Journal of the American Dental Association最新文献

{"title":"Dangers of Misinformation","authors":"Manas Bajpai MDS","doi":"10.1016/j.adaj.2025.04.012","DOIUrl":"10.1016/j.adaj.2025.04.012","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 7","pages":"Page 516"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120081","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":"Alpha-gal syndrome: potential for a hypersensitivity reaction after the use of dental products","authors":"John K. Brooks DDS,&nbsp;Naomi I. Hoch BS,&nbsp;Ellie R. Hoch BS,&nbsp;Ahmed S. Sultan BDS, PhD","doi":"10.1016/j.adaj.2025.04.001","DOIUrl":"10.1016/j.adaj.2025.04.001","url":null,"abstract":"<div><h3>Background</h3><div>Alpha-gal syndrome (AGS) is associated with a potentially severe delayed immunoglobulin E–based hypersensitivity reaction produced via transmission of a salivary oligosaccharide (galactose-⍺-1,3-galactose) predominately from the bite of the lone star tick (<em>Amblyomma americanum</em><em>)</em>. Sensitized people are at an increased risk of experiencing cross-reactivity reactions to numerous foods, pharmaceuticals, and medical and dental products that could result in a spectrum of pathophysiological responses, ranging from gastrointestinal and cutaneous disturbances to anaphylaxis. The authors have summarized the relevant literature and presented a case report describing an alpha-gal (AG) reaction associated with oral health care.</div></div><div><h3>Types of Studies Reviewed</h3><div>The authors provided an overview of clinical studies, review articles, case reports, and case series of AGS obtained from PubMed and Google Scholar electronic databases. In addition, various medical and dental pharmaceuticals and health care products were reviewed for the presence of AG epitopes.</div></div><div><h3>Results</h3><div>Factors implicated in an AGS-like event included consuming nonprimate red meat and dairy products, intake of pharmaceuticals with animal-based ingredients and excipients, and use of medical and dental products containing AG epitopes. The most common promoter of AGS-related dental events was the administration of animal-based hemostatic agents.</div></div><div><h3>Practical Implications</h3><div>Oral health care providers should be knowledgeable about the salient features of AGS and perform a thorough review of an affected patient’s diagnosis, triggering events, associated adverse incidents, and therapeutic measures used. To gain greater insight into an affected patient’s disorder, consultation with their attending allergist or immunologist is advised. To reduce the onset of a hypersensitivity reaction, attending clinicians must maintain strict avoidance of the use of pharmaceuticals and medical or dental products that express AG epitopes.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 7","pages":"Pages 538-546"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078842","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":"Influence of home or in-office tooth bleaching on the color stability of white-spot lesions after resin infiltration","authors":"Christoph Matthias Schoppmeier Dr Med Dent,&nbsp;Max von Kohout MSc,&nbsp;Li Sun,&nbsp;Malin Janson Dr Med Dent,&nbsp;Isabel Deeg Dr Med Dent,&nbsp;Anna Greta Barbe Prof Dr Med, Dr Med Dent,&nbsp;Michael Jochen Wicht Dr Med Dent","doi":"10.1016/j.adaj.2025.04.009","DOIUrl":"10.1016/j.adaj.2025.04.009","url":null,"abstract":"<div><h3>Background</h3><div>The authors investigated the color stability of resin-infiltrated white-spot lesions (WSL) after in-office tooth bleaching (IB) or home tooth bleaching (HB) and assessed the potential for staining and rebleaching.</div></div><div><h3>Methods</h3><div>Sixty caries-free third molars were demineralized to create WSLs and then divided into 4 groups: (1) no treatment (control) group; (2) demineralization plus resin infiltration group; (3) demineralization plus resin infiltration plus IB group; (4) and demineralization plus resin infiltration plus HB group. After exposure to coffee solution to simulate 12-month staining potential, a second bleaching procedure was performed. Color measurements were obtained at 10 defined time points using standardized digital imaging and analyzed in the Commission Internationale de l’Eclairage-L^∗a^∗b^∗ (lightness, red-green axis, yellow-blue axis) color space. To precisely document color changes, time points included baseline, after WSL creation, after resin infiltration, after bleaching procedures, after thermocycling (aging), after coffee exposure, and after rebleaching.</div></div><div><h3>Results</h3><div>No significant differences in bleaching effectiveness were observed between IB and HB after initial (<em>P</em> = .127) or subsequent (<em>P</em> = .111) bleaching. Similarly, there were no significant differences (<em>P</em> = .867) in staining potential between the IB and HB groups after 12 days. Both bleaching methods restored the WSL color close to the baseline after staining.</div></div><div><h3>Conclusions</h3><div>Both IB and HB restored the color of resin-infiltrated WSLs to near-baseline levels after staining in vitro, with no significant differences between the 2 methods. Although results of the treatments showed responsiveness to whitening protocols, color stability under staining conditions remained limited, highlighting the need for further investigation into long-term maintenance strategies.</div></div><div><h3>Practical implications</h3><div>Both IB and HB approaches may be clinically viable for maintaining the esthetic stability of treated WSLs over time once sufficient evidence from clinical studies becomes available.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 7","pages":"Pages 517-529.e3"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570565","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 papillary nodule of the hard palatal mucosa","authors":"Richard J. Vargo DMD, MBA,&nbsp;Alivia M. Shasteen DMD,&nbsp;Emma K. Barner BS,&nbsp;David E. Greaves DDS,&nbsp;Daniel C. Stoeckel DDS","doi":"10.1016/j.adaj.2024.08.012","DOIUrl":"10.1016/j.adaj.2024.08.012","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 7","pages":"Pages 580-585"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372175","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":"Advancing dental diagnostics with OpenAI's o1-preview","authors":"Arman Danesh BMSc,&nbsp;Arsalan Danesh DDS,&nbsp;Farzad Danesh DDS, MSC","doi":"10.1016/j.adaj.2025.04.003","DOIUrl":"10.1016/j.adaj.2025.04.003","url":null,"abstract":"<div><h3>Background</h3><div>The introduction of o1-preview (OpenAI) has stirred discussions surrounding its potential applications for diagnosing complex patient cases. The authors gauged changes in o1-preview’s capacity to diagnose complex cases compared with its predecessors ChatGPT-3.5 (OpenAI) and ChatGPT-4 (legacy) (OpenAI).</div></div><div><h3>Methods</h3><div>The authors used diagnostic challenges retrieved from the literature using 2 different approaches to elucidate o1-preview’s capacity to produce plausible differential diagnoses (DDs) and final diagnoses (FDs). The first approach instructed the chatbot to independently construct a DD before selecting a final diagnosis. The second approach instructed the chatbot to rely on DDs retrieved from the literature accompanying the diagnostic challenge. A 2-tailed <em>t</em> test was used to compare sample means, and a 2-tailed χ² test was used to compare sample proportions. A <em>P</em> value &lt; .05 was considered statistically significant.</div></div><div><h3>Results</h3><div>The o1-preview model produced a plausible DD and a correct diagnosis for 94% and 80% of cases, respectively, when relying on an independent diagnostic approach, marking a significant increase from ChatGPT-3.5 (DD: difference, 32%; <em>P =</em> .001; FD: difference, 40%; <em>P</em> &lt; .001) and ChatGPT-4 (legacy) (DD: difference, 18%; <em>P =</em> .012; FD: difference, 18%; <em>P</em> = .048). When relying on DDs retrieved from the literature, the model achieved a diagnostic accuracy of 86%, displaying a superior performance than its predecessors, although these results were not significant (ChatGPT-3.5: difference, 16%; <em>P</em> = .055; ChatGPT-4 (legacy): difference, 6%; <em>P</em> = .427).</div></div><div><h3>Conclusions</h3><div>Although further validation is required, the transformative findings of this investigation shift the discussion surrounding ChatGPT’s integration as a diagnostic tool to be not a question of if, but instead a matter of when.</div></div><div><h3>Practical Implications</h3><div>Although o1-preview has yet to achieve a proficient diagnostic accuracy, the model served well in generating DDs for complex cases.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 7","pages":"Pages 555-562.e3"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571141","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 value-based care program in dentistry centered on caries risk assessment","authors":"John D.B. Featherstone MSc, PhD,&nbsp;Ana Karina Mascarenhas BDS, MPH, DrPH,&nbsp;Cherag D. Sarkari DDS, BDS, MDS","doi":"10.1016/j.adaj.2025.04.002","DOIUrl":"10.1016/j.adaj.2025.04.002","url":null,"abstract":"<div><h3>Background</h3><div>The Benefits and Rewards for Utilization, Services and Healthy Outcomes program (known as BRUSH) (Liberty), a value-based oral health care program, was implemented in 4 US states from 2021 through 2022 using a caries risk assessment (CRA) strategy. This value-based care program provides oral health care for Medicaid beneficiaries up to the age of 21 years.</div></div><div><h3>Methods</h3><div>Deidentified data from patient insurance claims that included CRA levels with 2-year follow-up for 2,706 patients in Florida were available for analysis. Providers were incentivized to manage caries on the basis of an initial CRA and were rewarded financially if risk levels were lowered or maintained as low over 12 months. Statistical analyses were performed to identify changes in CRA over time in relation to demographic and clinical variables. Age, sex, and variables that were statistically significant in bivariate analyses were included in multiple regression models to identify predictors of change in risk level or procedures performed over the 24-month period.</div></div><div><h3>Results</h3><div>Results of data analysis from 2,706 patients showed that over the 24-month period, the program lowered caries risk in 64% of high-risk patients. For all risk levels at baseline, 65% had lowered risk or maintained low risk, suggesting good oral health outcomes over 24 months. Those with lowered risk were less likely to undergo restorative procedures (<em>P</em> &lt; .00001).</div></div><div><h3>Conclusions</h3><div>A value-based dental program based on CRA can reduce or maintain caries risk at a low level for patients over a period of 2 years.</div></div><div><h3>Practical Implications</h3><div>A successful value-based care program improves the oral health of people through reduced caries experience and, over time, will reduce costs.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 7","pages":"Pages 547-554"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570566","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":"Oral health and the pursuit of life and happiness","authors":"J. Tim Wright DDS, MS","doi":"10.1016/j.adaj.2025.05.001","DOIUrl":"10.1016/j.adaj.2025.05.001","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 7","pages":"Pages 511-512"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570564","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":"SmileCon 2025 CRC","authors":"","doi":"10.1016/S0002-8177(25)00315-0","DOIUrl":"10.1016/S0002-8177(25)00315-0","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 7","pages":"Pages 588-591"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571145","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":"Keeping your gums healthy","authors":"Anita M. Mark","doi":"10.1016/j.adaj.2025.05.006","DOIUrl":"10.1016/j.adaj.2025.05.006","url":null,"abstract":"","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 7","pages":"Page 594"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571146","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":"Dental diagnostic errors and characteristics associated with claims in the United States, 1990-2020","authors":"Richa Singhania BDS, MSPP,&nbsp;Enihomo Obadan-Udoh DDS, MPH, Dr Med Sc","doi":"10.1016/j.adaj.2025.04.010","DOIUrl":"10.1016/j.adaj.2025.04.010","url":null,"abstract":"<div><h3>Background</h3><div>Little is known about the magnitude of diagnostic errors in dentistry. The authors aimed to examine the prevalence of and demographic characteristics associated with dental diagnostic errors.</div></div><div><h3>Methods</h3><div>A cross-sectional analysis of dental paid malpractice claims from the National Practitioner Data Bank spanning from 1990 through 2020 identified the characteristics of the claims. The authors categorized the claims into diagnostic and others. Descriptive statistics, χ² tests, and regression analyses were used to assess the provider and patient characteristics associated with the claims.</div></div><div><h3>Results</h3><div>Of 58,229 dental paid claims, 8.7% were diagnostic claims, of which missed diagnoses (78.6%) were the most common. More diagnostic claims involved female patients (59.7%) and patients aged 50 through 59 years (22.2%) and providers aged 40 through 49 years (29.4%) who graduated from 1970 through 1979 (27.4%) and were from the Northeast region of the United States (32.2%) (<em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>Dental diagnostic errors, a major preventable cause of malpractice claims, have remained steady since 2008, and nondiagnostic claims decreased over time. Significant differences in patient and provider demographic characteristics were linked to these claims. Further analysis of dental diagnostic errors could guide tools to reduce these errors and enhance patient safety.</div></div><div><h3>Practical Implications</h3><div>The results of the study provide key insights for policy makers to understand the need for targeted strategies improving diagnostic accuracy, patient safety, and clinical outcomes, and guide provider training and continuing education.</div></div>","PeriodicalId":17197,"journal":{"name":"Journal of the American Dental Association","volume":"156 7","pages":"Pages 563-570"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571142","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}