Lip morphometry and morphologic pattern variation by ethnicity.

The aim of this research is to document and classify common lip print patterns and lip measurements, to evaluate their variations in Polish, Russian, Lithuanian women populations. 371 women (151 Lithuanians, 145 Poles, 75 Russians) from Vilnius University participated in this research. A questionnaire and lip print collection were administered. Each lip print was divided into six sextants, examined and classified. 120 women were photographed by Vectra M3 3D (Canfield Imaging Systems, USA) camera, lip morphometry was analyzed. In all lip print sextants, Type I was the most common among Lithuanians, Type III - among Polish and Type V - among Russian women. A statistically significant difference was found between Type I lip print pattern and Lithuanian ethnicity (p = 0.001) and Type III and Polish ethnicity (p = 0.015). The values of medial vertical height of cutaneous upper lip (p = 0.045), height of upper lip (p = 0.034), philtrum width (p = 0.020), height of lower vermilion (p = 0.015), upper lip vermilion area (p = 0.022), upper lip volume (p = 0.034) and total lip volume (p = 0.05) statistically significantly varied between the ethnicities. Morphometric findings were similar to other morphometric research on Caucasians.

Changes in Management Preference of Deep Carious Lesions and Exposed Pulps: Questionnaire Studies with a 10-Year Interval among Dentists in Lithuania.

We aimed to investigate changes in management preferences for deep carious lesions and pulps exposed during carious tissue removal that occurred during the last 10 years and identify associated dentists' background factors. The data were collected among dentists registered with the Lithuanian Dental Chamber at two time points using a similar questionnaire. In 2011, 400 randomly selected dentists received a questionnaire by mail, and 153 (38.3%) responded. In 2021, an electronic invitation to an online questionnaire was sent to all members of the Lithuanian Dental Chamber, and 213 (8.9%) dentists responded. The questionnaire included the definitions of management options, a radiograph, and a clinical picture of a deep carious lesion reaching to the inner fourth of dentine in a mature permanent tooth, asked management preferences in four different scenarios, as well as participants' background characteristics, reasons for management, and procedural preferences. Data were analyzed using bivariate and multivariable analyses. Compared to 2011, participants in 2021 had 60% lower odds of preferring nonselective versus selective caries removal (OR 0.4, 95% CI 0.2-0.7) and endodontic treatment versus nonselective and selective caries removal (OR 0.4, 95% CI 0.2-0.6) in the scenario of asymptomatic and symptomatic (indicating reversible pulpitis at most) deep lesions, respectively. For exposed pulp, participants in 2021 had lower odds than in 2011 of preferring endodontic treatment versus vital pulp therapy (direct pulp capping and pulpotomies) for both scenarios without symptoms (OR 0.4, 95% CI 0.2-0.7) and with symptoms (OR 0.2, 95% CI 0.1-0.4). A higher proportion of respondents in 2021 reported using rubber dam (44% vs. 17% in 2011, p < 0.001) and hydraulic calcium silicate cements as a capping material (68% vs. 40% in 2011, p < 0.001). The management preferences were associated with the university of graduation and the number of years in dental practice, indicating "recommended in textbooks" and "recommended in scientific publications" as reasons for management preferences. To conclude, a change toward less invasive management options was observed. To a certain extent, dentists have implemented evidence-based recommendations in dental practice. To ensure further adoption of scientific evidence, dentists should be encouraged to update themselves on the newest evidence-based practices.

Immediate and Long-Term Radiopacity and Surface Morphology of Hydraulic Calcium Silicate-Based Materials.

The present study aimed to evaluate and compare the radiopacity and surface morphology of AH Plus Bioceramic Sealer (AHPB), Bio-C Sealer (BIOC), Biodentine (BD), BioRoot RCS (BR), Grey-MTAFlow (GMF), White-MTAFlow (WMF), TotalFill BC Sealer (TF), and TotalFill BC Sealer HiFlow (TFHF) at different time moments­30 min, 24 h, and 28 days. Ten specimens of each material were prepared according to the ISO-6876:2012 standard and radiographed next to an aluminum step wedge using a digital sensor. The specimens were stored in a gelatinized Hank's balanced salt solution at 37 °C between assessments. The mean grayscale values of each specimen were converted into equivalent aluminum thickness by a linear regression model. Characterization of the surface morphology was performed by using a scanning electron microscope at ×4.0k and ×10.0k magnifications. The radiographic analysis revealed that all the tested materials exceeded the ISO-specified limit of 3 mm Al, with the highest radiopacity presented by AHPB and the lowest by BD. None of the tested materials demonstrated considerable variances between the 30 min and the 24 h radiopacity level (p < 0.05), and statistically significant long-term radiopacity changes were exhibited by BR, TFHF, and TF (p > 0.05). All the specimens demonstrated a common feature of limited precipitate formation, with numerous unreacted particles still presented on the surface after 24 h, whereas the particle rearrangement and the deposition of precipitates were clearly observed after 28 days.

Importance of education on infection control and on the hand skin health of dental personnel.

BACKGROUND: Hand hygiene plays a significant role in infection control, yet it is performed correctly only 40% of the time. The daily use of soap, disinfectants and gloves can also affect hand skin health. Periodical educational interventions regarding hand hygiene can improve infection control. OBJECTIVES: The current study aimed to identify the existing hand hygiene practices applied by dental personnel, to evaluate knowledge about infection control, to determine the adverse effects of hand hygiene on the skin, and to assess the effectiveness of the educational interventions concerning these topics. MATERIAL AND METHODS: This study was carried out at the Vilnius University Hospital Zalgiris Clinic, Lithuania. At the 1st stage, data was collected by using a self-administered questionnaire. At the 2nd stage, dental personnel underwent an educational intervention and the surveys were redistributed to determine any changes in the level of knowledge. RESULTS: In most cases, dental workers performed hand hygiene when it was needed. The proper method was selected by 53.4% on average. The main mistakes were the excessive use of soap and only occasional use of a disinfectant. The reported hand skin side effects included dryness (68.8%) and fissures (37.5%). Only half (50.5%) of the staff regularly used emollients. After the educational intervention, there was a 24.9% improvement in hand hygiene compliance. CONCLUSIONS: The correct procedure for hand hygiene was reported by half of the participants. Washing hands with soap was the preferable choice, while alcohol-based hand rub (ABHR) was avoided. Skin problems were reported by more than 70% of the respondents. Training had a positive impact on the hand hygiene knowledge of the dental personnel.

Self-determination theory guided oral self-care training for adolescents-A cluster randomised controlled trial.

Quality oral self-care is a key element in maintaining oral health, which is important for students' general health, their overall well-being and learning. The cluster randomised controlled trial tested the following hypotheses: (1) self-determination theory (SDT)-guided dental education is superior to conventional dental instruction in modifying oral self-care in adolescents; (2) after the discontinued dental education, improved oral self-care is only maintained for short rather than long term and (3) multiple predictors explain variations in adolescents' oral self-care at different observation periods. The intervention group (N = 97) received three face-to-face educational sessions to facilitate adolescents' intrinsic motivation, while the control group (N = 99) had one conventional dental instruction session. Dental plaque scores (% of tooth area covered by dental plaque) indicated a lack of oral self-care. Linear multivariable models tested the following predictors of oral self-care at different observation periods: socio-demographics (sex, socio-economic status, school) and self-determination attributes (autonomy, relatedness, competence). Results indicated that from baseline to the 6-month follow-up, dental plaque scores decreased (oral self-care improved) in the intervention group but not in the control group. At the 12-month follow-up point, there were no significant differences in mean plaque scores between the study groups. Baseline plaque levels (ß = 0.807), the type of dental instruction (theory guided vs. conventional) (ß = 0.208), relatedness (ß = 0.106) and competence (ß = 0.102) were significant predictors that explained 67.6% of the variance in dental plaque scores at the 12-month follow-up point. The theory-guided education was superior to conventional verbal instruction in improving adolescent oral self-care; however, this improvement was only maintained short term. Variations in adolescent oral self-care at short- and long-term observation points were explained by baseline oral self-care levels and two SDT components: relatedness and competence.

Prevalence of pulp stones in molars based on bitewing and periapical radiographs.

OBJECTIVE: To determine prevalence of pulp stones in molars of patients at the Institute of Dentistry Faculty of Medicine Vilnius University and to evaluate the association of pulp stones and gender, patient age, tooth condition. MATERIAL AND METHODS: Intraoral radiographs were reviewed using the Romexis program and pulp stones were assessed in molars.  Teeth were distributed into intact and non-intact. Information about patients' gender and age was collected. Data were processed using SPSS IBM (Statistical Package for the Social Sciences 22.0) program. Pearson's Chi-square test (χ2) was used. Results were considered to be statistically significant when the significance level of p<0.05. RESULTS: A total of 531 patients' bitewing and periapical radiographs of molars were evaluated. 2361 molars in total were assessed. Prevalence of pulp stones was 58.8% when pulp stones were found in at least one molar. Pulp stones were detected in 832 molars (35.24%). Patients from 18 to 93 years old were assessed. The highest pulp stones' occurrence was found in the age group from 38 years and older (71.07%). Non-intact maxillary right first molars and maxillary right and left second molars demonstrated a statistically significantly more frequent occurrence of pulp stones than intact molars (p<0.05). CONCLUSION: More than half of the participants had pulp stones in molars. Higher prevalence of pulp stones was associated with older age and decayed/filled teeth. There was no statistically significant difference between genders with regards to prevalence of pulp stones.

Shaping and Centering Ability, Cyclic Fatigue Resistance and Fractographic Analysis of Three Thermally Treated NiTi Endodontic Instrument Systems.

The better understanding of the clinically important behavioral features of new instrument systems has an important significance for the clinical endodontics. This study aimed to investigate the shaping and centering ability as well as cyclic fatigue resistance of HyFlex CM (CM), HyFlex EDM (EDM) and EdgeFile (EF) thermally treated nickel-titanium (NiTi) endodontic instrument systems. Sixty curved root canals of the mesial roots of mandibular molars were randomly assigned into three groups (n = 20) and shaped using CM, EDM and EF files up to the size 40 and taper 04 of the instruments. µCT scanning of the specimens before and after preparation was performed and the morphometric 2D and 3D parameters were evaluated in the apical, middle and coronal thirds of root canals. In each group, 40.04 instruments (n = 20) were subjected to the cyclic fatigue resistance test in artificial root canals at 37 °C temperature until fractures occurred, and the number of cycles to failure (NCF) was calculated. The fractographic analysis was performed using a scanning electron microscope, evaluating topographic features and surface profiles of the separated instruments. The one-way analysis of variance with post hoc Tuckey's test was used for statistical analysis of the data; the significance level was set at 5%. All systems prepared the comparable percentage of root canal surface with the similar magnitude of canal transportation in all root thirds (p > 0.05), but demonstrated significantly different resistance to cyclic fatigue (p < 0.05). The most resistant to fracture was EF, followed by EDM and CM. The length of the fractured fragments was not significantly different between the groups, and fractographic analysis by SEM detected the typical topographic features of separated thermally treated NiTi instrument surfaces.

Dental Trauma Experience, Attitudes and Trauma Prevention in 11- to 13-Year-Old Lithuanian Schoolchildren.

PURPOSE: To identify the prevalence and determinants of dental trauma in permanent anterior teeth among 11- to 13-year-old schoolchildren, to compare self-reported dental trauma rates with clinical examination trauma rates, and to examine mouthguard use among children engaged in contact sports. MATERIALS AND METHODS: A probability sampling scheme was used to recruit schools, with all 6th grade children in the selected schools invited to participate. A total of 2621 caregiver consent forms were sent, of which 807 were returned (31%). Caregivers were asked four trauma-related questions. Clinical examinations included assessment of dental trauma experience (trauma index with five severity codes), lip competence and incisal overjet. Child- and tooth-level analyses were performed. RESULTS: Clinical evidence of dental trauma was found in 52% of participants, 13% self-reported dental trauma, and 7% of children did not remember the occurrence of any trauma. The two most frequently self-reported reasons of dental injury were falls or collisions with objects (63%) and sport/leisure activities (32%). Nearly half of the more severe dental injuries did not receive the necessary treatments. One-third of schoolchildren participated in contact sport activities, but only 3% always used mouthguards. There was a substantial difference between the clinical and self-reported findings. Logistic regression analyses revealed no statistically significant associations between dental trauma experience and the potential determinants studied: gender, lip coverage and overjet. CONCLUSION: In this study, traumatic dental injuries were observed with 52% prevalence. A substantial discrepancy between self-reported and clinical findings was observed.

Knowledge about traumatic dental injuries in the permanent dentition: A survey of Lithuanian dentists.

BACKGROUND/AIMS: In Lithuania, dental trauma cases are often treated by general dentists, but it is unknown whether their age, self-evaluation of trauma knowledge and practice location can predict their actual knowledge and management of trauma cases. The aim of this study was to evaluate whether these factors can be used to predict the actual knowledge and management of trauma cases. METHODS: A 2-part questionnaire included 17 multiple-choice questions about practitioners' demographics, their self-evaluated knowledge and how frequently they treated traumatized permanent teeth as well as 13 clinical scenarios reflecting a variety of clinical trauma cases and their complications. A total of 980 randomly selected general dentists, representing 5 Lithuanian counties, participated in the study. RESULTS: The response rate was 59.4% (n = 582). Overall, 82.3% of general dentists reported that they treated only a few dental trauma cases and 14.4% chose to refer their patients; 55.1% of dentists considered their dental traumatology knowledge to be sufficient but incomplete and 34.0% self-evaluated their knowledge as insufficient. The most knowledge (based on self-evaluation) was reported by the younger dentists (≤50 years; P = .004). The mean correct knowledge score was 7.6 ± 2.2 of the 13 clinical scenarios. Both bivariate and multivariate analyses showed that greater trauma-related knowledge was associated with a younger age. Better knowledge was observed amongst the dentists who self-evaluated their own knowledge as sufficient or as comprehensive. CONCLUSION: Lithuanian general dentists have insufficient dental traumatology knowledge. Better knowledge was observed amongst younger dentists (≤50 years).

Self-efficacy theory-based intervention in adolescents: a cluster randomized trial-focus on oral self-care practice and oral self-care skills.

AIM: The cluster randomized trial tested the efficacy of professional dental education for improving oral self-care skills (OSC-S) and oral self-care practice (OSC-P) in adolescents. DESIGN: All 15- to 16-year-old adolescents from four public schools were invited and 206 agreed to participate. Schools were randomly allocated to the intervention group and to the control group. Five sessions were given for the intervention group and one for the control group. The OSC-S and OSC-P outcomes were measured as % Oral Cleanliness Scores at the baseline, 6-month, and 12-month observations. RESULTS: OSC-S and OSC-P correlated significantly (Pearson's) at the baseline (r = 0.777, P < 0.001), at the 6-month (r = 0.745, P < 0.001), and at the 12-month (r = 0.780, P < 0.001) examinations. After the guided oral healthcare interventions, a significant time × group effect was observed (repeated-measures anova, P < 0.001 for the OSC-S (multivariate η2 = 0.355) and for the OSC-P (multivariate η2 = 0.325). CONCLUSION: (i) Oral self-care skills and oral self-care practice scores were significantly correlated, (ii) self-efficacy theory-guided intervention was superior to the conventional dental instruction to improve oral self-care in adolescents, and (iii) varying levels of oral self-care improvement were observed among the intervention group adolescents.

A theory-guided school-based intervention in order to improve adolescents' oral self-care: a cluster randomized trial.

AIM: To evaluate the efficiency of social-cognitive theory-guided oral hygiene interventions in adolescents and to identify predictors of adolescents' self-care practice. DESIGN: A cluster randomized trial included 197 15- to 16-year-olds from two secondary schools. The intervention group received three face-to-face educational hands-on sessions facilitated by a dentist and adolescents worked in pairs. Individual dental plaque levels were measured at baseline, after intervention, at six and at 12 months. The structured questionnaire inquired about gender, family socio-economic status (baseline), and different social-cognitive domain variables (baseline, six, and 12 months). RESULTS: At baseline, there were no statistically significant differences in dental plaque scores between the intervention and control groups (P = 0.183). At the 6-month follow-up, the intervention group had significantly less dental plaque than the control group (P = 0.047), but the intergroup difference in dental plaque levels was not significant at the 12-month follow-up (P = 0.400). Variations in dental plaque levels at different time periods were explained by the following predictors: family's socio-economic status, social-cognitive domain variables, group affiliation, and baseline plaque levels. CONCLUSIONS: Social-cognitive theory-guided interventions improved oral self-care of adolescents in the short term. After the intervention was discontinued, the improvement in oral self-care of adolescents lasted for another 5 months.

Do hemophiliacs have a higher risk for dental caries than the general population?

OBJECTIVE: The aim of this study was to examine if patients with hemophilia were at increased risk for dental decay as compared to the general population. MATERIALS AND METHODS: Census sampling was used in this case-control study to recruit cases (patients with hemophilia) and a control group individuals recruited randomly from the general population, which were matched with cases based on gender, age and place of residence. Clinical examinations included dental health and salivary assessments (flow rate, buffer capacity, caries-associated bacteria) and a structured questionnaire which inquired about socioeconomic status and dental health-related behaviors. RESULTS: In the deciduous dentition, the overall caries experience (dmf) differed statistically significantly (P=0.003) between the hemophiliacs (2.6±2.6) and their matched healthy controls (6.1±2.5). Bivariate analyses did not reveal significant differences between cases and controls regarding salivary functions, except that higher bacteriological counts were found in healthy controls in deciduous dentitions than in patients with hemophilia (P=0.019). Children without hemophilia were from higher socioeconomic status families than hemophiliacs (P=0.004), but such differences were not found for adults (P=0.090). When compared to healthy adults, adult hemophiliacs had more gum bleeding at rest (P<0.001) as well as during their tooth brushing (P=0.007) and they also consumed more soft drinks than controls (P=0.025). CONCLUSIONS: Better dental health was observed in children with hemophilia as compared to children without it. There were no differences in dental health between adult hemophiliacs and healthy controls from the general population. None of the linear multiple regression models confirmed hemophilia to be an additional caries risk when it was controlled for other caries determinants.

Traumatic dental injuries: etiology, prevalence and possible outcomes.

OBJECTIVE: . The aim was to overview the etiology, prevalence and possible outcomes of dental trauma. MATERIAL AND METHODS: An electronic search of Medline (PubMed), Cochrane, SSCI (Social Citation Index), SCI (Science Citation Index) databases from 1995 to the present, using the following search words: tooth injuries, tooth trauma, traumatized teeth, dental trauma, dentoalveolar trauma, oral trauma, epidemiology, etiology, prevalence, prevention, pulp necrosis, inflammatory resorption, ankylosis, cervical resorption, was performed. RESULTS: During last decade traumatic dental injuries were recognized as public dental health problem worldwide. Prevalence of traumatic dental injuries varies between countries. According to the existing data they are more prevalent in permanent than in primary dentition. All treatment procedures in case of dental trauma are directed to minimize undesired consequences despite that treatment of traumatic dental injuries in the young patient is often complicated and can continue during the rest of his/her life. The changing lifestyle and requirements of modern society lead to an emergence of new patterns of dental trauma. A regular update of knowledge in dental traumatology is required.

Hemophilia and oral health.

OBJECTIVE: The aim was to overview the oral health aspects in hemophilia patients. MATERIAL AND METHODS: An electronic search of Medline (Pub Med), Cochrane, SSCI (Social Citation Index), SCI (Science Citation Index) databases from 1982 to the present, using the following search words: hemophilia, oral health, dental caries, dental caries prevalence, gingivitis, periodontitis, primary dentition, permanent dentition, dental treatment and review, was performed. The search yielded 196 titles and abstracts on chosen words. All articles were full-text reviewed and 40 of publications were included. RESULTS: Nowadays coagulation factor abnormalities are the most common of inherited bleeding disorders, but occur much less frequently approximating 10000-50000 male births than acquired coagulation defects. Von Willebrand disease, Hemophilia A and Hemophilia B account for 95-97% of all coagulation deficiencies. Hemophilias A and B are subdivided according to the factor's activity levels in the blood: mild, moderate or severe. The two main oral diseases affecting patients with hemophilia are the same as for the rest of population, i.e. dental caries and gingivitis/periodontitis. Only a few studies concerning oral health aspects in hemophilia patients were carried out. Some controversy exists concerning caries prevalence in both primary and permanent dentitions in children with hemophilia. People with congenital hemorrhagic diatheses constitute a very small proportion of the total population. Due to that fact treatment of such patients becomes a challenge to the most of dentists due to the fact that most of them have no experience in dealing with dental problems in such patients. CONCLUSION: There is a lack of epidemiological studies in oral health status of hemophilia patient.

Is the authoritative parenting model effective in changing oral hygiene behavior in adolescents?

This study examined whether the authoritative parenting model (APM) is more effective than conventional approaches for changing adolescent oral hygiene behavior. A total of 247 adolescents were recruited using a cluster random-sampling method. Subject groups were randomly allocated into an intervention group (APM-based interventions), a Control Group 1 (conventional dental education and behavior modification) or a Control Group 2 (conventional behavior modification). The results were assessed after 3 and 12 months. Oral hygiene level was assessed as percent dental plaque and the ratio of plaque percent change (RPC). At the 3-month follow-up, there were significant differences among the groups; the APM group had the largest decrease in plaque levels (24.5%), Control Group 1 showed a decrease in plaque levels of 15.4% and Control Group 2 showed an increase in plaque levels of 2.8%. At the 12-month follow-up, an improvement was observed in all groups, but there were no statistically significant differences among the groups. In the short term, the intervention based on the APM was more effective in changing adolescent oral hygiene behavior compared with the conventional approaches. The reasons for long-term positive change after discontinued interventions in control groups need to be explored in future studies.

Parenting style, locus of control, and oral hygiene in adolescents.

OBJECTIVE: The aim of the study was to test if variations in oral hygiene levels in adolescents were associated with locus of control and parenting styles after controlling for demographic factors. MATERIAL AND METHODS: The study sample comprised 237 adolescents aged 12-13 years. The structured questionnaire included demographic characteristics and items about parenting style and locus of control. The Individual Quantitative Plaque % Index (IQPI) and toothbrushing frequency were used as clinical outcome measures. RESULTS: In the bivariate analyses, socioeconomic status (P=0.012), number of children in the family (P=0.003), and frequency of toothbrushing (P=0.001) were related to dental plaque levels. Gender (P<0.001), socioeconomic status (P=0.022), and external locus of control (Spearman rho, -0.144, P=0.027) were statistically significantly associated with toothbrushing frequency. In the multivariate analyses, only socioeconomic status and toothbrushing frequency were statistically significantly related to the IQPI. When toothbrushing frequency as the second outcome variable was used, the IQPI and gender were statistically significant. The association with socioeconomic status did not reach statistical significance (P=0.07). CONCLUSIONS: Only socioeconomic status and toothbrushing frequency explained variation in dental plaque levels among adolescents. The expected relationship among parenting styles, locus of control, and oral hygiene levels was not confirmed.

Salivary factors and dental plaque levels in relation to the general health of elderly residents in a long-term care facility: a pilot study.

The goal of this study was to examine salivary factors and formation of dental plaque in elderly subjects who were institutionalized and to relate these factors to general health and medication use. This cross-sectional study consisted of 50 elderly individuals who were institutionalized and 25 healthy young volunteers who served as a reference group. For each subject, salivary flow rates, salivary pH, and buffering capacity were assessed. Baseline Plaque Index and Plaque Formation Rate Index were used as a measure of oral hygiene. Information on each patient's general health and medication use was acquired from the institution. An evaluation of the results of this study suggests that salivary protective qualities and dental plaque levels in the elderly subjects who were institutionalized were worse than in healthy young individuals. An association between the general health of the elderly and salivary flow rate was found.

A five years clinical evaluation of sealed occlusal surfaces of molars.

BACKGROUND: Air-abrasion can be used for enamel preparation before fissure sealing as well as acid etching which is the evidence-based method for enamel preparation before sealing. AIM: The aim of this study is to evaluate the status of sealed occlusal surfaces of the first permanent molars after one, two, and five years and to compare consequence of using the two different methods for enamel preparation before sealing. MATERIALS AND METHODS: At the baseline of the study 88 children of the age from 6 to 9 with caries-free permanent molars randomly received 185 sealants after using the air-abrasion system KCP 2000 PLUS (ADT Inc.) and 121 sealants using the acid etching method with Vococid (VoCo). Fissurit F (VoCo) was used for sealing. The status of occlusal surfaces of molars was scored as caries- free or decayed/restored by visual clinical assessment evaluation after one, two, and five years. RESULTS: The sealants retention rate was 97.2%, 91.9%, 61.2% in the air-abrasion group and 96.3%, 92.6%, 62.4% in the acid etching group after one, two, and five years, respectively. The results showed 98.2%, 98.0%, 89.8% caries free occlusal surfaces of molars prepared with air-abrasion method and 100%, 100%, 94.6% caries free occlusal surfaces of molars prepared with acid etching method after one, two, and five years respectively. CONCLUSION: The differences between the two methods: air-abrasion and acid etching in terms of sealant retention rate and caries development appeared to be statistically insignificant (p>0.05).

Best practices for dental sealants in community service-learning.

Community service-learning (CSL) in predoctoral dental education might be an effective tool for increasing sealant use by dentists--thus benefitting underserved children while facilitating students' learning of a clinical procedure in a real-life setting. This study reviewed the scientific literature on this topic in order to 1) evaluate the reasons for low sealant use among dentists, 2) consider important aspects of sealant use in community settings, and 3) identify best practices to use as guidelines for CSL regarding sealant use. As background, the MEDLINE database was searched with the key words "dental sealants" for human and laboratory studies in the English language. A total of 205 relevant articles were identified and overviewed. We found that the low use of sealants relate to dentists' orientation toward restorations rather than prevention, distrust in sealant treatment, lack of confidence in caries risk assessment, and concern about sealing over caries. The aspects to consider in the CSL projects are acquisition of knowledge and necessary skills of operators, cost-benefit approach to sealant placement, and meticulous sealant placement procedures, including the necessity for a short-term recall.

Theory-based oral health education in adolescents.

OBJECTIVES: The aims were to overview the previous use of psychological theories for oral health education in adolescents and to discuss current approaches which could enhance the effectiveness of behaviour modification in this age group. MATERIAL: The MEDLINE via OVID database was searched for relevant papers published during the last four decades. RESULTS: Only a few studies using psychological models and theories in oral health education for adolescents could be found and these studies were carried out a few decades ago. It was shown that socially disadvantaged adolescents, i.e. those who have the greatest need for improvements in oral health, might benefit most from the theory-based behavioural interventions. However, evidence from these trials can not be directly used to base oral health education in contemporary adolescents. An important consideration is that psychological models and theories developed for adults may not apply as well to adolescents, who are at different stages of behavioural development and with different cognitive abilities. CONCLUSIONS: Understanding the adolescent profile in oral health education appears to be crucial for success. The theory-based approaches to health behaviour modification, already successfully applied in other fields of medicine, might be a good alternative to conventional oral health promotion in adolescents.