Journal of the American Dental Association最新文献

{"title":"A 4-week randomized clinical trial evaluating plaque and gingivitis effects of a new oscillating-rotating electric toothbrush.","authors":"Ralf Adam, Julie Grender, Hans Timm, C Ram Goyal, Jimmy Qaqish","doi":"10.1016/j.adaj.2025.04.015","DOIUrl":"https://doi.org/10.1016/j.adaj.2025.04.015","url":null,"abstract":"<p><strong>Background: </strong>Many patients with gingivitis use manual toothbrushes, despite evidence of considerably greater plaque and gingivitis reductions with electric toothbrushes. A new oscillating-rotating (OR) toothbrush features a streamlined design and quieter sound that manual toothbrush users may find appealing.</p><p><strong>Methods: </strong>This parallel-group, 3-treatment, randomized, clinical study compared the new OR toothbrush, used in sensitive or daily clean mode, with a manual toothbrush for plaque (Rustogi Modified Navy plaque index) and gingivitis reduction (modified gingival index and number of bleeding sites) over 4 weeks among manual toothbrush users with gingivitis.</p><p><strong>Results: </strong>All 3 groups experienced significant improvement in all gingivitis and plaque measures at weeks 1 and 4 (P ≤ .005). The OR toothbrush used in either mode had significantly greater efficacy vs the manual toothbrush for all gingivitis and plaque measures at both time points (P ≤ .016). Week 4 treatment difference for whole-mouth plaque reduction between the manual toothbrush and OR sensitive and OR daily clean toothbrush treatments was -0.05 (95% CI, -0.062 to -0.037) and -0.078 (95% CI, -0.091 to -0.066), respectively. Only 20% of participants in the manual group transitioned from gingivitis (≥ 10% bleeding sites) to healthy (< 10% bleeding sites) vs 46.7% in the OR sensitive group and 60% in the OR daily clean group (P = .005).</p><p><strong>Conclusions: </strong>The new OR toothbrush was significantly more effective than a manual toothbrush at reducing plaque and gingivitis in manual toothbrush users with baseline gingivitis.</p><p><strong>Practical implications: </strong>The OR toothbrush improves periodontal health outcomes for manual toothbrush users and was designed to transition them to electric technology. This clinical trial was registered at ISRCTN-The UK's Clinical Study Registry. The registration number is ISRCTN61582326.</p>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing the care of patients with or anticipating total knee and hip arthroplasty surgery: Updated 2024 American Academy of Orthopaedic Surgeons and the American Association of Hip and Knee Surgeons guideline.","authors":"Lauren L Patton","doi":"10.1016/j.adaj.2025.05.009","DOIUrl":"https://doi.org/10.1016/j.adaj.2025.05.009","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence algorithm for real-time diagnostic assist in orofacial pain.","authors":"Glenn Thomas Clark, Anette Vistoso Monreal, Nicolas Veas, Gerald E Loeb","doi":"10.1016/j.adaj.2025.05.002","DOIUrl":"https://doi.org/10.1016/j.adaj.2025.05.002","url":null,"abstract":"<p><strong>Background: </strong>Misdiagnosis is prevalent in clinical practice due to incomplete and sometimes inconsistent data, which generate errors in the traditional diagnostic process. Orofacial pain, with its wide range of conditions, poses a considerable diagnostic challenge, particularly for inexperienced clinicians.</p><p><strong>Case description: </strong>A structured, machine learning-compatible note-taking system was used to document clinical history and examination features from 1,020 patients at an orofacial pain clinic. A naïve Bayesian inference algorithm was used to compute and display the probability of various diagnoses as data were added to the medical record during a clinical encounter. Its accuracy compared favorably with 5 machine learning algorithms for 5 new cases of each of 10 diagnoses varying in their prevalence in the database.</p><p><strong>Practical implications: </strong>The authors speculated that the key to achieving reasonable concordance was the highly structured electronic medical record, which included disease-defining or unique features of most diagnoses. Extension of these methods to broader clinical domains will require similar attention.</p>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does dentistry need risk calculators for more consistent and objective decision making?","authors":"Craig S. Miller DMD, MS","doi":"10.1016/j.adaj.2024.10.013","DOIUrl":"10.1016/j.adaj.2024.10.013","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 6","pages":"Pages 431-432"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors’ Response","authors":"Stephen K. Harrel DDS,&nbsp;Charles M. Cobb DDS, PhD","doi":"10.1016/j.adaj.2025.03.014","DOIUrl":"10.1016/j.adaj.2025.03.014","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 6","pages":"Pages 436-437"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between periodontal disease and hospitalization outcomes in ST-segment elevation myocardial infarction","authors":"Nadhem Abdallah MD,&nbsp;Abdilahi Mohamoud MBBS,&nbsp;Meriam Abdallah,&nbsp;Mohammed Samra MD,&nbsp;Mohammed Abdullah DMD,&nbsp;David T. Gilbertson PhD","doi":"10.1016/j.adaj.2025.03.007","DOIUrl":"10.1016/j.adaj.2025.03.007","url":null,"abstract":"<div><h3>Background</h3><div>Periodontal disease (PD) is linked to increased cardiovascular morbidity, but its impact on outcomes in ST-segment elevation myocardial infarction (STEMI) remains understudied. The authors investigated the effect of PD on STEMI outcomes.</div></div><div><h3>Methods</h3><div>The authors analyzed STEMI hospitalizations from the 2016-2019 National Inpatient Sample data set, comparing outcomes in patients with and without PD. Primary and secondary outcomes included mortality, mechanical circulatory support, mechanical ventilation, vasopressor use, cardiogenic shock, acute kidney injury, hospital length of stay, and total hospital cost. Multivariable regression adjusted for confounding factors.</div></div><div><h3>Results</h3><div>Of 2,595,584 STEMI hospitalizations, 0.2% involved patients with an <em>International</em> <em>Classification of Diseases, Tenth Revision, Clinical Modification</em> code for PD. A PD code was associated with higher odds of mechanical circulatory support use (adjusted OR [aOR], 1.57; 95% CI, 1.25 to 1.97), mechanical ventilation (aOR, 1.26; 95% CI, 1.01 to 1.58), cardiogenic shock (aOR, 1.48; 95% CI, 1.20 to 1.83), acute kidney injury (aOR, 1.32; 95% CI, 1.13 to 1.55), longer hospital stays (7.18 vs 4.40 days; <em>P</em> &lt; .001), and higher hospital costs ($141,245 vs $98,152; <em>P</em> &lt; .001). Mortality and vasopressor use were unchanged.</div></div><div><h3>Conclusions</h3><div>Among STEMI cases, a concomitant PD code was associated with higher odds of nonfatal adverse events and health care resource use.</div></div><div><h3>Practical Implications</h3><div>Recognizing PD as a comorbidity in STEMI may help tailor care strategies, reduce adverse outcomes, and improve resource allocation in clinical practice. Further studies could refine risk-stratification approaches.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 6","pages":"Pages 468-476.e1"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How does dental sleep medicine fit into the specialty of orofacial pain?","authors":"Isabel Moreno-Hay DDS, PhD,&nbsp;Steven Bender DDS,&nbsp;Aurelio Alonso DDS, PhD,&nbsp;Larry Lockerman DDS,&nbsp;Sherwin Arman DMD, MPH,&nbsp;Mariona Mulet Pradera DDS, MS","doi":"10.1016/j.adaj.2025.03.003","DOIUrl":"10.1016/j.adaj.2025.03.003","url":null,"abstract":"<div><h3>Background</h3><div>Sleep disturbances can lead to an increase in pain and vice versa. Pain, including orofacial pain, can affect sleep quality, leading to poor health, and poor health can affect sleep quality.</div></div><div><h3>Types of Studies Reviewed</h3><div>The authors examined the literature regarding orofacial pain and sleep disorders, reviewed the state of sleep medicine education in the predoctoral dental curriculum and graduate orofacial pain programs, and outlined the role of the orofacial pain specialist in screening for, and management of, sleep disorders associated with orofacial pain.</div></div><div><h3>Results</h3><div>In the clinical care of patients with orofacial pain, routine evaluation of sleep is mandatory to arrive at an accurate diagnosis and provide the most appropriate treatment recommendations. Education in sleep medicine is accomplished through orofacial pain postgraduate programs but is deficient in the predoctoral dental curriculum. Orofacial pain specialists play a crucial role in the screening and management of sleep disorders. Education in sleep medicine should also be implemented in the predoctoral dental curriculum to train future oral health care providers in the recognition of the frequently undiagnosed and untreated sleep disorders that lead to deleterious health consequences.</div></div><div><h3>Conclusions and Practical Implications</h3><div>Orofacial pain specialists have competency in the screening and management of sleep disorders commonly associated with orofacial pain as well as in sleep-related breathing disorders, as part of a multidisciplinary team of health care providers.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 6","pages":"Pages 439-446"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Dental Education","authors":"Hamed Fallah DDS,&nbsp;Erfan Biazar DDS,&nbsp;Mohamad Rezaei DDS","doi":"10.1016/j.adaj.2025.02.020","DOIUrl":"10.1016/j.adaj.2025.02.020","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 6","pages":"Pages 434-435"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144196396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing onset and course of odontogenic pediatric facial cellulitis","authors":"Kalee Abu-Ghazaleh DDS,&nbsp;Patrick Timothy Ruck DDS,&nbsp;Sarat Thikkurissy DDS, MS, MA,&nbsp;Jennifer Cully DMD, MEd","doi":"10.1016/j.adaj.2025.03.009","DOIUrl":"10.1016/j.adaj.2025.03.009","url":null,"abstract":"<div><h3>Background</h3><div>A severe consequence of unmet dental needs and failed treatment is the development of facial cellulitis of odontogenic origin (FCOO). Pediatric patients seek treatment for nontraumatic and urgent dental conditions at hospitals at higher rates relative to other medical conditions. Determining the factors influencing the onset and course of care for FCOO can have profound effects on medical systems.</div></div><div><h3>Methods</h3><div>The electronic health records of patients who sought treatment at a pediatric hospital dental clinic and received a diagnosis of FCOO were reviewed. Data collected were descriptive variables related to the course of care for their FCOO, the associations between FCOO and the presence or absence of a dental home, the use of advanced behavior guidance in the treatment of FCOO, and any associations between children and adolescents with a special health care need and FCOO.</div></div><div><h3>Results</h3><div>Data were collected from 201 participants with a mean (SD) age of 7.5 (4.1) years. The etiology of facial swelling was caries (73.1%), failed dental restorative treatment (22%), oral pathology (2.9%), or dental trauma (2%).</div></div><div><h3>Conclusions</h3><div>Patients without history of a first dental visit, patients without an established dental home, younger patients, and patients with a special health care need required a more intensive course of care for FCOO than their counterparts.</div></div><div><h3>Practical Implications</h3><div>The dental home should be advocated for, but in clinical practice it may not facilitate certain patients’ needs for routine and emergency oral health care. If an inpatient stay for FCOO becomes necessary, interdisciplinary communication between the medical and dental team members is necessary.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 6","pages":"Pages 488-496"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144195836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing whether breastfeeding is safe after an intraoral injection of 68 mg of articaine","authors":"Shu-Peng Liu MM,&nbsp;Xiao-Fei Wu PhD,&nbsp;Xiu-Qi Li MM,&nbsp;Quan Jing DMD, PhD,&nbsp;Hong-Yun Wang PhD","doi":"10.1016/j.adaj.2025.03.008","DOIUrl":"10.1016/j.adaj.2025.03.008","url":null,"abstract":"<div><h3>Background</h3><div>Limited information is available about the transfer of articaine into breast milk and the associated risks to breastfed infants. As such, health care providers and patients often forgo local anesthesia, postpone dental treatment, or stop breastfeeding after receiving articaine. The authors aimed to evaluate the safety of articaine use in mothers who are breastfeeding by means of examining its pharmacokinetic properties in breast milk and assessing the potential risks to breastfed infants.</div></div><div><h3>Methods</h3><div>Twelve breastfeeding mothers were randomly assigned to 2 groups and received an injection of 4% articaine (containing 68 mg of articaine) via supraperiosteal infiltration. Group A provided milk samples at various times postadministration, and milk output from group B was measured over the first 3 hours postadministration.</div></div><div><h3>Results</h3><div>The peak concentration of articaine in breast milk was 256.5 ng/mL at 0.25 hours, and declined to 12.9 ng/mL at 3 hours postadministration. The amount of articaine transferred to breast milk after 3 hours was calculated as 1.12 μg. Pharmacokinetic modeling predicted that the maximum plasma exposure in infants was 0.19 ng/mL, far below toxicity thresholds.</div></div><div><h3>Conclusions</h3><div>The study findings suggested that breastfeeding mothers can safely resume breastfeeding within 1 through 3 hours after administration of articaine, as the predicted infant exposure was considerably below the concentrations producing a pharmacologic effect.</div></div><div><h3>Practical Implications</h3><div>The results of this clinical study clarified the safety of using articaine in breastfeeding mothers and the optimal timing for resuming breastfeeding after dental procedures. This clinical trial was registered at the Chinese Clinical Trial Registry (<span><span>www.chictr.org.cn</span><svg><path></path></svg></span>). The registration number is ChiCTR2400082053.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 6","pages":"Pages 477-487.e6"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144195835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}