Striving for excellence in a little red dot: Exploring the evolution of oral and maxillofacial surgery training and practice in Singapore.

Oral and maxillofacial surgery (OMS) is a field that straddles knowledge and clinical experience from both medical and dental specialties. In the small island nation of Singapore, the rapidly and constantly changing needs of its diverse and aging population, as well as changes in the mindsets of both students and educators have led to many developments in the local OMS program. Tied to the only dental school in the country, the curriculum of the training program has kept up with the changes in the demographics and attitudes of the local patient pool, which comprises a multicultural population with both traditional and modern mindsets.

3D Bioprinting and Artificial Intelligence-Assisted Biofabrication of Personalized Oral Soft Tissue Constructs.

Regeneration of oral soft tissue defects, including mucogingival defects associated with the recession or loss of gingival and/or mucosal tissues around teeth and implants, is crucial for restoring oral tissue form, function, and health. This study presents a novel approach using three-dimensional (3D) bioprinting to fabricate individualized grafts with precise size, shape, and layer-by-layer cellular organization. A multicomponent polysaccharide/fibrinogen-based bioink is developed, and bioprinting parameters are optimized to create shape-controlled oral soft tissue (gingival) constructs.

Impact of Implant Design on Outcomes of Simultaneous Guided Bone Regeneration for Dehiscence Defects: A Systematic Review and Meta-Analysis.

Objective: This systematic review and meta-analysis aimed to determine the implications of implant design on the outcomes of simultaneous guided bone regeneration (GBR) to correct dehiscence defects.

Methods: A structured search strategy was applied to MEDLINE (PubMed), Cochrane Library, and Embase, to identify prospective clinical trials involving implants with simultaneous GBR to correct dehiscence defects. Data regarding implant characteristics, GBR materials, as well as dehiscence defect dimensions at implant placement and surgical re-entry was collected.

Prevalence and prophylactic management of premolars with dens evaginatus in singaporean school children: a retrospective cohort study.

Purpose: Dens evaginatus (DE) is characterised by the presence of a tubercle projection, which when fractured may lead to pulpal pathology. The aim of this study was to assess prevalence of DE in the local population and the long-term outcomes of asymptomatic DE premolars managed with tubercle grinding and composite overlay.

Methods: This is a retrospective cohort study of 9-year-old Singaporean children.

Antimicrobial surface coating in the emergency department as protective technology for infection control (ASEPTIC): a pilot randomized controlled trial.

Study Objective: We examined the effectiveness of an antimicrobial surface coating for continual disinfection of high touch-frequency surfaces in the emergency department (ED).

Methods: Following a preliminary observation identifying stretcher rails as the surface with highest touch-frequency in the ED, we conducted a pilot randomized controlled trial involving 96 stretcher rails. The stretchers were randomized to receive an antimicrobial surface coating or placebo coating.

Superficial circumflex iliac perforator flaps for maxilla defects with intraoral anastomosis or pedicle elongation techniques.

Background: To evaluate the feasibility and safety of the superficial circumflex iliac perforator flap (SCIP) for maxillary reconstruction with intraoral anastomosis, pedicle elongation, and super-microsurgery techniques to overcome its anatomical shortcomings due to the attractive merits of the flap.

Methods: Patients who underwent reconstruction of maxillary defects with SCIPs from July 2020 to December 2022 were included. Intraoral anastomosis, pedicle elongation, and super-microsurgery were performed during surgery with or without a neck incision.

Reliability of ChatGPT in automated essay scoring for dental undergraduate examinations.

Background: This study aimed to answer the research question: How reliable is ChatGPT in automated essay scoring (AES) for oral and maxillofacial surgery (OMS) examinations for dental undergraduate students compared to human assessors?

Methods: Sixty-nine undergraduate dental students participated in a closed-book examination comprising two essays at the National University of Singapore. Using pre-created assessment rubrics, three assessors independently performed manual essay scoring, while one separate assessor performed AES using ChatGPT (GPT-4). Data analyses were performed using the intraclass correlation coefficient and Cronbach's α to evaluate the reliability and inter-rater agreement of the test scores among all assessors.

Performance of large language models in oral and maxillofacial surgery examinations.

This study aimed to determine the accuracy of large language models (LLMs) in answering oral and maxillofacial surgery (OMS) multiple choice questions. A total of 259 questions from the university's question bank were answered by the LLMs (GPT-3.5, GPT-4, Llama 2, Gemini, and Copilot).

Temperament and past behaviour can predict behaviour success for nitrous oxide sedation.

Background: There is currently insufficient evidence on potential predictors of a child's behaviour with nitrous oxide (NO) sedation.

Aim: To examine the association between a child's temperament and behavioural outcomes during dental treatment with NO sedation, and the child's perception to NO sedation.

Design: At the first visit (dental treatment visit), temperament was assessed using the Child Behaviour Questionnaire-Short Form and behaviour was assessed by an independent rater using the Venham Behaviour Rating Scale.

Efficacy of adjunctive modalities during tooth extraction for the prevention of osteoradionecrosis: A systematic review and meta-analysis.

Background: Jaw osteoradionecrosis (ORN) is a complication in patients with previous head and neck radiotherapy. Its incidence increases with dental extractions. Hence, this review aimed to evaluate the efficacy of adjunctive treatment modalities undertaken at the time of extraction in previous head and neck radiotherapy patients in preventing ORN.

Development of a dental diet-tracking mobile app for improved caries-related dietary behaviours: Key features and pilot evaluation of quality.

Objective: Diet significantly contributes to dental decay (caries) yet monitoring and modifying patients' diets is a challenge for many dental practitioners. While many oral health and diet-tracking mHealth apps are available, few focus on the dietary risk factors for caries. This study aims to present the development and key features of a dental-specific mobile app for diet monitoring and dietary behaviour change to prevent caries, and pilot data from initial user evaluation.

A video-based decision aid improved knowledge and decreased decisional conflict for asymptomatic persistent endodontic lesions.

Aim: This prospective cohort study aimed to (i) evaluate patients' treatment decisions, decisional conflict and knowledge levels before and after use of a video-based decision aid (DA) on asymptomatic persistent endodontic lesions (APEL) and to (ii) elicit important decision factors for patients in the decision-making process.

Methodology: A video DA modelled after the International Patient Decision Aids Standards (IPDAS) was designed. The video was pilot-tested, revised and used on 50 patients referred to the graduate endodontic clinic and presenting with an incidental finding of APEL detected on radiographs, with informed consent (DSRB 2020/00133).

Implant presence-triggered osteonecrosis: A scoping review.

Unlike medication-related osteonecrosis of the jaw (MRONJ), implant presence-triggered osteonecrosis of the jaw (IPTO) is not well appreciated. Recent reports have suggested a mechanical aetiology unique to osseointegrated dental implants that may be responsible for this phenomenon. A scoping review was performed to consolidate the available evidence.

Acceptance of silver diamine fluoride use in community dwelling older adults, nursing home residents, and caregivers.

Objectives: To compare the level of acceptance of silver diamine fluoride (SDF) treatment between different functional groups of older adults aged 65-years-old and above.

Methods: Three groups were recruited representing functionally-independent ("Community dwelling"), frail ("Nursing home"), and functionally-dependent older adults ("Caregiver": proxy respondent involved in caring for an older adult of all functional levels). Participants viewed a video on SDF and an interviewer-led questionnaire collected demographics, dental experience and perception on SDF use.

Addressing the overlooked: Integrating oral healthcare in a geriatric care system: Insights from Singapore.

Oral health of the older population has long been overlooked in global healthcare agenda. Limited access to oral healthcare for dependent older adults results in poor oral health, negatively impacting their quality of life, nutrition and overall well-being. Especially for nations experiencing rapid ageing population, efforts must be urgently made to integrate oral healthcare services into the current healthcare system and policy.

Placing the maxilla in the most aesthetic sagittal position: validation of several reference lines in relation to the forehead shape.

The ideal sagittal position of the maxilla is highly subjective in orthognathic surgical treatment planning. There is no consensus on an analysis to predict the ideal sagittal position of the maxilla. The objective of this study was to determine the preferred maxillary position in relation to the forehead shape, in the Southern Chinese population.

The oral health landscape in Singapore: A commentary on key features, challenges and future policies.

Over the last decade, Singapore has grappled with substantial healthcare challenges, chiefly a bourgeoning aging population and a mounting burden of chronic diseases. The oral health landscape has also changed, with the Ministry of Health placing a greater focus on a life-course approach supported by policies that facilitate Singaporeans to receive dental care appropriately and affordably. A pivotal oral health policy is the National Dental Strategy, a comprehensive framework governing dental services in the public sector.

One-year outcome of selective caries removal versus pulpotomy treatment of deep caries: A pilot randomized controlled trial.

Aim: This study aimed to compare the outcome of SCR and Pulpotomy in teeth with deep caries extending at least 75% into dentine.

Methodology: This two-armed, parallel-group, randomized, superiority trial included vital mature permanent teeth with deep primary or secondary caries diagnosed radiographically as being at least 75% into the thickness of dentine, without clinical signs of symptomatic irreversible pulpitis or radiographic evidence of a periapical lesion. Carious teeth were blindly allocated to receive either SCR or Pulpotomy using computer-generated randomized patient codes concealed in opaque envelopes.

Dental trauma in endoscopy: A systematic review and experience of a tertiary endoscopy centre.

Background: Dental injury is the leading cause of litigation in anaesthesia but an underrecognized preventable complication of endoscopy.

Aim: To determine frequency and effects of dental injury in endoscopy, we present findings from an audit of outpatient endoscopy procedures conducted at a tertiary university hospital and a systematic review of literature.

Methods: Retrospective review of 11265 outpatient upper endoscopy procedures over the period of 1 June 2019 to 31 May 2021 identified dental related complications in 0.

Validation of low-cost mobile phone applications and comparison with professional imaging systems for three-dimensional facial imaging: A pilot study.

Purpose: The objective of this study was to investigate the accuracies of three-dimensional (3D) facial scanning mobile phone applications as compared to professional 3D facial imaging systems.

Materials And Methods: A manikin head model was used as the subject for comparing six 3D facial imaging systems which comprised three professional 3D scanners (3dMDface, Artec Eva and Vectra H2) and three mobile phone applications (Bellus3D, ScandyPro and Hedges). For each system, five scans were taken to analyse (1) linear accuracy using 9 measurements (2) global and (3) regional 3D accuracy of the scanned surface by root mean square (RMS) and colour map analysis.

An International Investigation of Molar Incisor Hypomineralisation (iMIH) and Its Association with Dental Anomalies: Development of a Protocol.

Background: Molar incisor hypomineralisation (MIH) is a common disorder of tooth development, which has recently been found to be associated with a higher prevalence of hypodontia. The aim of this international multicentre study is to determine the association between MIH and other developmental anomalies in different populations.

Methods: Investigators were trained and calibrated for the assessment of MIH and dental anomalies and ethical approvals obtained in each participating country.

Solitary plexiform neurofibroma of the tongue: report of a case with no evidence of neurofibromatosis type 1.

Neurofibromas are frequently present in the skin, but are uncommon in the oral and maxillofacial region. There are three histological variants of neurofibroma: localized, diffuse, and plexiform. The plexiform histological variant of neurofibroma is the least common and is a rare occurrence in the oral cavity.