Do dental anxiety and satisfaction with dental professionals modify the association between affordability and dental service use? A population-based longitudinal study of Australian adults.

OBJECTIVES: This study aimed to assess the association between affordability in terms of difficulty paying dental bills in Australian dollars and dental service use in the presence of sociodemographic confounders, and to assess the role of dental anxiety and satisfaction with dental professionals as mediators. The second aim was to investigate how dental anxiety and satisfaction with dental professionals modify the association between affordability and use of dental services in Australian adults. METHODS: Longitudinal data from the Australian National Study of Adult Oral Health (2004-06 and 2017-18) was used. Poisson regression and path analysis were conducted to determine the association between affordability and frequency of use of dental services. Effect measure modification (EMM) analysis was performed by stratification of dental anxiety and satisfaction with dental professionals. RESULTS: The study included 1698 Australian adults and identified that the prevalence of low frequency of dental visits was 20% more for those who had difficulty paying dental bills. Adults with dental anxiety (prevalence ratio [PR] = 1.14) and those who were dissatisfied with dental professionals (PR = 1.17) had a higher prevalence of low frequency of dental visits in the presence of difficulty paying dental bills. This indicated that dental anxiety and dissatisfaction with dental professionals were effect modifiers on this pathway. CONCLUSIONS: Adults who experience dental anxiety and dissatisfaction with dental professionals are more likely to avoid dental visits when faced with difficulty paying dental bills. However, it is important to note that these associations do not necessarily imply a causal relationship.

The effectiveness of electronic screening and brief intervention for alcohol-related maxillofacial trauma: a randomized controlled trial.

OBJECTIVES: This study aims to deliver a novel web-app-based electronic Screening and Brief Intervention to patients with alcohol-related facial trauma and assess changes in at-risk drinking behaviors and attitudes toward their drinking and alcohol-related trauma. STUDY DESIGN, SETTING, AND SAMPLE: This was a 2-arm parallel randomized controlled trial. Participants who had sustained alcohol-related facial injuries were recruited from 3 Australian hospitals. RESULTS: Fifty-six participants were enrolled and randomized initially with 45 participants completing the questionnaire at baseline and 3-month follow-up. Most of the participants were male (71.1%), aged between 18 and 29 (40%), and presented to the ED for the first time (68.9%). The study revealed that the intervention group participants found the information provided via the e-SBI helpful in changing their drinking habits and seek help. The e-SBI intervention had a moderate effect on ASSIST Scores (d = -.59; 95% CI, -.03, 1.18). The effect sizes of the e-SBI on the secondary outcomes also ranged between small and moderate. CONCLUSIONS: The novel app-based e-SBI can effectively deliver information on harmful drinking and provide brief intervention and other venues for help and subsequently improve awareness and willingness to seek help and reduce the risk of injury recurrence.

Assessing the status of oral health integration in South East Asian Regional Office countries' Universal Health Coverage-A scoping review.

BACKGROUND: Oral diseases affect close to 3.5 billion people worldwide and there has been a call by the World Health Organization (WHO) to integrate oral health into the Universal Health Coverage (UHC) agenda. OBJECTIVES: To collate and synthesise information regarding the status of integration of oral health into the health systems covered by UHC across the 11 countries in the South East Asian Regional Office. METHODS: Drawing on the framework of the six building blocks of health systems as devised by WHO, we compared the public dental care coverage models, with a focus on outpatient dental care in these countries. We gathered this information from publicly available resources, databases and peer-reviewed publications to populate the template guided by the WHO Health System Building Blocks. RESULTS: We found a poor access to oral health care, lopsided distribution of manpower, rickety health information systems, and private sector domination and inadequate or absent financing mechanisms for outpatient procedures. The private sector was dominant in all countries except Thailand and Srilanka. Financing was absent in most countries and deficient in Thailand and Indonesia. Dental workforce was deficient in most countries except India, Srilanka, and Thailand. Health information systems were weak with no dental items under price control. Better UHC indicators did not guarantee a lower oral disease burden. CONCLUSIONS: Our review highlighted the close connection between service quality and human resources, governance, and finance. There is a need to establish standardised dental treatment guidelines that are uniformly adopted across countries, integrate oral health into national health and development programs, push for functional oral health research through collecting robust surveillance, economic, and social impact data and the development of cost-effective strategies tailored to each country's unique needs.

Theories, Models, Frameworks, Guidelines, and Recommendations for Trauma-Informed Oral Healthcare Services: A Scoping Review.

BACKGROUND: Traumatic life experiences (TLE) are common and can affect a person's physical being and health-related behaviors, including those related to oral health. This scoping review aimed to identify evidence exploring the implementation and provision of trauma-informed care (TIC) in oral health services delivery. METHODS: Arksey and O'Malley's framework with enhancements proposed by Levac et al. and Peters et al. was used. Studies were selected based on a preset inclusion and exclusion criteria and the population/concept/context framework. Primary charting of descriptive data was conducted, followed by thematic analysis to identify ideas common within the included literature. Searches were conducted in Medline (via Ovid), APA PsycINFO (via Ovid), Embase (Elsevier), Scopus, CINAHL (via EBSCO), and Cochrane databases. Google Scholar and ProQuest were used to identify grey literature. RESULTS: The search identified 251 records, with fifteen records meeting the inclusion criteria. Limited models, frameworks, and recommendations for trauma-informed practices in oral health services were identified. Recommendations for TIC practices were identified, and clinical practice adjustments for dental practitioners were described to improve service delivery for patients who may have experienced trauma. Avenues for future research were identified. CONCLUSIONS: Limited evidence exists to guide trauma-informed practice in oral health service delivery. This scoping review highlights the need for further research into approaches and practices of TIC for oral health services delivery to assess their efficacy and the need to develop evidence-based TIC frameworks to meet the unique needs of oral health service providers and populations.

Assessment of usefulness and reliability of YouTube™ videos on denture care.

INTRODUCTION: The world's population is in a demographic transition with a rising ageing population. Tooth loss is frequent among older people resulting in the replacement of natural teeth using complete or partial dentures. YouTube™ is the second most popular website in the world and is being increasingly used to access health care information. The aim of this study is to evaluate the usefulness and reliability of the information in YouTube™ videos regarding denture care. METHODS: The YouTube™ website was used to systematically search for videos using the keyword 'denture care'. Videos meeting the eligibility criteria were assessed separately by two independent researchers. The usefulness of the videos was assessed using the Global Quality Assessment Scale and a customized usefulness scoring scheme. Based on these scores, the usefulness of the videos was categorized as low, medium and high. A modified DISCERN tool (mDISCERN) was used for assessing reliability with scores ranging from 0 to 5. Other video characteristics like source/ownership of the videos, duration, views, likes, dislikes, number of days posted, like ratio, view ratio, interaction index and Video Power Index were also obtained. Statistical analysis was carried out using the Kruskal-Wallis test, Spearman correlation test and multiple linear regression analysis. RESULTS: A total of 120 videos were included. Based on the usefulness score, the usefulness of 65.8% of videos were classified as low, 32.5% were medium and 1.6% had high usefulness. The mDISCERN score for 74.2% of videos was 2 or below 2 indicating that the majority of videos had low reliability. Video characteristics did not differ significantly according to the usefulness of videos. Videos uploaded by dentists or dental hygienists had significantly higher usefulness scores (p < 0.001) in comparison to videos uploaded by other sources. However, reliability scores did not differ based on the sources of the videos. Video reliability was found to have a significant (B = 2.08, p < 0.001) positive association with video usefulness. CONCLUSION: YouTube™ cannot be recommended as the only source of information for denture care as most videos received low usefulness and reliability ratings in our study. Dentists and dental health professionals could take an active part in enhancing denture care-related content on YouTube™ and enable patients to have adequate and reliable knowledge of denture hygiene practices.

Effect of build orientation on the trueness of occlusal splints fabricated by three-dimensional printing.

PURPOSE: Scientific evidence pertaining to the evaluation of trueness of occlusal splints fabricated using different three-dimensional (3D) printers and build orientations compared to subtractive technologies is lacking. METHODS: Overall, one hundred and ten occlusal splints were manufactured using two different 3D printers and a dental mill. Five groups of ten were fabricated using the 3D printers at different build orientations (0, 30, 45, 60, and 90 degrees). In addition, a comparison group of ten occlusal splints was subtractively manufactured using a five-axis dental mill. All occlusal splints were scanned and exported as a standard tessellation language file. Analysis was conducted with metrology software with root mean square estimate average positive deviation and average negative deviation used as the measured outcome. RESULTS: The 0 degree printing orientation was the most accurate for printer one with the root mean square value of 0.05 ± 0.01 mm, and 60 degree printing orientation was most accurate for printer two with the RMS value of 0.11 ± 0.01 mm. Subtractively manufactured occlusal splint had significantly higher trueness with the lowest RMS value of 0.03 ± 0.05 mm. CONCLUSION: Build orientations influence the trueness of additively manufactured occlusal splints while occlusal splints produced by subtractive manufacturing were statistically significantly more accurate.

A Novel Irrigation System to Reduce Heat Generation during Guided Implantology: An In Vitro Study.

The purpose of this in vitro study is to evaluate the effectiveness of incorporating a new irrigation system into a surgical guide and monitor its effect on heat generation during implant bed preparation. A total of 48 surgically guided osteotomies were performed on 12 bovine ribs divided into 4 groups, using different irrigation techniques: Group A (test) had entry and exit channels incorporated into the guide; Group B had a similar design with an entry channel only; Group C had conventional external irrigation; and Group D (control) had no irrigation. Heat generation during the osteotomies was measured using thermocouples placed at a depth of 2 mm and 6 mm. The lowest mean temperature was observed in Group A (22.1 °C at 2 mm and 21.4 °C at 6 mm), which was statistically significant when compared with Groups C and D (p < 0.001). Group A showed a lower mean temperature compared with Group B as well; however, it was statistically significant only at 6 mm depth (p < 0.05). In conclusion, the proposed surgical guide has significantly reduced heat generation during implant osteotomy compared to conventional external irrigation. The integration of an exit cooling channel can resolve limitations found in previously designed surgical guides such as debris blockage and can be easily incorporated into computer designing and 3D printing software.

Prevalence of Dental Anomalies and Its Role in Sex Estimation among Children of Jazan Region, Saudi Arabia.

BACKGROUND: This study aimed to ascertain the prevalence of dental anomalies and their ability to estimate sex status. MATERIAL AND METHODS: This cross-sectional radiographic study was based on the evaluation of dental anomalies of Saudi children aged between 5 and 17 years. A total of 1940 orthopantomograms (OPG) were screened, of which 1442 were included. All the OPGs were digitally evaluated with ImageJ software. The demographic variables and dental anomaly findings were subjected to descriptive and comparative statistical analysis. Discriminant function analysis was conducted for sex estimation. p value < 0.05 was considered as significant. RESULTS: The mean age of the children in this study was 11.35 ± 0.28 years. At least one dental anomaly was detected in 161 children (11.17%), including 71 males and 90 females. Only 13 children (8.07%) presented with more than one anomaly. The most common dental anomaly detected was root dilaceration (47.83%) followed by hypodontia (31.68%). The least common dental anomaly was infraocclusion (1.86%). The sex prediction accuracy using discriminant function analysis was 62.9% (p < 0.01). CONCLUSION: The prevalence of dental anomalies was 11.17% with root dilaceration and hypodontia being the most common. The role of dental anomalies in sex estimation was found to be ineffective.

Evaluation of the Expression Levels of miR-21-5p and miR-429 Genes in Biopsy Samples from Patients with Oral Squamous Cell Carcinoma.

INTRODUCTION: MicroRNAs (miRs) are a group of endogenous, non-coding, 18-24 nucleotide length single-strand RNAs that mediate gene expression at the post-transcriptional level through mRNA degradation or translational repression. They are involved in regulating diverse cellular biological processes such as cell cycle, differentiation, and apoptosis. The deregulation of miRs affects normal biological processes, leading to malignancies, including oral squamous cell carcinoma (OSCC). This study evaluates the expression level of miR-21-5p and miR-429 genes in biopsy samples from patients with OSCC and performs a comparison with controls. MATERIALS AND METHODS: In this study, tissue samples were obtained from 40 individuals (20 OSCC patients and 20 healthy controls) to determine miR-21-5p and miR-429 expression using the ΔCT method and analyzed by the Mann-Whitney test. RESULTS: The mean age of subjects in the control and patient groups was 47.15 and 53.8 years, respectively. According to the Mann-Whitney test, significant differences were observed in miR-21-5p (p < 0.0001) and miR-429 (p = 0.0191) expression levels between the two groups (p < 0.05). CONCLUSIONS: The expression of miR-21-5p, miR-429, and combined miRNAs in the OSCC group was significantly higher compared to the control group. As a result, changes in the expression of these biomarkers in cancerous tissues could potentially be considered as a marker for the early diagnosis of OSCC.

A meta-analysis to evaluate the prevalence of maxillofacial trauma caused by various etiologies among children and adolescents.

AIMS: Children and adolescents who are affected by trauma may have complications that are more serious and dangerous. Herein, a meta-analysis to evaluate the prevalence of maxillofacial trauma caused by various etiologies according to the geographic regions of the world among children and adolescents was conducted. MATERIALS AND METHODS: A comprehensive search was performed in four databases of PubMed/MEDLINE, Web of Science, Cochrane Library, and Scopus from January 1, 2006 until July 7, 2021. To evaluate the quality of included articles, an adapted version of the Newcastle-Ottawa scale was used. The prevalence of maxillofacial trauma was estimated by event rates and 95% confidence intervals in relation to etiology and geographic region of study population. RESULTS: Through search in the databases and the electronic sources, 3071 records were identified, and 58 studies were eligible for inclusion in the meta-analysis. A total of 264,433 maxillofacial trauma cases were reported by all included studies. Globally, the overall prevalence of maxillofacial trauma was highest due to Road Traffic Crashes (RTC) (33.8%) followed by falls (20.7%), violence (9.9%), and sports (8.1%) in children/adolescents. The highest prevalence of maxillofacial trauma were observed in African population (48.3%) while trauma due to falls was most prevalent in Asian population (44.1%). Maxillofacial trauma due to violence (27.6%) and sports (13.3%) were highest in North Americans. CONCLUSION: The findings demonstrate that RTC was the most prevalent etiology of maxillofacial trauma in the world. The prevalent causes of maxillofacial trauma differed between the regions of study population.

Oral and Maxillofacial Injuries Associated With E-Cigarette Explosions: A Systematic Review and Management Guidelines Proposal.

PURPOSE: E-cigarettes have become increasingly popular devices used to consume nicotine in recent years. There is a growing body of evidence regarding the risk of spontaneous explosion of these devices causing burn and projectile injuries. The primary purpose of this review was to summarize all injuries to the oral and maxillofacial region secondary to explosion of e-cigarettes. The secondary purpose was to propose an initial management algorithm for such injuries based on the findings in the literature. This review also aims to test the hypothesis that e-cigarette explosive injuries to the oral region were associated with an increased risk of intubation and surgery and examine whether any other injury pattern was associated with an increased risk of intubation or surgery. METHODS: A cohort study based on identifying cases in the literature was conducted to summarize injuries to the oral and maxillofacial region and examine the associations between injury types and location and management. A literature search of the major biomedical databases was conducted in September 2022 using terms such as e-cigarette, explosion, blast, trauma, and burn, among others, which yielded 922 studies. Nonclinical studies, review articles, and studies without injuries to the facial region were excluded. Study subjects were recorded for demographics, device characteristics, injury mechanism, injury location, management, and complications. Chi-squared analysis was used to determine if the predictor variables of type of injury (burn or projectile) and its associated location (ocular, facial, or intraoral for burns and facial thirds for projectile) were associated with the outcomes of intubation and surgical management. The collected data were then used as a guide to propose an initial management algorithm for these injuries. RESULTS: Twenty eight studies, including 20 case reports and 8 case series met the inclusion criteria. A total of 32 explosions of e-cigarettes to 32 patients caused 105 recorded injuries to the facial region. Projectile injuries made up 73.3% (n = 77) of all facial injuries, while burn injuries made up of 26.7% (n = 28). There were 14 (43.8%) patients who suffered both projectile and burn injuries. Burn injuries mostly involved the face (64.3%, n = 18), oral cavity (25%, n = 7), and eye (10.7%, n = 7). The majority (81.8%, n = 63) of projectile injuries occurred in the lower facial third. There were 20 (62.5%) patients who suffered a bone or tooth fracture. Management of injuries involved surgery in 62.5% (n = 20) of patients, which included open reduction and internal fixation of fractures, dental extraction, bone and skin grafts, and ocular surgery. A complication rate of 44.4% (n = 8) was observed across studies that reported on follow-up. There was no statistically significant association between explosive injury to the oral region and intubation or surgical management. There was also no other statistically significant association between any other injury type and location with intubation or surgical management. CONCLUSIONS: E-cigarettes are at risk for spontaneous combustion that can cause serious oral and maxillofacial injuries, particularly to the lower facial third and commonly requiring surgical management. Safety of these devices should be improved through increased user education and regulation.

Evaluation of Beta-Defensin 1 and Mannose-Binding Lectin 2 Polymorphisms in Children with Dental Caries Compared to Caries-Free Controls: A Systematic Review and Meta-Analysis.

Background and objective: Some variants in defensin beta 1 (DEFB1) and mannose-binding lectin 2 (MBL2) genes can be associated with oral diseases. Herein, we designed a systematic review and meta-analysis to evaluate the association of DEFB1 (rs11362, rs1799946, and rs1800972) and MBL2 (rs7096206 and rs1800450) polymorphisms with the susceptibility to dental caries (DC) in children. Materials and methods: A systematic literature search was conducted in the PubMed/Medline, Web of Science, Scopus, and Cochrane Library databases until 3 December 2022, without any restrictions. The odds ratio (OR), along with a 95% confidence interval (CI) of the effect sizes, are reported. Analyses including a subgroup analysis, a sensitivity analysis, and funnel plot analyses were conducted. Results: A total of 416 records were identified among the databases, and nine articles were entered into the meta-analysis. A significant relationship was found between the T allele of DEFB1 rs11362 polymorphism and DC susceptibility, and the T allele was related to an elevated risk of DC in children (OR = 1.225; 95%CI: 1.022, 1.469; p = 0.028; I2 = 0%). No other polymorphisms were associated with DC. All articles were of moderate quality. Egger's test in homozygous and dominant models demonstrated a significant publication bias for the association of DEFB1 rs1799946 polymorphism with DC risk. Conclusions: The results demonstrated that the T allele of DEFB1 rs11362 polymorphism had an elevated risk for DC in children. However, there were only few studies that evaluated this association.

The Effect of Stacking on the Accuracy of 3D-Printed Full-Arch Dental Models.

The objective of this study was to assess the effect of stacking on the dimensional and full-arch accuracy of 3D-printed models, utilising a standardised assessment methodology. A previously validated methodology involving a standard tessellation language image (STL) reference model, comprising seven spheres on a horseshoe base resembling a dental arch, was used. Six 3D-designed STL models were prepared, optimised, and stacked horizontally using 3D Sprint software. The stacking file was transferred to the NextDent 5100 printer to build the physical models. To assess accuracy, a coordinate measuring machine (CMM) measured the diameter of the spheres n=210, and twenty-one vectors extended between the centres of each of the seven spheres (n = 630). When compared to the reference model, significant differences were observed for dimensional (p = 0.006) and full-arch accuracy (p = 0.006) for all stacked models. Additionally, significant differences were observed between the stacked models for the dimensional accuracy between the posterior (p = 0.015), left posterior (p = 0.005) and anteroposterior (p = 0.002). The maximum contraction was observed in the fourth stacked model, which demonstrated the highest median deviation and least precision within the full-arch (MD = 666 µm, IQR = 55 µm), left posterior (MD = 136 µm, IQR = 12 µm), posterior (MD = 177 µm, IQR = 14 µm) and anteroposterior (MD = 179 µm, IQR = 16 µm) arch segments. In general, the anterior and left posterior arch segments recorded the highest contractions with a median deviation of 34 µm and 29 µm, and precision of 32 µm and 22 µm, respectively. Statistically significant differences were observed between the stacked models in terms of dimensional accuracy that were within clinically acceptable thresholds. The greatest contraction was noted in the fourth model, displaying the least full-arch accuracy compared to the other models. Stacked, additively manufactured, full arch models are a viable alternative for diagnostic, orthodontic, and single-unit prosthodontic applications. In contrast, caution should be exercised when utilising stacked models for full arch high accuracy prosthodontic applications. Further research is needed to assess the impact of additional variables including different printers and resins.

Titanium Implant Surface Effects on Adherent Macrophage Phenotype: A Systematic Review.

Immunomodulatory biomaterials have the potential to stimulate an immune response able to promote constructive and functional tissue remodeling responses as opposed to persistent inflammation and scar tissue formation. As such, the controlled activation of macrophages and modulation of their phenotype through implant surface modification has emerged as a key therapeutic strategy. METHODS: Online databases were searched for in vitro studies between January 1991 and June 2020 which examined the effect of titanium implant surface topography on the adherent macrophage phenotype at either the gene or protein level. RESULTS: Thirty-nine studies were subsequently included for review. Although there was significant heterogeneity between studies, treatment of titanium surfaces increased the surface roughness or hydrophilicity, and hence increased macrophage attachment but decreased cell spreading. Physical coating of the titanium surface also tended to promote the formation of cell clusters. Titanium and titanium-zirconium alloy with a micro- or nano-scale rough topography combined with a hydrophilic surface chemistry were the most effective surfaces for inducing an anti-inflammatory phenotype in adherent macrophages, as indicated by significant changes in cytokine gene expression and or cytokine secretion profiles. CONCLUSIONS: The published data support the hypothesis that incorporation of specific topographical and physiochemical surface modifications to titanium can modulate the phenotypic response of adherent macrophages.

Protocol of a cluster randomised controlled trial evaluating the effectiveness of an online parenting intervention for promoting oral health of 2-6 years old Australian children.

INTRODUCTION: Dental decay is a major problem among Australian children. It can be prevented through good self-care and limiting sugar intake, but many parents/caregivers lack the skills and confidence to help their children adopt these practices. This trial will evaluate the efficacy of Healthy Habits Triple P - Oral health, a web-based online programme, in improving children's oral health-related behaviours (toothbrushing, snacking practices and dental visits) and related parenting practices, thereby preventing dental caries. METHODS AND ANALYSIS: This is a cluster, parallel-group, single-blinded, randomised controlled trial of an online intervention for parents/caregivers of children aged 2-6 years. From the City of Gold Coast (Australia), 18 childcare centres will be randomly selected, with equal numbers randomised into intervention and control arms. Intervention arm parents/caregivers will receive access to a web-based parenting intervention while those in the control arm will be directed to oral health-related information published by Australian oral health agencies. After the completion of the study, the Healthy Habits Triple P - Oral health intervention will be offered to parents/caregivers in the control arm. The primary outcome of this trial is toothbrushing frequency, which will be assessed via Bluetooth supported smart toothbrushes and parent/caregiver report. Data on other outcomes: parenting practices and child behaviour during toothbrushing, consumption of sugar rich foods and parents' confidence in dealing with children's demands for sugar rich food, and dental visiting practices, will be collected through a self-administered questionnaire at baseline (before randomisation), and 6 weeks (primary endpoint), 6 months and 12 months after randomisation. Data on dental caries will be collected at baseline, 12 and 18 months post-randomisation. ETHICS AND DISSEMINATION: Ethical approval has been obtained from Human Research Ethics Committees of Griffith University (2020/700) and the University of Queensland (2020002839). Findings will be submitted for publication in leading international peer-reviewed journals. TRIAL REGISTRATION NUMBER: ACTRN12621000566831.

Premolar maturity index (IPM) for indicating legal age 12 years in a sample of south Indian children - A digital pantomographic study.

Legal age of 12 years has been set as the minimum age of criminal responsibility in many countries. This paper concerned a method for predicting the legal age 12 years based on the maturation of lower first and second premolars. The sample consisted of 900 digital pantomographs of south Indian children (450 males, 450 females) aged between 8 and 16 years. Among them, 580 DPTs were used as test sample and 320 DPTs as validation sample. New cut-offs at the age threshold 12 years were determined by using the measurement of open apices in first premolars (IPM1 < 0.10), second premolars (IPM2 < 0.14) and the combined method (IPM1 + IPM2 < 0.12). The sensitivity (Se), specificity (Sp) and posttest probability (PTP) were established. For IPM1 < 0.10, the Se, Sp and PTP were 92.4 %, 91.3 % and 91.1 % for males and 90.8 %, 87 % and 86.5 % for females. For IPM2 < 0.14, they were 92.6 %, 93.6 % and 93.4 % for males and 91.5 %, 83.1 % and 83.4 % for females. And, for the combined predictor (IPM1 + IPM2 < 0.12), these values were 92.6 %, 94.8 % and 94.6 % and 90.5 %, 84.9 % and 84.7 % in males and females respectively. The best score of positive predictive value and specificity was obtained for males with the combined predictor (IPM1 + IPM2 < 0.12) and with single predictor (IPM1 < 0.10) for females. To conclude, the combined predictor has resulted in better discrimination in males, while in females the single predictor (IMP1 < 0.10) did slightly better. Further studies are warranted to test the combination of dental and skeletal indicators for the prediction of 12 years in the studied population.

Poor implementation of tobacco control measures and lack of education influences the intention to quit tobacco: a structural equation modelling approach.

BACKGROUND: Tobacco consumption remains a public health issue and is one of the major causes of death in India. This study presents a validated conceptual model to assess the interaction between education, perceived application of tobacco control measures, type of tobacco and their effects on the intention to quit tobacco. Additionally, the direct and mediating roles of tobacco use -frequency, -duration, and -dependency on the intention to quit is also investigated. METHODS: An analytical cross-sectional study was carried out, and data from tobacco users of six randomly selected states in India was collected via face-to-face interviews. Structural equation modeling (SEM) was performed using R v 3.6.3 to test the model fit and to explore the association between tobacco control measures and the intention to quit tobacco. RESULTS: From 1962 tobacco users, 43.7% wanted to quit tobacco immediately. Tambakoo (57.7%) was the most common type of tobacco used and 68.9% said that minors could buy tobacco. Findings from SEM showed that that one standard deviation (SD) increase in the perceived application of tobacco control measures is directly associated with a 0.181 SD increase in the intention to quit tobacco (B = 0.181, P < 0.001), and this effect was partially mediated by frequency of tobacco consumption (B = 0.06, P < 0.05). Also, a better education level was associated with a higher intention to quit tobacco (B = 0.14, P < 0.001). CONCLUSIONS: To conclude, the application of tobacco control measures and a better education level may positively affect the intention to quit tobacco. The frequency of tobacco use and the number of influencers play an essential role in deciding to quit. In future, longitudinal studies are recommended to further substantiate the evidence.

Associations between fear of COVID-19, dental anxiety, and psychological distress among Iranian adolescents.

OBJECTIVES: The present study evaluated the association of fear of COVID-19 with dental anxiety, oral health-related quality of life (OHRQoL), and psychological distress (depression, anxiety and stress), as well as exploring the mediating role of dental anxiety in the association of fear of COVID-19 with OHRQoL and psychological distress. METHODS: A cross-sectional study was conducted among adolescents in high schools of Qazvin city (Iran) from March-June 2021, recruited through a two-stage cluster sampling method. All the adolescents completed a self-administered survey assessing (i) fear of COVID-19, (ii) depression, anxiety and stress, (iii) OHRQoL, and (iv) dental anxiety. Structural equation modelling was used to evaluate all the hypothesised associations, and the model fit was estimated. RESULTS: A total of 2429 adolescents participated in the study. The conceptual model fitted the data well. Fear of COVID-19 had a direct effect on dental anxiety (B = 0.316; bias-corrected bootstrapping 95% CI = 0.282, 0.349), depression (B = 0.302; bias-corrected bootstrapping 95% CI = 0.259, 0.347), anxiety (B = 0.289; bias-corrected bootstrapping 95% CI = 0.246, 0.334), stress (B = 0.282; bias-corrected bootstrapping 95% CI = 0.237, 0.328), and OHRQoL (B = -0.354; bias-corrected bootstrapping 95% CI = -0.530, -0.183). Also, dental anxiety mediated the association of fear of COVID-19 with depression, anxiety stress, and OHRQoL. CONCLUSIONS: High levels of fear of COVID-19 were associated with high levels of dental anxiety and poorer OHRQoL. Moreover, fear of COVID-19 was positively associated with anxiety, depression and stress. Increased levels of dental anxiety were also associated with increased anxiety, stress, depression, and poorer OHRQoL.

A systematic review on neutrophils interactions with titanium and zirconia surfaces: Evidence from in vitro studies.

OBJECTIVES: This systematic review aimed to assess in vitro studies that evaluated neutrophil interactions with different roughness levels in titanium and zirconia implant surfaces. MATERIAL AND METHODS: An electronic search for literature was conducted on PubMed, Embase, Scopus, and Web of Science and a total of 14 studies were included. Neutrophil responses were assessed based on adhesion, cell number, surface coverage, cell structure, cytokine secretion, reactive oxygen species (ROS) production, neutrophil activation, receptor expression, and neutrophil extracellular traps (NETs) release. The method of assessing the risk of bias was done using the toxicological data reliability assessment tool (TOXRTOOL). RESULTS: Ten studies have identified a significant increase in neutrophil functions, such as surface coverage, cell adhesion, ROS production, and NETs released when interacting with rough titanium surfaces. Moreover, neutrophil interaction with rough-hydrophilic surfaces seems to produce less proinflammatory cytokines and ROS when compared to naive smooth and rough titanium surfaces. Regarding membrane receptor expression, two studies have reported that the FcγIII receptor (CD16) is responsible for initial neutrophil adhesion to hydrophilic titanium surfaces. Only one study compared neutrophil interaction with titanium alloy and zirconia toughened alumina surfaces and reported no significant differences in neutrophil cell count, activation, receptor expression, and death. CONCLUSIONS: There are not enough studies to conclude neutrophil interactions with titanium and zirconia surfaces. However, different topographic modifications such as roughness and hydrophilicity might influence neutrophil interactions with titanium implant surfaces.

Online Parenting Intervention for Children's Eating and Mealtime Behaviors: Protocol of a Randomized Controlled Trial.

INTRODUCTION: Obesity and overweight are significant health problems among Australian children. Parents play a vital role in establishing healthy eating behaviors in their children. However, parents often experience difficulties in implementing effective parenting practices and lack confidence in their ability to help children adopt these behaviors. This trial will evaluate the efficacy of an online program, Healthy Habits Triple P, in improving children's snacking and mealtime behaviors and related parenting practices. METHODS AND ANALYSIS: This is a single-blinded, randomized controlled trial for parents of young Australian children aged 2-6 years. Participants will be recruited through childcare centers, social media, online parent forums and existing networks. The participants in the intervention arm will receive access to a web-based parenting intervention in addition to nutrition-related information for parents published by the National Health and Medical Research Council of Australia; those in the control arm will receive nutrition-related information only. After the completion of the study, the parenting intervention will be offered to the control arm. The primary outcome will be improvement in children's eating habits. The secondary outcomes include parents' self-efficacy, confidence, children's mealtime behaviors and mealtime parenting strategies. Both primary and secondary outcomes will be evaluated through online-administered, validated parent-reported questionnaires. We will also undertake a quantitative and qualitative evaluation of the practicality and acceptability of the intervention.