Improvement on oral health related quality of life after orthosurgical treatment: a mixed methods study.

The aim of this study was to understand the influence of orthosurgical treatment on oral health-related quality of life (OHRQoL) in patients with Class II and III skeletal malocclusion by conducting a mixed method case series study. Nineteen patients submitted to orthosurgical treatment in a private practice in Brazil were included in the sample. Data were collected retrospectively and interviews were held from March 2020 to July 2021. Patients answered to the Oral Health Impact Profile (OHIP-14) in the first part of the interview and subsequently answered the qualitative questions. The overall mean of OHIP-14 after treatment was 4.21 (SD 4.68). The qualitative data were analyzed according to thematic analysis and four themes emerged from the interviews: a) concept of quality of life, b) pre-treatment life, c) post-treatment life, and d) positive and negative aspects of treatment. Quality of Life was reported by the patients as the absence of feeling pain, having emotional and physical health, having a satisfactory esthetic appearance and self-esteem. Before treatment, most Class II patients used to complain about breathing and sleeping problems, while Class III patients complained more intensely about esthetics. Pain was a common problem reported by both Class II and Class III patients. In general, improvement was perceived in self-esteem, esthetics, function and pain. Complaints about negative aspects of the treatment were restricted to the postoperative period. The orthosurgical treatment was important for improving the OHRQoL of patients in terms of esthetic, functional and psychosocial aspects.

Dental Students' Positive and Negative Views on Aging at an Undergraduate Course at the University of British Columbia, Canada.

Background: Different views of aging exist, including ageism as the stereotyped idea about older adults in general. The objective of this study was to perform an initial exploration on how third-year undergraduate dental students at the University of British Columbia (UBC), Vancouver, Canada self-perceived themselves at ages 65, 75, or 85 years old. Methods: For a period of 10 years, and using a cross-sectional design, third-year undergraduate dental students were asked to envision themselves at 65, 75, or 85 years old in a brief 150-word written essay. We employed a thematic analysis of the textual data via a coding process as suggested. The main themes were identified and displayed in a table with their respective categories of information. NVivo® 12 (QSR International) software was used for data analysis. Results: Between 2010 and 2020, a total of 519 students enrolled in the UBC undergraduate dental program; 425 essays were collected. Initial coding and thematic analysis led to the identification of four main themes and eight categories; themes included "Ups and Downs," "Financial Sustainability," while categories focused on "Trade-offs," and "Camaraderie," for example. Different levels of ageism were also apparent when students saw themselves experiencing isolation and forgetfulness regardless of the selected age and the academic year. For other students, they anticipate aging would be healthy, joyful, and productive. Conclusion: Ageism was present when students imagined themselves at three different older ages, but so were more realistic views of an aging. Further studies are warranted to unravel the impact of geriatric education in tackling stereotypes and ageism.

Early childhood factors in the development of oral health behaviours in adolescence: A structural equation modelling approach.

OBJECTIVES: Oral health behaviour is a learning process that begins in the early years of an individual's life. The aim of this study was to evaluate the associations between demographic, socioeconomic, and psychosocial factors and oral health behaviours during the transition period from childhood to adolescence. METHODS: This was a cohort study with a follow-up of 7 years. The baseline assessment occurred in 2010 with a random sample of 639 preschool children from southern Brazil. Demographic, socioeconomic and psychosocial oral health conditions were assessed at baseline. Oral health habit variables were collected at follow-up and included questions regarding dental care and oral hygiene behaviours. Structural equation modelling was performed to assess the direct and indirect relationships between predictors at baseline in oral health behaviours at follow-up. RESULTS: A total of 449 children were re-examined at follow-up (70.3% cohort retention rate). Factors directly related to poorer oral health behaviours (lower use of dental services, dental visits for emergency reasons and lower frequency of toothbrushing) were lower household income, lower maternal education, lower frequency of visits to neighbours or friends, and male sex. Considering indirect pathways, the household income and maternal education at baseline influenced oral health behaviours at follow-up via visits to neighbours or friends. CONCLUSIONS: Our findings suggest that household income, maternal education and social capital play an important role in the development of oral health behaviours during the transition from childhood to adolescence. Acquisition of healthy oral behaviours is an important factor to consider in childhood. With this knowledge, public health policies can be developed to intervene in specific causal factors and improve oral health during this transitional period.

Effect of preheating on the physicochemical properties and bond strength of composite resins utilized as dental cements: An in vitro study.

STATEMENT OF PROBLEM: Little is known regarding the use of preheated composite resins to bond indirect restorations and its impact on mechanical properties when compared with resin cements. PURPOSE: The purpose of this in vitro study was to compare the chemical and physical properties and bond strength to enamel and ceramics of preheated composite resins and resin cements. MATERIAL AND METHODS: Two composite resins, the microhybrid Filtek Z250XT and the nanoparticulate Z350XT were tested, and 2 commercially available resin cements, the dual-polymerized Rely-X ARC and the light-polymerized Rely-X Veneer were used as controls. A device (HotSet) was used to preheat the composite resins to 69 °C before light-polymerization. The following properties were tested: flexural strength, modulus of elasticity, fracture toughness, microshear bond strength to enamel and ceramics, degree of conversion, flow, sorption and solubility, and color stability. Statistical analysis was done with ANOVA and Holm-Sidak for multiple comparisons (α=.05). RESULTS: Preheating had no significant effect on the degree of conversion, flexural strength, fracture toughness, solubility, or microshear bond strength to the enamel of the tested composite resins (P>.05). However, preheating increased the sorption and reduced the microshear bond strength to the ceramic (P<.05). The flowability of the composite resins increased with heating but showed lower values when compared with both resin cements (P<.05). Color stability was more affected in the preheated composite resins than in the resin cements. CONCLUSIONS: The preheating process resulted in little to no benefit in the evaluated properties for the composite resins. Resin cements appear to be the best option for cementing indirect restorations.

Improvement on oral health related quality of life after orthosurgical treatment: a mixed methods study

Abstract The aim of this study was to understand the influence of orthosurgical treatment on oral health-related quality of life (OHRQoL) in patients with Class II and III skeletal malocclusion by conducting a mixed method case series study. Nineteen patients submitted to orthosurgical treatment in a private practice in Brazil were included in the sample. Data were collected retrospectively and interviews were held from March 2020 to July 2021. Patients answered to the Oral Health Impact Profile (OHIP-14) in the first part of the interview and subsequently answered the qualitative questions. The overall mean of OHIP-14 after treatment was 4.21 (SD 4.68). The qualitative data were analyzed according to thematic analysis and four themes emerged from the interviews: a) concept of quality of life, b) pre-treatment life, c) post-treatment life, and d) positive and negative aspects of treatment. Quality of Life was reported by the patients as the absence of feeling pain, having emotional and physical health, having a satisfactory esthetic appearance and self-esteem. Before treatment, most Class II patients used to complain about breathing and sleeping problems, while Class III patients complained more intensely about esthetics. Pain was a common problem reported by both Class II and Class III patients. In general, improvement was perceived in self-esteem, esthetics, function and pain. Complaints about negative aspects of the treatment were restricted to the postoperative period. The orthosurgical treatment was important for improving the OHRQoL of patients in terms of esthetic, functional and psychosocial aspects.

Drawings to explore faculties' and students' perceptions from different generations cohorts about dental education: A pilot study.

INTRODUCTION/AIMS: We aimed at using drawings as a form of data collection to give voice to older and younger generations in regards to educational practices in undergraduate dentistry. MATERIALS AND METHODS: First year dental students (younger generations) and faculty members (older generations) produced drawings depicting their perceptions of the current dental education learning environment. Qualitative analysis was conducted independently by two researchers using the drawings to produce codes, categories and themes. RESULTS: 15 drawings were produced: 9/34 (26.4%) made by students and 6/20 (30%) made by faculty members. The generated themes indicated that students and faculties found that dental education is going through a challenging time, because of the restrictions caused by the COVID-19 pandemic; and that they were aware about the evident division between basic/preclinical and applied/clinical courses. Faculties showed hopeful signs that the situation may get better. Students' drawings evoked the following topics: digital connectedness, diversity, time goes by, and future aspirations in Dentistry. DISCUSSION: This study reinforced the validity of visual methods as an approach in research and showed different graphical features (features that might be intentionally or unintentionally represented in the drawings) that gave voice to participants. These voices could have been invisible in more traditional qualitative approaches, such as interviews or questionnaires. CONCLUSIONS: Although the two groups of participants came from different generation cohorts, they had aligned perceptions regarding challenges in dental education, and mentioned the separation between preclinic and clinic. Drawings were unique, innovative, and an interesting tool to express perceptions regarding today's learning environment. These insights can consequently help educators to personalize teaching approaches to better meet the needs of the students.

Influence of toothache on oral health-related quality of life during adolescence: a cohort study.

OBJECTIVES: This study aims to evaluate the influence of toothache in early adolescence on oral health-related quality of life (OHRQoL) on later adolescence. MATERIALS AND METHODS: A longitudinal study was conducted, starting in 2012 within a random sample of 1,134 adolescents of 12-year-olds, in Santa Maria, Brazil. Clinical, socioeconomic, demographic, and subjective variables were obtained. Toothache was collected through the question "In the last 6 months, did you have toothache?" Six years later, the same adolescents answered the short form of the Child Perceptions Questionnaire (CPQ11-14). Multilevel Poisson regression was used to evaluate the association between toothache at baseline (2012) with overall and domain-specific CPQ11-14 scores at follow-up (2018). RESULTS: A total of 769 adolescents were revaluated in 2018 (68% rate retention), with a mean age of 17.5 years (SD, 0.64). Adolescents who reported toothache at the baseline presented a had a higher mean score in the overall CPQ questionnaire during follow-up (Incidence rate ratio (IRR) = 1.25; 95% CI 1.20-1.31). Toothache was also associated with all domain-specific CPQ11-14 even after adjusting the other variables. CONCLUSIONS: Brazilian adolescents who had toothache in early adolescence, even if only a single episode, have a negative impact on OHRQoL throughout adolescence. CLINICAL RELEVANCE: These findings serve as a warning for dental professionals to dedicate their preventive approaches and to promote healthy standards in this age group, in order to avoid episodes of toothache and negative impact on OHRQoL.

Report of an experience: self-study to foster self-regulated learning for International DentalDegree Program (IDDP) students in Canada / Relato de experiência: estudo autônomo para encorajar o aprendizado autorregulado dos estudantes do Programa de Graduação Internacional de Odontologia (IDDP) no Canadá

This article aimed tobrieflyreport a self-study methodology experience performed in the International Dental Degree Program (IDDP) ina University in Canada. This approach fostered students` self-regulated learning.Due to Covid-19 pandemic theon-sitedentistry school classes were discontinued. Students from the IDDP were allowed to go to on-siteonly to perform pre-clinical activities (supervised by one faculty member at a time). As the 2020 class of the IDDP program was small (2 students), the director of the IDDP Program and faculty members considered that self-study would be an appropriate idea.We noticed that students were successful in self-regulating their learning. Some of the examples for that were: students used note-taking sheets, monitored their comprehension of class lecture material, asked questions etc.The experience with IDDP students showed that the self-study opportunity was a favorable learning environment for the teaching of pre-clinical disciplines (AU).

Este artigo objetivou descrever brevemente uma experiência com a metodologia de estudo autônomo realizada no Programa de Graduação Internacional de Odontologia (IDDP) em uma Universidade no Canadá. Esta abordagem encorajou o aprendizado autorregulado dos estudantes.Devido à pandemia COVID-19 as aulas "on-site" da faculdade de odontologia foram descontinuadas. Os estudantes do programa IDDP eram permitidos frequentar o prédio da faculdade somente para realizar as atividades pré-clínicas (e eram supervisionados por apenas um professor de cada vez). Como a turma de 2020 do programa IDDP era pequena (2 alunos), o diretor do programa e os professores consideraram que o estudo autônomo seria uma ideia apropriada. Percebeu-se que os estudantes tiveram sucesso em autorregular o aprendizado. Como por exemplo: usaram suas anotações, monitoraram a compreensão do material teórico disponibilizado, fizeram perguntas etc.A experiência com os estudantes do programa IDDP mostrouque a oportunidade de estudo autônomo se caracterizou como um ambiente favorável para os professores usarem nas disciplinas pré-clínicas (AU).

Exploring mindfulness and artworks/drawings to predict dental students' performance.

PURPOSE/OBJECTIVES: To explore and assess self-reported trait mindfulness and artwork/drawings as tools to predict students' performance. METHODS: This longitudinal study explored whether year 2 dental students' artwork/drawings produced during the first week of a preclinical endodontics course and Mindfulness Attention Awareness Scale (MAAS) scores could be used as a predictor of performance (grades/rank) at the end of the course. A convergent design of mixed methods approaches was used to integrate the quantitative and qualitative datasets. Qualitative analysis consisted of a multilayered process of thematic analysis of artwork/drawings that was used to generate codes, categories, and themes-according to lower and higher students' grades. Quantitative analysis consisted of statistical correlation between mindfulness scores and final grades. Findings were independently analyzed and further merged to answer our research question. RESULTS: The bivariate analysis found nonsignificant relationship between students' grades/rank and mindfulness scores: Pearson's correlation r = -0.097 (p = 0.578) and Spearman's correlation rho = 0.120 (p = 0.494). Codes, categories, and themes resulting from graphical data collected from the artwork/drawings strongly suggested that the higher students' grades group depicted solutions to deal with negative feelings/emotions and presented traits of confidence to reach goals. Artworks produced from students with lower grades left questions, such as in relation to competency in dentistry, unanswered, but at the same time, they seemed to perceive everything as emotion related. Upon merging the findings, we recognized more image components suggestive of positive feelings exuding from the artworks/drawings of higher grades group; but an increase in mindfulness was not associated with increase (or decrease) in final grade. CONCLUSION: Feelings/emotions represented in the artwork/drawings produced in the beginning of the course predicted students' performance at the end of the course; however, self-reported trait mindfulness was not correlated with performance.

The interrelationship between confidence and correctness in a multiple-choice assessment: pointing out misconceptions and assuring valuable questions.

INTRODUCTION: The aim of this study was to better understand the interfaces of being correct or incorrect and confident or unconfident; aiming to point out misconceptions and assure valuable questions. METHODS: This cross-sectional study was conducted using a convenience sample of second-year dental students (n = 29) attending a preclinical endodontics course. Students answered 20 multiple-choice questions ("basic" or "moderate" level) on endodontics, all of which were followed by one confidence question (scale). Our two research questions were: (1) How was the students' performance, considering correctness, misconceptions, and level of confidence? (2) Were the questions valuable, appropriate and friendly, and which ones led to misconceptions? Four situations arouse from the interrelationship between question correctness and confidence level: (1st) correct and confident, (2nd) correct and unconfident, (3rd) incorrect and confident (misconception) and (4th) incorrect and unconfident. Statistical analysis (α = 5%) considered the interaction between (a) students' performance with misconceptions and confidence; (b) question's difficulty with correctness and confidence; and (c) misconceptions with clinical and negative questions. RESULTS: Students had 92.5% of correctness and 84.6% of confidence level. Nine students were responsible for the 12 misconceptions. Students who had more misconceptions had lower correctness (P < 0.001). High achieving students had low confidence in their incorrect responses (P = 0.047). 'Moderate' questions had more incorrectness (P < 0.05) and less confidence (P = 0.02) than 'basic'. All questions were considered valuable [for example, the ones that presented images or required a mental picture of a clinical scenario, since they induced less misconception (P = 0.007)]. There was no difference in misconceptions between negative questions and other questions (P = 0.96). CONCLUSION: Preclinical endodontic students were highly correct and very confident in their responses. Students who had more misconceptions had also the lowest performance in the assessment. Questions were valuable; but some will worth further improvement for the future. A multiple-choice assessment, when combined with confidence questions, provided helpful information regarding misconceptions and questions value.

COVID-19 pandemic reduces the negative perception of oral health-related quality of life in adolescents.

PURPOSE: As people around the world are facing the Covid-19 outbreak, their perception of oral health problems could be changed. This study aimed to evaluate the immediate effects of the Covid-19 pandemic on oral health-related quality of life (OHRQoL) of adolescents. METHODS: A cohort study with schoolchildren from southern Brazil was conducted. Data on adolescents' OHRQoL were collected from December 2019 to February 2020 (T1), before the Brazilian Covid-19 outbreak. Posteriorly, the data were collected again in June and July of 2020 (T2), under the Brazilian Covid-19 outbreak. The OHRQoL was assessed using the Brazilian short version of the CPQ11-14. Demographic and socioeconomic characteristics and the degree of social distancing were also assessed. Changes in OHRQoL between T1 and T2 were evaluated by adjusted Multilevel Poisson regression models for repeated measures. RESULTS: From 290 individuals evaluated at T1, 207 were reevaluated at T2 (response rate of 71.3%). The overall CPQ11-14 mean score was significantly lower during the pandemic, reducing from 10.8 at T1 to 7.7 at T2. This significant reduction was also observed for all CPQ domains, indicating a lower negative impact of oral conditions on adolescents' quality of life during the pandemic. Adolescents from families that had a middle or low degree of social distancing during the pandemic and whose parents were harmed in employment had higher CPQ11-14 scores. CONCLUSION: Overall and specific-domains CPQ-14 scores were significantly lower during the Brazilian Covid-19 outbreak, indicating a decrease in the perception of oral health problems by adolescents over that period.

Use of mind maps in dental education: An activity performed in a preclinical endodontic course.

PURPOSE/OBJECTIVES: (1) to assess the ability of dental students to use mind maps to express the relationships of endodontic theory and technique; (2) to explore features illustrated from the highest- and lowest-graded mind maps; and (3) to evaluate improvements in successive mind maps from the same student. METHODS: A total of 31 second-year students were asked to configure a mind map on root canal cleaning-shaping and then 18 weeks later develop a second mind map on root canal obturation. Faculty visually analyzed the mind maps using a qualitative approach: a multilayered process of thematic analysis. Codes and themes were generated to investigate if students were able to express appropriate and evidence-based ideas on the topics (accuracy of relationships and depth of information presented). Two of the highest- and 2 of the lowest-graded mind maps for each activity were directly compared. Improvement by the same student from the first to second mind map was also evaluated based on trend/style and creativity. RESULTS: The majority of the students accurately expressed the scientific basis for root canal cleaning-shaping and obturation. The highest-graded mind maps displayed the biomedical and humanistic conceptions of critical thinking. In comparing the second mind map to the first, nearly 50% of the students incorporated more detail and artistic expression in the second map. CONCLUSIONS: using mind maps in dental education can benefit students with different learning styles and help the instructor to identify the level of conceptualization that the student had developed about a topic.

Remoção de obturações endodônticas de Endosequence BC/CPoint em canais radiculares curvos usando instrumentos rotatórios ou reciprocantes / Removal of Endosequence BC/CPoint endodontic fillings in curved root canals using rotary or reciprocating instruments

Objetivo: O presente estudo usou micro-CT para avaliar a quantidade de material obturador remanescente em canais radiculares curvos que tinham sido obturados com cimento Endosequence BC/Cpoint ou com cimento AH/ guta-percha, depois do retratamento utilizando instrumentos rotatórios ou reciprocantes. Métodos: Sessenta canais mesiovestibulares de molares superiores foram instrumentados até MTwo #35.04. As amostras foram randomicamente alocadas em quatro grupos (n=15): os canais do G1 e G2 foram obturados com AH/guta-percha, e os canais do G3 e G4 foram obturados com BC/Cpoint. O material obturador foi removido usando instrumentos rotatórios ou reciprocantes ­ G1 e G3: R25 Reciproc + reinstrumentação com R40; e G2 e G4: Sistema ProTaper Universal Retratamento + reinstrumentação com MTwo 40.06. Micro-CTs foram usadas para medir a quantidade de material obturador remanescente (mm3 ) para o canal inteiro e para cada terço, em dois momentos: 1) após a remoção do material obturador; e 2) após a reinstrumentação. Resultados: Após a remoção do material obturador, BC/CPoint permaneceu mais dentro do canal do que AH/guta-percha quando o canal inteiro (29,92% x 19,25%, p=0,0290) e o terço apical foram analisados. Após a reinstrumentação, BC/CPoint permaneceu mais do que AH/guta-percha somente no terço apical. Protocolos de tratamento com instrumentos rotatórios ou reciprocantes removeram material obturador sem diferença para AH/guta-percha (G1 e G2: p> 0,05) e BC/CPoint (G3 e G4: p> 0,05). Conclusões: BC/Cpoint é mais difícil de ser removido de canais radiculares curvos do que AH/guta-percha. Instrumentos rotatórios e reciprocantes têm habilidade similar na remoção de material obturador (AU).

Objective: This study used micro-CT to evaluate the amount of remaining filling material in curved root canals obturated with Endosequence BC Sealer/Cpoint or AH/gutta-percha after a rotary or reciprocating retreatment. Methods: Sixty mesiobuccal canals of maxillary molars were instrumented up to MTwo #35.04. Samples were randomly assigned to four groups (n=15): canals from G1 and G2 were filled with AH/gutta-percha, and canals from G3 and G4 were filled with BC/Cpoint. Filling material was removed using rotary or reciprocating instruments: G1 and G3: R25 Reciproc + re-shaping with R40; and G2 and G4: ProTaper Universal Retreatment system + re-shaping with MTwo 40.06. Micro-CT was used to measure the remaining amount of filling material (mm3 ), for the whole canal, and for each third, in two moments: 1) after filling removal and 2) after canal re-shaping. Results: After filling removal, BC/CPoint remained more into the canal than AH/Gutta-percha when the whole canal (29.92% x 19.25%, p = 0.0290) and the apical third were analyzed. After re-shaping, BC/CPoint remained more than AH/Gutta-percha only in the apical third. Rotary or reciprocating retreatment protocols removed filling material without difference for AH/gutta-percha (G1 and G2: p > 0.05) and BC/CPoint (G3 and G4: p > 0.05). Conclusion: BC/Cpoint is more difficult to be removed from curved root canals than AH/gutta-percha. Reciprocating and rotary instruments have similar ability to remove filling material (AU).

Effect of routine dental attendance on child oral health-related quality of life: A cohort study.

BACKGROUND: There is an improvement in oral health status among people who receive preventive dental care during their lifetime, highlighting the possible effect in resolving oral health problems and consequently oral health-related quality of life (OHRQoL). AIM: Assessed the effect of routine dental attendance on child OHRQoL. DESIGN: This cohort study used baseline data from 639 preschoolers from 2010. After 7 years, 449 children were re-examined (70.3%). Mothers of the children completed a questionnaire collecting data on the pattern of use of dental services. Children were classified as adhering to long-term routine dental attendance according to their pattern of use (routine vs curative) in the baseline and in follow-up. The child OHRQoL was assessed through the Child Perception Questionnaire (CPQ8-10). The association between routine dental attendance and child OHRQoL was assessed using multilevel Poisson regression models. RESULTS: The proportion of participants who reported the worst CPQ8-10 scores were higher among those who, at some point in their life, experienced a curative dental attendance. Also, the mean CPQ8-10 was two times higher for non-routine dental attendance. CONCLUSION: The findings showed that there is an impact of long-term routine attendance on child OHRQoL. This is important for tackling oral health iniquities.

Dentin Microhardness and Sealer Bond Strength to Root Dentin are Affected by Using Bioactive Glasses as Intracanal Medication.

This study investigated the human dentin microhardness (MH) and the MTA Fillapex® (Fillapex) and AH Plus®(AH) bond strength (BS) to dentin after using calcium hydroxide (Ca(OH)2) and bioactive glasses (45S5 and an experimental niobium phosphate bioactive glass (NbG)) as intracanal medications. For the MH test dentin slices were filled with medications and were submitted to Knoop MH (KHN) test (at day-0 (baseline data/without medication) and at day-15 (after using medication)). For the BS test, after medications had remained for 15 days in the roots, dentin slices were obtained and filled with the sealers. Seven days later, sealer BS to dentin was measured by push-out test (MPa). Data were statistically analyzed. Failure mode was visually assessed. The use of NbG, 45S5 for 15 days, increased the dentin MH and reduced the BS between AH sealer and dentin, but did not interfere with the Fillapex BS.