German Dentists' Preferences for the Treatment of Apical Periodontitis: A Cross-Sectional Survey

Artificial Intelligence in Dentistry: A Narrative Review of Diagnostic and Therapeutic Applications

Advancements in digital and precision medicine have fostered the rapid development of artificial intelligence (AI) applications, including machine learning, artificial neural networks (ANN), and deep learning, within the field of dentistry, particularly in imaging diagnosis and treatment. This review examines the progress of AI across various domains of dentistry, focusing on its role in enhancing diagnostics and optimizing treatment for oral diseases such as endodontic disease, periodontal disease, oral implantology, orthodontics, prosthodontic treatment, and oral and maxillofacial surgery. Additionally, it discusses the emerging opportunities and challenges associated with these technologies. The findings indicate that AI can be effectively utilized in numerous aspects of oral healthcare, including prevention, early screening, accurate diagnosis, treatment plan design assistance, treatment execution, follow-up monitoring, and prognosis assessment. However, notable challenges persist, including issues related to inaccurate data annotation, limited capability for fine-grained feature expression, a lack of universally applicable models, potential biases in learning algorithms, and legal risks pertaining to medical malpractice and data privacy breaches. Looking forward, future research is expected to concentrate on overcoming these challenges to enhance the accuracy and applicability of AI in diagnosing and treating oral diseases. This review aims to provide a comprehensive overview of the current state of AI in dentistry and to identify pathways for its effective integration into clinical practice.

Inconsistent decision making in dental caries diagnosis and treatment: A case-based questionnaire survey

Background and Aims

Delayed implementation of new knowledge into clinical practice poses patient safety risks. This study investigates agreement on use of the dental caries interventions, sealing, and stepwise excavation.

Methods

A cross-sectional questionnaire survey, based on 11 constructed cases with descriptions of patient symptoms, radiographic, and clinical findings. Interrater agreement on dental caries- and pulp diagnoses and interventions were measured with Cohen's and Light's κ. The data collection period was September 28 to November 5, 2021. To explore variations in use and knowledge factors, we examined Danish dentists' attitudes toward continuing education.

Results

Based on 243 responses, moderate interrater agreement for dental caries and pulp diagnoses and weak agreement on interventions were seen. The agreement with the gold standard for caries was moderate. No agreement was found for dental pulp diagnosis, and for interventions the agreement was weak. No pattern in agreement with the gold standard was seen in relation to case difficulty level. The majority reported knowing of and using stepwise excavation, in conflict with findings that less than half chose stepwise excavation in cases, where considered appropriate. One in four (25%) reported to be unfamiliar with sealing, and half (50%) use sealing regularly. Better access to continuing education and for universities to offer continuing education as alternatives to one-sided private market were requested.

Conclusion

Some patients may receive too radical treatment despite available less invasive evidence-based effective treatments. Dentists acknowledge the importance of continuing education. Easier access and perhaps more incentives for seeking out high-quality continuing education from trustworthy sources are needed.

Endo-Perio Lesions and Dentists' Treatment Approach: A Survey

BACKGROUND Endo-perio lesions are a great challenge for dentists. The aim of this study was to evaluate the treatment approach of dental practitioners to endo-perio lesions by considering the current endo-perio classification. MATERIAL AND METHODS An online survey was prepared, consisting of questions about the treatment approach to 3 simulated cases with endo-perio lesions, shown on periapical radiography. Details of the patient's age, presence of systemic disease, smoking, and how the single- or multi-rooted tooth would affect the treatment plan were also included in the simulated cases presented in the survey. The survey was sent to 1500 dentists via e-mail, WhatsApp, and social media platforms. The chi-square test was used for comparison of data. Significance was evaluated at P<0.05. RESULTS In total, 338 dentists participated in the survey, including general dentists, endodontists, and periodontists. Fifty-three percent of participants stated that they would perform root canal treatment and initial periodontal treatment simultaneously, when both treatments were required. In cases classified as grade 3, most general dentists, endodontists, and periodontists answered that they would prescribe systemic antibiotics if there was diffuse extra-oral swelling (P<0.05). Moreover, in grade 3 cases, more general dentists chose the option "extraction" as the best choice, compared with endodontists and periodontists, who did not choose extraction as often (P<0.05). CONCLUSIONS According to the results of this study, general dentists, endodontists, and periodontists generally follow different approaches to endo-perio lesions. A consensus is needed on this issue to develop a successful multidisciplinary approach to endo-perio lesions.

Preferences and experiences regarding the treatment of obstructive sleep apnea with mandibular advancement splints - a cross-sectional pilot survey

OBJECTIVE

To obtain a current overview of the use of mandibular advancement splints (MAS) as a therapeutic option for obstructive sleep apnea (OSA) in the dental profession in Northern Germany.

METHODS

A questionnaire was mailed to 2431 dental professionals, and 8.3% responded. Descriptive data analysis was performed on each question separately.

RESULTS

Most of the surveyed dentists (51.7%) estimated the success rate of MAS therapy to be higher than 75%. Analysis of the relationship between the number of splints prescribed annually and the dental specialization (p = 0.22), work experience (p = 0.14), estimated success rate of MAS therapy (p = 0.96), and discontinuation of MAS therapy (p = 0.57) revealed no significant correlations.

CONCLUSION

Mandibular advancement splints seem to be a safe and successful therapy for OSA. There seems to be a lack of information on the patient side and a lack of education on the dentist side.

Dental Nurses' Mental Health in Germany: A Nationwide Survey during the COVID-19 Pandemic

Several studies have found a rise in the rate of psychological discomfort among healthcare personnel since the COVID-19 pandemic outbreak. In this study, we analyzed the relationship between psychological variables of anxiety, depression, stress, avoidance, intrusion and hyperarousal and several factors among German dental nurses. For this poll, dental nurses were asked nationwide to take part via an online-based survey from July 2020 to January 2021. This survey gathered data on demographics, as well as psychological assessments through the Impact of Events Scale-Revised (IES-R) instrument, and the Depression Anxiety Stress Scales (DASS-21). The correlations between DASS-21/IES-R ratings and sociodemographic data were investigated using univariate analyses (Kruskal-Wallis and Mann-Whitney U tests). Single comparisons were performed using the Dunn-Bonferroni post hoc test if a relevant test result was significant followed by multiple linear regressions. Furthermore, 252 dental nurses took part in the study and showed overall normal or mild results of all psychological variables. Having immune-deficiency or chronic diseases, employment at a dental practice, being married, having no children and seeing the pandemic as a financial threat were presented as significant risk factors (p ≤ 0.05) with higher DASS-21 and IES-R scores. These results emphasize the aspects that must be considered to safeguard German dental nurses' mental wellbeing during the crisis.

A multicentric survey to evaluate preclinical education in Endodontology in German-speaking countries

AIM

To evaluate preclinical education in Endodontology at Austrian, German and Swiss dental schools using an online survey.

METHODOLOGY

An online survey divided into nine categories was sent using SurveyMonkey software to 37 dental schools, before the spread of the COVID-19 pandemic. The questionnaire included 50 questions to evaluate preclinical endodontic education, such as faculty-to-student ratios, topics taught and materials used, in preclinical phantom head courses. Seven and 14 days after the first e-mail contact, dental schools received a reminder e-mail. After four and six weeks, the dental schools were contacted by telephone and asked to participate in the online survey. The processing time was eight weeks in total.

RESULTS

The response rate was 89%. Preclinical endodontic education at the participating dental schools differs considerably. Theory classes ranged from 1 to 70 h (15 h mean), and practical classes ranged from 3 to 78 h (39 h mean). The faculty-to-student ratio varied between 1:4 and 1:38 (1:15 mean). Forty-five per cent of the dental schools had a specialist in endodontics teaching theory. Several dental microscopes were available for preclinical teaching purposes at 82% of the dental schools. The majority (82%) taught root canal preparation with rotary or reciprocating NiTi instruments. Overall, 85% of the dental schools taught lateral compaction, amongst other methods, for canal filling.

CONCLUSION

A substantial divergence amongst the dental schools regarding the time dedicated to theory and practical instruction in Endodontology was reported. However, convergence in the use of root canal treatment techniques and materials was reported.

The Psychological Impact of the COVID-19 Pandemic on Dentists in Germany

Since the announcement of the coronavirus 2019 (COVID-19) outbreak as a pandemic, several studies reported increased psychological distress among healthcare workers. In this investigation, we examined the association between psychological outcomes and various factors among German dentists. Dentists from all German federal states were invited to participate in this study through a self-administered online questionnaire between July and November 2020. This questionnaire collected information on demographics, Depression Anxiety Stress Scales (DASS-21), and the Impact of Events Scale-Revised (IES-R) instrument. The associations displayed between demographic and psychological outcomes of depression, anxiety, stress, intrusion, avoidance, and hyperarousal were evaluated. Seven-hundred-and-thirty-two dentists participated in the survey and reported overall scores of (4.88 ± 4.85), (2.88 ± 3.57), (7.08 ± 5.04), (9.12 ± 8.44), (10.68 ± 8.88) and (10.35 ± 8.68) for depression, anxiety, stress, intrusion, avoidance, and hyperarousal, respectively. For females, being between 50-59 years of age, being immune deficient or chronically ill, working at a dental practice, and considering the COVID-19 pandemic a financial hazard were reported as significant associated factors (p < 0.05) with higher DASS-21 and IES-R scores. These findings underline the aspects which need to be taken into attention to protect the mental wellbeing of dentists in Germany during the crisis.

Kobra Surgery Simulator-A Possibility to Improve Digital Teaching? A Case-Control Study

Computer-aided simulations have long been of great importance in university teaching; however, to date, there is limited use of such simulations in the dental surgical sector. For this purpose, an oral surgery simulator, "Kobra", was implemented in student training and was evaluated for dental education. Dental students (group 1, third-year and group 2, fourth-year) and dentists of the faculty (control group) were trained to use the simulator. The outcomes for group 1 (apicoectomy of an upper lateral incisor with Kobra), group 2 (removal of an impacted lower wisdom tooth with Kobra) and the control group (both procedures with Kobra) were evaluated. For evaluation purposes, subjective parameters (improvement of practical skills, comparison between conventional training and Kobra simulation, and implementation of simulation-based teaching) and objective parameters (removal of bone, tooth substance and soft tissue measured while performing the Kobra simulation) were assessed using questionnaires with a scale ranging from 1-5. A total of 49 students (third-year n = 29, with 22 women and 7 men; fourth-year n = 20, with 17 women and 3 men) and 10 dentists (women n = 5 and men n = 5) participated. Compared to the Kobra simulation, the conventional training method with plastic models was still favored (the difference was non-significant). Compared to the dentists, the simulation data showed a less precise surgical performance of the students (the difference was not significant). The Kobra simulation may offer an additional method to conventional surgery training using plastic models, with benefits for students and faculty staff.

Oral Health Attitudes among Preclinical and Clinical Dental Students: A Pilot Study and Self-Assessment in an Egyptian State-Funded University

Dentists should present to patients as good role models in their oral health behaviour. Previous studies have demonstrated how education can improve dental students’ oral health. This pilot investigation aimed to compare and evaluate the features of the oral health behaviour and attitudes of preclinical and clinical dental students at Ain Shams University, a public Egyptian university. The Hiroshima University-Dental Behaviour Inventory (HU-DBI) survey was provided to 149 (78 female/71 male) dental students. Dichotomised (agree/disagree) answers to 20 HU-DBI items were possible, with a maximum conceivable score of 19. An estimation of oral health behaviour and attitudes was calculated by the sum of correct oral health answers to every item by the study groups and evaluated statistically. The score of oral health-favouring answers was higher in clinical (11.50) than preclinical students (10.63) and was statistically significant (p < 0.05). Single-item evaluations showed no statistical significance, except in one survey item. This survey exhibited weak differences in the improvement of oral hygiene behaviour and attitudes between participating preclinical and clinical students, as well as overall poor oral health behaviour in both groups. This inadequacy of Egyptian public dental education in terms of sufficient student oral health progress emphasises the necessity for supplementary courses and curricular reviews that accentuate the need for future dentists to display the correct oral health behaviour.