Knowledge, beliefs, attitude, and practices of E-cigarette use among dental students: A multinational survey.

BACKGROUND: E-cigarette use is a trend worldwide nowadays with mounting evidence on associated morbidities and mortality. Dentists can modify the smoking behaviors of their patients. This study aimed to explore the knowledge, beliefs, attitude, and practice of E-cigarette use among dental students. MATERIALS AND METHODS: This multinational, cross-sectional, questionnaire-based study recruited undergraduate dental students from 20 dental schools in 11 countries. The outcome variable was current smoking status (non-smoker, E-cigarette user only, tobacco cigarette smoker only, dual user). The explanatory variables were country of residence, sex, age, marital status, and educational level. Multiple linear regression analysis was performed to explore the explanatory variables associated with E-cigarette smoking. RESULTS: Of the 5697 study participants, 5156 (90.8%) had heard about E-cigarette, and social media was the most reported source of information for 33.2% of the participants. For the 5676 current users of E-cigarette and/or tobacco smoking, 4.5% use E-cigarette, and 4.6% were dual users. There were significant associations between knowledge and country (P< 0.05), educational level (B = 0.12; 95% CI: 0.02, 0.21; P = 0.016) and smoking status (P< 0.05). The country of residence (P< 0.05) and smoking status (P< 0.05) were the only statistically significant factors associated with current smoking status. Similarly, there were statistically significant associations between attitude and country (P< 0.05 for one country only compared to the reference) and history of previous E-cigarette exposure (B = -0.52; 95% CI: -0.91, -0.13; P = 0.009). Also, the practice of E-cigarettes was significantly associated with country (P< 0.05 for two countries only compared to the reference) and gender (B = -0.33; 95% CI: -0.52, -0.13; P = 0.001). CONCLUSION: The knowledge of dental students about E-cigarette was unsatisfactory, yet their beliefs and attitudes were acceptable. Topics about E-cigarette should be implemented in the dental curriculum.

Oral health practices and self-reported adverse effects of E-cigarette use among dental students in 11 countries: an online survey.

OBJECTIVES: E-cigarette use has become popular, particularly among the youth. Its use is associated with harmful general and oral health consequences. This survey aimed to assess self-reported oral hygiene practices, oral and general health events, and changes in physiological functions (including physical status, smell, taste, breathing, appetite, etc.) due to E-cigarette use among dental students. METHODS: This online, multicounty survey involved undergraduate dental students from 20 dental schools across 11 different countries. The questionnaire included demographic characteristics, E-cigarette practices, self-reported complaints, and associated physiological changes due to E-cigarette smoking. Data were descriptively presented as frequencies and percentages. A Chi-square test was used to assess the potential associations between the study group and sub-groups with the different factors. Statistical analysis was performed using SPSS at P < 0.05. RESULTS: Most respondents reported regular brushing of their teeth, whereas only 70% used additional oral hygiene aids. Reported frequencies of complaints ranged from as low as 3.3% for tongue inflammation to as high as 53.3% for headache, with significant differences between E-cigarette users and non-users. Compared to non-smokers, E-cigarette users reported significantly higher prevalence of dry mouth (33.1% vs. 23.4%; P < 0.001), black tongue (5.9% vs. 2.8%; P = 0.002), and heart palpitation (26.3%% vs. 22.8%; P = 0.001). Although two-thirds of the sample reported no change in their physiological functions, E-cigarette users reported significant improvement in their physiological functions compared to never smokers or tobacco users. CONCLUSION: Dental students showed good oral hygiene practices, but E-cigarette users showed a higher prevalence of health complications.

Effect of self-assessment in a removable prosthodontics preclinical course on skills and competence.

PURPOSE: Self-assessment is increasingly implemented in medical professions' curricula. In this research, the authors measure the effects of self-assessment within a preclinical removable prosthodontics course among dental students in a private dental school according to the European qualifications framework descriptors. MATERIALS AND METHODS: Thirty subjects, all fourth-year dental students, were included in this experiment. Fifteen subjects were included in each of the experimental and control groups during one semester. The experimental group subjects used the study roadmap tool in their preclinical tasks. The control group subjects executed the same preclinical tasks under instructor supervision only. All subjects were filmed, and an autonomy score was given to every subject per session. At the end of the semester, cognitive skills development was compared using the Kember et al. questionnaire while practical skills development was compared using a comparison of grades. Two focus groups were undertaken with experimental group subjects. Qualitative and quantitative data were collected and statistically analyzed (p < 0.005). RESULTS: Subjects from the experimental group showed development in critical thinking, practical skills, autonomy, and taking responsibility, thus development in the competence level. CONCLUSION: Implementation of self-assessment within preclinical courses may develop skills and competence among dental students, yet more studies are needed.

Masticatory efficiency of implant-supported mandibular overdentures retained with attachments compared with conventional dentures: an in vitro digital colorimetric image analysis.

Despite the patient-reported advantages of implants in improving quality of life, satisfaction, and mastication, objective evaluations of the masticatory function and performance of implant-supported dentures are not well represented in the literature. The aim of the present study was to compare the masticatory efficiency of patients with conventional dentures with that of patients with mandibular overdentures retained by implants with 2 Locator attachments. A randomized clinical trial including 20 edentulous patients was conducted. The participants were randomly recruited into 2 groups, a group of 10 patients wearing conventional prostheses in both the maxilla and mandible, and a group of 10 patients wearing a conventional maxillary prosthesis opposite an implant-supported overdenture. To be included in the study, the patients had to have a well-formed ridge (Class I according to the Atwood classification). Their masticatory efficiency, assessed a minimum of 6 months after they received the denture, was evaluated through a color-mixing test using 2 colors of a commercially available chewing gum and ViewGum software, which calculated the variance of hue in the masticated specimens. The masticatory efficiency of the 2 groups was compared using repeated-measures analysis of variance (α = 0.05), which revealed no statistically significant difference between the implant-supported overdenture and conventional denture groups (P > 0.05). Within the limits of this study, the results suggest that a mandibular implant overdenture has no advantage over a conventional complete denture with regard to masticatory efficiency or food comminution in patients who have a well-formed mandibular ridge.

Happiness among dentists: a multi-scale, multi-national study from 21 countries.

OBJECTIVES: The extent to which dentists are happy with their profession and their life has not been well studied. The present study aimed to explore the level of happiness, satisfaction with life and psychological well-being among a sample of dental professionals from 21 countries. MATERIALS AND METHODS: The sample comprised 2,200 dentists from 21 countries. Three scales - Subjective Happiness Scale (SHS), Satisfaction With Life Scale (SWLS), and Affect Balance Scale (ABS) - were used to measure the subjective responses. Data related to demographic and social characteristics were recorded. Mann-Whitney and Kruskal-Wallis tests were used as appropriate. Scales were correlated, and multiple linear regression analyses were employed to identify the independent determinants of SHS, SWLS and ABS. Data were analysed using the SPSS software program; a value of P <0.05 was considered significant. RESULTS: The overall mean scores of SHS, SWLS and ABS were 18.53 ± 5.06, 23.06 ± 6.25 and 1.26 ± 2.40, respectively, with significant differences found across countries: dentists working in Croatia, Peru and Serbia recorded the highest scores, unlike dentists practicing in Yemen, Syria, and Iraq, who recorded the lowest scores. There were significant, moderately positive correlations between the various scales: SHS and SWLS: r = 0.535, P < 0.001; SHS and ABS: r = 0.58, P < 0.001; and SWLS and ABS: r = 0.533, P < 0.001. Country of practice, age, qualification and monthly income were the significant independent predictors of SHS, SWLS and ABS. CONCLUSION: Country of residence and social characteristics were associated with dentists' responses regarding their feelings and subjective well-being.

Lesión quística en un premolar superior relacionada con un molar primario pulpotomizado / Lesão cística num pré-molar superior relacionada com um molar decíduo pulpotomizado / Cystic lesion on an upper premolar related to pulpotomized primary molar

La pulpotomía es un tratamiento endodóncico frecuentemente realizado en niños. A pesar de que se trata de un procedimiento seguro, se han reportado efectos secundarios. Caso clínico: Un niño de 10 años de edad llegó para revisión dental. Los resultados de los rayos X mostraron una lesión radiolúcida por encima del segundo molar primario superior izquierdo, relacionada con el diente permanente. La extracción de los primeros y segundos molares primarios se realizó bajo anestesia local. La lesión quística se eliminó quirúrgicamente, y el análisis histopatológico mostró un quiste dentígero inflamatorio. Una cavidad casomarsupialización fue creada para permitir la erupción de los premolares. Después de un año de seguimiento, el hueso se había regenerado totalmente y los premolares habían erupcionado completamente. Conclusión: Este caso resalta la necesidad de una supervisión regular de los dientes pulpotomizados, incluso si están asintomáticos, además de la fase de erupción de los dientes permanentes y primarios. La marsupialización del quiste dentígero permitió el tratamiento eficaz y la preservación del premolar involucrado.

A pulpotomia é um tratamento endodôntico frequentemente realizado em crianças. Ainda que seja um procedimento seguro, efeitos colaterais foram reportados. Relato de caso: Um menino de 10 anos veio para um check-up dentário. Os resultados da radiografia mostraram uma lesão radiolúcida acima do segundo molar superior esquerdo, relacionada com o dente permanente. A extração dos primeiros e segundos molares decíduos foi realizada sob anestesia local. A lesão cística foi removida cirurgicamente e a análise histopatológica revelou um cisto dentígero inflamado. Uma cavidade marsupialização foi criada para permitir a erupção dos pré-molares. Depois de um ano de acompanhamento, o osso encontrava-se completamente regenerado e os pré-molares tinham erupcionado completamente. Conclusão: Este relato de caso destaca a necessidade de uma supervisão regular dos dentes pulpotomizados, mesmo se estes são assintomáticos, tal como acontece na fase de erupção dos dentes permanentes e decíduos. A marsupialização do cisto dentígero proporcionou um tratamento eficaz e permitiu a preservação do pré-molar envolvido.

Pulpotomy is a frequent endodontic treatment performed in children. Even though it is a safe procedure, side effects have been reported. Case Report: A 10-year-old boy came for a dental checkup. X-ray findings showed a radiolucent lesion above the maxillary second deciduous left molar, related to the permanent tooth. Extraction of the first and second deciduous molars was realized under local anesthesia. The cystic lesion was removed surgically, and histo-pathological analysis showed an inflammatory dentigerous cyst. A marsupialization cavity was created to allow eruption of the premolars. After a one-year follow-up, the bone had completely regenerated, and premolars had completely erupted. Conclusion: This case report highlights the need for regular supervision of pulp treated teeth, even if they are asymptomatic, as well as eruption phase of permanent and deciduous teeth. Marsupialization of the dentigerous cyst provided effective treatment and allowed preservation of the involved premolar.

Retentive force variations of stud attachments for implant overdentures.

Implant overdentures are considered a standard treatment option by many practitioners, especially for edentulous mandibles. Stud attachments have been used extensively in the construction of these overdentures. In this study, the retentive forces of O-ring/ball and Locator overdenture attachments under various conditions in the mouth were investigated through pull-out tests. In dry testing, the retentive forces of the O-ring/ball attachment started higher than those of the Locator attachment but significantly decreased after 50 insertion-removal cycles (P = 0.014). The Locator attachment had no significant change in its retentive force over time (P = 0.328). In wet testing, a saliva substitute was applied to the stud attachments between cycles. The retentive force of the O-ring/ball attachment increased significantly in wet testing compared to dry testing (P < 0.0001). The retentive force of the Locator system during wet testing did not change significantly from that achieved during dry testing for the first 80 cycles, but then it increased to reach the same levels as the O-ring/ball system at 510 cycles (P < 0.05). Within the limitations of the present study, the results suggest that it is advisable to avoid using O-ring/ball attachments as anchors for implant overdentures in a dry mouth environment. In such cases, Locator attachment or metal-to-metal attachment components would be preferable as implant overdenture anchors. In a saliva-irrigated mouth, there is no significant difference between the retentive properties of the O-ring/ball and Locator attachments over 6-9 months' use.

The ala-tragus line as a guide for orientation of the occlusal plane in complete dentures.

AIM: The use of the ala-tragus line (ATL) to orient the occlusal plane (OP) is controversial because there is a lack of agreement on the exact points of reference for this line. This study determined the relationship between the natural OP and ATL which was established by using the inferior border of the ala of the nose and (1) the superior border of the tragus (ATL1), (2) the tip (ATL2), and (3) the inferior border of the tragus (ATL3). MATERIALS AND METHODS: Lateral cephalometric radiographs were taken of each subject by a standard method and tracings were obtained on acetate paper to show the OP and the three ala-tragus lines. The relationship between the OP and each of ATL was measured for each subject. Mean and standard deviation values were then calculated for the relationship. Statistical analysis was performed using repeated measure analysis of variance followed by Bonferroni pairwise comparisons and Student's t-test (α = 0.05). RESULTS: Significant differences were noted between the three mean angles (p = 0.046). The mean angle (3.275 degrees ± 2.54) formed by OP and ATL2 was significantly the smallest (p < 0.05). CONCLUSION: The ala-tragus line, extending from the inferior border of the ala of the nose to the tip of the tragus of the ear presented the closest relationship to the natural occlusal plane.

Relationship between the occlusal plane corresponding to the lateral borders of the tongue and ala-tragus line in edentulous patients.

AIM: Definitions of the ala-tragus line (ATL) cause confusion, because the exact points of reference for this line do not agree. This study determined the relationship between the prosthetic occlusal plane (OP) corresponding to the lateral borders of the tongue and ATL which was established by using the inferior border of the ala of the nose and (1) the superior border of the tragus (ATL 1), (2) the tip (ATL 2) and (3) the inferior border of the tragus (ATL 3). MATERIALS AND METHODS: Neutral zone moldings using phonation and autopolymerizing acrylic resin were recorded and leveled with the lateral borders of the tongue. Lateral cephalometric radiographs were taken of each subject by a standard method. Tracings were obtained on acetate paper to show the prosthetic OP and the three ATLs. The relationship between the prosthetic OP and each of ATL was measured for each subject. Mean and standard deviation values were then calculated for the relationship. Statistical analysis was performed using repeated measure analysis of variance followed by Bonferroni pairwise comparisons and Student's t-test (α = 0.05). RESULTS: Significant difference was found between the three mean angles (p = 0.001). There was no significant difference between the mean angle (5.00° ± 4.38) formed by OP and ATL 2, and the mean angle (4.90° ± 3.50) formed by OP and ATL 3 (p = 1.00) which revealed the smallest. CONCLUSION: The findings of this study indicated that ATLs, extending from the inferior border of the ala of the nose to (1) the tip of the tragus of the ear, and (2) the inferior border of the tragus presented the closest relationship to the prosthetic OP corresponding to the lateral borders of the tongue. CLINICAL SIGNIFICANCE: When the ATL is used for orientation of the OP in denture construction, it would seem preferable to define it as running from the inferior border of the ala of the nose to the tip or to the inferior border of the tragus of the ear.

Complete denture prosthodontics for a patient with Parkinson's disease using the neutral zone concept: a clinical report.

A patient with Parkinson's disease was given new dentures made by utilizing the neutral zone concept. Many modeling oral functions (including swallowing, phonation, sucking, smiling, and grimacing) and two materials were used to shape six neutral zone impressions but only one impression was deemed satisfactory for the patient. The patient's lack of neuromuscular control coupled with xerostomia made it impossible to construct a denture with perfect, absolute equilibrium and no displacement; however, denture stability was improved considerably and the patient wore the dentures for several years. Based on this case, a slow-setting material of low viscosity was preferable for shaping the neutral zone.

Variations in rest vertical dimension: effects of headrest in edentulous patients.

Some clinicians believe that using a headrest may result in an inaccurate rest vertical dimension (RVD) and thus alter the occlusal vertical dimension when fabricating complete dentures. This study measured the RVD established by a group of totally edentulous subjects seated in a relaxed upright position with the Frankfort Plane parallel to the horizontal and the head unsupported and compared this measurement with the RVD established when the same subjects were seated in a relaxed upright position and looking straight at the horizon with the head supported by a headrest. The mean values obtained when the head was unsupported were compared to those obtained when the head was supported by a headrest. Statistical analysis was performed using Student's t-test (alpha = 0.05). No significant differences were noted in the RVD between the two positions (P = 0.38).

Variations in rest vertical dimension: effects of standing posture in edentulous patients.

The orientation of a patient's head changes, depending on whether he or she is sitting or standing in a relaxed upright position. An edentulous patient's vertical dimension at rest may show variations that can result in an inaccurate determination of his or her occlusal vertical dimension. This study recorded the rest vertical dimension (RVD) established among 60 totally edentulous subjects who were standing in the position of greatest comfort (self-balance position) and compared it with the patients' RVD when they were seated in a relaxed upright position, with the Frankfort Plane parallel to the horizontal. The RVD was measured (in mm) between two dots located on the midline of the face. Two measurements were made: one when the patient was seated upright and relaxed (with the Frankfort Plane parallel to the horizontal) with no head support, and the other when the patient was standing relaxed on both feet in a self-balance position. Five alternated measurements were made for each subject in each position. A mean RVD was calculated for each subject in each body posture and the mean values from both positions were compared. Statistical analysis was performed using Student's t-test (alpha = 0.05). No significant differences were noted between the RVD of the seated and standing positions (P = 0.67).

Morphologic comparison of two neutral zone impression techniques: a pilot study.

STATEMENT OF PROBLEM: Several studies have compared dentures fabricated using neutral zone and conventional techniques. However, studies comparing swallowing and phonetic techniques for assessing the location and shape of the neutral zone could not be identified in the literature. PURPOSE: The purpose of this pilot study was to compare the outline form of the phonetic and swallowing neutral zone impression techniques for the same subjects. MATERIAL AND METHODS: Nine denture wearers with advanced mandibular ridge resorption were included in this study. For each subject 2 trays were prepared in autopolymerizing acrylic resin. One method used phonetics and tissue conditioner to shape the neutral zone; the second method used swallowing and modeling plastic impression compound. The resulting neutral zone impressions were leveled to the same occlusal height by gently grinding the occlusal surface on sandpaper until it corresponded with landmarks (corners of the mouth, two thirds of the height of the retromolar pads, bilaterally) noted on the cast. The impression was inverted onto graph paper, and the contour was outlined with a lead pencil. One impression was made for each subject, for each technique. The buccal contours of both neutral zones coincided at the median line. The maximum distance between the zones was measured in a buccolingual direction in the anterior, premolar, and molar regions bilaterally. When the location of the phonetic neutral zone in relation compared to the swallowing neutral zone was buccally oriented, a plus score was given. When the phonetic neutral zone was lingually located, a minus score was given. When the 2 lines coincided, a score of 0 was given. Measurements were made from direct readings on the graph paper. Statistical analysis was performed using the Sign test (alpha=.05). RESULTS: Significant differences were noted buccally in the left molar (P =.031) and right molar (P =.003) regions and also in the left and right premolar regions (P =.007), where the swallowing neutral zone was found to be located buccal to the phonetic neutral zone. Significant differences were also noted lingually, in the right premolar region (P =.015), where the swallowing neutral zone was found to be located lingual to the phonetic neutral zone. There was no significant difference between the techniques for the anterior region. CONCLUSION: Within the limits of this study, the phonetic neutral zone appears to be narrower posteriorly compared to the swallowing neutral zone, thus limiting premolar and molar positioning.