Search results for: dental state

Authors: Ghazal Mortazavi, S. M. J. Mortazavi

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Electricians, power line engineers and power station workers, welders, aluminum reduction workers, MRI operators and railway workers are occupationally exposed to different levels of electromagnetic fields. Mercury is among the most toxic metals. Dental amalgam fillings cause significant exposure to elemental mercury vapour in the general population. Today, substantial evidence indicates that mercury even at low doses may lead to toxicity. Increased release of mercury from dental amalgam fillings after exposure to MRI or microwave radiation emitted by mobile phones has been previously shown by our team. Moreover, our recent studies on the effects of stronger magnetic fields entirely confirmed our previous findings. From the other point of view, we have also shown that papers which reported no increased release of mercury after MRI, may have some methodological flaws. Over the past several years, our lab has focused on the health effects of exposure of laboratory animals and humans to different sources of electromagnetic fields such as mobile phones and their base stations, mobile phone jammers, laptop computers, radars, dentistry cavitrons, and MRI. As a strong association between exposure to electromagnetic fields and mercury level has been found in our studies, our findings lead us to this conclusion that occupational exposure to electromagnetic fields in workers with dental amalgam fillings can lead to elevated levels of mercury. Studies which reported that exposure to mercury can be a risk factor of Alzheimer’s disease (AD) due to the accumulation of amyloid beta protein (Aβ) in the brain and those reported that long-term occupational exposure to high levels of electromagnetic fields can increase the risk of Alzheimer's disease and dementia in male workers support our concept and confirm the significant role of the occupational exposure to electromagnetic fields in increasing the mercury level in workers with amalgam fillings.

Keywords: occupational exposure, electromagnetic fields, workers, mercury release, dental amalgam, restorative dentistry

Procedia PDF Downloads 394

Authors: Fatemeh Jannesarvatan, Ghazaal Parastooei, Jimmy frerejan, Saedeh Mokhtari, Peter Van Rosmalen

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Medical and dental education increasingly emphasizes the acquisition, integration, and coordination of complex knowledge, skills, and attitudes that can be applied in practical situations. Instructional design approaches have focused on using real-life tasks in order to facilitate complex learning in both real and simulated environments. The Four component instructional design (4C/ID) model has become a useful guideline for designing instructional materials that improve learning transfer, especially in health profession education. The objective of this study was to apply the 4C/ID model in the creation of virtual patients (VPs) that dental students can use to practice their clinical management and clinical reasoning skills. The study first explored the context and concept of complication factors and common errors for novices and how they can affect the design of a virtual patient program. The study then selected key dental information and considered the content needs of dental students. The design of virtual patients was based on the 4C/ID model's fundamental principles, which included: Designing learning tasks that reflect real patient scenarios and applying different levels of task complexity to challenge students to apply their knowledge and skills in different contexts. Creating varied learning materials that support students during the VP program and are closely integrated with the learning tasks and students' curricula. Cognitive feedback was provided at different levels of the program. Providing procedural information where students followed a step-by-step process from history taking to writing a comprehensive treatment plan. Four virtual patients were designed using the 4C/ID model's principles, and an experimental design was used to test the effectiveness of the principles in achieving the intended educational outcomes. The 4C/ID model provides an effective framework for designing engaging and successful virtual patients that support the transfer of knowledge and skills for dental students. However, there are some challenges and pitfalls that instructional designers should take into account when developing these educational tools.

Keywords: 4C/ID model, virtual patients, education, dental, instructional design

Procedia PDF Downloads 51

Authors: Astika Swastirani

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Chronological age estimation can be done by looking at the stage of growth and development of teeth from orthopantomogram and mandibular remodeling from lateral cephalogram. Mandibular morphological changes associated with the size and remodeling during growth is a strong indicator of age estimation. These changes can be observed with lateral cephalogram. Objective: To prove the difference between chronological age and age estimation using orthopantomogram (dental age) and lateral cephalogram (skeletal age). Methods: Sample consisted of 100 medical records, 100 orthopantomograms digital and 100 lateral cephalograms digital belongs to 50 male and 50 female of Airlangga University hospital of dentistry. Orthopantomogram were matched with London atlas and lateral cephalograms were observed by digital tracing. The difference of dental age and skeletal age was analyzed by pair t –test. Result: Result of the pair t-test between chronological age and dental age in male (p-value 0.002, p<0.05), in female (p-value 0.605, p>0.05). Result of pair t-test between the chronological age and skeletal age (variable length Condylion-Gonion, Gonion-Gnathion, Condylion-Gnathion in male (p-value 0.000, p<0.05) in female (variable Condylion-Gonion length (p-value 0.000, Condylion-Gnathion length (p-value 0,040) and Gonion-Gnathion length (p-value 0.493). Conclusion: Orthopantomogram with London atlas and lateral cephalograms with Gonion- Gnathion variable can be used for age estimation in female. Orthopantomogram with London atlas and lateral cephalograms with Condylion-Gonion variable, Gonion-Gnathion variable and Condylion-Gnathion can not be used for age estimation in male.

Keywords: age estimation, chronological age, dental age, skeletal age

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Authors: Sidra Suleman, Maliha Suleman, Stephen Brindley

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Oral rehabilitation of head and neck cancer patients plays a crucial role in the quality of life for such individuals post-treatment. Placement of dental implants or implant-retained prostheses can help restore oral function and aesthetics, which is often compromised following surgery. Conventional prosthodontic techniques can be insufficient in rehabilitating such patients due to their altered anatomy and reduced oral competence. Hence, there is a strong clinical need for the placement of dental implants. With an increasing incidence of head and neck cancer patients, the demand for such treatment is rising. Aim: The aim of the study was to determine the survival rate of dental implants in head and neck cancer patients placed at the Restorative and Maxillofacial Department, Royal Stoke University Hospital (RSUH), United Kingdom. Methodology: All patients who received dental implants between January 1, 2013 to December 31, 2020 were identified. Patients were excluded based on three criteria: 1) non-head and neck cancer patients, 2) no outpatient follow-up post-implant placement 3) provision of non-dental implants. Scanned paper notes and electronic records were extracted and analyzed. Implant survival was defined as fixtures that had remained in-situ / not required removal. Sample: Overall, 61 individuals were recruited from the 143 patients identified. The mean age was 64.9 years, with a range of 35 – 89 years. The sample included 37 (60.7%) males and 24 (39.3%) females. In total, 211 implants were placed, of which 40 (19.0%) were in the maxilla, 152 (72.0%) in the mandible and 19 (9.0%) in autogenous bone graft sites. Histologically 57 (93.4%) patients had squamous cell carcinoma, with 43 (70.5%) patients having either stage IVA or IVB disease. As part of treatment, 42 (68.9%) patients received radiotherapy, which was carried out post-operatively for 29 (69.0%) cases. Whereas 21 (34.4%) patients underwent chemotherapy, 13 (61.9%) of which were post-operative. The Median follow-up period was 21.9 months with a range from 0.9 – 91.4 months. During the study, 23 (37.7%) patients died and their data was censored beyond the date of death. Results: In total, four patients who had received radiotherapy had one implant failure each. Two mandibular implants failed secondary to osteoradionecrosis, and two maxillary implants did not survive as a result of failure to osseointegrate. The overall implant survival rates were 99.1% at three years and 98.1% at both 5 and 7 years. Conclusions: Although this data shows that implant failure rates are low, it highlights the difficulty in predicting which patients will be affected. Future studies involving larger cohorts are warranted to further analyze factors affecting outcomes.

Keywords: oncology, dental implants, survival, restorative

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Authors: Atin Adhikari, Sushma Kurella, Pratik Banerjee, Nabanita Mukherjee, Yamini M. Chandana Gollapudi, Bushra Shah

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Different sharp instruments, drilling machines, and high speed rotary instruments are routinely used in dental clinics during dental cleaning. Therefore, these cleaning procedures release a lot of oral microorganisms including bacteria in clinic air and may cause significant occupational bioaerosol exposure risks for dentists, dental hygienists, patients, and dental clinic employees. Two major goals of this study were to quantify volumetric airborne concentrations of bacteria and to assess overall microbial activity in this type of occupational environment. The study was conducted in several dental clinics of southern Georgia and 15 dental cleaning procedures were targeted for sampling of airborne bacteria and testing of overall microbial activity in settled dusts over clinic floors. For air sampling, a Biostage viable cascade impactor was utilized, which comprises an inlet cone, precision-drilled 400-hole impactor stage, and a base that holds an agar plate (Tryptic soy agar). A high-flow Quick-Take-30 pump connected to this impactor pulls microorganisms in air at 28.3 L/min flow rate through the holes (jets) where they are collected on the agar surface for approx. five minutes. After sampling, agar plates containing the samples were placed in an ice chest with blue ice and plates were incubated at 30±2°C for 24 to 72 h. Colonies were counted and converted to airborne concentrations (CFU/m3) followed by positive hole corrections. Most abundant bacterial colonies (selected by visual screening) were identified by PCR amplicon sequencing of 16S rRNA genes. For understanding overall microbial activity in clinic floors and estimating a general cleanliness of the clinic surfaces during or after dental cleaning procedures, ATP levels were determined in swabbed dust samples collected from 10 cm2 floor surfaces. Concentration of ATP may indicate both the cell viability and the metabolic status of settled microorganisms in this situation. An ATP measuring kit was used, which utilized standard luciferin-luciferase fluorescence reaction and a luminometer, which quantified ATP levels as relative light units (RLU). Three air and dust samples were collected during each cleaning procedure (at the beginning, during cleaning, and immediately after the procedure was completed (n = 45). Concentrations at the beginning, during, and after dental cleaning procedures were 671±525, 917±1203, and 899±823 CFU/m3, respectively for airborne bacteria and 91±101, 243±129, and 139±77 RLU/sample, respectively for ATP levels. The concentrations of bacteria were significantly higher than typical indoor residential environments. Although an increasing trend for airborne bacteria was observed during cleaning, the data collected at three different time points were not significantly different (ANOVA: p = 0.38) probably due to high standard deviations of data. The ATP levels, however, demonstrated a significant difference (ANOVA: p <0.05) in this scenario indicating significant change in microbial activity on floor surfaces during dental cleaning. The most common bacterial genera identified were: Neisseria sp., Streptococcus sp., Chryseobacterium sp., Paenisporosarcina sp., and Vibrio sp. in terms of frequencies of occurrences, respectively. The study concluded that bacterial exposure in dental clinics could be a notable occupational biohazard, and appropriate respiratory protections for the employees are urgently needed.

Keywords: bioaerosols, hospital hygiene, indoor air quality, occupational biohazards

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Authors: Magdalena Korytowska, Gunnar Lengstrand, Cecilia Larsson Wexell

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Background: Breast cancer (BC) is the most common cancer among women worldwide, and cases are continuing to increase in Sweden. Bone is the most common metastatic site in breast cancer patients, where > 65-75% of women with advanced breast cancer develop bone metastases during their disease. To prevent the skeletal-related events of metastases (e.g., pathological fractures, bone loss, cancer-induced bone pain, and hypercalcemia bone), two different classes of antiresorptive medications (AR), bisphosphonate and denosumab are typically administered every 3 to 4 weeks. Since 2015, adjuvant bisphosphonate treatment has been used every six months for three to five years in postmenopausal women for the prevention of skeletal metastases and improved survival. Methods: A case-control study was conducted to test the hypotheses that patients treated with high-dose AR are at higher risk of developing MRONJ than breast cancer patients with adjuvant bisphosphonate treatment at a lower dose. Medical and odontological data was collected between 2015-2020. Assessment of oral health and dental care before and during oncological treatment took place at the specialist clinic for Orofacial medicine linked to the specific hospital. Results: In total, 220 patients were included, 101 patients in the high-dose group and 119 patients in the adjuvant BP-treatment group. MRONJ was diagnosed in 13 patients (14%) in the high-dose group. The mandible was affected in most of the cases (84.6%), with a mean duration of high-dose treatment of 19.7 months. In 46.2% of cases, no dental cause of MRONJ could be identified. Overall, estrogen receptor-positive (ER+) BC was the most representative type in 172 patients (78.2%). However, this was 83.9% in the high-dose cases group. The most used drug was denosumab. Twenty-five patients (26.9%) switched their medication from ZOL to denosumab during their oncological treatment. Patients with ER+ breast cancer were reported in 88 patients (87.8%) in the adjuvant group that was treated with ZOL. Conclusions: MRONJ was diagnosed only in the high-dose AR group. Dental assessment and care of patients in the adjuvant group should be considered, with a recommendation to potentially prolong ZOL treatment from 3 to 5 years, with concomitant use of hormonal therapy in patients diagnosed with ER+ breast cancer to prevent bone loss induced by oncological treatment. A new referral for dental assessment is very important in the case of bone metastases when treatment with high dose AR will be required since it is associated with a higher risk of MRONJ.

Keywords: antiresorptive therapy, breast cancer, dental care, MRONJ

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Authors: Joaquim de Almeida Dultra, Daiana Cristina Pereira Santana, Fátima Karoline Alves Araújo Dultra, Liliane Akemi Kawano Shibasaki, Mariana Machado Mendes de Carvalho, Ieda Margarida Crusoé Rocha Rebello

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Defects originating from mandibular resections can cause significant functional impairment and facial disharmony, and they have complex rehabilitation. The aim of this report is to demonstrate the authors' experience facing challenging rehabilitation after mandibular resection in a patient with ameloblastoma. Clinical and surgical steps are described simultaneously, highlighting the adaptation of the final fixed prosthesis, reported in an unprecedented way in the literature. A 37-year-old male patient was seen after a sports accident, where a pathological fracture in the symphysis and left mandibular body was identified, where a large radiolucent lesion was found. The patient underwent resection, bone graft, distraction osteogenesis, rehabilitation with dental implants, prosthesis, and finally, orofacial harmonization, in an interval of six years. Rehabilitation should consider the patient's needs individually and should have as the main objective to provide similar aesthetics and function to that present before the disease. We also emphasize the importance of interdisciplinary work during the course of rehabilitation.

Keywords: ameloblastoma, mandibular reconstruction, distraction osteogenesis, dental implants. dental prosthesis, implant-supported, treatment outcome

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Authors: Sonam Behl, Raju, Ginu Rajan, Paul Farrar, B. Gangadhara Prusty

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Reinforcing dental composites with micro-sized fibres can significantly improve the physio-mechanical properties of dental composites. The short fibres can be oriented randomly within dental composites, thus providing quasi-isotropic reinforcing efficiency unlike unidirectional/bidirectional fibre reinforced composites enhancing anisotropic properties. Thus, short fibres reinforced dental composites are getting popular among practitioners. However, despite their popularity, resin-based dental composites are prone to failure on account of shrinkage during photo polymerisation. The shrinkage in the structure may lead to marginal gap formation, causing secondary caries, thus ultimately inducing failure of the restoration. The traditional methods to evaluate polymerisation shrinkage using strain gauges, density-based measurements, dilatometer, or bonded-disk focuses on average value of volumetric shrinkage. Moreover, the results obtained from traditional methods are sensitive to the specimen geometry. The present research aims to evaluate the real-time shrinkage strain at selected locations in the material with the help of optical fibre Bragg grating (FBG) sensors. Due to the miniature size (diameter 250 µm) of FBG sensors, they can be easily embedded into small samples of dental composites. Furthermore, an FBG array into the system can map the real-time shrinkage strain at different regions of the composite. The evaluation of real-time monitoring of shrinkage values may help to optimise the physio-mechanical properties of composites. Previously, FBG sensors have been able to rightfully measure polymerisation strains of anisotropic (unidirectional or bidirectional) reinforced dental composites. However, very limited study exists to establish the validity of FBG based sensors to evaluate volumetric shrinkage for randomly oriented fibres reinforced composites. The present study aims to fill this research gap and is focussed on establishing the usage of FBG based sensors for evaluating the shrinkage of dental composites reinforced with randomly oriented fibres. Three groups of specimens were prepared by mixing the resin (80% UDMA/20% TEGDMA) with 55% of silane treated BaAlSiO₂ particulate fillers or by adding 5% of micro-sized fibres of diameter 5 µm, and length 250/350 µm along with 50% of silane treated BaAlSiO₂ particulate fillers into the resin. For measurement of polymerisation shrinkage strain, an array of three fibre Bragg grating sensors was embedded at a depth of 1 mm into a circular Teflon mould of diameter 15 mm and depth 2 mm. The results obtained are compared with the traditional method for evaluation of the volumetric shrinkage using density-based measurements. Degree of conversion was measured using FTIR spectroscopy (Spotlight 400 FT-IR from PerkinElmer). It is expected that the average polymerisation shrinkage strain values for dental composites reinforced with micro-sized fibres can directly correlate with the measured degree of conversion values, implying that more C=C double bond conversion to C-C single bond values also leads to higher shrinkage strain within the composite. Moreover, it could be established the photonics approach could help assess the shrinkage at any point of interest in the material, suggesting that fibre-Bragg grating sensors are a suitable means for measuring real-time polymerisation shrinkage strain for randomly fibre reinforced dental composites as well.

Keywords: dental composite, glass fibre, polymerisation shrinkage strain, fibre-Bragg grating sensors

Procedia PDF Downloads 126

Authors: Kiamran Radjabli

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State Estimator became an intrinsic part of Energy Management Systems (EMS). The SCADA measurements received from the field are processed by the State Estimator in order to accurately determine the actual operating state of the power systems and provide that information to other real-time network applications. All EMS vendors offer a State Estimator functionality in their baseline products. However, setting up and ensuring that State Estimator consistently produces a reliable solution often consumes a substantial engineering effort. This paper provides generic recommendations and describes a simple practical approach to efficient tuning of State Estimator, based on the working experience with major EMS software platforms and consulting projects in many electrical utilities of the USA.

Keywords: convergence, monitoring, state estimator, performance, troubleshooting, tuning, power systems

Procedia PDF Downloads 136

Authors: Dong Xie, Yuling Xu, Leah Howard

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Secondary caries is found to be one of the main reasons to the restoration failure of dental restoratives. To prevent secondary caries formation, dental restoratives ought to be made antibacterial. In this study, a natural fruit component furaneol was tethered onto polyacid, the formed polyacid was used to formulate the light-curable glass-ionomer cements, and then the effect of this new antibacterial compound on compressive strength (CS) and antibacterial activity of the formed cement was evaluated. Fuji II LC glass powders were used as fillers. Compressive strength (CS) and S. mutans viability were used to evaluate the mechanical strength and antibacterial activity of the formed cement. The experimental cement showed a significant antibacterial activity, accompanying with an initial CS reduction. Increasing the compound loading significantly decreased the S. mutans viability from 5 to 81% and also reduced the initial CS of the formed cements from 4 to 58%. The cement loading with 7% antibacterial polymer showed 168 MPa, 7.8 GPa, 243 MPa, 46 MPa, and 57 MPa in yield strength, modulus, CS, diametral tensile strength and flexural strength, respectively, as compared to 141, 6.9, 236, 42 and 53 for Fuji II LC. The cement also showed an antibacterial function to other bacteria. No human saliva effect was noticed. It is concluded that the experimental cement may potentially be developed to a permanent antibacterial cement.

Keywords: antibacterial, dental materials, strength, cell viability

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Authors: A. Srion, W. Thepsuwan, N. Monmaturapoj

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Two Lithium disilicate (LD) glass ceramics based on SiO2-Li2O-K2O-Al2O3 system were prepared through glass melting method and then fabricated into dental crowns via hot pressing at 850˚C and 900˚C in order to study the effect of the pressing temperatures on theirs phase formation and microstructure. The factor such as heat treatment temperature (as-cast glass, 600˚C and 700˚C) of the glass ceramics used to press was also investigated the effect of an initial microstructure before pressing. X-ray diffraction (XRD) and scanning electron microscopy (SEM) were used to determine phase formation and microstructure of the samples, respectively. X-ray diffraction result shows that the main crystalline structure was Li2Si2O5 by having Li3PO4, Li0.6Al0.6Si2O6, Li2SiO3, Ca5 (PO4)3F, SiO2 as minor phases. Glass compositions with different heat treatment temperatures exhibited a difference phase formation but have less effect during pressing. Scanning electron microscopy analysis showed microstructure of lath-like of Li2Si2O5 in all glasses. With increasing the initial heat treatment temperature, the longer the lath-like crystals of lithium disilicate were increased especially when using glass heat treatment at 700˚C followed by pressing at 900˚C. This could be suggested that LD1 heat treatment at 700˚C which pressing at 900˚C presented the best formation by hot pressing and compiled microstructure.

Keywords: lithium disilicate, hot pressing, dental crown, microstructure

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Authors: Edit Xhajanka, Gresa Baboci, Irene Malagnino, Mimoza Canga, Vito Antonio Malagnino

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Purpose: This study aimed at identifying dental caries increment or reduction, based on factors such as smoking, the scaling of teeth, BMI before and during pregnancy, carbohydrates consumption in relation to childbirth. Material and method: In this observational study, the sample included a total of 98 pregnant women and their age class was 18-45 years old, with a median age of 31.5 years. The setting of the participants resides in Vlora –Albania. Moreover, 64.4% were from the city and 35.6% were from the nearby villages. The study was conducted in the time period January 2018 –June 2021. Body mass index (BMI) was calculated using the standard formula (kg/m²). Maternal pre, during and post-pregnancy BMI was collected by using a validated questionnaire. Statistical analysis was performed using IBM SPSS Statistics 23.0. The significance level (α) was set at 0.05, whereas P-value and analysis of variance (ANOVA) were used to analyze the data. Results: Based on the data analysis, 44.4% of the sample declared that they did smoke before pregnancy and 55.6% not smoked during their pregnancy. As a result, no association was found between smoking and length of pregnancy P=0.95. There is also a strong relation (P=0.000) between the number of teeth with caries before pregnancy and the number of teeth with caries during pregnancy. There is a significant relationship between the scaling of teeth and childbirth, P=0.05. BMI before and during pregnancy in relation to carbohydrates consumption have a significant correlation P=0.004 and P=0.002. The values of BMI before and during pregnancy in relation to childbirth have a strong correlation: P=0.043 and P=0.040, respectively. As a result, obesity was associated with preterm birth. The percentage of children born during 34-36 weeks of pregnancy was 69%, and children born during 32-34 weeks of pregnancy were 31%. CONCLUSION: There was a positive association between dental caries experience, BMI and carbohydrates consumption. Obesity in pregnancy is increasing worldwide; that is why this study suggests the importance of an appropriate weight before and during pregnancy.

Keywords: BMI, dental caries, pregnancy, scaling, smoking

Procedia PDF Downloads 171

Authors: Heesu Kim

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This paper determines the varieties of state roles played in East Asia’s telecommunication market, regarding broadband industry. Technological capacity and the relationship between state and market affect the varieties of state role. In explaining the state’s engagement in the market, technology has always been considered as a necessary and sufficient condition. However technology variable has been useful in only explaining the extent of state’s involvement. This paper contributes by bringing in the political-economic factor, which is the relationship between state and market. This factor aids in distinguishing the varieties of state role played in emerging industries. Interaction between these two variables distinguishes 4 types of state roles played in the broadband industry. These roles are distinguished and characterized by the intensity of state’s intervention and the existence of technological capacity. This paper classifies four types of state role through the case of Singapore, China, Taiwan and Korea’s broadband industrial policy.

Keywords: East Asia, entrpreneurial state, industrial policy, regulatory state, technological capacity

Procedia PDF Downloads 138

Authors: Predrag Kavaric, Vladimir L. Jubic, Maxim Cadenovic

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The patient was transferred from his dentist to our tertiary medical institution. In anamnesis, we got information that his dental intervention was two years ago when he got dental implants but because of the coronavirus pandemic event, he didn’t finish the whole procedure. After two years, he decided that he will continue his work at his dentist, then his dentist noticed that there is no earlier inserted implant in the upper jaw on the right side. They do Panoramic X-ray and find that the implant is all in the maxillary sinus cavity. The flour of the maxilla was intact without any fistula on the place where the implant was inserted in the maxilla bone, After that initial diagnostic they sent the patient to maxillofacial surgery and otorhinolaryngology. We asked for a CT scan of paranasal sinuses, which confirmed the foreign body in the right maxillary sinus. The plan was that in general anesthesia we do FESS and try to find a foreign body in the maxillary sinus or in case of failure to do Caldwel Luc on that side. After preoperative preparation in GA, we do FESS. In inspection, we find small polyps and chronically changed mucosa of osteomeatal complex and right maxillary sinus. After removing polyps we did uncinectomy and medial maxillectomy. With Heuweiser Antrum grasping forceps after several attempts we managed to extract a foreign body from the bottom of the right maxillary sinus. On the first postoperative day we did detamponade, and then we discharge the patient from hospital. The Covid pandemic has contributed to the postponement of a large number of planned operations, which has resulted in various complications in the treatment of a number of patients. In this case, it happened that the implant was most likely rejected by the bone but in the direction of the maxillary sinus, which is not a common cause. On the other hand, the success was that less traumatic intervention was able to remove the foreign body from the maxillary sinus in which it was located. Since the sinus floor is free of bone defects, it can be continued relatively quickly with dental procedures.

Keywords: x-ray, surgery, maxillar sinus, complication, fees

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Authors: Ceri McIntosh

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A 25-year-old male was referred to the Maxillofacial department by his general dental practitioner with a complaint of mobile teeth. Medically he was well though he took mirtazapine for anxiety. He was found to have had previous extractions of the lower right second premolar and first molar, with grade 2 mobility of the upper right first and second molars and lower right lateral incisor. Radiographically there was significant external root resorption of these teeth, which were subsequently extracted. Over the next 18 months, the resorption continued around multiple teeth on the right side, and when the mobile teeth were removed, they showed no remaining root, including loss of coronal dentine, leaving only an enamel shell. No cause has been identified either histologically or in the patient’s blood work. A review of relevant literature will be included in this case report.

Keywords: case report, idiopathic resorption, idiopathic root resorption, external resorption

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Authors: Eyal Rosen

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This study is aimed to report a possible effect of the presence of dental implants on the development of crown or root fractures in adjacent natural teeth. A series of 26 cases of teeth diagnosed with crown or root fractures following the placement of adjacent dental implants is presented. In addition, a comprehensive systematic review of the literature was performed to detect other studies that evaluated this possible complication. The case series analysis revealed that all crown-fractured teeth were non-endodontically treated teeth (n=18), and all root fractured teeth were endodontically treated teeth (n=8). The time from implant loading to the diagnosis of a fracture in an adjacent tooth was longer than 1 year in 78% of cases. The majority of crown or root fractures occurred in female patients, over 50 years of age, with an average age of 59 in the crown fractures group, and 54 in the root fractures group. Most of the patients received 2 or more implants. Nine (50%) of the teeth with crown fracture were molars, 7 (39%) were mandibular premolars, and 2 (11%) were incisor teeth. The majority of teeth with root fracture were premolar or mandibular molar teeth (6 (75%)). The systematic review of the literature did not reveal additional studies that reported on this possible complication. To the best of the author’s knowledge this case series, although limited in its extent, is the first clinical report of a possible serious complication of implants, associated fractures in adjacent endodontically and non-endodontically treated natural teeth. The most common patient profile found in this series was a woman over 50 years of age, having a fractured premolar tooth, which was diagnosed more than 1 year after reconstruction that was based on multiple adjacent implants. Additional clinical studies are required in order to shed light on this potential serious complication.

Keywords: complications, dental implants, endodontics, fractured teeth

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Authors: Areej R. Banjar, Abraham G. Campbell

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The use of Mixed Reality (MR) in teaching and training is growing popular and can improve students’ ability to perform technical procedures. This short paper outlines the creation of an interactive educational MR 3D application that aims to improve the quality of instruction for dentistry students. This application is called MRImplantology and aims to teach the fundamentals and preoperative planning of dental implant placement. MRImplantology uses cone-beam computed tomography (CBCT) images as the source for 3D dental models that dentistry students will be able to freely manipulate within a 3D MR world to aid their learning process.

Keywords: augmented reality, education, dentistry, cone-beam computed tomography CBCT, head mounted display HMD, mixed reality

Procedia PDF Downloads 159

Authors: Ting Zou, Chengfei Zhang

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Objectives: The purpose of this study was to investigate the role of Semaphorin 4D (Sema4D)/Plexin-B1 signaling on osteo/odontogenic differentiation of human dental pulp stem cells (DPSCs) and uncover its molecular mechanism. Methods: DPSCs were cultured in osteo/odontogenic medium. After treatment with Sema4D (10μg/mL), osteo/odontogenic differentiation and mineralization was evaluated by measuring alkaline phosphatase (ALP) activity and alizarin red S staining respectively. The expression of osteo/odontogenic genes (ALP, Col1A1, BSP, and Runx2) was determined by real-time polymerase chain reaction. p-Plexin-B1, Plexin-B1, Col1A1, RhoA, and ErbB2 were analyzed by western. Results: ALP activity and mineralization formation of DPSCs were significantly decreased after treatment with Sema4D (P<0.05). Sema4D significantly down-regulated osteo/odontogenic-related genes expression (ALP, Col1A1, BSP, and Runx2). p-Plexin-B1, Plexin-B1 and RhoA protein expression levels increased after stimulated with Sema4D, while the expression of Col1A1 decreased. Pretreatment with Plexin-B1 antibody blocked Sema4D induced p-Plexin-B1 expression. Conclusion: Sema4D suppressed osteo/odontogenic differentiation of DPSCs via RhoA-mediated pathways.

Keywords: Sema4D/Plexin-B1, dental pulp stem cells, osteo/odontogenic differentiation, alkaline phosphatase (ALP)

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Authors: T. Almutairi, K. Naudi, N. Nairn, X. Ju, B. Eng, J. Whitters, A. Ayoub

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Purpose: At present Cone Beam Computed Tomography (CBCT) imaging does not record dental morphology accurately due to the scattering produced by metallic restorations and the reported magnification. The aim of this pilot study is the development and validation of a new method for the replacement of the distorted dentition of CBCT scans with the dental image captured by the digital intraoral camera. Materials and Method: Six dried skulls with orthodontics brackets on the teeth were used in this study. Three intra-oral markers made of dental stone were constructed which were attached to orthodontics brackets. The skulls were CBCT scanned, and occlusal surface was captured using TRIOS® 3D intraoral scanner. Marker based and surface based registrations were performed to fuse the digital intra-oral scan(IOS) into the CBCT models. This produced a new composite digital model of the skull and dentition. The skulls were scanned again using the commercially accurate Laser Faro® arm to produce the 'gold standard' model for the assessment of the accuracy of the developed method. The accuracy of the method was assessed by measuring the distance between the occlusal surfaces of the new composite model and the 'gold standard' 3D model of the skull and teeth. The procedure was repeated a week apart to measure the reproducibility of the method. Results: The results showed no statistically significant difference between the measurements on the first and second occasions. The absolute mean distance between the new composite model and the laser model ranged between 0.11 mm to 0.20 mm. Conclusion: The dentition of the CBCT can be accurately replaced with the dental image captured by the intra-oral scanner to create a composite model. This method will improve the accuracy of orthognathic surgical prediction planning, with the final goal of the fabrication of a physical occlusal wafer without to guide orthognathic surgery and eliminate the need for dental impression.

Keywords: orthognathic surgery, superimposition, models, cone beam computed tomography

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Authors: Junaid Ahmed, Nandita Shenoy

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Maintaining lifelong knowledge and skills is essential for safe clinical practice. Continuing Professional Development (CPD) is an established method that can facilitate lifelong learning. It focuses on maintaining or developing knowledge, skills and relationships to ensure competent practice.To date, relatively little has been done to comprehensively and systematically synthesize evidence to identify subjects of interest among practising dentist. Hence the aim of our study was to identify areas in clinical practice that would be favourable for continuing professional dental education amongst practicing dentists. Participants of this study consisted of the practicing dental surgeons of Mangalore, a city in Dakshina Kannada, Karnataka. 95% of our practitioners felt that regular updating as a one day program once in 3-6 months is required, to keep them abreast in clinical practice. 60% of subjects feel that CPD programs enrich their theoretical knowledge and helps in patient care. 27% of them felt that CPD programs should be related to general dentistry. Most of them felt that CPD programs should not be charged nominally between one to two thousand rupees. The acronym ‘CPD’ should be seen in a broader view in which professionals continuously enhance not only their knowledge and skills, but also their thinking,understanding and maturity; they grow not only as professionals, but also as persons; their development is not restricted to their work roles, but may also extend to new roles and responsibilities.

Keywords: continuing professional development, competent practice, dental education, practising dentist

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Authors: Fadwa Chtioui

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Vital Pulp Therapy (VPT) is nowadays challenging the deep-rooted dogma of root canal treatment, being the only therapeutic option for permanent teeth diagnosed with irreversible pulpitis or carious pulp exposure. Histologic and clinical research has shown that compromised dental pulp can be treated without the full removal or excavation of all healthy pulp, and the outcome of the partial or full pulpotomy followed by a Tricalcium-Silicate-based dressing seems to show promising results in maintaining pulp vitality and preserving affected teeth in the long term. By reviewing recent advances in the techniques of VPT and their clinical effectiveness and safety in permanent teeth with irreversible Pulpitis, this work provides a new understanding of pulp pathophysiology and defense mechanisms and will reform dental practitioners' decision-making in treating irreversible pulpits from root canal therapy to vital pulp therapy by taking advantage of the biological effects of Tricalcium Silicate materials. Biography of presenting author: Fadwa Chitoui graduated from the school of Dental Medicine of Monastir, Tunisia, in 2015. After getting her DDS degree with honors, she earned her Postgraduate master's Degree in Endodontics and Restorative Dentistry from her Faculty. Since 2021, she has Started her own private and specialized practice based in the capital Tunis. She enjoys the sphere of associative life, worked with national and international associations, and got engaged in scientific dental research, whereby she tailored her passion for her field of specialty towards broadening her knowledge and ambitions, holding conferences and workshops nationally and internationally and publishing scientific articles in several journals.

Keywords: irreversible pulpitis, permanenet teeth, vital pulp therapy, pulpotomy

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Authors: Jong Yeop Kim, In Kyong Yi, Hyun Jeong Kwak, Sook Young Lee, Sung Yong Park

Abstract:

Background: Several video laryngoscopes (VLs) were used to facilitate tracheal intubation in the normal and potentially difficult airway, especially by novice personnel. The aim of this study was to compare tracheal intubation performance regarding the time to intubation, glottic view, difficulty, and dental click, by a novice using McGrath VL, Pentax Airway Scope (AWS) and Macintosh laryngoscope in normal and cervical immobilized manikin models. Methods: Thirty-five anesthesia nurses without previous intubation experience were recruited. The participants performed endotracheal intubation in a manikin model at two simulated neck positions (normal and fixed neck via cervical immobilization), using three different devices (McGrath VL, Pentax AWS, and Macintosh direct laryngoscope) at three times each. Performance parameters included intubation time, success rate of intubation, Cormack Lehane laryngoscope grading, dental click, and subjective difficulty score. Results: Intubation time and success rate at the first attempt were not significantly different between the 3 groups in normal airway manikin. In the cervical immobilized manikin, the intubation time was shorter (p = 0.012) and the success rate with the first attempt was significantly higher (p < 0.001) when using McGrath VL and Pentax AWS compared with Macintosh laryngoscope. Both VLs showed less difficulty score (p < 0.001) and more Cormack Lehane grade I (p < 0.001). The incidence of dental clicks was higher with McGrath VL than Macintosh laryngoscope in the normal and cervical immobilized airway (p = 0.005, p < 0.001, respectively). Conclusion: McGrath VL and Pentax AWS resulted in shorter intubation time, higher first attempt success rate, compared with Macintosh laryngoscope by a novice intubator in a cervical immobilized manikin model. McGrath VL could be reduced the risk of dental injury compared with Macintosh laryngoscope in this scenario.

Keywords: intubation, manikin, novice, videolaryngoscope

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Authors: Abdullah Eqal Al Mazrooei

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In this work, a new nonlinear model will be introduced. The model is in the state-space form. The nonlinearity of this model is in the state equation where the state vector is multiplied by its self. This technique makes our model generalizes many famous models as Lotka-Volterra model and Lorenz model which have many applications in the real life. We will apply our new model to estimate the wind speed by using a new nonlinear estimator which suitable to work with our model.

Keywords: nonlinear systems, state-space model, Kronecker product, nonlinear estimator

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Authors: Pooja Bakshi

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In the following paper, an attempt would be made to engage with the relationship between the state and the imperatives of security from a gendered lens. This will be juxtaposed with the feminist engagement with International Law. Theorizations from the literature on South Asian politics and Global politics would be applied to the manner in which the Indian state has defined and proposed to deal with concerns of internal security pertaining to the ‘Left Wing Extremism’ in 2010-2011. It would be argued that the state needs to be disaggregated into the legislature, executive and the judiciary; since there are times when some institutional parts of the state provide space for progressive democratic engagement whilst other institutions don’t. The specific contours of violence faced by women and children at the hands of the state, in the above-mentioned discourse would also be examined. In the end, implications of the security state discourse on debates in International Law would be elaborated.

Keywords: feminist engagement, human rights, state response to left extremism, security studies in South Asia

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Authors: Faten Khanfir, Mohamed Tlili, Ali Medeb Hamrouni, Raki Selmi, M. S. Khalfi, Faten Ben Amor

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Introduction: dental implant failure is a major concern for the clinician and the patient. Objectives: The aim of our study is to investigate the way in which 100 Tunisian dentists carried implant treatment for their patients from the early phase of planning and selection of patients to the placement of the implant in order to look for the implant failure factors. Results: significant correlations were found between failure rates > 5 and their corresponding factors as the number of implants placed (p = 0.001<0, 05), smoking (0.046 <0.05), unbalanced diabetes (0.03<0.05), aseptic protocol (= 0.004< 0.05) and the drilling speed (0,002<0.05) Conclusion: It seems that the number of implant placed, smoking, diabetes, aseptic protocol, and the drilling speed may contribute to dental implant failure.

Keywords: failure, implants, survey, risk, osseointegration

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Authors: Supanitayanon Lalita, Dechkunakorn Surachai, Anuwongnukroh Niwat, Srikhirin Toemsak, Roongrujimek Pitchaya, Tua-Ngam Peerapong

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Objective: To compare maximum load, percentage of elongation, physical characteristics of 4 types of dental floss: (1) Thai Silk Floss (silk, waxed), (2) Oral B® Essential Floss (nylon, waxed), (3) Experimental Floss Xu (nylon, unwaxed), (4) Experimental Floss Xw (nylon, waxed). Materials & method: Four types of floss were tested (n=30) with a Universal Testing Machine (Instron®). Each sample (30 cm long, 5 cm segment) was fixed, and pulled apart with load cell of 100 N and a test speed of 100 mm/min. Physical characteristics were investigated by digital microscope under 2.5×10 magnification, and scanning electron microscope under 1×100 and 5×100 magnification. The size of the filaments was measured in micron (μm) and the fineness were measured in Denier. Statistical analysis: For mechanical properties, the maximum load and the percentage of elongation were presented as mean ± SD. The distribution of the data was calculated by the Kolmogorov-Smirnov test. One-way ANOVA and multiple comparison (Tukey HSD) were used to analyze the differences among the groups with the level of a statistical difference at p < 0.05. Results: The maximum load of Floss Xu, Floss Xw, Oral B and Thai Silk were 47.39, 46.46, 25.38, and 23.70 N, respectively. The percentage of elongation of Oral B, Floss Xw, Floss Xu and Thai Silk were 72.43, 44.62, 31.25, and 16.44%, respectively. All 4 types of dental floss showed statistically differences in both the maximum load and percentage of elongation at p < 0.05, except for maximum load between Floss Xw and Floss Xu that showed no statistically significant difference. Physical characteristics of Thai silk revealed the most disintegrated, the smallest, and the least fine filaments. Conclusion: Floss Xu had the highest maximum load. Oral B had the highest percentage of elongation. Wax coating on Floss X increased the elongation but had no significant effect on the maximum load. The physical characteristics of Thai Silk resulted in the lowest mechanical properties values.

Keywords: dental floss, maximum load, mechanical property, percentage of elongation, physical property

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Authors: Sulaiman A. Alrumman, Abd El-Latif Hesham

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Despite medical progress worldwide, dental caries are still widespread. Miswak is derived from the plant arak (Salvadora persica). It is used by Muslim people as a natural product for the cleansing of teeth, to ensure oral and dental hygiene. This study was designed to evaluate the antimicrobial effects of ethanol, methanol, and ethanol/methanol extracts of miswak against three bacterial pathogens of the oral cavity. The pathogens were isolated from the oral cavity of volunteers/patients and were identified on the basis of 16S rRNA gene amplification data. Sequence comparisons were made with 16S rRNA gene sequences available in the GenBank database. The results of sequence alignment and phylogenetic analysis identified the three pathogens as being Staphylococcus aureus strain KKU-020, Enterococcus faecalis strain KKU-021 and Klebsiella pneumoniae strain KKU-022. All miswak extracts showed powerful antimicrobial activity against the three pathogens. The maximum zone of inhibition (40.67±0.88 mm) was observed against E. faecalis with ethanolic extracts whilst methanolic extracts showed the minimum zone of inhibition (10.33±0.88 mm) against K. pneumonia KKU-022. Based on the significant effects of the miswak extracts against the oral cavity pathogens in our study, we recommend that miswak is to be used as a dental hygiene method to prevent tooth caries.

Keywords: antibacterial, miswak, Salvadora persica, oral cavity pathogens

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Authors: Hyeong-Jin Kim, Jong Kook Lee

Abstract:

Zirconia has biological, mechanical and optical properties, so, it used as a dental implant material in human body. But, it is difficult to form directly bonding with living tissues after the procedure and induces the falling away from implanted parts of the body. To improve this phenomenon, it is essential to increase the surface roughness of zirconia implants and induce a forming-ability of strong bonds. In this study, we performed a room temperature spray coating on zirconia specimen to obtain a highly roughened zirconia surface. To get optimal surface roughness, we controlled the distance between the nozzle and the substrate, coating times and powder condition. Bonding microstructure, surface roughness, and chemical composition of the coating layer were observed by SEM, XRD and roughness tester.

Keywords: implant, aerosoldeposition, zirconia, dental

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Authors: Dilip Gogoi

Abstract:

This paper attempts to explore the notion of sovereign state system, its emergence and legitimization by the treaty of Westphalia, 1648 in Europe and examines how the very notion of sovereign state is subject to changes in the later part of the 20th century both politically and economically in the wake of globalisation. The paper firstly traces the tradition of Westphalian sovereign state system which influenced the dominant understanding about sovereign state system till mid 20th century. Secondly, it explores how the notion of sovereign nation state is subjected to change in the post World War II specially in the context of universal acceptance of human rights and right to intervene in internal affairs of a sovereign state to protect the same, the decolonization and legitimization of the principle of self determination and through the experience of European Integration. Thirdly, it analyses how globalisation drives certain fundamental changes and poses challenges to the sovereign state system. The concluding part of the paper argues that sovereign state system is relevant and will continue to be relevant although it needs to redefine its role in the changing global environment.

Keywords: Westphalia, sovereignty, nation-state system, intervention, globalisation

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Authors: Sana Ilyas, Kishalaya Mukherjee, Suresh Shetty

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Lip Augmentation has become more common in recent years. Patients do not expect to experience facial palsy after having lip augmentation. This poster will present the findings of such a presentation and will discuss the possible pathophysiology and management. (This poster has been published as a paper in the dental update, June 2022) Aim: The aim of the study was to explore the link between facial nerve palsy and lip fillers, to explore the literature surrounding facial nerve palsy, and to discuss the case of a patient who presented with facial nerve palsy with seemingly unknown cause. Methodology: There was a thorough assessment of the current literature surrounding the topic. This included published papers in journals through PubMed database searches and printed books on the topic. A case presentation was discussed in detail of a patient presenting with peripheral facial nerve palsy and associating it with lip augmentation that she had a day prior. Results and Conclusion: Even though the pathophysiology may not be clear for this presentation, it is important to highlight uncommon presentations or complications that may occur after treatment. This can help with understanding and managing similar cases, should they arise.It is also important to differentiate cause and association in order to make an accurate diagnosis. This may be difficult if there is little scientific literature. Therefore, further research can help to improve the understanding of the pathophysiology of similar presentations. This poster has been published as a paper in dental update, June 2022, and therefore shares a similar conclusiom.

Keywords: facial palsy, lip augmentation, causation and correlation, dental cosmetics

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