Vilma Brukiene

Background/Objectives: Dentists, due to their close contact with patients, are in a unique position to recognize and report cases of child abuse and neglect. This study aimed to explore dentists’ knowledge and attitudes toward child abuse and neglect encountered in their professional practice. Methods: An anonymous questionnaire survey was conducted among 414 members of the Lithuanian Dental Chamber (general dentists, dental specialists, dental hygienists, and dental assistants) and 153 graduating dental students, yielding a total sample of 567 respondents. They reported knowledge and attitudes regarding reasons for child abuse within the family and barriers to referring suspected cases. The underlying structure of responses was examined using exploratory factor analysis, and differences in knowledge and attitudes across professional groups were tested using ANOVA. Results: Most respondents agreed that low family socioeconomic status (87.7%), child’s disability (65.3%), and medical conditions (53.2%) are the main reasons for child abuse. These and other reasons clustered into two factors: family social vulnerability, and child health-related vulnerability; however, professional specialization had only a very small effect on both factors (η² = 0.013 and η² = 0.017, respectively). The majority of respondents (75.6%) agreed that dentists should report cases of child abuse or violence against children in all circumstances. The barriers to reporting child abuse were fear of negative consequences, and professional uncertainty; professional specialization had a significant effect on both of these factors (η² = 0.019, p = 0.027 and η² = 0.037, p < 0.001, respectively). Dental specialists reported the highest levels of fear of negative consequences and professional uncertainty, whereas students reported the fewest difficulties in reporting. Dental specialists and students demonstrated the highest levels of knowledge, while dental hygienists demonstrated the lowest level of knowledge regarding child abuse (mean sum score of knowledge was 11.2 (SE 0.38) vs. 10.0 (SE 0.30), respectively, p = 0.014). Conclusions: Overall, Lithuanian dentists, including students, demonstrate moderate knowledge and attitude in recognizing cases of child abuse and neglect; however, differences across professional groups remain and should be addressed to ensure more effective child protection.

Background/Objectives: Empathy is a core component of professional competence in dentistry, influencing patient-centered care and treatment outcomes. Evidence suggests that empathy may decline during clinical training, but data from Lithuanian dental students are lacking. This study aimed to assess empathy levels and subscale patterns among Lithuanian dental students and examine their association with academic year. Methods: A cross-sectional study was conducted among third- to fifth-year dental students at the two universities in Lithuania. The Lithuanian version of the Jefferson Scale of Empathy–Health Professions Students (JSE-HPS) was used to measure total empathy and three subscales: Perspective Taking (PT), Compassionate Care (CC), and Standing in the Patient’s Shoes (SPS). Internal consistency was assessed using Cronbach’s alpha. Factor validity was examined via principal component analysis with Varimax rotation and Kaiser normalization. Differences across academic years were analyzed using Kruskal–Wallis tests. Results: A total of 252 students completed the questionnaire (response rate: 93%). The Lithuanian JSE-HPS demonstrated good internal consistency (α = 0.808) and confirmed a three-factor structure. The mean total empathy score was 106.07 ± 12.55. JSE-HPS scores differed significantly between dental classes (p < 0.001). Fifth-year students had significantly lower JSE-HPS scores than third- and fourth-year students (101.65 vs. 107.05 and 109.36; p = 0.035 and p = 0.007). PT and CC scores significantly declined in fifth-year students compared with earlier years, whereas SPS scores remained stable. Conclusions: The Lithuanian version of the JSE-HPS is a reliable and psychometrically sound tool for assessing empathy. Clinical training was significantly associated with a decline in total empathy scores among Lithuanian dental students, highlighting the impact of academic progression on both cognitive and affective components of empathy. Given the cross-sectional design, causal inferences cannot be drawn.

Background and Objectives: The inappropriate use of antibiotics can lead to antimicrobial resistance. Overprescribing in dental practice has been reported. This study aimed to describe patterns of antibiotic prescription for treating and preventing odontogenic infections based on reports from Lithuanian dentists. Materials and Methods: Questionnaires were sent to all 4751 Lithuanian dentists registered in the database of the Lithuanian Dental Chamber who had consented to participate in surveys. The questionnaire addressed antibiotic prescription preferences for the treatment and prevention of various dental pathologies. The statistical analysis included chi-square tests and a factor analysis to evaluate prescription frequences in different clinical scenarios considering the respondents’ specialty and age. Results: Of 647 responses, 497 were from general dentists, 35 from oral surgeons, 40 from endodontists, 20 from periodontists, and 35 from prosthodontists. Respondents were grouped by age: A (≤35 years, n = 207), B (36–50 years, n = 224), and C (≥51 years, n = 209). Amoxicillin was the first-choice antibiotic for 81.1% of respondents (group A more frequently than other groups, p = 0.001). A 7-day treatment duration was preferred by 60.8%, while 33.6% chose 5 days. For patients allergic to β-lactam antibiotics, 63% preferred clindamycin. Over 90% cited acute apical abscess with systematic involvement as an indication for antibiotic prescription. A factor analysis of 18 clinical scenarios revealed prescription differences among dental specialists, oral surgeons, and periodontists prescribing antibiotics more frequently than general dentists and endodontists. For prophylaxis, 87.5% recommended antibiotics for patients at risk of infectious endocarditis after a cardiologist’s consultation (group C less frequently than other groups, p = 0.021). Conclusions: Lithuanian dentists generally prefer narrow-spectrum antibiotics for the treatment of odontogenic infections. There are notable differences in prescription patterns among dental specialists, with younger dentists showing a trend towards more rational antibiotic use.

The present study aimed to evaluate and compare the radiopacity and surface morphology of AH Plus Bioceramic Sealer (AHPB), Bio-C Sealer (BIOC), Biodentine (BD), BioRoot RCS (BR), Grey-MTAFlow (GMF), White-MTAFlow (WMF), TotalFill BC Sealer (TF), and TotalFill BC Sealer HiFlow (TFHF) at different time moments—30 min, 24 h, and 28 days. Ten specimens of each material were prepared according to the ISO-6876:2012 standard and radiographed next to an aluminum step wedge using a digital sensor. The specimens were stored in a gelatinized Hank’s balanced salt solution at 37 °C between assessments. The mean grayscale values of each specimen were converted into equivalent aluminum thickness by a linear regression model. Characterization of the surface morphology was performed by using a scanning electron microscope at ×4.0k and ×10.0k magnifications. The radiographic analysis revealed that all the tested materials exceeded the ISO-specified limit of 3 mm Al, with the highest radiopacity presented by AHPB and the lowest by BD. None of the tested materials demonstrated considerable variances between the 30 min and the 24 h radiopacity level (p < 0.05), and statistically significant long-term radiopacity changes were exhibited by BR, TFHF, and TF (p > 0.05). All the specimens demonstrated a common feature of limited precipitate formation, with numerous unreacted particles still presented on the surface after 24 h, whereas the particle rearrangement and the deposition of precipitates were clearly observed after 28 days.

The better understanding of the clinically important behavioral features of new instrument systems has an important significance for the clinical endodontics. This study aimed to investigate the shaping and centering ability as well as cyclic fatigue resistance of HyFlex CM (CM), HyFlex EDM (EDM) and EdgeFile (EF) thermally treated nickel–titanium (NiTi) endodontic instrument systems. Sixty curved root canals of the mesial roots of mandibular molars were randomly assigned into three groups (n = 20) and shaped using CM, EDM and EF files up to the size 40 and taper 04 of the instruments. µCT scanning of the specimens before and after preparation was performed and the morphometric 2D and 3D parameters were evaluated in the apical, middle and coronal thirds of root canals. In each group, 40.04 instruments (n = 20) were subjected to the cyclic fatigue resistance test in artificial root canals at 37 °C temperature until fractures occurred, and the number of cycles to failure (NCF) was calculated. The fractographic analysis was performed using a scanning electron microscope, evaluating topographic features and surface profiles of the separated instruments. The one-way analysis of variance with post hoc Tuckey’s test was used for statistical analysis of the data; the significance level was set at 5%. All systems prepared the comparable percentage of root canal surface with the similar magnitude of canal transportation in all root thirds (p > 0.05), but demonstrated significantly different resistance to cyclic fatigue (p < 0.05). The most resistant to fracture was EF, followed by EDM and CM. The length of the fractured fragments was not significantly different between the groups, and fractographic analysis by SEM detected the typical topographic features of separated thermally treated NiTi instrument surfaces.

The aim of this study was to investigate the shaping ability and cyclic fatigue resistance of Genius (GN) and WaveOne (WO) nickel-titanium (NiTi) instruments. Forty mesial root canals of mandibular molars were randomly divided into two groups, according to the instrument system used for root canal preparation (n = 20): GN and WO. Root canals were prepared to the full working length using the crown-down technique, with up to 40.04 instruments for GN group and 40.08 instruments for WO group. Specimens were scanned with a µCT before and after instrumentation. The changes in 3D parameters and degree of canal transportation were evaluated in the apical, middle and coronal thirds of root canals. Size 25, taper 0.04 (GN) and 0.08 (WO) instruments (n = 20) were used in simulated root canals until fracturing, and the number of cycles to failure (NCF) was recorded. The fractured files were investigated under a scanning electron microscope to characterize fractured surfaces. Data were analyzed using ANOVA post hoc Tuckey’s tests with the significance level set at 5%. The GN system was able to prepare the higher percentage of the canal surface with less canal transportation in all root canal thirds and displayed the higher resistance to cyclic fatigue in comparison to WO instruments (p < 0.05). However, the length of the fractured segments was not significantly different among the groups; meanwhile, SEM investigations revealed the typical topographic characteristics of fractured surfaces. Hybrid GN instruments demonstrated superior shaping ability and resistance to cyclic fatigue. However, both NiTi instrument systems prepared the root canals with no significant shaping errors, considerable changes in 3D parameters and no significant differences in the topographic appearances of the instrument surfaces after fractures.

The aim was to overview the oral health aspects in hemophilia patients. An electronic search of Medline (Pub Med), Cochrane, SSCI (Social Citation Index), SCI (Science Citation Index) databases from 1982 to the present, using the following search words: hemophilia, oral health, dental caries, dental caries prevalence, gingivitis, periodontitis, primary dentition, permanent dentition, dental treatment and review, was performed. The search yielded 196 titles and abstracts on chosen words. All articles were full-text reviewed and 40 of publications were included. Nowadays coagulation factor abnormalities are the most common of inherited bleeding disorders, but occur much less frequently approximating 10000-50000 male births than acquired coagulation defects. Von Willebrand disease, Hemophilia A and Hemophilia B account for 95-97% of all coagulation deficiencies. Hemophilias A and B are subdivided according to the factor's activity levels in the blood: mild, moderate or severe. The two main oral diseases affecting patients with hemophilia are the same as for the rest of population, i.e. dental caries and gingivitis/periodontitis. Only a few studies concerning oral health aspects in hemophilia patients were carried out. Some controversy exists concerning caries prevalence in both primary and permanent dentitions in children with hemophilia. People with congenital hemorrhagic diatheses constitute a very small proportion of the total population. Due to that fact treatment of such patients becomes a challenge to the most of dentists due to the fact that most of them have no experience in dealing with dental problems in such patients. There is a lack of epidemiological studies in oral health status of hemophilia patient.

This study examined whether the authoritative parenting model (APM) is more effective than conventional approaches for changing adolescent oral hygiene behavior. A total of 247 adolescents were recruited using a cluster random-sampling method. Subject groups were randomly allocated into an intervention group (APM-based interventions), a Control Group 1 (conventional dental education and behavior modification) or a Control Group 2 (conventional behavior modification). The results were assessed after 3 and 12 months. Oral hygiene level was assessed as percent dental plaque and the ratio of plaque percent change (RPC). At the 3-month follow-up, there were significant differences among the groups; the APM group had the largest decrease in plaque levels (24.5%), Control Group 1 showed a decrease in plaque levels of 15.4% and Control Group 2 showed an increase in plaque levels of 2.8%. At the 12-month follow-up, an improvement was observed in all groups, but there were no statistically significant differences among the groups. In the short term, the intervention based on the APM was more effective in changing adolescent oral hygiene behavior compared with the conventional approaches. The reasons for long-term positive change after discontinued interventions in control groups need to be explored in future studies.

The goal of this study was to examine salivary factors and formation of dental plaque in elderly subjects who were institutionalized and to relate these factors to general health and medication use. This cross-sectional study consisted of 50 elderly individuals who were institutionalized and 25 healthy young volunteers who served as a reference group. For each subject, salivary flow rates, salivary pH, and buffering capacity were assessed. Baseline Plaque Index and Plaque Formation Rate Index were used as a measure of oral hygiene. Information on each patient's general health and medication use was acquired from the institution. An evaluation of the results of this study suggests that salivary protective qualities and dental plaque levels in the elderly subjects who were institutionalized were worse than in healthy young individuals. An association between the general health of the elderly and salivary flow rate was found.

The aims were to overview the previous use of psychological theories for oral health education in adolescents and to discuss current approaches which could enhance the effectiveness of behaviour modification in this age group. The MEDLINE via OVID database was searched for relevant papers published during the last four decades. Only a few studies using psychological models and theories in oral health education for adolescents could be found and these studies were carried out a few decades ago. It was shown that socially disadvantaged adolescents, i.e. those who have the greatest need for improvements in oral health, might benefit most from the theory-based behavioural interventions. However, evidence from these trials can not be directly used to base oral health education in contemporary adolescents. An important consideration is that psychological models and theories developed for adults may not apply as well to adolescents, who are at different stages of behavioural development and with different cognitive abilities. Understanding the adolescent profile in oral health education appears to be crucial for success. The theory-based approaches to health behaviour modification, already successfully applied in other fields of medicine, might be a good alternative to conventional oral health promotion in adolescents.