Effectiveness of Online Interactive Education in Dental Radiology.

OBJECTIVE: This study aimed to assess the effectiveness of an interactive education approach in oral and maxillofacial radiology for dentists, utilizing the online interactive educational program Mentimeter. METHOD: Seven continuing education sessions for dentists in oral and maxillofacial radiology were conducted employing Mentimeter. Following these sessions, surveys gauged participants' responses to the learning method and its effectiveness. The questionnaire comprised 20 questions categorized into convenience, active learning, academic achievement, time management, and lecture quality. RESULT: Among about 300 participants, 222 responded to the survey, with 74 (33.3%) having prior experience in similar education. Across categories of active learning, academic achievement, and lecture quality, participants consistently rated the method with an average score exceeding 4 out of 5, indicating a highly positive response. Statistically significant gender differences were observed in 9 out of 20 questions, with female respondents providing more positive evaluations than males. Respondents without prior similar education reported enhanced focus and understanding compared to those with experience. No statistically significant differences were observed in other survey questions. CONCLUSION: In the realm of continuing education in oral and maxillofacial radiology for dentists, the interactive educational program Mentimeter emerges as an effective tool, fostering positive academic achievements through active learning.

Foreign body aspiration and ingestion in dental clinic: a seven-year retrospective study.

Background: This retrospective study investigated the incidence rate of accidental foreign body aspiration and ingestion according to patient sex, age, and dental department. This study aimed to verify whether the incidence rate is higher in geriatric than in younger patients and whether it is different among dental departments. Methods: Accidental foreign body aspiration and ingestion cases were collected from electronic health records and the safety report system of Yonsei University Dental Hospital from January 2011 to December 2017. The collected data included patients' age, sex, medical conditions, treatment procedures, and foreign objects that were accidentally aspirated or ingested. The incidence rate was calculated as the number of accidental foreign body aspirations and ingestions relative to the total number of patient visits. Differences depending on the patients' sex, age, and dental department were statistically identified. Results: There were 2 aspiration and 37 ingestion cases during the 7-year analysis period. The male to female incidence ratio was 2.8:1. The incidence rate increased with age and increased rapidly among those aged 80 years or older. Seven of the 37 patients with accidental foreign body ingestion had intellectual disability, Lou Gehrig's disease, dystonia, or oral and maxillofacial cancer. The incidence rate was highest in the Predoctoral Student Clinic and the Department of Prosthodontics. The most frequently swallowed objects were fixed dental prostheses and dental implant components. Conclusion: The incidence rate of accidental foreign body aspiration and ingestion differed according to patient sex, age, and dental department. Dental practitioners must identify high-risk patients and apply various methods to prevent accidental foreign body aspiration and ingestion in dental clinics. Inexperienced practitioners should be particularly careful.

Factors affecting root migration after coronectomy of the mandibular third molar.

ABSTRACT: Nerve injury especially inferior alveolar nerve (IAN) is the one of the complications that occur when the mandibular third molar (M3) is extracted and in case of high risk patients, coronectomy might be an alternative to tooth extraction. The purpose of this retrospective study was to analyze root migration and its influencing factors at 6 months after coronectomy in both 2- and 3-dimensions using periapical view and cone-beam computed tomography (CBCT). We analyzed 33 cases of root remnant after coronectomy and measured the amount of migration in CBCT. The following factors that could possibly affect root migration were also analyzed: age, gender, number of M3 roots, shape of M3s, Pell, and Gregory classification, mesiodistal (MD) angulation, buccolingual (BL) angulation, contact point with the second molar, root curvature, and complete removal of the coronal portion. Migration of greater than 2 mm was found in 64% of the roots in the 2-dimensional (2D) analysis, and the average root migration was 4.11 mm in the 3-dimensional (3D) analysis. The factors affecting migration were the root morphology, complete removal of the coronal portion, impaction depth, and MD angulation in the 2D analysis, and MD and BL angulation in the 3D analysis. Ensuring sufficient space for root migration especially considering angulation, depth and complete removal of the coronal portion might be important factors after coronectomy of the M3. Root remnant after coronectomy of M3 may migrate in young patients who has sufficient empty coronal space and this may reduce the nerve damage by the separation of IAN and M3.

Orthodontic Extrusion of Mandibular Third Molar With a Miniscrew and Cross-Arch Elastic.

Sensory dysfunction is the most serious complication that occurs after extracting lower third molars in close proximity to the inferior alveolar nerve (IAN). Even experienced surgeons have difficulties in avoiding nerve damage when the root is anatomically adjacent to the nerve canal. A useful method for reducing nerve damage during extraction is to perform orthodontic extrusion, in which the distance between the nerve and the root increased after applying an orthodontic force on the third molar while extruding the tooth. Here, we report the case of a 37-year-old female who presented with a partially erupted left lower third molar and risk of IAN nerve damage because of close anatomical proximity between the nerve and root. She underwent extraction using a miniscrew placed in the maxilla and a routine orthodontic mechanism using a cross-arch elastic band that induced a 3-mm vertical eruption in the impacted third molar without using complex orthodontic devices. In addition, tilting the dental axis to the lingual side resolved the proximity between the IAN and the tooth, thereby allowing extraction to proceed without major complications.

Effect of teriparatide on early sinus graft healing in the ovariectomized rabbit.

OBJECTIVES: The purpose of this study was to determine the effect of administering intermittent parathyroid hormone 1-34 [teriparatide, (PTH)] on the maxillary sinus lift and bone grafting in osteoporotic rabbits induced by ovariectomy and glucocorticoid. MATERIALS AND METHODS: Ovariectomies were performed on 20 female New Zealand white rabbits that were randomly divided into two groups: (a) the PTH group (n = 10), in which 10 µg kg-1  day-1 PTH was injected subcutaneously 5 days a week for 5 weeks (from 1 week before until 4 weeks after sinus surgery), and (b) the saline group (n = 10), in which saline substituted PTH at the same dose, mode of administration, and duration. Bone grafting with bovine bone mineral was augmented into 13 sinuses, and bone grafts and implants were simultaneously performed in seven sinuses, in both groups. Animals were sacrificed at 4 weeks after surgery. To determine whether PTH was an effective treatment for osteoporosis, we measured the bone mineral density (BMD) of the right femur using micro-computed tomography and performed radiographic and histometric analyses of the maxillary sinus surgery site. The Mann-Whitney test was used for statistical analysis. RESULTS: It was found that BMD increased in the femur, whereas none of the radiographic and histometric parameters differed significantly between the groups in the sinus, while there were large interindividual variations within groups. CONCLUSIONS: These findings suggest that intermittent PTH does not promote new bone formation in the augmented maxillary sinus of ovariectomized rabbits.

Characteristics of patients who visit the dental emergency room in a dental college hospital.

BACKGROUND: Emergencies in dentistry can be classified as medical and dental. Medical emergencies occur mainly during dental treatment in patients with a systemic disease. Dental emergency departments are largely divided into dental emergency rooms located in dental college hospitals and medical emergency rooms located in medical institutions. This study aimed to analyze the characteristics of and provide help to dental emergency patients in a dental hospital. METHODS: Overall, 1806 patients admitted to a dental emergency room at Yonsei University Dental Hospital for 1 year were included. The data collection period was from October 1, 2014 to September 30, 2015. An investigator reviewed medical records from the electronic medical record (EMR) system and radiographs. RESULTS: The patients were 1,070 men and 736 women. The sex ratio was 1.45:1. The commonest age group was of 0-9 years, including 451 (25.0%) patients, followed by 20-29 years, including 353 (19.5%) patients, and 30-39 years, including 277 (15.3%) patients. Of the 108 patients transferred to the Severance emergency department, 81 had trauma, 19 were in pain, 4 were bleeding, and 4 had other complaints. Among chief complaints, 1,079 patients (60.3%) had trauma, 564 (31.5%) had pain, and 75 (4.2%) had bleeding. Twenty-three cases (1.3%) were caused by temporomandibular disorder (TMD). CONCLUSION: Dentists should be able to adequately assess patients in a dental emergency room and treat trauma, pain, and bleeding.

Bleeding related to dental treatment in patients taking novel oral anticoagulants (NOACs): a retrospective study.

OBJECTIVE: Several novel oral anticoagulants (NOACs) are currently prescribed for patients suffering from atrial fibrillation, pulmonary thromboembolism, and venous thrombosis. However, there is no clinical guideline for dental treatment in patients taking NOACs. This study investigated bleeding events related to various dental treatments. MATERIALS AND METHODS: This retrospective study included 120 patients (153 cases) who were prescribed NOACs and received dental procedures in the Department of Advanced General Dentistry at Yonsei University Dental Hospital from January 2014 to June 2017. The indication for NOACs, initiation of NOACs, duration of discontinuance, creatinine clearance, and type of dental treatment were investigated. Bleeding events were assessed at a follow-up visit to the clinic. RESULTS: Postoperative bleeding occurred in only 9 of the 153 included cases; they comprised 2 cases of scaling, 3 cases of simple extraction, 3 cases of the first stage of implant surgery, and 1 case of resin filling. The creatinine clearance (P = .111) and duration of discontinuance (P = .222) did not differ significantly between the groups with and without bleeding events. CONCLUSIONS: Our data indicate that most dental treatments may be performed in patients taking NOACs without an increased likelihood of bleeding events regardless of the discontinuance duration. Moreover, any postoperative bleeding can be stopped by applying compressive pressure or local hemostatic agents. CLINICAL RELEVANCE: Our study suggests that patients taking NOACs who need dental treatments may have a bleeding tendency based on our retrospective data. Preoperative history taking and treatment modification should therefore be considered before performing dental surgery.

Comparison of postnatal catch-up growth according to definitions of small for gestational age infants.

PURPOSE: Small for gestational age (SGA) is confusingly defined as birth weight (BW) either below 3rd percentile or 10th percentile for infants. This study aimed to compare postnatal catch-up growth between SGA groups according to different definitions. METHODS: Data of 129 infants born with BW below the 10th percentile and admitted to Korea University Anam Hospital and Ansan Hospital were retrospectively reviewed. Height and weight were measured at 6, 12, and 24 months. Results were compared between group A (BW: <3rd percentile) and group B (BW: 3rd-10th percentile). RESULTS: Group A included 66 infants and group B included 63. At age 6 months (n=122), 62.9% of group A and 71.7% (P=0.303) of group B showed catch-up growth in weight. At 6 months (n=69), 55.9% of group A and 80.0% of group B (P<0.05) showed catch-up growth in height. At 12 months (n=106), 58.5% of group A, and 75.5% (P=0.062) of group B showed catch-up growth in weight. At 12 months (n=75), 52.8% of group A and 64.1% of group B (P=0.320) showed catch-up growth in height. Up to age 24 months, 66.7%/80.0% in group A and 63.6%/80.0% in group B showed catch-up growth in weight/height. CONCLUSION: Despite different definitions, there were no significant differences between the two SGA groups in postnatal catch-up growth up to age 24 months, except for height at 6 months. Compared to infants with appropriate catch-up growth, low gestational age and BW were risk factors for failed catch-up growth at 6 months.

Distribution of medical status and medications in elderly patients treated with dental implant surgery covered by national healthcare insurance in Korea.

BACKGROUND: The purpose of this study was to investigate the distribution of systemic diseases and medications in patients older than 65 years of age who visited the hospital for implant treatment, as well as to investigate basic information about surgical complications that may occur after insured implant treatment. METHODS: A total of 126 patients over 65 years of age were treated for implant surgery from October 1, 2013 to October 30, 2016. Electronic chart review was conducted to obtain medical records, which included sex, age, systemic diseases, medication(s) being taken, and control of the medications. Five patients were excluded due to lack of medical records giving information about systemic disease. RESULTS: Of the 126 patients, 112 (88.9%) were taking medication due to systemic disease and 9 patients (7.1%) were not. The sex distribution was 71 women and 55 men and the highest proportion of patients were between 65 and 69 years old. The most common diseases were, from most to least frequent, hypertension, cardiovascular disease, diabetes, and osteoporosis. The drug groups that can cause major complications after dental treatment were classified as hemorrhagic, osteoporotic, and immunosuppressive agents, and were taken by 45 (35.7%), 22 (17.5%) and 4 (3.2%) patients, respectively. CONCLUSION: Given that 88.9% of the elderly patients who were eligible for insurance implant treatment had systemic disease, it is necessary to carefully evaluate patients' medical histories and their general conditions in order to prevent emergencies during implant surgery.

Parathyroid Hormone (1-34) Might Not Improve Early Bone Healing after Sinus Augmentation in Healthy Rabbits.

Purpose. This study evaluated the effect of administering intermittent parathyroid hormone [PTH (1-34), henceforth PTH] on the early-stage bone healing of maxillary sinus augmentation in healthy rabbits. Materials and Methods. Bovine bone mineral was grafted on the sinuses of 20 female New Zealand white rabbits. The animals were randomly divided into two groups, PTH (n = 10) or saline (n = 10), in which either PTH or saline was injected subcutaneously 5 days a week for 2 weeks. Half of the animals in each group were killed at 2 weeks postoperatively and the other half were killed at 4 weeks postoperatively. The dosage of PTH was 10 µg/kg/day. Radiographic and histomorphometric analyses were performed. Result. The new bone area (NBA) did not differ significantly between the PTH and saline groups. The NBA in the PTH group in the total augmented area and in the demarcated window, center, and Schneiderian membrane regions increased significantly from 2 to 4 weeks. The number of osteoclasts decreased significantly from 2 to 4 weeks in both groups, with no difference between the two groups. Conclusion. Intermittent PTH might not stimulate new bone formation in healthy rabbits during the first 4 weeks of healing.

Teriparatide therapy for bisphosphonate-related osteonecrosis of the jaw associated with dental implants.

This report describes a case of teriparatide (TPTD) therapy for bisphosphonate (BP)-related osteonecrosis of the jaw induced after implant placement. A 75-year-old woman taking oral BP was referred with uncontrolled osteonecrosis of the mandible related to the implant placement. With conservative treatment, BP was suspended and daily subcutaneous injections of 20 µm/d TPTD were started. After 4 months of the therapy, fixture removal and sequestrectomy were performed. Histological analysis revealed necrotic lamellar bone and empty osteocytic lacunae. In contrast, multiple irregular reversal lines of the lamellar bone and active osteoblasts were noted adjacent to the lesion. There was a significant increase in serum C-terminal telopeptide cross-link of type 1 collagen and serum osteocalcin after commencement of the therapy. After 7 months off therapy, the serum levels of the 2 markers remained at a high level compared with the baseline.

The influence of mandibular skeletal characteristics on inferior alveolar nerve block anesthesia.

BACKGROUND: The inferior alveolar nerve block (IANB) is the most common anesthetic techniques in dentistry; however, its success rate is low. The purpose of this study was to determine the correlation between IANB failure and mandibular skeletal characteristics. METHODS: In total, 693 cases of lower third molar extraction (n = 575 patients) were examined in this study. The ratio of the condylar and coronoid distances from the mandibular foramen (condyle-coronoid ratio [CC ratio]) was calculated, and the mandibular skeleton was then classified as normal, retrognathic, or prognathic. The correlation between IANB failure and sex, treatment side, and the CC ratio was assessed. RESULTS: The IANB failure rates for normal, retrognathic, and prognathic mandibles were 7.3%, 14.5%, and 9.5%, respectively, and the failure rate was highest among those with a CC ratio < 0.8 (severe retrognathic mandible). The failure rate was significantly higher in the retrognathic group than in normal group (P = 0.019), and there was no statistically significant difference between the other two groups. CONCLUSIONS: IANB failure could be attributable, in part, to the skeletal characteristics of the mandible. In addition, the failure rate was found to be significantly higher in the retrognathic group.

Effect of premolar extraction and presence of the lower third molar on lower second molar angulation in orthodontic treatment.

OBJECTIVE: To evaluate the change in mandibular second-molar (M2) angulation in orthodontic treatment with premolar extraction and lower third molar (M3). STUDY DESIGN: Panoramic radiographs were evaluated in 3 groups of 129 participants: (1) control, no orthodontic treatment (n = 65); (2) extraction, orthodontic treatment with premolar extraction (n = 30); and (3) nonextraction, orthodontic treatment without premolar extraction (n = 34). The angular difference and ratio of M2 to the first molar (M1), the change in the angulation of M2 between pre- and postorthodontic treatment, and the distal bone level of M2 were assessed. RESULTS: The angular difference and ratio of M2 to M1, the angulation change of M2 between pre- and postorthodontic treatment, and the distal bone level of M2 were higher in the nonextraction group than in the control and extraction groups. CONCLUSIONS: The successful orthodontic alignment of the M2 may not be achieved in nonextraction cases when the M3s are present.

Effect of recombinant human bone morphogenetic protein-2/absorbable collagen sponge (rhBMP-2/ACS) on healing in 3-wall intrabony defects in dogs.

BACKGROUND: Recombinant human bone morphogenetic protein-2 (rhBMP-2) in an absorbable collagen sponge (ACS) carrier is being evaluated as a candidate therapy for periodontal regeneration. The objective of this study was to evaluate regeneration of alveolar bone and cementum, and associated root resorption and ankylosis following surgical implantation of rhBMP-2/ACS in a canine clinical model. METHODS: Bilateral 3-wall intrabony periodontal defects were surgically induced in the premolar region in the maxilla and mandible in 8 young adult Korean mongrel dogs. The defects in each animal received rhBMP-2/ACS (rhBMP-2 at 0.2 mg/ml, total implant volume/defect approximately 0.1 ml) or buffer/ACS, or served as sham-operated controls. Surgeries were sequenced for each animal to provide postmortem observations following 8- and 24-week healing intervals. Treatment outcomes were evaluated using clinical, radiographic, and histometric parameters. RESULTS: Surgical implantation of rhBMP-2/ACS resulted in accelerated enhanced bone formation in the 3-wall intrabony periodontal defects but in no apparent enhancement of cementum regeneration. rhBMP-2/ACS did not appear to be associated with aberrant healing events such as root resorption and ankylosis under these simulated clinical conditions. CONCLUSIONS: Surgical implantation of rhBMP-2/ACS may be used safely to support regeneration of alveolar bone in intrabony periodontal defects in dogs without aberrant events such as root resorption or ankylosis complicating the regenerative procedure. rhBMP-2/ACS does not appear to have a significant effect on cementum regeneration and formation of a functional periodontal ligament in this model.