Antibiotics and antimicrobial resistance: Evaluation of the knowledge, attitude, and perception among students and faculty within US dental schools.

PURPOSE: This study examined knowledge, attitudes, perceptions, and awareness regarding antibiotic use among students and academic faculty in US dental schools. METHODS: Two questionnaires, 1 for third-year/fourth-year dental students and the other for academic deans/department chairs were administered electronically. Questions on demographics, antibiotic knowledge, educational formats, and the role of dentistry in antibiotic stewardship were included. Knowledge about antibiotics and antibiotics stewardship was compared between third-year and fourth-year students and between students and academic faculty using t-test and chi-squared test at 0.05 significance level. RESULTS: A total of 18 responses on the academic dean and department chair survey and 172 responses on the dental student survey were collected. Overall, 71% of students reported that they could benefit from more education regarding antibiotics. Both faculty and students agreed that dentistry should play an important role in reducing antimicrobial resistance, but most dental students were "not at all familiar" with the term antimicrobial stewardship and several (32%) were unsure if clinical guidelines were present at their schools. CONCLUSION: Improvements to the dental educational curriculum regarding the responsible use of antibiotics, along with the implementation of stewardship programs within dentistry are strongly encouraged.

Denosumab Use as a Predictor Variable for External Cervical Resorption: A Case-Control Study.

INTRODUCTION: The objective of this case-control study was to investigate the association between denosumab use and the risk of developing external cervical resorption (ECR). METHODS: Thirty-three patients ≥45 years old who were diagnosed with ECR were selected. Controls were matched to the cases based on sex and age (±5 years) in a 1:1 ratio. Confounders were classified into systemic factors, including a history of systemic sclerosis, hepatitis B, denosumab use, and bisphosphonate use, or local factors, including a history of traumatic occlusion, periodontal procedures (scaling and root planing and periodontal surgeries), and tooth extraction (excluding third molar extraction). Additionally, the number of remaining teeth in each subject was recorded using panoramic radiographs. The baseline characteristics of the 2 groups, including age, sex, and the number of remaining teeth, were compared using the chi-square and Mann-Whitney U tests. Binary logistic regression was used to determine the possible association between denosumab use and the risk of developing ECR (α < 0.05). RESULTS: No significant differences in baseline characteristics were observed between the case and control groups (P > .05). After adjusting for systemic and local cofounders, denosumab use was significantly associated with the occurrence of ECR (odds ratio = 7.317; 95% confidence interval, 1.410-37.966; P < .05). CONCLUSIONS: Based on the binary logistic regression model, denosumab use could significantly predict the risk of developing ECR.

Dynamically Navigated versus Freehand Access Cavity Preparation: A Comparative Study on Substance Loss Using Simulated Calcified Canals.

INTRODUCTION: The aim of this in vitro study was to compare the speed, qualitative precision, and quantitative loss of tooth structure with freehand and dynamically navigated access preparation techniques for root canal location in 3-dimensional-printed teeth with simulated calcified root canals. METHODS: Forty maxillary and mandibular central incisors (tooth #9 and tooth #25) were 3-dimensionally printed to simulate canal calcification. Under simulated clinical conditions, access preparations were randomly performed with contemporary freehand and dynamically navigated techniques. Qualitative precision and quantitative loss of tooth structure were assessed on postoperative cone-beam computed tomographic scans using ITK-SNAP open-source segmentation (http://www.itksnap.org/). The associations between jaw, technique, volume of substance loss, and operating time were determined using analysis of variance models with Tukey-adjusted post hoc pair-wise comparisons. The kappa statistic was used to determine agreement between 2 independent, blinded raters on the qualitative assessment of the drill path. The association between the technique and jaw and qualitative assessment scoring was compared using the Fisher exact test. The significance level was set at .05. RESULTS: Dynamically navigated accesses resulted in significantly less mean substance loss in comparison with the freehand technique (27.2 vs 40.7 mm3, P < .05). Dynamically navigated accesses were also associated with higher optimal precision (drill path centered) to locate calcified canals in comparison with the freehand technique (75% vs 45%, P > .05). Mandibular teeth were associated with a negligible difference in substance loss between the access techniques (19.0 vs 19.1 mm3, P > .05). However, qualitatively the freehand technique was still prone to 30% higher chance of suboptimal precision (drill path tangentially transported) in locating calcified canals. Overall, dynamically navigated accesses were prepared significantly faster than freehand preparations (2.2 vs 7.06 minutes, P < .05). CONCLUSIONS: Within the limitations of this in vitro study, overall dynamically navigated access preparations led to significantly less mean substance loss with optimal and efficient precision in locating simulated anterior calcified root canals in comparison with freehand access preparations.

Evaluation and Diagnosis of the Traumatized Dentition.

Traumatic dental injuries comprise a number of the dental emergency patients who are often seen after hours or on an unscheduled basis in a dental practice environment. Although there are a variety of traumatic dental injuries that can occur, each with their own recommended treatment protocols, the initial evaluation and diagnosis of the traumatized dentition make up a critical aspect of the management of these cases. This article will highlight the key components of a thorough and efficient examination process of the traumatized dentition to include (1) documenting an accurate history of the events causing the injury, (2) performing a systematic clinical examination to include the use of clinical photographs and pulp sensibility tests, (3) obtaining appropriate radiographic images and scans, (4) understanding some considerations unique to evaluating young patients with traumatic injuries, and (5) recognizing the importance of having accurate and thorough documentation of these types of cases. Once the evaluation and diagnosis phase has been completed, the necessary treatment protocols can be initiated in an appropriate manner.

Evaluation and diagnosis of the traumatized dentition.

Traumatic dental injuries comprise a number of the dental emergency patients who are often seen after hours or on an unscheduled basis in a dental practice environment. Although there are a variety of traumatic dental injuries that can occur, each with their own recommended treatment protocols, the initial evaluation and diagnosis of the traumatized dentition make up a critical aspect of the management of these cases. This article will highlight the key components of a thorough and efficient examination process of the traumatized dentition to include (a) documenting an accurate history of the events causing the injury, (b) performing a systematic clinical examination to include the use of clinical photographs and pulp sensibility tests, (c) obtaining appropriate radiographic images and scans, (d) understanding some considerations unique to evaluating young patients with traumatic injuries, and (e) recognizing the importance of having accurate and thorough documentation of these types of cases. Once the evaluation and diagnosis phase has been completed, the necessary treatment protocols can be initiated in an appropriate manner.