Concordancia interexaminador de hallazgos periodontales utilizando radiografía periapical convencional

Introducción: la enfermedad periodontal afecta más de la mitad de la población en Colombia siendo estimada una de las primeras causas de morbilidad oral. Las ayudas diagnósticas que permitan la evaluación  de su extensión y severidad resultan de importancia puesto que así se tendrán herramientas confables para cuantifcar la gravedad del problema. Objetivo: determinar la concordancia interexaminador para  la detección de hallazgos radiográfcos en pacientes con periodontitis crónica localizada empleando radiografía periapical convencional. Métodos: estudio de pruebas diagnósticas incluyendo pacientes con periodontitis crónica localizada, sobre el diente con peor nivel de inserción clínico y a través de una sola radiografía convencional por órgano dentario empleando técnica de paralelismo. Las valoraciones radiográfcas fueron realizadas por dos evaluadores independientes y cegados para los hallazgos: lámina dura, defectos óseos y tipo de defecto. El acuerdo obtenido se estimó a través de Kappa de Cohen. Resultados: se tomaron en total 125 radiografías. La edad promedio fue 38,8±9,9 años, y 61,6% eran mujeres. La concordancia para lámina dura fue 0,08 (IC 95 %: -0,04 – 0,21), defectos óseos 1,00 (IC 95 %: 1,00 – 1,00); tipo de defecto presente 0,31 (IC 95 %: 0,29 – 0,38). Conclusiones: la concordancia se evaluó como nula, casi perfecta y aceptable para los hallazgos lámina dura, presencia de defectos óseos y tipo de defecto respectivamente. Para algunos hallazgos y dada la importancia de los procesos diagnósticos y terapéuticos se necesitan valoraciones más exactas que se traduzcan en un mayor grado de acuerdo.Introduction: periodontal disease affects more than 50% of the Colombian population being considered as one of the main causes of oral morbidity. Diagnostic tests that could evaluate its extension and severity are important since we can account then for reliable tools to quantify the disease severity. Objetive: To estimate the interrater reliability for the detection of radiographic fndings in chronic periodontitis patients using conventional periapical radiography. Methods: It was performed a diagnostic test study including patients diagnosed with untreated localized chronic periodontitis including the worst prognosis tooth and performing a single conventional radiography using parallelism technique. We assigned a code for each radiograph and two independent and blinded assessors performed radiographic measurements for the following fndings: lamina dura, presence of bone defects and defect type. Agreement evaluation was performed through Cohen’s Kappa statistic. Results: We evaluated 125 radiographs. Average age was 38,8±9,9 years from whose 61,6 % were female patients. Reproducibility for lamina dura was 0,08 (95% CI: -0,04 – 0,21); bone defects 1,00 (95% CI: 1,00 – 1,00) and type of bone defects 0,31 (95% CI: 0,29 – 0,38). Conclusions: reliability for lamina dura assessment was considered null, for bone defects almost perfect while for type of bone defect acceptable. For some fndings it is necessary accurate assessments, which could refect higher agreement due to the importance of diagnostic and treatment plan establishment.&nbsp

Children's oral health-related behaviours and early childhood caries: A latent class analysis

Objective: In this cross-sectional study in a large community-based sample of preschool-age children, we sought to identify distinct clusters of modifiable early childhood oral health-related behaviours (OHBs) and quantify their association with clinical and parent-reported measures of early childhood oral health. Methods: We relied upon a questionnaire (n = 8033; 11% in Spanish) and clinical oral health data (n = 6404; early childhood caries [ECC] prevalence = 54%] collected in the context of an epidemiologic study of early childhood oral health among 3- to 5-year-old children in North Carolina. Latent class analysis was used to identify clusters of modifiable OHBs based on parents' responses to 6 questionnaire items pertaining to their children's oral hygiene, diet and dental home. The optimal number of clusters was determined based on measures of model fit and interpretability. We examined associations of OHB clusters with clinical and parent-reported child oral health status (ie, ECC prevalence, severity and proportion with untreated disease) using bivariate association tests and multivariable regression modelling with marginal effects estimation accounting for clustered data. We used Mplus v.8.6 (Muthén & Muthén, Los Angeles, CA, USA) and Stata v.16.1 (StataCorp, College Station, TX, USA) for data analyses. Results: We identified 2 OHB clusters, a favourable (74%) and an unfavourable (26%) one. Children in the favourable OHB cluster had better oral hygiene practices (ie, tooth brushing frequency and fluoridated toothpaste use), lower consumption frequency of sugar-containing snacks and beverages, less frequent reports of night-time bottle-feeding history and a higher likelihood of a dental home. Children in the unfavourable cluster had significantly higher ECC prevalence (57% vs 53%), caries burden (mean dmfs = 9.3 vs 7.6), untreated disease (43% vs 33%) and worse parent-reported oral health status than the favourable cluster. Conclusions: Our findings demonstrate the importance and utility of clustering common, modifiable ECC risk factors in population studies - health promotion efforts may centre on groups of people rather than individual behavioural risk factors

Pediatric patients’ reasons for visiting dentists in all WHO regions

Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the four oral healthrelated quality of life (OHRQoL) dimensions (4D) or areas in which oral disorders impact pediatric patients. Using their dentists’ assessment, the study aimed to evaluate whether pediatric dental patients’ oral health concerns ft into the 4D of the Oral Health-Related Quality of Life (OHRQoL) construct.Dentists who treat children from 32 countries and all WHO regions were selected from a web-based survey of 1580 international dentists. Dentists were asked if their pediatric patients with current or future oral health concerns ft into the 4D of the Oral Health-Related Quality of Life (OHRQoL) construct. Proportions of all pediatric patients’ oral health problems and prevention needs were computed

Guardians’ Self-Reported Fair/Poor Oral Health Is Associated with Their Young Children’s Fair/Poor Oral Health and Clinically Determined Dental Caries Experience

In this cross-sectional, community-based study among a multi-ethnic sample of preschool-age children in North Carolina, United States, we sought to quantify the association between guardians’ self-reported oral health and their children’s oral health and determine whether race/ethnicity and education level modify these associations. We used questionnaire (n = 7852) responses about caregivers’ and their children’s oral health and clinical examination-derived (n = 6243) early childhood caries (ECC) status defined at the ICDAS ≥ 3 caries lesion detection threshold. We used multi-level mixed-effects generalized linear models to examine the associations between the guardians’ reported oral health and their children’s reported and clinically determined oral health among the entire sample and within strata of race/ethnicity, guardians’ education, and children’s dental home. The guardians’ and their children’s reported fair/poor oral health (FPOH) were 32% and 15%, respectively, whereas 54% of the children had ECC and 36% had unrestored disease. The guardians’ FPOH was strongly associated with their children’s FPOH (average marginal effect (AME) = +19 percentage points (p.p.); 95% CI = 17–21), and this association was most pronounced among Hispanics, lower-educated guardians, and children without a dental home. Similar patterns, but smaller-in-magnitude associations, were found for the guardians’ FPOH and their children’s clinically determined ECC (AME = +9 p.p.; 95% CI = 6–12) and unrestored disease (AME = +7 p.p.; 95% CI = 4–9). The study’s findings support a strong association between guardians’ and their children’s reported and clinically determined oral health and implicate ethnicity, education, and having a dental home as factors possibly modifying the magnitude of these associations

A Web-Based Rendering Application for Communicating Dental Conditions

The importance of visual aids in communicating clinical examination findings or proposed treatments in dentistry cannot be overstated. Similarly, communicating dental research results with tooth surface-level precision is impractical without visual representations. Here, we present the development, deployment, and two real-life applications of a web-based data visualization informatics pipeline that converts tooth surface-level information to colorized, three-dimensional renderings. The core of the informatics pipeline focuses on texture (UV) mapping of a pre-existing model of the human primary dentition. The 88 individually segmented tooth surfaces receive independent inputs that are represented in colors and textures according to customizable user specifications. The web implementation SculptorHD, deployed on the Google Cloud Platform, can accommodate manually entered or spreadsheet-formatted tooth surface data and allows the customization of color palettes and thresholds, as well as surface textures (e.g., condition-free, caries lesions, stainless steel, or ceramic crowns). Its current implementation enabled the visualization and interpretation of clinical early childhood caries (ECC) subtypes using latent class analysis-derived caries experience summary data. As a demonstration of its potential clinical utility, the tool was also used to simulate the restorative treatment presentation of a severe ECC case, including the use of stainless steel and ceramic crowns. We expect that this publicly available web-based tool can aid clinicians and investigators deliver precise, visual presentations of dental conditions and proposed treatments. The creation of rapidly adjustable lifelike dental models, integrated to existing electronic health records and responsive to new clinical findings or planned for future work, is likely to boost two-way communication between clinicians and their patients

Frequency of Four-dimensional Oral Health Problems across Dental Fields - a Comparative Survey of Slovenian and International Dentists.

Objectives To compare the frequency of patients' oral health problems and prevention needs among Slovenian and international dentists with the aim to validate the four oral health-related quality of life (OHRQoL) dimensions across six clinical dental fields in all World Health Organization (WHO) regions. Methods An anonymous electronic survey in the English language was designed using Qualtrics software. A probability sampling for Slovenia and a convenience sampling strategy for dentist recruitment was applied for 31 countries. Dentists engaged in six dental fields were asked to categorize their patients' oral health problems and prevention needs into the four OHRQoL dimensions (Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact). Proportions of patients' problems and prevention needs were calculated together with the significance of Slovenian and international dentists' differences based on dental fields and WHO regions. Results Dentists (n=1,580) from 32 countries completed the survey. There were 223 Slovenian dentists (females: 68%) with a mean age (SD) of 41 (10.6) years and 1,358 international dentists (females: 51%) with a mean age (SD) of 38 (10.4). Pain-related problems and prevention needs were the most prevalent among all six dental fields reported by dentists; Slovenian (37%) and 31 countries (45%). According to Cohen, differences between Slovenia, the broader European Region, and 31 countries were considered non-significant (<0.1). Conclusion According to the dentists' responses, the frequency of patients' oral health problems and prevention needs are proportionate between Slovenia and 31 countries, regionally and globally. The four OHRQoL dimensions can be considered universal across all dental fields

Cohort Profile: ZOE 2.0—A Community-Based Genetic Epidemiologic Study of Early Childhood Oral Health

Early childhood caries (ECC) is an aggressive form of dental caries occurring in the first five years of life. Despite its prevalence and consequences, little progress has been made in its prevention and even less is known about individuals&rsquo; susceptibility or genomic risk factors. The genome-wide association study (GWAS) of ECC (&ldquo;ZOE 2.0&rdquo;) is a community-based, multi-ethnic, cross-sectional, genetic epidemiologic study seeking to address this knowledge gap. This paper describes the study&rsquo;s design, the cohort&rsquo;s demographic profile, data domains, and key oral health outcomes. Between 2016 and 2019, the study enrolled 8059 3&ndash;5-year-old children attending public preschools in North Carolina, United States. Participants resided in 86 of the state&rsquo;s 100 counties and racial/ethnic minorities predominated&mdash;for example, 48% (n = 3872) were African American, 22% white, and 20% (n = 1611) were Hispanic/Latino. Seventy-nine percent (n = 6404) of participants underwent clinical dental examinations yielding ECC outcome measures&mdash;ECC (defined at the established caries lesion threshold) prevalence was 54% and the mean number of decayed, missing, filled surfaces due to caries was eight. Nearly all (98%) examined children provided sufficient DNA from saliva for genotyping. The cohort&rsquo;s community-based nature and rich data offer excellent opportunities for addressing important clinical, epidemiologic, and biological questions in early childhood

Why Patients Visit Dentists – A Study in all World Health Organization Regions

The dimensions of oral health-related quality of life (OHRQoL) Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the major areas where patients are impacted by oral diseases and dental interventions. The aim of this study was to evaluate whether dental patients' reasons to visit the dentist fit the 4 OHRQoL dimensions