The Use of a New Safe Angle Concept for Immediate Implant Placement in the Anterior Maxilla: A Cross-Sectional CBCT Study

PURPOSE: To introduce a new method for labiopalatal positioning and angulation of immediately placed dental implants in the anterior maxilla with relation to the type of abutment used (straight/angled abutment). MATERIALS AND METHODS: CBCT scans from the database of a private practice were searched for patients who received immediate implants in the anterior maxilla. After superimposition of the initial and postoperative scans, the incisor root angle (IRA), incisor implant angle (IIA), and the difference between these angles were measured. An assessment was then made about whether the implant position would be within the safe angle or not. Age, sex, tooth/implant site, and type of prosthetic abutment (straight/angled) were retrieved from the patients' records. RESULTS: A total of 74 patients with 95 immediate implants altogether were selected for analysis. In regard to the type of abutment, 76 (80%) were straight, and 19 abutments (20%) were angled. Regardless of abutment type, 72 implants (75.8%) were placed within the safe angle, while 23 implants (24.2%) were placed outside it. All 19 implants with angled abutments were placed outside the safe angle. There were statistically significant associations between placement within the safe angle and type of abutment (P < .001; OR = 19), IRA (P < .001; effect size = 0.904), difference between IIA and IRA (P < .001; effect size = 1.209), and sex (P < .001; OR = 2.995). There was no statistically significant association between placement within the safe angle and IIA (P = .757, effect size = 0.063), site (P = .200; effect size = 0.184 ), or age (P = .387; effect size = 0.208). There was a statistically significant association between the type of abutment and the IRA (P = .001; effect size = 0.762) as well as the difference between IIA and IRA (P < .001; effect size = 1.056). CONCLUSIONS: The safe angle concept can be used as a reliable planning tool to determine the correct implant positioning for immediate implant placement in the anterior maxilla. Applying the safe angle concept will reduce the need for angled abutments for prosthetic correction.

A Novel Dental Implant Approach for Crestal Sinus Elevation: A Case Series Study.

The aim of this study was to evaluate the radiographic and clinical outcomes of patients undergoing sinus membrane elevation via a minimally invasive crestal approach utilizing the dental implant. Twenty patients having 1 or more missing posterior teeth were included. The maxillary sinus membrane was elevated using dental implant via a crestal approach in areas with insufficient residual bone. CBCT scans were used to measure the amount of newly formed bone, implant length inside the sinus, bucco-palatal sinus width, and bone thickness. Surgical and postsurgical complications along with implant survival were also measured. The mean (±SD) values for the newly formed bone after 1 year were 2.4 (±1.87) mm, while values for implant length inside the sinus were 4 (±1.49) mm. The results showed that percentage of implant length inside the sinus and the palatal bone thickness were statistically significant positive predictors of the newly formed bone. Higher percentage of implant length inside the sinus and increased palatal bone thickness were associated with larger amounts of newly formed bone. A high patient satisfaction was reported along with a 100% implant survival. The utilization of the novel dental implant approach for crestal sinus elevation demonstrated predictable clinical and radiographic outcomes. This novel technique is simple to both patients and clinicians, rendering it a promising and cost-efficient procedure.

The impact of oral health literacy on dental anxiety and utilization of oral health services among dental patients: a cross sectional study.

BACKGROUND: Low oral health literacy levels and deficient oral health knowledge jeopardize the communication between dentists and patients in different communities. This study aimed to examine the impact and association of oral health literacy with patients' levels of dental anxiety and their utilization of dental health services. METHODS: This cross-sectional study was conducted at the Misr International University (MIU) dental clinics. The study utilized a structured, interview led questionnaire that was administered by second year dental students, over the period of two successive academic years 2018-2019 and 2019-2020. A total of 440 student interviewed a convenience sample of 440 dental patients: including 269 females (61.1%) and 171 males (38.9%). The questionnaire consisted of four sections; a demographic section, a modified Arabic Rapid Estimate of Adult Literacy (ARELAD-30) Tool that measures the ability of the participants to read 30 commonly used dental terms. This questionnaire was modified by the authors to measure the participants' knowledge by asking them to choose the most accurate meaning for each word based on their previous knowledge. Scoring was dependent on the participant's immediate correct pronunciation, as well as comprehension of each word. The Arabic Modified Dental Anxiety Scale (AMDAS) was used to measure the level of dental anxiety, and the dental health service utilization was measured using the Utilization of oral health services questionnaire. RESULTS: One quarter (24.1%) of the participants read the 30 items of the A-REALD correctly. The average percentage of correct responses to the meaning of the dental terms was 71.2%. There was no statistically significant association between A-REALD and knowledge scores (Spearman's Correlation coefficient ρ = -0.008, p-value = 0.872). There was a statistically significant inverse correlation between age and MDAS (Correlation coefficient ρ = -0.146, p-value = 0.002). A-REALD scores were inversely correlated with time since last visit (Regression coefficient = -0.027, p-value = 0.036, with 95% CI: -0.052 - -0.002). CONCLUSION: Within the limitations of this study, it can be concluded that oral health literacy is significantly associated to dental health services utilization, while, dental anxiety is related to other variables, such as age and gender.

Oral and para-oral lymphomas: a 10-year multi-center retrospective study in Egypt with time series analysis and forecasting to 2030.

BACKGROUND: Little is known about the epidemiology of lymphomas occurring in oral and para-oral sites, especially in developing countries such as Egypt. Hence, the aim of this study was to describe the frequency and time trends of oral and para-oral lymphomas in Cairo governorate from 2010 to 2019, with forecasting to 2030, and to examine relations between age, gender, site and type of lymphoma. METHODS: Histopathological reports of patients diagnosed with oral and para-oral lymphomas from 2010 to 2019 were retrospectively retrieved from archives of six different centers in Cairo governorate. Data regarding age, gender and site was collected and associations between types of lymphoma and these variables were detected using appropriate statistical methods. The significance level was set at p ≤ 0.05. Time series analysis was used to determine the trend of lymphoma frequency within 10 years of the study and to predict frequency until 2030. RESULTS: Lymphomas constituted 2.86% of oral and para-oral lesions. Non-Hodgkin lymphoma was more common than Hodgkin lymphoma. Patients with non-Hodgkin lymphoma showed a higher median age than patients with Hodgkin lymphoma (p = 0.001). Non-Hodgkin lymphoma was more prone to occur intra-orally (p = 0.014). No statistical significance was observed in gender distribution between Hodgkin and non-Hodgkin lymphoma. Even though no specific time trend was observed from 2010 to 2019, forecasting for frequency of lymphomas through 10 years (2020 to 2030) showed a predicted increase. CONCLUSIONS: The findings of this study were consistent with majority of other studies held in various geographic regions. The study revealed that frequency of oral and para-oral lymphomas in Cairo governorate is expected to rise; hence, oral pathologists should be more clinically suspicious and expect to encounter these lesions more in their practice within the upcoming years.

Applying the Kirkpatrick model to evaluate dental students' experience of learning about antibiotics use and resistance.

INTRODUCTION: "Antibiotic resistance" is of main concern in global health and that it could hinder the achievement of sustainable development goals. One of the reported contributing factors is the irrational prescribing behaviour of healthcare professionals including dentists. Efforts to design and evaluate effective educational programmes for undergraduate dental students about appropriate prescribing behaviour during their early educational years could mitigate the risk of antibiotic resistance. MATERIALS AND METHODS: A total of 322 students participated in the study. Their knowledge of antibiotics and antibiotic resistance was assessed. Students received a specially designed, interactive educational programme. The success of the programme was assessed after the educational sessions and 2 years later using Kirkpatrick's four-level evaluation model. RESULTS: This study is the first study to use Kirkpatrick model to evaluate an educational programme for dental students. The results of the first level of evaluation showed an overall satisfaction score of 82.1%. The second level revealed an increase in the percentage of correct answers after the educational sessions from 68.3% to 80%, and significant agreement with responsible antibiotics usage (p-value = .020, Effect size = 0.121). The third level showed that the percentage of correct answers 2 years later was 87.5%. The fourth level confirmed the success of the programme as 88.9% of participants reported using the knowledge gained from the programme when prescribing antibiotics. CONCLUSIONS: Our study emphasises the success of the used educational programme and highlights the need for educational interventions in the under graduate dental curriculum.

Association between oral health-related quality of life and general health among dental patients: a cross-sectional study.

Globally, the prevalence of chronic diseases is increasing significantly, causing deterioration of oral and general health and therefore quality of life. The present study was designed to assess the relationship between oral health-related quality of life and general health of dental patients. The study is part of the University's plan to achieve the United Nations Sustainable Development Goals number 1, 3, 4 and 5. Dental school students' satisfaction with their early engagement in clinical activities and research work was also evaluated. A convenience sample of 600 subjects attending dental clinics aged ≥18 years of both sexes was included in the study. Second-year dental students conducted the study under the supervision of public health staff members over two successive academic years (2015-2016 and 2016-2017). Oral health-related quality of life was assessed using the Dental Impact on Daily Living (DIDL) questionnaire. Blood pressure, random blood glucose level, body mass index, and waist circumference were measured as indicators of general health. There were statistically significant inverse correlations between DIDL scores and both mean blood pressure (r = -0.215, p < 0.001) and mean blood glucose level (r = -0.272, p < 0.001). Non-significant inverse correlations were observed between DIDL scores and both body mass index (r = -0.062, p = 0.131) and waist circumference (r = -0.040, p = 0.340). Students' satisfaction scores with research activities were high, ranging from 75.9% to 78%. Dentists must raise patients' awareness about the importance of oral health and its impact on their quality of life and general health. Participation of dental students in dental research is encouraged even in their early academic years.

Management of peri-implantitis using a diode laser (810 nm) vs conventional treatment: a systematic review.

The purpose of this study was to systematically assess clinical studies on the effect of using a diode laser in the treatment of peri-implantitis. Study question was "In patients with peri-implantitis around functional dental implants, can treatment by a diode Laser (810 nm) versus conventional treatment be effective in reducing the probing depth?". The study included only randomized controlled clinical trials that involved patients with peri-implantitis. Included articles evaluated a diode laser (810 nm) used as monotherapy or as adjuvant therapy in the non-surgical treatment while their control group received conventional methods of treatment for peri-implantitis. Studies that involved other types of laser treatment options, surgical therapy, photodynamic therapy, case series, or case reports were excluded. Three electronic databases were searched for published articles from 2010 to 2018: PubMed/Medline, Cochrane, and Web of Science. The references were manually hand searched for relevant articles. The search initially identified 44 studies, which were filtered to yield a total of 3 eligible studies. All included studies compared laser treatment by a diode laser (810 nm) to conventional therapy by mechanical debridement for a follow-up period ranging from 6 months to 1 year, and risk of bias was assessed for each of the three included studies. A qualitative analysis of the three studies was conducted. This systematic review could not support the usage of a diode laser in the treatment of peri-implantitis. To confirm this assumption, more clinical trials with long-term follow-up periods are recommended.

Assessing Knowledge, Practices, Use and Raising Awareness of Antibiotic And Antibiotic Resistance Among Dental Patients Before and After Educational Sessions / Avaliação de conhecimentos, práticas, uso e conscientização sobre antibióticos e resistência a antibióticos entre pacientes odontológicos antes e depois das sessões educacionais

Objectives: Education and awareness-raising are global health policy tools to modify public behavior towards antibiotic resistance. Considering the high frequency of antibiotic use and self-medication in Egypt, together with the lack of an awareness agenda, our objectives were to assess the knowledge and practices related to antibiotic use and resistance among patients attending dental clinics, and to evaluate the changes in knowledge following a specially designed one-on-one educational session. Material and Methods: A convenience sample of 310 dental patients participated in this study. A modified questionnaire was used to assess knowledge and practices related to antibiotic use and resistance. Second-year dental students were trained to administer the questionnaire and to use the educational materials they designed to raise awareness. Following the education session, patients completed another similar questionnaire to assess the changes in their knowledge. Results: Increasing awareness of antibiotic resistance can be an effective way to address the antibiotic resistance crisis. More than half of the participants (55.6%) did not know whether antibiotics treat diseases caused by bacterial or viral infections. The majority of participants (85.5%) had taken antibiotics during the last year, and (50.5%) of them had taken the same antibiotic more than once. Higher educational levels of the participants were significantly associated with a higher level of knowledge. Statistically significant increase in the percentages of correct answers to all questions were observed after the educational sessions. Conclusion: The one-on-one educational session is an effective approach to address the antibiotic resistance crisis (AU)

Objetivos: Educação e conscientização são ferramentas de política de saúde global para modificar o comportamento do público em relação à resistência aos antibióticos. Considerando a alta frequência de uso de antibióticos e automedicação no Egito, juntamente com a falta de uma agenda de conscientização, nossos objetivos foram avaliar o conhecimento e as práticas relacionadas ao uso de antibióticos e resistência entre pacientes atendidos em clínicas odontológicas, e avaliar as mudanças em conhecimento após uma sessão educacional especialmente projetada para este assunto. Material e Métodos: Uma amostra de 310 pacientes odontológicos participou deste estudo. Um questionário modificado foi usado para avaliar o conhecimento e as práticas relacionadas ao uso e resistência a antibióticos. Os alunos do segundo ano do curso de odontologia foram treinados para aplicar o questionário e usar os materiais educacionais que elaboraram para aumentar a conscientização. Após a sessão educacional, os pacientes responderam a outro questionário semelhante para avaliar as mudanças em seus conhecimentos. Resultados: Aumentar a conscientização sobre a resistência aos antibióticos pode ser uma forma eficaz de lidar com a crise de resistência aos antibióticos. Mais da metade dos participantes (55,6%) não sabia se os antibióticos tratam doenças causadas por infecções bacterianas ou virais. A maioria dos participantes (85,5%) havia tomado antibiótico no último ano e (50,5%) deles havia tomado o mesmo antibiótico mais de uma vez. O maior nível de escolaridade dos participantes foi significativamente associado a um maior nível de conhecimento. Aumentos estatisticamente significativos nas porcentagens de respostas corretas para todas as questões foram observados após a sessão educacional. Conclusão: A sessão educacional individual é uma abordagem eficaz para lidar com a crise de resistência aos antibióticos. (AU)