Special Issue "Innovative Solutions for Oral Healthcare"

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Nursing".

Deadline for manuscript submissions: closed (30 April 2021) | Viewed by 18060

Special Issue Editor

Dr. Saturnino Marco Lupi
E-Mail Website
Guest Editor
Department of Clinico-Surgical, Diagnostic and Pediatric Sciences, Dental Clinic, University of Pavia, P.le Golgi 2, 27100 Pavia, Italy
Interests: dentistry; oral surgery; maxillofacial surgery; tissue regeneration; bone regeneration; dental implants; implant surface treatments; dental radiology; oral pathology; tooth anatomy; community dentistry; caries prevention; oral cancer; dental prosthesis; gnathology; dental material; laser
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear colleagues,

Our commitment to oral healthcare can include numerous topics. Innovative tests and analyses can facilitate early and more accurate diagnosis. Dental care can have both positive and negative short- and long-term effects which impact on oral health, quality of life, and the costs of future care. The expected benefits and satisfaction of clinical requests should guide the choice of materials and therapeutic strategies. The health and wellbeing of the population are influenced by the prevention and treatment of oral diseases and their relapse. Therapeutic choices are influenced by the costs and effectiveness of therapies, professional skills of the caregiver,  increasingly complex patient profile due to the presence of numerous comorbidities, and difficulty of the individual case. Dental materials must be carefully validated in terms of safety, biocompatibility, and biological effects. Finally, the spread of infectious diseases such as COVID-19 imposes changes in therapeutic choices and the clinical management of dental patients.

We will feature original research studies, reviews, short reports, case reports, and opinion pieces from researchers on these topics.

Dr. Saturnino Marco Lupi
Guest Editor

Manuscript Submission Information

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Keywords

  • diagnosis
  • treatment decision
  • decision-making
  • risk/benefit
  • cost-effectiveness
  • dose–response relationship
  • risk factors
  • wound healing
  • complications
  • working hours
  • quality of life
  • oral health behavior
  • oral health education
  • continuing education
  • motivation
  • comprehensive oral healthcare
  • dental esthetics
  • minimally invasive dentistry
  • tooth loss
  • oral disease
  • bone loss
  • dental implant
  • osseointegration
  • root canal treatment
  • emergency
  • dental trauma
  • interdisciplinary treatment
  • digital dentistry
  • oral rehabilitation
  • infectious disease
  • orthodontics
  • restorative dentistry
  • pediatric dentistry
  • prosthodontics
  • special care dentistry
  • dentists
  • periodontics
  • endodontists
  • paramedic
  • dental students
  • survey
  • epidemiology
  • randomized clinical trial
  • review
  • children
  • older adults

Published Papers (16 papers)

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Research

Jump to: Review, Other

Article
Relationship between Masticatory Function and Bone Mineral Density in Community-Dwelling Elderly: A Cross-Sectional Study
Healthcare 2021, 9(7), 845; https://doi.org/10.3390/healthcare9070845 - 05 Jul 2021
Viewed by 682
Abstract
The relationship between masticatory function and bone mineral density (BMD) is unclear. This cross-sectional study examined this relationship after adjusting for confounding factors. The subjects were 702 community-dwelling elderly adults (306 men, 396 women) who had been recruited for the Community-Based Healthcare Research [...] Read more.
The relationship between masticatory function and bone mineral density (BMD) is unclear. This cross-sectional study examined this relationship after adjusting for confounding factors. The subjects were 702 community-dwelling elderly adults (306 men, 396 women) who had been recruited for the Community-Based Healthcare Research and Education study in 2019. Objective masticatory function was assessed using the gummy jelly method. The median for each descriptive statistic was 69.0 years for age, 86.2% for the young adult mean, and 18.0 for masticatory function. Comparisons of the groups with good and poor masticatory function by sex revealed a significant difference in muscle mass and the tooth number for both sexes (p < 0.05). Men showed significant differences in age (p < 0.05) and salivary occult blood findings (p < 0.05). Multivariate analysis using propensity scores showed a significant association between masticatory function and BMD in both sexes (men: odds ratio 163.0, 95% confidence interval 1.36–19,610.55, p = 0.04; women: odds ratio 48.65, 95% confidence interval 1.52–1561.15, p = 0.03 in women). Masticatory function and BMD in the community-dwelling elderly may be related. However, other factors, including frailty and sarcopenia, may also be involved. Regular oral health care by dentists and dental hygienists may benefit this population. Full article
(This article belongs to the Special Issue Innovative Solutions for Oral Healthcare)
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Article
Investigation on the Effect of Oral Breathing on Cognitive Activity Using Functional Brain Imaging
Healthcare 2021, 9(6), 645; https://doi.org/10.3390/healthcare9060645 - 29 May 2021
Viewed by 1632
Abstract
Oral breathing directly affects behavioral performance and dental health. Various relationships between oral breathing and periodontal disease have been well-described. However, the effect of oral breathing on cognitive performance remains unclear. This study aimed to investigate the effects of oral breathing on cognitive [...] Read more.
Oral breathing directly affects behavioral performance and dental health. Various relationships between oral breathing and periodontal disease have been well-described. However, the effect of oral breathing on cognitive performance remains unclear. This study aimed to investigate the effects of oral breathing on cognitive function using functional magnetic resonance imaging (fMRI). Twenty-two healthy participants (mean age, 22.27 ± 1.42 years) performed a two-back (2B) working memory fMRI task using a 3T MRI scanner while breathing through their oral or nasal passage. Functional activity analysis was performed using a statistical parametric mapping software package. One-sample group analyses were performed in 2B > Rest contrast. Functional connectivity analysis was conducted using MATLAB-based imaging software. Mixed ANOVA analysis was performed. The results showed more brain activation and connection during nasal breathing than during oral breathing. For Nasal > Oral contrast, various functional connections are known to have a significant relationship with working memory, including the left cerebellum, left and right inferior parietal gyrus. This can be significant evidence to demonstrate that oral breathing is an inappropriate method for intellectual activity using brain imaging techniques. Therefore, this study suggests that changing various habits related to oral breathing is important for cognitive function. Full article
(This article belongs to the Special Issue Innovative Solutions for Oral Healthcare)
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Article
Feasibility of a Portable Electronic Nose for Detection of Oral Squamous Cell Carcinoma in Sudan
Healthcare 2021, 9(5), 534; https://doi.org/10.3390/healthcare9050534 - 03 May 2021
Viewed by 1246
Abstract
Background: Oral squamous cell carcinoma (OSCC) is increasing at an alarming rate particularly in low-income countries. This urges for research into noninvasive, user-friendly diagnostic tools that can be used in limited-resource settings. This study aims to test and validate the feasibility of e-nose [...] Read more.
Background: Oral squamous cell carcinoma (OSCC) is increasing at an alarming rate particularly in low-income countries. This urges for research into noninvasive, user-friendly diagnostic tools that can be used in limited-resource settings. This study aims to test and validate the feasibility of e-nose technology for detecting OSCC in the limited-resource settings of the Sudanese population. Methods: Two e-nose devices (Aeonose™, eNose Company, Zutphen, The Netherlands) were used to collect breath samples from OSCC (n = 49) and control (n = 35) patients. Patients were divided into a training group for building an artificial neural network (ANN) model and a blinded control group for model validation. The Statistical Package for the Social Sciences (SPSS) software was used for the analysis of baseline characteristics and regression. Aethena proprietary software was used for data analysis using artificial neural networks based on patterns of volatile organic compounds. Results: A diagnostic accuracy of 81% was observed, with 88% sensitivity and 71% specificity. Conclusions: This study demonstrates that e-nose is an efficient tool for OSCC detection in limited-resource settings, where it offers a valuable cost-effective strategy to tackle the burden posed by OSCC. Full article
(This article belongs to the Special Issue Innovative Solutions for Oral Healthcare)
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Article
Three-Dimensional Reproducibility of the Soft Tissue Landmarks Taken by Structured-Light Facial Scanner in Accordance with the Head Position Change
Healthcare 2021, 9(4), 428; https://doi.org/10.3390/healthcare9040428 - 07 Apr 2021
Viewed by 635
Abstract
The aim of this study was to evaluate the three-dimensional reproducibility of the structured-light facial scanner according to the head position change. A mannequin head was used and angle of the mannequin’s axis-orbital plane to the true horizontal plane was adjusted to +10, [...] Read more.
The aim of this study was to evaluate the three-dimensional reproducibility of the structured-light facial scanner according to the head position change. A mannequin head was used and angle of the mannequin’s axis-orbital plane to the true horizontal plane was adjusted to +10, +5, 0, −5, and −10°. Facial scanning was conducted 30 times, respectively, and 150 3D images were obtained. Reoriented landmarks of each group were compared and analyzed. Reproducibility decreased as the distance from the facial center increased. Additionally, the landmarks below showed lower reproducibility and higher dispersion than landmarks above. These differences occurred mainly in the anteroposterior direction as opposed to other directions. Positive inclination of the head position showed superior reproducibility compared to a negative inclination. This study showed that reproducibility of a structured-light scanner could be varied depending on the head position. Inaccuracies of landmarks in the anteroposterior direction are greater than in other directions. This means that evaluations of the profile using a structured-light scanner should be made carefully. Therefore, the proper head position should be set to ensure the accuracy of the image. Full article
(This article belongs to the Special Issue Innovative Solutions for Oral Healthcare)
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Article
Environmental Cadmium Exposure and Dental Indices in Orthodontic Patients
Healthcare 2021, 9(4), 413; https://doi.org/10.3390/healthcare9040413 - 02 Apr 2021
Cited by 3 | Viewed by 732
Abstract
Background. Previous studies have shown that environmental cadmium exposure could disrupt salivary gland function and is associated with dental caries and reduced bone density. Therefore, this cross-sectional study attempted to determine whether tooth decay with tooth loss following cadmium exposure is associated with [...] Read more.
Background. Previous studies have shown that environmental cadmium exposure could disrupt salivary gland function and is associated with dental caries and reduced bone density. Therefore, this cross-sectional study attempted to determine whether tooth decay with tooth loss following cadmium exposure is associated with some dental or skeletal traits such as malocclusions, sagittal skeletal pattern, and tooth decay. Methods. Between August 2019 and June 2020, 60 orthodontic patients with no history of previous orthodontics, functional appliances, or surgical treatment were examined. The patients were stratified into two groups according to their urine cadmium concentrations: high (>1.06 µg/g creatinine, n = 28) or low (<1.06 µg/g creatinine, n = 32). Results. The patients were 25.07 ± 4.33 years old, and most were female (female/male: 51/9 or 85%). The skeletal relationship was mainly Class I (48.3%), followed by Class II (35.0%) and Class III (16.7%). Class I molar relationships were found in 46.7% of these patients, Class II molar relationships were found in 15%, and Class III molar relationships were found in 38.3%. The mean decayed, missing, and filled surface (DMFS) score was 8.05 ± 5.54, including 2.03 ± 3.11 for the decayed index, 0.58 ± 1.17 for the missing index, and 5.52 ± 3.92 for the filled index. The mean index of complexity outcome and need (ICON) score was 53.35 ± 9.01. The facial patterns of these patients were within the average low margin (26.65 ± 5.53 for Frankfort–mandibular plane angle (FMA)). There were no significant differences in the above-mentioned dental indices between patients with high urine cadmium concentrations and those with low urine cadmium concentrations. Patients were further stratified into low (<27, n = 34), average (27–34, n = 23), and high (>34, n = 3) FMA groups. There were no statistically significant differences in the urine cadmium concentration among the three groups. Nevertheless, a marginally significant p-value of 0.05 for urine cadmium concentration was noted between patients with low FMA and patients with high FMA. Conclusion. This analysis found no association between environmental cadmium exposure and dental indices in our orthodontic patients. Full article
(This article belongs to the Special Issue Innovative Solutions for Oral Healthcare)
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Article
Diagnostic Accuracy of Oral Cancer and Suspicious Malignant Mucosal Changes among Future Dentists
Healthcare 2021, 9(3), 263; https://doi.org/10.3390/healthcare9030263 - 02 Mar 2021
Cited by 3 | Viewed by 721
Abstract
This study aimed to assess the ability of dental students and recent graduates to detect and recognize mucosal changes that are suggestive of oral cancer and potentially malignant disorders. In this cross-sectional study, a questionnaire was administered to dental students and recent graduates [...] Read more.
This study aimed to assess the ability of dental students and recent graduates to detect and recognize mucosal changes that are suggestive of oral cancer and potentially malignant disorders. In this cross-sectional study, a questionnaire was administered to dental students and recent graduates of Ajman University (n = 132). Completed questionnaires were received from 84 (63.6%) females and 48 (36.4%) males which included fifth-year students (n = 80), interns (n = 39), and dental practitioners (n = 13). This questionnaire was designed to assess the respondent’s ability to detect and recognize different types of oral lesions, as well as their knowledge of oral cancer appearance and malignancy potential. The overall accuracy of diagnosis was 46%. The participants correctly identified normal variations, benign tumors, malignant tumors, and premalignant lesions at rates of 60.3%, 31.0%, 55.7%, and 33.4%, respectively. There was no significant difference between the two genders in their ability to recognize and detect correct answers (females, 48.3%; males, 47.2%). According to education level, interns provided the highest percentage of correct answers (52.5%), followed by newly dental practitioners (51.9%) and fifth-year students (44.1%). Conclusion: The respondents of this survey did not exhibit a satisfactory diagnostic capability in recognizing mucosal changes consistent with the clinical presentation of oral cancer. Thus, a need exists for improved and updated educational methods for undergraduate students regarding oral cancer and potentially malignant disorders. Meanwhile, practitioners should look for oral abnormalities to provide better diagnosis and management. Practitioners should also stay up to date on the oral malignancy topic by attending workshops and clinicopathological conferences. Full article
(This article belongs to the Special Issue Innovative Solutions for Oral Healthcare)
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Article
Efficacy of Arabic Coffee and Black Tea in Reducing Halitosis: A Randomized, Double-Blind, Controlled, Crossover Clinical Trial
Healthcare 2021, 9(3), 250; https://doi.org/10.3390/healthcare9030250 - 01 Mar 2021
Cited by 1 | Viewed by 876
Abstract
The aim of the study was to objectively evaluate the short-term effect of Arabic coffee and black tea on oral halitosis. This study was a single-center, randomized, double-blind, placebo-controlled, crossover clinical trial on 17 healthy individuals. During the initial visit, pre-treatment breath samples [...] Read more.
The aim of the study was to objectively evaluate the short-term effect of Arabic coffee and black tea on oral halitosis. This study was a single-center, randomized, double-blind, placebo-controlled, crossover clinical trial on 17 healthy individuals. During the initial visit, pre-treatment breath samples were collected from each subject and analyzed using portable gas chromatography (OralChroma™). Four interventions were evaluated, with Arabic coffee and black tea as the test intervention tools, mouthwash containing a solution (0.05% chlorhexidine, 0.05% cetylpyridinium chloride, and 0.14% zinc lactate (CHX-CPC-Zn)) as a positive control, and drinking water as a negative control. Halitosis was induced by rinsing with 10 mL solution of L-cysteine for 30 s. Twenty minutes later, a breath sample was taken to record the baseline volatile sulfur compounds (VSC) levels (T0). Then, the participants were asked to rinse with 10 mL of a randomly-assigned solution for 30 s. Sixty minutes later, another breath sample was recorded (T1). Finally, after 120 min, the final breath sample was recorded (T2). It was found that rinsing with Arabic coffee decreased the level of H2S both in the first hour (T1) and the second hour (T2). The reduction was significantly greater at T1 (p = 0.017). There was a similar result after the volunteers rinsed with black tea. At T2, Arabic coffee showed a substantially greater reduction in H2S (p < 0.001). On the contrary, using CHX-CPC-Zn showed a significant and continuous decrease in H2S values in the breath throughout the experiment (p < 0.001). Water showed no significant impact on the level of VSC (p = 0.71). This study demonstrates that black tea and Arabic coffee had inhibitory effects on halitosis that was greater in the first hour and was not sustained over a long period. Additionally, Arabic coffee had a greater inhibitory effect on halitosis than black tea. Full article
(This article belongs to the Special Issue Innovative Solutions for Oral Healthcare)
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Article
Effects of Attitude, Barriers/Facilitators, and Visual Differentiation on Oral Mucosa Pressure Ulcer Prevention Performance Intention
Healthcare 2021, 9(1), 76; https://doi.org/10.3390/healthcare9010076 - 14 Jan 2021
Viewed by 889
Abstract
Oral mucosa pressure ulcers (PUs) can result in frequent pain and discomfort, and have negative effects on quality of life. We aimed to examine attitude, barriers/facilitators of oral mucosa PU prevention, the ability to differentiate oral mucosa PU, and to identify factors influencing [...] Read more.
Oral mucosa pressure ulcers (PUs) can result in frequent pain and discomfort, and have negative effects on quality of life. We aimed to examine attitude, barriers/facilitators of oral mucosa PU prevention, the ability to differentiate oral mucosa PU, and to identify factors influencing PU prevention performance intention. This was a cross-sectional descriptive study of 112 nurses in seven tertiary hospitals and three secondary hospitals. The data collection period was from August to December 2018. For data analysis, descriptive statistics, t-test, ANOVA, Pearson’s correlation coefficient, and multiple regression were used. The mean score of attitudes toward oral mucosa PU prevention was 3.74 ± 0.39. Barriers to oral mucosa PU prevention were 5.65 ± 1.66, and facilitators were 5.35 ± 1.34. The mean correct answer rate of visual differentiation ability was 13%. The factors affecting intention to perform oral mucosa PU prevention were facilitators of oral mucosa PU prevention (β = 0.32, p = 0.001) and attitude (β = 0.26, p = 0.005). To increase intention to perform oral mucosa PU prevention, positive attitudes and enhanced facilitators should be encouraged. Therefore, standardized guidelines and strategies, such as educational opportunities and allocation of resources and personnel focused on oral mucosa PU prevention, need to be provided. Full article
(This article belongs to the Special Issue Innovative Solutions for Oral Healthcare)
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Article
Structure and Validity of Questionnaire for Oral Frail Screening
Healthcare 2021, 9(1), 45; https://doi.org/10.3390/healthcare9010045 - 05 Jan 2021
Cited by 4 | Viewed by 924
Abstract
Oral frailty is defined as the mild decline in oral function and located at the early and reversible stage of frailty. Therefore, early detection and early treatment of oral frailty is very useful. Simple and easy questionnaires, such as an oral frailty checklist, [...] Read more.
Oral frailty is defined as the mild decline in oral function and located at the early and reversible stage of frailty. Therefore, early detection and early treatment of oral frailty is very useful. Simple and easy questionnaires, such as an oral frailty checklist, have been widely used for the screening and enlightenment of oral frailty of the Japanese people. We evaluate the structure and validity of the oral frailty checklist. The questionnaire of oral frailty was distributed for the citizens more than 50 years old from December 2018 to January 2019. The structural validity of the questionnaire is analyzed by structural equation modeling (SEM). The characteristics of the items are analyzed by Item Response Theory (IRT). The data of 725 subjects (360 men, 359 women, 6 no answer, mean age 71.3 ± 9.05) are analyzed. The questionnaire consisted of three latent variables. Items of “Brushing teeth at least twice a day”, “Regular attendance of dental clinic”, and “Using denture”, had low discrimination ability. The questionnaire used in this study is a useful tool for the screening of oral frailty. However, its scoring system needs to be improved. Full article
(This article belongs to the Special Issue Innovative Solutions for Oral Healthcare)
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Article
Orthodontic Treatment and Healthcare Goals: Evaluation of Multibrackets Treatment Results Using PAR Index (Peer Assessment Rating)
Healthcare 2020, 8(4), 473; https://doi.org/10.3390/healthcare8040473 - 10 Nov 2020
Cited by 1 | Viewed by 809
Abstract
Background: The evaluation of orthodontic treatment outcomes using an objective method is important in order to maintain high treatment quality and final healthcare of patients. It allows professionals and university students to raise the level of the therapy. The aim of this study [...] Read more.
Background: The evaluation of orthodontic treatment outcomes using an objective method is important in order to maintain high treatment quality and final healthcare of patients. It allows professionals and university students to raise the level of the therapy. The aim of this study was to assess the orthodontic treatment outcomes in an Italian postgraduate School of Orthodontics using Peer Assessment Rating (PAR) Index. Methods: A sample of 50 patients treated in a postgraduate program was randomly selected. PAR index was used to assess pre-treatment and post-treatment study casts by two different examiners. The influence of different variables such as gender, treatment method, and need for extraction was statistically analyzed. Results: The average numerical reduction of PAR between the beginning and the end of the treatment was 18.74 (CI 95% 16.53–20.95), while the percentage reduction was 94.8% (CI 95% 91.91–97.68). All cases improved: 8% of patients resulted in the improved category, while 92% of them were in the greatly improved group. Conclusions: According to PAR index, the results showed that patients received a high-standard therapy. None of the factors studied influenced significantly the treatment outcomes. Full article
(This article belongs to the Special Issue Innovative Solutions for Oral Healthcare)
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Review

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Review
Clinical Comparation of Extra-Short (4 mm) and Long (>8 mm) Dental Implants Placed in Mandibular Bone: A Systematic Review and Metanalysis
Healthcare 2021, 9(3), 315; https://doi.org/10.3390/healthcare9030315 - 12 Mar 2021
Cited by 1 | Viewed by 915
Abstract
This systematic review (SR) aimed to evaluate implant survival rate, marginal bone loss (MBL), and biological/prosthetic complications of extra-short 4 mm dental implants. An electronic search without language or date restrictions was performed in five databases and in gray literature for articles published [...] Read more.
This systematic review (SR) aimed to evaluate implant survival rate, marginal bone loss (MBL), and biological/prosthetic complications of extra-short 4 mm dental implants. An electronic search without language or date restrictions was performed in five databases and in gray literature for articles published until August 2020. Prospective cohort studies and randomized clinical trials (RCTs) that evaluated the clinical performance of extra-short 4 mm dental implants were included. Studies were independently assessed for risk of bias using the Cochrane Collaboration’s tool. The protocol of this SR was registered in the PROSPERO database under number CRD42019139709. Four studies were included in the present SR. There was no significant difference in implant survival rate (p = 0.75) between extra-short 4 mm and long implants. After 12 months of function, the extra-short implants had a significantly (p = 0.003) lower marginal bone loss (MBL) rate when compared to long implants. Extra-short implants had a lower number of biological and prosthetic complications when compared to long implants. After 12 months of follow-up, extra-short 4 mm dental implants placed in the mandible exhibit satisfactory clinical outcomes concerning implant survival rate and MBL when compared to longer implants, with a low number of biological and prosthetic complications. A higher number of RCTs with longer follow-up is necessary for the future. Full article
(This article belongs to the Special Issue Innovative Solutions for Oral Healthcare)
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Review
The Modern and Digital Transformation of Oral Health Care: A Mini Review
Healthcare 2021, 9(2), 118; https://doi.org/10.3390/healthcare9020118 - 25 Jan 2021
Cited by 19 | Viewed by 2107
Abstract
Dentistry is a part of the field of medicine which is advocated in this digital revolution. The increasing trend in dentistry digitalization has led to the advancement in computer-derived data processing and manufacturing. This progress has been exponentially supported by the Internet of [...] Read more.
Dentistry is a part of the field of medicine which is advocated in this digital revolution. The increasing trend in dentistry digitalization has led to the advancement in computer-derived data processing and manufacturing. This progress has been exponentially supported by the Internet of medical things (IoMT), big data and analytical algorithm, internet and communication technologies (ICT) including digital social media, augmented and virtual reality (AR and VR), and artificial intelligence (AI). The interplay between these sophisticated digital aspects has dramatically changed the healthcare and biomedical sectors, especially for dentistry. This myriad of applications of technologies will not only be able to streamline oral health care, facilitate workflow, increase oral health at a fraction of the current conventional cost, relieve dentist and dental auxiliary staff from routine and laborious tasks, but also ignite participatory in personalized oral health care. This narrative article review highlights recent dentistry digitalization encompassing technological advancement, limitations, challenges, and conceptual theoretical modern approaches in oral health prevention and care, particularly in ensuring the quality, efficiency, and strategic dental care in the modern era of dentistry. Full article
(This article belongs to the Special Issue Innovative Solutions for Oral Healthcare)
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Review
Patients Taking Direct Oral Anticoagulants (DOAC) Undergoing Oral Surgery: A Review of the Literature and a Proposal of a Peri-Operative Management Protocol
Healthcare 2020, 8(3), 281; https://doi.org/10.3390/healthcare8030281 - 20 Aug 2020
Cited by 2 | Viewed by 1473
Abstract
Patients on anticoagulant therapy for the prevention of cardiovascular accidents present an increased risk of bleeding following dental and oral surgery. Four recently introduced non-vitamin K antagonist oral anticoagulants, namely dabigatran etexilate (direct thrombin inhibitor), rivaroxaban, apixaban, and edoxaban (Xa factor direct inhibitor), [...] Read more.
Patients on anticoagulant therapy for the prevention of cardiovascular accidents present an increased risk of bleeding following dental and oral surgery. Four recently introduced non-vitamin K antagonist oral anticoagulants, namely dabigatran etexilate (direct thrombin inhibitor), rivaroxaban, apixaban, and edoxaban (Xa factor direct inhibitor), are widely spreading for convenience of use compared to the older drug class. Dental management of patients taking these drugs has substantial differences compared to patients on vitamin K antagonist therapy. Anticoagulation is not assessed directly through a hematological test, but indirectly by renal function. The interventions must be scheduled at the time of minimum blood concentration of the drug. Bleeding can occur even after several days following the surgery. The interaction with drugs administered for dental care must be carefully evaluated. The peri-operative diet can influence the risk of bleeding. Local measures favoring coagulation must be adopted. The interventions with higher risk must be divided into multiple less invasive interventions. Although antidotes exist for these drugs, their use does not seem necessary for dental interventions that have been planned optimally. Furthermore, in this review of the literature a decision protocol is proposed for the evaluation of the suspension of the anticoagulant drug before oral surgery. Cessation of any anticoagulant should only be made in consultation with the patient’s general practitioner/cardiologist, who will weigh up the risk of bleeding from the proposed procedure with the risk of thrombosis/stroke in each individual patient. Full article
(This article belongs to the Special Issue Innovative Solutions for Oral Healthcare)
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Other

Jump to: Research, Review

Systematic Review
Psychological Distress among Undergraduate Dental Students in Saudi Arabia and Its Coping Strategies—A Systematic Review
Healthcare 2021, 9(4), 429; https://doi.org/10.3390/healthcare9040429 - 07 Apr 2021
Cited by 3 | Viewed by 951
Abstract
The objective of this paper was to evaluate the studies that have reported on psychological issues among dental students in Saudi Arabia and to develop coping strategies to overcome these mental health-related issues. The present systematic review is in accordance with the guidelines [...] Read more.
The objective of this paper was to evaluate the studies that have reported on psychological issues among dental students in Saudi Arabia and to develop coping strategies to overcome these mental health-related issues. The present systematic review is in accordance with the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search for the articles was carried out in the electronic databases by four independent researchers. The data search was performed in the electronic search engines like PubMed, Google Scholar, Web of Science, Scopus, Medline, Embase, Cochrane and Saudi Digital Library for scientific research articles published from January 2000 until December 2020. STROBE guidelines were adopted for qualitative analysis of six articles which met the eligibility criteria. The analysis of the literature revealed that most of the studies included were conducted in the past 8 years in different regions of Saudi Arabia. Findings of this systematic review clearly state that dental students in Saudi Arabia experience higher levels of depression, stress and anxiety and stress during their education period, with a higher stress for female students compared to male students. There is an urgent need to introduce interventional programs and preventive strategies to overcome the long-term effects. Full article
(This article belongs to the Special Issue Innovative Solutions for Oral Healthcare)
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Case Report
Natal and Neonatal Teeth: A Case Report and Mecanistical Perspective
Healthcare 2020, 8(4), 539; https://doi.org/10.3390/healthcare8040539 - 04 Dec 2020
Viewed by 1196
Abstract
The presence of teeth on babies earlier than four months is a rare condition. Therefore, adequate treatment for each case should be instituted as soon as possible, considering that certain complications may arise. This report describes a rare case in which a newborn [...] Read more.
The presence of teeth on babies earlier than four months is a rare condition. Therefore, adequate treatment for each case should be instituted as soon as possible, considering that certain complications may arise. This report describes a rare case in which a newborn baby required the extraction of two mobile mandibular natal teeth to prevent the risk of aspiration. After two years, the clinical re-evaluation showed a residual tooth instead of a temporary one. This case report shows that adequate diagnosis should include a radiographic examination to determine whether these teeth are components of normal or supernumerary dentition, as well as further investigations on the relationship with the adjacent teeth. Another important aspect highlighted in this case report is the need for a post-extraction curettage of the socket in order to reduce the risk of ongoing development of the dental papilla cells. Full article
(This article belongs to the Special Issue Innovative Solutions for Oral Healthcare)
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Case Report
A Single Case Report of Granular Cell Tumor of the Tongue Successfully Treated through 445 nm Diode Laser
Healthcare 2020, 8(3), 267; https://doi.org/10.3390/healthcare8030267 - 13 Aug 2020
Viewed by 1074
Abstract
Oral granular cell tumor (GCT) is a relatively rare, benign lesion that can easily be misdiagnosed. Particularly, the presence of pseudoepitheliomatous hyperplasia might, in some cases, lead to the hypothesis of squamous cell carcinoma. Surgical excision is the treatment of choice. Recurrence has [...] Read more.
Oral granular cell tumor (GCT) is a relatively rare, benign lesion that can easily be misdiagnosed. Particularly, the presence of pseudoepitheliomatous hyperplasia might, in some cases, lead to the hypothesis of squamous cell carcinoma. Surgical excision is the treatment of choice. Recurrence has been reported in up to 15% of cases treated with conventional surgery. Here, we reported a case of GCT of the tongue in a young female patient, which was successfully treated through 445 nm diode laser excision. Laser surgery might reduce bleeding and postoperative pain and may be associated with more rapid healing. Particularly, the vaporization effect on remnant tissues could eliminate GCT cells on the surgical bed, thus hypothetically leading to a lower rate of recurrence. In the present case, complete healing occurred in 1 week, and no recurrence was observed after 6 months. Laser surgery also allows the possibility to obtain second intention healing. Possible laser-induced histopathological artifacts should be carefully considered. Full article
(This article belongs to the Special Issue Innovative Solutions for Oral Healthcare)
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