A city-wide survey of dental students' opinions on undergraduate oral surgery teaching.

PURPOSE: This study aimed to carry out a city-wide survey to evaluate undergraduate students' opinions on their oral surgery training by measuring their self-confidence. MATERIALS AND METHODS: A cross-sectional survey of 383 3rd year, 412 4th year and 363 5th year undergraduate dental students from six dental schools in Istanbul with a mean age of 22.73 ± 1.55 was conducted towards the end of the academic year. A web link to the questionnaire was sent to the contact person at the participating dental schools. The questionnaires were anonymously evaluated. Descriptive statistics were calculated, and Chi-square tests were performed to examine the data. A P-value of <.05 was considered to be statistically significant. RESULTS: In total, 1158 responses were returned, representing 67% of the overall students in the 2018-2019 academic year. The male respondents were significantly more self-confident than females in the general aspects of surgical skills. More than half of the respondents (53%) felt confident in oral surgery knowledge to undertake independent practice. Although 5th year respondents felt more confident in the general aspect of the questionnaire, their ability of differentiation of odontogenic and non-odontogenic pain was lower than their counterparts. The majority (86%) of the participants disagreed that the only knowledge required for oral surgery was that of tooth and jaw anatomy. CONCLUSION: This survey revealed perceived confidence in tooth and retained root extraction. The male respondents were found to be more self-confident. There is a need for improvement in surgical skills, recognition of malignancies and differentiation of the origin of the pain.

Students' perspectives on undergraduate oral surgery education.

PURPOSE: This study evaluated students' perceptions of their self-confidence regarding aspects of their undergraduate oral and maxillofacial surgical training. It further aimed to develop a reliable Turkish version of the questionnaire originally developed by the Association of British Academic Oral Maxillofacial Surgeons (ABAOMS) Education Committee. METHODS: A cross-sectional survey of 40 fourth-year and 47 fifth-year dentistry students of Yeditepe University Faculty of Dentistry in Turkey with a mean age of 23.30 ± 1.50 was conducted in January and February 2018. The ABAOMS questionnaire was adapted to the Turkish language and culture. The items were organized in five domains (general information, self-confidence in oral surgery, role of outreach, anatomy knowledge in relation to oral surgery, and career aspirations) with most response options on a five-point Likert-type scale. Reliability was assessed through an internal consistency analysis and a test-retest approach. Descriptive statistics, independent samples t-tests, and Chi-squared for contingency tests were used to examine the data. RESULTS: Cronbach's alpha coefficient on the questionnaire was 0.89. The responses reflected general agreement among the respondents. Females were significantly more self-confident than males. Although the fifth-year respondents were more self-confident than the fourth-year respondents on items regarding anatomy knowledge, fourth-year respondents were more self confident in forceps extractions. Other than that no major differences in self-confidence were found between the two groups. CONCLUSION: Though self-confidence was high regarding extraction of teeth and retained roots, the participants of this study lacked self-confidence in performing surgical extractions and its related procedures, recognition of malignancies, and ability to differentiate between pain of odontogenic or non-odontogenic origin. Female students were relatively more self-confident. Teaching should focus on practical applications that support students' sense of self-confidence in their abilities. The Turkish version of the questionnaire was a reliable instrument.

Three-Dimensional Volumetric Assessment of the Effect of Decompression on Large Mandibular Odontogenic Cystic Lesions.

PURPOSE: The primary approach to treating large cystic lesions is controversial. The aims of the present study were to assess the effects of decompression before enucleation for the treatment of large cystic lesions and to compare the rate of decrease of keratocystic odontogenic tumor, ameloblastoma, and dentigerous cyst at specific times (preoperatively and at 6 months). PATIENTS AND METHODS: The study included 40 patients (mean age, 31.22 ± 8.78 yr) with large mandibular lesions (>3 cm). Decompression was used to release intraluminal pressure and decrease the volume of the lesion. Three-dimensional computed tomography was applied to all patients at the diagnosis stage and at 6 months after decompression. Volumetric analysis was performed using software designed for 3-dimensional measurement of volumes. Other variables, such as age, gender, and rate of decrease, were recorded. RESULTS: There were important differences in rates of decrease between preoperative and 6-month lesion volumes. Statistical analyses showed no significant differences among groups for age, gender, and histologic lesion type (P > .05). CONCLUSION: Decompression of large cystic lesions could be useful for surgical interventions without complications.

Retrograde peri-implantitis: evaluation and treatment protocols of a rare lesion.

OBJECTIVE: Retrograde peri-implantitis (RPI) is defined as bone loss around an osseointegrated implant apex that usually appears within the first few months of its placement. This retrospective study aimed to evaluate the relationships between RPI and demographic factors, local bone and intraoral factors, and implant and surgery-related factors. METHOD AND MATERIALS: A retrospective study was conducted in 116 patients with a total of 369 implants placed between January and June 2019. The associations between RPI and the following data were evaluated: location of the recipient site, bone quality, reason for previous tooth loss, condition of adjacent teeth, marginal bone loss, immediate or late placement of implants, implant brand and size, activation of lesions, and treatment modality.
Results: Among the 14 (3.8%) implants that showed RPI, 10 (5.8%) were in the maxilla and four (?2.0%) were in the mandible, which were detected before prosthetic loading. There was no significant difference in terms of RPI between the arches. Of the 14 RPI implants, four (28.?6%) were placed into a previously periapical lesion site, three (21.4%) had endodontically treated adjacent teeth, two (14.3%) were immediately placed following extraction, three (?21.4%) revealed marginal bone loss, and one (7.1%) was lost at the abutment connection. Eight RPI implants healed spontaneously, while the remaining six were subjected to treatment (P = .05).
Conclusion: Local bone and intraoral factors, particularly the reason for tooth loss at the recipient site and the condition of the adjacent teeth, had stronger effects on RPI than other factors. (Quintessence Int 2021;52:112-121; doi: 10.3290/j.qi.a45264).

The preventive effect of medicinal herbal extract and gelatin sponge on alveolar osteitis: An in vivo micro-computed tomography and immunohistochemical analysis in rats.

OBJECTIVE: The purpose of this study was to evaluate the preventive effect of medicinal herbal extract (MHE) and gelatin sponge on alveolar osteitis (AO) in an experimental rat model. DESIGN: Twenty-one Sprague-Dawley male rats with a mean age of 12 weeks were used. After extraction of the maxillary right first molar, an AO model was created for each animal. The animals were randomly separated to three equal groups. Group I served as a control, Group II was subjected to an intra-alveolar MHE application, and gelatin sponge was left in the sockets of Group III. On the 7th post-extraction day, the animals were sacrificed. The specimens were analyzed by micro-computed tomography (micro-CT), histopathologically and immunohistochemically. RESULTS: Macroscopic evaluation revealed mild to intense signs of AO in all groups, but the difference was not significant (p < 0.05). Micro-CT analysis showed that bone formation was the highest in Group III (bone volume/total volume; 10.63 ± 4.9 %), whereas bone mineral density was the highest in Group I (2.05 ± 0.2 g/cm3). The difference was not significant (p > 0.05). In Group III, only 16.7 % of specimens showed no signal of inflammatory response (p < 0.01). The difference was not significant between the positive labeling for receptor activator of nuclear kappa-ß (RANK), receptor activator of nuclear kappa-ß ligand (RANKL), osteoprotegerin and osteopontin, but the intensity of Groups II and III was higher than the Group I for osteopontin (p < 0.01). CONCLUSIONS: MHE and gelatin sponge were not effective enough to prevent alveolar osteitis, but positive results were obtained in bone healing.

Does giving brief information keep patients calm during different oral surgical procedures?

OBJECTIVES: Dental anxiety may play a central role in the oral health status and treatment outcomes of oral surgical procedures. The study aimed to investigate the effect that brief written information has over patients undergoing oral surgical procedures and to evaluate factors that may cause anxiety. METHOD AND MATERIALS: A prospective study was performed on 38 mandibular third molar surgery patients (mean age 26.74 ± 6.44 years) and 56 implant surgery patients (mean age 49.13 ± 15.11 years). Each group was divided into two subgroups, and written information, explaining what they could expect and details about the procedure, was provided to study groups. The Spielberger State-Trait Anxiety Inventory was used to measure state (STAI-S) and trait anxiety (STAI-T). The visual analog scale (VAS) was used for pain scores preoperatively and on days 1, 3, 5, and 7. Demographic data and intraoperative behaviors of patients were recorded. RESULTS: All groups had similar anxiety scores at baseline. Preoperative STAI-S and VAS scores were similar between study and control groups (P > .05). Study groups showed significantly lower mean intraoperative anxiety levels (P < .05). The implant group had a significantly lower VAS score (P < .05). STAI-T and preoperative STAI-S were not related to VAS. Postoperative STAI-S and VAS and recuperation were correlated (P < .05). Women showed significantly higher anxiety and VAS scores. CONCLUSION: The patients who received written information did not report lower anxiety scores. However, improved patient cooperation could be achieved with this method. Different surgical procedures may cause anxiety for different reasons.

Evaluation of Significant Radiographic Findings and Their Impact on the Oral Health-Related Quality of Life of Patients with Complete Dentures.

PURPOSE: The aim of this study was to assess the frequency and location of positive radiographic findings in edentulous patients and to evaluate the oral health-related quality of life (OHRQoL) and complacency of patients with positive radiologic findings. MATERIALS AND METHODS: A total of 1,349 asymptomatic edentulous patients were retrospectively evaluated using a digital panoramic system for the presence of retained root fragments, impacted teeth, foreign bodies, radiolucencies, radiopacities, mental foramen at or near the alveolar crest, and maxillary sinus pneumatization. The patients with positive findings were called for a follow-up to take a new panoramic radiograph. The functional status and symptoms of participants were measured with the Oral Health Impact Profile (OHIP-14). RESULTS: At least one or more of the radiographic findings were observed in 35.21% of the evaluated radiographs. The most frequent finding was sinus pneumatization (20.9%). The mean total OHIP score was 9.74 ± 8.34. There was no statistically significant difference observed for gender, age, education levels, marital status, or having surgical interventions for total OHIP-14 scores (P > .05). CONCLUSION: The results of this study suggest that routine radiographic examination of edentulous patients may not be crucial before rehabilitation, and using a total percentage of positive radiographic findings may result in the exaggeration of the disease risk in edentulous patients.

Mandibular bone mineral density in patients with Behçet's disease.

OBJECTIVES: Behçet's disease (BD) is a chronic, recurring vasculitis of unknown etiology. Patients with BD may use a lot of medications associated with the clinical symptoms. Drugs that are used in the treatment of BD may cause bone loss. The aims of the current study were to compare the bone mineral density (BMD) values between BD and healthy volunteers and describe the effect of disease duration on mandibular BMD. MATERIALS AND METHODS: The study comprised 30 healthy volunteers (15 males and 15 females, mean age 35.50±6.80 years) and 45 patients with BD (24 males and 21 females, mean age 38.93±8.93 years). The BD group was subdivided according to disease duration (0-5, 6-10, and >10 years). The BMD value of the mandibular body was determined by the dual energy X-ray absorptiometry technique. RESULTS: The mean mandibular body BMD values were 1.294±0.21 g/cm(2) in the control group and 1.216±0.22 g/cm(2) in the BD patients, although there was no statistically significant difference. The BMD was observed to decrease with increased disease duration but not to a statistically significant degree. CONCLUSION: The results of this study showed that although the BMD value decreased as the duration of the disease increased, no statistically significant difference was found between the BD patients and the healthy control group.