ABSTRACT
OBJECTIVE: To evaluate dental students' perceptions of manual and digital cephalometric landmark identification methods based on their preferences, difficulty level, and procedure time required to provide insights into the future of dental education, considering incorporating digital technology in dental schools. MATERIALS AND METHODS: Fifty-five second-year dental students were randomly divided into two groups: (1) group A, students who performed manual landmark identification first, followed by digital method; and (2) group B, students who performed digital method first, followed by manual method. The duration of the procedure was recorded. Subsequently, all students completed a questionnaire regarding the difficulty they experienced using a visual analog scale and their preferences. Landmark identification accuracy was measured. RESULTS: Digital landmark identification was preferred by 93% of students. The mean procedure time for digital method was significantly lower than that of manual method (13.00 ± 5.60 vs. 9.70 ± 4.60; p = 0.002). Group B completed manual and digital methods in a shorter time than group A. Group A experienced less difficulty with manual procedure than group B. However, statistically significant differences were not observed in the difficulty level of digital technique. A statistically significant difference in the mean accuracy was shown in favor of the manual method. However, this difference is clinically insignificant (p = 0.001). CONCLUSIONS: Students considered digital method to be effective for learning and preferred it over manual method. Furthermore, digital landmark identification demonstrated better performance and was faster than manual method, suggesting that this must be incorporated in undergraduate dental education.
ABSTRACT
The objective of this study is to evaluate the effectiveness of discontinuing high-dose antiresorptive (AR) therapy in reducing the risk of medication-related osteonecrosis of the jaw (MRONJ) in patients treated with AR medications and undergoing dentoalveolar surgery or tooth extractions. The review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. A literature search was conducted using the databases MEDLINE, Embase, Web of Science, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) from inception till the 1st of April, 2022. Both observational and interventional studies that evaluated the effect of AR drug holiday in the development of MRONJ in patients receiving AR medications and who require dentoalveolar surgical procedures were included. Trials published as abstracts, case reports, case series, non-systematic reviews, and others were excluded. All findings were reported as odds ratios (ORs) and corresponding 95% confidence intervals (CIs). The Newcastle-Ottawa Quality Assessment Scale was used to evaluate the methodological quality assessment, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was used to evaluate the quality of the evidence. Eight articles (6808 subjects) were included for analysis. Of the participants, 4847 cases (drug holiday group) were compared to 1961 controls (non-drug holiday group). Based on the random effects model, the pooled summary OR was 0.73 (95% CI: 0.51-1.06) for the drug holiday group compared to the non-drug holiday group. In other words, the drug holiday group was not significantly different from the non-drug holiday group in the development of MRONJ following a tooth extraction procedure (p = 0.10). The statistical heterogeneity was low across all studies (I2 = 13%, p = 0.33). Within the limits of the available evidence, our findings revealed that drug holidays with AR will not minimize the risk of MRONJ and thus cannot be advised. It may be possible to arrive at more definitive conclusions from large prospective studies and randomized trials of good quality.
ABSTRACT
BACKGROUND: The clinical attachment level (CAL) and radiographically assessed bone levels are used to assess the loss of periodontal tissue support in periodontitis, a chronic, multifactorial inflammatory disease of the periodontium. However, few studies have been done to study the relationship between these two parameters. According to our knowledge, this is the first study investigating the relationship between the two measurements using intraclass correlation analysis. AIM: The aim of the study is to investigate the relationship between CAL and radiographically assessed bone level in teeth affected with periodontitis. METHODS: A retrospective cross-sectional study was conducted by selecting a sample of 880 periodontal sites in 104 periodontitis patients, aged 25-60 years. CAL and peri-apical radiographs of the selected sites were obtained from the computerized patient records. The distance from the cemento-enamel junction (CEJ) to the base of the alveolar bone level (ABL) was measured. The data was analyzed using SPSS. RESULTS: Intraclass correlation analysis (ICC) revealed a moderate degree of reliability between CAL and CEJ to ABL measurements. The average ICC was 0.68 with a 95% confidence interval of 0.53-0.77 (p < .001) indicating moderate to good reliability. Comparing the types of teeth, the central incisors, particularly the lower central incisors showed the highest ICC values (ICC: 0.822, CI: 0.77-0.86) indicating good reliability while the premolar and molars showed poor to moderate agreement (Maxillary premolars ICC: 0.464, CI: -0.18-0.74; maxillary first molar ICC: 0.516, CI: -0.154-0.772; mandibular first premolar ICC: 0.662, CI: 0.269-0.782; mandibular first molar ICC: 0.625, CI: 0.31-0.82). A moderate correlation existed between the radiographic and the clinical assessments (r = 0.5, p < .001). CONCLUSION: Despite the fact that significant varying levels of reliability has been found between CAL and radiographic bone level, both the clinical and radiographic examinations should be performed for the accuracy of diagnosis.
