Echo intensity and gray-level co-occurrence matrix analysis of soft tissue grafting biomaterials and dental implants: an in vitro ultrasonographic pilot study.

OBJECTIVE: To characterize different allogeneic and xenogeneic soft tissue graft substitutes and to assess their echo intensity and grayscale texture-related outcomes by using high-frequency ultrasonography (HFUS). METHODS: Ten samples from each of the following biomaterials were scanned using HFUS: bilayered collagen matrix (CM), cross-linked collagen matrix (CCM), multilayered cross-linked collagen matrix (MCCM), human-derived acellular dermal matrix (HADM), porcine-derived acellular dermal matrix (PADM), collagen tape dressing (C) and dental implants (IMPs). The obtained images were then imported in a commercially available software for grayscale analysis. First-order grayscale outcomes included mean echo intensity (EI), standard deviation, skewness, and kurtosis, while second-order grayscale outcomes comprised entropy, contrast, correlation, energy and homogeneity derive from the gray-level co-occurrence matrix analysis. Descriptive statistics were performed for visualization of results, and one-way analysis of variance with Bonferroni post-hoc tests were performed to relative assessments of the biomaterials. RESULTS: The statistical analysis revealed a statistically significant difference among the groups for EI (p < .001), with the group C showing the lowest EI, and the IMP group presenting with the greatest EI values. All groups showed significantly higher EI when compared with C (p < .001). No significant differences were observed for energy, and correlation, while a statistically significant difference among the groups was found in terms of entropy (p < 0.01), contrast (p < .001) and homogeneity (p < .001). IMP exhibited the highest contrast, that was significantly higher than C, HADM, PADM, CCM and CM. CONCLUSIONS: HFUS grayscale analysis can be applied to characterize the structure of different biomaterials and holds potential for translation to in-vivo assessment following soft tissue grafting-related procedures.

The long-term success of periodontal regeneration: a 10-year follow-up case report.

OBJECTIVE: The predictability and long-term success of periodontal regeneration begins with oral hygiene education, disease management, and an individually tailored periodontal maintenance protocol. The treatment outcomes could be enhanced when biologics and bone grafts are combined. The aim of this report was to describe the outcome of two complex infrabony defects in the same patient treated with recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and freeze-dried bone allograft (FDBA) over 10 years. CASE PRESENTATION: Two complex infrabony defects were treated following guided tissue regeneration principles and procedures. Full-thickness flaps were raised to allow visualization of the defects. The areas were debrided, and exposed root surfaces were planed. FDBA and rhPDGF-BB were combined to fill both defects. A collagen membrane was used over the bone graft in one case. The flaps were reapproximated to achieve primary closure. The patient was seen for regular periodontal maintenance visits and clinical and radiographic follow-ups over 10 years. Throughout the examination periods, the probing depths improved without bleeding on probing, and there was radiographic evidence of bone regeneration. CONCLUSION: The growth factor-infused bone graft was successfully utilized for periodontal regeneration in complex bony defects.

Full-Mouth Rehabilitation Using a Tissue-Level Angled-Head Dental Implant System: A Retrospective Analysis with Long-Term Follow-Up.

PURPOSE: A new tissue-level implant design with angulations of 17, 30, and 45 degrees has been introduced to allow the use of the existing bone while maintaining the restorative platform at an angle to ensure an optimal functional and esthetic result for treatment of edentulous patients. The aim of this study was to measure implant survival, bone loss, and peri-implant health of the novel tissue-level angled-head dental implant system. MATERIALS AND METHODS: A retrospective analysis of cases from three private offices that were using the new implant system was performed. Data regarding patients' demographics, number and location of implants, restoration type, bone loss, implant failure, bleeding, and pocket depths were collected and analyzed. The data collected were analyzed using mainly descriptive statistics. RESULTS: A total of 29 participants were selected, and 185 dental implants were placed. The average patient age was 61 ± 7 years, and 52% were female. Some of the patients were medically compromised; 7% were diabetic, 20% were smokers, and 7% had osteoporosis. The average time from dental implant placement to the placement of the screw-retained crowns was 6 ± 5 months. Four implants failed with an average time to failure of 18 ± 8 months. Implant survival rate was 97.8%. The average bone loss was 0.014 ± 0.082 mm at 1 year, 0.133 ± 0.306 mm at 5 years, and 0.426 ± 0.903 mm at 10 years. Overall, 18.9% of implants were associated with bleeding, and only one implant had a pocket depth greater than or equal to 5 mm. CONCLUSION: The new tissue-level implant design with angulations of 17, 30, and 45 degrees has demonstrated predictable survival and success rates with minimal bone loss. The long-term follow-up seems highly promising; however, further studies are warranted to validate the results.

The role of educators, mentors, and motivation in shaping dental students to become life-long learners: A pan-Canadian survey.

PURPOSE: The core values taught in dental school will arguably stay with the student for their whole career. An instructor has the power to influence a student's education through guidance, mentorship, and encouragement. This influence could be the factor that determines whether a student will become a motivated practitioner. The aim of this study was to identify whether dental schools are providing motivation to students to excel in their career and to become life-long learners. METHODS: A web-based questionnaire was distributed electronically during 2020-2021 to Canadian dental students via email, social media, etc. The questionnaire included questions on demographics, the dental school environment, instructor evaluation, and dental student perspectives on education. RESULTS: Of the 318 participants, 95.7% indicated their school follows a pass/fail system in some to all courses. Note that 61.2% found didactic components were weighted more heavily than clinical components. A greater number of participants found that their clinical instructors were more invested than their didactic instructors, in seeing their students become successful (53.0%) and excellent (44.6%) in their future careers. A total of 84.7% have not found a mentor, and 76% are not interested. Most participants indicated they are "moderately" motivated by their instructors to take continuing education courses (41.3%) and "not at all" motivated to continue their studies in a hospital (42.1%) or speciality residency program (56.3%). CONCLUSIONS: Instructors, educators, and mentors play a vital role in shaping dental student motivation in didactic and clinical courses, and beyond the school environment. Teaching institutions should incorporate opportunities for mentorship and student feedback to improve the delivery of dental education. Further studies may include assessing the role of mentorship at dental schools.

Public Concerns during the COVID-19 Lockdown: A Multicultural Cross-Sectional Study among Internet Survey Respondents in Three Countries.

(1) Background: this study aimed to evaluate the worries, anxiety, and depression in the public during the initial coronavirus disease 2019 (COVID-19) pandemic lockdown in three culturally different groups of internet survey respondents: Middle Eastern (Israel), European (Poland), and North American (Canada). (2) Methods: a cross-sectional online survey was conducted in the mentioned countries during the lockdown periods. The survey included a demographic questionnaire, a questionnaire on personal concerns, and the Patient Health Questionnaire-4 (PHQ-4). A total of 2207 people successfully completed the survey. (3) Results: Polish respondents were the most concerned about being infected. Canadian respondents worried the most about their finances, relations with relatives and friends, and both physical and mental health. Polish respondents worried the least about their physical health, and Israeli respondents worried the least about their mental health and relations with relatives and friends. Canadian respondents obtained the highest score in the PHQ-4, while the scores of Israeli respondents were the lowest. (4) Conclusions: various factors should be considered while formulating appropriate solutions in emergency circumstances such as a pandemic. Understanding these factors will aid in the development of strategies to mitigate the adverse effects of stress, social isolation, and uncertainty on the well-being and mental health of culturally different societies.

Dental personnel in Israel, Canada, and France during the COVID-19 pandemic: attitudes, worries, emotional responses, and posttraumatic growth.

OBJECTIVES: The spread of COVID-19 has posed significant challenges for dental professionals worldwide. The aims of the present study were twofold: (i) to study the attitudes, emotional responses, and worries among the dental personnel; and (ii) to look for the ability of dental personnel to experience posttraumatic self-growth as a result of the distress caused by the pandemic. METHOD AND MATERIALS: A cross-sectional online survey using an anonymous questionnaire was performed simultaneously in Israel, Canada, and France during the initial lockdown period. RESULTS: Israeli dental practitioners were less worried about their physical health, mental health, or relationships with family and friends than their Canadian and French counterparts. The Canadian dental practitioners were most committed and most willing to treat their patients, as well as most concerned about not being able to treat patients in the same personal way as before the lockdown. French dental practitioners showed the highest level of fear to treat patients. There were no differences in dental practitioners' levels of anxiety, depression, or posttraumatic growth among the countries. Dental practitioners' posttraumatic growth was significantly associated with worries regarding their physical health. CONCLUSION: Responses of dental personnel to the COVID-19 pandemic varied worldwide. Despite the differences, evidence exists that some of the dental practitioners' worries and concerns are associated with psychologic growth as a result of the pandemic. Better understanding and acknowledgment of dental personnel's worries and concerns can facilitate growth and enable positive functioning under the continuous situation of uncertainty.

The International Association of Dental Traumatology ToothSOS mobile app: A 2-year report.

BACKGROUND/AIM: The shift in health care and technology calls for innovation through mobile applications as free educational resources for the masses. The International Association of Dental Traumatology (IADT) created ToothSOS, an app (software application for mobile devices) to provide dental trauma information for patients and professionals. The app contains information on the emergency management and prevention of dental injuries, as well as treatment guidelines for dental practitioners. The aim of this study was to assess public utilization of the ToothSOS app in the first 2 years since its launch. METHODS: The ToothSOS app was launched by the IADT in the first week of April 2018. Data regarding the number of downloads and usage of the app in the first 2 years (from April 2018 to May 2020) were collected and analyzed. RESULTS: The total number of ToothSOS downloads over the 2 years was 47 725. The number of downloads peaked in the first month when the app was initially released. Thereafter, the number of downloads decreased to an average of 1423 ± 363 downloads every month. Europe was the territory with the greatest number of downloads followed by the United States and Canada, Asia, Latin America and the Caribbean, and Africa, the Middle East, and India. CONCLUSIONS: Within as short a period as 2 years, the ToothSOS app continues to gain public interest. Further attempts and public campaigns should be made in order to increase the visibility of the app. Dental professionals should encourage patients and communities to use the app in order to increase awareness for the prevention and proper emergency management of traumatic dental injuries.

Maxillary sinus augmentation procedures: a narrative clinical review.

An edentulous posterior maxilla can present a challenge for placement of dental implants due to the proximity of the maxillary sinus. Sinus augmentation is a surgical bone grafting procedure aimed to increase the bone height for implant support. A number of sinus augmentation techniques have been presented and the outcomes show good implant success rates. In order to achieve the desirable outcomes, it is important to gain knowledge of the maxillary sinus anatomy and complete a thorough preoperative evaluation. Being aware of the location of vasculature, nerves, and the presence of septa will help reduce the risk of intraoperative and postoperative complications. This review provides a narrative clinical overview related to the anatomy, preoperative evaluation, contraindications, techniques, postoperative care, outcome measures, and complications of sinus augmentation procedures.