Smoke and mirrors - does smoking cause discolouration of composite restorations?

DATA SOURCES: Searches were carried out across PubMed, Embase, Scopus and Web of Science for studies published until 28th March 2022. STUDY SELECTION: In vitro studies assessing colour stability of resin-based composites (RBCs) exposed to conventional cigarette smoke (CS), tobacco heating systems (THS) or electronic nicotine delivery systems (ENDS) were considered. Included studies used a spectrophotometer or colorimeter for assessment of discolouration and measured discolouration using CIELAB or CIEDE2000 colour difference formulas. Literature not published in English was excluded. DATA EXTRACTION AND SYNTHESIS: Data was extracted from thirteen studies which met the inclusion criteria. A data collection form was used to collate the extracted information on sample shape, sample diameter, sample thickness, time elapsed before smoke exposure, smoke exposure protocol, colour measurement device, sample finishing method, brushing simulation and whether exposure was to CS, THS or ENDS. RESULTS: All 13 included studies analysed CS, four studies analysed ENDS and two studies analysed THS. A high level of variability was identified between the studies in relation to smoke exposure protocol. CS caused the highest level of discolouration of RBCs. CONCLUSIONS: This systematic review of in vitro studies found CS caused irreversible RBC discolouration. ENDS and THS caused less colour change, which could be reversed with repolishing or bleaching procedures, although evidence was limited. Further research is required to consider the long-term effect of CS, ENDS and THS on discolouration of RBCs.

Should we test asymptomatic children for SARS-CoV-2?

Design Cross-sectional study.Sample selection This study included 921 children (471 male, 450 female) due to receive either routine dental care involving aerosol generating procedures or comprehensive dental care under general anaesthetic. Data was collected at a paediatric dental clinic associated with the University of Illinois, Chicago. Patients were screened by a telephone questionnaire assessing for coronavirus disease 2019 (COVID-19) or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Asymptomatic patients and those with no known disease exposure went on to receive a reverse transcription polymerase chain reaction (RT-PCR) test for SARS-CoV-2, the causative pathogen for COVID-19. Those displaying symptoms of COVID-19 or who had potentially been exposed to the virus or disease were not included in this study and were referred for onwards medical advice.Data analysis Electronic dental records were accessed to retrieve patient demographics, insurance type, dental diagnosis and past medical history. The percentage of positive SARS-CoV-2 test results was calculated for each category. Positive and negative test results were compared appropriately for both categorical and continuous variables, with significance reached when p <0.05. SPSS version 27 was used for statistical analysis.Results This study found the positivity rate for SARS-CoV-2 to be 2.3% (21/921) in asymptomatic dental patients aged under 18 years. Age, insurance type, medical history and dental diagnosis were comparable in both positive and negative test result groups. The Hispanic/Latinx population had a higher percentage (3.1%) of positive tests than other groups. More male patients tested positive for SARS-CoV-2 (13 male, 8 female), but this was not statistically significant.Conclusions RT-PCR testing identified children carrying SARS-CoV-2 who had been cleared to attend an appointment following a screening questionnaire.

Presentation and surgical management of a superficial temporal artery pseudoaneurysm: A case report.

INTRODUCTION AND IMPORTANCE: A Superficial Temporal Artery Pseudoaneurysm is an uncommon, but important, differential diagnosis for masses in the head and neck region. This work has been reported in line with SCARE 2020 criteria [1]. CASE PRESENTATION: An 81-year-old male presented to the Oral and Maxillofacial Department with a facial swelling that had been present for a duration of three weeks. A provisional diagnosis of a haematoma was made and an ultrasound carried out to confirm diagnosis. Ultrasonography and CT Angiography confirmed a pseudoaneurysm arising from the left superficial temporal artery. CLINICAL DISCUSSION: Although this is a relatively uncommon diagnosis it is important to be aware of the key diagnostic tools used to identify a pseudoaneurysm. Specifically, their potential to exclude a pseudoaneurysm prior to diagnosing a simple post-traumatic haematoma. This is important as the treatment strategies for the two pathologies differ considerably. Useful learning points from this case include diagnostic aids such as the unique pulsatile nature of the mass and the role of ultrasonography and CT Angiography in confirming diagnosis and guiding surgical management. CONCLUSION: Pseudoaneurysms are an important consideration as a differential diagnosis of masses in the head and neck region. This case report may impact upon management of future similar cases by highlighting significant aspects of their clinical diagnosis and surgical management, enabling early identification and appropriate management.