Clinical activities suspended: How the COVID-19 affected the self-confidence of Italian dental students

Introduction: COVID-19 emergency caused several effects on the dental educational system, especially affecting courses including practical activities. The study aims to evaluate the impact of the suspension of dental clinical activities on the Italian dental students' self-confidence. Furthermore, the other purpose of the research is to find an integrative didactics solution to improve the clinical training of dentistry during the COVID-19 pandemic. Materials and methods: A questionnaire was administered to evaluate the impact of the suspension of clinical activities on dental students' self-confidence. A 67-questions survey tested the students' self-confidence in several dental disciplines (Conservative Dentistry, Endodontics, Oral Surgery and Dental Emergency). The study reached a sample of 193 dental students and the answers from 9 different Italian dental schools were analysed. Results: The degree of students' self-confidence for all the dental disciplines investigated was found statistically different between the periods before and after the interruption of clinical activities. The students proposed, as a potential solution to improve their practice during the COVID-19 pandemic, to combinate the use of a video tutorials and dental simulators. Conclusion: The interruption of the training in clinical practice significantly affected the educational career and the self-confidence of students. An alternative teaching method involving the use of video tutorials as support in teaching clinical procedures deserves to be considered

A Retrospective Cohort Study of Traumatic Root Fractures in Primary Dentition: Can Splinting Type Improve Therapeutic Outcomes?

(1) Introduction: Deciduous traumatic dental injuries pose a serious global health concern. Root fractures show an incidence rate of approximately 2%; however, the literature is limited regarding the appropriate treatment and prognosis of affected teeth. This retrospective study aims to analyze the long-term outcomes of orthodontic splinting using brackets compared with composite resin-only splinting in two homogeneous samples affected by root fractures. The study also examines the onset and patterns of root resorption. (2) Methods: The first group included 25 patients with 27 deciduous upper incisors affected by root fracture; Group 2 consisted of 35 patients with 38 root fractures of maxillary deciduous teeth. The categorical data for both groups were analyzed using the chi-squared homogeneity test. Age groups were compared using the Mann–Whitney U test; p < 0.005 was considered statistically significant. (3) Results: In both groups, the male gender predominated similarly. In Group 1, early decidual loss occurred in 16% of cases, whereas in Group 2 it occurred in 51% of cases. Pulp canal obliteration was observed in 68% of deciduous teeth in Group 1, compared with 30% in Group 2. No complications affecting permanent teeth were noted in Group 1; in Group 2, 29% developed enamel dysplasia and 26% experienced delayed eruption, with statistically significant differences in these proportions. Apical fragment resorption was observed in 92% of cases in Group 1 and 30% in Group 2. (4) Conclusions: The treatment of deciduous tooth root fractures using orthodontic splints can yield significant benefits, such as reduction of early tooth loss. Furthermore, the study confirms that early resorption of the distal fragment of fractured roots is a common physiological phenomenon in primary teeth and typically occurs within a year following trauma

Proposal for Introducing a Digital Aesthetic Dentistry Course in Undergraduate Program: Contents and Ways of Administration

Background: Nowadays, digital dentistry is a fundamental skill that dentists need to acquire at this time. The digital workflow has gained acceptance and is widely used in most disciplines of dentistry. For this reason, it might be advisable to include this content in the undergraduate curriculum. The aim of this work was to create a course in digital aesthetic dentistry and evaluate its effectiveness. Methods: Dental students at the University of Verona (from third to sixth year) participated in a 2-h course on photography, digital aesthetic analysis, and digitally planned rehabilitations. Students were randomly divided into two groups, the first group attending the course with video tutorials and the second group attending the traditional class with slides. The students’ ability to perform digital aesthetic analysis and rehabilitation was tested. In addition, a questionnaire was completed to determine student satisfaction with the course and method of delivery. Statistical analysis was performed. Results: The course was highly appreciated, especially by the students who received the video tutorials. Good results were obtained in the performance of digital analysis and rehabilitation, which were better in the first group. Conclusions: Digital aesthetic dentistry was a success in terms of newly acquired skills. From this point of view, the proposal of a course on this subject in the undergraduate curriculum deserves a close evaluation. The video tutorial method seems to be a good way to teach operative digital procedure

Digital Dental Models: Is Photogrammetry an Alternative to Dental Extraoral and Intraoral Scanners?

Background: 3D models are nowadays part of daily clinical practice. Photogrammetry is a brand-new method for transforming small objects into 3D models while keeping their original shape and size. The aim of this study was to evaluate the accuracy, in terms of precision and trueness, of a digital dental model acquired with photogrammetry compared with those obtained using extraoral scanners and intraoral scanners, starting from the same plaster model. Methods: A plaster model was converted into a digital model using photogrammetry, an extraoral scanner and an intraoral scanner. Different references were measured twice at a distance of 30 min for each model, on the digital models using the software Blender and on the plaster model using a calibre. The Interclass Correlation Coefficient was calculated for each pair of measurements. A volumetric analysis was performed by superimposing the digital models. The coefficient of variation was calculated. A two-way ANOVA test was conducted. Results: For each reference, the coefficient of variation was less than 3%, and the two ANOVA tests resulted in a non-significant value in both cases (p > 0.05). The volumetric analysis demonstrated good agreement between the models derived from the different acquisition methods. Conclusions: Photogrammetry seems to be a good method for acquiring digital models starting from a plaster model, all the methods tested seem to be good for obtaining an accurate three-dimensional digital model. Other studies are needed to evaluate clinical efficacy

Oral microbiota in oropharyngeal cancers: friend or foe?

Oral microbiome is a complex population of micro-organisms, which by cross-talking with the local immune system, plays a major role in the immune homeostasis of the oral cavity, further contributing in the physiology of the gastro-intestinal microbiota. Understanding their involvement in the onset and pathogenesis of oropharyngeal cancers is paramount, despite very few reports deal with the fundamental role exerted by oral microbiota disorders, such as dysbiosis and impairment in the oral microbiome composition as causative factors in the development of oropharyngeal tumors. Current research, via metabolomic or meta-transcriptomic analyses, is wondering how this complex microbial population regulates the immune homeostasis in oral and pharyngeal mucosa and whether changes in bacterial composition may give insights on the role of oral microbiome in the development of oropharyngeal tumors, so to prevent their occurrence

The influence of growth hormone on pediatric body composition: A systematic review

Background: Growth hormone (GH) affects metabolism and regulates growth in childhood. The most prominent feature of GH deficiency (GHD) in children is diminished height velocity that eventually leads to short stature. In adult-onset GHD, lean body mass (LBM) is reduced, and visceral fat mass (FM) increased. Beneficial effects of GH treatment on body composition in adults with GHD, including an increase in muscle mass and a decrease in FM, are well established. Relatively few studies have investigated the effects of GH treatment on the body composition of pediatric patients with idiopathic or hypothalamic-pituitary disease-associated GH deficiency. This systematic review aimed to summarize available evidence relating to the effects of GH treatment on body composition in children with GHD. Methods: The PubMed, Science Direct, Cochrane Trials, and Embase databases, were searched with keywords including "GH", "body composition", "children", and "growth hormone" for English-language articles, published between January 1999 and March 2021. Two reviewers independently evaluated the search results and identified studies for inclusion based on the following criteria: participants had a confirmed diagnosis of GHD (as defined in each study); participants were pediatric patients who were receiving GH or had stopped GH treatment, regardless of whether they were pre- or post-pubertal; the intervention was recombinant human GH (rhGH; somatropin); and outcomes included changes in body composition during or after stopping GH therapy. Data extracted from each study included study quality, study sample characteristics, study interventions, and body composition. Data on fat-free mass and LBM were combined into a single category of LBM. Results: Sixteen studies reporting changes in body composition (i.e., FM and LBM) associated with GH treatment in children with GHD were identified and included in the review. Collectively, these studies demonstrated that FM decreased, and LBM increased in response to GH replacement therapy. Conclusion: Despite study limitations (i.e., potential effects of diet and physical activity were not considered), we concluded that a periodic body composition assessment is required to ensure that a satisfactory body composition is achieved during GH replacement therapy in children with GHD

Feasibility of preoperative planning using anatomical facsimile models for mandibular reconstruction

BACKGROUND: Functional and aesthetic mandibular reconstruction after ablative tumor surgery continues to be a challenge even after the introduction of microvascular bone transfer. Complex microvascular reconstruction of the resection site requires accurate preoperative planning. In the recent past, bone graft and fixation plates had to be reshaped during the operation by trial and error, often a time-consuming procedure. This paper outlines the possibilities and advantages of the clinical application of anatomical facsimile models in the preoperative planning of complex mandibular reconstructions after tumor resections. METHODS: From 2003 to 2005, in the Department of Maxillofacial Surgery of the University of Udine, a protocol was applied with the preoperative realization of stereolithographic models for all the patients who underwent mandibular reconstruction with microvascular flaps. 24 stereolithographic models were realized prior to surgery before emimandibulectomy or segmental mandibulectomy. The titanium plates to be used for fixation were chosen and bent on the model preoperatively. The geometrical information of the virtual mandibular resections and of the stereolithographic models were used to choose the ideal flap and to contour the flap into an ideal neomandible when it was still pedicled before harvesting. RESULTS: Good functional and aesthetic results were achieved. The surgical time was decreased on average by about 1.5 hours compared to the same surgical kind of procedures performed, in the same institution by the same surgical team, without the aforesaid protocol of planning. CONCLUSION: Producing virtual and stereolithographic models, and using them for preoperative planning substantially reduces operative time and difficulty of the operation during microvascular reconstruction of the mandible

Musicoterapia e controllo dell’ansia in ambito odontoiatrico

OBJECTIVES Among the anxiety disorders, den-tal anxiety (AD) – i.e., the abnormal fear of undergoing even minor dental treatments – represents a significant problem for oral health as such patients withdraw from adequate care and as the setting is deteriorated by the state of tension of the patient, which can hinder the normal execution of the proce-dures. Therefore, many more or less invasive methods have been proposed to remedy this problem, from intravenous sedation to con-scious sedation using nitrous ox-ide, hypnosis, or diazepines. This literature review aims to dis-cuss the current evidence on the efficacy of music therapy for con-trolling dental anxiety in adults. MATERIALS AND METHODS Medline, PubMed, Embase, Sco-pus, and Cochrane were searched. In addition, randomized controlled trials and quasi-experi-mental studies of adult outpatient participants from 1960 to 2020 were included in the review. The intervention considered was re-ceptive music therapy using headphones as a single interven-tion, experimented with a place-bo, relaxation, and pharmacologi-cal techniques. Outcomes were measured with various self-ad-ministered questionnaires and rating scales. RESULTS Sixteen articles were extracted from the initial pool of 471 studies. The results can be summarized as follows:-listening to music in head-phones (EMT) before and during dental procedures is as effective as a short pre-surgery relaxation session in AD control;-the use of EMT significantly re-duces the level of stress com-pared to other interventions;-the use of EMT with songs pre-ferred by the patient decreases intra-operative anxiety concern-ing the level of pre-operative anxiety, and there are decreased levels of heart rate, blood pres-sure, and respiratory rate;-the EMT with soothing piano music and volume control sig-nificantly reduces AD levels;-the EMT stabilizes pre-and in-tra-operative physiological pa-rameters and suppresses pre-and intra-operative anxiety-re-lated sympathetic activity;-432 Hz music seems to offer an extra edge over 440 Hz music. DISCUSSION There is extensive literature on the efficacy of a musical intervention in controlling anxiety in various medical conditions. The studies considered suggest the effective-ness of music in controlling dental anxiety, using headphones rather than loudspeakers, and allowing the patient to adjust the volume. No conclusive results emerged re-garding the preferability of a play-list chosen by the operator rather than the patient. What appears essential is the structured administration of the treatment and the collection of data that objectivize the results al-so in the eyes of the patient. The hypotheses on the effective-ness of EMT on AD are that: 1) mu-sic has a distracting effect, dis-tracting the patient from the ongo-ing experience; 2) music, especial-ly with noise-canceling head-phones, tends to eliminate all those noises experienced as threatening that are related to a dental session. CONCLUSIONS Music administered in the form of structured receptive music thera-py can be a helpful additional non-pharmacological intervention in the control of dental anxiety when administered in a structured manner and possibly modeled on the specific needs and tastes of the patient. However, further experimental re-search will be necessary to fully exploit this natural method’s mo-dalities, which can be readily available in all dental surgeries. CLINICAL SIGNIFICANCE Receptive music therapy applied structured during dental treat-ments significantly reduces anxi-ety in adults and represents a cheap, non-invasive, and easily applicable alternative in dental surgeries compared to current in-tervention

Local Administration of ElectroMagnetic Field as Add-On Therapy in the Treatment of Chronic Facial Pain: A Pilot Study

: Fibromyalgic syndrome and orofacial neuropathic pain are major public health concerns affecting up to 5% and 10%, respectively, of the general population. They generally require medications such as antidepressants and anticonvulsants, which may additionally impact the quality of life with their side effects. Modern technologies and related applications have changed several fields of human life, even in medicine. In the current study, the local administration of electromagnetic fields as add-on therapy for the treatment of cervical and facial pain in patients with fibromyalgia or neuropathic pain has been evaluated. A total of 15 patients were recruited, and an electromagnetic field was delivered through a small patch applied between C3 and C4. Patients were followed for 12 months, and pain levels were rated via the VAS scale; ∆% was calculated through the analysis of median VAS scale values at each time point. Mild-to-moderate improvements were found, especially after six months. Patients with fibromyalgic syndrome showed better response rates than those with orofacial neuropathic pain. Joint stiffness, masticatory fatigue, and sleep disturbances were also reduced. In conclusion, the local application of electromagnetic field appeared effective in treating fibromyalgic and neuropathic pain in the head and neck district, with broader improvements and no side effects

The role of fluoride tablets in the prophylaxis of dental caries. A literature review

Doing a meta-analysis to answer the question: “Does fluoride tablets prevent dental caries among children and adolescents?” A review of the literature is performed using the following databases: PubMed, Embase, CINAHL, Cochrane Library, Embase, NHS Evidence Oral Health, PsycINFO, Web of Knowledge, Metalib. The keywords used are dental fluoride, fluoride tablets. The studies analyzed was limited to English language with free abstract. For the studies selection was taken into consideration the criteria proposed by the Cochrane Oral Health Group. Few studies with good quality were identified in general. Only 3 out of 779 studies were acceptable. Evident disagreements among the results show that there’s a limited effectiveness on fluoride tablets