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Kouhi M, de Souza Araújo IJ, Asa'ad F, Zeenat L, Bojedla SSR, Pati F, Zolfagharian A, Watts DC, Bottino MC, Bodaghi M. Recent advances in additive manufacturing of patient-specific devices for dental and maxillofacial rehabilitation. Dent Mater 2024; 40:700-715. [PMID: 38401992 DOI: 10.1016/j.dental.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 02/08/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVES Customization and the production of patient-specific devices, tailoring the unique anatomy of each patient's jaw and facial structures, are the new frontiers in dentistry and maxillofacial surgery. As a technological advancement, additive manufacturing has been applied to produce customized objects based on 3D computerized models. Therefore, this paper presents advances in additive manufacturing strategies for patient-specific devices in diverse dental specialties. METHODS This paper overviews current 3D printing techniques to fabricate dental and maxillofacial devices. Then, the most recent literature (2018-2023) available in scientific databases reporting advances in 3D-printed patient-specific devices for dental and maxillofacial applications is critically discussed, focusing on the major outcomes, material-related details, and potential clinical advantages. RESULTS The recent application of 3D-printed customized devices in oral prosthodontics, implantology and maxillofacial surgery, periodontics, orthodontics, and endodontics are presented. Moreover, the potential application of 4D printing as an advanced manufacturing technology and the challenges and future perspectives for additive manufacturing in the dental and maxillofacial area are reported. SIGNIFICANCE Additive manufacturing techniques have been designed to benefit several areas of dentistry, and the technologies, materials, and devices continue to be optimized. Image-based and accurately printed patient-specific devices to replace, repair, and regenerate dental and maxillofacial structures hold significant potential to maximize the standard of care in dentistry.
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Affiliation(s)
- Monireh Kouhi
- Dental Materials Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
| | - Isaac J de Souza Araújo
- Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan, School of Dentistry, Ann Arbor, MI, United States
| | - Farah Asa'ad
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Oral Biochemistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lubna Zeenat
- School of Engineering, Deakin University, Geelong 3216, Australia; Department of Biomedical Engineering, IIT Hyderabad, Kandi, Sangareddy, Telangana 502285, India
| | - Sri Sai Ramya Bojedla
- Department of Biomedical Engineering, IIT Hyderabad, Kandi, Sangareddy, Telangana 502285, India
| | - Falguni Pati
- Department of Biomedical Engineering, IIT Hyderabad, Kandi, Sangareddy, Telangana 502285, India
| | - Ali Zolfagharian
- School of Engineering, Deakin University, Geelong 3216, Australia
| | - David C Watts
- School of Medical Sciences, University of Manchester, Manchester, UK
| | - Marco C Bottino
- Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan, School of Dentistry, Ann Arbor, MI, United States; Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Mahdi Bodaghi
- Department of Engineering, School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK.
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Jadach R, Asa'ad F, Rasperini G, Osypko K. Classifying Maxillary Sinuses of Polish Patients for Sinus Lift: A Pilot Study. Dent J (Basel) 2024; 12:35. [PMID: 38392239 PMCID: PMC10888488 DOI: 10.3390/dj12020035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/29/2024] [Accepted: 02/02/2024] [Indexed: 02/24/2024] Open
Abstract
To date, there is no systematic anatomical classification available that could help clinicians in choosing between the lateral and palatal approach in sinus lift procedures. The aim was to provide a simple-to-use and memorable classification of the maxillary sinus concerning the thickness of lateral and palatal walls to facilitate the most adequate choice for the window location during direct sinus floor elevation. Cone beam computed tomography scans were consecutively obtained for 200 maxillary sinuses of patients needing dental implant placement with potential maxillary sinus augmentation. The thickness and height of the alveolar bone of the lateral and palatal walls of the maxillary sinuses were assessed. Four variants were distinguished. Class 0: an adequate sub-sinus residual bone height; without the need for sinus floor augmentation. Classes 1-3 had a reduced sub-sinus residual bone height. Class 1: a thinner lateral than palatal sinus wall. Class 2 (the most frequent; 49%): the comparable thickness of both walls in which either lateral, palatal, or crestal window osteotomies can be applied. Class 3 (the least frequent; 3%): a thinner palatal sinus wall in comparison to the lateral wall. The presented anatomical classification simplifies the decision-making process of choosing the most adequate window location and osteotomy technique.
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Affiliation(s)
- Radosław Jadach
- Dental Salon, Oral Surgery Academy, Horbaczewskiego 53a, 54-130 Wrocław, Poland
| | - Farah Asa'ad
- Department of Biomaterials, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, 413 90 Göteborg, Sweden
- Department of Oral Biochemistry, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, 413 90 Göteborg, Sweden
| | - Giulio Rasperini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Foundation IRCCS Ca' Granda Policlinic, 20122 Milan, Italy
| | - Karolina Osypko
- Dental Salon, Oral Surgery Academy, Horbaczewskiego 53a, 54-130 Wrocław, Poland
- Platinum Clinic, Księcia Witolda 49, 50-202 Wrocław, Poland
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Asa'ad F, Petrenya N, Jönsson B, Holde GE, Oscarson N, Hadler-Olsen E, Vieira AR, Petzold M, Larsson L. Polymorphism in epigenetic regulating genes in relation to periodontitis, number of teeth, and levels of high-sensitivity C-reactive protein and glycated hemoglobin: The Tromsø Study 2015-2016. J Periodontol 2023; 94:1324-1337. [PMID: 37382343 DOI: 10.1002/jper.23-0108] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND The aim of this study was to investigate the association between periodontitis and four single nucleotide polymorphisms (SNPs) in genes involved in epigenetic regulation of DNA, and between these same SNPs and tooth loss, high-sensitivity C-reactive protein (hs-CRP), and glycated hemoglobin (HbA1c) levels. METHODS We included participants with periodontal examination (n = 3633, aged: 40-93 years) from the Tromsø Study seventh survey (2015-2016), Norway. Periodontitis was defined according to the 2017 AAP/EFP classification system as no periodontitis, grades A, B, or C. Salivary DNA was extracted and genotyping was performed to investigate four SNPs (rs2288349, rs35474715, rs34023346, and rs10010325) in the sequence of the genes DNMT1, IDH2, TET1, and TET2. Association between SNPs and periodontitis was analyzed by logistic regression adjusted for age, sex, and smoking. Subgroup analyses on participants aged 40-49 years were performed. RESULTS In participants aged 40-49 years, homozygous carriage of minor A-allele of rs2288349 (DNMT1) was associated with decreased susceptibility to periodontitis (grade A: odds ratio [OR] 0.55; p = 0.014: grade B/C OR 0.48; p = 0.004). The minor A-allele of rs10010325 (TET2) was associated with increased susceptibility to periodontitis (grade A OR 1.69; p = 0.035: grade B/C OR 1.90; p = 0.014). In the entire sample, homozygous carriage of the G-allele of rs35474715 (IDH2) was associated with having ≤24 teeth (OR 1.31; p = 0.018). Homozygous carriage of the A-allele of TET2 was associated with hs-CRP≥3 mg/L (OR 1.37; p = 0.025) and HbA1c≥6.5% (OR 1.62; p = 0.028). CONCLUSIONS In this Norwegian population, there were associations between polymorphism in genes related to DNA methylation and periodontitis, tooth loss, low-grade inflammation, and hyperglycemia.
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Affiliation(s)
- Farah Asa'ad
- Department of Biomaterials, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Oral Biochemistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Natalia Petrenya
- The Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway
| | - Birgitta Jönsson
- The Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gro Eirin Holde
- The Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Nils Oscarson
- Clinic of Periodontology, The Public Dental Service, Region Västra Götaland, Skövde, Sweden
| | - Elin Hadler-Olsen
- The Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway
- Department of Medical Biology, Faculty of Health Sciences, UiT the Artic University of Norway, Tromsø, Norway
| | - Alexandre R Vieira
- Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Max Petzold
- School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Lena Larsson
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Abstract
Titanium (Ti) particles and ions have been investigated in recent years as important factors in the pathogenesis of peri-implantitis. However, their role in the pathogenesis is yet to be fully understood. A review of pertinent literature was performed in various databases to determine the current position of Ti particles and ions role in the pathogenesis of peri-implantitis. There are several in vitro, preclinical and clinical published studies that have addressed the role of Ti particles and ions in the pathogenesis of peri-implantitis. These studies explored the effect of Ti particles and ions in the pathogenesis of peri-implantitis with respect to foreign body reaction, cellular response, epigenetic mechanisms, namely DNA methylation, and the oral microbiome. Studies have shown that the release of Ti particles/ions during implant insertion, early healing stages, late healing stages, and treatments during peri-implantitis might contribute to peri-implantitis through different mechanisms, such as foreign body reaction, cellular response, DNA methylation, and shaping the oral microbiome by increasing dysbiosis. However, further studies are needed to elucidate the complex interactions between all these mechanisms and Ti particles/ions in the pathogenesis and progression of peri-implantitis.
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Affiliation(s)
- Farah Asa'ad
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Oral Biochemistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Peter Thomsen
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Marcel F Kunrath
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Dentistry, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
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Asa'ad F, Cho YD, Larsson L. Editorial: On the Inflammatory Cascade-From Bacteria Through the Epithelium to the Connective Tissue. Front Cell Infect Microbiol 2022; 12:936833. [PMID: 35755844 PMCID: PMC9231893 DOI: 10.3389/fcimb.2022.936833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 05/17/2022] [Indexed: 12/02/2022] Open
Affiliation(s)
- Farah Asa'ad
- Department of Biomaterials, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden.,Department of Oral Biochemistry, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden
| | - Young-Dan Cho
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, South Korea
| | - Lena Larsson
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden
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Larsson L, Garaicoa-Pazmino C, Asa'ad F, Castilho RM. Understanding the role of endotoxin tolerance in chronic inflammatory conditions and periodontal disease. J Clin Periodontol 2021; 49:270-279. [PMID: 34970759 DOI: 10.1111/jcpe.13591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/17/2021] [Accepted: 12/23/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This review aims to present the current understanding of endotoxin tolerance (ET) in chronic inflammatory diseases and explores the potential connection with periodontitis. SUMMARY Subsequent exposure to lipopolysaccharides (LPS) triggers ET, a phenomenon regulated by different mechanisms and pathways, including toll-like receptors (TLRs), nuclear factor kappa-light-chain-enhancer of activated B cells (NFκB), apoptosis of immune cells, epigenetics, and microRNAs (miRNAs). These mechanisms interconnect ET with chronic inflammatory diseases that include periodontitis. While the direct correlation between ET and periodontal destruction has not been fully elucidated, emerging reports point towards the potential tolerization of human periodontal ligament cells (hPDLCs) and gingival tissues with a significant reduction of TLR levels. CONCLUSIONS There is a potential link between ET and periodontal diseases. Future studies should explore the crucial role of ET in the pathogenesis of periodontal diseases as evidence of a tolerized oral mucosa may represent an intrinsic mechanism capable of regulating the oral immune response. A clear understanding of this host immune regulatory mechanism might lead to effective and more predictable therapeutic strategies to treat chronic inflammatory diseases and periodontitis. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Lena Larsson
- Department of Periodontology Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Carlos Garaicoa-Pazmino
- Department of Periodontics, University of Iowa, College of Dentistry and Dental Clinics, Iowa City, IA, USA.,School of Dentistry, Espíritu Santo University, Samborondon, Ecuador
| | - Farah Asa'ad
- Department of Biomaterials, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.,Department of Oral Biochemistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Rogerio M Castilho
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Laboratory of Epithelial Biology, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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Ferrantino L, Camurati A, Gambino P, Marzolo M, Trisciuoglio D, Santoro G, Farina V, Fontana F, Asa'ad F, Simion M. Aesthetic outcomes of non-functional immediately restored single post-extraction implants with and without connective tissue graft: A multicentre randomized controlled trial. Clin Oral Implants Res 2021; 32:684-694. [PMID: 33638216 DOI: 10.1111/clr.13733] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 01/31/2021] [Accepted: 02/04/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To compare the 1-year aesthetic results of flapless single implants, placed in fresh extraction sockets with bone replacement and immediate provisional restoration with or without a connective tissue graft (CTG). MATERIAL AND METHODS The present study proposes a partially blinded multicentre parallel randomized controlled trial, where computer-generated tables were used for central randomization to allocate treatments. A total of 59 of the 60 patients screened by eight private practices in Northern Italy fulfilled the inclusion criteria. Immediate implants were placed in a fresh extraction socket with a non-functional immediate provisional restoration with (Test group) or without (Control group) a CTG. The primary outcome variable was the implant Crown Aesthetic Index (ICAI) at the 1-year follow-up. RESULTS ICAI for the 59 randomized patients (Test group = 31, Control group = 28) at the 1-year follow-up was 4.69 (95% CI = 3.16-6.22) for the Test group and 3.45 (95% CI = 1.83-5.08) for the Control group, without statistically significant difference between the two groups (p = .086). One implant failure was recorded in each group, resulting in an implant survival rate of 96.8% [95% CI = 83.3-99.9] for the Test group and 96.4% [95% CI = 81.7-99.9] for the Control group. Other secondary outcome variables and complication rates were comparable across the two groups. CONCLUSIONS Within the limitations of the present clinical trial, the results suggested that the adjunct use of CTG is not mandatory to achieve successful aesthetic outcomes for a well-planned immediate implant placement with immediate non-functional provisional restoration in a fresh extraction socket.
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Affiliation(s)
- Luca Ferrantino
- Department of Esthetic Dentistry, Istituto Stomatologico Italiano, University of Milan, Milan, Italy
| | | | | | | | - Davide Trisciuoglio
- Maxillo-Facial and Odontostomatology Unit, Department of Periodontology, Fondazione Cà Granda IRCCS Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | | | | | | | - Farah Asa'ad
- Department of Biomaterials, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Massimo Simion
- Maxillo-Facial and Odontostomatology Unit, Department of Periodontology, Fondazione Cà Granda IRCCS Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
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Ichioka Y, Asa'ad F, Malekzadeh BÖ, Westerlund A, Larsson L. Epigenetic changes of osteoblasts in response to titanium surface characteristics. J Biomed Mater Res A 2020; 109:170-180. [PMID: 32441439 DOI: 10.1002/jbm.a.37014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/06/2020] [Accepted: 04/19/2020] [Indexed: 12/12/2022]
Abstract
We aimed to investigate the influence of titanium surface characteristics on epigenetic mechanisms and DNA damage/repair pathways. Osteoblast-like cells (MG63) were incubated on glass, smooth titanium, and minimally rough titanium discs, respectively, for 0, 1, 6, and 24 hr. The presence of double-stranded DNA damage (γH2AX), DNA repair (Chk2), and epigenetic markers (AcH3 & DNMT1) were investigated using immunofluorescence. There were no Chk2-positive cells on the minimally rough titanium surfaces at all-time points, in comparison to glass and smooth titanium. Total γH2AX-positive cells on minimally rough titanium gradually decreased as incubation time increased, on the contrary to smooth titanium. Minimally rough titanium surfaces induced cytoplasmic staining of DNMT1 up to 99% at 24 hr. For epigenetic markers related to the DNA damage/repair pathway, minimally rough titanium surfaces showed the lower percentage of AcH3-positive cells compared to glass and smooth titanium surface. The findings in the current study show that titanium surface characteristics indeed influence DNA damage and the DNA repair pathway, including epigenetic factors.
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Affiliation(s)
- Yuki Ichioka
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Farah Asa'ad
- Department of Biomaterials, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | | | - Anna Westerlund
- Department of Orthodontics, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Lena Larsson
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
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Asa'ad F. Shared decision-making (SDM) in dentistry: A concise narrative review. J Eval Clin Pract 2019; 25:1088-1093. [PMID: 30920092 DOI: 10.1111/jep.13129] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 02/27/2019] [Accepted: 03/02/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this review was to evaluate the implementation of shared decision-making (SDM) in dentistry and the roles of informed consent and patient decision-making aids (PDAs) as part of this process. MATERIALS AND METHODS A review of pertinent literature was performed using PubMed and MEDLINE to determine the current position of the application of SDM in dentistry and the influence of informed consent and PDAs on this process. RESULTS Limited number of published studies on the implementation of SDM in dental practice is available. These studies demonstrated that SDM is influenced by many factors. Informed consent intertwines with the SDM process and begins with providing high quality information to patients and employing PDAs. PDAs have been developed for some dental fields to facilitate the SDM process. CONCLUSIONS SDM is applied in dentistry and is influenced by many factors. Informed consent is an important part of this process. PDAs in more dental fields need to be further developed, in order to ensure a satisfactory integration of patients in the SDM process.
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Affiliation(s)
- Farah Asa'ad
- Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
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Asa'ad F, Monje A, Larsson L. Role of epigenetics in alveolar bone resorption and regeneration around periodontal and peri‐implant tissues. Eur J Oral Sci 2019; 127:477-493. [DOI: 10.1111/eos.12657] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Farah Asa'ad
- Institute of Odontology The Sahlgrenska Academy University of Gothenburg Göteborg Sweden
| | - Alberto Monje
- Department of Oral Surgery and Stomatology ZMK School of Dentistry Bern Switzerland
- Department of Periodontology Universitat Internacional de Catalunya Barcelona Spain
| | - Lena Larsson
- Department of Periodontology Institute of Odontology University of Gothenburg Göteborg Sweden
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Suárez-López Del Amo F, Rodriguez JC, Asa'ad F, Wang HL. Comparison of two soft tissue substitutes for the treatment of gingival recession defects: an animal histological study. J Appl Oral Sci 2019; 27:e20180584. [PMID: 31596366 PMCID: PMC6768116 DOI: 10.1590/1678-7757-2018-0584] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 04/15/2019] [Indexed: 11/28/2022] Open
Abstract
Objectives: This study aimed to compare two different soft tissue replacement grafts in their ability to treat gingival recession defects and successfully integrate with the surrounding tissues. Methodology: Nine beagle dogs were included and followed up to 10 weeks. Sites for intervention were allocated to one of the grafting materials investigated. Treatment consisted of coronally advanced flap combined with one of the two soft tissue substitutes on a previous surgically created defect. Materials employed were porcine-derived acellular dermal matrix (ADM) [Novomatrix™ (Test)] and collagen-based matrix (CBM) [Mucograft® (Control)]. Animals were sacrificed at 2, 6, and 10 weeks postoperatively and compared using descriptive histology and histomorphometric outcomes. Results: Macroscopic findings were similar between test and control groups at all intervals. After 10 weeks, both groups demonstrated successful incorporation of the grafting materials without signs of rejection and with comparable tissue integration. The histomorphometric data were similar between groups at 2 weeks; however, the test group provided greater root coverage and increase in tissue thickness than the control at 6- and 10-weeks post surgically. Conclusions: Both porcine-derived ADM and CBM revealed similar histological outcomes with successful integration and absence of adverse events. Test group provided superior outcomes regarding root coverage and increase in tissue thickness.
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Affiliation(s)
- Fernando Suárez-López Del Amo
- University of Oklahoma Health Sciences Center, Department of Periodontics, Oklahoma City, OK, USA.,University of Michigan School of Dentistry, Department of Periodontics and Oral Medicine, Ann Arbor, MI, USA
| | - Juan C Rodriguez
- University of Michigan School of Dentistry, Department of Periodontics and Oral Medicine, Ann Arbor, MI, USA
| | - Farah Asa'ad
- The Sahlgrenska Academy at the University of Gothenburg, Institute of Odontology, Göteborg, Sweden
| | - Hom-Lay Wang
- University of Michigan School of Dentistry, Department of Periodontics and Oral Medicine, Ann Arbor, MI, USA
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Goker F, Larsson L, Del Fabbro M, Asa'ad F. Gene Delivery Therapeutics in the Treatment of Periodontitis and Peri-Implantitis: A State of the Art Review. Int J Mol Sci 2019; 20:ijms20143551. [PMID: 31330797 PMCID: PMC6679027 DOI: 10.3390/ijms20143551] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 07/15/2019] [Accepted: 07/16/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Periodontal disease is a chronic inflammatory condition that affects supporting tissues around teeth, resulting in periodontal tissue breakdown. If left untreated, periodontal disease could have serious consequences; this condition is in fact considered as the primary cause of tooth loss. Being highly prevalent among adults, periodontal disease treatment is receiving increased attention from researchers and clinicians. When this condition occurs around dental implants, the disease is termed peri-implantitis. Periodontal regeneration aims at restoring the destroyed attachment apparatus, in order to improve tooth stability and thus reduce disease progression and subsequent periodontal tissue breakdown. Although many biomaterials have been developed to promote periodontal regeneration, they still have their own set of disadvantages. As a result, regenerative medicine has been employed in the periodontal field, not only to overcome the drawbacks of the conventional biomaterials but also to ensure more predictable regenerative outcomes with minimal complications. Regenerative medicine is considered a part of the research field called tissue engineering/regenerative medicine (TE/RM), a translational field combining cell therapy, biomaterial, biomedical engineering and genetics all with the aim to replace and restore tissues or organs to their normal function using in vitro models for in vivo regeneration. In a tissue, cells are responding to different micro-environmental cues and signaling molecules, these biological factors influence cell differentiation, migration and cell responses. A central part of TE/RM therapy is introducing drugs, genetic materials or proteins to induce specific cellular responses in the cells at the site of tissue repair in order to enhance and improve tissue regeneration. In this review, we present the state of art of gene therapy in the applications of periodontal tissue and peri-implant regeneration. PURPOSE We aim herein to review the currently available methods for gene therapy, which include the utilization of viral/non-viral vectors and how they might serve as therapeutic potentials in regenerative medicine for periodontal and peri-implant tissues.
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Affiliation(s)
- Funda Goker
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, 20122 Milano, Italy
| | - Lena Larsson
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, SE-405 30 Gothenburg, Sweden
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, 20122 Milano, Italy
- IRCCS Orthopedic Institute Galeazzi, 20161 Milano, Italy
| | - Farah Asa'ad
- Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, SE-405 30 Gothenburg, Sweden.
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Tavelli L, Asa'ad F, Acunzo R, Pagni G, Consonni D, Rasperini G. Minimizing Patient Morbidity Following Palatal Gingival Harvesting: A Randomized Controlled Clinical Study. INT J PERIODONT REST 2019; 38:e127-e134. [PMID: 30304077 DOI: 10.11607/prd.3581] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This clinical study was conducted to evaluate the impact of different hemostatic treatments following palatal gingival harvesting on patient discomfort. Fifty patients who needed a mucogingival surgery requiring gingival graft harvesting were enrolled and randomly assigned to one of five groups: (1) a control group in which only sutures were applied; (2) a cyanoacrylate group; (3) a periodontal dressing material group; (4) a hemostatic gelatin sponge group; and (5) a group in which the gelatin sponge and cyanoacrylate were combined. In the 2 weeks following the procedures, perception of pain, healing, consumption of drugs, and willingness to repeat the procedure were recorded through visual analog scale (VAS) by patients. Over the 2 weeks, lower pain (VAS) was found in all test groups compared to the control group (P < .01, value for time-group interaction). Notably, the gelatin sponge combined with cyanoacrylate group had very low pain (VAS ≤ 0.5 points) throughout the 14 days. The lowest healing scores at day 10 were associated with the control group (6.8 VAS points) in contrast to the four test groups (8.2 to 9.0 VAS points, P = .0001). Pain was inversely correlated with age (P < .05). Pain also depended on the apicocoronal dimension of the graft: the higher the graft, the more pain was experienced by the participants (0.4 VAS points per 1 mm, P < .05). Within the limitations of this study, palatal coverage appears to result in better outcomes when compared to suture alone. In particular, a double-layered protection of the palatal wound with a gelatin sponge combined with cyanoacrylate appeared to be the best option in reducing pain and postoperative discomfort.
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Farronato D, Fumagalli D, Asa'ad F, Rasperini G. Decontamination of Customized Laser-Microtextured Titanium Abutments: A Comparative in Vitro Study of Different Cleaning Procedures. INT J PERIODONT REST 2018; 38:e87–e95. [PMID: 29677228 DOI: 10.11607/prd.3250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The aim of this study was to evaluate different cleaning procedures for customized laser-microtextured titanium abutments. A total of 20 customized laser-microtextured abutments were randomized into four groups: no cleaning (control group), ultrasonic treatments + autoclave cycle (group 1), ultrasonic treatments + argon plasma (group 2), and only argon plasma (group 3). Surface contaminants were assessed through scanning electron microscopy and energy-dispersive x-ray spectroscopy microanalysis. In the control group, 99.96% of the abutment surfaces were contaminated with organic and inorganic pollutants. Group 3 showed the second highest contamination percentage, with almost 23% of the analyzed surfaces polluted. Samples in groups 1 and 2 were almost clean, with negligible traces of microparticles (0.009% and 0.047% of the surfaces were contaminated, respectively). These results were statistically significant for differences between control and test groups, and between groups 1 and 2 in comparison to 3 (P < .001). Abutment decontamination with argon plasma alone might not be as effective on laser-microtextured surfaces as other cleaning protocols.
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Saleh MHA, Ravidà A, Suárez-López del Amo F, Lin GH, Asa'ad F, Wang HL. The effect of implant-abutment junction position on crestal bone loss: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2018; 20:617-633. [DOI: 10.1111/cid.12600] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 01/27/2018] [Indexed: 12/21/2022]
Affiliation(s)
- Muhammad H. A. Saleh
- Department of Periodontics and Oral Medicine; University of Michigan School of Dentistry; Ann Arbor Michigan
| | - Andrea Ravidà
- Department of Periodontics and Oral Medicine; University of Michigan School of Dentistry; Ann Arbor Michigan
| | | | - Guo-Hao Lin
- Department of Orofacial Sciences; University of California; San Francisco California
| | - Farah Asa'ad
- Department of Biomedical, Surgical & Dental Sciences; University of Milan; Milan Italy
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine; University of Michigan School of Dentistry; Ann Arbor Michigan
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Farronato D, Fumagalli D, Asa'ad F, Pasini PM, Mangano F, Rasperini G. Failed Blade Implant After 25 Years in Function: Case Description and Histologic Analysis. INT J PERIODONT REST 2018; 38:e29-e32. [PMID: 29447315 DOI: 10.11607/prd.3384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This report describes a failed blade implant after 25 years in function in the left maxilla and the results of histologic analysis of peri-implant tissues. The blade was retrieved, and histologic findings revealed that it was not osseointegrated despite being successfully in function for so many years. The long-term function of blade implants without osseointegration can be attributed to biotolerance exhibited by the implant rather than actual osseointegration.
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Asa'ad F, Bollati V, Pagni G, Castilho RM, Rossi E, Pomingi F, Tarantini L, Consonni D, Giannobile WV, Rasperini G. Evaluation of DNA methylation of inflammatory genes following treatment of chronic periodontitis: A pilot case-control study. J Clin Periodontol 2017; 44:905-914. [DOI: 10.1111/jcpe.12783] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2017] [Indexed: 12/18/2022]
Affiliation(s)
- Farah Asa'ad
- Department of Biomedical, Surgical and Dental Sciences; Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico; University of Milan; Milan Italy
| | - Valentina Bollati
- EPIGET-Epidemiology, Epigenetics and Toxicology Lab; Department of Clinical Sciences and Community Health; University of Milan; Milan Italy
- Epidemiology Unit; Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico; Milan Italy
| | - Giorgio Pagni
- Department of Biomedical, Surgical and Dental Sciences; Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico; University of Milan; Milan Italy
| | - Rogerio M. Castilho
- Laboratory of Epithelial Biology; University of Michigan School of Dentistry; Ann Arbor MI USA
- Department of Periodontics and Oral Medicine; School of Dentistry; University of Michigan; Ann Arbor MI USA
| | - Eleonora Rossi
- Department of Biomedical, Surgical and Dental Sciences; Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico; University of Milan; Milan Italy
| | | | - Letizia Tarantini
- EPIGET-Epidemiology, Epigenetics and Toxicology Lab; Department of Clinical Sciences and Community Health; University of Milan; Milan Italy
| | - Dario Consonni
- Epidemiology Unit; Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico; Milan Italy
| | - William V. Giannobile
- Department of Periodontics and Oral Medicine; School of Dentistry; University of Michigan; Ann Arbor MI USA
| | - Giulio Rasperini
- Department of Biomedical, Surgical and Dental Sciences; Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico; University of Milan; Milan Italy
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Alhabashneh R, Khader Y, Herra Z, Asa'ad F. Erratum to: The association between periodontal disease and metabolic syndrome among outpatients with diabetes in Jordan. J Diabetes Metab Disord 2015; 14:76. [PMID: 26649285 PMCID: PMC4672556 DOI: 10.1186/s40200-015-0207-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 09/24/2015] [Indexed: 01/18/2023]
Affiliation(s)
- Rola Alhabashneh
- Preventive Department-Periodontics, College of Dentistry, Jordan University of Science and Technology, Irbid, 22110 Jordan ; Department of Community Medicine, Jordan University of Science and Technology, Irbid, 22110 Jordan
| | - Yousef Khader
- Department of Community Medicine, Jordan University of Science and Technology, Irbid, 22110 Jordan
| | - Zaid Herra
- Preventive Department-Periodontics, College of Dentistry, Jordan University of Science and Technology, Irbid, 22110 Jordan
| | - Farah Asa'ad
- Preventive Department-Periodontics, College of Dentistry, Jordan University of Science and Technology, Irbid, 22110 Jordan
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Alhabashneh R, Khader Y, Herra Z, Asa'ad F, Assad F. The association between periodontal disease and metabolic syndrome among outpatients with diabetes in Jordan. J Diabetes Metab Disord 2015; 14:67. [PMID: 26280008 PMCID: PMC4537782 DOI: 10.1186/s40200-015-0192-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 07/15/2015] [Indexed: 11/11/2022]
Abstract
Background To date, conflicting results have been reported about the association between metabolic syndrome (MetS) and periodonttitis. Methods Two hundred and eighty patients with type 2 diabetes were recruited from outpatients visiting diabetes clinics in Islamic Hospital, Amman-Jordan. The oral hygiene and the periodontal status of all teeth, excluding third molars, were assessed using the plaque index of Silness and Löe, the gingival index of Löe and Silness, probing pocket depth (PPD), and clinical attachment level (CAL). Data were analyzed using the general linear model multivariate procedure with average PPD, average CAL, percent of teeth with CAL ≥3 mm, and percent of teeth with PPD ≥3 mm as outcome variables and diabetes, MetS and its individual components as predictors. Results Overall, 83.2 % of patients with diabetes had MetS. In the multivariate analysis, patients with MetS had a significantly more severe periodontitis, as measured by average PPD and average CAL (P < 0.005). The extent of periodontitis, as measured by the percent of teeth with CAL ≥3 mm and the percent of teeth with PPD ≥3 mm, was also significantly greater among patients with MetS (P < 0.005). As the number of metabolic components additional to diabetes increased, the odds of having periodontitis increased, and the odds were greatest when all the components additional to diabetes were present (OR = 10.77, 95 % CI: 2.23 -51.95). Conclusion Patients with MetS displayed more severe and extensive periodontitis. Having other MetS components additional to diabetes increased the odds of having periodontitis.
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Affiliation(s)
- Rola Alhabashneh
- Preventive Department-Periodontics, College of Dentistry, Jordan University of Science and Technology, PO Box: 3030, Irbid, 22110 Jordan ; Department of Community Medicine, Jordan University of Science and Technology, PO Box: 3030, Irbid, 22110 Jordan
| | - Yousef Khader
- Department of Community Medicine, Jordan University of Science and Technology, PO Box: 3030, Irbid, 22110 Jordan
| | - Zaid Herra
- Preventive Department-Periodontics, College of Dentistry, Jordan University of Science and Technology, PO Box: 3030, Irbid, 22110 Jordan
| | - Farah Asa'ad
- Preventive Department-Periodontics, College of Dentistry, Jordan University of Science and Technology, PO Box: 3030, Irbid, 22110 Jordan
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Abstract
Objective: To determine the knowledge of periodontal disease and pregnancy outcomes among the gynecologists practicing in Riyadh, Saudi Arabia. Materials and Methods: A cross-sectional survey of 200 randomly chosen gynecologists from Riyadh was carried out by using a structured, self-administered, closed-ended questionnaire. Knowledge of periodontal disease and possible ways of prevention; knowledge of periodontal disease and pregnancy outcomes; and oral self-care attitudes among gynecologists were assessed. Results: One-quarter of the gynecologists knew the meaning of dental plaque. Almost 57.5% believed that the frequency of toothbrushing should be increased during pregnancy. Eighty percent of gynecologists were aware of the serious effects of smoking on the pregnant woman and her child. Less than half (44.5%) believed that there is a relationship between gum disease and premature labor. Gynecologists working in the government sector were significantly more aware about the causes of inflamed gum in pregnancy, gum disease and its prevention, and negative effects of smoking on pregnancy. A significantly higher percentage of male and senior gynecologists aged between 50 and 54 years answered that gum disease would lead to the delivery of a preterm or low-birth-weight infant. Conclusion: Gynecologists considered in the present study showed an acceptable level of knowledge and awareness toward periodontal health and the association between periodontal disease and adverse pregnancy outcomes.
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Affiliation(s)
- Ghousia Rahman
- Department of Preventive Dental Sciences, Division of Periodontics and Dental Hygiene, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia
| | - Farah Asa'ad
- Department of Preventive Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad Abdul Baseer
- Department of Preventive Dental Sciences, Division of Community Dentistry, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia
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Asa'ad F, Rasperini G, Pagni G, Rios HF, Giannì AB. Pre-augmentation soft tissue expansion: an overview. Clin Oral Implants Res 2015; 27:505-22. [PMID: 26037472 DOI: 10.1111/clr.12617] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this study was to explore the development of soft tissue expanders, their different types and their potential applications prior to bone augmentation and implant placement. MATERIAL AND METHODS A review of pertinent literature was performed using PubMed to comprehend the dynamics of soft tissue expanders and determine the current position of their pre-augmentation applications. RESULTS There is promising, albeit preliminary information regarding the benefits of pre-augmentation soft tissue expansion. Findings cannot be generalised due to relatively small sample size. CONCLUSIONS Further clinical trials with larger sample sizes and long-term follow-up are needed before soft tissue expanders can be confidently applied in everyday clinical practice.
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Affiliation(s)
- Farah Asa'ad
- Department of Biomedical, Surgical and Dental Sciences, Foundation IRCCS Ca' Granda Polyclinic, University of Milan, Milan, Italy
| | - Giulio Rasperini
- Department of Biomedical, Surgical and Dental Sciences, Foundation IRCCS Ca' Granda Polyclinic, University of Milan, Milan, Italy
| | - Giorgio Pagni
- Department of Biomedical, Surgical and Dental Sciences, Foundation IRCCS Ca' Granda Polyclinic, University of Milan, Milan, Italy
| | - Hector F Rios
- Department of Periodontics and Oral Medicine, Michigan Center for Oral Health Research, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Aldo B Giannì
- Department of Biomedical, Surgical and Dental Sciences, Foundation IRCCS Ca' Granda Polyclinic, University of Milan, Milan, Italy
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Baseer MA, Rahman G, Asa'ad F, Alamoudi F, Albluwi F. Knowledge, attitude and practices of gynecologists regarding the prevention of oral diseases in Riyadh city, Saudi Arabia. Oral Health Dent Manag 2014; 13:97-102. [PMID: 24603924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM To assess the knowledge, attitude and practices of gynecologists regarding the prevention of oral diseases in Riyadh city, Saudi Arabia. METHODS A structured, self administered, close-ended questionnaire was distributed among the randomly chosen sample of 200 gynecologists and their responses were recorded and analyzed. RESULTS Nearly half of the respondents knew all the main risk factors of dental caries, gingivitis and malocclusion. An overall mean scores of 16.49 ± 5.63, 6.62 ± 1.59 and 7.13 ± 2.82, were observed for knowledge of risk factors, attitude and practices towards prevention of oral diseases respectively. Gynecologists working in the private hospitals showed signifi cantly higher mean attitude and practice scores towards prevention of oral diseases. A linear positive correlation between knowledge and attitude (r=0.11, p=0.11), knowledge and practice (r=0.07, p=0.26), instead a negative correlation between attitude and practice (r=-0.04, p=0.53) was found by a Spearman's test. CONCLUSION Gynecologists considered in the present study showed inadequate oral health knowledge, attitude and practices towards prevention of oral diseases. However, gynecologists expressed their need for further information regarding the prevention of oral diseases.
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Affiliation(s)
- Mohammad Abdul Baseer
- Department of Community and Preventive Dentistry, Riyadh Colleges of Dentistry and Pharmacy, Annamuthajiya Campus (King Fahad Road), P. O Box: 84891, Riyadh 11681, Kingdom of Saudi Arabia, Tel: 009662931177 Ext-1065, Mobile: 00966552818231, Fax: 0096612932277; e-mail:
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