Radhika Thakkar

Background: Implant therapy is a standard of care for long-term tooth replacement. While high survival rates have been reported for implants placed by specialists, data on outcomes achieved by Advanced Education in General Dentistry (AEGD) residents remain limited. Objectives: To evaluate the clinical performance and complication rates of dental implants placed and restored by AEGD residents under faculty supervision, and to identify factors influencing outcomes after at least one year in function. Methods: A retrospective review was conducted for implants placed between April 2012 and December 2021 at the Eastman Institute for Oral Health. Only implants with ≥1-year follow-up were included. Data included demographics, medical history, smoking status, oral hygiene, peri-implant health, and prosthetic outcomes. Logistic regression was used to assess associations between risk factors and complications. Results: Among 262 implants that survived ≥1 year, the complication rate was low: screw loosening occurred in 8.4%, crown issues in 3.4%, abutment or screw fractures in 0.4%, and early peri-implantitis in 11.5%. Examiner satisfaction was high for esthetics (82.8%) and occlusion (85.9%), and over 80% of patients rated their outcomes between 8 and 10 on a 10-point scale. Diabetes and high plaque index were significant predictors of peri-implantitis. Conclusions: Implants placed and restored by AEGD residents under structured faculty supervision achieved low complication frequencies, and strong patient satisfaction comparable to specialist outcomes.

Objectives: This study aimed to evaluate the success rates of NSRCT performed by AEGD residents and to identify predictive factors associated with clinical outcomes and patient satisfaction. Methods: A retrospective chart review was conducted on cases treated between 2012 and 2021. Eligible cases included fully developed permanent teeth that underwent NSRCT and received a final restoration by general dentistry residents, with a minimum of 12 months of follow-up. Data collected included demographic information, medical history, clinical symptoms, radiographic findings, instrumentation, type and timing of final restorations, and patient satisfaction scores. Treatment success was defined as the absence of symptoms and either the resolution or stability of periapical radiolucency. Patient satisfaction and pain levels were also analyzed. Results: AEGD residents achieved radiographic and clinical RCT success rates of 93.3% and 91.5%, respectively. Multivariate logistic regression showed that the presence of an intact restoration was significantly associated with increased odds of tooth retention (odds ratio [OR] = 3.4, p < 0.001), while post placement in a straight root was also a significant predictor of survival (OR = 4.2, p = 0.02). Conversely, pre-existing radiolucency (OR = 0.37, p = 0.018) and the use of a metal post (OR = 0.23, p = 0.012) were significantly associated with lower odds of tooth retention. Worse periodontal health was significantly associated with increased odds of pain on percussion, with a 74.19% increase in odds per worsening category (OR = 1.74, p = 0.002). Patient satisfaction was significantly higher when restorations remained intact, with esthetic satisfaction increasing by a factor of 3.08 (OR = 3.08, p < 0.001) and functional satisfaction increasing by a factor of 3.9 (OR = 3.9, p < 0.001). Conclusions: Endodontic treatments performed by AEGD residents demonstrated high success rates and favorable patient-reported outcomes. Restoration integrity, periodontal health, and post and final restoration selection play critical roles in treatment success and patient satisfaction.

This chapter “Bridging Gaps in Oral Health Access with Teledentistry” delves into the ways that teledentistry may be used to address oral health disparities amongst vulnerable populations, including elderly residents of nursing homes and patients with special needs. Teledentistry represents a revolutionary change with its integration of digital imaging, remote consultations, and advanced technology particularly for patients with complex medical history. The chapter also highlights examples of implementation of teledentistry at the global level. Furthermore, the chapter outlines the inevitable challenges, such as technology constraints, regulatory impediments, acceptability concerns, and geographic obstacles. Strategies for overcoming these challenges are put forth, emphasising teamwork, with a focus on enhanced regulatory structures and continuing training for dental practitioners to implement new technology. In order to satisfy the specific needs of these vulnerable populations, customised teledentistry focused on patient-centric approach is crucial. Looking ahead, the chapter describes future direction for growth, importance of collaborative approach, possible developments in technology and emphasises how important it is to carry out further research and work together. This chapter functions as a comprehensive guide, in reducing disparities in oral health amongst the underprivileged with the inclusion of teledentistry.

The present study aimed to assess the effect of fluoridated and nonfluoridated mouth ri nses on resistance to friction between orthodontic bracket and archwire. This study comprises 60 premolar stainless steel (SS) brackets with 0.022 inches slot size. The 0.019 × 0.025 dimensions SS archwires were cut into 5 cm long specimens. They were grouped into three main categories, group I: artificial saliva (control solution), group II: Aloe Dent mouthwash (ALO), and group III: 0.05% sodium fluoride mouthwash. The specimens from each group were either immersed in the test solution or in the control solution for 10 hours. Later, the specimens were transferred to an incubator maintained at 37°C. Post 10 hours, the specimens were immersed for 30 minutes in distilled water. A scanning electron microscope was used to study the surface morphology and a universal testing machine was used to measure the frictional resistance. The distribution of normality for three study groups' recorded data was checked using Shapiro-Wilk test. The highest frictional resistance (1.94 ± 0.02) was demonstrated by specimens immersed in 0.05% sodium fluoride mouthwash than those immersed in Aloe Dent mouthwash (1.28 ± 0.66) and artificial saliva (1.10 ± 0.32). The difference found between the groups by an analysis of covariance was statistically significant. The highest surface roughness (22.30 ± 0.12) was revealed by specimens immersed in 0.05% sodium fluoride mouthwash than those immersed in Aloe Dent mouthwash (18.28 ± 0.26) and artificial saliva (15.86 ± 0.42). A statistically significant difference between the groups was shown by an analysis of covariance. After considering the drawbacks of this study, we conclude that specimens immersed in Aloe Dent mouthwash demonstrated less frictional resistance and surface roughness when compared to those immersed in 0.05% sodium fluoride mouthwash. During sliding mechanism, the frictional resistance between orthodontic archwire and brackets imposes problems, such as lessening the applied force and movement of tooth, and also results in anchorage loss. So, orthodontists should always take care while prescribing mouthwashes to reduce their effects on the friction.

Kakkar M, et al. J Dent Anesth Pain Med. 2016 Sep;16(3):199-202. https://doi.org/10.17245/jdapm.2016.16.3.199