Enabling Virtual Learning for Biomechanics of Tooth Movement: A Modified Nominal Group Technique.

Virtual learning is a medium that can enhance students' understanding of a specific topic. The emergence of the COVID-19 pandemic provided an opportunity for dental education to shift from traditional learning to blended learning as it began to utilize technology to help students study effectively. In this study, we collaborated with experts in the field of dentistry to reach a consensus about which topics are appropriate to include in the virtual learning module about the biomechanics of tooth movement. We convened a panel of five experts who had a minimum of two years of experience in teaching orthodontics and introduced them to the Nominal Group Technique (NGT), which is a well-established, organized, multistep, assisted group meeting technique for generating consensus. The following ten key topics were identified for inclusion in the module: physiology of tooth movement; tooth movement-definition, type, theory, indications; force systems; anchorage; fixed appliances; biomaterials related to tooth movement; removable appliances; factors affecting tooth movement; iatrogenic effect of tooth movement; and current advances and evidence regarding tooth movement. The modified NGT approach led to the development of a ranked thematic list of the topics related to the biomechanics of tooth movement that can be delivered to students via virtual learning.

Analysis of Deep Learning Techniques for Dental Informatics: A Systematic Literature Review.

Within the ever-growing healthcare industry, dental informatics is a burgeoning field of study. One of the major obstacles to the health care system's transformation is obtaining knowledge and insightful data from complex, high-dimensional, and diverse sources. Modern biomedical research, for instance, has seen an increase in the use of complex, heterogeneous, poorly documented, and generally unstructured electronic health records, imaging, sensor data, and text. There were still certain restrictions even after many current techniques were used to extract more robust and useful elements from the data for analysis. New effective paradigms for building end-to-end learning models from complex data are provided by the most recent deep learning technology breakthroughs. Therefore, the current study aims to examine the most recent research on the use of deep learning techniques for dental informatics problems and recommend creating comprehensive and meaningful interpretable structures that might benefit the healthcare industry. We also draw attention to some drawbacks and the need for better technique development and provide new perspectives about this exciting new development in the field.

Comparison of Soft Tissue Changes Produced by Two Different Appliances on Mixed Dentition Children.

OBJECTIVE: This study was focused on comparing and analyzing the soft tissue changes induced by Reverse Twin-Block (RTB) and Reverse Pull Face Mask (RPFM) in early and late mixed dentition Malay children having Class III malocclusion. METHODS: This cross-sectional study includes a total sample of 95 Malay children of both early (8-9 years) and late (10-11 years) mixed dentition stages. The comparison was between 49 samples treated by RTB and 46 samples treated by RPFM. Both pre- and posttreatment changes were assessed with Holdaway's analysis using the CASSOS software. In each cephalogram, 71 anatomic landmarks were traced. Descriptive and multiple regression analyses were performed for statistical evaluation. RESULTS: Statistically significant changes were noticed in soft tissue facial angle, subnasale to H-line, skeletal profile convexity, upper lip strain, H-line angle, lower lip to H-line, and inferior sulcus to H-line measurements. Gender disparity was noticed in upper lip strain. Other significant changes were influenced by the type of appliance. However, the mean differences were minute to notice clinically. Age difference did not have any effect on the treatment changes. CONCLUSIONS: RPFM revealed treatment outcome with more protruded upper lip than RTB.

Effect of malocclusion severity on oral health related quality of life in Malay adolescents.

BACKGROUND: The present study aims to determine the impact of malocclusion on oral health related quality of life (OHRQoL) among 13-16 years old Malay school children. METHODS: School children aged between 13 and 16 years old were randomly selected from a secondary school in Penang. Malay version of Oral Health Impact Profile-14 (OHIP-14) questionnaires were given to the subjects. This questionnaire has 14 questions with seven domains which are functional limitation, psychological discomfort, physical pain, physical disability, psychological and social disability, and handicap. Index of orthodontic treatment need dental health component was used to assess the orthodontic treatment need. Overjet (reversed overjet), open bite, overbite, cross bite, impeded eruption, crowding, defects of cleft lip and palate, Class II and Class III buccal occlusion, present of supernumerary and hypodontia were assessed. RESULTS: 255 students participated in this study. Mean score and standard deviation for OHIP-14 were 8.64 (± 7.32) for males and 11.05 (± 9.41) for females respectively. There was statistically significant difference in mean score of OHIP-14 between male and female (p = 0.023). A weak positive correlation was found between malocclusion severity and OHRQoL (r = 0.186; p < 0.01). Malocclusion had a negative impact on OHRQoL of the students in the present study. This impact was prominent in psychological discomfort and psychological disability domains of OHIP-14 (p < 0.05). CONCLUSION: Increase in severity of malocclusion was associated with a negative impact on OHRQoL. Females exhibited more negative impact of malocclusion on their OHRQoL. Psychological domain was the most affected one.

Corrigendum to "Evaluation of Some Mechanical Properties of a Maxillofacial Silicon Elastomer Reinforced with Polyester Powder".

[This corrects the article DOI: 10.1155/2019/2948457.].

Developing consensus in identifying challenges of undergraduate orthodontic education in Malaysian public universities using e-Delphi.

AIM: The aim of the study was to seek consensus, identify and explore the challenges facing undergraduate orthodontic education and propose equitable solutions for overcoming the challenges amongst Malaysian public university dental schools. METHODS: An iterative e-Delphi technique was employed as the method for gathering consensus on a range of topics found pertinent to affect orthodontic teaching and learning established through literature review. A total of ten expert panellists were recruited through a targeted invitation to the orthodontists from Malaysian public universities offering undergraduate dental education. The e-Delphi comprised of three rounds of anonymous e-survey. The consensus was sought for two open-ended and two closed-ended questions. RESULTS: The response rates for all the three rounds were 100 per cent. The total number of questions responded by the participants in all the three rounds was forty-four. Round one achieved consensus on two closed-ended questions. Round two achieved a consensus on twenty-eight out of thirty-four (82.35%) questions with round three achieving a consensus on four out of six (66.66%) questions. A 70% consensus was considered as the minimum level of agreement for all the rounds. In total, consensus and agreement were achieved on two closed-ended questions and twenty-nine items from the open-ended questions. CONCLUSION: The study was able to identify a range of issues affecting undergraduate orthodontic education with a good level of consensus using the e-Delphi technique highlighting the need for curriculum refinement. The study has, in addition, proposed tangible methods to enable such a change.

Effectiveness of a Health Education Program to Improve Knowledge and Attitude Towards Cervical Cancer and Pap Smear: A Controlled Community Trial in Malaysia.

OBJECTIVE: We examined the effectiveness of a health education program to improve; knowledge and attitude towards cervical cancer and Pap smear, and uptake of Pap smear test among female entrepreneurs in Kedah, a northern state of Malaysia. METHODS: This controlled community trial involved 210 women from the districts of Alor Setar and Sungai Petani. Simple random sampling was applied to select 105 women from each district. Self-administered questionnaires were used to obtain information about the variables of interest. Health education intervention program included educational talk, demo video, experience sharing, pamphlet distribution, and text message reminders. Evaluation of outcomes was performed twice. The text message reminders acted as the cues to action that were sent between the two evaluation times at one-month interval. Women in the control group received educational talk alone. In the control group, evaluation of outcomes was done only once, which was one month after the educational talk. RESULTS: Knowledge on cervical cancer and Pap smear, and attitude towards Pap smear among women in both intervention and control group improved significantly at Evaluation stage 1. However, no further improvements were observed in the intervention group at Evaluation stage 2. The uptake of Pap smear in the intervention group increased significantly from 48.0% at Baseline to 68.0% at Evaluation stage 1 (P<0.001), and from 68.0% to 79.0% at Evaluation stage 2 (P<0.001). A significant increase in Pap smear uptake was also seen in the control group from 63.0% at Baseline to 76.0% at Evaluation stage 1 (P=0.003). CONCLUSIONS: Educational talk alone was effective in improving knowledge on cervical cancer and Pap smear, attitude towards the test, and the actual uptake of the test. However, text reminders were more effective than having an educational talk alone in increasing uptake of Pap smear test among participants.
.

Treatment effects of two different appliances on pharyngeal airway space in mixed dentition Malay children.

BACKGROUND: Treatment of Class III malocclusion is related to redirecting the growth of mandible, which may have an impact on the pharyngeal airway. OBJECTIVE: To evaluate and compare the treatment effect of Reverse Twin-Block (RTB) and Reverse Pull Face Mask (RPFM) on Pharyngeal Airway Space (PAS) in early and late mixed dentition Class III samples. METHODS: Ninety-five mixed dentition Malay children with Class III malocclusion were included in this study. Data consists of 190 pre- and post-treatment lateral cephalograms of early (8-9 years) and late (10-11 years) mixed dentition Class III samples. forty-nine samples were under RTB and forty-six samples were under RPFM. Treatment changes were evaluated by McNamara airway analysis and changes in tongue and hyoid bone position. RESULTS: Both upper and lower pharyngeal airway width were increased after treatment with RTB and RPFM ruling out the chance of airway constriction. There was also posterior positioning of the tongue and hyoid bone indicating mandibular retrusion. No significant treatment changes were found on the Pharyngeal Airway Space by the factor age, gender or type of appliance. CONCLUSIONS: Both RTB and RPFM increased the Pharyngeal Airway Space and produced similar treatment effect. As age does not affect the treatment outcome significantly, treatment can be delayed until late mixed dentition stage.

Validity and reliability of the Malay version of Sleep Apnea Quality of Life Index--preliminary results.

BACKGROUND: The objective of this study was to determine the validity and reliability of the Malay translated Sleep Apnea Quality of Life Index (SAQLI) in patients with obstructive sleep apnea (OSA). METHODS: In this cross sectional study, the Malay version of SAQLI was administered to 82 OSA patients seen at the OSA Clinic, Hospital Universiti Sains Malaysia prior to their treatment. Additionally, the patients were asked to complete the Malay version of Medical Outcomes Study Short Form (SF-36). Twenty-three patients completed the Malay version of SAQLI again after 1-2 weeks to assess its reliability. RESULTS: Initial factor analysis of the 40-item Malay version of SAQLI resulted in four factors with eigenvalues >1. All items had factor loadings >0.5 but one of the factors was unstable with only two items. However, both items were maintained due to their high communalities and the analysis was repeated with a forced three factor solution. Variance accounted by the three factors was 78.17% with 9-18 items per factor. All items had primary loadings over 0.5 although the loadings were inconsistent with the proposed construct. The Cronbach's alpha values were very high for all domains, >0.90. The instrument was able to discriminate between patients with mild or moderate and severe OSA. The Malay version of SAQLI correlated positively with the SF-36. The intraclass correlation coefficients for all domains were >0.90. CONCLUSIONS: In light of these preliminary observations, we concluded that the Malay version of SAQLI has a high degree of internal consistency and concurrent validity albeit demonstrating a slightly different construct than the original version. The responsiveness of the questionnaire to changes in health-related quality of life following OSA treatment is yet to be determined.

Efficacy of a marine bacterial nuclease against biofilm forming microorganisms isolated from chronic rhinosinusitis.

BACKGROUND: The persistent colonization of paranasal sinus mucosa by microbial biofilms is a major factor in the pathogenesis of chronic rhinosinusitis (CRS). Control of microorganisms within biofilms is hampered by the presence of viscous extracellular polymers of host or microbial origin, including nucleic acids. The aim of this study was to investigate the role of extracellular DNA in biofilm formation by bacteria associated with CRS. METHODS/PRINCIPAL FINDINGS: Obstructive mucin was collected from patients during functional endoscopic sinus surgery. Examination of the mucous by transmission electron microscopy revealed an acellular matrix punctuated occasionally with host cells in varying states of degradation. Bacteria were observed in biofilms on mucosal biopsies, and between two and six different species were isolated from each of 20 different patient samples. In total, 16 different bacterial genera were isolated, of which the most commonly identified organisms were coagulase-negative staphylococci, Staphylococcus aureus and α-haemolytic streptococci. Twenty-four fresh clinical isolates were selected for investigation of biofilm formation in vitro using a microplate model system. Biofilms formed by 14 strains, including all 9 extracellular nuclease-producing bacteria, were significantly disrupted by treatment with a novel bacterial deoxyribonuclease, NucB, isolated from a marine strain of Bacillus licheniformis. Extracellular biofilm matrix was observed in untreated samples but not in those treated with NucB and extracellular DNA was purified from in vitro biofilms. CONCLUSION/SIGNIFICANCE: Our data demonstrate that bacteria associated with CRS form robust biofilms which can be reduced by treatment with matrix-degrading enzymes such as NucB. The dispersal of bacterial biofilms with NucB may offer an additional therapeutic target for CRS sufferers.