Search Results (24)

Objectives: Digitalization has revolutionized dentistry, introducing advanced technological tools that improve diagnostic accuracy and access to healthcare. This study aims to examine the effects of integrating digital technologies into the dental field, analyzing the associated benefits and risks, with particular paid attention to the therapeutic relationship and decision-making autonomy. Materials and Methods: A literature search was conducted in PubMed, Scopus, Web of Science, and Cochrane Library, complemented by Google Scholar for non-indexed studies. The selection criteria included peer-reviewed studies published in English between 2014 and 2024, focusing on digital dentistry, artificial intelligence, and medical ethics. This is a narrative review. Elements of PRISMA guidelines were applied to enhance transparency in reporting. Results: The analysis highlighted that although digital technologies and AI offer significant benefits, such as more accurate diagnoses and personalized treatments, there are associated risks, including the loss of empathy in the dentist–patient relationship, the risk of overdiagnosis, and the possibility of bias in the data. Conclusions: The balance between technological innovation and the centrality of the dentist is crucial. A human and ethical approach to digital medicine is essential to ensure that technologies improve patient care without compromising the therapeutic relationship. To preserve the quality of dental care, it is necessary to integrate digital technologies in a way that supports, rather than replaces, the therapeutic relationship. Full article

Background: This study aimed to assess the prevalence of SARS-CoV-2 infection, vaccination, and immune status among a population, both Dentists and University Professors, within a clinical setting at one and at 12 months after COVID-19 vaccination. Methods: A cross-sectional study involving 47 professionals (aged 27–52) was conducted in the University Fernando Pessoa. Participants completed an online survey on SARS-CoV-2 infection status and vaccination, received and provided plasma samples for serological analysis. The protocol was approved by the UFP-Ethics Committee. Anti-S1-RBD SARS-CoV-2 IgM and IgG antibody titration values (AU/mL) were measured, by enzyme-linked-immunosorbent assay (ELISA), with reactive immunoglobulins (Ig) seropositivity for values ≥1 AU/mL. Results: SARS-CoV-2 infection rate increased from 8.5% in July 2021 to 48.9% in June 2022, with 8.5% experiencing reinfection. Vaccination rate was 91.5% by July 2021 and increased slightly to 93.6% by June 2022; 72.3% of the sample received a third dose. IgG seropositivity increased from 91.5% to 95.7% in June 2022. After one-year, significant associations were found between IgG seropositivity and both participant’s age (p = 0.009; <50 years) and vaccine doses (p = 0.003; 1–3 doses) received. Conclusions: SARS-CoV-2 infection rate, vaccination, and IgG seropositivity rates were high and increased over one year. The age and vaccination status were associated with the immunity status at 12th month follow-up. Findings highlight variability in IgG seroprevalence due to multiple influencing factors, which justifies future studies. Full article

Objective: This cross-sectional content analysis aimed to investigate how oil pulling is portrayed on YouTube Shorts, focusing on the types of speakers, claims made, and alignment with scientific evidence. The study further explored how the content may influence viewer perception, health behaviors, and the potential spread of misinformation. Methods: On 28 January 2025, a systematic search of YouTube Shorts was performed using the term “oil pulling” in incognito mode to reduce algorithmic bias. English language videos with at least 1000 views were included through purposive sampling. A total of 47 Shorts met the inclusion criteria. Data were extracted using a structured coding framework that recorded speaker type (e.g., dentist, hygienist, influencer), engagement metrics, stated benefits, oil type and regimen, the use of disclaimers or citations, and stance toward oil pulling rated on a 5-point Likert scale. Speaker background and nationality were determined through publicly available channel descriptions or linked websites, with user identities anonymized and ethical approval deemed unnecessary due to the use of publicly available content. In total, 47 videos met the inclusion criteria. Results: Of the 47 YouTube Shorts that met the inclusion criteria, most were posted by influencers rather than dental professionals. These videos predominantly encouraged oil pulling, often recommending coconut oil for 10–15 min daily and citing benefits such as reduced halitosis and improved gum health. However, a smaller subset advanced more extreme claims, including reversing cavities and remineralizing enamel. Notably, US-licensed dentists and dental hygienists tended to discourage or express skepticism toward oil pulling, assigning lower Likert scores (1 or 2) to influencers and alternative health practitioners (often 4 or 5). Conclusions: YouTube Shorts largely promote oil pulling through anecdotal and testimonial-driven content, often diverging from evidence-based dental recommendations. The findings reveal a disconnect between professional dental guidance and popular social media narratives. While some benefits like halitosis reduction may have limited support, exaggerated or misleading claims may result in improper oral hygiene practices. Greater engagement from dental professionals and improved health communication strategies are needed to counteract misinformation and reinforce oil pulling’s role, if any, as an adjunct—not a replacement—for standard oral care. Future studies should explore viewer interpretation, behavioral influence, and cross-platform content patterns to better understand the impact of short-form health videos. Full article

Objectives: A dentist may assume incorrect working positions throughout their professional career, which can lead to musculoskeletal disorders (MSDs). This study aimed to quantify the prevalence of self-reported MSDs in dentists and the body region most affected, as well as to evaluate the most frequent working position, the area of work and the age group most frequently associated with MSDs. Methods: This is a cross-sectional observational study adhering to the STROBE and CHERRIES guidelines, approved by the local Ethics Committee. An online questionnaire (including the Nordic Musculoskeletal Symptoms Questionnaire) was applied to a convenience sample of Portuguese and Italian dentists. Data analysis was conducted with non-parametric comparisons (IBM© SPSS^® Statistics vs. 28.0, p < 0.05). Results: A total of 341 dentists (170 Portuguese, 171 Italian) aged 18–75 years participated. The prevalence of self-reported MSDs in Portugal and Italy was 78.8% and 81.9%, respectively. The most affected self-reported MSD body regions were the neck (65.3% Portuguese and 61.4% Italian dentists), shoulder (49.4% Portuguese and 39.2% Italian) and lumbar region (52.4% and 39.2%, respectively). The neck region was the one reported to cause the highest work absenteeism. The higher age group (41–50 years and higher) has a higher risk for self-reported MSD. Multivariate analysis highlighted increased practice time as a significant risk factor for MSDs in the previous year in both countries. Age group, practice duration and work position relative to the patient were significantly linked to MSD occurrence and work avoidance. Conclusions: Dentists showed a high prevalence of self-reported MSD despite performing clinical activity mostly seated. It was concluded that dentists older than 40 years and those who have been working for more than 20 years have a higher risk of MSD, and that endodontics is the area where they report feeling more discomfort. Dentists should be encouraged to take more breaks between appointments and regular exercise to prevent the development/progression of MSDs. Full article

Background/Objectives: In Marburg (Hesse, Germany), the selective intensive preventive program (SIP) with fluoride varnish applications had to be interrupted due to the COVID-19 pandemic. The aim of this retrospective anonymized evaluation was to investigate possible effects of SIP interruption on oral health in socially vulnerable 7- and 8-year-olds. Methods: The caries increment in 7- and 8-year-olds for the test group (N = 180) between last dental check-up before the interruption of SIP (02/2019–02/2020) and the first check-up after restart (01/2022–07/2022) were calculated from dental public health service data. The test group was compared to a control group of children (N = 215; same age and schools, with SIP, data collected between the school year 2017/18 and 2019/20). One dentist conducted the dental examinations. The University of Marburg ethics committee approved the study. The Mann–Whitney U test and Pearson’s chi-square test were used for statistical analysis. Results: There was no significant difference in the caries increment in the first dentition between the test and the control group for both age groups. In the different groups, a maximum of 61% of the children with caries experience were completely treated. There was no significant difference between the test and control groups in either the percentage of sealed first permanent molars or the degree of restoration. Conclusions: The interruption of SIP had no negative impact on caries increment. It is possible that the children examined went through the pandemic without a significant increase in tooth decay because the children were well-trained in tooth brushing since kindergarten. Full article

Background/Objectives: Managing caries lesions that affect the inner third of the dentin is crucial to ensuring pulp vitality; the clinician must make decisions that will affect the vitality of the tooth. Our purpose is to understand the behavior of Spanish dentists in treating deep cavities and to examine whether variations exist based on their academic training and/or years of professional experience. Methods: This study was approved by the ethics committee of the Balearic Islands CEI-IB. A survey was conducted using the SurveyMonkey platform with 11 questions, the first 4 of which focused on defining the characteristics of the respondents. The following six concerned a clinical case of deep caries in tooth number 4.7, and the last regarded the opinion of the actual treatment of the case. The survey was sent by email in April 2022. The results were analyzed with the SPSS 29.0 program using the chi-square test. Results: A total of 347 responses were obtained (93.95%), and those surveyed stated that they apply minimal intervention concepts in their treatments, with 90.49% performing conservative dentistry treatments daily. A total of 56.48% of the respondents had bachelor’s degrees, 12.39% had graduated, 33.14% had a postgraduate degree, 38.90% had a master’s degree, and 17% had a doctorate. Most (40.63%) had been in professional practice for 16–30 years. Conclusions: Significant differences were identified regarding years of professional experience in terms of decision-making in methods of treatment and the choice of materials used for pulp protection. Likewise, significant differences were found regarding the academic training of the respondents, the cavity cleaning method selected, and the use of chemical substances for removing carious dentin. We can conclude that academic training and years of professional practice influence decision-making at some points in treating deep caries lesions. Full article

The World Health Organization’s (WHO) 2022 update on the classification of odontogenic and maxillofacial bone tumors has revolutionized diagnostic and treatment paradigms by integrating novel molecular insights. Fibro-osseous lesions of the maxillo-facial bones constitute a heterogeneous group encompassing fibrous dysplasia, Psammomatoid Ossifying Fibroma (PSOF), Juvenile Trabecular Ossifying Fibroma (JTOF), and other variants. Despite histological similarities, their distinct clinical manifestations and prognostic implications mandate precise differentiation. The intricacies of diagnosing fibro-osseous lesions pose challenges for pathologists, maxillofacial surgeons, dentists and oral surgeons, underscoring the importance of a systematic approach to ensure optimal patient management. Herein, we present two cases, fibrous dysplasia and Cemento-Ossifying Fibroma, detailing their clinical encounters and management strategies. Both patients provided informed consent for publishing their data and images, adhering to ethical guidelines. Full article

Background: Dentists bear the burden of responsibility for antimicrobial resistance since antibiotics are the drugs most prescribed by dentists. Often, “inappropriate” antibiotic use is considered as a “gray area” by dentists mainly due to ethical challenges associated with the clinical judgement depending on patients and/or prescribers. Aim: The study aimed to assess whether and in what way dental ethical principles underpin rational antibiotic use by investigating perceptions of postgraduate and undergraduate dental students without formal knowledge of dental ethics. Method: A cross-sectional anonymous survey comprised nine close-ended questions and was conducted among dental students (n = 125). The investigated practice of appropriate antibiotic prescribing in the survey relied on the respect of three basic principles of ethics: autonomy, non-maleficence, and beneficence. Results: Results show that dental students exhibit a lack of dental ethics knowledge that results in an inappropriate antibiotic-prescribing practice: prescribing an antibiotic when it is not necessary, without examination, or for indications that are not within the competence of the dentist. Multivariate regression analysis revealed that there was a significant difference between under- and postgraduates. Conclusions: Within the pharmacology course, a review of the clinical scenarios which cover both ethical and clinical complexities regarding the appropriate use of antibiotics should be introduced as an educational approach. Full article

The SWOT (strengths, weaknesses, opportunities, and threats) analysis is a framework used to evaluate a company’s competitive position and to develop strategic planning. In the competitive dental sector, it can aid dentists in identifying and analyzing internal strengths and weaknesses, as well as external opportunities and threats. This study focuses on senior dental students of the Department of Dentistry at the National and Kapodistrian University of Athens, Greece, aiming to scrutinize their use of SWOT analysis and assess its application as a tool for evaluating entrepreneurial goals and making career decisions in dental entrepreneurship. The research sample comprises 116 senior dental students (N1) in the final undergraduate year of their dental education, with data collection accomplished through the administration of an e-questionnaire during the obligatory course of “Organization and management of dental practices” in December 2023. The data extracted from the SWOT analysis encompass internal and external factors, gender distinctions, and outcomes derived from Stepwise Binary Logistic Regression concerning predictor markers. The results from the SWOT analysis of 114 valid questionnaires (N2), revealed that participants identified communication skills (50%) and organization skills (49.10%) as their primary strengths, followed by favorable personal traits contributing to goal success (36%). Weaknesses predominantly centered around emotional and personal traits like anxiety (41.20%) and other characteristics, alongside practical challenges such as lack of initial capital (24.60%). Main opportunities included collaboration with experienced dentists (33.30%) and access to training programs (27.20%), while economic instability in Greece (77.20%) and the saturated dentist profession (26.30%) were perceived as significant threats. Gender differences were notable, with female dentists more likely to report organization skills as a strength and anxiety as a weakness. Values such as industriousness, persistence, and ethics were commonly shared, with actions focusing on training programs (57.9%) and gaining experience with experienced dentists (29.8%). Cluster analysis identified two subgroups, with one emphasizing utilizing all available options (n = 49) and the other prioritizing on gaining professional skills and experience (n = 65). Logistic regression indicated that participants valuing industriousness were less likely to explore all available options, while those recognizing personal traits were more likely to do so. The study’s outcomes highlight key predictor factors linked to a proactive orientation in career decision-making among senior dental students. These insights offer valuable implications for educational institutions and career counselors. Full article

Artificial intelligence has made substantial progress in medicine. Automated dental imaging interpretation is one of the most prolific areas of research using AI. X-ray and infrared imaging systems have enabled dental clinicians to identify dental diseases since the 1950s. However, the manual process of dental disease assessment is tedious and error-prone when diagnosed by inexperienced dentists. Thus, researchers have employed different advanced computer vision techniques, and machine- and deep-learning models for dental disease diagnoses using X-ray and near-infrared imagery. Despite the notable development of AI in dentistry, certain factors affect the performance of the proposed approaches, including limited data availability, imbalanced classes, and lack of transparency and interpretability. Hence, it is of utmost importance for the research community to formulate suitable approaches, considering the existing challenges and leveraging findings from the existing studies. Based on an extensive literature review, this survey provides a brief overview of X-ray and near-infrared imaging systems. Additionally, a comprehensive insight into challenges faced by researchers in the dental domain has been brought forth in this survey. The article further offers an amalgamative assessment of both performances and methods evaluated on public benchmarks and concludes with ethical considerations and future research avenues. Full article

Cone beam computed tomography (CBCT) has become an essential tool in modern dentistry, allowing dentists to analyze the relationship between teeth and the surrounding tissues. However, traditional manual analysis can be time-consuming and its accuracy depends on the user’s proficiency. To address these limitations, deep learning (DL) systems have been integrated into CBCT analysis to improve accuracy and efficiency. Numerous DL models have been developed for tasks such as automatic diagnosis, segmentation, classification of teeth, inferior alveolar nerve, bone, airway, and preoperative planning. All research articles summarized were from Pubmed, IEEE, Google Scholar, and Web of Science up to December 2022. Many studies have demonstrated that the application of deep learning technology in CBCT examination in dentistry has achieved significant progress, and its accuracy in radiology image analysis has reached the level of clinicians. However, in some fields, its accuracy still needs to be improved. Furthermore, ethical issues and CBCT device differences may prohibit its extensive use. DL models have the potential to be used clinically as medical decision-making aids. The combination of DL and CBCT can highly reduce the workload of image reading. This review provides an up-to-date overview of the current applications of DL on CBCT images in dentistry, highlighting its potential and suggesting directions for future research. Full article

The introduction of artificial intelligence (AI)-based dental applications into clinical practice could play a significant role in improving diagnostic accuracy and reforming dental care, but its implementation relies on the readiness of dentists, as well as the health system, to adopt it in everyday practice. A cross-sectional anonymous online survey was conducted among experienced dentists and final-year undergraduate students from the School of Dental Medicine at the University of Belgrade (n = 281) in order to investigate their current perspectives and readiness to accept AI into practice. Responders (n = 193) in the present survey, especially final-year undergraduates (n = 76), showed a lack of knowledge about AI (only 7.9% of them were familiar with AI use) and were skeptical (only 34% of them believed that AI should be used), and the underlying reasons, as shown by logistic regression analyses, were a lack of knowledge about the AI technology associated with a fear of being replaced by AI, as well as a lack of regulatory policy. Female dentists perceived ethical issues more significantly than men regarding AI implementation in the practice. The present results encourage an ethical debate on education/training and regulatory policies for AI as a prerequisite for regular AI use in dental practice. Full article

Professional dental ethics for students are based on promoting oral health for dental patients and reinforcing an anthropocentric approach to communication and dental services. A total of 133 dental students (males 33.8% N1 = 46, females 66.2% N2 = 87) completed the study questionnaire. Descriptive statistics were applied, and non-parametric Kruskal–Wallis tests were used (p < 0.05). Students refuse services to patients that misbehave (37.6%), have irrational demands (18%), and when clinical cases exceed their capabilities (36.8%). Of the participants, 50.4% want to waive confidentiality when abuse is declared. Ethical role models are educators (33.8%), other qualified dentists (25.6%), and their parents (21.8%). Female gender positively affects integrity (p = 0.046), altruism (p = 0.032), and difficulty in conversations among colleagues (p = 0.036). Students outside the capital are less interested in esthetic issues (p = 0.007), in giving more than one treatment plan (p = 0.006), and in being confronted with inadequate treatments from other colleagues (p = 0.005). Family income positively affects clinical skills (p = 0.003), trust issues (p = 0.008), and moral insight and intuition (p = 0.02). Presentation with clinical scenarios is the preferred educational method (49.6%). Dental students show compassion for poor patients, respect patients’ autonomy, and guide patients to choose the best treatment plan before receiving dental ethics seminars. There is a positive relationship between the ethical footprints of students and gender, origin, family income, postgraduate studies, and future professional plans. Factors and ways to incorporate ethics in the dental curriculum could be considered when planning relevant courses. Full article

Objectives: Dialysis patients suffer from xerostomia based on hyposalivation even in stimulated saliva testing. Therefore, the aim of this study was (i) to evaluate an optimized oral hygiene system with an oral care gel reducing oral dryness, supporting dental plaque control and reducing the number of gingivitis affected teeth; (ii) to document the efficacy in a randomized controlled trial with dental indices; and (iii) to record the individual’s oral health related quality of life. Methods: After ethical approval (EC-UWH 103/2019), 44 dialysis patients provided signed informed consent and were divided into two groups followed up for four weeks. Subjects of the verum group (A) received daily oral care gel OROFAN^® based on biopolymers with a mild antibacterial and saliva stimulating action. They were compared to the control group (B) who executed routine oral hygiene with conventional dentifrice and toothbrushes. At baseline (T0), the medical report and all dental indices (sialometry, DMF/S, plaque index, periodontal index, tongue coating and denture hygiene index) were assessed. After 2 weeks and 4 weeks, T1 and T2 dry mouth frequency and all dental indices were assessed. An Oral Health Impact Profile was documented at baseline (T0) and at the end of the study (T2). Results: Twenty-two subjects were allocated to group A and to group B. At baseline, there were no statistical differences concerning renal insufficiency (years on dialysis and complications), systemic diseases and dental background (caries experience, periodontal diseases, plaque index and number of gingivitis affected teeth). All subjects exhibited hyposalivation (<0.7–1.0 mL/min). The control group (B) showed no statistical differences from baseline (T0) to the end of the study (T2) in dry mouth parameters, in all dental plaque and inflammation indices and in their Oral Health Impact Profile. In contrast, the verum group (A) exhibited a highly significant (p < 0.001) decrease in xerostomia frequency, in the number of gingivitis affected teeth and in their plaque index. Furthermore, their Oral Health Impact Profile improved considerably (p < 0.01). Significance of Results: Terminally ill patients may gain better oral health and, consequently, an improved quality of life by rather simple oral care using long-lasting, edible anti-inflammatory oral hygiene gel and a dentist’s devotion. Full article

The lack of vaccines in the first half of 2021 led to the need to prioritize access to vaccination. This approach has been associated with a number of issues, including ethics and effectiveness. However, analyses providing data on this topic are scarce. This work describes the effect of a priority approach to vaccination on the different development of the pandemic between Czech dentists and the Czech general population. The dentist-related data were obtained from survey studies published in 2021 and 2022, and the Czech general population data were mined from the Our World in Data online database. The analysis shows that until the beginning of vaccination, i.e., in December 2020, the prevalence of laboratory-confirmed COVID-19 infection among dentists was higher than in the general population by 22.5% (8.65% vs. 6.70%). This trend was reversed already in the first month after the start of vaccination, and the difference increased every month. Finally, in June 2021, priority vaccination statistically significantly (p < 0.0001) reduced the resulting prevalence among dentists (12.67%) compared to the general population (15.55%), which is a difference of 18.5%. This represents a prevalence shift between the populations by 40% during 6 months of priority vaccination. The results support the conclusion that the priority vaccination of healthcare workers was not only ethical but also rational and effective. Full article