Augmenting patient monitoring during intravenous moderate sedation with artificial intelligence: A pilot study.

Purpose/objectives: A precordial stethoscope (PS) is essential for ensuring clear breath sounds during open airway sedations. However, a traditional PS limits the ability of new users to simultaneously listen to heart and lung sounds alongside experienced practitioners, hindering their learning and development. Bluetooth speaker systems allow for multiple providers but amplify all noise.

Effects of the multi-channeled oral irrigation (MCOI) unit in preventing dental plaque formation and gingivitis: A randomized controlled trial.

Purpose: To evaluate the efficacy of COMORAL a new multi-channeled oral irrigation (MCOI) unit with pulsating water jet, in plaque score reduction and gingivitis.

Methods: This was a single-blinded clinical randomized controlled trial (NCT05031260). Forty-two healthy subjects between 18 to 35 years old were initially recruited, and the control group (n = 20) and the intervention group (n = 17) were randomly assigned.

A retrospective chart review evaluating pre-operative dental extractions on patients with end-stage heart failure undergoing advanced surgical cardiac therapies.

Objectives: End-stage heart failure patients are functionally compromised by multiple physiologic mechanisms, placing them at increased risk of peri- and post-operative complications. This study aimed to evaluate if dental treatment performed before advanced cardiac interventions, including orthotopic heart transplant and mechanical circulatory support, increases the risk of adverse events.

Study Design: A retrospective chart review spanning January 2011 to December 2020 was performed.

Mechanism of bisphosphonate-related osteonecrosis of the jaw (BRONJ) revealed by targeted removal of legacy bisphosphonate from jawbone using competing inert hydroxymethylene diphosphonate.

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) presents as a morbid jawbone lesion in patients exposed to a nitrogen-containing bisphosphonate (N-BP). Although it is rare, BRONJ has caused apprehension among patients and healthcare providers and decreased acceptance of this antiresorptive drug class to treat osteoporosis and metastatic osteolysis. We report here a novel method to elucidate the pathological mechanism of BRONJ by the selective removal of legacy N-BP from the jawbone using an intra-oral application of hydroxymethylene diphosphonate (HMDP) formulated in liposome-based deformable nanoscale vesicles (DNV).

Predictive factors of osteoradionecrosis necessitating segmental mandibulectomy: A descriptive study.

Objective: The objective of this study was to assess characteristics of patients with mandibular osteoradionecrosis (ORN) of severity necessitating segmental mandibulectomy and osteocutaneous free flap reconstruction.

Study Design: This study is a retrospective review of patients who underwent free flap reconstruction of the mandible at the UCLA Medical Center between January 2016 and February 2020 secondary to ORN.

Results: Twenty-nine charts with detailed dental and medical records were identified.

Pre-Cardiac Dental Treatment Does Not Increase the Risk of Adverse Events.

Purpose: Elimination of dental sources of infection prior to cardiovascular surgery (CVS) is performed to reduce perioperative infection and complications. This study aims to evaluate if preoperative dental intervention is associated with increased risk of adverse events.

Methods: A retrospective medical record review of inpatient consultations (n = 1513) completed by the Hospital Dentistry Service at University of California Los Angeles Medical Center from January 2011 to December 2020 was performed.

Dexmedetomidine reduces the amount of benzodiazepines and opioids administered during moderate conscious sedation for dental treatment.

Aim: To assess the efficacy of dexmedetomidine (DEX) on the intravenous moderate sedation (IVMS) regimen, while treating patients of the special patient care (SPC) population. This study aims to incorporate DEX into the typical IVMS drug regimen in order to reduce the amount of benzodiazepines (BZD) and opioids administered and as a result reduce the amount of unwanted side effects.

Method And Results: A retrospective study was performed in the University of California Los Angeles (UCLA) SPC Clinic, where 42 patients were seen with and without DEX for dental treatment under IVMS.

Removal of Pre-Existing Periodontal Inflammatory Condition before Tooth Extraction Ameliorates Medication-Related Osteonecrosis of the Jaw-Like Lesion in Mice.

Medication-related osteonecrosis of the jaw (MRONJ) is a rare but detrimental intraoral lesion that predominantly occurs in patients with long-term use of antiresorptive agents, such as bisphosphonate and denosumab, a human anti-receptor activator of NF-κB ligand (RANKL) monoclonal antibody (Ab). Surgical intervention, such as tooth extraction, is a known risk factor for MRONJ, which is often performed to eliminate preexiting pathologic inflammatory conditions, such as periodontal diseases. Nonetheless, it remains unknown whether pre-existing periodontal disease condition exacerbates, or removal of such condition ameliorates, MRONJ development after tooth extraction.

Clinical validation of a nanodiamond-embedded thermoplastic biomaterial.

Detonation nanodiamonds (NDs) are promising drug delivery and imaging agents due to their uniquely faceted surfaces with diverse chemical groups, electrostatic properties, and biocompatibility. Based on the potential to harness ND properties to clinically address a broad range of disease indications, this work reports the in-human administration of NDs through the development of ND-embedded gutta percha (NDGP), a thermoplastic biomaterial that addresses reinfection and bone loss following root canal therapy (RCT). RCT served as the first clinical indication for NDs since the procedure sites involved nearby circulation, localized administration, and image-guided treatment progress monitoring, which are analogous to many clinical indications.

Managing Intraoral Lesions in Oral Cancer Patients in a General Dental Practice: An Overview.

As medical technology advances in the area of cancer therapeutics, dental practitioners will encounter patients with active cancer or a history of cancer. Typically, these patients may have had or are undergoing therapies such as surgery, radiation, chemotherapy or a combination of therapies. These patients may present with multiple side effects that dental practitioners can manage or prevent.

Dental treatment in the cardiothoracic intensive care unit for patients with ventricular assist devices awaiting heart transplant: a case series.

Objective: This report aims to describe the dental protocol for treating in the intensive care unit patients with end-stage heart failure who have had ventricular assist devices (VADs) emergently implanted as a bridge to heart transplant. This protocol permitted the rendering of safe and effective dental care in this setting and did not result in near-term (1-30 days) excessive hemorrhage, local and systemic infection, or contamination of the VAD.

Study Design: This descriptive cross-sectional study by the University of California, Los Angeles, Hospital Dental Service examined the dental care of 9 patients (mean age, 50 ± 12.

Novel strategies to enhance survival and growth of pulp cells after dental restorations.

Using ex vivo human tooth, the authors demonstrated that dental pulp stromal cells that survive after placement of composite, mineral trioxide aggregate, and glass ionomer are weaker since they undergo synergistic cell death when exposed to 2-hydroxyethylmethacrylate. DPSCs extracted from teeth that were restored with the combination of composite or MTA or GI with N-acetyl cysteine were protectedfrom cell death. Therefore, application of NAC may protect the DPSCs from adverse effects after tooth restoration.

Resolution of pain and complete healing of mandibular osteoradionecrosis using pentoxifylline and tocopherol: a case report.

The radiation-induced fibroatrophic process (RIF) is a time-dependent adverse sequela to high-dose radiotherapy that can result in irreversible tissue death and bone exposure in the irradiated tissue. Osteoradionecrosis (ORN) is a late effect of RIF, described as bony exposure present for more than 3 months that can occur in 20% of patients irradiated for head and neck cancer. The intractable characteristics of ORN make both management and resolution of the disease process challenging, with 25% of cases recurring despite aggressive treatment with resection and reconstruction of the necrotic bone.

Minimally Invasive Periodontal Treatment Using the Er,Cr: YSGG Laser. A 2-year Retrospective Preliminary Clinical Study.

MINIMALLY INVASIVE SURGERY (MIS) USING THE ERBIUM, CHROMIUM: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser (Waterlase MD, Biolase, Irvine, CA) to treat moderate to advanced periodontal disease is presented as an alternative to conventional therapies. To date, there are few short- or long-term studies to demonstrate the effects of this laser in treating and maintaining periodontal health. Electronic clinical records from 16 patients - total of 126 teeth, with pocket depths ranging from 4 mm to 9 mm - were treated with the same protocol using the Er,Cr:YSGG laser.

Periodontal disease and bisphosphonates induce osteonecrosis of the jaws in the rat.

Bisphosphonates (BPs) are medications used commonly to treat primary and metastatic bone cancer, as well as osteoporosis. Although BPs improve bone mineral density, reduce fracture risk, and reduce hypercalcemia of malignancy, some patients develop BP-related osteonecrosis of the jaws (BRONJ). This devastating complication is defined as clinically exposed bone in the maxillofacial region for more than 8 weeks.

Increased prevalence of bisphosphonate-related osteonecrosis of the jaw with vitamin D deficiency in rats.

Necrotic bone exposure in the oral cavity has recently been reported in patients treated with nitrogen-containing bisphosphonates as part of their therapeutic regimen for multiple myeloma or metastatic cancers to bone. It has been postulated that systemic conditions associated with cancer patients combined with tooth extraction may increase the risk of osteonecrosis of the jaw (ONJ). The objective of this study was to establish an animal model of bisphosphonate-related ONJ by testing the combination of these risk factors.

Radiographic quantification of chronic dental infection and its relationship to the atherosclerotic process in the carotid arteries.

Background: Atherosclerosis may be initiated/accelerated by chronic dental infection (CDI). Noninvasively visualizing the carotid arteries is an accepted surrogate marker for determining coronary artery atherosclerosis (CAA). We hypothesized that 36 individuals with radiographic carotid atheromas would have more radiographic CDI than risk-matched individuals without atheromas.

Dental management of chemoradiation patients.

The utilization of combined chemoradiation therapy has recently increased in the treatment of head and neck cancers. This patient population is significantly more prone to various oral complications during and after medical therapy. Oral complications and long-term effects include mucositis, xerostomia, alterations in taste, vascular compromise, mucosal thinning and increased risk of rampant caries and periodontal disease.

Comparing cutting efficiencies of diamond burs using a high-speed electric handpiece.

This study sought to compare the cutting efficiency of different diamond burs on initial use as well as during repeated use, alternating with sterilization. Long, round-end, tapered diamond burs with similar diameter, profile, and diamond coarseness (125-150 microm grit) were used. A high-torque, high-speed electric handpiece (set at 200,000 rpm) was utilized with a coolant flow rate of 25 mL/min.

Composite resin bond strength to primary dentin prepared with Er, Cr:YSSG laser.

This in vitro study evaluated the shear bond strength of a hybrid composite resin bonded to primary dentin prepared with an Er, Cr:YSGG hydrokinetic laser compared to conventional bur prepared primary dentin. The results suggest that primary dentin surfaces treated with the Er, Cr:YSGG laser, with or without etching, may provide comparable or increased composite resin bond strengths depending upon bonding agent used.

Palifermin for oral mucositis after intensive therapy for hematologic cancers.

Background: Oral mucositis is a complication of intensive chemotherapy and radiotherapy with no effective treatment. We tested the ability of palifermin (recombinant human keratinocyte growth factor) to decrease oral mucosal injury induced by cytotoxic therapy.

Methods: This double-blind study compared the effect of palifermin with that of a placebo on the development of oral mucositis in 212 patients with hematologic cancers; 106 patients received palifermin (60 microg per kilogram of body weight per day) and 106 received a placebo intravenously for three consecutive days immediately before the initiation of conditioning therapy (fractionated total-body irradiation plus high-dose chemotherapy) and after autologous hematopoietic stem-cell transplantation.

Panic disorder: psychopathology, medical management and dental implications.

Background: This article reviews the clinical features, epidemiology, pathophysiology, dental findings, and dental and medical management of the care of patients with panic disorder, or PD.

Types Of Studies Reviewed: The authors conducted a MEDLINE search for the period 1998 through 2003, using the key term "panic disorder" to define the pathophysiology of the disorder, its epidemiology and dental implications. The articles they selected for further review included those published in peer-reviewed journals.

Dental management of the Down and Eisenmenger syndrome patient.

About 40% to 50% of Down syndrome (DS) patients can have significant congenital heart defects such as patent ductus arteriosus, Tetralogy of Fallot, and septal defects. Patients with large septal defects may develop Eisenmenger syndrome (ES), which is defined by the cardiac septal defect and pulmonary hypertension coupled with a reverse right to left shunting of blood flow. DS patients that suffer from this condition require special considerations in the delivery of their dental care to prevent further medical complications or emergencies such as infection, cyanotic episodes, and thromboemboli.

Effects of various irrigation solutions on microleakage of Class V composite restorations.

Statement Of The Problem: Irrigation solutions used in the preparation of composite restorations have been reported to contain potential contaminants that may interfere with, and compromise, composite bonding.

Purpose: The purpose of this in vitro study was to evaluate microleakage of Class V composite restorations after irrigation of acid conditioner with various solutions. MATERIAL AND MENTODS: Standardized Class V preparations (5 mm wide, 4 mm high and 2 mm deep) were made at the cemento-enamel junction on available buccal, lingual, mesial, and distal surfaces of extracted human posterior teeth.

The prevalence of calcified carotid atheromas on the panoramic radiographs of patients with dilated cardiomyopathy.

Objective: Individuals with dilated cardiomyopathy (DCM) often die from heart failure without a transplant. Of those who do receive a transplant, a significant number suffer a perioperative stroke, although the cause is often in doubt. Our study attempts to determine whether the prevalence of calcified carotid artery atheromas, a known cause of stroke, is greater on the panoramic radiographs of individuals with DCM than it is among controls.