Ngoc Tam Dan Nguyen

Background: Accurate assessment of endodontic case difficulty before treatment is essential to reduce procedural errors. The American Association of Endodontists (AAE) (2022) developed a standardized case difficulty assessment form to classify endodontic cases into low-, moderate-, and high-difficulty levels. Objectives: To describe clinical and radiographic characteristics, patient conditions, and classify endodontic case difficulty according to the 2022 AAE assessment form at Hue University of Medicine and Pharmacy Hospital, and to investigate endodontic procedural errors associated with case difficulty. Methods: A prospective assessment was conducted on 60 teeths from 52 patients diagnosed with pulpal and/or periapical diseases indicated for non-surgical endodontic treatment at Hue University of Medicine and Pharmacy Hospital from December 2024 to August 2025. All cases underwent clinical and radiographic examination and were classified using the AAE case difficulty assessment form. Postgraduate trainee dentists performed endodontic treatments, and procedural errors were recorded based on radiographic criteria. Results: High-difficulty cases accounted for 80.0%, while moderate-difficulty cases accounted for 20.0%; no low-difficulty cases were identified. The most common procedural errors were overfilling (18.3%) followed by underfilling, ledge formation (15.0%), inhomogeneity, lack of taper (10.0%), instrument separation (6.7%), and perforation (5%). Procedural errors occurred exclusively in high-difficulty cases, accounting for 41.7%. A statistically significant association was found between endodontic case difficulty and procedural errors (p < 0.05), whereas no significant association was observed between case difficulty and specific error types (p > 0.05). Conclusions: The AAE endodontic case difficulty assessment form is a valuable tool for clinical decision-making. High-difficulty cases predominated and were significantly associated with a higher incidence of procedural errors.

Background: Fixed orthodontic appliances hinder oral hygiene maintenance, promote the development of white spot lesions (WSLs), and impose a significant risk on the dentition. Objective: to evaluate the prevalence and association of oral hygiene status and WSLs among orthodontic patients attending orthodontic departments at Hue University. Methods: A cross-sectional study was conducted in 2024 on 100 students from the University of Medicine and Pharmacy, Hue University, undergoing fixed orthodontic treatment. Data were collected through clinical assessment of patients’ enamel damage index (WSLs) (International Caries Detection and Assessment System, ICDAS) and oral hygiene status (Simple Oral Hygiene Index, OHI-S). Results: Among 100 orthodontic patients (mean OHI-S: 1.32 ± 1.39), 48% had fair, 30% had poor, 22% had good hygiene, with no cases of excellent hygiene. The prevalence of WSLs was 44.0%. Female had lower OHI-S scores (1.28 ± 1.38 vs. 1.45 ± 1.43) and a lower of WSLs prevalence (40.79% vs. 54.17%) than males. There were moderate positive correlations of OHI-S and WSLs (r = 0.27, p = 0.0053) and treatment duration (r = 0.35, p = 0.03). Treatment duration had a strong, positive correlation with WSLs (r = 0.72, p = 0.0000). Conclusions: Among orthodontic patients, there were high prevalence of poor to fair oral hygiene with high occurrent of WSLs. Female had better oral health status and lower occurrence of WSLs. Poor oral hygiene and longer treatment duration was associated with a higher prevalence of WSLs.

To examine associations between tongue function domains and questionnaire-based high-risk sleep-disordered breathing classification across age groups, and to explore interaction effects between functional and anatomical factors. A cross-sectional study included 1,244 participants (462 children aged 6–8 years and 782 young adults aged 18–25 years). High-risk classification was defined as meeting ≥ 1 age-appropriate threshold: Pediatric Sleep Questionnaire (PSQ ≥ 8), Epworth Sleepiness Scale (ESS > 10), or Snoring Severity Scale (SSS ≥ 7) for children; Berlin Questionnaire (≥ 2 positive categories), ESS > 10, or SSS ≥ 7 for young adults. Tongue function included mobility, strength, posture, and orofacial domains. Multivariable logistic regression with backward stepwise selection was used in pooled and age-stratified models. Pre-specified interaction terms were systematically tested to explore effect modification between functional and anatomical factors. The prevalance of high-risk classification was 26.8% in children, 11.9% in young adults, and 17.5% overall. In children, low tongue resting posture (AOR = 1.69) and frequent nocturnal open-mouth posture (AOR = 2.69) were independently associated with high-risk classification. In young adults, better orofacial function (AOR = 0.79), greater posterior mobility (AOR = 0.96), and higher posterior strength (AOR = 0.98) were protective. Posterior mobility and age group moderated the association between tonsillar hypertrophy and high-risk classification (AOR = 0.53 and AOR = 2.06, respectively), though not in age-stratified models. In children, combined tonsillar hypertrophy and restricted posterior mobility were associated with substantially higher prevalence (34.5% vs. 13.8%; dose-response p=.006). Tongue function showed age-group-specific associations with questionnaire-based high-risk classification. Incorporating both anatomical and functional assessments within age-specific frameworks may improve early identification and inform future research. The online version contains supplementary material available at 10.1007/s11325-026-03666-3.