Oral, Volume 1, Issue 3 (September 2021) – 10 articles

The aim of the study was to investigate the cross-sectional association between diabetes and dental caries in a representative sample of 23,089 adults residing in Spain. Data from the Spanish National Health Survey 2017 were analysed. Diabetes (independent variable) and dental caries (dependent variable) were evaluated through a self-reported questionnaire. The association between diabetes and dental caries in the overall sample was assessed using logistic regression models adjusted for sex, age, marital status, education, smoking, alcohol consumption, obesity, hypertension, and hypercholesterolemia. The prevalence of dental caries was 20.6% in the overall population and was significantly higher in men and in young (≤40 years) and middle-aged adults (41–65 years) than in women and older adults (>65 years), respectively. After adjusting for control variables, there was a positive and significant association between diabetes and dental caries in the overall population (OR = 1.30, 95% CI = 1.15–1.46). The relationship between diabetes and dental caries was particularly strong in women (OR = 1.45, 95% CI = 1.22–1.71) and in adults aged ≤40 years (OR = 1.80, 95% CI = 1.05–3.05). In conclusion, in this large representative sample of Spanish adults, diabetes was associated with having a higher prevalence of dental caries, with females and younger adults at greatest risk. Patients with diabetes and dental practitioners should be aware of these associations and act accordingly. Future research should aim to investigate the mediating factors involved in the observed association between diabetes and dental caries. Full article

(1) Background: to propose a new approach for crown veneers, with the use of an aesthetic porcelain coating, only in part of the zirconia infrastructure, and to analyze its biomechanical behavior to minimize chipping failures. (2) Methods: a maxillary molar was modeled using CAD software, preparing for traditional crowns and veneer crowns with various lengths. Five groups were formed: M—control group (monolithic crown of ultra-translucent zirconia); B—conventional (bilayer crown of ultra-translucent zirconia and ceramic covering); V—veneer (ultra-translucent zirconia crown with reduction only in the buccal and application of covering ceramics); V1—ultra-translucent zirconia crown with buccal reduction and 1 mm occlusal extension for covering ceramic application); V1.5—ultra-translucent zirconia crown with buccal reduction and 1.5 mm occlusal extension for application of covering ceramics. A load of 600 N was performed axially to a fossa bottom to simulate parafunction, and 300 N to the cusp tip to obtain the maximum principal stress results. (3) Results: group B showed a higher stress concentration in the occlusal region of the restorations, while the other groups absorbed the stress and dissipated it throughout the crown, presenting a higher stress concentration in the interface region with the tooth. (4) Conclusion: the highly translucent zirconia ceramic only associated with buccal covering ceramic could add aesthetic gain and rigidity to the system and could be a good option to restore maxillary molars in patients who do not have parafunction. Full article

Background: It is vital to provide evidence-based research documentation to guide policy decision-making. There is a limited number of studies that participate in dental policy evidence-based research. Case Description: Texas is one of the states with limited dental service coverage for its Medicaid Beneficiaries. The recent senate bill 87R 1152 proposes expansion of dental preventive service to disability status Medicaid Beneficiaries. It is vital to understand how effective the extensive dental service under Medicaid coverage is through evidence-based research. True causal analysis of such public policies by utilizing observational data is only feasible through limited identification strategies. The current paper identifies that. Practical Implication: Through the identified research plan and conceptual framework, it can be established if extensive Medicaid dental service coverages effectively prevent dental disease burden in Texas. Full article

The COVID-19 virus is highly infectious, and it places both patients and dental health care providers at high risk for contracting the disease. Therefore, it is crucial for dental teams to practice preventative measures against COVID-19 by wearing personal protective equipment (PPE), handwashing, ensuring adequate ventilation and sticking to strict protocols when conducting aerosol-generating procedures. Methods: A cross-sectional survey using an online platform was conducted to assess dentists’ knowledge, attitude and awareness of COVID-19 in Trinidad and Tobago. Descriptive statistics, Pearson’s chi-square and Fisher exact test were performed. Results: One hundred and ninety-two dentists participated in the survey. The age group, 30–39, comprised 40.6% of the respondents. General dentists comprised 80.7% of the sample. The majority of the respondents evaluated their awareness of COVID-19 as above average. There was no difference in knowledge between dentists and specialists regarding routes of transmission and preventative techniques. More female dentists reported feeling anxious and fearful. Conclusions: There was a high level of agreement between different professionals about the preventative measures, routes of transmission and incubation period. There was a lot of variation in knowledge about the survivability of the virus on innate objects. More education campaigns, seminars, and rehabilitation services targeting dentists in Trinidad and Tobago are required. Full article

The aim of the article is to discuss the development of calcium channel blocker (CCB) influenced gingival enlargement. Data and Sources: MEDLINE/PubMed, Scopus, ScienceDirect, and Google Search databases. The article reviews contemporary and classic literature with a focus on pathophysiology, clinical presentation, and risk factors associated with this condition. The application of various treatment options is also discussed. Study selection: Clinical studies, systematic reviews, in vitro studies, and case reports. Conclusion: Dental plaque, genetic predisposition, and type of drug used are critical in the development of drug-influenced gingival enlargement (DIGE). The surgical technique employed to treat the pathosis plays an important role in long term success of therapy. There has been an upward trend in occurrence of CCB-influenced gingival enlargement due to the unbridled use of CCBs. Due to the cosmetic and functional ramifications; the review underscores the importance of clinical research on prevention, treatment, and causes of recurrence of CCB-influenced gingival enlargement. Full article

“Epulis” is a widely used term to describe a localized gingival enlargement. However, a wide range of neoformations might present as localized, slow-growing, asymptomatic gingival masses. A systematic review was conducted to outline the pathological entities that were provisionally dignosed as “epulis” and whose final diagnosis was made after microscopic examination. An electronic search of PubMed, Google Scholar and Scopus databases from January 2000 to February 2021 was performed. An initial search of the databases identified a total of 864 documents, and after a careful process of screening and selection, 14 studies were included in this systematic review and processed for data extraction. The results show that histological examination, sometimes combined with immunohistochemistry, might reveal a wide spectrum of lesions, including hamartomatous lesions, non-neoplastic lesions, benign and malign neoplasms and metastases from distant cancers. Full article

Background: The perception of facial aesthetics is a complex topic due to its subjective nature and it can be influenced by several factors. The purpose of this study was to compare the perception of general dentists, orthodontists, maxillofacial surgeons, and lay people by evaluating facial aesthetics in skeletal class III patients, especially for maxillary sagittal position. Methods: A survey consisting of three sets of pre-treatment photographs of four dysmorphic patients was used. The questionnaire was submitted to a total of 200 participants divided into the following four subgroups: general dentists, orthodontists, maxillofacial surgeons, and lay people. Their opinion on facial disharmony, sagittal position of the jaws, asymmetry of the chin, projection of the cheekbone area, and lip aesthetics was recorded. Results: Significant differences were found between experts and non-experts in the perception of the maxillary position, asymmetry of the chin and zygomatic area (p < 0.01). No statistically significant differences were found among the groups in the perception of mandibular position and lip aesthetics. Conclusion: The respondents with a medical or dental background perceived the presence of maxillary retrusion more than others. Only orthodontists and maxillofacial surgeons have recognized an alteration of the middle facial third as a greater component of skeletal class III malocclusion. Full article

This paper explores the reasons for multiple caries in children from the viewpoint of clinical practice, namely General Dental Practitioners (GDPs) and their teams, to identify obstacles to reducing inequalities in caries experience. The context of the research is the distribution of dental caries in UK communities where disease prevalence correlates with deprivation and these sub-groups are not attending for dental care on a regular basis. A focus group of dentists, along with individual interviews with dentists and dental support staff were chosen to explore the perceptions of GDPs, Dental Therapists, and Dental Nurses. The content analysis of the data highlighted six main themes. These included sugar, in terms of the amount, availability and the marketing of it; socioeconomic associations with dental caries experience; the dentists’ role; the National Health Service (NHS) dental contract in terms of time-constraints in meeting targets and finally, the management of the child with multiple caries. This research suggests that there are possible barriers to the delivery of equitable care to populations. These include availability and access to GDPs along with the perceptions held by GDPs. Training aimed to develop a targeted behavioural approach towards deprived sub-groups is required in order to avoid unintended social exclusion. Full article

Background: Nanoparticles such as multi-walled carbon nanotubes present resistance, resilience and biocompatibility with human tissues and could be incorporated into glass ionomer cement materials to improve their characteristics. Therefore, the aim of the present study was to evaluate the effect of multi-walled carbon nanotube (MWCNT) incorporation on different glass ionomer cements’ compressive (σc) and diametral tensile strengths (σt). Methods: Eighty (80) specimens were divided into four groups (N = 20/gr) according to the glass ionomer cement type (conventional and high-viscosity) and the presence or absence of multi-walled carbon nanotubes. Samples were kept in water for 24 h prior to the tests. Data were analyzed using two-way ANOVA and Tukey’s test (p = 0.05). Results: For both σc (p = 0.1739) and σt (p = 0.2183), the glass ionomer cements’ viscosity did not influence the results. The presence of MWCNTs decreased the mean compressive strength values (p = 0.0001) and increased the diametral tensile strength (p = 0.0059). For both conventional and high-viscosity glass ionomer cements, the compressive strength values were higher than the tensile strength data. Conclusions: Regardless of the cement viscosity, the multi-walled carbon nanotube incorporation reduced the compressive strength and increased the tensile strength values. Full article

Global developmental delay (GDD) is an inability to attain developmental milestones within the anticipated age range. It comprises a delay in two or more of the developmental domains: gross and fine motor; speech and language; cognition; personal and social development; and activities of daily living. With a wide aetiology, GDD can have a major impact on growth and development; it may manifest itself in many diverse medical and dental complications, which necessitate the care from several multidisciplinary healthcare professionals. Of relevance to the paediatric dentistry, special needs dentistry, and orthodontics disciplines, this case report provides an example of a paediatric dental patient with GDD that was both severe and significant. The author outlines the findings, clinical and behavioural management, and future considerations. Full article