Risk of dental disease non-battle injuries and severity of dental disease in deployed U.S. Army personnel.

Dental Disease and Non-Battle Injuries (D-DNBI) continue to be a problem among U.S. Army active duty (AD), U.S. Army National Guard (ARNG), and U.S. Army Reserve (USAR) deployed soldiers to Operation Iraqi Freedom/Operation New Dawn in Iraq and Operation Enduring Freedom in Afghanistan. A previous study reported the annual rates to be 136 D-DNBI per 1,000 personnel for AD, 152 for ARNG, and 184 for USAR. The objectives of this study were to describe D-DNBI incidence and to determine risk factors for dental encounters and high severity diagnoses for deployed soldiers. The 78 diagnoses were classified into three categories based on severity. Poisson regression was used to compare D-DNBI rates and logistic regression was used to analyze the risk of high severity D-DNBI. In both campaigns, Reserve had a higher risk of D-DNBI than active duty. For Afghanistan, ARNG and USAR demonstrated over 50% increased risk of D-DNBI compared to AD. In Iraq, USAR had a 17% increased risk over AD. Females had a higher risk of D-DNBI (>50%) compared to males in both campaigns. High severity D-DNBI made up 2.77% of all diagnoses. Within Afghanistan, there was a 4.6% increased risk of high severity D-DNBI for each additional deployment month.

Histologic Evaluation of Osseous Regeneration Following Combination Therapy With Platelet-Rich Plasma and Bio-Oss in a Rat Calvarial Critical-Size Defect Model.

Platelet-rich plasma (PRP) is an autogenous source of growth factors shown to facilitate human bone growth. Bio-Oss, an osteoconductive xenograft, is used clinically to regenerate periodontal defects, restore dental alveolar ridges, and facilitate sinus-lift procedures. The purpose of this study was to analyze whether a combination of PRP and Bio-Oss would enhance bone regeneration better than either material alone. PRP and/or Bio-Oss were administered in an 8-mm critical-size defect (CSD) rat calvarial model of bone defect between 2 polytetrafluoroethylene membranes to prevent soft tissue incursion. Eight weeks after the induction of the CSD, histologic sections were stained with hematoxylin and eosin stain and analyzed via light microscopy. Qualitative analyses revealed new bone regeneration in all 4 groups. The Bio-Oss and PRP plus Bio-Oss groups demonstrated greater areas of closure in the defects than the control or PRP-only groups because of the space-maintaining ability of Bio-Oss. The groups grafted with Bio-Oss showed close contact with new bone growth throughout the defects, suggesting a stronger graft. The use of PRP alone or in combination with Bio-Oss, however, did not appear to enhance osseous regeneration at 8 weeks. Areas grafted with Bio-Oss demonstrated greater space-maintaining capacity than controls, and PRP was an effective vehicle for placement of the Bio-Oss. However, at 8 weeks this study was unable to demonstrate a significant advantage of using PRP plus Bio-Oss over using Bio-Oss alone.

The incidence of dental disease nonbattle injuries in deployed U.S. Army personnel.

BACKGROUND: In the past, the U.S. Army Reserve (USAR) and Army National Guard (ARNG) have exhibited lower levels of medical and dental readiness than active duty (AD) Soldiers when activated for deployment. OBJECTIVE: The objective was to compare dental disease and nonbattle injury (D-DNBI) incidence rates and describe the most common D-DNBI diagnoses in Army AD, ARNG, and USAR Soldiers deployed to Iraq (Operation Iraqi Freedom/Operation New Dawn) and Afghanistan or Kuwait (Operation Enduring Freedom). METHODS: Data from the Center for AMEDD Strategic Studies (CASS) were used to determine D-DNBI encounter rates and diagnoses for deployed Army Soldiers. RESULTS: "Dental Caries" was the leading diagnosis (10.00%) for Soldiers in both theaters. For Operation Iraqi Freedom, D-DNBI rates were highest in 2010 at 144.05 per 1,000 Soldiers per year (AD 135.77, ARNG 151.39 and USAR 183.76). In comparison, D-DNBI rates in Operation Enduring Freedom were highest in 2012 with an overall rate of 85.77 per 1,000 Soldiers per year (AD 72.48, ARNG 129.38 and USAR 129.52). CONCLUSIONS: In both campaigns, the data suggest that ARNG and USAR Soldiers had higher D-DNBI rates when compared to AD Soldiers. Further investigation is needed to decrease D-DNBI rates and to determine risk factors that may influence D-DNBI rates among Army components during deployments.

Operational cost analysis of dental emergencies for deployed US Army personnel during operation Iraqi freedom.

The documentation of dental emergency (DE) rates in past global conflicts has been well established; however, little is known about wartime DE costs on the battlefield. Using DEs as an example for decreased combat effectiveness, this article analyzes the cost of treating DEs in theater, both in terms of fixed and variable costs, and also highlighted the difficulties that military units experience when faced with degradation of combat manpower because of DEs. The study found that Dental-Disease and Non-Battle Injury cost the U.S. Army a total of $21.4M between July 1, 2009 and June 30, 2010, and $21.9M between July 1, 2010 and June 30, 2011. The results also revealed that approximately 32% of DE required follow-up treatment over the 2-year period, which increased the costs associated with a DE over time. Understanding the etiology and cost of DE cases, military dental practitioners will be better equipped to provide oral health instructions and preventive measures before worldwide deployments.

Use of the dental disease nonbattle injury encounter module to assess the emergency rate on an Army military installation within the United States.

The objectives of this study are (1) to establish a baseline rate for dental emergencies (DE) occurring within a Brigade Combat Team (BCT) garrisoned on a military installation located in the continental United States (CONUS), and (2) to determine if differences in risk of DE are observed in soldiers of different Dental Fitness Classifications (DFC). Data concerning DE were documented by Army Dental Corps providers using CONUS Dental Disease Nonbattle Injury Emergency Encounter module of the Corporate Dental Application (CDA). The data were collected from September 1, 2011 to December 15, 2011. The number of soldiers at risk, the BCT dental readiness, the DFC of each soldier who experienced a DE, and the date of the dental visit that preceded the DE were documented from CDA. The estimated rate of 221 DE per 1,000 soldiers per year was observed. The risk of DE for DFC 3 soldiers was five times that of soldiers who were DFC 1 or 2. Assessing the DE rate of a BCT in garrison is useful for stakeholders and policymakers who must accommodate the impact of DE on mission readiness.