Clinical experience improves academic outcomes in dental Oral surgery education

Introduction

This paper aimed to determine if the level of a dental student's clinical experience in oral surgery influences the student's oral surgery academic outcomes.

Materials and Methods

The oral surgery clinical activity and academic outcomes for all students who completed their dental training in 2017, 2018, 2019 and 2020 from the University of Sydney were analysed for correlation.

Results

The clinical activity performed by 313 students was recorded. There was a weak, but statistically significant, Pearson correlation between total dental extractions and academic outcomes (r = .243, p = <.001). The total number of dental extractions performed was the only statistically significant variable on academic outcomes with linear regression analysis (β = .227, p = .005; model R² = .077). The increase of a student's clinical experience from less than 45 to more than 65 dental extractions raised their oral surgery academic results by an average of 6.4%. There were no academic benefits to earlier clinical experience.

Conclusion

An increase in experience with dental extractions resulted in an increase in oral surgery academic outcomes, plateauing at 65 dental extractions. There was no academic advantage to dental student's having earlier clinical experience.     

Examining the effects of early patient care and biomedical science integration on predoctoral dental student competence and confidence

Introduction

Our study investigates early experiential learning as a method of curricular integration by allowing students to begin their clinical experience in the first year of the programme, as well as distributing biomedical classes throughout the predoctoral dental school curriculum.

Materials and Methods

This study utilises a quasi-experimental design with two different groups, Standard Curriculum Group and Integrated Curriculum Group, n = 87. Data were collected from 2017 to 2021.

Results

We found that, on average, it took 608 h less for the participants in an integrated curriculum group to reach clinical competence in comparison to peers who did not experience the same methods of integration in their programme. These data were collected through daily faculty evaluations of students' progression as well as participants' own self-assessment. Our results indicate that participants in the Integrated Curriculum Group also experienced a positive effect on their confidence in their ability to apply the biomedical sciences to patient care.

Discussion/Conclusion

Our findings demonstrate that predoctoral dental programmes may be able to bring about positive outcomes for students' clinical confidence and competence by providing patient care opportunities early in the programme and sequencing the biomedical sciences throughout the curriculum. As such, it appears that early experiential learning may be a viable option for curricular integration that can have a positive effect on both students' confidence in their clinical abilities and their progression to clinical competence.     

Temporomandibular disorder symptoms and their association with quality of life,emotional states and sleep quality in South‐East Asian youths

Population studies on the prevalence of temporomandibular disorders (TMD) and their associations with quality of life (QoL), emotional states and sleep quality in South‐East Asian youths are not available. This cross‐sectional study assessed the presence of TMD and their relationships to QoL, depression, anxiety, stress and sleep quality in a cohort of South‐East Asian adolescents/young adults. Three hundred and sixty‐two students from a polytechnic were enrolled in the study and completed an online questionnaire consisting of the Fonesca's Anamnestic Index (FAI), Oral Health Impact Profile for TMD (OHIP‐TMD), Depression, Anxiety and Stress Scales‐21 (DASS‐21) and Pittsburgh Sleep Quality Index. The FAI appraises TMD severity while OHIP‐TMD determines the effect of TMD on oral health‐related QoL. Statistical analysis was performed using chi‐square test for categorical data whilst one‐way ANOVA/post hoc Bonferroni's tests were employed for numerical scores (P < 0.05). Of the 244 participants who completed the questionnaires in their entirety (37 males; 207 females, mean age 20.1 ± 3.2 years), 32.4% had mild TMD, 9.4% had moderate TMD and 58.2% were TMD free. The total prevalence of TMD was 41.8% (n = 102) and most OHIP‐TMD domains including functional limitation (P = 0.000), physical pain (P = 0.000), handicapped (P = 0.000) and psychological discomfort (P = 0.001) showed significant differences in mean scores depending on TMD severity. A similar trend was observed for DASS‐21. The majority of participants with TMD (69.6%; n = 71) had poor sleep quality (P = 0.004). TMD appear to be prevalent in South‐East Asian youths with varying severity. Severity of TMD had some bearing on QoL, emotional states as well as sleep quality.     

Epidemiological aspects of dental trauma associated with maxillofacial injures: Ten years of clinical experience in Trieste,Italy

Background/Aims

The prevalence of dental injuries in patients with facial fractures is relevant. Epidemiologically, dental trauma in association with facial fractures generally affects the age group between 20 and 40 years old, with a higher prevalence in males. The aim of this retrospective study was to identify the incidence and etiology of dental trauma associated with facial fractures over a 10-year period.

Methods

From January 2009 to April 2019, among 381 patients with facial fractures, 353 were included in this study. Age, gender, trauma etiology, injured teeth and dental treatment were investigated.

Results

From 353 patients, with a mean age of 49.7 ± 19.9 years, 247 (70%) were males and 106 (30%) were females. Accidental falls were the most common type of injury (n = 118, 33.4%), followed by road accidents (n = 90, 25.5%), assaults (n = 60, 17%) and sports trauma (n = 37, 10.5%). Fifty-five subjects (15.60%) had dental injuries associated with facial fractures. Of the 145 teeth involved, 48 (33.1%) were diagnosed with luxation, 22 teeth (15.2%) were avulsed, 11 teeth (7.5%) suffered a concussion and there were 10 (6.8%) alveolar wall fractures.Uncomplicated enamel-dentin fracture was the more frequent hard tissue injury (n = 21, 14.5%), followed by complicated crown-root fracture (n = 10, 6.9%), infraction (n = 8, 5.5%), enamel fracture (n = 3, 2%) and complicated enamel-dentin fracture (n = 3, 2%). There was a peak in incidence between 21 and 40 years (42%). Males had a significantly higher risk of facial fractures with dental injury (75%). Maxillary incisors and canines (62.8%) were the most affected teeth.

Conclusions

There was a high prevalence of dental injuries associated with facial fractures. Maxillary incisors were the most injured teeth, with a higher prevalence in males.     

‘Study of the maxillary yaw on cone beam computed tomography: A preliminary report and comparison between two different dento-skeletal malocclusions’

Objectives

To assess the skeletal and dental maxillary transverse compensation (yaw) on the cone beam computed tomography (CBCT) three-dimensional reconstructed image of the skull in two groups of patients, both clinically affected by a class III malocclusion with deviation of the lower midline.

Materials and Methods

An observational retrospective study was designed to analyse differences in two groups of patients, the first one was composed by patients affected by horizontal condylar hyperplasia, the second one by patients affected by dento-skeletal asymmetric class III malocclusion. Each group was composed by 15 patients. Transverse analysis was performed by measuring five landmarks (three bilateral and two uneven) with respect to a mid-sagittal plane; sagittal analysis was performed by measuring the sagittal distance on the mid-sagittal plane between bilateral points. Means were compared through inferential analysis.

Results

In the condylar hyperplasia group, all differences between the two sides were not statistically significant, nor for canines' difference (P = .0817), for molars (P = .1105) or for jugular points (.05871). In the class III group, the differences between the two sides were statistically significant for molars (P = .0019) and jugular points (P = .0031) but not for canines (P = .1158). Comparing the two groups, significant differences were found only for incisors' midline deviation (P = .0343) and canine (P = .0177).

Conclusion

The study of the yaw on CBCT should be integrated into three-dimensional cephalometry and could help in differentiating the various malocclusion patterns.     

Platelet indices (mean platelet volume and platelet distribution width) have correlations with periodontal inflamed surface area in coronary artery disease patients: A pilot study

1 Background

The plausible mechanisms regarding the relationship between periodontitis and coronary artery disease (CAD) has long been the focus of studies. This study aimed to test the hypothesis that higher periodontal inflamed surface area (PISA) values have positive correlations with increased complete blood parameters in patients with CAD.

2 Methods

Patients who underwent coronary angiography with a suspicion of CAD between the ages 30 to 75 years were included. Clinical periodontal parameters (probing depth [PD], clinical attachment loss, bleeding on probing) were recorded, and the participants were divided into four groups after the coronary angiography: group 1: CAD (+) with periodontitis (n = 20), group 2: CAD (+) without periodontitis (n = 20), group 3: CAD (‐) with periodontitis (n = 21), group 4: CAD (‐) without periodontitis (n = 16). Complete blood counts were analyzed regarding the differences and correlations between the investigated parameters.

3 Results

CAD (+) P (+) individuals had significantly higher platelet distribution width (PDW) values than the other groups (P < 0.0125). Positive lower correlations were found between PISA scores and mean platelet volume (MPV, P = 0.021, rho = 0.264), PISA and PDW (P = 0.240, rho = 0.036) in the whole study group; and moderate correlation between PD and red blood cell distribution width (RDW, P = 0.049, rho = 0.445) in CAD (‐) groups with/without periodontitis were found. Age was found to predict CAD with o lower OR (1.17, P < 0.01).

4 Conclusion

The results of the present study highlight some blood parameters (PDW, RDW, and MPV) in CAD patients with/without periodontitis in terms of the relationship between inflammatory diseases and their significant low and moderate correlations with PISA values.     

Association of temperament with dental anxiety and behaviour of the preschool child during the initial dental visit

The aim of this study was to investigate whether there is an association between temperament characteristics of preschool children, dental anxiety, and their dental behaviour. A total of 100 children, aged 3–5 yr, who were attending their initial dental visit accompanied by a parent, were included in this cross‐sectional study. Dental anxiety of children was measured using the Facial Image Scale. The behaviour of children during the initial oral examination and oral prophylaxis was assessed using Frankl's behaviour rating scale. Temperament was assessed using Emotionality, Activity, Shyness Temperament Survey for Children (parental ratings). Statistically significant weak linear positive correlations were seen between the following: the percentage duration of definitely negative behaviour and shyness scores (r_s = 0.28); anxiety level and emotionality scores (r_s = 0.28); and anxiety level and shyness scores (r_s = 0.26). Multinomial logistic regression analysis revealed that children with higher anxiety had higher odds of showing definitely negative behaviour, which decreased with increasing age of the child. Emotionality and shyness temperaments may be weakly associated with dental anxiety, and shyness may be weakly associated with the dental behaviour of the preschool child. Definitely negative dental behaviour is associated with dental anxiety and age of the child.     

Are we passing the acceptable? Standard setting of theoretical proficiency tests for foreign-trained dentists

Introduction

Dentists educated outside the EU, EEA and Switzerland have the option to undergo proficiency testing to practice dentistry in Sweden. A standardised evidence-based procedure for proficiency tests is crucial. This paper explores if the standard setting of the theoretical examination in the Swedish proficiency test for foreign dentists is fit to differentiate candidates who meet the acceptable standard for licensure from those who do not, by analysis of inter-rater reliability and credibility of Angoff panels and the test's ability to differentiate candidates regarding learning outcomes and dental disciplines.

Materials and Methods

In a cohort study design, test results were collected from seven examinations during 2018–2019 (n = 316), combined with Angoff judgements and demographic data from The National Board of Health and Welfare. Intraclass correlation, Pearson correlation and linear regression were calculated.

Results

All exams demonstrated substantial judge inter-rater reliability using the Angoff procedure (0.65–0.82). Item difficulty predicted by the expert panels showed significant positive correlations with the item difficulty by candidate results (0.69–0.77). Candidates who did not meet the requirements for pass mark in the theoretical test revealed a significantly reduced performance overall in professional qualifications (i.e., learning outcomes) and reduced performance within dental disciplines.

Conclusions

The results indicate that a modified Angoff method is a feasible, simple, and defensible method for setting the pass mark for the theoretical examinations. The standard setting appears to differentiate candidates who do not meet the requirements of the professional qualifications of the dental degree. Adjustments could be undertaken to further discriminate for competence within single dental disciplines.     

The German version of the Child Perceptions Questionnaire (CPQ-G11-14): translation process, reliability, and validity in the general population

The aims of this study were to develop a German version of the Child Perceptions Questionnaire (CPQ11-14, a measure of oral health-related quality of life in 11–14-year-old children) and to assess the instrument’s reliability and validity in German children ages 11–14. The English original version of the CPQ11-14 questionnaire was translated into German (CPQ-G11-14) by a forward–backward translation method. Reliability was investigated in 1,061 subjects aged 11–14 years from a regional sample (Wernigerode, Saxonia-Anhalt, Germany) who were recruited during the annual dental public health examination. The subjects completed the CPQ-G11-14 and were clinically examined for the presence of dental caries, plaque accumulation, and malocclusion. In the reliability assessment, questionnaire summary score test–retest reliability was excellent (intraclass correlation coefficient, 95% confidence interval (CI) = 0.83, 0.73–0.94) and internal consistency was satisfactory (Cronbach’s alpha, lower limit of CI = 0.87, 0.86). Validity of the CPQ-G11-14 questionnaire was supported by correlations with global ratings of oral health and overall well-being that were moderate in magnitude and met expectations (r = 0.35; 95% CI, 0.30–0.40 and r = 0.30; 95% CI, 0.24–0.35, respectively). In conclusion, the German version of the CPQ11-14 was reliable and valid in a general population of 11–14-year-old German children.     

Major Stress Sources Amongst Dental Students at Damascus University,Syria

IntroductionStress amongst dental students is frequently reported. Various environmental, socioeconomic, and cultural factors affect students’ perceived stress levels. The aim of this study was to investigate stress levels and sources amongst undergraduate dental students at Damascus University, Syria.MethodsA cross-sectional design was used. A questionnaire was undertaken in 2019 at the Faculty of Dentistry at Damascus University. Students participated voluntarily in the survey. The sample comprised students at the preclinical and clinical stage. A modified 29-item version of the validated Dental Environmental Stress (DES) questionnaire with a 5-point scale (1 = not stressful to 5 = extremely stressful) was used as the measurement tool. Ethical approval was granted by Damascus University.ResultsIn all, 365 students participated in the study, with a response rate of 96% (365/379). Cronbach's alpha was 0.83, indicating good reliability of the measurement tool. The overall mean score of the perceived stress was 2.64 (95% confidence interval [CI], 2.5-2.7). The mean scores for clinical factors, academic work, educational environment, personal factors, and living accommodation were 3.22 (95% CI, 3.1-3.3), 3.17 (95% CI, 3.1-3.2), 2.99 (95% CI, 2.9-3.0), 2.15 (95% CI, 2.1-2.2), 2.15 (95% CI, 2.0-2.2), respectively. The specific stressors with the highest mean scores were lack of dental equipment and difficulty in finding requested clinical cases; the respective means were 4.1 (95% CI, 4.0-4.2) and 3.9 (95% CI, 3.8-4.0).ConclusionsThe findings revealed moderate stress levels amongst students. The major stress factors pertained to stressors from the clinical, academic, and educational environment domains. Certain clinical and environmental stressors, such as difficulty in finding clinical cases and lack of dental equipment, were more powerful than the strongest academic stressors, such as examinations and grades and amount of assigned work.     

Structures,processes and outcomes of objective structured clinical examinations in dental education during the COVID-19 pandemic: A scoping review

Introduction

Objective structured clinical examinations (OSCEs) are an essential examination tool within undergraduate dental education. Fear of spread of the COVID-19 virus led to dental institutions exploring alternative means of conducting OSCEs. The aim of this scoping review was to investigate what structures, processes and outcomes of dental OSCEs were reported during the COVID-19 pandemic.

Materials and Methods

This scoping review was conducted and reported adhering to the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review guidelines (PRISMA-ScR). Published literature was identified through a systematic search of PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Resources Information Center (Eric), ProQuest and Google Scholar. Identified articles were independently reviewed by two authors (KS, AD), followed by synthesis in terms of the reported structures, processes and outcomes. Articles reporting cancellation or rescheduling were also included, extracting data on reasons and any suggestions/recommendations.

Results

The search yielded a total of 290 studies of which 239 sources were excluded after removal of duplicates, leaving 51 studies for title and abstract evaluation. Thirty-four articles were excluded as they did not report on the topic of interest, leaving 17 for full-text evaluation, of which nine were analysed according to the pre-set themes. All dental OSCEs taking place (n = 6) were conducted online whilst the remaining (n = 3) were either cancelled or rescheduled. Data on structures reported specific online videoconferencing software used and provision of staff and student training. Processes on the execution of online OSCEs varied significantly from one study to the other, providing rich data on how dental institutions may carry out such assessments tailored to their need. Information regarding outcomes was sparse, as little attention was paid to the results of the students compared to pre-pandemic, lacking investigation into reliability and validity of online dental OSCEs.

Conclusion

Dental OSCEs could be conducted online implementing well-planned structures and processes; however, further evidence is needed to prove its reliability and validity based on outcomes. Dental institutions may need to consider alternative methods to assess practical competencies if online OSCEs are to take place.     

Academic distress,perceived stress and coping strategies among dental students in Saudi Arabia

ObjectivesTo evaluate the sources of stress among students in the dental school environment, their perceived levels of stress and effective coping strategies.MethodsThis study was conducted during the first semester of the academic year, 2009–10, at the College of Dentistry, King Saud University, Saudi Arabia. The eligible study group consisted of 556 undergraduate dental students from all five class years; they were surveyed with a detailed assessment tool. The validated and translated questionnaire comprised the modified version of the dental environmental stress (DES) survey, the perceived stress scale (PSS) and the brief coping scale (BCS).ResultsThe overall findings substantiated with multiple regression indicate that, out of 20 factors of both DES and BC instruments, six factors were significantly and independently related to perceived stress scores (F = 34.638; p < 0.0001). Especially, the factors self-efficacy and workload of DES and the factors behavioral disengagement, denial, positive reframing and venting of BC were positively and independently related to perceived stress scores.ConclusionsDental students displayed relatively high perceived stress scores. Female, advanced and married, compared with male, junior and single students reported more stress. Changes in certain environmental factors and coping strategies independently affected the perceived stress score. Strategies for stress management must be incorporated into dental education to ensure the output of effective dentists.     

Investigation of factors that influence pain experienced and the use of pain medication following periodontal surgery

Aims

To determine the relationship between anticipated pain and actual pain experienced following soft tissue grafting or implant surgery; to identify the factors that predict actual pain experienced and the use of pain medication following soft tissue grafting or implant surgery.

Materials and Methods

Prior to dental implant placement (n = 98) or soft tissue grafting (n = 115) and for seven days following the procedure, patients completed a visual analog scale indicating anticipated or experienced pain, respectively. The use of pain medication and alcohol, and smoking were measured.

Results

Actual pain experienced on day 1 was lower (p < .01) than anticipated pain and continued to decrease (p ≤ .01) for each of the 7 consecutive days. Anticipated and actual pain were positively correlated. Increasing age (p < .05), having sedation during the surgery (p < .05), and lower use of pain pills (p < .01) predicted lower pain experienced. Actual pain experienced was a predictor of pain pill use (p < .01). Greater nervousness (p < .01) prior to surgery was a predictor of greater anticipated pain.

Conclusions

Patients anticipated more pain than they actually experienced. Sedation, age and number of pain pills used predicted pain experienced. This trial was registered with clinicaltrials.gov as NCT03064178.     

Disparity in embrasure fill and papilla height between tooth‐ and implant‐borne fixed restorations in the anterior maxilla: a cross‐sectional study

Purpose

The objective of the present study was to compare inter‐proximal fill and papilla height between different embrasures.

Material & Methods

One hundred and fifty non‐smoking consecutive patients (mean age 54, range 32–73; 63 males and 87 females) without periodontal disease were selected in a multidisciplinary practice during regular supportive care. All had been treated for multiple tooth loss in the anterior maxilla at least 1 year earlier by means of a fixed restoration on teeth (n = 50) or implants (n = 100) using straightforward procedures (without hard and/or soft tissue augmentation). Embrasure fill was assessed by means of Jemt's papilla index and papilla height was registered following local anaesthesia by means of bone sounding by one clinician.

Results

Tooth‐pontic and tooth‐implant embrasures demonstrated comparable inter‐proximal fill and papilla height (≥58% Jemt's score 3; mean papilla height ≥4.1 mm). Between missing teeth, embrasure fill and papilla height were lower regardless of the embrasure type. The implant‐implant and implant‐pontic embrasure demonstrated comparable outcome (≤42% Jemt's score 3; mean papilla height ≤ 3.3 mm; p ≥ 0.416), which was significantly poorer when compared to the pontic‐pontic embrasure (82% Jemt's score 3; mean papilla height 3.7 mm; p ≤ 0.019). Overall, papilla index and papilla height demonstrated a weak correlation (Spearman's correlation coefficient: 0.198; p = 0.002).

Conclusions

The re‐establishment of a papilla is difficult when there is no tooth involved. In that scenario a short papilla should be expected and implant‐borne restorations demonstrate the poorest outcome. Moreover, an implant with a pontic may not perform better than adjacent implants.     

Alterations in the primary teeth of children with microcephaly in Northeast Brazil: a comparative study

Background

The outbreak of microcephaly between 2015 and 2017 in Brazil created an international public health emergency.

Aim

This study sought to evaluate the chronology, sequence of eruption, and the presence of anomalies amongst children with microcephaly compared with normoreactive children.

Design

A comparative study of 108 children aged 0–2 years attending public services was conducted. The microcephaly group (MG; n = 54) and the nonmicrocephaly group (NMG; n = 54) were matched by age, gender, and family income at a 1 : 1 ratio. Erupted teeth and the presence of anomalies were evaluated and compared. Chi‐square tests, Pearson's correlations, Fisher's exact tests, and Student's t‐tests were applied (α = 0.05).

Results

No between‐group differences were found with regard to gender (P = 0.560) or age (P = 0.529). The MG presented with a higher percentage of alterations in eruption sequence, opacity, self‐injury, and delayed eruption compared with the NMG (P < 0.05). The MG was more likely to exhibit changes in tooth eruption sequence (OR = 12.23, 95% CIs = 3.25–46.03, P < 0.001), delayed eruption (OR = 23.12; 95% CIs = 7.09–75.40, P < 0.001), and opacity (n = 12.19, 95% CIs = 1.44–103.28, P = 0.022) than the NMG.

Conclusion

Children with microcephaly present with greater delays in chronology, alterations in eruption sequence, and enamel defects than normoreactive children.

     

Validity of the Oral Behaviours Checklist: correlations between OBC scores and intensity of facial pain

The first purpose of this study was to translate the Oral Behaviours Checklist (OBC) into Dutch and to examine its psychometric properties. The second purpose was to examine the correlations between scores on the OBC and facial pain, while controlling for the possible confounding effects of psychosocial factors, such as stress, depression, somatisation and anxiety. The OBC was translated, following the international RDC/TMD consortium guidelines. Its psychometric properties were examined by assessing the test–retest reliability and concurrent validity [correlations between the OBC and the previously developed Oral Parafunctions Questionnaire (OPQ)]. Participants were 155 patients with TMD (77% female; mean age and s.d. = 43·6 and 14·4 years). The translation of the OBC into Dutch proceeded satisfactorily. The psychometric properties of the Dutch OBC were good; test–retest reliability was excellent (ICC = 0·86, P < 0·001). Concurrent validity was good: the correlation between the OBC and OPQ was high (r = 0·757, P < 0·001), while the correlations between individual items ranged from 0·389 to 0·892 (P < 0·001). Similar to previous Dutch studies using the OPQ, no significant correlation was found between oral parafunctions and facial pain (r = 0·069, P = 0·892). No significant correlations could be found between oral parafunctional behaviours and facial pain.     

Association of dental caries and salivary sIgA with tobacco smoking

Background

Salivary secretory IgA (sIgA) is said to play an important role in the immune response against dental caries. This study aimed to determine the salivary sIgA levels in healthy smokers and non‐smokers, and its correlation with dental caries.

Methods

A total of 70 healthy subjects were selected and classified into four groups according to dental caries and tobacco smoking habits: smoking with caries (Group 1, n = 15); smoking without caries (Group 2, n = 15); non‐smoking with caries (Group 3, n = 15); and non‐smoking without caries (Group 4, n = 25). Salivary sIgA was measured using ELISA. The fissure and proximal caries were examined clinically and radiographically. Caries status was determined according to the decay surface index.

Results

Smokers showed a higher number of caries and the lowest concentration of sIgA. The highest levels of sIgA were observed in non‐smoking and caries‐free subjects compared to caries‐active smokers (123.2 ± 19.9 vs. 13.3 ± 4.1 μg/ml respectively, p < 0.001). Also, the mean level of sIgA in Group 4 was significantly higher than Group 3 (p = 0.009). More importantly, higher and significant levels of sIgA were found in Group 3 versus Group 1 (p < 0.0001) and Group 2 (p = 0.0004).

Conclusions

Our findings indicate that low concentrations of salivary sIgA are correlated with a higher prevalence of dental caries in smokers.     

Comparison between digital and conventional impression techniques in children on preference,time and comfort: A crossover randomized controlled trial

Objective

To compare the conventional alginate impression and the digital impression taken with an intraoral scanner of both dental arches in children, using a randomized crossover design.

Trial Design

This is a monocentric, controlled, superiority, randomized, crossover, open study.

Methods

Twenty-four orthodontic patients between 6 and 11 years of age underwent intraoral scanning (TRIOS 3; 3Shape) and alginate impression of both dental arches with an interval of 1 week between the two procedures. Participants were recruited from September 2021 to March 2022 and the study was completed in April 2022. Impression time for the two procedures was compared. Patients were asked which one of the two impression procedures they preferred. A questionnaire including Visual Analogue Scale (VAS) for comfort, pain, gag reflex and difficulty in breathing, was administered to the patients.

Results

Eighteen out of 24 patients preferred digital impression (75%, 95% confidence interval [CI]: 55% to 88%; P = .014). Scanning time was significantly shorter than alginate impression time (difference −118 seconds; 95% CI: −138 to −99; P < .001). Comfort was significantly higher for digital impression (difference 1.7; 95% CI: 0.5 to 2.8; P = .007). There was no difference in pain (difference −0.2; 95% CI: −1.5 to 1.0; P = .686) while gag reflex and breathing difficulties were smaller for digital impression (gag reflex difference −2.5; 95% CI: −4.0 to −0.9; P = .004 and breathing difficulties difference −1.5; 95% CI: −2.5 to −0.5; P = −.004).

Conclusions

Digital impression is preferred by children aged 6–11 years and it is significantly faster in acquisition time than conventional alginate impression.

Registration

The study was registered on ClinicalTrials.gov with registration number NCT04220957 on January 7th, 2020 ( https://clinicaltrials.gov/ct2/show/NCT04220957 ).     

Factors associated with pain and analgesic consumption following non‐surgical periodontal therapy under local anaesthesia and carried out by dental students

Aim

Evaluate factors associated with pain and analgesic consumption following non‐surgical periodontal therapy.

Materials and methods

The sample consisted of 218 patients with chronic periodontitis, submitted to non‐surgical scaling and root planing under local anaesthesia at a public dental service in southern Brazil. The data collection instruments included a demographic questionnaire, as well as State‐Trait Anxiety Inventory, Corah?s Dental Anxiety Scale, Visual Analogue Scale, Numerical Rating Scale and Verbal Rating Scale. The presence and intensity of pain were evaluated at 2, 6, 12, 24 and 48 hr after scaling and root planing.

Results

A total of 52.3% of the patients reported mild intensity pain at some point during the 48 hr after scaling and root planing with local anaesthesia. Smoking (PR = 1.47; 95% CI = 1.16–1.65), severe periodontal inflammation (PR = 1.31; 95% CI = 1.09–1.58) and dental anxiety (PR = 1.24; 95% CI = 1.03–1.49) were associated with postoperative pain after adjusting for age, gender and state and trait anxiety scores. Moreover, 46.8% of the subjects used analgesics at some time during the 48‐hr follow‐up period and dental anxiety was the only factor associated with postoperative analgesic use.

Conclusions

Smoking, severe periodontal inflammation and dental anxiety were identified as factors associated with pain after non‐surgical scaling and root planing with local anaesthesia. Dental anxiety was also a factor associated with postoperative analgesic use.