Journal of the American Dental Association最新文献

{"title":"Dental plaque: Who is in the neighborhood and why it matters.","authors":"Jessica L Mark Welch, Gary G Borisy","doi":"10.1016/j.adaj.2025.05.005","DOIUrl":"https://doi.org/10.1016/j.adaj.2025.05.005","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528473","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":"Embracing frameworks, moral courage, and reflection in the ethical decision-making process: Beyond impulse and spontaneity.","authors":"Fotini V Anagnostopoulos-King","doi":"10.1016/j.adaj.2025.05.011","DOIUrl":"https://doi.org/10.1016/j.adaj.2025.05.011","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497409","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":"Diagnostic accuracy of detecting caries and other intraoral findings using parent-obtained smartphone photographs in teledentistry.","authors":"Mirissa D Price, Steven D Ureles, Hesham Alhazmi, Rosalyn M Sulyanto, Man Wai Ng","doi":"10.1016/j.adaj.2025.05.003","DOIUrl":"https://doi.org/10.1016/j.adaj.2025.05.003","url":null,"abstract":"<p><strong>Background: </strong>The authors evaluated whether parent-obtained smartphone photographs can accurately assess frank caries and other intraoral findings compared with point-of-care clinical examination findings.</p><p><strong>Methods: </strong>Children's parents submitted intraoral photographs for a teledentistry consultation before dental rehabilitation in the operating room. Two calibrated dentists recorded hard- and soft-tissue findings from the photographs. These findings were compared with clinical findings recorded in the operating room. Sensitivity, specificity, likelihood ratios, prevalence, accuracy, and positive and negative predictive values were calculated for occlusal, frontal, and combined views. Fagan nomogram was used to predict caries risk graphically.</p><p><strong>Results: </strong>Of 138 patients, 70% were in primary dentition and 30% were in mixed dentition. All photographic views had high specificity for detecting caries (range, 97.1%-100.0%). Except for the mandibular anterior dentition, which had a sensitivity of 67.2% (95% CI, 53.5% to 79.0%), when all photographic views were combined, the maxillary occlusal and frontal images together showed high sensitivity of 94.8% through 99.1% in detecting caries in the primary dentition. Similar trends were observed for the mixed dentition. Combined photographs had an accuracy of 94.1% through 100.0%, with the positive likelihood ratio exceeding 33.3 for all photographs and sextants. Positive likelihood ratio ranged from 44.5 through 132.7 for detecting caries in primary dentition. Low sensitivity was found for detecting demineralization and soft-tissue findings.</p><p><strong>Conclusions: </strong>Parents can reliably obtain accurate and clinically meaningful intraoral photographs using a smartphone when following a written photograph guide.</p><p><strong>Practical implications: </strong>Parent-obtained smartphone photographs can provide accurate and clinically meaningful detection of frank caries in the primary and mixed dentitions.</p>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497408","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":"Tirzepatide gains US Food and Drug Administration approval for the management of obstructive sleep apnea: Implications for oral health care providers.","authors":"Mohamed G Hassan, Dina G Hassan, Gamaleldin A Hassan","doi":"10.1016/j.adaj.2025.05.007","DOIUrl":"https://doi.org/10.1016/j.adaj.2025.05.007","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is a common condition characterized by repeated airway collapse during sleep, leading to breathing interruptions. OSA increases the risk of developing hypertension, heart disease, stroke, and respiratory complications, reducing overall health and quality of life. The authors aimed to provide oral health care providers with an update on the US Food and Drug Administration-approved medication tirzepatide (Zepbound; Lilly) and its implications for multidisciplinary OSA management and oral health care-related services.</p><p><strong>Types of studies reviewed: </strong>A comprehensive MEDLINE search was conducted, and original research articles and systematic reviews related to OSA and tirzepatide were reviewed.</p><p><strong>Results: </strong>A multidisciplinary approach involving lifestyle modifications, pharmaceutical interventions, oral appliance therapy, and surgical options tailored to patient-specific needs is required for effective management of OSA. In 2024, the US Food and Drug Administration approved tirzepatide for managing obesity in adults with OSA. By means of promoting weight loss, tirzepatide has been found to reduce breathing interruptions and enhance sleep quality. Although dental care providers do not prescribe tirzepatide, they play a critical role in early identification and referral of patients at risk of experiencing OSA through clinical screening. They recognize craniofacial features associated with airway obstruction, provide oral appliance therapy, and collaborate closely with health care providers.</p><p><strong>Practical implications: </strong>Tirzepatide offers a novel approach to managing OSA by means of targeting metabolic and inflammatory factors that contribute to this condition. It has the potential to affect oral health, including the management of periodontal disease, dental implant procedures, and orthodontic interventions. Dental care providers should consider patient-centered needs and the interrelationship between systemic health and oral health.</p>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497411","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":"Ten strategies to reduce risk and respond effectively to malpractice claims.","authors":"Peter E Murray, Franklin Garcia-Godoy","doi":"10.1016/j.adaj.2025.05.008","DOIUrl":"https://doi.org/10.1016/j.adaj.2025.05.008","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497410","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":"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}