PURPOSE/OBJECTIVE:Studies show that short-duration trainings with real-time feedback can improve visible light curing unit (VLCU) technique among dental students. This study tested the effect of such trainings on individuals from different professional backgrounds (dental students, assistants, hygienists, and dentists). METHODS:Attendees (n = 109) at a large dental meeting were asked to light-cure a simulated occlusal Class I posterior restoration using a Managing Accurate Resin Curing Patient Simulator (MARC-PS) as they would in practice or Simulation Clinic. They were then provided visual feedback and short, technique-focused instruction before repeating the simulation. Differences in mean irradiance (mW/cm2), total radiant exposure (J/cm2), rates of minimally acceptable (> 6J/cm2), and optimal (≥ 16J/cm2) radiant exposures, and the stability of radiant exposure curve profiles were compared by profession before and after training using a combination of Kruskal-Wallis, Wilcoxon Signed Rank, and χ2 tests. RESULTS:Results showed significant increases in mean irradiance (χ2 = 32.8, p-value < 0.001), total radiant exposure (χ2 = 17.304, p-value < 0.001), and rates of stable radiant exposure profiles (χ2 = 32.5, p-value < 0.0001) after training for dental students, hygienists, and assistants. The magnitude of increase varied by profession, which hygienists showing the greatest increase. In addition, training had a stabilizing effect that lowered variance across groups and produced more uniform irradiance and total radiant exposure values regardless of professional background. CONCLUSIONS:These short refresher trainings were an effective way to improve VLCU technique regardless of professional background and have the added benefit of producing uniformity across different members of the dental team.

The introduction of self-adhesive filling materials has shown advantage in clinical use due to reduced procedure time. The newly developed self-adhesive Surefil One (SO) was compared to other current self-adhesive materials Vertise Flow (VF) and GC Fuji II LC (FJ). Shear bond strength (SBS) to dentin, flexural strength and water sorption were measured at 24 h and 4 weeks. Fluoride release was measured up to 4 weeks. SO showed intermediate fluoride-release that was higher than VF, but lower than FJ. SO demonstrated lower flexural strength than VF at 24 h but maintained that same strength to 4 weeks. SO had SBS comparable to FJ and VF at 24 h but it decreased at 4 weeks. Caution should be exercised when selecting and using SO, as well as the other two self-adhesive materials. Further studies are necessary to evaluate the efficacy for their clinical use in direct restorations.

OBJECTIVES:Approximately two-thirds of the world's population suffers from dental caries, and clinical treatment of the resulting lesions varies from dental fillings to devitalization. Despite recent advances in regenerative endodontic therapy, scaffolds intended for the regeneration of the dentin-pulp complex with innate odontogenic potential and microarchitecture similar to these dental tissues are still scarce. Taking advantage of the physio-biological properties of demineralized dentin extracellular matrix (ECM), we developed a functional hydrogel that combines insoluble molecules of dentin with chitosan. METHODS:Dentin powder obtained from extracted teeth was partially demineralized with acetic acid. Demineralized dentin and chitosan powder were separately dissolved in acetic acid to form suspensions that were then mixed in volume ratios of 25/75 or 50/50 (v/v %). The extrudability and gelation time of hydrogel precursors were assessed. Three-dimensional constructs were fabricated following pre-hydrogels pH-adjustment, injection into custom-made molds and incubation at 37 °C. Constructs were characterized for infrared spectral analysis, relative sol-gel fraction, degree of porosity, flexural elastic modulus, in-vitro biodegradability, in-vitro bioactivity, antimicrobial properties against Enterococcus faecalis and biocompatibility for OD-21 cells. RESULTS:For most of the tested properties, the two proposed hydrogels showed differences, but regardless of these differences, both materials presented morphology, biomechanical attributes, cytocompatibility, and antibacterial properties to serve as dental pulp cell-inducing scaffolds. CONCLUSIONS:Dentin ECM-chitosan hydrogels exhibited in-vitro bioactivity, biocompatibility, and antimicrobial properties to be considered as promising candidates for application as injectable scaffolds for dentin-pulp complex regeneration. CLINICAL SIGNIFICANCE:Extracellular matrices (ECMs) from native tissues have long been considered ideal scaffolds for tissue regeneration. Here, we describe the physicochemical, mechanical, and biological attributes of newly developed hydrogels derived from the functionalization of demineralized dentin ECM with chitosan. The proposed dentin-ECM-chitosan hydrogels have demonstrable microarchitecture, biophysical characteristics, biocompatibility, and antibacterial capacity to produce cell-inducing scaffolds for use in regenerative dentistry.

Objective:To survey the commonality of needle-changing practices among veterinarians and measure whether 1 or 2 passages through a vaccine vial septum affects needle sharpness. Methods:An anonymous online survey of needle-changing behaviors by veterinary professionals was conducted from April to May 2023. Subsequently, a blinded randomized controlled bench trial assessed the impact of septum passage on needle sharpness between June and August 2023 at Midwestern University. Veterinary hypodermic needles of 3 brands and 4 gauges were tested after passing through a septum 0, 1, or 2 times. The primary outcome was the peak penetration force (PF) required to puncture standardized material. Secondary analysis involved visual examination of needles with the use of an optical 3-D surface roughness measurement instrument. Results:Of 482 survey respondents, 76% routinely changed needles due to concerns about dulling. Experimental results showed a minor increase in PF after 1 (9%) and 2 (18%) septum passages. Needle gauge and brand impacted PF more than septum passage, with differences of 6% to 58% and 9% to 10%, respectively. Visual inspection revealed a 40% incidence of gross defects after 1 passage and 52% after 2 passages, with PF through the vial septum being the strongest damage predictor. Conclusions:While septum passage slightly increased the PF, brand and gauge had a more substantial impact. Clinical Relevance:This study suggests that changing needles may not be necessary for maintaining sharpness if proper technique is used, potentially reducing the risk of needlestick injuries and medical waste.

ABSTRACT Background Dental schools play an influential role in shaping education and training of future dental professionals. This study investigated the prevalence and evolving trend of opioid analgesic prescription across dental surgical and endodontic procedures between 2013–2023 within a predoctoral dental school. Methods Electronic health records (axiUm database) of our predoctoral dental school were retrospectively searched for dental surgical and endodontic procedure codes dated between July 2013–May 2023. Differences in frequency of opioid prescriptions across study period and procedure types were compared using Chi‐square tests. Logistic regression was used to determine whether COVID‐19 pandemic, tooth involved, patient's age, or multiple‐procedure were associated with the prescription of opioid analgesics. Results A total of 1,145 opioid prescriptions were dispensed after 54,652 dental surgical and endodontic procedures completed over 41,343 dental visits. The prevalence of opioid‐prescribing practice was 3.3% after dental surgical procedures and 0.7% after endodontic procedures, with a statistically significant difference across procedure types ( p < 0.00001). 42.4% of all opioid prescriptions were dispensed after surgical removal of erupted teeth. Opioid‐analgesic prescribing practice was influenced by multiple procedures conducted during the same dental visit (odds ratio, OR = 9,047,709), tooth number (OR = 1.04), and COVID‐19 period (OR = 6,101,435). The 10‐year period revealed a −58.3% percentage change in opioid‐prescribing practices (from 1.2% in 2013 to 0.5% in 2023), after a peak in 2016 (∼6.1%). Conclusions There was a low combined 2.8% prevalence of opioid‐analgesic prescriptions following dental surgical (3.3% prevalence) and endodontic (0.7% prevalence) procedures at a predoctoral dental school, with a steady decline after 2016.

Objectives: Obstructive sleep apnea (OSA) poses a significant global health burden but remains largely undertreated and underdiagnosed.Its screening relies on acquiring robust multidisciplinary knowledge and clinical application during training.However, its educational presence in predoctoral dental schools is limited.This cross-sectional study evaluated the knowledge of OSA among predoctoral dental students at various stages of education and their awareness of the dentist's role in managing OSA.Two campuses of the same institution, offering different approaches of educational contents on OSA, were compared.Methods: A REDCap TM survey, consisting of the Obstructive Sleep Apnea Knowledge and Attitudes questionnaire, was distributed to all dental students from the two campuses (College of Dental Medicine-Arizona and College of Dental Medicine-Illinois) across all 4 years of dental school.Knowledge percentage and mean score were calculated based on number of correct answers and compared between the two campuses, sex, academic performance, and years of education with independent t-test, chi-square, and analysis of variance. Results:The survey was completed by 169 students.Average total knowledge score was 59.1% (10.6 ± 3.7).Third-and fourth-year students scored significantly higher than first-and second-year students.Participants from the campus with more OSA educational content achieved higher overall scores.Self-reported hours of education positively correlated with knowledge scores.As many as 87.0% of the participants were aware of the role of dental providers in managing OSA. Conclusion:This study highlighted a moderate knowledge of OSA among dental students.As increased hours of education was associated with greater knowledge in this field, it also emphasized the importance of integrating more educational content on OSA into the predoctoral curriculum.

Objectives: To measure difference in tooth shade and color achieved via two different over-the-counter bleaching agents with and without their associated light-emitting diodes (LEDs). Methods: A total of 84 extracted human anterior teeth were randomly divided into seven groups. Gypsum models were made with 6 extracted teeth in an arch form (n = 12; 2 arches/group). Samples were kept hydrated throughout treatment (25 degrees C). Bleaching treatment followed manufacturers' instructions with at least 1-h of rehydration between treatments. Control tooth arches were left untreated. L*a*b* values were measured with a Vita Easyshade (VITA North America, Yorba Linda, CA) three times per tooth using white and black backgrounds. triangle E (CIE 2000) was compared between and within treatment groups over time with ANOVA and post hoc Tukey (a = 0.05). Results: Subgroup testing confirmed the data were normally distributed. Two-way ANOVA showed significant interaction between product (Control, Crest, Snow) and treatment (light only, product only, light and product) on triangle E values for black (p-value < 0.001, F = 15.28) and white (p-value < 0.001, F = 13.62) backgrounds. Post hoc pairwise Tukey tests showed a significant effect of light-and-product treatments in contrast to light- or product-only treatments. Repeated measures ANOVA of between-treatment change (triangle E) by product showed significant interaction between time and treatment for Snow products (p < 0.001, F = 10.9) and independent effects of time and treatment for Crest products (Time: p-value < 0.001, Treatment: p-value < 0.01, F = 7.21) on a black background. On white backgrounds, only a significant effect of treatment was reported for both Snow (p-value < 0.01, F = 5.427) and Crest (p-value < 0.001, F = 5.61). Conclusions: Overall, a combination of light and gel produces significantly higher tooth color and shade change over time, with the highest change seen for Snow products. Statement of Significance: Many patients use over-the-counter tooth bleaching products because they are more cost effective and easier to access than in-office bleaching. However, these products may have adverse effects, such as increased sensitivity with repeated use, in addition to increased consumption of time and money. This project measured tooth shade between treatments which can help determine which product is most effective for at home use.

Chitosan (CS) and phloroglucinol (PhG), two extracts abundantly found in marine life, were investigated for their ability to biomodify demineralized dentin by enhancing collagen crosslinks and improving dentin extracellular matrix (ECM) mechanical and biochemical stability. Dentin obtained from non-carious extracted human molars were demineralized with phosphoric acid. Baseline Fourier-transform infrared (FTIR) spectra, apparent flexural elastic modulus (AE) and dry mass (DM) of each specimen were independently acquired. Specimens were randomly incubated for 5 min into either ultrapure water (no-treatment), 1% glutaraldehyde (GA), 1% CS or 1% PhG. Water and GA were used, respectively, as a negative and positive control for collagen crosslinks. Specimens' post-treatment FTIR spectra, AE, and DM were obtained and compared with correspondent baseline measurements. Additionally, the host-derived proteolytic activity of dentin ECM was assessed using hydroxyproline assay (HYP) and spectrofluorometric analysis of a fluorescent-quenched substrate specific for matrix metalloproteinases (MMPs). Finally, the bond strength of an etch-and-rinse adhesive was evaluated after application of marine compounds as non-rinsing dentin primers. Dentin specimens FTIR spectral profile changed remarkably, and their AE increased significantly after treatment with marine compounds. DM variation, HYP assay and fluorogenic substrate analysis concurrently indicated the biodegradation of CS- and PhG-treated specimens was significantly lesser in comparison with untreated specimens. CS and PhG treatments enhanced biomechanical/biochemical stability of demineralized dentin. These novel results show that PhG is a primer with the capacity to biomodify demineralized dentin, hence rendering it less susceptible to biodegradation by host-proteases.

(1) Background: Joint hypermobility refers to joint movement beyond normal range. Dentistry requires fine motor skills and manual dexterity; thus, the presence of hand joint hypermobility requires early assessment and intervention. The aim of this cross-sectional study was to assess the prevalence of hand joint hypermobility among first-year dental students and investigate correlations between the severity of their hypermobility and muscular strength. (2) Methods: First-year dental students were evaluated by an occupational therapy team composed of certified hand therapists. The extension of distal interphalangeal, proximal interphalangeal, and metacarpophalangeal finger joints was assessed with bilateral testing of digit hypermobility (with a cut-off of >20° for hypermobility) and classified as high, moderate, or low risk according to number/types of joints involved. Muscular strength was assessed by comparing grip strength, lateral pinch, and three-point pinch to norm values. Right- vs. left-handed individuals, and females vs. males were compared with an independent t-test; the relationships between the variables were investigated using the Pearson correlation. (3) Results: Out of 141 dental students (24.6 ± 3.0, 70% females, 87% right-handed), 15% and 16% were classified as having a high and moderate risk of hypermobility, respectively, with no sex difference. Right-handed students scored significantly higher in the right lateral pinch than left-handed students (18.2 ± 4.8 vs. 13.2 ± 4.1, p = 0.045). A higher severity of hypermobility was associated with bilateral lower grip and pinch strength (p < 0.05). (4) Conclusions: One third of the first-year dental students exhibited moderate to severe hand joint hypermobility. Moreover, those identified as having moderate to severe hand joint hypermobility showed a decreased grip strength.

Recent studies have revealed considerable promise in the antiviral properties of metal nanomaterials, specifically when biologically prepared. This study demonstrates for the first time the antiviral roles of the plant cell-engineered gold nanoparticles (pAuNPs) alone and when conjugated with quercetin (pAuNPsQ). We show here that the quercetin conjugated nanoparticles (pAuNPsQ) preferentially inhibit the cell entry of two medically important viruses-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and herpes simplex virus type-1 (HSV-1) using different mechanisms. Interestingly, in the case of SARS-CoV-2, the pre-treatment of target cells with pAuNPsQ inhibited the viral entry, but the pre-treatment of the virus with pAuNPsQ did not affect viral entry into the host cell. In contrast, pAuNPsQ demonstrated effective blocking capabilities against HSV-1 entry, either during the pre-treatment of target cells or by inducing virus neutralization. In addition, pAuNPsQ also significantly affected HSV-1 replication, evidenced by the plaque-counting assay. In this study, we also tested the chemically synthesized gold nanoparticles (cAuNPs) of identical size and shape and observed comparable effects. The versatility of plant cell-based nanomaterial fabrication and its modification with bioactive compounds opens a new frontier in therapeutics, specifically in designing novel antiviral formulations.

AIMS:Chitosan-based biomaterials exhibit several properties of biological interest for endodontic treatment. Herein, a low molecular weight chitosan (CH) solution was tested for its antimicrobial activity against Enterococcus faecalis (E. faecalis) and effects on dentine structure.METHODOLOGY:The root canal of 27 extracted uniradicular teeth were biomechanically prepared, inoculated with a suspension of E. faecalis and randomly assigned to be irrigated with either 5.25% sodium hypochlorite (NaClO), 0.2% CH or sterile ultrapure water (W). Bacteriologic samples were collected from root canals and quantified for of E. faecalis colony-forming units (CFUs). The effectiveness of CH over E. faecalis biofilms was further measured using the MBEC Assay®. Additionally, dentine beams and dentine powder were obtained, respectively, from crowns and roots of 20 extracted third molars. Dentine samples were treated or not with 17% EDTA and immersed in either CH or W for 1 min. The effects of CH on dentine structure were evaluated by assessment of the modulus of elasticity, endogenous proteolytic activity and biochemical modifications.RESULTS:The number of E. faecalis CFUs was significantly lower for samples irrigated with CH and NaClO. No significant differences were found between CH and NaClO treatments. Higher modulus of elasticity and lower proteolytic activity were reported for dentine CH-treated specimens. Chemical interaction between CH and dentine was observed for samples treated or not with EDTA.CONCLUSIONS:Present findings suggest that CH could be used as an irrigant during root canal treatment with the triple benefit of reducing bacterial activity, mechanically reinforcing dentine and inhibiting dentine proteolytic activity.

Chitosan-based biomaterials exhibit several properties of biological interest for endodontic treatment. Herein, a low molecular weight chitosan (CH) solution was tested for its antimicrobial activity against Enterococcus faecalis ( E. faecalis ) and effects on dentine structure. The root canal of 27 extracted uniradicular teeth were biomechanically prepared, inoculated with a suspension of E. faecalis and randomly assigned to be irrigated with either 5.25% sodium hypochlorite (NaClO), 0.2% CH or sterile ultrapure water (W). Bacteriologic samples were collected from root canals and quantified for of E. faecalis colony-forming units (CFUs). The effectiveness of CH over E. faecalis biofilms was further measured using the MBEC Assay®. Additionally, dentine beams and dentine powder were obtained, respectively, from crowns and roots of 20 extracted third molars. Dentine samples were treated or not with 17% EDTA and immersed in either CH or W for 1 min. The effects of CH on dentine structure were evaluated by assessment of the modulus of elasticity, endogenous proteolytic activity and biochemical modifications. The number of E. faecalis CFUs was significantly lower for samples irrigated with CH and NaClO. No significant differences were found between CH and NaClO treatments. Higher modulus of elasticity and lower proteolytic activity were reported for dentine CH-treated specimens. Chemical interaction between CH and dentine was observed for samples treated or not with EDTA. Present findings suggest that CH could be used as an irrigant during root canal treatment with the triple benefit of reducing bacterial activity, mechanically reinforcing dentine and inhibiting dentine proteolytic activity.

Experimental adhesives containing co-doped metaloxide nanoparticles were demonstrated to display strong and long-term antibacterial properties against Streptococcus mutans biofilms. The present study represents an effort to characterize the shear-bond strength (SBS) and color stability (CS) of these novel biomaterials. Experimental adhesives were obtained by dispersing nitrogen and fluorine co-doped titanium dioxide nanoparticles (NF_TiO2, 10%, 20% or 30%, v/v%) into OptiBond Solo Plus (OPTB). Dentin surfaces were wet-polished (600-Grit). Specimens (n = 5/group) of Tetric EvoCeram were fabricated and bonded using either OPTB or experimental (OPTB + NF_TiO2) adhesives. Specimens were stored in water (37 °C) for twenty-four hours (T1), three months (T2), and six months (T3). At T1, T2, or T3, specimens were removed from water storage and were tested for SBS. Disc-shaped specimens (n = 10/group; d = 6.0 mm, t = 0.5 mm) of adhesives investigated were fabricated and subjected to thermocycling (10,000 cycles, 5–55 °C, 15 s dwell time). Specimens’ colors were determined with a VITA Easyshade® V spectrophotometer (after every 1000 cycles). SBS data was analyzed using two-way ANOVA and post-hoc Tukey tests, while CS data was analyzed using one-way ANOVA and post-hoc Tukey tests (α = 0.05). Mean values of SBS ranged from 16.39 ± 4.20 MPa (OPTB + 30%NF_TiO2) to 19.11 ± 1.11 MPa (OPTB), from 12.99 ± 2.53 MPa (OPTB + 30% NF_TiO2) to 14.87 ± 2.02 (OPTB) and from 11.37 ± 1.89 (OPTB + 20% NF_TiO2) to 14.19 ± 2.24 (OPTB) after twenty-four hours, three months, and six months of water storage, respectively. Experimental materials had SBS values that were comparable (p > 0.05) to those from OPTB independently of nanoparticle concentration or time-point considered. Experimental materials with higher NF_TiO2 concentrations had less intense color variations and were more color stable than OPTB even after 10,000 thermocycles. In combination, the results reported have demonstrated that experimental adhesives can establish strong and durable bonds to human dentin while displaying colors that are more stable, thereby suggesting that the antibacterial nanotechnology investigated can withstand the harsh conditions within the oral cavity without compromising the esthetic component of dental restorations.

INTRODUCTION:Musculoskeletal (MSK) disorders account for 11%-98% of occupational health issues for dental professionals, with an onset as early as in dental school. Dental ergonomics is among the risk factors; thus, a prompt assessment is crucial in preventing future MSK pain. The aim of this study was to retrospectively assess dental ergonomics of second-year dental students after dedicated lectures were introduced in the predoctoral curriculum.METHODS:Three cohorts of second-year dental students were evaluated during preclinical activity in July 2019, January 2022, and December 2022 by an Occupational Therapy (OT) faculty and calibrated OT students. Dental ergonomics was assessed with the Rapid Upper Limb Assessment (RULA). Dental student cohorts were compared with one-way analysis of variance (ANOVA).RESULTS:The average RULA final score of 409 participants was 5.1 ± 0.9, with no difference between the three cohorts (p = 0.676). The January 2022 cohort scored significantly lower in wrist-arm score than that of 2019 (p = 0.001) and December 2022 (p = 0.046). Neck and lower limb posture were significantly higher in January 2022 cohort than in 2019 (p = 0.001 and 0.013) and December 2022 (p = 0.001 and 0.005) cohorts. The December 2022 cohort revealed a medium, high and extremely high risk of developing MSK of 40.2%, 37.1%, and 21.6%, respectively, with no difference between sexes.CONCLUSION:The risk of developing MSK pain was medium-high in predoctoral dental students and was not related to sex. The overall dental ergonomics required attention and rapid change. Further implementation of varied forms of teaching and monitoring of dental ergonomics from the early years of education is recommended to prevent development of MSK pain at young age and foster better postural habits.

Gelatin-methacryloyl hydrogels (GelMA) have demonstrated their utility as scaffolds in a variety of tissue engineering applications. OBJECTIVES:In this study, a highly functionalized GelMA hydrogel was synthesized and assessed for degree of functionalization. As the proposed GelMA hydrogel was coupled to a visible-light photoinitiator, we hypothesized it might serve as base to formulate a model dentin primer for application in restorative dentistry. METHODS:GelMA was mixed with photoinitiator lithium phenyl-2,4,6-trimethylbenzoylphosphinate (LAP), photopolymerized for 0-40 s using a dental light-curing device and tested for extrudability, degree of photo-crosslinking (DPxlink), water sorption/solubility/swelling (WS/SL/SW) and apparent modulus of elasticity (AE). Model dentin primer was prepared by mixing GelMA+LAP with a primer of a commercial three-step etch-and-rinse adhesive. After application of GelMA-based primer to acid-etched dentin, samples were bonded with correspondent adhesive agent, photopolymerized and had their immediate bond strength compared to control samples primed and bonded with the same commercial material. RESULTS:Extrudability of hydrogel was confirmed using a microsyringe to write the acronym "CDMI". DPxlink of GelMA+LAP changed significantly as a function of photopolymerization time (20 s < 30 s ≤ 40 s). WS, SL and SW were significantly reduced in hydrogels polymerized for 30 and 40 s. AE of hydrogels varied significantly as a function of photopolymerization time (20 s < 30 s ≤ 40 s; 20 s ‡ 40 s). Bond strength of dentin primed with GelMA-based primer was lower (∼29.3 MPa) but not significantly of that of control (∼34.6 MPa). CONCLUSIONS:Optimization of a GelMA-based dentin primers can lead to the development of promising biomimetic adhesives for dentin rehabilitation.

PURPOSE/OBJECTIVES:This study had a twofold outcome. The first aim was to develop an efficient, machine learning (ML) model using data from a dental school clinic (DSC) electronic health record (EHR). This model identified patients with a high likelihood of failing an appointment and provided a user-friendly system with a rating score that would alert clinicians and administrators of patients at high risk of no-show appointments. The second aim was to identify key factors with ML modeling that contributed to patient no-show appointments.METHODS:Using de-identified data from a DSC EHR, eight ML algorithms were evaluated: simple decision tree, bagging regressor classifier, random forest classifier, gradient boosted regression, AdaBoost regression, XGBoost regression, neural network, and logistic regression classifier. The performance of each model was assessed using a confusion matrix with different threshold level of probability; precision, recall and predicted accuracy on each threshold; receiver-operating characteristic curve (ROC) and area under curve (AUC); as well as F1 score.RESULTS:The ML models agreed on the threshold of probability score at 0.20-0.25 with Bagging classifier as the model that performed best with a F1 score of 0.41 and AUC of 0.76. Results showed a strong correlation between appointment failure and appointment confirmation, patient's age, number of visits before the appointment, total number of prior failed appointments, appointment lead time, as well as the patient's total number of medical alerts.CONCLUSIONS:Altogether, the implementation of this user-friendly ML model can improve DSC workflow, benefiting dental students learning outcomes and optimizing personalized patient care.

Early diagnosis of oral potentially malignant disorders (OPMDs) may be hindered by similar clinical presentations shared between benign oral lesions and OPMDs. The goal of this retrospective pilot study was to assess the use of machine learning (ML) as an adjunctive evaluation in conjunction with conventional comprehensive oral examination of OMPDs. Digital images of 80 deidentified intraoral lesions (40 benign intraoral lesions and 40 OPMDs) were collected. The images, which were previously identified independently by experienced oral pathologists, were used to create 3 datasets: raw images, grayscale images, and enhanced color images. The datasets were subsequently divided into training (n = 60), test (n = 10), and validation (n = 10) groups so that class labels (benign lesion or OMPD) were distributed equally in each group. A cross-validated grid search was used to optimize the hyperparameters of the Extreme Gradient Boosting (XGBoost) classifications model. Predictions were made on the test group and used to optimize the prediction threshold. The final results were validated by predictions based on the validation group. The XGBoost classification model was able to differentiate between benign intraoral lesions and OPMDs with a mean classification accuracy of 70%, sensitivity of 80%, and specificity of 60% when grayscale and enhanced color intraoral images were used. A mean classification accuracy of 50%, sensitivity of 40%, and specificity of 60% were observed when raw intraoral images were used. The results demonstrated that ML may be a promising tool for the diagnosis of OPMDs when used as an adjunct to conventional comprehensive oral examination.

This prospective clinical study evaluated the experiences and preferences of both patients and clinicians when performing class I–V cavity preparation procedures using a 9300 nm CO2 laser without anesthetic. A total of 233 procedures were performed on 103 patients. Following treatment, patients were asked to describe discomfort/pain levels and preferences for future treatment with either laser treatment or traditional therapy. Additionally, clinicians were asked to rate their experiences with the procedures in three technical domains: speed, ease-of-use, and precision. In total, 98% of patients preferred laser treatment to traditional therapy and 93% of all procedures performed were completed with no anesthesia. Younger patients and patients receiving multiple restorations reported significantly higher discomfort, though discomfort scores were very low overall (below 3 on a 10-point pain scale). While there were significant differences in clinician experiences, each clinician reported having generally high satisfaction using the laser with respect to speed, ease of use, and precision. In conclusion, the 9300 nm CO2 laser provides clinicians a viable option for cavity preparations in dentistry as evidenced by high rates of anesthesia-free procedures with low reported discomfort, the fact that nearly all patients would opt for laser use on future cavity preparations, and generally positive experiences reported by clinicians.