Analysis of dental traumatic patterns in standing electric scooter-related accidents.

BACKGROUND: There have been several studies about the increasing accident risks and injuries of standing electric scooters, but there is no study about the dental traumatic injuries related with standing electric scooter so far. OBJECTIVES: The purpose of this study is to report the overall dental traumatic patterns, and compare the patterns of standing electric scooter-related dental trauma with other traumatic causes. Also, considerations about minimizing the risks of electric scooter-related trauma will be discussed. METHODS: Data on patients who visited Region Trauma Center of Wonju Severance Christian Hospital with dental emergency from January 2020 to December 2022 were collected. RESULTS: The crown-root fracture and avulsion occurred significantly higher in electric scooter-related accidents than others. Furthermore, relatively minor dental injuries including concussion and subluxation showed higher percentage to be occurred as combined injuries in electric scooter-related accidents. The prevalence of traumatized posterior teeth was significantly higher in electric scooter-related trauma than others. Most of patients were teenagers and twenties. Also, the electric scooter-related accidents mostly occurred at evening and night. Furthermore, the number of patients wearing a helmet in electric scooter accidents was 1 out of 33. CONCLUSION: The standing electric scooter-related dental trauma resulted in an increased prevalence of relatively severe dental trauma. Supplementation and reinforcement of the related policies as well as strict enforcement of the laws on electric scooter users will be needed to prevent severe dental and craniofacial trauma.

Effect of intra-alveolar delivery of Frondoside A on inflammatory response of delayed tooth replantation.

BACKGROUND/AIM: Frondoside A is a sea cucumber extract which is well known for its anti-inflammatory and immunomodulatory properties. The purpose of this study was to evaluate the effect of Frondoside A application in the alveolar socket on inflammatory responses after delayed replantation in rat teeth. MATERIALS AND METHODS: Human periodontal ligament cells were cultured and exposed to Frondoside A. Cell-counting kit-8 assay was performed to evaluate the cell viability and nitric oxide assay was performed to assess the anti-inflammatory effect of Frondoside A. Molars were extracted from 32 Sprague-Dawley rats and randomly divided into control and Frondoside A groups. After 30 min of extra-oral dry time, molars were replanted. In the Frondoside A group, Frondoside A solution was applied in the alveolar socket before replantation. The animals were sacrificed after 28 days and histologically and immunohistochemically evaluated. RESULTS: 0.5 µM Frondoside A showed higher cellular viability at 6 h and lower production of nitric oxide compared with other Frondoside A solutions (p < .05). The Frondoside A group demonstrated lower inflammatory resorption scores in both middle 1/3 and apical 1/3 of root compared to the control group (p < .05). The Frondoside A group showed lower levels of expression in both cathepsin K and CD45 compared with the control group (p < .05). CONCLUSIONS: Within the limits of this study, intra-alveolar delivery of Frondoside A alleviates inflammatory root resorption in delayed replantation of rat teeth.

Relationship between insomnia and working from home among Korean domestic workers: results from the 5th Korean working condition survey.

BACKGROUND: Social distancing has been increasingly implemented following the COVID-19 pandemic and more people have been working from home. Consequently, the screen time has increased, which can disrupt the natural sleep-wake cycle and delay sleep onset. Given that studies on the health of employees who work from home remain insufficient, particularly with respect to the risk of sleep disorders including insomnia, this study aimed to assess the relationship between working from home and insomnia among workers using data from the 5th Working Conditions Survey conducted in Korea. METHODS: Of 30,108 wage workers, we enrolled 818 employees who worked from home and 4,090 employees who worked from the office, a 1:5 pair sample based on sex and occupational group. Personal and occupational characteristics, working from home, and insomnia were included in the analysis. Age, education, employment status, working years, working hours per week, work-life balance, self-perceived health, depression, and anxiety were all adjusted as potential confounding variables. Conditional logistic regression analysis was performed using working from home as an independent variable and insomnia as a dependent variable to determine the correlation between working from home and insomnia. RESULTS: Working from home was associated with sleep onset latency disorder, OR = 3.23 (95% CI: 2.67-3.91), sleep maintenance disorder, OR = 3.67 (95% CI: 3.02-4.45), and non-restorative sleep, OR = 3.01 (95% CI: 2.46-3.67); working from home had a statistically significant relationship with all three types of insomnia. CONCLUSIONS: Within the limits of the study, these findings can be used as a fundamental basis for the implementation of policies and guidelines to prevent insomnia in workers who work from home.

Needs assessment for faculty development in dental education, at the University of Health Sciences, Lao PDR.

Due to the short history of dental education in Laos, the educational system is still incomplete, with only a few faculty development (FD) programs. This study aims to identify the needs assessment for FD, in Lao dental education. A survey was conducted, with dentists from the Faculty of Dentistry, in 2022. Data on demographics, perceived importance, and ability, on the 13 roles and competencies of teachers, as well as the 26 FD items' needs assessment were collected. Data were compared between the two groups (lecturers and assistant teachers), and analyzed to identify different needs. Sixty-seven responses were included, after excluding inappropriate ones. Lecturers and assistant teachers expressed their needs for developing a syllabus, and teaching using simulation. Lecturers revealed the need to improve their roles as resource developers, followed by learning facilitators and lecturer in a classroom setting. Assistant teachers reported their prioritized needs for improving their role as on-the-job role models, followed by lecturer in a classroom setting, and mentor, personal adviser, or tutor. Assistant teachers showed higher educational needs scores than lecturers, in most questionnaire items. Although the needs assessment of FD indicates different needs, based on the differing roles and responsibilities, assistant teachers' needs scores are generally higher. An FD program could prioritize the most common needs of both groups at an early stage, but the topics most needed by each group should also be considered. This study can inform a future FD program, to improve Lao dental education.

Digital Workflow for Edentulous Patients with Implant-Supported Fixed Prostheses: A Fully Digital Technique.

Dentists have made prostheses using traditional methods, which are inconvenient and time-consuming. It includes functional impression taking, plaster model production, wax rim production, intermaxillary relationship and occlusal plane setting, artificial tooth arrangement, denture polymerization, polishing, etc. To make prostheses in this way, the patient has to visit the dentist several times, and it takes a long time for them to receive treatment. In addition, the potential for errors associated with the denture-manufacturing process and the use of denture materials has always existed. However, the recent use of digital technology in dentistry has made it possible to create digital prostheses. Several techniques for the immediate loading of implants with a fixed prostheses in edentulous patients have been developed. However, these techniques are partially digital techniques that include laboratory work for prosthesis fabrication. This article aimed to describe a fully digital technique for implant-supported fixed prostheses. It includes intra-oral scanning of edentulous patients, implant placement planning, and final prosthesis fabrication. This technique facilitates a simple and more efficient immediate restoration after implant placement without using stone casts.

Modified submental intubation techniques for maxillofacial surgery - A report of five cases.

BACKGROUND: Submental intubation has been the recommended airway management procedure for maxillofacial surgery since proposed by Altemir in 1986. We adopted various submental intubation modifications based on modified intubation protocols and report on the effectiveness and problems of each modified method. CASE: Among a total of 13 submental intubation cases during the last five years, five representative methods are described. The proximal end of the endotracheal tube was protected by a nelaton catheter in case 1, by a suction connector in case 2, and by a dental needle cap in case 3. In case 4, a nasal speculum was used to expand a single route, and in case 5, a laparoscopic trocar was used to secure a single route. CONCLUSIONS: Use of a laparoscopic trocar might be the most effective way to obtain a single submental route. However, considering cost, use of a nasal speculum is also an effective suboptimal solution.

Effect of Anchor-Guiding Sleeve Length on the Accuracy of Computer-Guided Flapless Implant Surgery.

The objective of this study was to evaluate the effect of anchor-guiding sleeve length on the accuracy of computer-guided flapless implant surgery in edentulous cases. Twelve identical polyurethane edentulous mandibular models were equally divided into short and long anchor-guiding sleeve groups based on the type of anchor-guiding sleeve. After implant placement and scan body connections, digital impressions were taken using the intraoral scanner. Using the software's measurement function, the deviation parameters between the planned and actual position of the placed implants were calculated and compared using the Mann-Whitney U test. In the short anchor-guiding sleeve group, the median angular deviation was 4.05° (range, 2.87°-7.55°). The median linear deviation was 1.17 mm (range, 0.24-2.17 mm) for the implant apex and 0.82 mm (range, 0.43-1.67 mm) for the implant shoulder. The median deviation of the depth was 0.31 mm (range, 0.20-0.79 mm). In the long anchor-guiding sleeve group, the median angular deviation was 2.70° (range, 1.77°-4.08°). The median linear deviation was 0.88 mm (range, 0.21-1.77 mm) for the implant apex and 0.63 mm (range, 0.11-1.97 mm) for the implant shoulder. The median deviation of the depth was 0.24 mm (range, 0.09-0.53 mm). There were significant differences between the 2 groups in the angular and linear deviations at the implant apex and the shoulder and depth deviation. The accuracy of the muco-supported surgical guide was improved using the long anchor-guiding sleeve, thus providing more accurate flapless implant placement in edentulous models. However, model experiments do not always produce predictable and possible uncontrolled cause-and-effect outcomes under natural clinical conditions. Therefore, further in vivo investigations are required to determine whether the results of this study are consistent with clinical findings.

A Digital Fabrication of Dental Prosthesis for Preventing Self-Injurious Behavior Related to Autism Spectrum Disorder: A Case Report.

This case report aimed to demonstrate the prosthetic solution of an autism patient with self-injurious behavior using digital dentistry. A 24-year-old male visited our clinic with chief complaints of severe gingival recession associated with self-injurious behavior. Bilateral fixed prosthesis with denture flange were delivered using a digital workflow for the protection of the gingiva. The patient showed healed gingival tissue, behavioral modification, and acceptable oral hygiene during the follow-up period. Also, his caregivers reported no recurrence of the self-injurious behavior. Autism patients usually show self-injurious behavior, which can damage their oral tissue. With adoption of this prosthesis, behavior modification as well as healing of oral tissue was achieved.

Reliability of a Trapezium Miniplate with Endoscope-Assisted Internal Fixation in Mandibular Subcondylar Fractures: A Three-Dimensional Analysis.

This study aimed to evaluate the reliability of a trapezium plate for open reduction and internal fixation (ORIF) of mandibular subcondylar fractures with the simultaneous use of an endoscope. We selected and retrospectively studied 18 patients (12 males and 6 females) with unilateral mandibular subcondylar fractures who visited the Wonju Severance Christian Hospital. The mean age of the patients was 43.43 ± 15.76 years. Patients underwent ORIF with trapezium miniplate application through an intraoral incision under general anesthesia. The clinical and radiographic findings of the fractured side were compared with those of the non-operated side at 6 months follow-up. All occlusions became stable, and transient functional disturbances disappeared within 6 months of periodic follow-up. Functional mandibular movement recovered within the normal range, with an average mouth opening of 41.5 mm, protrusion of 7.5 mm, and lateral excursion of 7 mm at 6 months. Radiographic controls and statistical analysis confirmed a decent anatomical reduction in all 18 cases. In conclusion, the use of a trapezium miniplate with endoscope-assisted ORIF in mandibular subcondylar fractures can be useful for fixation and functional recovery.

Immediate nonfunctional loading of implants placed simultaneously using computer-guided flapless maxillary crestal sinus augmentation with bone morphogenetic protein-2/collagen matrix.

BACKGROUND: Immediate loading has shown positive results for total, partial, or single edentulism. The effects of BMP-2 addition to graft materials on bone formation and implant stability in the early stages of healing have rarely been studied, especially in patients with severely atrophic maxillae. PURPOSE: To evaluate the effects of simultaneously placed immediate non-functional loaded implants and bone morphogenetic protein-2 (BMP-2)-loaded Bio-Oss collagen, on bone formation and implant stability during the early healing stages of patients with a severely atrophic posterior maxilla using crestal approach. MATERIALS AND METHODS: Thirty-three cases presenting posterior maxillary residual alveolar bone height of 1-3 mm were evaluated. Flapless crestal sinus augmentation surgery was performed using BMP-2-loaded Bio-Oss collagen, with non-functional implants immediately loaded after surgery. The bone height was assessed using preoperative and postoperative cone beam computed tomography (CBCT). Bone density of the sinus graft sites and implant stability (after 3 months) were evaluated using postoperative CBCT scans and Periotest, respectively. The periodontal parameters and marginal bone loss around the implant were checked after 37.3 months of final prosthesis. RESULTS: The survival rate of the implants was 100% and the gingiva around the implants remained healthy. All implants remained integrated, and all sinus grafts showed radiographic bone formation. The results indicated high level of bone density and good implant stability, showing minimal marginal bone loss after 37.3 months. CONCLUSION: This technique could be used in the posterior maxillary region exhibiting poor bone quantity.

Vertical ridge augmentation using xenogenous bone blocks: a comparison between the flap and tunneling procedures.

PURPOSE: Previous studies have shown that the subperiosteal tunneling procedure in vertical ridge augmentation accelerates healing after grafting and prevents graft exposure, with minor postoperative complications. It is conceivable that new bone formation would be greater with the tunneling procedure than with the flap procedure, because the former is minimally invasive. This hypothesis was tested in this study by comparing new bone formation between the flap and tunneling procedures after vertical ridge augmentation using xenogenous bone blocks in a canine mandible model. MATERIALS AND METHODS: Two Bio-Oss blocks were placed on the edentulous ridge in each side of the mandibles of 6 mongrel dogs. The blocks in each side were randomly assigned to grafting with a flap procedure (flap group) or grafting with a tunneling procedure (tunneling group). RESULTS: The mean percentage of newly formed bone within the block was 15.3 ± 6.6% in the flap group and 46.6 ± 23.4% in the tunneling group. CONCLUSION: Based on data presented in this study, when a tunneling procedure is used to place xenogenous bone blocks for vertical ridge augmentation, bone formation in the graft sites is significantly greater than when a flap procedure is used.

Simultaneous sinus lift and implantation using platelet-rich fibrin as sole grafting material.

Recently, several authors have shown that simultaneous sinus lift and implantation using autologous platelet-rich fibrin as the sole filling material is a reliable procedure promoting bone augmentation in the maxillary sinus. The aim of this study was to examine the effect of simultaneous sinus lift and implantation using platelet-rich fibrin as the sole grafting material on bone formation in a canine sinus model. An implant was placed after sinus membrane elevation in the maxillary sinus of six adult female mongrel dogs. The resulting space between the membrane and sinus floor was filled with autologous platelet-rich fibrin retrieved from each dog. The implants were left in place for six months. Bone tissue was seen at the lower part of the implants introduced into the sinus cavity. The height of the newly formed bone around the implants ranged from 0 mm to 4.9 mm (mean; 2.6 ± 2.0 mm) on the buccal side and from 0 mm to 4.2 mm (mean; 1.3 ± 1.8 mm) on the palatal side. The findings from this study suggest that simultaneous sinus lift and implantation using platelet-rich fibrin as sole grafting material is not a predictable and reproducible procedure, especially with respect to the bone formation around the implants in the sinus cavity.

A comparative study of the regenerative effect of sinus bone grafting with platelet-rich fibrin-mixed Bio-Oss® and commercial fibrin-mixed Bio-Oss®: an experimental study.

Anorganic bovine bone (Bio-Oss®) particles are one of the most popular grafting materials. The particles are often mixed with platelet-rich fibrin (PRF) or a commercial fibrin (Tisseel®) to form a mouldable graft material. The objective of this study was to compare the potentials of PRF-mixed Bio-Oss® and Tisseel®-mixed Bio-Oss® to enhance bone regeneration in a canine sinus model. Six mongrel dogs were used in this study. After elevating the sinus membrane in both maxillary sinus cavities, an implant was placed into the sinus cavity. In one of the sinus cavities, the PRF/Bio-Oss® composite was grafted, and the Tisseel®/Bio-Oss® composite was grafted in the other sinus cavity. After a 6 month healing period, bone formation in the graft sites and bone-implant contact were evaluated. The mean osseointegration rate was 43.5 ± 12.4% and new bone formation rate 41.8 ± 5.9% in the PRF/Bio-Oss® composite sites. In the Tisseel®/Bio-Oss® composite sites they were 30.7 ± 7.9% and 31.3 ± 6.4%. There were statistically significant differences between the groups. The findings from this study suggest that when platelet-rich fibrin is used as an adjunct to Bio-Oss® particles for bone augmentation in the maxillary sinus, bone formation in the graft sites is significantly greater than when Tisseel® is used.

A 1-year prospective clinical study of soft tissue conditions and marginal bone changes around dental implants after flapless implant surgery.

BACKGROUND: Despite several reports on the clinical outcomes of flapless implant surgery, limited information exists regarding the clinical conditions after flapless implant surgery. OBJECTIVE: The objective of this study was to evaluate the soft tissue conditions and marginal bone changes around dental implants 1 year after flapless implant surgery. STUDY DESIGN: For the study, 432 implants were placed in 241 patients by using a flapless 1-stage procedure. In these patients, peri-implant soft tissue conditions and radiographic marginal bone changes were evaluated 1 year after surgery. RESULTS: None of the implants were lost during follow-up, giving a success rate of 100%. The mean probing depth was 2.1 mm (SD 0.7), and the average bleeding on probing index was 0.1 (SD 0.3). The average gingival index score was 0.1 (SD 0.3), and the mean marginal bone loss was 0.3 mm (SD 0.4 mm; range 0.0-1.1 mm). Ten implants exhibited bone loss of >1.0 mm, whereas 125 implants experienced no bone loss at all. CONCLUSION: The results of this study demonstrate that flapless implant surgery is a predictable procedure. In addition, it is advantageous for preserving crestal bone and mucosal health surrounding dental implants.

Comparison of flap and flapless procedures for the stability of chemically modified SLA titanium implants: an experimental study in a canine model.

BACKGROUND: Flapless implant surgery has been shown to accelerate recovery and increase the vascularity of the peri-implant mucosa after implant placement. OBJECTIVE: The aim of this study was to compare dental implant stabilization patterns between flap and flapless implant surgeries over the first 8 weeks after implant placement. STUDY DESIGN: In 6 mongrel dogs, bilateral, edentulated, and flat alveolar ridges were created in the mandible. After 3 months of healing, 2 implants (Straumann SLA-active) were placed in each side of the mandible using either a flap or flapless procedure. The implant stability quotient (ISQ) that was obtained from Osstell Mentor was measured at the time of implantation and weekly over the first 8 weeks after implant placement. RESULTS: Implants stabilized more quickly without flap elevation than with flap elevation. For flapless implants, an increase in stability occurred after 2 weeks without a period of decreasing stability. However, for flap implants, a shift in implant stability from decreasing stability to increasing stability occurred after 2 weeks. CONCLUSION: In the canine model, flapless surgical placement of implants may increase the initial stability of implants compared with implants placed after the reflection of the mucoperiosteal flap.