Epidemiological study on radiographic dental health in Albania.

The aim of this epidemiological study is to assess the dental health status of the Albanian population and the most frequently performed dental treatments, also highlighting the differences between sex, geographic area and educational level. The study was performed by analyzing digital orthopanoramic radiographs of 739 Albanian patients, male and female, divided into 5 age groups. In addition, the patients were divided according to regions of origin in North, Centre and South and classified according to the level of education. The parameters examined are as follows: Missed Teeth (MT), Filled teeth (FT), Endodontically treated teeth (TT), Prosthetic restorations (PR). There are no statistically significant results regarding the distribution by area. Subjects with at least one missing tooth (MT) decreases with increasing education level. The percentage of individuals with Missed Teeth in the population increases with increasing age groups. Educational background affects health. This study highlights the need to introduce a national oral health system in Albania that would extend interventions to a wider segment of the population.

Effect of pressure and light curing of composite micro hardness.

The aim of this study is to evaluate the micro hardness Vickers of a composite micro hybrid polymerized under constant pressure. Twelve experimental samples were made equally divided into two groups: an experimental group and a control. Enamel plus HRi (Micerium) microbiotic composite resin, UD3 colour, was inserted into a syringe heater (ENA HEAT Composite Heating Conditioner) so that the material could be brought to a temperature of 39°C. A defined amount of composite resin is taken from the syringe with a Heidemann spatula and placed between two slides, previously cleaned with 90 ° alcohol. The samples are then inserted one at a time into a special device for constant pressure application. Vickers hardness measurements were made on the top of surfaces. The mean value of the samples belonging to the experimental group is 56.81 ± 0.71. The mean value of the control samples is 52.02 ± 2. The results obtained allow us to state that applying a constant pressure during the cementation phase of indirect adhesive restorations allows to obtain better mechanical characteristics of the composite used as a cementing agent.

Dentinal substrate variability and bonding effectiveness: SEM investigation.

Though the literature reports a well-documented scientific evidence of the performance of modern adhesive systems on normal dentin, few researches are available on the interaction between adhesives and compromised dentin. In this study, the authors analyzed the microscopic structural aspects of the adhesive interface on two common altered dentin substrates: dentin contaminated by metallic oxides and caries affected dentin. Thirty teeth were selected and divided in three groups of ten teeth according to the different dentin substrate they had: (A) normal dentin, (B) caries-affected dentin and (C) dentin contaminated by metallic oxides. The experimental cavity preparation was realised exposing in each sample, portion of pathologic dentin and portion of sound dentin as control. Each cavity was restored with micro-hybrid composite, with total etching and a two-step adhesive system. Each sample was sectioned in two halves analysed with two SEM micro-morphological methods: direct observation and decalcification. SEM investigations were able to show the difference in thickness and morphology of the adhesive interface with the two different dentin variables. Caries affected dentin determined the formation of less distinctive resin tags with few micro-tags. Discoloured dentin showed a poor infiltration with few resin tags probably due to alterations in the tubular structures. The micro-morphological variability of dentin substrate influences the clinical efficacy of bonding restorations determining significant differences in the qualitative and quantitative aspects of resin tags.

Abuse potential of gabapentin in dentistry.

Gabapentin is an anticonvulsant drug widely prescribed for various ailments, including orofacial pain. It was once thought to have no potential for abuse; however, the last decade has seen a dramatic rise in the nonmedical use of gabapentin, particularly among opioid-dependent patients. Gabapentin is sedating and interacts with other sedating medications such as opioids, which can lead to impairment and accidents and may raise the risk of overdose. Dentists must be aware of the potential for abuse of gabapentin and weigh its benefits against its risks when prescribing the drug.

Epithelial and Fibrous Hyperplasia: An Oral Manifestation of Tuberous Sclerosis Complex. A Case Study.

The authors present a case study of a 13-year-old female with a past medical history of tuberous sclerosis complex (TSC), an autosomal dominant disorder. It usually presents with a triad of epilepsy, mental deficiency and facial angiofibromas that are often distributed around the nose, cheek and chin, and are frequently shaped like butterfly wings. In addition, oral manifestations include gingival enlargement and developmental enamel pitting on the facial aspect of the anterior permanent dentition in 50% to 100% of patients. The patient's chief complaint was gingival enlargement and gingival bleeding. The histology of the excised gingival tissue revealed epithelial and fibrous hyperplasia, consistent with TSC.

Open-label, randomized, non-inferiority clinical trial of artesunate-amodiaquine versus artemether-lumefantrine fixed-dose combinations in children and adults with uncomplicated falciparum malaria in Côte d'Ivoire.

BACKGROUND: Emergence of artemisinin resistance has raised concerns that the most potent anti-malarial drug may be under threat. Artesunate-amodiaquine (AS-AQ) and artemether-lumefantrine (AL) are, respectively, the first- and second-line treatments for uncomplicated falciparum malaria in Côte d'Ivoire. Constant monitoring by National Malaria Control Programme (NMCP) of drug efficacy is an important tool in establishing rational anti-malarial drug policies in Côte d'Ivoire. METHODS: In an open label, randomized controlled clinical trial, children and adults were randomized to receive AS-AQ or AL. Both drug regimens were given for three days, and follow-up was for 42 days. The primary endpoint was the 42-day cure rate and was defined as proportion of patients with PCR-corrected cure rate after 42 days of follow-up. RESULTS: A total of 383 patients who were attending the Anonkoua-koute (Abidjan), Petit Paris (Korhogo) and Libreville (Man) hospitals and presenting with symptomatic acute uncomplicated falciparum malaria were randomized to receive AS-AQ (188) and AL (195). The intention-to-treat analysis showed effectiveness rates of 94.7% and 96.4% for AS-AQ and AL, respectively on day 42. After adjustment for PCR, these rates were 96.8% and 99%, respectively. At day 42, in per-protocol analysis, Adequate clinical and parasitological response (ACPR) PCR uncorrected was 97.8% and 97.4% for AS-AQ and AL, respectively. The PCR adjusted ACPR was 100% for each combination and both regimens were well tolerated. CONCLUSIONS: This study has shown the high efficacy of AS-AQ in patients of all ages with acute uncomplicated falciparum malaria and AS-AQ was non-inferior to AL. Continuous efficacy monitoring is recommended.

Septic arthritis of the shoulder in a dental patient: a case report and review.

Septic arthritis of the glenohumoral joint is rare following dental procedures, comprising approximately 3% of all joint infections. Septic arthritis following bacteremia from dental procedures is uncommon and generally occurs in prosthetic joints. Predisposing causes may include immunocompromising diseases such as diabetes, HIV infection, renal failure and intravenous drug abuse. We report a rare case of unilateral glenohumoral joint septic arthritis in a 60-year-old male patient (without a prosthetic joint) secondary to a dental procedure. The insidious nature of the presentation is highlighted. Septic arthritis infections, though rare, require a high level of clinical suspicion. Vague symptoms of shoulder pain may mask the initial diagnosis, as was the case in our patient. Incision and drainage via surgical intervention are often required, followed by parenteral antibiotics.

Septic arthritis of the shoulder in a dental patient.

Septic arthritis of the glenohumoral joint is rare following dental procedures, comprising approximately 3% of all joint infections. Septic arthritis following bacteremia from dental procedures is uncommon and generally occurs in prosthetic joints. Predisposing causes may include immunocompromising diseases such as diabetes, HIV infection, renal failure and intravenous drug abuse. We report a rare case of unilateral glenohumoral joint septic arthritis in a 60-year-old male patient (without a prosthetic joint) secondary to a dental procedure. The insidious nature of the presentation is highlighted. Septic arthritis infections, though rare, require a high level of clinical suspicion. Vague symptoms of shoulder pain may mask the initial diagnosis, as was the case in our patient. Incision and drainage via surgical intervention are often required, followed by parenteral antibiotics.

Orally dissolving buprenorphine for opioid use disorder linked to caries.

BACKGROUND: Buprenorphine is under scrutiny because of the development of xerostomia and caries. The purpose of this article was to inform dental care professionals about the oral effects of buprenorphine and to increase knowledge and awareness of medication-assisted treatment in the management of opioid use disorder (OUD). CASE DESCRIPTION: In 2022, the US Food and Drug Administration issued a warning about xerostomia and caries associated with the use of transmucosal (sublingual and buccal formulations) buprenorphine. Dental health care professionals should instruct patients taking buprenorphine on how to prevent these dental issues by means of rinsing with water and swallowing once the drug has been completely dissolved, followed by toothbrushing at least 1 hour after taking the drug. In addition, a fluoride supplement should be prescribed. PRACTICAL IMPLICATIONS: It is imperative for dentists to recognize buprenorphine as medication-assisted treatment and to recognize a patient as having an OUD. While taking buprenorphine, the patient should have more frequent oral health care appointments, including home care instructions and caries risk assessment to monitor for caries and xerostomia so that treatment, if indicated, could be initiated as soon as possible. In addition, the dentist's role in OUD is to make sure patients follow the treatment recommendations and use the buprenorphine and to not have them discontinue because of potential caries risk.

Medical and dental standardization for solid organ transplant recipients.

Communication between the organ transplant team and dentist is important in formulating individualized care plans to reduce the incidence of pre- and post-transplant complications. Periodontal diseases and other oral infections may present serious risks that could compromise the success of a solid organ transplant. This article reviews why dentistry is an important component of total transplant care while the patient is on the waiting list for a transplant and after the transplantation. Recommendations regarding the care of the organ transplant patient are given.

Bleeding on probing: what does it mean?

A major part of the comprehensive periodontal examination involves the assessment and recording of bleeding on probing (BOP). Many factors can influence bleeding, including medications, systemic diseases, and smoking. A review of classic and current literature is presented, discussing the role of BOP as a clinical parameter in periodontics.

Head and neck cancer in two American presidents: Case reports.

Two former U.S. presidents, Ulysses S. Grant and Grover Cleveland, were diagnosed with head and neck cancer in 1884 and 1893, respectively. A historical review of the risk factors, diagnoses, and treatments is examined and compared with modern-day interpretations. A comparison was made using the original diagnoses with today's equivalent diagnosis. Different treatment outcomes at the time of the original diagnoses relative to today's treatment are reviewed. Clinicians must be familiar with risk factors, signs, symptoms, diagnosis, and treatment of head and neck cancer.

Doxycycline-induced dizziness in a dental patient.

Many dentists are unaware of the documented adverse drug reaction of doxycycline-induced dizziness. Because doxycycline is frequently prescribed in dentistry, it is important for dentists and patients to be aware of this significant adverse reaction to prevent medical complications. A clinical case is reported in which a patient developed dizziness after taking doxycycline that was prescribed following periodontal surgery. The dizziness resolved when the doxycycline was stopped. Patients and dentists should be educated to recognize the signs and symptoms of doxycycline's adverse reactions.

Doxycycline-induced dizziness in dental patient. Case report.

Many dentists are unaware of the documented adverse drug reaction of doxycycline: induced dizziness. Because doxycycline is frequently prescribed in dentistry, it is important for dentists and patients to be aware of this significant adverse reaction to prevent medical complications. A clinical case is reported in which a patient developed dizziness after taking doxycycline that was prescribed following periodontal surgery. The dizziness resolved when the doxycycline was stopped. Patients and dentists should be educated to recognize the signs and symptoms of doxycycline's adverse reactions.

Recognition and treatment of migraine patient in dental practice.

Migraine headache is a common, disabling clinical problem afflicting millions of Americans. Many dental problems are related to headaches and many conditions can cause orofacial pain and headaches, which complicates a definitive diagnosis. Temporomandibular joint disorders, toothache, jaw and sinus pain often coexist with headaches. A toothache of nonodontogenic origin may require a team of dentists and physicians to diagnosis and manage. It is important for the dentist to recognize and understand the management of common headaches, such as migraine, and be able to differentiate between a nonodontogenic headache and a "real" toothache.

Clinical antibacterial effectiveness Healozone Technology after incomplete caries removal.

AIM: Aim of this study was to evaluate the local effects of ozone gas on bacteria present within deep carious lesions after selective caries excavation. MATERIALS AND METHODS: The present study included 75 patients who had at least two Class I caries with deep lesion D2 and/or D3. The cavities were divided into 2 groups: the ozone group received treatment with Healozone X4, while the control group did not receive any treatment. Dentin samples were taken from both groups using two sterile multi-blade drills at 800 rpm without irrigation. The drills were then stored in separate tubes, each containing 5ml of RTF (Reduced Transport Fluid) and placed in culture for the next two hours. A total microbial count of the CFU of Streptococcus Mutans and Lactobacillus was performed. CONCLUSIONS: From the analysis of data on the dentin samples treated with ozone, there is a decrease in the bacterial load present in the infected carious dentin.

Implementation of the American Society of Anesthesiologists Physical Status classification system in periodontal practice.

The American Society of Anesthesiologists Physical Status (ASA-PS) classification is a preoperative rating given to each patient by an anesthesia provider with the sole purpose of assessing the physical state of the patient before anesthesia is administered. It was designed originally as a standardized way for dentists and physicians to convey information about the patient's overall health status and allow outcomes to be stratified by a global assessment of their severity of illness. However, in practice, the ASA-PS classification is often misused as a measure of operative risk, which is the basis of much criticism. Modification of periodontal treatment may be necessary in certain medically complex patients. The ASA-PS classification serves an integral part of risk assessment in determining how a patient should be managed by the periodontist. It should be incorporated into all periodontal practices. Medical assessment of patients has become an essential part of dentistry, as even the most common medical problems may require modifications to routine periodontal care. Periodontists must assess and manage patients for underlying medical conditions and are required to provide dental care to a diversity of medically complex patients. Today many patients in a periodontal practice have multiple medical conditions and are taking many medications. It is more difficult to manage these types of patients, and proper assessment of their physical status is an important part of clinical practice. The ASA-PS classification system is a valuable assessment tool that subjectively categorizes patients into subgroups by preoperative physical fitness prior to administering anesthesia.

Recognizing doxycycline-induced esophageal ulcers in dental practice: a case report and review.

BACKGROUND: Doxycycline-induced esophageal ulcer is a documented adverse drug reaction. Unfortunately, many health care professionals are not familiar with this particular drug reaction. Because doxycycline frequently is prescribed in the clinical practice of periodontics, it is important for dentists to be aware of this potential drug reaction. METHODS: The authors describe the case of a patient who was taking doxycycline after undergoing periodontal surgery and experienced a complication. The diagnosis revealed that the patient had developed an esophageal ulcer as a result of taking the doxycycline. RESULTS: The patient's esophageal ulcer resolved with the aid of dietary changes and a prescription of rabeprazole, a proton pump inhibitor. CONCLUSIONS: and CLINICAL IMPLICATIONS: The etiology of doxycycline-induced esophageal ulceration is complex, and proper diagnosis is essential for its resolution. Dentists should be aware of the potential for this adverse drug reaction.

A comprehensive analysis of Babe Ruth's head and neck cancer.

BACKGROUND: This article discusses the nasopharyngeal carcinoma (NPC) of American baseball icon Babe Ruth, as well as the diagnosis and treatment of NPC. CASE DESCRIPTION: NPC is a tumor originating from the epithelium of the nasopharynx. It is the leading form of cancer in certain well-defined populations in areas such as southern China, Southeast Asia, the Arctic, North Africa and the Middle East; it is relatively rare in the United States. Despite the fact that Babe Ruth's family was of German descent and NPC is not prevalent in Germany, reports regarding Ruth's autopsy demonstrate that his head and neck cancer was NPC. CLINICAL IMPLICATIONS: Dentists play a pivotal role in the recognition of oral signs and symptoms and in the diagnosis of NPC, as well as the subsequent oral care of patients during and after treatment.