Open AccessReview
Human Gingival Crevicular Fluids (GCF) Proteomics: An Overview
Dent. J. 2017, 5(1), 12; doi:10.3390/dj5010012 -
Abstract
Like other fluids of the human body, a gingival crevicular fluid (GCF) contains proteins, a diverse population of cells, desquamated epithelial cells, and bacteria from adjacent plaque. Proteomic tools have revolutionized the characterization of proteins and peptides and the detection of early disease
[...] Read more.
Like other fluids of the human body, a gingival crevicular fluid (GCF) contains proteins, a diverse population of cells, desquamated epithelial cells, and bacteria from adjacent plaque. Proteomic tools have revolutionized the characterization of proteins and peptides and the detection of early disease changes in the human body. Gingival crevicular fluids (GCFs) are a very specific oral cavity fluid that represents periodontal health. Due to their non-invasive sampling, they have attracted proteome research and are used as diagnostic fluids for periodontal diseases and drug analysis. The aim of this review is to explore the proteomic science of gingival crevicular fluids (GCFs), their physiology, and their role in disease detection. Full article
Figures

Open AccessArticle
The Association between Postgraduate Studies, Gender and Qualifying Dental School for Graduates Qualifying from UK Dental Schools between 2000 and 2009
Dent. J. 2017, 5(1), 11; doi:10.3390/dj5010011 -
Abstract
Various factors will influence a dental graduate’s decision to undertake postgraduate education and training, including encouragement from family, partners and staff at individual dental schools, although there is currently little information available regarding the number and distribution (by dental school) of recent dental
[...] Read more.
Various factors will influence a dental graduate’s decision to undertake postgraduate education and training, including encouragement from family, partners and staff at individual dental schools, although there is currently little information available regarding the number and distribution (by dental school) of recent dental graduates undertaking postgraduate studies. The aim of this study was to analyse data on postgraduate qualifications achieved by dentists who graduated from UK dental schools between 2000 and 2009 and relate this to graduate gender. Data were collected from the General Dental Council (GDC) in an anonymous electronic format, analysed and ordered by year of graduation, dental school, gender and type of postgraduate qualification. Nearly one-quarter (24%) of the dentists that graduated between 2000 and 2004 completed postgraduate studies, with more females (26%) than males (23%) obtaining further postgraduate qualifications. Overall, Bristol produced the largest proportion of graduates completing postgraduate study (39%) and of these the largest proportion of female graduates (45%). Glasgow produced the largest proportion of male graduates completing postgraduate study (37%). Membership of the Faculty of Dental Surgery (MFDS), one of the Royal Colleges, was the most popular postgraduate qualification obtained followed by Membership of the Faculty of General Dental Practitioners UK (MFGDP). This study provides insight into postgraduate studies undertaken by UK dental graduates. An increasing proportion of females are gaining Bachelor of Dental Surgery (BDS) qualifications and therefore the number of female dental graduates obtaining postgraduate qualifications is likely to increase further. This also suggests the male domination of the dental profession is likely to decrease. Full article
Figures

Figure 1

Open AccessCase Report
Unexpected Hazards with Dental High Speed Drill
Dent. J. 2017, 5(1), 10; doi:10.3390/dj5010010 -
Abstract
An expected accident can happen at any time during a routine practice in the dental office due to the types of instruments used. One of the instruments used in routine dental practice is a high speed drill and a bur. If Personal Protective
[...] Read more.
An expected accident can happen at any time during a routine practice in the dental office due to the types of instruments used. One of the instruments used in routine dental practice is a high speed drill and a bur. If Personal Protective Equipment (PPE) is not practiced at any time in the dental office, very serious injuries could easily happen to the clinician, staff or to the patient. Full article
Figures

Figure 1

Open AccessArticle
Modified Glass Ionomer Cement with “Remove on Demand” Properties: An In Vitro Study
Dent. J. 2017, 5(1), 9; doi:10.3390/dj5010009 -
Abstract
Objectives: To investigate the influence of different temperatures on the compressive strength of glass ionomer cement (GIC) modified by the addition of silica-coated wax capsules; Material and Methods: Commercially-available GIC was modified by adding 10% silica-coated wax capsules. Test blocks were fabricated from
[...] Read more.
Objectives: To investigate the influence of different temperatures on the compressive strength of glass ionomer cement (GIC) modified by the addition of silica-coated wax capsules; Material and Methods: Commercially-available GIC was modified by adding 10% silica-coated wax capsules. Test blocks were fabricated from pure cement (control) and modified cement (test), and stored in distilled water (37 °C/23 h). The compressive strength was determined using a universal testing machine under different temperatures (37 °C, 50 °C, and 60 °C). The maximum load to failure was recorded for each group. Fractured surfaces of selected test blocks were observed by scanning electron microscopy (SEM); Results: For the control group, the average compressive strength was 96.8 ± 11.8, 94.3 ± 5.7 and 72.5 ± 5.7 MPa for the temperatures 37 °C, 50 °C and 60 °C respectively. The test group reported compressive strength of 64.8 ± 5.4, 47.1 ± 5.4 and 33.4 ± 3.6 MPa at 37 °C, 50 °C and 60 °C, respectively. This represented a decrease of 28% in compressive strength with the increase in temperature from 37 °C to 50 °C and 45% from the 37 °C to the 60 °C group; Conclusion: GIC modified with 10% silica-coated wax capsules and temperature application show a distinct effect on the compressive strength of GIC. Considerable compressive strength reduction was detected if the temperature was above the melting temperature of the wax core. Full article
Figures

Figure 1

Open AccessReview
Oral Health, Nutritional Choices, and Dental Fear and Anxiety
Dent. J. 2017, 5(1), 8; doi:10.3390/dj5010008 -
Abstract
Oral health is an integral part of overall health. Poor oral health can lead to an increased risk of chronic diseases including diabetes mellitus, cardiovascular disease, and some types of cancer. The etiology of these diseases could be linked to the individual’s inability
[...] Read more.
Oral health is an integral part of overall health. Poor oral health can lead to an increased risk of chronic diseases including diabetes mellitus, cardiovascular disease, and some types of cancer. The etiology of these diseases could be linked to the individual’s inability to eat a healthy diet when their dentition is compromised. While periodontal or implant surgery may be necessary to reconstruct tissue around natural teeth or replace missing teeth, respectively, some individuals avoid such interventions because of their associated fear and anxiety. Thus, while the relationship between poor oral health, compromised nutritional choices and fear and anxiety regarding periodontal procedures is not entirely new, this review provides an up-to-date summary of literature addressing aspects of this complex relationship. This review also identifies potential strategies for clinicians to help their patients overcome their fear and anxiety associated with dental treatment, and allow them to seek the care they need. Full article
Figures

Figure 1

Open AccessEditorial
Acknowledgement to Reviewers of Dentistry Journal in 2016
Dent. J. 2017, 5(1), 6; doi:10.3390/dj5010006 -
Abstract The editors of Dentistry Journal would like to express their sincere gratitude to the following reviewers for assessing manuscripts in 2016.[...] Full article
Open AccessArticle
An Evaluation of the Accuracy of the Subtraction Method Used for Determining Platelet Counts in Advanced Platelet-Rich Fibrin and Concentrated Growth Factor Preparations
Dent. J. 2017, 5(1), 7; doi:10.3390/dj5010007 -
Abstract
Platelet concentrates should be quality-assured of purity and identity prior to clinical use. Unlike for the liquid form of platelet-rich plasma, platelet counts cannot be directly determined in solid fibrin clots and are instead calculated by subtracting the counts in other liquid or
[...] Read more.
Platelet concentrates should be quality-assured of purity and identity prior to clinical use. Unlike for the liquid form of platelet-rich plasma, platelet counts cannot be directly determined in solid fibrin clots and are instead calculated by subtracting the counts in other liquid or semi-clotted fractions from those in whole blood samples. Having long suspected the validity of this method, we herein examined the possible loss of platelets in the preparation process. Blood samples collected from healthy male donors were immediately centrifuged for advanced platelet-rich fibrin (A-PRF) and concentrated growth factors (CGF) according to recommended centrifugal protocols. Blood cells in liquid and semi-clotted fractions were directly counted. Platelets aggregated on clot surfaces were observed by scanning electron microscopy. A higher centrifugal force increased the numbers of platelets and platelet aggregates in the liquid red blood cell fraction and the semi-clotted red thrombus in the presence and absence of the anticoagulant, respectively. Nevertheless, the calculated platelet counts in A-PRF/CGF preparations were much higher than expected, rendering the currently accepted subtraction method inaccurate for determining platelet counts in fibrin clots. To ensure the quality of solid types of platelet concentrates chairside in a timely manner, a simple and accurate platelet-counting method should be developed immediately. Full article
Figures

Figure 1

Open AccessArticle
Association of Quality of Coronal Filling with the Outcome of Endodontic Treatment: A Follow-up Study
Dent. J. 2017, 5(1), 5; doi:10.3390/dj5010005 -
Abstract
The aim of this study was to assess the effect of the quality of the coronal restoration and the root filling on the success of endodontic treatment. Patients treated at Kuwait University Dental Clinics (KUDC) from 2003 to 2014 were contacted by telephone
[...] Read more.
The aim of this study was to assess the effect of the quality of the coronal restoration and the root filling on the success of endodontic treatment. Patients treated at Kuwait University Dental Clinics (KUDC) from 2003 to 2014 were contacted by telephone calls. Demographic data and clinical records of patients, including age, gender, the tooth number, and medical history were recorded. Each patient received clinical examination for all teeth, including assessment of the coronal filling (type, quality), root- and/or coronal fracture, and the periodontal condition around the tooth (e.g., probing depth, gingival recession); percussion and mobility tests. A periapical radiograph of the endodontic treated tooth was taken to determine the health of the periapical tissues using the periapical index. The quality of the root filling was assessed by length and density of the root filling. The mean follow-up period was 4.8 years. The overall success rate of endodontic treatment was 86%; teeth without any initial periapical lesion had a success of 93%, whereas those with such lesion had a success rate of 80%. Periapical healing was not significantly associated with either the length of root filling (p = 0.40) or the density of root filling (p = 0.099), but was statistically significantly associated with the presence of coronal filling defects (p = 0.001). This study demonstrated that inadequate coronal filling but not the quality of root filling was associated with a higher prevalence of periapical lesions. Full article
Open AccessArticle
Prioritizing the Risk Factors of Severe Early Childhood Caries
Dent. J. 2017, 5(1), 4; doi:10.3390/dj5010004 -
Abstract
Severe early childhood caries remains the most common chronic disease affecting children. The multifactorial etiology of caries has established a controversy about which risk factors were more significant to its development. Therefore, our study aimed through meticulous statistical analysis to arrange the “well
[...] Read more.
Severe early childhood caries remains the most common chronic disease affecting children. The multifactorial etiology of caries has established a controversy about which risk factors were more significant to its development. Therefore, our study aimed through meticulous statistical analysis to arrange the “well agreed upon” common risk factors in order of significance, to aid the clinician in tailoring an adequate preventive program. The study prioritized or reshuffled the risk factors contributing to severe early childhood caries and placed them in the order of their significance as follows: snacking of sugary food several times a day, increased number of siblings to three or more, night feeding, child self-employed brushing, mother’s caries experience, two siblings, on demand feeding, once/day sugary food, sharing utensils, one sibling, male gender, father’s education, late first dental visit, brushing time, mother’s education, no dental visit, decreased brushing frequency, and no night brushing. Full article
Figures

Figure 1

Open AccessReview
Angiogenesis in the Development of Medication-Related Osteonecrosis of the Jaws: An Overview
Dent. J. 2017, 5(1), 2; doi:10.3390/dj5010002 -
Abstract
Medication-related osteonecrosis of the jaws (MR-ONJ) is one of the most relevant side effects of bisphosphonate therapy; it is clinically defined as a non-healing wound in combination with an avascular and necrotic jaw within ongoing bisphosphonate therapy or after completed bisphosphonate therapy. Different
[...] Read more.
Medication-related osteonecrosis of the jaws (MR-ONJ) is one of the most relevant side effects of bisphosphonate therapy; it is clinically defined as a non-healing wound in combination with an avascular and necrotic jaw within ongoing bisphosphonate therapy or after completed bisphosphonate therapy. Different theories concerning the development of MR-ONJ have been reported, while the exact pathophysiology is still unknown. Recent studies have increasingly focused on angiogenesis and revascularization concerning MR-ONJ pathophysiology, which seems to be a relevant factor in the development of MR-ONJ and a possible and promising point of action for MR-ONJ prevention and therapy. Therefore, and with respect to the different aspects and specific forms of angiogenesis, the enclosed review summarizes the possible role of angiogenesis and revascularization in the pathophysiology of MR-ONJ. Special focus is given to the strong negative influence of bisphosphonates on progenitor and mature endothelial cells in vitro as well as on microvessel sprouting in vitro and in vivo, which might result in overall reduced wound healing of oral soft and hard tissues, and therefore in an exposed and avascular jaw from a clinical viewpoint. Further, it will be summarized whether and in what way the aspect of angiogenesis might be used for possible MR-ONJ prevention and therapy. Full article
Open AccessArticle
Undergraduate Confidence When Undertaking Root Canal Treatment and Their Perception of the Quality of Their Endodontic Education
Dent. J. 2017, 5(1), 1; doi:10.3390/dj5010001 -
Abstract
The General Dental Council expects graduating dentists to be competent at treating pulpal disease. Previous studies have found dental undergraduates to have low levels of confidence with respect to endodontic treatments. The aim of this study was to investigate the confidence of undergraduate
[...] Read more.
The General Dental Council expects graduating dentists to be competent at treating pulpal disease. Previous studies have found dental undergraduates to have low levels of confidence with respect to endodontic treatments. The aim of this study was to investigate the confidence of undergraduate dental students at the University of Bristol when performing root canal treatment, and to investigate their perception of the quality of their endodontic education. An anonymous questionnaire, based upon one used in a 2015 study at Cardiff University, was distributed to all (n = 204) undergraduate students in Years 3–5 at the University of Bristol. The results were analysed using the Statistical Package for the Social Sciences software (SPSS). There was a 59% (n = 120) response rate and a significant (p < 0.01) difference in confidence levels for root canal treatments (RCTs) completed between these students. All (100%) Year-5 students felt confident in completing anterior RCTs, and 91% felt confident in completing posterior RCTs. The majority (93%) of Year-4 students felt confident in completing anterior RCTs, and 77% felt confident in completing posterior RCTs. Over one-half (56%) of Year-3 students felt confident in anterior RCTs and 17% in posterior RCTs. With respect to the individual stages of RCT (access cavity, cleaning and shaping of root canal system, and obturation/filling), results showed that there was a significant difference (p < 0.01) in confidence levels between year groups. Many students thought the amount of time spent on endodontic teaching and the quality of teaching to be satisfactory. Improvements suggested for future endodontic teaching included higher numbers of staff supervision and additional endodontic practice on extracted teeth before seeing patients. There was a strong association between students’ clinical experience and their levels of confidence when completing RCT. Increasing the amount of clinical experience of RCTs could enhance students’ confidence further. Full article
Open AccessArticle
A Study for Tooth Bleaching via Carbamide Peroxide-Loaded Hollow Calcium Phosphate Spheres
Dent. J. 2017, 5(1), 3; doi:10.3390/dj5010003 -
Abstract
The objective of this study was to investigate if a prolonged bleaching effect of carbamide peroxide-loaded hollow calcium phosphate spheres (HCPS) can be achieved. HCPS was synthesized via a hydrothermal reaction method. Carbamide peroxide (CP) was-loaded into HCPS by mixing with distilled water
[...] Read more.
The objective of this study was to investigate if a prolonged bleaching effect of carbamide peroxide-loaded hollow calcium phosphate spheres (HCPS) can be achieved. HCPS was synthesized via a hydrothermal reaction method. Carbamide peroxide (CP) was-loaded into HCPS by mixing with distilled water as solvent. We developed two bleaching gels containing CP-loaded HCPS: one gel with low HP concentration as at-home bleaching gel, and one with high HP concentration as in-office gel. Their bleaching effects on stained human permanent posterior teeth were investigated by measuring the color difference before and after bleaching. The effect of gels on rhodamine B degradation was also studied. To investigate the potential effect of remineralization of using HCPS, bleached teeth were soaked in phosphate buffer solution (PBS) containing calcium and magnesium ions. Both bleaching gels had a prolonged whitening effect, and showed a strong ability to degrade rhodamine B. After soaking in PBS for 3 days, remineralization was observed at the sites where HCPS attached to the teeth surface. CP-loaded HCPS could prolong the HP release behavior and improve the bleaching effect. HCPS was effective in increasing the whitening effect of carbamide peroxide and improving remineralization after bleaching process. Full article
Figures

Figure 1

Open AccessArticle
Osteonecrosis of the Jaws (ONJ) after Bisphosphonate Treatment in Patients with Multiple Myeloma: Decreasing ONJ Incidence after Adoption of Preventive Measures
Dent. J. 2016, 4(4), 45; doi:10.3390/dj4040045 -
Abstract
Bisphosphonates (BPs) are administered to Multiple Myeloma (MM) patients with bone lytic lesion. Osteonecrosis of the Jaw (ONJ) is a complication reported since 2003 in patients treated with intravenous (IV) BPs such as zoledronic acid and pamidronate, with 6%–26.3% frequency in early literature
[...] Read more.
Bisphosphonates (BPs) are administered to Multiple Myeloma (MM) patients with bone lytic lesion. Osteonecrosis of the Jaw (ONJ) is a complication reported since 2003 in patients treated with intravenous (IV) BPs such as zoledronic acid and pamidronate, with 6%–26.3% frequency in early literature series, before some preventive measures were recommended. We evaluated the occurrence of ONJ with and without dental preventive measures in MM patients treated with BPs in our centre between 1996 and 2015. Since 2005, MM patients (already under treatment or before treatment) underwent a baseline mouth assessment (dental visit, Rx orthopantomography, and eventual tooth avulsion or dental care if necessary) and were followed by a multidisciplinary team. We reviewed the charts of 119 MM patients receiving IV BPs, classified into 3 groups: (a) “historic group” (21 patients who had started BP treatment in years before the awareness of ONJ); (b) “screening group” (20 patients starting BPs without baseline evaluation); and (c) “prevention group” (78 patients starting therapy only after baseline preventive assessment and eventual dental care measures). ONJ was observed in 3/21 patients (14.2%) from group a, in 2/20 patients (10%) from group b, and in no patients from group c (0%). Notably, the median number of IV BP administrations decreased after 2005. Our data confirmed a meaningful reduction of ONJ risk in MM patients treated with BPs if preventive measures are applied. Both implementation of prevention measures and reduction of cumulative doses of IV BPs could have contributed to a decreased incidence of ONJ. Full article
Open AccessArticle
Quality of Life and Poor Oral Health: A Comparison of Postmenopausal Women
Dent. J. 2016, 4(4), 44; doi:10.3390/dj4040044 -
Abstract
Inter-relationships between traditional dental variables are becoming more evident in far reaching aspects of life, such as psychosocial interaction, self-esteem, overall health and even occupational performance. This study compares quality of life (QoL) in postmenopausal women (PMW) with poor oral health (POH) with
[...] Read more.
Inter-relationships between traditional dental variables are becoming more evident in far reaching aspects of life, such as psychosocial interaction, self-esteem, overall health and even occupational performance. This study compares quality of life (QoL) in postmenopausal women (PMW) with poor oral health (POH) with QoL in PMW with good oral health. A total of 200 randomly recruited PMW received a dental evaluation and completed the Utian Quality of Life Survey. The participants were divided into POH and healthy groups based on a dental exam. Mean scores were calculated for each QoL item, domain and the overall summary score. For each of the four parameters for periodontitis diagnosis, periodontitis b s patients’ QoL outcomes were compared to those of healthy patients using a T-test with a threshold of significance at p < 0.05. QoL in all fields measured was significantly poorer in the POH patients compared to the healthy patients: occupational score (19.95 ± 5.35 vs. 27.56 ± 6.13), health score (18.02 ± 8.23 vs. 26.59 ± 6.45), emotional score (15.68 ± 10.22 vs. 21.15 ± 9.15), sexual score (6.2 ± 5.98 vs. 10.02 ± 5.35), and total score (60.21 ± 25.85 vs. 84.26 ± 22.35). This study finds that PMW with POH report significantly poorer quality of life. Clinicians caring for PMW should be aware that oral health impacts QoL and make appropriate referral decisions for patients’ dental care. Full article
Open AccessCase Report
Bilateral Transverse Mandibular Second Molars: A Case Report
Dent. J. 2016, 4(4), 43; doi:10.3390/dj4040043 -
Abstract
Impaction of mandibular second permanent molars is a rare occurrence, with prevalence rates reported to be between 0.65% and 2.0%. In the absence of systemic conditions, impactions are usually unilateral. There appears to be no consensus as to the optimal treatment for impacted
[...] Read more.
Impaction of mandibular second permanent molars is a rare occurrence, with prevalence rates reported to be between 0.65% and 2.0%. In the absence of systemic conditions, impactions are usually unilateral. There appears to be no consensus as to the optimal treatment for impacted mandibular second molars and treatment plans will be based upon the individual case. Treatment may involve orthodontics and/or various surgical techniques, and early diagnosis is important. This paper presents an unusual case of bilateral transverse impaction of both mandibular second and third molars that was diagnosed at 18 years of age. All impacted molars were extracted. Full article
Figures

Figure 1

Open AccessCase Report
Custom Made Replacement of the Mandibular Condyle in a Case of Fibrous Dysplasia with Cystic Degeneration; A Case Report
Dent. J. 2016, 4(4), 42; doi:10.3390/dj4040042 -
Abstract
This paper describes a rare case of fibrous dysplasia with cystic degeneration in the mandibular condyle. Diagnostic and therapeutic considerations are discussed. A 40-year old woman presented with pain near the region of her right ear. Physical and radiographic examination showed no abnormalities
[...] Read more.
This paper describes a rare case of fibrous dysplasia with cystic degeneration in the mandibular condyle. Diagnostic and therapeutic considerations are discussed. A 40-year old woman presented with pain near the region of her right ear. Physical and radiographic examination showed no abnormalities besides the presence of a mixed radiopaque/radiolucent expansive lesion of the right condyle. Pathologic examination showed high bone-turnover with bone formation. Bone scintigraphy showed a monostotic active fibrous lesion in the right part of the mandible. Bisphosphonate treatment did not sufficiently treat the patient’s symptoms and physiotherapy to treat craniomandibular dysfunction as a factor in the pain was also unsuccessful. The patient later developed an acute external otitis due to a narrowed outer ear canal and had to be admitted to the hospital for treatment with intravenous antibiotics. Approximately two years after first presentation, resection of the affected bone (condylectomy) and reconstruction with a custom total joint prosthesis was indicated due to repeated functional deficits with considerable morbidity. Pathologic examination of the resected mandibular condyle showed increased bone formation including formation of neocortex and some cystic formation. This was diagnosed as fibrous dysplasia with cystic degeneration. Approximately two years after surgery, the patient functioned well. Full article
Figures

Figure 1

Open AccessReview
Role of Teriparatide in Medication-Related Osteonecrosis of the Jaws (MRONJ)
Dent. J. 2016, 4(4), 41; doi:10.3390/dj4040041 -
Abstract
While the optimal treatment concept of medication-related osteonecrosis of the jaws (MRONJ) is still in debate, several adjunct therapies have been introduced. Among these adjunctive measures, recombinant human parathyroid hormone (rhPTH, teriparatide) seems to be the most promising treatment modality. Several studies have
[...] Read more.
While the optimal treatment concept of medication-related osteonecrosis of the jaws (MRONJ) is still in debate, several adjunct therapies have been introduced. Among these adjunctive measures, recombinant human parathyroid hormone (rhPTH, teriparatide) seems to be the most promising treatment modality. Several studies have presented the beneficial effect of short-term teriparatide; they have shown an improved level of bone markers and radiographic evidence of bone healing. Although clinical validation by a controlled trial with prospective design would be essential, short-term teripratide therapy would be a good treatment option for MRONJ patients with impaired bone remodeling. Full article
Open AccessArticle
Environmental Factors Influencing Adoption of Canadian Guidelines on Smoking Cessation in Dental Healthcare Settings in Quebec: A Qualitative Study of Dentists’ Perspectives
Dent. J. 2016, 4(4), 40; doi:10.3390/dj4040040 -
Abstract
Background: This study aimed to understand dentists’ perspective of the environmental determinants which positively or negatively influence the implementation of Canadian smoking cessation clinical practice guidelines (5As: Ask-Advise-Assess-Assist-Arrange) in private dental clinics in Quebec. Methods: This study used a qualitative design and an
[...] Read more.
Background: This study aimed to understand dentists’ perspective of the environmental determinants which positively or negatively influence the implementation of Canadian smoking cessation clinical practice guidelines (5As: Ask-Advise-Assess-Assist-Arrange) in private dental clinics in Quebec. Methods: This study used a qualitative design and an integrative conceptual framework composed of three theoretical perspectives. Data collection was conducted in individual semi-directed interviews with 20 private dentists lasting between 35 and 45 min. The audio-recorded data were transcribed verbatim, followed by a directed content analysis. Results: Some of the barriers identified to counselling in smoking cessation were lack of time, patient attitude, lack of prescription of nicotine replacement therapies, lack of reimbursement, and the lack of training of the dental team. Enablers cited by participants were the style of dentist’s leadership, the availability of community, human and material resources, the perception of counselling as a professional duty, and the culture of dental medicine. In addition to these variables, dentists’ attitude and behaviour were affected by different organisations giving initial or continual training to dentists, governmental policies, and the compatibility of Canadian smoking cessation guidelines with the practice of dentistry. Conclusion: Our findings will inform the development of smoking cessation interventions in dental healthcare settings. Full article
Figures

Figure 1

Open AccessCase Report
Delayed Diagnosis of Osteonecrosis of the Jaw (ONJ) Associated with Bevacizumab Therapy in Colorectal Cancer Patients: Report of Two Cases
Dent. J. 2016, 4(4), 39; doi:10.3390/dj4040039 -
Abstract
Medication-induced Osteonecrosis of the Jaw (MRONJ) has been reported not only after use of antiresorptive agents (bisphosphonates and denosumab), but also in cancer patients receiving antiangiogenic agents, alone or combined with antiresorptive drugs. We report two cases of MRONJ observed in colorectal cancer
[...] Read more.
Medication-induced Osteonecrosis of the Jaw (MRONJ) has been reported not only after use of antiresorptive agents (bisphosphonates and denosumab), but also in cancer patients receiving antiangiogenic agents, alone or combined with antiresorptive drugs. We report two cases of MRONJ observed in colorectal cancer patients after bevacizumab therapy only. MRONJ was diagnosed, respectively, two and seven months after a tooth extraction; both the patients had received two courses of bevacizumab infusions (for a total of 29 and 10 administrations, respectively). We discuss if tooth extraction during or after antiangiogenic therapy could be a potential trigger of MRONJ, but also if an underlying bone disease not evident before oral surgery might be a possible cause. A careful drug history has to be registered by dental specialists in cancer patients before oral surgery and adequate imaging might be obtained to avoid a delayed diagnosis. Full article
Figures

Figure 1

Open AccessReview
Current Controversies on the Pathogenesis of Medication-Related Osteonecrosis of the Jaw
Dent. J. 2016, 4(4), 38; doi:10.3390/dj4040038 -
Abstract
Medication-related osteonecrosis of the jaw (MRONJ) was first reported more than a decade ago. Since then, numerous cases have been diagnosed. Currently, there are three groups of drugs related to MRONJ: bisphosphonates, denosumab and anti-angiogenic drugs. As MRONJ can lead to debilitating clinical
[...] Read more.
Medication-related osteonecrosis of the jaw (MRONJ) was first reported more than a decade ago. Since then, numerous cases have been diagnosed. Currently, there are three groups of drugs related to MRONJ: bisphosphonates, denosumab and anti-angiogenic drugs. As MRONJ can lead to debilitating clinical sequels and limited effective treatment options are available, much research has been done in understanding its pathophysiology. Until now, the exact pathogenesis of MRONJ has not been fully elucidated. While history of invasive dental procedures or local trauma may be present, some cases occur spontaneously without any preceding factors. This review aims to examine and discuss the three main hypotheses for the pathogenesis of MRONJ, namely suppressed bone turnover, cellular toxicity and infection. Full article
Figures

Figure 1