Assessing Adherence to Provider's Recommendations in Caries Risk Assessment and Management: A Retrospective Data Review.

AIM: To evaluate the distribution of caries risk category of patients at a dental institution and determine adherence to providers' recommendations. MATERIALS AND METHODS: A cross-sectional retrospective review of 1,235 patients records that included data collection on demographics, the sum of the number of decayed, missing due to caries, and filled teeth in the permanent teeth (DMFT), presence of frequent snacking, stimulated salivary flow rate, stimulated saliva pH, saliva buffering capacity, biofilm activity, caries risk category, anti-caries prescription accept/decline, and change in the caries risk category. Statistical analysis was carried out through Pearson's Chi-squared test and linear model ANOVA with a significance level of 0.05. RESULTS: Pearson's Chi-squared test showed a statistically significant difference in frequency by risk category (p < 0.001) indicating that patients were skewed toward high and extreme caries risk. Linear model ANOVA showed that higher risk categories were associated with lower salivary flow rates (p = 0.010) and higher biofilm activity (p < 0.001). About, 1 out of 3 patients were reported to have frequent snacking (N = 391, 32%). Frequent snacking patients were more likely to present with higher caries risk assessment (p < 0.001), younger age (p < 0.001), and female (p < 0.001). Despite recommendations from the dental student provider, only 27% accepted the anti-cavity prescriptions while 61% declined the recommendation. CONCLUSION: Distribution of caries risk category is not evenly distributed, but rather skewed toward high and extreme caries risk levels. Despite the identified risks, there is low adherence to the recommendations provided by healthcare providers. The results underscore the necessity for targeted interventions and initiatives aimed at fostering behavioral changes to enhance oral health outcomes. CLINICAL SIGNIFICANCE: There is a high need for targeted interventions and initiatives that promote behavioral changes to enhance oral health outcomes.

Correlation of radiographic features and treatments with the frequency of recurrence in odontogenic keratocysts of the mandible.

PURPOSE: Odontogenic keratocysts (OKCs) have high recurrence potential. The aim of the study is to evaluate the correlation of radiographic features and treatments with the frequency of recurrence in OKCs in the mandible. MATERIALS AND METHODS: This is a cohort retrospective study. The size of the lesions was measured on orthopantomography. Radiographic features (unilocular or multilocular), location, treatment type (enucleation or marsupialization), follow-up time, age, and sex were variable factors. Subjects were studied in 2 groups: a recurrence group and a nonrecurrence group. The radiographic size was considered to be a predictive factor, and the frequency of recurrence was an outcome of the study. An independent t-test and chi-squared test were used to compare variables between recurrence and nonrecurrence groups. Cox regression was applied to the time effect evaluation of the lesion's size and recurrence. A receiver operating characteristic test was used to find a cutoff point for recurrence in the size of radiographic views. RESULTS: Ninety-one subjects were studied. Radiographic features and sizes were different between the 2 groups. The frequency of recurrent lesions was significantly different in various sites of the mandible. Cox regression demonstrated a positive effect of follow-up time on the risk of recurrence. In a 1-year increase in the follow-up time, the recurrence rate increased 1.07 times. An analysis of the data showed a positive relationship between radiographic size and recurrence rate. A 1-cm increase in the lesion's size increased the recurrence rate 1.67 times. A receiver operating characteristic test demonstrated 5.25 cm as a cutoff point in radiographic size; the radiographic size sensitivity was 88.5% (69.8%-97.4%), and specificity was 93.8% (85%-98.3%) for recurrence lesions. Lesions that were 5.25 cm or more on radiographic views had a significant relationship with recurrence rate (P < 0.05). The positive predictive value was 85.2% (65.4%-95.1%), and the negative predictive value was 95.3% (86%-98.8%). CONCLUSIONS: The radiographic size may be a predictive factor for the frequency of recurrence lesions in OKCs. Primary multilocular lesions had a greater probability for recurrence than unilocular lesions.

Relationship between mandibular anatomy and the occurrence of a bad split upon sagittal split osteotomy.

PURPOSE: A bad split is a troublesome complication of the sagittal split osteotomy (SSO). The aim of this study was to evaluate the relation between the occurrence of a bad split and mandibular anatomy in SSO using cone-beam computed tomography. MATERIALS AND METHODS: The authors designed a cohort retrospective study. Forty-eight patients (96 SSO sites) were studied. The buccolingual thickness of the retromandibular area (BLR), the buccolingual thickness of the ramus at the level of the lingula (BLTR), the height of the mandible from the alveolar crest to the inferior border of the mandible, (ACIB), the distance between the sigmoid notch and the inferior border of the mandible (SIBM), and the anteroposterior width of the ramus (APWR) were measured. The independent t test was applied to compare anatomic measurements between the group with and the group without bad splits. The receiver operating characteristic (ROC) test was used to find a cutoff point in anatomic size for various parts of the mandible related to the occurrence of bad splits. RESULTS: The mean SIBM was 47.05±6.33 mm in group 1 (with bad splits) versus 40.66±2.44 mm in group 2 (without bad splits; P=.01). The mean BLTR was 5.74±1.11 mm in group 1 versus 3.19±0.55 mm in group 2 (P=.04). The mean BLR was 14.98±2.78 mm in group 1 versus 11.21±1.29 mm in group 2 (P=.001). No statistically significant difference was found for APWR and ACIB between the 2 groups. The ROC test showed cutoff points of 10.17 mm for BLR, 36.69 mm for SIBM, and 4.06 mm for BLTR. CONCLUSION: This study showed that certain mandibular anatomic differences can increase the risk of a bad split during SSO surgery.