Zehra Yonel

Background: Adoption of additive manufacture of printed typodonts within dentistry for education occurs despite inadequate reproduction of desirable tactile characteristics of human tooth tissues. Variable findings regarding material properties and educational outcomes of 3D‐printed typodonts are reported. A systematic review is therefore warranted to synthesise the evidence and understand how materials used in 3D‐printed typodonts impact tactile perception and dental educational value to ultimately inform evidence‐based adoption in dental education. Methods: This systematic review aimed to investigate the impact of 3D‐printed typodonts on tactile perception and educational value of simulative dental education compared to traditionally manufactured options and natural teeth, especially regarding the materials used. The review adhered to PRISMA‐P 2015 and PRISMA‐2020 guidelines and checklist. The protocol was registered (INPLASY202520062). The research question was defined using a PICOS framework. An online search of 7 databases revealed 29 studies for full text review. Results: Dental education benefitted from 3D‐printed typodonts, improving motivation, confidence and technical ability of pre‐clinical students. 24 studies (83%) reported educational benefit of 3D‐printed typodonts. Despite the increased educational value of 3D‐printed typodonts over traditionally manufactured typodonts, both educators and students criticised tactile perception of cutting, specifically related to hardness, which failed to replicate human tissues. The resins used in vat‐polymerisation 3D‐printed typodonts were predominantly commercially available. Modification of resins has shown some potential mechanical benefits in objective studies. Conclusion: Simulation education may be enhanced by printing technologies, but their fidelity needs to better represent the tactile sensation of human tissues in cutting and instrumentation. Collaboration between material science expertise and educational researchers to develop new vat‐polymerisation resins for 3D‐printed enhancing simulation education may demonstrate benefits.

This qualitative study explored how patients perceive and experience Type 2 diabetes (T2D) risk assessment delivered within NHS high‑street dental practices. Fifteen adults who had completed a risk-assessment questionnaire and point‑of‑care HbA1c test participated in semi‑structured interviews analysed using inductive reflexive thematic analysis. Participants widely supported the concept of opportunistic diabetes risk assessment in dental settings, describing the process as convenient, acceptable and reassuring, particularly because it offered a single‑visit workflow and immediate results. Trust in familiar dental staff contributed strongly to perceptions of legitimacy and comfort. Many participants valued receiving a tangible HbA1c number and expressed a desire for a plain‑language printed explanation outlining the meaning of the result and recommended next steps. While weight‑ and waist‑circumference related questions were generally acceptable, several participants emphasised the importance of privacy and clear pre‑test communication to minimise discomfort. Preferences for follow‑up strongly favoured a dual‑communication approach: automatic GP notification complemented by a patient‑held copy to ensure understanding and encourage action. Views diverged regarding whether dental teams should directly refer into diabetes prevention programmes, but all participants agreed that strong integration with GP pathways was essential. Some also highlighted equity considerations, including the deterrent effect of patient fees and the need to ensure that screening does not compromise access to routine dental care. Overall, dental practices were seen as a credible, convenient and potentially impactful setting for early identification of T2D risk, provided pathways remain patient‑centred, well‑explained and integrated with broader primary care systems.

Purpose of review: This review synthesises the recent evidence regarding integrated care pathways between primary care medical and dental services in managing patients with type 2 diabetes mellitus. It aims to assess existing models, explore their recommendations and identify barriers and facilitators to integration. By examining existing models of collaboration, referral systems, and multidisciplinary interventions, this review will assess the effectiveness of integrated approaches in improving patient outcomes and enhancing early diagnosis. Recent findings: Eighteen studies were included, encompassing a wide range of healthcare locations. The findings highlighted a consistent lack of interprofessional knowledge, limited referral systems and lack of support in commissioning frameworks. Whilst several interventions demonstrated favourable outcomes, most lacked systemic support or long-term sustainability. Summary: Several interventions to integrate oral and medical care for patients with diabetes demonstrate significant clinical and public health benefits of enhanced integration of care. However, there is limited uptake of implementation due to operational and policy-related challenges. To support sustainable and reliable integration, infrastructure and commissioning changes are required. Existing guidance and commissioning standards should be implemented with appropriate funding. Future efforts should prioritise implementation of integrated medical and dental care pathways for patients with diabetes. Barriers to implementation should be addressed urgently.

Background: The transition from pre-clinical to clinical teaching is often a time of heightened anxiety for students. With the shift to bi-modal teaching during the pandemic there was an opportunity to explore the use of 360-degree videos and virtual reality (VR) simulation teaching to enhance educational experience and smooth the transition from pre-clinical to clinical teaching. The aims of this study were to understand students’ perceptions of face-to-face and virtual simulation teaching during the recovery phase of the COVID-19 pandemic. Methods: Two groups of students were recruited all of whom were about to have their clinical introduction to the periodontology department. All 20 students received current standard induction programme. One group (n = 7 students) received standard teaching only. One group (n = 13 students) in addition to standard teaching methods also received access to 360-degree video and VR headset prior to standard teaching. Focus groups were then conducted with the students. A topic guide was developed and piloted. Focus groups were conducted online, audio was recorded and transcribed verbatim. Transcripts were analysed codes and themes were developed using thematic analysis as a framework for analysing the focus groups. Results: The 3 key themes identified were: the importance of familiarity with the clinical environment, preparation prior to attending clinical sessions and the benefit of practical experience. Conclusion: This study demonstrates how 360-videos and VR technology may enhance dental education, provided it is implemented appropriately and at the correct time in training. Overall, students had a positive attitude towards using 360-videos and acknowledged its value in meeting a range of learning objectives, including infection control, IT training, and clinic orientation.

The aim of this study was to develop and externally validate a score for use in dental settings to identify those at risk of undiagnosed nondiabetic hyperglycemia (NDH) or type 2 diabetes (T2D). The Studies of Health in Pomerania (SHIP) project comprises 2 representative population-based cohort studies conducted in northeast Germany. SHIP-TREND-0, 2008 to 2012 (the development data set) had 3,339 eligible participants, with 329 having undiagnosed NDH or T2D. Missing data were replaced using multiple imputation. Potential covariates were selected for inclusion in the model using backward elimination. Heuristic shrinkage was used to reduce overfitting, and the final model was adjusted for optimism. We report the full model and a simplified paper-based point-score system. External validation of the model and score employed an independent data set comprising 2,359 participants with 357 events. Predictive performance, discrimination, calibration, and clinical utility were assessed. The final model included age, sex, body mass index, smoking status, first-degree relative with diabetes, presence of a dental prosthesis, presence of mobile teeth, history of periodontal treatment, and probing pocket depths ≥5 mm as well as prespecified interaction terms. In SHIP-TREND-0, the model area under the curve (AUC) was 0.72 (95% confidence interval [CI] 0.69, 0.75), calibration in the large was −0.025. The point score AUC was 0.69 (95% CI 0.65, 0.72), with sensitivity of 77.0 (95% CI 76.8, 77.2), specificity of 51.5 (95% CI 51.4, 51.7), negative predictive value of 94.5 (95% CI 94.5, 94.6), and positive predictive value of 17.0 (95% CI 17.0, 17.1). External validation of the point score gave an AUC of 0.69 (95% CI 0.66, 0.71), sensitivity of 79.2 (95% CI 79.0, 79.4), specificity of 49.9 (95% CI 49.8, 50.00), negative predictive value 91.5 (95% CI 91.5, 91.6), and positive predictive value of 25.9 (95% CI 25.8, 26.0). A validated prediction model involving dental variables can identify NDH or undiagnosed T2DM. Further studies are required to validate the model for different European populations.

Point of care testing (POCT) devices have been developed to facilitate immediate results with the potential to aid screening for new disease and enable patients to self-monitor their disease. Non-communicable diseases (NCDs) are the major cause of mortality globally and are increasing in prevalence as the population ages. Allied health care professionals (AHPs) are skilled in undertaking risk assessment and delivering preventative advice, providing opportunities to access large proportions of the population who may not visit their doctor, within non-traditional community settings. There is evidence of high levels of support from public, patients and health professionals for engaging AHPs in risk-targeted early case detection of certain NCDs. Thus, POCT devices offer a potential alternative to traditional venous blood collection, as novel care pathways for increasing early case detection and access to preventative care. The objectives of this study were to: (i) determine the concordance of the specific POCT devices with laboratory-based standard assays employed within clinical biochemistry laboratories. (ii) compare the sampling experience of both methods via patient-reported experiences. A prospective, two-centre study was undertaken involving 158 participants who provided informed consent. Venous blood was collected for traditional assays of HbA1c, creatinine/ estimated Glomerular-Filtration-Rate (eGFR) and vitamin-D. Capillary blood was collected by finger prick test and also assayed for the same biochemical indices (Nova StatSensor (creatinine/eGFR); Siemens DCA-Vantage (HbA1C); CityAssays (vitamin-D)). All users were provided with device training. Participants reported any discomfort experienced by each simultaneously applied method (randomised in order) via a 100 mm Visual-Analogue-Scale. Results for each POCT device and the laboratory standard were analysed by Bland-Altman plots to determine assay concordance. POCT devices demonstrated good concordance with laboratory testing, with at least 95% of all samples being within two standard deviations, for each of the devices tested. The majority of participants reported less discomfort with POCT than venepuncture, with the average reported discomfort being 17/100 mm less for POCT compared to venous blood sample collection on the visual analogue scale. The POCT devices demonstrated acceptable concordance with laboratory-based assays, and patients reported lower levels of discomfort compared to traditional means of blood collection. This study demonstrates the potential of using these devices as acceptable methods for opportunistic testing of “at-risk” individuals within non-traditional community care settings.

Gingivitis is an extremely common oral inflammatory condition and can be induced in humans using an acute 21-day experimental gingivitis model. Neutrophils are known to be highly prevalent in the gingival crevice during gingival inflammation; however, the effect of gingivitis and the associated biofilm on peripheral blood neutrophils (PBN) is not well characterised. Thus, the aim of this study was to examine the impact of inflammation induced by experimental gingivitis and its resolution upon the function of PBN. Fifteen systemically healthy volunteers undertook a split-mouth 21-day experimental gingivitis study followed by a resolution phase of 14 days. PBN function, including reactive oxygen species (ROS) production, neutrophil extracellular trap (NET) release, directional chemotactic accuracy and expression of host mediators in gingival crevicular fluid (GCF), were measured at baseline (day 0), on day 21 and on day 35. NET formation and ROS production were significantly elevated at day 21. Chemotactic speed was also elevated in response to bacterial peptide fMLP at day 21. At day 35, ROS production in response to an Fcgamma stimulant, opsonised Staphylococcus aureus, remained elevated. The data presented suggest a lasting biological impact of the experimental gingivitis on PBN function even after clinical symptoms have abated.