pocket depth (PPD) was 3.46 ± 0.19 mm (test) and 4.20 ± 0.20 mm (control), with a statistically significant difference between the groups (p = 0.01). Similarly, at 6 months re-evaluation, PPD was 1.46 ± 0.12 mm (test) and 2.33 ± 0.13 mm (control) with a highly significant statistical difference (p = 0.001). Plaque index showed a difference between both test and control groups at baseline, 3 months and 6 months (p = 0.001) while gingival index, modified sulcular bleeding index and radiographic osseous defect depth showed a difference at 3 months and 6 months (p = 0.001). Within the study's limitations, 980-nm diode laser can result in significant improvements in the clinical and radiographic parameters and is very well tolerated by the subjects.

Serum ceruloplasmin as cancer marker in oral pre-cancers and cancers.

BACKGROUND AND AIM: Oxidative stress leads to a compensatory increase in levels of serum ceruloplasmin in patients with such imbalances. Greater than normal serum ceruloplasmin levels are noticed in numerous cancers including the leukemias and Hodgkin's lymphoma. The purpose of the present study was to estimate and evaluate the efficacy of serum ceruloplasmin levels as a potential biomarker in the early detection of oral potentially malignant epithelial lesions (PMELs) including leukoplakia, oral submucous fibrosis (OSMF), and oral squamous cell carcinoma (OSCC) patients. MATERIALS AND METHODS: The present observational study was conducted over a period of 2 years wherein 100 subjects aged between 18 to 60 years were divided into four groups with Group A consisting of 25 healthy controls, Group B and C with 25 patients each, clinically diagnosed with oral leukoplakia and OSMF and Group D with 25 patients clinically diagnosed and histopathologically proven OSCC. The patients were subjected to incisional biopsy after routine hematological investigation while the same sera samples were used for analysis of serum ceruloplasmin levels. STATISTICAL ANALYSIS USED: Comparison of serum ceruloplasmin levels between the groups was performed using one way analysis of variance (one way ANOVA) test while P < 0.05 was considered statistically significant. RESULTS: The mean serum ceruloplasmin levels were found to be 43.19 ± 1.90mg/dl in subjects of group A, 47.68 ± 1.51mg/dl in group B, 47.74 ± 1.45mg/dl in group C and 47.73 ± 0.74mg/dl in group D. Using one-way ANOVA, statistically significant variations were found in the values of mean serum ceruloplasmin levels in subjects of the four groups (F-value = 59.58, P = 0.0001). CONCLUSIONS: The observations of the present study revealed that serum ceruloplasmin levels were found to be raised in all 3 study groups including oral leukoplakia, OSMF and OSCC as compared to the controls while the results were found to be statistically significant.

Analysis of inferior nasal turbinate width and concha bullosa in subjects with nasal septum deviation: a cone beam tomography study.

BACKGROUND: In individuals with nasal septal deviation (NSD), compensatory hypertrophy of the nasal turbinates occurs as a protective mechanism of the nasal passage from dry and cold air. NSD associated nasal turbinate hypertrophy is usually recurrent, requiring repetitive imaging. Therefore, a multiplanar imaging modality with a low radiation dose is best suited for long-term follow-up of this condition. This study aimed to evaluate the association of width of inferior turbinates and presence of concha bullosa with the degree of NSD using Cone beam computed tomography (CT). METHODS: The CBCT scans of 100 patients with NSD were selected as per convenience sampling and were evaluated by two maxillofacial radiologists. The width of the non-hypertrophied inferior turbinate (NHT) on the convex side of the NSD, and hypertrophic inferior turbinates (HT) on the concave side of the NSD were measured at three locations. The septal deviation angle (SDA) and the presence of concha bullosa (CB) were determined. RESULTS: A significant difference was observed in the anterior, middle, posterior, and mean widths between HT and NHT (p < 0.001). There was a significant difference in the widths of the HT and NHT among different types of NSD. A strong positive correlation (r = 0.71, p < 0.001) was found between SDA and the mean width of the HT. Age (P = 0.71) and gender (P = 0.65) had no significant difference among different types of NSD. Regression analysis revealed that the presence of CB (p = 0.01) and middle width of the HT (p < 0.001) are significant predictors of SDA and type of NSD. CONCLUSION: The results of the present study reveal that the middle width of the HT and the presence of CB influence the degree of NSD. The present study results recommend the use of CBCT as a substitutive low radiation dose imaging modality for evaluation of NSD, CB, and associated inferior turbinate hypertrophy.

The effect of concha bullosa and nasal septal deviation on palatal dimensions: a cone beam computed tomography study.

INTRODUCTION: Nasal septal deviation (NSD) and concha bullosa (CB) are associated with airway obstruction in mouth breathers. Mouth breathing is associated with alterations in maxillary growth and palatal architecture. The aim of our study was to determine the effect of the presence of CB and NSD on the dimensions of the hard palate using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: A retrospective study was conducted using CBCT scans of 200 study subjects. The study subjects were divided into four groups based on the presence of CB and NSD. Septal deviation angle (SDA), palatal interalveolar length (PIL), palatal depth (PD) and maxillopalatal arch angle (MPAA) were measured in the study groups. RESULTS: The presence of NSD and CB was associated with significant (p < 0.001) differences in the palatal dimensions of the study subjects. The PIL and MPA (p < 0.001) were significantly reduced (p < 0.001), whereas the PD was significantly increased (p < 0.001) in study subjects with NSD and CB. There was no significant change in the palatal dimensions between the unilateral and bilateral types of CB. Among the palatal dimensions, the PIL had the most significant association (R2 = 0.53) with SDA and CB. There was a significant correlation between the palatal dimensions and SDA when CB was present along with NSD. CONCLUSION: Based on the results of this study, it can be concluded that the presence of NSD and CB have a significant effect on the palatal dimensions and, therefore, they may be associated with skeletal malocclusion.

Talon cusp variations: 2 case reports.

Talon cusps in anterior teeth are relatively rare developmental anomalies. They are characterized by the presence of an accessory cusp-like structure projecting from the cingulum area or cementoenamel junction. Facial talons occur very rarely; <10 cases have been described in the literature. This article attempts to describe the variants of this anomaly with 2 case reports involving facial and bilateral palatal manifestation.

Evaluation of Serum and Salivary Lactate Dehydrogenase Levels in Patients with Oral Potentially Malignant Conditions/Lesions: A Clinical and Biochemical Study.

Background: Oral cancer encompasses all malignancies that originate in the oral tissues and remains a major public health problem throughout the world as an important case of poor health and illness. Head and neck cancer accounts for 9.8% of the estimated 6,44,600 incidental cancer cases in India. Oral Squamous Cell Carcinoma (SCC) is a serious and developing concern globally, accounting for more than 90% of malignant cancers of the oral cavity. Salivary diagnostics have been demonstrated to have potential in the detection and screening of oral pre-cancer and cancer in a variety of research settings. The continual and close contact between saliva and the mucosa, where cancer develops, is the foundation of this diagnostic capability. Materials and Methods: This research utilized spectrophotometry to quantify Lactate Dehydrogenase levels in serum and saliva of 30 healthy people which consisted the control group and 31 Oral Potentially Malignant people which constituted the study group. Results: On estimation and comparison, the mean Lactate Dehydrogenase levels in serum (397.4968+71.6392 IU/L) and saliva (675.4935+139.3352 IU/L) among patients with Oral Potentially malignant lesions/conditions were higher than the mean Lactate Dehydrogenase levels in serum (390.8667+71.0953 IU/L) and saliva (201.3700+89.1439 IU/L) among controls. Conclusion: Higher serum and salivary LDH levels in Oral Potentially malignant lesions/conditions than in control groups signifies the importance of assessing salivary LDH levels, in the prognosis of the same. Further prospective longitudinal studies are required to assess the salivary LDH levels among the patients with malignant transformation of Oral Potentially malignant lesions/conditions to oral cancers.

Establishing universal sectioning depth and angle for surgical coronectomy of impacted mandibular third molars: an imaging-based study.

Introduction: Coronectomy is a safer option than extraction for third molars with an increased risk of injury to the inferior alveolar nerve. However, it can still cause complications due to a lack of standardized and effective tooth sectioning techniques. We proposed a standardized protocol for third molar coronectomy involving standardized tooth sectioning parameters to minimize potential complications, surgical failure, and the need for further procedures. Methods: The study was conducted on 69 eligible archived CBCTs. The coronal sections of the mandibular at the anterior-most level of the lower third molar were used to determine various axes and reference points. This was done to establish the target angle and depth for the coronectomy sectioning. The data on the depth and angle of the sectioning was presented in means and standard deviation. A multivariate analysis of variance was used to determine the impact of study variables on drill depth and angle. Linear regression and correlation between study variables were also used to predict the drill depth and angle. Results: The samples included 46 males and 23 females aged from 21 to 47 years. The mean drill angle was determined as 25.01 ± 3.28. The mean drill depth was 9.60 ± 9.90 mm. The bucco-lingual tilt had a significant effect on the drill depth, F(1, 62) = 5.15, p < 0.05, but no significant impact on the drill angle, F(1, 62) = 29.62, p > 0.05. The study results suggest that a standardized sectioning protocol can be effective during surgical coronectomy procedures. Discussion: Drilling at a 25-degree angle to a depth of 9.5 mm is advisable to obtain the desired results. This approach will ensure no remaining enamel is left, minimize the chances of root extrusion and future eruption, and improve the outcome.

Impact of class II and class III skeletal malocclusion on pharyngeal airway dimensions: A systematic literature review and meta-analysis.

Background: This study is a pioneer systematic review and meta-analysis aimed at comparing the influence of Class II and Class III skeletal malocclusions on pharyngeal airway dimensions. It stands as the inaugural comprehensive assessment to collate and analyze the disparate findings from previously published articles on this topic. The objective of this study was to identify published articles that compare the effects of class II and class III skeletal malocclusion on the pharyngeal airway dimensions. Methods: An all-inclusive search for existing published studies was done to identify peer-reviewed scholarly articles that compared the influence of class II and class III skeletal malocclusion on pharyngeal airway dimensions. The search was done via five electronic databases: Cochrane Library, EMBASE, Scopus, Web of Science, and PubMed. Screening of the articles was done and the eligible studies were critically assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Results: The initial search yielded 476 potential articles of which, nine were finally included in this study for a total of 866 patients. Three studies were of cross-sectional design and six were of retrospective study design. Following a critical analysis and review of the studies, class III skeletal malocclusion had significantly larger volume and area measurements compared to class II skeletal malocclusion. Conclusion: Research in the field of literature has established that variations in skeletal classifications have a discernible effect on the size of the pharyngeal airways. With the advancement of skeletal malocclusions to a class III, there is an observed increase in both the volume and cross-sectional area of the airways.

Minor physical anomalies including palatal rugae pattern and palatal dimensions in children with sickle cell disease: A cross-sectional analytical study.

Background: Sickle cell disease (SCD) is the most common hereditary hemoglobinopathy, which delays growth leading to an altered skeleton and craniofacial pattern. Palatal rugae patterning has been considered the regulator of the development of the palate. The purpose of the research work was to study the morphology of the palate, rugae pattern, and its dimensions in SCD children and compare them with healthy normal children, and to evaluate its role as minor physical anomalies (MPAs). Methods: A cross-sectional case-control study was designed as per STROBE guidelines. The sample comprised 50 children diagnosed with sickle cell disease (Group SCD) and 50 normal healthy children as control (Group C) belonging to the same age group (10-18 years). Dental impressions were made, followed by the pouring of dental casts. The length of the palatal rugae was measured and categorized into primary (>5 mm), secondary (3 mm-5 mm), and fragmentary rugae (<3 mm). The shape of each primary palatal rugae was identified and categorized as curved, wavy, straight, circular and non-specific. Linear and angular measurements of the palatal rugae patterns and palatal dimensions (width, height, area) were measured and recorded. Results: The total number of palatal rugae and fragmentary rugae was lesser in Group SCD than in Group C (p < 0.05). The depth of the palate was significantly increased, whereas the area of the palate significantly decreased in Group SCD. Conclusions: The children with SCD showed distinctive palatal rugae patterns and dimensions when compared with normal healthy children that can be attributed as potential MPAs for sickle cell disease. Children with SCD had an under-developed palatal rugae pattern with a deep, narrow and small palate when compared to healthy children.The dimensions of the palatal rugae pattern in SCD showed reduced distance between the incisive papilla and the first and last rugae, indicating a further decrease in the anteroposterior dimensions of the palate. These findings may aid in the early diagnosis and prevention of malocclusion in children with SCD by appropriate interceptive orthodontic treatment.

Corrigendum to "A study on the association between the inferior nasal turbinate volume and the maxillary sinus mucosal lining using cone beam tomography" [Heliyon Volume 8, Issue 3, MARCH 2022, Article e09190].

[This corrects the article DOI: 10.1016/j.heliyon.2022.e09190.].

Efficiency of Near-Infrared Technology in the Clinical Detection of Carious Lesions: A Systematic Review.

The field of dentistry has seen various technological advances regarding caries detection, some lesions still prove to be difficult to detect. A reasonably new detection method, near-infrared (NIR), has shown good results in caries detection. This systematic review aims to compare NIR with conventional methods in terms of caries detection. Online databases (PubMed, Scopus, ScienceDirect, EBSCO, and ProQuest) were used for the literature search. The search was performed from January 2015 till December-2020. A total of 770 articles were selected, of that 17 articles qualified for the final analysis as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The articles were assessed according to a modified Critical Appraisal Skills Programme checklist, and then synthesis of the review started. The inclusion criteria were clinical trials done in vivo on teeth with active caries of vital or nonvital teeth. This review excluded nonpeer reviewed articles, case reports, case series, opinions, abstracts, non-English written articles, studies of subjects with arrested caries, or teeth with developmental defects of tooth structure and teeth having environmental defects of tooth structure, as well as in-vitro studies. The review compared near-infrared technology with radiography, visual inspection, and laser fluorescence in terms of caries detection, sensitivity, specificity, and accuracy. The sensitivity of NIR ranged from 99.1 to 29.1%. Studies showed that NIR exhibited higher sensitivity for occlusal enamel and dentin caries. The specificity of NIR ranged from 94.1 to 20.0%. In enamel and dentinal occlusal caries, NIR demonstrated lower specificity than that of radiograph. The specificity of NIR in early proximal caries was low. Accuracy was determined in 5 out of 17 studies where the values ranged from 97.1 to 29.1%. The accuracy of NIR was the highest for dentinal occlusal caries. NIR shows promising evidence as an adjunct in caries examination due to its high sensitivity and specificity; however, more studies are required to determine its full potential in different situations.

Knowledge and Preparedness of Dentists in Response to Bioterrorism.

Introduction: In the current climate of heightened terrorist activity, the deliberate release or threat of biological agents like viruses, bacteria, fungi, or their toxins to induce sickness or death among civilians has become a genuine possibility. The most crucial action during a bioterrorist strike is early warning. The possibility of such an occurrence in dental setting is underestimated. Methods and Materials: Seventy five graduate students participated in the research. In a survey on zoonotic diseases, participants were asked whether they were familiar with the transmission from person to person, if the diseases caused significant morbidity and mortality, whether they were simple to produce and disseminate, and whether they posed a high risk of infection. Results: Graph Prism was used to examine the data. A single proportion test was used to determine the "Aware Not Aware" group. The first 10 questions assessed dentists objective knowledge of bioterrorism. The importance of the last six questions was determined by their analysis of dentists' preparedness and desire to respond to a bioterrorism associated occurrence via perceived knowledge. Conclusion: Given the real danger they may face, dentists needed to be vigilant regarding the prevention, detection, and treatment of zoonotic illnesses transmitted in their offices or as a vector while being commended for their courage in the face of adversity.

A New Scoring System of Oral Lichen Planus.

Lichen planus (LP) is a chronic, immune-mediated mucocutaneous disorder increasingly becoming common in the general population with female predominance. Clinically, there are different forms of lichen planus with the presence of the main characteristic feature of Wickham striae. Literature, to date, is abundant with various scoring systems of oral lichen planus, and among them, the most commonly followed scoring system was the one proposed by the Thongprasom system because of its simplicity and ease of application. Aim: The aim of the present study is to critically review all the disease scoring systems on oral lichen planus (OLP) that have been reported in the literature during the past decades. A systematic literature search was performed using PUBMED, MEDLINE, EMBASE, and COCHRANE Library with language restriction to English. The search was carried out incorporating the published literature from 1980 to 2020 using the MeSH (medical subject heading) terms. A literature search was done using keywords: Staging, Grading, Oral lichen planus, Diagnostic, and Therapeutic. Out of 25 publications, related to search strategy, 22 full articles, which were related to the disease scoring system for oral lichen planus, were acquired for further inspection. Out of the 22 articles, 15 articles met the inclusion criteria. The data was collected and a brief summary of the studies regarding the different disease scoring systems for oral lichen planus was explained. Taking into consideration, the parameters were not included in the previous disease scoring system. A new proposal encompassing a scoring system for oral lichen planus considering the missing parameters along with an amalgamation of histopathological criteria of dysplasia is presented. It also proposes to grade and stage the lesions and recommend appropriate therapy for each of such lesions.

Multiple impacted second molars: a rare radiographic finding.

Impaction or cessation of eruption is a relatively common dental finding. The third molars are the teeth usually associated with impaction, followed by canines and premolars. Impaction of second molars has been rarely reported. This report reviews an extremely rare case of multiple impacted second molars, including a discussion of the clinical and radiological features of the case.

Impact of fully guided implant planning software training on the knowledge acquisition and satisfaction of dental undergraduate students.

BACKGROUND: A majority of dental school students do not undergo hands-on clinical training in implantology in the undergraduate curriculum. Training is usually restricted to pre-implant evaluation and post-implant prostheses. Virtual implant planning software (VIPS) provides an alternative opportunity for undergraduate students to experience implant planning much before gaining hands-on experience. However, not many studies have the contribution of VIPS to the knowledge acquisition of students. We conducted a preliminary study to evaluate the knowledge acquisition of the students when exposed to a hands-on session of VIPS. We also evaluated students' satisfaction levels, when exposed to hands-on training in fully guided implant planning software. METHODS: A two-part theory lecture on fully guided implant planning was delivered to 90, 5th (final)-year dental undergraduate students by the oral radiology faculty. The students were then randomly divided into three groups. Group A was exposed to didactic lectures only. Group B was shown a video for fully guided implant planning in addition to the didactic lecture. Group C was shown a video for fully guided implant planning in addition to a didactic lecture and then performed a hands-on session of virtual implant planning under faculty guidance. Students from all groups were given an MCQ-based test. After the completion of the test students from group A and B also received VIPS hands-on training. Students from all three groups answered and a feedback questionnaire regarding their satisfaction levels with VIPS. RESULTS: The overall test score of students in Group C was higher than their colleagues in both Groups A and B and the differences were statistically significant (p = 0.01). More than 85% of the students were satisfied with the teaching approach. CONCLUSIONS: The utilization of VIPS in the training of dental undergraduate students improves their performance confirming better knowledge acquisition and content mastery.

Efficiency and accuracy of artificial intelligence in the radiographic detection of periodontal bone loss: A systematic review.

Purpose: Artificial intelligence (AI) is poised to play a major role in medical diagnostics. Periodontal disease is one of the most common oral diseases. The early diagnosis of periodontal disease is essential for effective treatment and a favorable prognosis. This study aimed to assess the effectiveness of AI in diagnosing periodontal bone loss through radiographic analysis. Materials and Methods: A literature search involving 5 databases (PubMed, ScienceDirect, Scopus, Health and Medical Collection, Dentistry and Oral Sciences) was carried out. A specific combination of keywords was used to obtain the articles. The PRISMA guidelines were used to filter eligible articles. The study design, sample size, type of AI software, and the results of each eligible study were analyzed. The CASP diagnostic study checklist was used to evaluate the evidence strength score. Results: Seven articles were eligible for review according to the PRISMA guidelines. Out of the 7 eligible studies, 4 had strong CASP evidence strength scores (7-8/9). The remaining studies had intermediate CASP evidence strength scores (3.5-6.5/9). The highest area under the curve among the reported studies was 94%, the highest F1 score was 91%, and the highest specificity and sensitivity were 98.1% and 94%, respectively. Conclusion: AI-based detection of periodontal bone loss using radiographs is an efficient method. However, more clinical studies need to be conducted before this method is introduced into routine dental practice.

Osteoradionecrosis of the mandible and mastoiditis after radiotherapy for parotid mucoepidermoid carcinoma.

Osteoradionecrosis of the mandible in conjunction with mastoiditis is an extremely rare occurrence following irradiation of salivary gland malignancy in the orofacial region. We report one such case of a patient who presented to us with trismus, jaw pain, and ear discharge. Imaging of the jaws revealed classical features of osteoradionecrosis and mastoiditis. This case is important because presenting features like trismus and dental infection led us to investigative procedures that revealed extensive bone involvement including mastoiditis. Trismus progressively increased over a period of 8 years. In this case, we would like to emphasize the importance of good oral hygiene in the postradiotherapy stage for head and neck cancer.

Palatal schwannoma in an elderly woman.

Schwannoma also known as neurilemmoma is a benign tumour derived from schwann cells and is relatively rare in occurrence. Only 1% of the schwannomas in the head and neck region occur at intra-oral sites. Schwannomas usually occur during the third or fourth decades of life and the tongue is the most common intra-oral site. A case of intra-oral schwannoma in a 70-year-old female in the region of hard palate is described which is extremely rare.