Clinical Trial Designs for the Testing of OTC Products for Dentine Hypersensitivity-A Systematic Review

Aim: The aim of the present study was to review the papers in the published literature and to compare the clinical trial methodology used in these studies to evaluate the products for Dentine Hypersensitivity (DH) based on the previously recommended guidelines of Holland, et al. (1997). Material and Methods: A systematic search was conducted on PubMed and Embase for double blind randomized placebo-controlled clinical studies conducted over ≥6 weeks assessing the efficacy of OTC products for the treatment of DH in otherwise healthy adult subjects with reported and diagnosed DH. Results: A total of 35 studies were included in this review from an initial search of 882 titles. All the included studies complied with the guidelines in terms of study design, duration, subject selection, adequate control(s) and subject instructions. 91% of studies used a sample size of ≥ 25 per arm. Most studies (91%) complied with the minimum required number of teeth to be test ed except in two studies. All the studies used an objective assessment however only two studies (22.8%) included a subjective evaluation to an everyday stimulus when evaluating DH. Only two studies included assessment of the impact of DH treatment on the participants’ Quality of Life (QoL). Most studies did not include a recommended specific run in/wash period (10 studies [28.5%]) or a follow up period following the cessation of the study (2 studies [5.7%]). All studies reported the reduction of DH as a percentage reduction from baseline values. None of the studies reported a total relief of pain irrespective of the in- tervention(s) evaluated although there were mean reductions in both test and control groups. Conclusions: All of the included studies reported a significant statistical reduction of pain in both the test and control groups, although none of the studies reported the complete absence of the pain response following any of the interventions at the end of the studies. Overall, most studies complied with the recommendations from the Holland, et al. guidelines however, there is still a need to include both a run in/wash out and follow up periods in future studies. Furthermore, it may be recommended to include a subjective evaluation of the treatment outcome to overall sensitivity from day to day activities as well as the effect on the QoL (person-centered approach) in future studies. None of the included studies reported the complete absence of the pain response following any of the interventions at the end of the studies

The Prevalence of Periodontal Pain Associated with Scuba Diving: A Questionnaire Study

Aim: The aim of the study was to evaluate the relationship between dental problems such as, periodontal pain, and scuba diving. Material and method: A questionnaire study was conducted using a cross-sectional self-administered questionnaire in five dive centres in Kuwait. The questionnaire consisted of 31 (multiple-choice and open ended) questions in three sections, 1) covering the demographic data, diving experience, dental and periodontal profiles of the scuba divers; 2) the response of the diver regarding his or her visits to the dentist, 3) the type of the pain experienced during the dive and whether it was a shooting pain, tooth sensitivity, pulsating pain, dull ache, throbbing, or pressure pain. One final question related to the diver’s response regarding visiting the dentist after a dental problem and the treatment provided. Data were entered and analyzed using SPSS, software v. 22 (IBM UK, Guildford). Results: 170 questionnaires were handed out, 20 were not returned (88.2% response rate). 150 divers completed the questionnaire (104 Male [69.3%], 46 Female [30.7%], mean age 32.3 ± 7.2 years) were included for analysis. Nine subjects (6.3%) experienced ‘gum problems’ with shooting pain (n = 4) and tooth sensitivity (n = 3) being the most common problems (Fig. 1). Pain symptoms were not, however dependent on age, gender, or the frequency of diving. Toothache was more prevalent in divers ≤30 years of age (n = 136) (16.2%) with other types of pain e.g., headache (49%), sinus pain (32.2%), jaw pain (22.1%) also reported (Fig. 2). Conclusions: Periodontal pain was an uncommon complication during diving, toothache was more prevalent in divers ≤30 years of age (16.2%). The other dental problems experienced by divers were headache (49%), sinus pain (32.2%), jaw pain (22.1%) and toothache (16.2%)

Perception and Understanding of Greek Dentists on Periodontal Regenerative Procedures: A Questionnaire Based Study

Objectives: The aim of this cross-sectional questionnaire study was to evaluate the perception and preferences of Greek dentists who either specialised in or had an interest in periodontal regenerative procedures and to compare the results with corresponding findings from two previous studies from different countries. Materials and methods: The questionnaire was divided in two main sections and included multiple choice and/or open/closed questions. The first section consisted of six questions and was designed to collect demographic data of the sample and the second section, consisting of 15 questions, included general questions regarding periodontal regeneration procedures and questions based on specific clinical cases. 200 questionnaires were distributed at selected venues in Greece by the investigators. The participants were given one month to complete and return to the questionnaires to the School of Dentistry in Thessaloniki. Statistical analysis: Data management and analysis was performed using both Microsoft Excel 2007® (Microsoft Corporation, Reading, UK) and SPSS® version 22.0 software (IBM United Kingdom Ltd, Portsmouth, UK). Frequencies and associations between the demographic profiles of the participants were evaluated and presented in the form of frequency tables, charts, and figures. Results: 104 questionnaires (67 males, 37 females: mean age 43.2 years [±9.8]) (52% response rate) were received. Of those who responded 56.7% (n=59) specialized in Periodontics and 43.3% (n=45) specialized in a variety of other dental disciplines (General Dentistry, Oral Surgery and Implantology). Guided tissue regeneration procedures and the use of enamel matrix derivative were recommended for the reconstruction of bony defects and both subepithelial connective tissue graft and coronally advanced flap with or without enamel matrix derivative were the most popular choices for root coverage. Smoking was considered a contraindication by most of the participants and conflicting responses were given regarding the use of antibiotics as part of the post-operative care following regenerative procedures. Conclusions: The participants incorporated both traditional and “novel” techniques and products in reconstructive procedures and appeared to be up to date with the evidence from the dental literature. However, it was evident that there was confusion regarding the role of antibiotics in regenerative procedures

Estudio preliminar de micromamíferos del Pleistoceno Superior de la cueva de Loutraki (Pella, Macedonia, Grecia)

[Abstract] The Loutraki Bear-cave (Northern Greece) yielded a rich Pleistocene fauna including mammals, amphibians and reptiles. In the present study the small mammal fauna associated with cave-bear remains is studied. The material comes from a long-time excavation project, which is still in progress. This study allows us to propose a Late Pleistocene age for the Loutraki fauna. The composition of the LAC-micromammalin fauna suggests a complex environment

A Survey of the Professional Opinions of Dentists in Kuwait in the Use of Periodontal Regenerative Surgical Procedures for the Treatment of Infra Bony and Localized Gingival Defects

Aim: This questionnaire-based study evaluated the attitude and knowledge of periodontal regeneration procedures by Kuwaiti dentists. Furthermore, the study aimed to validate the results of a previous cross-sectional postal questionnaire conducted by Siaili et al., [1], based on UK-based dentists with a specialty or a special interest in periodontology. Material and Methods: A cross-sectional questionnaire was completed involving 31 questionnaires and conducted from Kuwaiti dentists by e-mail (pilot phase) together with the 98 Kuwaiti-based dentists (main phase). The questionnaire consisted of 21 questions involving both multiple choices answers and open-ended or dichotomous options and was divided in two broad sections addressing: 1) the general profile of dentists and 2) their preferences regarding the management of intrabony, interradicular and marginal tissue recession defects together with their opinions on smoking and use of antibiotics in regeneration procedures. Data were analyzed and entered using SPSS version 21 (IBM UK, Guildford) and frequency tables constructed, any associations between the variables were tested at the 5% level significance (p ≤ 0.05). Results: Kuwaiti Dentists (M 90: F 39; mean age: 35.7 ± 7.2 years) completed 129 questionnaires. The use of guided tissue regeneration procedures with absorbable membranes was the most popular option for the regeneration of intrabony defects. The use of connective tissue grafts and coronally advanced flaps were the most frequently chosen treatment modalities for root coverage procedures. A reasonable level of participants using special flap techniques for regenerative procedures was also reported. 90.4% of respondents prescribed antibiotics of which Amoxillicin /Metronidazole (33.6%) was the most reported. 73.4% of the participants did not consider smoking to be a contraindication for periodontal regeneration procedures. Conclusion: The results from the present study would suggest that Kuwaiti dentists were aware of current innovations in periodontal regeneration, however there were conflicting responses regarding the exclusion criteria of smokers prior to the regenerative procedure and the prescription of post-operative antibiotics following regenerative procedures compared with the evidence from the published literature. The use animal-derived materials for regenerative procedures was not acceptable to most of the participants in the study

Impact of Smoking as a Risk Factor for Dental Implant Failure: A Critical Review

Abstract Introduction There are numerous studies in the published literature that report on the increased risk of implant complications and failure in patients who smoke. An association between dental implants, grafting procedures (e.g. bone grafts maxillary sinus augmentation) and smoking history has been reported in the literature. Cigarette smoking may adversely affect wound healing and thus, jeopardize the success of bone grafting and dental implantation. Aim The aim of the present study was to conduct a critical review to evaluate the effects of a dose dependent impact of smoking on the success or failure of dental implants. Method A systematic search of the electronic databases and subsequent hand searching of the relevant articles published in English was performed and resulted in 60 papers. Of the 60 papers identified by this process, only eight studies were included in the review, based on the inclusion and exclusion criteria. Results The included studies compared the effects of smoking on both marginal bone loss and implant failure. Four out of five studies reported a strong correlation between smoking and an increased risk of implant failure. However, only two of the four studies reported on whether the risk of implant failure was affected by the quantity of daily cigarette consumption. Furthermore, of the three studies that analysed the effect of smoking on marginal bone loss, only two studies reported an increase in bone loss in smokers. None of the included studies demonstrated any correlation between smoking dose and increased marginal bone loss around a dental implant. The results suggested that there are limited evidenced-based data regarding the establishment a relationship between the quantity of cigarette consumption (in terms of smoking dose) and its effect on dental implant failure. There appeared to be limited data on clinical dental implant protocols regarding the acceptance of smokers in terms of a dose-related risk when considering patient suitability for implant placement. Conclusions The results from these studies included in the present review would therefore emphasize the importance of a patient’s smoking status and the necessity of assessment and their ability to comply with professional recommendations, including oral hygiene instructions, prior to any implant treatment planning procedure. The patient should also be advised of the possibility of a poor prognosis following implant placement in patients who smoke, particularly in the maxillary region and in advanced surgical techniques e.g., sinus lift or bone regeneration

A Survey of Dentists in the Management of Dentine Hypersensitivity: A Questionnaire-based Study.

OBJECTIVE: Previous studies have indicated that dentists may be uncertain about the etiology, diagnosis, and effective management of dentine sensitivity/dentine hypersensitivity (DH).: The purpose of the present study was to evaluate the knowledge and understanding of Greece-based dental professionals in treating DH.: MATERIALS AND METHODS: A 26-item questionnaire was sent to a representative sample of Greek dentists. RESULTS: Two hundred thirty questionnaires were originally provided to the participants and of the 210 questionnaires that were returned, 191 questionnaires (90 M; 86 F; mean age 36.26 years [standard deviation: 11.34]) were included for analysis, a response rate of 83% was observed. 39.8% of dentists indicated that 1 in 10 of their patients experienced discomfort from DH with 76.4% of dentists indicating that their patients initiated the conversation on DH. In contrast, 44% of the dentists indicated that they initiated the relevant conversation. 34.9% of dentists indicated that the duration of discomfort lasted up to 3 weeks and 76.4% indicated that DH had an impact on their patients' quality of life. Incorrect tooth brushing was considered to be a major etiological factor (68.6%) with "air blast" (37.3%) and "probing" (15%) as the main methods for identification. 83.6% of dentists indicated that they were confident in recommending over-the-counter products for home use. CONCLUSION: The results of this study suggest that in terms of knowledge and understanding of DH, there is still confusion concerning some aspects of the diagnosis and management of the condition

Genetic prediction of ICU hospitalization and mortality in COVID-19 patients using artificial neural networks

There is an unmet need of models for early prediction of morbidity and mortality of Coronavirus disease-19 (COVID-19). We aimed to a) identify complement-related genetic variants associated with the clinical outcomes of ICU hospitalization and death, b) develop an artificial neural network (ANN) predicting these outcomes and c) validate whether complement-related variants are associated with an impaired complement phenotype. We prospectively recruited consecutive adult patients of Caucasian origin, hospitalized due to COVID-19. Through targeted next-generation sequencing, we identified variants in complement factor H/CFH, CFB, CFH-related, CFD, CD55, C3, C5, CFI, CD46, thrombomodulin/THBD, and A Disintegrin and Metalloproteinase with Thrombospondin motifs (ADAMTS13). Among 381 variants in 133 patients, we identified 5 critical variants associated with severe COVID-19: rs2547438 (C3), rs2250656 (C3), rs1042580 (THBD), rs800292 (CFH) and rs414628 (CFHR1). Using age, gender and presence or absence of each variant, we developed an ANN predicting morbidity and mortality in 89.47% of the examined population. Furthermore, THBD and C3a levels were significantly increased in severe COVID-19 patients and those harbouring relevant variants. Thus, we reveal for the first time an ANN accurately predicting ICU hospitalization and death in COVID-19 patients, based on genetic variants in complement genes, age and gender. Importantly, we confirm that genetic dysregulation is associated with impaired complement phenotype