Systems for the provision of oral health care in the black sea countries. Part 12: Ukraine

This paper is part of a series describing systems for the provision of oral health care in countries that surround or are near to the Black Sea. It starts by outlining the country and its population structure. It then provides a description of the general and oral public and private health care systems in Ukraine. It describes the dental workforce (dentists, oral hygienists, dental specialists and dental technicians) and its education, setting out the numbers of dentists and other dental workers. A section on dental education at undergraduate, specialist, and continuing levels follows. Finally, the paper gives some information on the oral epidemiology and costs of oral care in Ukraine

Practical Implementation of Evidence-Based Dentistry Into Daily Dental Practice Through a Short Time Dependent Searching Method

INTRODUCTION:Despite the fact that the benefits of implementation of Evidence-Based Dentistry (EBD) into clinical practice is increasingly being highlighted, there are still clear limitations in its implementation into daily dental practice. One potentially important barrier to effective implementation into practice is the perception of EBD as a time-consuming process. The aim of the present study is to increase the familiarity of dental practitioners with the benefits of different time-dependent 'practical' search strategies important to EBD using a clinical question from the field of dental implantology as an example. MATERIALS AND METHODS:The PICO (population, intervention, comparison, outcome) question used in this study was: "In young adults with anterior single-tooth implant what is the effect of immediate or delayed loading on success?" A bibliographic search according to the Haynes 5S pyramid, together with 3 different time-dependent strategies (5-min, 30-min and more than 60-min), were applied. RESULTS:Both the Haynes 5S Pyramid and time-dependent search strategies revealed promising results for enhancing decision-making for determining the feasibility of immediate or conventional loading of anterior single dental implants. Results clearly showed that selection of the loading protocol would be case (patient)-specific and also indicated high primary implant stability and bone quality as the most important prerequisites for a successful immediate/early loading. From among the 3 different time-dependent strategies (5 min, 30 min and more than 60 min), the 60+ min search results were quite comparable with the Haynes pyramid search results. CONCLUSION:It is likely that the different time-dependent search strategies may have the potential to support the clinical decision making process and may improve the implementation of EBD into daily dental practice. Increased time spent searching naturally seems to increase the extent of this support. However, even with short time-dependent searches, busy dental clinicians may get an improved idea/opinion regarding a clinical question

Benzothiazinones kill Mycobacterium tuberculosis by blocking arabinan synthesis

New drugs are required to counter the tuberculosis (TB) pandemic. Here, we describe the synthesis and characterization of 1,3-benzothiazin-4-ones (BTZs), a new class of antimycobacterial agents that kill Mycobacterium tuberculosis in vitro, ex vivo, and in mouse models of TB. Using genetics and biochemistry, we identified the enzyme decaprenylphosphoryl-beta-d-ribose 2'-epimerase as a major BTZ target. Inhibition of this enzymatic activity abolishes the formation of decaprenylphosphoryl arabinose, a key precursor that is required for the synthesis of the cell-wall arabinans, thus provoking cell lysis and bacterial death. The most advanced compound, BTZ043, is a candidate for inclusion in combination therapies for both drug-sensitive and extensively drug-resistant TB

Class II Malocclusion in Adult Patients: What Are the Effects of the Intermaxillary Elastics with Clear Aligners? A Retrospective Single Center One-Group Longitudinal Study

Aim: To evaluate the dental effects of the treatment with clear aligners and intermaxillary elastics in adult patients with Class II malocclusion. Material and methods: A sample of 20 Class II patients treated with Invisalign aligners (5 M and 15 F; mean age of 27.6 ± 6.3 years) was included in this single-center one-group longitudinal study. Dental cast and cephalometric records were analyzed before (T0) and after treatment (T1). Data were analyzed with a t-test for paired data (p < 0.05). Results: There was a significant reduction of the Overjet (OVJ= −1.4 ± 0.2; p ≤0.001) and a retroposition of upper incisors (U1-NPo = −1.3 ± 1.7; p < 0.001). Furthermore, distalization of upper molars with an improvement of molar class (U6-PT Vertical = −0.93 ± 0.97; p < 0.001; Molar Relation = −0.75 ± 0.45; p < 0.001) was observed. A good control of the lower and upper incisor inclination was present, highlighted by the non-significant changes in these values (L1-GoGn = −0.12 ± 5.4; p = 0.923; U1-AnsPns = −1.1 ± 8.1; p = 0.551). In the lower arch, an increase in the intermolar diameter (0.6 ± 1.0; p = 0.01) was present. Finally, there were no statistically significant changes in all the skeletal variables (ANPg = 0.005 ± 0.687; p = 0.974; SN/MP = −0.47 ± 1.9; p = 0.298). Conclusions: Treatment with Invisalign aligners shows a reduction of the Overjet, a retroposition of the upper incisors, good control of the lower incisors, and an improvement of the molar relationship

The adolescent patient: parental responsibility, the right to be informed and the right to be heard

The increasing emphasis placed on patients’ rights, in dentistry as in other areas, is also having repercussions for the structure of the relationship between health care staff, the under-age patient and his/ her parents. The Authors reflect about the decision-making process when the patient is a minor in the field of dentistry and underline the role of the parties involved (dentist, parents, under-age patient) in different circumstances (e.g. ordinary care or non-routine care; urgent situations; conflict between parents; refusal of the parents; disagreement between the parents and the child, refusal of the under –age patient; etc.).. The Law must first ensure that the minors’ needs for protection are met by awarding their parents the power and duty to care for them and, thus, also to take health care decisions in their interest. At the same time, domestic legislation and international legislation supports the need to give greater weight to minors’ opinions as they approach the age of majority and thus as they acquire a certain degree of maturity. The rights of under-age patients are safeguarded by actively involving them in the decision-making process, with particular reference to their right to information and right to be heard, to the extent that their age and understanding allow, with due consideration to the specific situation

Treatment of mild Class II malocclusion in growing patients with clear aligners versus fixed multibracket therapy: A retrospective study

Objective: To compare the dental and skeletal effects of intermaxillary elastics on the correction of mild Angle's Class II division 1 malocclusion with clear aligner treatment (CA) versus fixed multibracket (FMB) in growing patients. Settings and sample population: The study sample consisted of 49 consecutively patients (mean age ± SD 12.9 ± 1.7 years), 32 females and 17 males referred from the School of Orthodontics of the University of Bratislava Comenius (Slovakia). All patients were treated with a non-extraction orthodontic treatment, 25 with FMB and 24 with CA. Methods: The cephalometric analysis was performed at the beginning (T0) and the end of the treatment (T1). The t test for unpaired data was carried out to compare cephalometric values at T0 and changes at T1-T0 between the two groups. The level of significance was set as P <.0035. Results: The two groups showed no statistically significant differences (ANPg = −0.1°; P =.762) in the correction of the sagittal intermaxillary relation. The analysis of vertical skeletal changes showed no statistically significant effects on mandibular inclination (SN/MP = 0.1°; P =.840). The two treatments had a statistically significant and clinically relevant difference in controlling the inclination of the lower incisors (L1/GoGn = 4.8°, CAG = −0.5°± 3.9°; FMB = 4.3°± 5.8°; P <.001). Conclusions: Class II elastics combined with CA and FMB produce a similar correction on sagittal discrepancies in growing patients. CA presented a better control in the proclination of the lower incisors. CA and elastics might be a good alternative in the correction of mild Class II malocclusion in cases where a proclination of lower incisors is unwanted

Systems for the Provision of Oral Health Care in the Black Sea Countries Part 12: Ukraine

This paper is part of a series describing systems for the provision of oral health care in countries that surround or are near to the Black Sea. It starts by outlining the country and its population structure. It then provides a description of the general and oral public and private health care systems in Ukraine. It describes the dental workforce (dentists, oral hygienists, dental specialists and dental technicians) and its education, setting out the numbers of dentists and other dental workers. A section on dental education at undergraduate, specialist, and continuing levels follows. Finally, the paper gives some information on the oral epidemiology and costs of oral care in Ukraine

Patient and Parental Satisfaction following Orthodontic Treatment with Clear Aligners and Elastodontic Appliances during Mixed Dentition: A Cross-Sectional Case–Control Study

The aim of the current study was to assess patient and parental satisfaction following treatment during mixed dentition with two removable orthodontic devices: elastodontic appliances (EAs) and clear aligners (CAs). Consecutive patients below the age of 12 years who had completed the active phase of EA or CA therapy were recruited. A dedicated written questionnaire divided into four sections was used to measure parental and patient satisfaction regarding treatment experiences and treatment outcomes. The total sample included 56 subjects: 28 belonged to the EA group (7 girls and 21 boys; mean age 11 years); 28 belonged to the CA group (12 girls and 16 boys; mean age 9 years). Patients and parents of both the EA and CA groups were satisfied with the treatment experiences and outcomes. According to parental reporting, EA treatment was significantly more painful than CA therapy (p = 0.003), but this was not confirmed by the patients (p = 0.100). Both parents and patients reported EAs being significantly more difficult to wear than CAs (p < 0.001 and p = 0.001, respectively). Functional improvements were reported, including a reduction in grinding sounds in the CA group (p = 0.020) and breathing improvements in the EA group (p = 0.023). According to the parents, school life and social life were significantly improved in the CA group, as compared to the EA group (school life p < 0.001, social life p = 0.001). Finally, parents belonging to the CA group found that their child’s treatment was much shorter than expected (p = 0.003)