Rates and predictors of exposure to Legionella pneumophila in the United States among dental practitioners: 2002 through 2012

Background

In this study, the authors compared the odds of exposure to Legionella pneumophila among currently active dental practitioners with that of nonpractitioners and evaluated demographic and clinical practice predictors of exposure.

Predictors of postretention stability of mandibular dental arch dimensions in patients treated with a lip bumper during mixed dentition followed by fixed appliances

Objective:To identify which dental and/or cephalometric variables were predictors of postretention mandibular dental arch stability in patients who underwent treatment with transpalatal arch and lip bumper during mixed dentition followed by full fixed appliances in the permanent dentition.Materials and Methods:Thirty-one patients were divided into stable and relapse groups based on the postretention presence or absence of relapse. Intercuspid, interpremolar, and intermolar widths; arch length and perimeter; crowding; and lower incisor proclination were evaluated before treatment (T0), after lip bumper treatment (T1), after fixed appliance treatment (T2), and a minimum of 3 years after removal of the full fixed appliance (T3). Logistic regression analyses were performed to evaluate the effect of changes between T0 and T1, as predictive variables, on the occurrence of relapse at T3.Results:The model explained 53.5 % of the variance in treatment stability and correctly classified 80.6 % of the sample. Of the seven prediction variables, intermolar and interpremolar changes between T0 and T1 (P = .024 and P = .034, respectively) were statistically significant. For every millimeter of increase in intermolar and interpremolar widths there was a 1.52 and 2.70 times increase, respectively, in the odds of having stability. There was also weak evidence for the effect of sex (P = .047).Conclusions:The best predictors of an average 4-year postretention mandibular dental arch stability after treatment with a lip bumper followed by full fixed appliances were intermolar and interpremolar width increases during lip bumper therapy. The amount of relapse in this crowding could be considered clinically irrelevant.     

Adjuncts for the evaluation of potentially malignant disorders in the oral cavity: Diagnostic test accuracy systematic review and meta-analysis—a report of the American Dental Association

Background

Oral squamous cell carcinoma is the most common manifestation of malignancy in the oral cavity. Adjuncts are available for clinicians to evaluate lesions that seem potentially malignant. In this systematic review, the authors summarized the available evidence on patient-important outcomes, diagnostic test accuracy (DTA), and patients’ values and preferences (PVPs) when using adjuncts for the evaluation of clinically evident lesions in the oral cavity.

Dental disease before radiotherapy in patients with head and neck cancer: Clinical Registry of Dental Outcomes in Head and Neck Cancer Patients

Background

No evidence-based guidelines exist for preventive dental care before radiation therapy (RT) in patients with head and neck cancer (HNC). An ongoing multicenter, prospective cohort study, Clinical Registry of Dental Outcomes in Head and Neck Cancer Patients (OraRad), is addressing this knowledge gap. The authors evaluated the level of dental disease before RT in the OraRad cohort, factors associated with dental disease, and dental treatment recommendations made before RT.

Patient‐Centered Perspectives and Understanding of Peri‐Implantitis

Background: Patients undergoing dental treatment have an uncertain understanding about dental implant therapy and its complications. Therefore, the aims of this study assess the following: 1) level of knowledge, awareness, and attitudes about peri‐implantitis; 2) information provided by dentists/specialists who perform the treatment; and 3) perceptions, level of satisfaction, and impact on patient quality of life (QoL). Methods: Patients with implant restorative therapy currently undergoing peri‐implant maintenance therapy were recruited. Participants completed an anonymous questionnaire that included general aspects of prognosis, including the following: 1) peri‐implantitis; 2) etiology; 3) awareness; 4) attitudes; 5) treatment; 6) prevention; 7) risk factors; 8) quality of information; 9) level of patient satisfaction; and 10) QoL. Associations among questionnaire data were identified using univariate and multivariate analyses. Results: Overall, 411 implants were included from 135 patients with implants. Frequency of peri‐implantitis in the survey was 17.8% at the participant level, with 70% of them reporting high level of post‐surgical satisfaction. Worry and concern were frequent findings among patients with peri‐implantitis (64%), and 32% reported that living with the disease was terrible. The vast majority of patients (74.1%) did not have knowledge about peri‐implant pathology. Patients with peri‐implantitis showed statistically significantly better understanding of implant therapy (P <0.001) and also higher average concern (P = 0.004). Conclusions: Patients generally have a poor understanding and perception of peri‐implantitis and its impact. QoL was impaired by the presence of peri‐implantitis with high level of concern and low level of therapeutic satisfaction. Therefore, it is important to develop standardized information brochures to educate patients on risk factors and indicators of the disease to assist in the prevention of peri‐implantitis.     

Effects of whitening dentifrice on yttria-stabilized tetragonal zirconia polycrystal surfaces after simulating brushing

Statement of problem

The changes that occur after brushing yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) are unknown. These changes may favor the retention of microorganisms and chemisorption of water, impairing its longevity.

Marginal bone loss around dental implants with and without microthreads in the neck: A systematic review and meta-analysis

Statement of problem

Whether microthreads in the crestal portion can reduce the amount of marginal bone loss (MBL) around implants has not yet been determined.

Association of Preventive Maintenance Therapy Compliance and Peri‐Implant Diseases: A Cross‐Sectional Study

Background: This study aims to investigate association between peri‐implant maintenance therapy (PIMT) and the frequency of peri‐implant diseases and to further identify factors that contribute to failure of PIMT compliance. Methods: A cross‐sectional study on patients who were healthy and partially edentulous was conducted. They were grouped in the following categories according to PIMT compliance: 1) regular compliers (RC) (≥2 PIMT/year); 2) erratic compliers (EC) (<2 PIMT/year); and 3) non‐compliers (NC) (no PIMT). Radiographic and clinical analyses were carried out including probing depth (PD), plaque index (PI), bleeding on probing (BOP), mucosal redness (MR), suppuration (SUP), keratinized mucosa dimension, and marginal bone loss. A multiple logistic regression model was estimated at implant and patient level to obtain adjusted odds ratios (ORs) and to control possible confounding effects among variables. Results: Overall, 206 implants in 115 patients fulfilled inclusion criteria. At patient level, it was shown that association between compliance and peri‐implant condition was statistically significant (P = 0.04). Compliance was associated with 86% fewer conditions of peri‐implantitis. The probability of PIMT compliance was substantially associated with frequency of peri‐implantitis (OR = 0.13, P = 0.01). Patients with a history of periodontal disease multiplied their probability of being EC (versus NC) 4.23 times with respect to not having a history of periodontal disease (P = 0.02). Moreover, light smokers significantly resulted to be NC compared with RC (P = 0.04) and EC (P = 0.02). Nevertheless, mucositis was not found to be statistically associated with level of compliance. In addition, PD, PI, BOP, MR, and SUP varied significantly according to PIMT compliance and peri‐implant condition. Conclusions: Peri‐implant maintenance compliance ≥2 PIMT/year seems to be crucial to prevent peri‐implantitis in healthy patients. Furthermore, history of periodontal disease and disease severity, as well as its extent and a smoking habit, appear to be factors that influence the compliance risk profile (NCT02789306).     

Hereditary angioedema: death after a dental extraction

Hereditary angioedema (HAE) is a group of three uncommon and potentially fatal conditions, each of which is transmitted as a somatic dominant trait. A recognized trigger to attacks is dental treatment, with tooth extraction frequently reported in the published work. The clinical symptoms may not manifest for many hours or even days after the procedure. We describe a recent case in Australia in which death resulted from HAE following dental extraction, and we discuss its post‐mortem presentation and diagnosis, highlighting the need for dental practitioners to be aware of this condition.