A Pregnant Patient (First Trimester) Reporting for Pain in Relation to the Maxillary Left First Molar Was Prescribed a Full Mouth Series Radiographs in the Dental Office.

This case scenario shows the value of conducting a thorough clinical examination that will direct appropriate radiographic selection and prescription criteria to be able to arrive at a diagnosis. Proper management of a patient's chief complaint and imaging needs during pregnancy is of utmost importance. It is prudent to limit ionizing radiation during the first trimester to what is minimally needed and defer elective imaging until after the birth of the baby. It is important for dental health care providers to do what is necessary for the patient for the emergent situation and postpone all elective imaging and follow the published FDA/ADA radiographic selection criteria.

Screening for diabetes risk using the diabetes risk test and point-of-care hemoglobin A1C values in adults seen in a dental clinic.

OBJECTIVE: To explore the feasibility of screening for type 2 diabetes (T2DM) and the prevalence of adult patients seen in a dental clinic at risk for T2DM based on American Diabetes Association (ADA) diabetes risk test (DRT) scores and point of care hemoglobin A1C (A1C) values. METHOD AND MATERIALS: This was a cross-sectional analysis of data from adults 18 to 89 years old seen in an academic dental clinic between November 2019 and April 2022 without prior history of diabetes. Clinical and demographic data were obtained from electronic health records and odontograms. Frequency distributions, chi-square, and Mann-Whitney U tests were used for data analysis. RESULTS: Of the 13,519 patients whose data were included, 54.7% (n = 7,389) were women. Of those with race and ethnicity data, 53.6% (n = 2,871) were white, 40.2% (n = 2,153) were African American, and 29.5% (n = 1,559) were Hispanic/Latino. Mean ± SD age was 47.0 + 17.0 years; mean ± SD body mass index was 28.0 ± 6.1 kg/m2. Thirty-five percent (n = 4,774) had diabetes risk test scores reflecting T2DM risk. Those at risk were more likely to be older, male, and overweight/obese than those not at risk (P < .001). Of those at risk who consented to a point of care A1C (9.8%, n = 470), 40.2% (n = 189) had values consistent with dysglycemia (A1C ≥ 5.7%); 34.9% (n = 164) reflecting prediabetes (A1C = 5.7% to 6.4%) and 5.3% (n = 25) diabetes (A1C ≥ 6.5%). CONCLUSIONS: Diabetes screening in a dental clinic identified that over one-third of adults without T2DM were at risk based on diabetes risk test scores. Of those who had point of care A1Cs conducted; 40% had dysglycemia. Diabetes screening in an academic dental clinic can help identify patients at risk for T2DM.

Fabrication and use of silicon hollow-needle arrays to achieve tissue nanotransfection in mouse tissue in vivo.

Tissue nanotransfection (TNT) is an electromotive gene transfer technology that was developed to achieve tissue reprogramming in vivo. This protocol describes how to fabricate the required hardware, commonly referred to as a TNT chip, and use it for in vivo TNT. Silicon hollow-needle arrays for TNT applications are fabricated in a standardized and reproducible way. In <1 s, these silicon hollow-needle arrays can be used to deliver plasmids to a predetermined specific depth in murine skin in response to pulsed nanoporation. Tissue nanotransfection eliminates the need to use viral vectors, minimizing the risk of genomic integration or cell transformation. The TNT chip fabrication process typically takes 5-6 d, and in vivo TNT takes 30 min. This protocol does not require specific expertise beyond a clean room equipped for basic nanofabrication processes.

High-Q Nanophotonic Resonators on Diamond Membranes using Templated Atomic Layer Deposition of TiO2.

Integrating solid-state quantum emitters with nanophotonic resonators is essential for efficient spin-photon interfacing and optical networking applications. While diamond color centers have proven to be excellent candidates for emerging quantum technologies, their integration with optical resonators remains challenging. Conventional approaches based on etching resonators into diamond often negatively impact color center performance and offer low device yield. Here, we developed an integrated photonics platform based on templated atomic layer deposition of TiO2 on diamond membranes. Our fabrication method yields high-performance nanophotonic devices while avoiding etching wavelength-scale features into diamond. Moreover, this technique generates highly reproducible optical resonances and can be iterated on individual diamond samples, a unique processing advantage. Our approach is suitable for a broad range of both wavelengths and substrates and can enable high-cooperativity interfacing between cavity photons and coherent defects in diamond or silicon carbide, rare earth ions, or other material systems.

The clinical performance of chairside caries risk assessment kits.

OBJECTIVE: Caries risk assessment is an important component of clinical practice. The goal of this project was to evaluate the diagnostic performance of two commercially available kits (the Saliva-Check mutans and the Plaque-Check pH kit; GC-America) in distinguishing caries-active from caries-free individuals. The effect of following instructions not to eat, drink, or perform oral hygiene, prior to testing, was also investigated on the effectiveness of these kits. METHOD AND MATERIALS: The subjects included 26 caries-affected children and 20 caries-free adults. Plaque and saliva samples were collected for analysis by the two kits following the manufacturer's instructions. For 63 additional subjects, instructions not to eat, drink, or practice oral hygiene were omitted prior to sample collection. The sensitivity and specificity in distinguishing caries-free from caries-active subjects was calculated for both kits. RESULTS: The sensitivity (88%) and specificity (90%) of the Saliva-Check mutans kits were satisfactory in the subjects refraining from eating etc. In contrast, both the sensitivity and the specificity of this kit were reduced when subjects were tested without use instructions. When tested in subjects that followed instructions, the pH kit's sensitivity and specificity were 72% and 55% respectively. This modest diagnostic performance was reduced when pH values were measured in subjects not following use instructions. CONCLUSION: These kits, particularly the Saliva-Check mutans kits, can contribute to patient education by documenting microbial caries risk factors. Though difficult to implement in practice, subjects should refrain from eating or other activities that disturb the oral environment prior to sample collection.

Use of dental radiographic minipanel series in disabled adults in a university-based special care dental clinic.

OBJECTIVE: To compare the diagnostic efficacy of a minipanel series to a conventional 18-radiograph full-mouth series in a disabled adult population in a university clinic. METHOD AND MATERIALS: Eighty patients who attended the New Jersey Dental School special care services clinic between 2004 and 2006 were selected for a double-blind quasiexperimental study based on existing full-mouth series radiographs. A minipanel series consisting of eight radiographs from the 18-radiograph full-mouth series was used as a comparison against a matched pair of an 18-radiograph exam. The diagnostic efficacy of this eight-radiograph series was tested against the more conventional 18-radiograph full-mouth series to determine whether the minipanel series was an acceptable substitute for the full-mouth series in this population group. Traditionally, it is difficult to obtain full-mouth series radiographs in patients with disabilities. RESULTS: From the 80 studied patients, a total of 2,219 teeth were available for study. A median of 29 teeth per patient was found in the full-mouth series and 28 teeth per patient in the minipanel series category. The difference was statistically significant (P < .001). Of the patients evaluated, 78 (97.5%) had at least one problem detected when the full-mouth series was used. Of these 78 with at least one problem, 74 (94.8%) were identified using the minipanel series. The sensitivity for the minipanel series when compared to the gold-standard full-mouth series was 63% (95% confidence interval [CI], 59.2 to 68.0) for tooth-specific disease; the specificity was 92% (95% CI, 92.2 to 94.5). CONCLUSION: Prospective studies are needed for the acceptance and use of minipanel radiographic series in conjunction with a clinical examination.

Screening for cardiovascular risk factors in a dental setting.

BACKGROUND: The authors assessed the utilization of oral health care professionals (OHCPs) as a resource for identifying patients who were unaware of their increased risk of developing cardiovascular disease (CVD). METHODS: OHCPs administered a CVD risk-screening questionnaire, measured blood pressure and tested cholesterol levels, high-density lipoprotein levels and hemoglobin A1c (HgA1c) levels using "finger-stick" blood testing in 100 patients treated in a dental school clinic who were unaware of their CVD risk status. The authors determined the prevalence of specific risk factors (that is, smoking and abnormal levels of systolic blood pressure, lipids, body mass index and HgA1c) and calculated Framingham 10-year coronary heart disease (CHD) risk scores. RESULTS: Seventeen percent of the 100 patients (35 percent of men, 5 percent of women) had an increased global risk of experiencing a CHD event within 10 years (Framingham risk score>10 percent). Seventy-three percent of participants had one or more risk factors and 31 percent had two or more risk factors present. More men than women had low levels of high-density lipoprotein (45 percent [18/40] of men versus 3.3 percent [2/60] of women; P<.0001). The mean Framingham CHD risk score increased with increasing risk factor burden. CONCLUSIONS: OHCPs identified patients with an increased CHD risk who could benefit from primary prevention activities. A substantial proportion of study patients who were unaware of their risk status were at an increased risk of experiencing a CHD event within 10 years. OHCPs could contribute to public health CHD control efforts.