Dental team engagement and motivation in Post-Covid-19 time
Suggestions for a quick safely recovered daily routine

Dear readers,
According to guidelines and specific national conditions, dentists are getting ready to restart their clinical activities; everybody has updated safety protocols to protect ourselves, our teams and obviously our patients from contagion risk and cross infections.
However we have to face an underestimated risk and this could undermine all our efforts: the correct implementation of every protocol, especially if safety-related, requires a global care and an high level of mental focus by the professionals involved..[…]

Mario R. Cappellin

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Entry-level survival in a post-crisis world

Dear readers,
Every major crisis is an opportunity to either perish or be successful. Not in the least for medical and dental journals. Journals see their advertising revenues plummeting. At the same time digitization offers relief. Zoom meetings replace physical meetings and are an excellent opportunity for a journal editorial board to have regular meetings despite their international membership. Now that even top-journals have accepted to pre-publish manuscripts before peer-review and to allow all peers publicly scrutinize the submission an irreversible new way of peer-reviewing has entered the scene: crowd-reviewing by peers.[…]

Constantinus Politis

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Prevotella species – the most prevalent black-pigmented anaerobic bacteria among oropharyngeal isolates obtained from a sample of healthy young adults


The oropharynx comprises the palatine tonsils, tongue base, soft palate and posterior pharyngeal wall and is lined by a nonkeratinized stratified squamous epithelium [1]. The oropharynx mucosa comes in contact with saliva and nasopharyngeal secretion. The oropharynx microbiota is complex and comprises hundreds of microbial species [2,3], most of them organized in biofilms associated with the respective microenvironment [4]. About 80% of the local normal flora is represented by the viridans streptococci and commensal species of Haemophilus and Neisseria [5,6]…

(abstract) Introduction: The black-pigmented Prevotella – Porphyromonas group comprises members of the normal flora of the oral cavity, oropharyngeal, intestinal and genitourinary tract, but may be associated with various infections too. The purpose of this study was to identify the species of this anaerobic group which frequently colonize the oropharynx in clinically healthy young adults. Methodology: The microbiological investigation was carried out on a strain collection of 93 dark-pigmented anaerobic isolates originated from the oropharynx of healthy dental students, at the Department of Microbiology, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy – Bucharest. All isolates of Gram-negative bacilli were identified at the genus and species level by conventional methods, MASTRING ID (MAST Group Ltd., U.K.) and Rapid ID 32 A system (BioMérieux, France), while the isolates of anaerobic cocci were tested only by MASTRING ID. Results: The microscopy of the Gram-stained smears and the results of the MASTRING ID test performed with the 93 black-pigmented anaerobic isolates indicated that 77 strains were Gram-negative bacilli and/or coccobacilli, while 16 strains were Gram-positive cocci. The identification of the Gram-negative bacilli at the species level concluded that 57 strains belonged to Prevotella denticola, 18 strains to Prevotella melaninogenica and 2 strains to Prevotella intermedia. Conclusion: P. denticola and P. melaninogenica might be considered the main species of the black-pigmented Prevotella-Porphyromonas group which colonize the oropharynx in healthy young adults. These species are usually beta-lactamase producers and their high rate of oropharyngeal colonization should be considered when antibiotics are needed in oral infections therapy. Keywords: Oropharynx, Microbiota, Anaerobes, Black-Pigmented Bacteria, Prevotella. | (read pdf) |


Dental findings of persons with osteogenesis imperfecta in Vietnam


Osteogenesis imperfecta (OI) is the collective term for a heterogeneous group of connective tissue syndromes. Seventeen mutated genes have been found related to OI syndromes [1,2]. The mutation incidence varies in different populations from 1/20,000 to 1/10,000 OI cases [3–5]. The clinical classification of OI includes five types (type I–V) [2,6]. Type I is a mild phenotype with dominantly inherited OI and blue sclerae; type II is related to perinatal lethality; type III results in progressive deformity throughout the lifespan; type IV is similar to type I, but sclerae are normal; and type V has mesh-like bone appearance due to calcification in inter-osseous membranes. In clinical studies, types I, III and IV are often mentioned to describe the clinical features of living individuals with OI syndrome…

(abstract) Background: Osteogenesis imperfecta (OI) is the collective term for a heterogeneous group of connective tissue syndromes. The aim of the current study is to describe dental characteristics, including dentinogenesis imperfecta (DGI), dental wear, occlusal features, and dental caries experience of Vietnamese persons with OI. Methods: The sample consisted of 74 individuals with OI classified into type I (n=25), type III (n=24), and type IV (n=25). All participants were examined for DGI through the evaluation of intrinsic color variation, dental wear using Hooper’s index, occlusal features (including Angle’s classification, overjet, overbite, crossbite) and dental caries experience by using the dmft/DMFT index. Results: DGI was found in 62.2% of the sample and was significantly related to OI type III and type IV (p=0.019). Dental wear occurred in 36.5% and was equivalent among OI types. Angle Class III malocclusion was more prevalent in type III (66.7%) and type IV (54.5%) than in type I (37.5%). High prevalence of reverse overjet (60.3%), posterior crossbite (32.2%), and missing teeth (23.3%) were found in the OI sample. The mean dmft/DMFT score was 3.0/2.2. The dental findings related to dental wear, occlusal features, and dental caries did not show significant differences among type I, III, and IV. Conclusion: There was a high prevalence of DGI and dental wear in the Vietnamese OI sample. Occlusal features were related to a high prevalence of class III malocclusion, overjet, open bite, posterior crossbite, and missing teeth. Dental caries experience of persons with OI was at a moderate level. Keywords: Dental Care for Disabled; Dentinogenesis Imperfecta; Dental Occlusion; Osteogenesis Imperfecta. | (read pdf) |


Minh Son Nguyen: ORCIDiD | Publons | ResearchGate | PubMed | Google Scholar | Scopus | WOS
Mare Saag: ResearchGate | PubMed | Google Scholar
Ho Duy Binh: ORCIDiD
Katre Maasalu: ORCIDiD
Sulev Kõks: ORCIDiD
Aare Märtson: ORCIDiD
Thi Thuy Le
Triin Jagomägi: ORCIDiD  ResearchGate 


Is there an age limit for implant dentistry?


The growing numbers of population ≥ 65 years [1] offer an important challenge for the dental profes-sion. Implant dentistry has a major contribution to improving life quality [2-4]. Aging may compromise implant survival due to compromised wound healing [5,6]. The proliferative phase of healing is prolonged due to reduced numbers of stem cells [6]. A study in a rat model demonstrated that the younger group achieved good bone contact faster than the older one. The results suggested that the rate and volume of new bone formation around implants decrease with age [7]…

(abstract) Introduction: Aging may impede implant survival due to compromised wound healing. The present study assessed, retrospectively, whether there is an age limit for implant dentistry. Methodology: All patients treated with a single implant brand in a single medical center were included. Early implant failure (EIF) was recorded. The cohort was divided to a younger (20 to 65) and an older (≥65) group. The comparison between groups was based on: (1) gender (2) physical status (3) implant location (4) implant dimensions (5) number of implants placed per patient and (6) bone grafting. Results: Out of 121 patients, the younger group comprised 57 and the older 64. The younger cohort received 192 implants (mean: 3.25}3.68, range: 1 to 16 implants per patient) vs. 171 (mean 2.78}1.91, range: 1 to 11 implants per patient) in the older group. The older did not differ significantly (p > 0.05) from the younger in any of the parameters evaluated. EIF on implant and patient level was 1.0 and 3.5%, respectively in the younger vs. 1.1 and 3.1%, respectively in the older. Seven patients were ≥80 years. EIF at implant and patient level was 8.3 %and 14.3% respectively. Conclusions: Elderly patients ≥65 years old presented a similarly low EIF rate as younger patients 20 to 65 years old, while patients ≥80 years old may have a slight tendency for a higher EIF rate. Hence, there seems to be no age limit for implant dentistry. Keywords: Early Implant Failure; Osseointegration; Older Population; Dental Implant; Aging.  | (read pdf) |


Daya Masri: ORCIDiD | Publons | ResearchGate | CrossRef | PubMed | Google Scholar | Scopus | WOS
Liat Chaushu: ORCIDiD | ResearchGate | CrossRef | PubMed | Google Scholar
Joseph NissanORCIDiD | ResearchGate | PubMed | Google Scholar
Sarit Adriana Naishlos: ORCIDiD | Publons | ResearchGate | CrossRef | PubMed | Google Scholar | Scopus | WOS
Gavriel ChaushuORCIDiD | Publons | ResearchGate | CrossRef | PubMed | Google Scholar | WOS



Unclarities about articaine: contraindications


Articaine is a dental local anesthetic of the amide group. It is the only anesthetic specifically developed for use in dentistry. It was first synthesized in 1969 when it was still referred to as carticaine. Its name changed to articaine in 1976 when it reached the markets in Germany [1]. In the following years, articaine got approval for clinical use around the world and has steadily become increasingly popular. It is the second most used dental local anesthetic in the United States with a market share of 39,3% in 2018 (the most popular still being lidocaine, the golden standard in local anesthetics) [1]. In Germany, it is even more popular, accounting for 97% of local anesthetic use by dentists in 2018 [2]…

(abstract) Background: Articaine is one of the most widely used local anesthetics in dentistry. It is formulated with epinephrine in a 1:100,000 or 1:200,000 concentration as a vasoconstrictor. The addition of epinephrine gives the drug an extensive list of formal contraindications. Objective: To review the literature on the chemistry and safety of articaine with epinephrine, and to review the validity of each of the contraindications. Data sources: The base knowledge was the result of reading a handbook on local anesthesia. Afterward, a literature search was made for publications between 1990 and 2019 concerning contraindications to articaine and dental epinephrine. Some articles about the pharmacological properties of articaine were also used. Finally, what was used was the list of contraindications in the package leaflet of articaine in Belgium as stated on 11/11/2019. Study selection: Articles of good quality and with clear information discussing and explaining these contraindications were included. Data extraction: Information about which contraindications, which drug interactions, and what physiological reasoning is behind them was extracted. Data synthesis: This information was synthesized in an extensive overview. First, the profile, safety and pharmacological properties of articaine with epinephrine were reviewed. Afterwards, an overview of the contraindications and drug interactions was given as stated in the package leaflet and each of them was explained. Keywords: Articaine; Epinephrine; Pharmacology; Contraindications; Pregnancy. | (read pdf) |


Stress and inflammation in periodontal disease: a review of the basic biological mechanisms


Periodontitis is a chronic inflammatory condition affecting the supporting tissues of the teeth, which results in loss of connective tissue and bone support and is a major cause of tooth loss in adults [1]. The advanced form of the disease affects a smaller part of the adult population, around 7% to 15% [2] while milder to moderate forms of the disease are found in approximately 50% of the population [3]. Its etiopathogenicity is complex with many factors interplaying, and due to this dynamic interrelated play, no isolated factor could solely explain the tissue destruction phenomenon [4]…

(abstract) Background: Periodontitis is a multifactorial infectious disease influenced by a myriad of other conditions and factors amongst which, psychosocial stress has emerged as a potential risk indicator. In order to establish this link in a generally accepted theory, we need to better understand the physiological pathways of stress on immune response with implications in the periodontal disease. Objective: This article aims at synthesizing the current knowledge on the effect of the psychological factors on the periodontal disease and to provide an insight into the bidirectional links between stress-related disorders and periodontitis via  psychoneuroimmunology studies. Data sources: A search was performed in 2 databases – PubMed and Google Scholar, supplemented by a manual search in peer-reviewed journals and cross-referenced with the articles accessed. The key terms used were: periodontal disease, periodontitis, stress, psychosocial stress, inflammation. Study selection: The inclusion criteria were all published potentially relevant articles on relationship between stress, inflammation and periodontitis on human and animal models. The exclusion criteria were articles with non-available full text and articles that were not written in English. Data extraction: Two reviewers extracted information regarding the quality and study characteristics independently. The studies were assessed for their methodology, statistical analysis, characteristics of the periodontal outcome measures, and psychological measurements. Data synthesis: Considerable evidence documents the link between psychosocial stress and periodontitis. This should redirect the attention of researchers and clinicians towards a multidisciplinary approach to periodontitis where psychosocial disturbances might be a key component into the rebus of disease progression and treatment results. Keywords: Periodontitis; Stress; Psychosocial Stress; Inflammation; Glucocorticoids. | (read pdf) |


Oriola Madhi: ORCIDiD | Publons | ResearchGate | Google Scholar 
Rozarka Budina: ORCIDiD | Publons | ResearchGate | Google Scholar 
Blerta Rumano: ORCIDiD | Publons | Google Scholar 


Trend of scientific production on digital implant dentistry (1990-2019): a bibliometric study


Compared to the era of the introduction of dental implants in the 1960s, implant therapy is now highly predictable and has become a widely used treatment modality to replace missing dentition [1]. Along with the continuous technological progress in the treatment planning software, computer-aided design (CAD), and computer-assisted manufacturing technology (CAM), a strong digitalization trend in implant dental medicine is noticed in clinical practice [2]. Evolving from being a merely “surgically driven” to a “restoration-driven” treatment, the concept of implant therapy currently turns to “computer-assisted” implant placement and even a completely digital workflow [3,4]…

(abstract) Background and Objective: Digital implantology has become a hot topic in dentistry. The purpose of this paper was to present trends regarding the interests of this field using bibliometric indicators. Data sources:  On the basis of articles in the Web of Science database, we performed a quantitative analysis of publications in 1990-2019 on digital implant dentistry. Data Extraction and Synthesis: Excel and VOSviewer were applied to assess the publication trend. A total number of 3680 publications with 57,930 citations up to February 8, 2020, were obtained. More than half (2013; 54.70%) of the articles were published in the last five years (2015–2019). The United States was in the leading position, with the highest H-index (60), 23.91% of the publications, and 28.74% of the total citations. Among the top 10 active authors, eight were from Europe, and the other two were from the United States. The University of Bern (Switzerland) (101; 2.745%) was the most productive institution, followed by the University of Sao Paulo (Brazil) (89; 2.418%), and the University of Michigan (United States) (84; 2.283%). The most active journal in publishing articles related to digital implantology was the Clinical Oral Implant Research (336; 9.13%), together with the International Journal of Oral & Maxillofacial Implants (336; 9.13%). Three of the top 15 funding agencies were well-known implant companies. Digital workflow, digital impression, and 3D printing are becoming popular research topics. In conclusion, there was a noticeable growth in scientific publications in digital implant dentistry, and most key bibliometric indicators demonstrated its upward trends. Keywords: Bibliometrics; Dental Implants; Digital Technologies; Evidence-Based Dentistry; Dental Research. | (read pdf) |


Zhaozhao Chen: ORCIDiD | Publons | ResearchGate | PubMed | Google Scholar | WOS
Junying Li: ORCIDiD | Publons | ResearchGate | PubMed 
Cho-Ying Lin: ORCIDiD | Publons | ResearchGate | PubMed | Google Scholar | WOS
Hom-Lay Wang: ORCIDiD | Publons | ResearchGate | CrossRef | PubMed | Google Scholar | WOS


Barriers to good oral health for nursing home residents: a literature review


Oral diseases are a major global public health problem affecting individuals, communities, and the society as a whole, as over 3,5 billion people face chronic and progressive oral diseases [1]. Older adults who reside in nursing homes are a particularly vulnerable part of the population with high rates of oral diseases. Neglected oral health has severe consequences for the residents’ general health and quality of life and has been associated with increased risk for aspiration pneumonia, diabetes mellitus, cardiovascular diseases and malnutrition [2-9]…

(abstract) Background: Oral health in older adults who live in nursing homes is generally poor, with high rates of mainly preventable oral conditions. Objective: The aim of this review was to present an overview of the barriers to good oral health for older nursing home residents. Data sources: Electronic databases were used (PubMed, Google Scholar, ScienceDirect). Reference lists from relevant studies and cited papers were also investigated. Study selection: The review included reports from national surveys and full papers of any study design, systematic reviews and guidelines published in peer-reviewed journals in English published until February 2019. Data extraction: The recorded barriers to good oral health were allocated to the main categories described in the socioecological model of health promotion. Data synthesis: The identified barriers to oral health of nursing home residents were allocated into intrapersonal, interpersonal, organizational and public health policy issues. The main intrapersonal barriers included the residents’ physical and mental disease, resistance to care, poor oral health literacy and difficulties in accessing dental care. Interpersonal factors included inadequate knowledge and training of caregivers and health professionals on oral health and care for frail older people, as well as negative attitudes of caregivers and family members towards oral hygiene provision in nursing homes. Organizational factors included low priority of oral health in nursing homes, limitations in time and number of staff and limited collaboration with dental professionals. Ineffective oral health policies included lack of priority for oral health and unsupportive oral care systems. Keywords: Barriers; Oral Health; Oral Hygiene; Nursing Homes; Older Adults | (read pdf) |


Kalliopi Konstantopoulou: ORCIDiD | Publons | ResearchGate 
Anastassia Kossioni: ORCIDiD | Publons | ResearchGate | PubMed | Google Scholar | Scopus | WOS
Hercules Karkazis: ORCIDiD | Publons | ResearchGate | PubMed | Google Scholar | Scopus 
Gregory Polyzoisi: ORCIDiD | Publons | ResearchGate | PubMed | Google Scholar | Scopus | WOS


Your reliable support in oral surgery: PIEZOSURGERY® touch by Mectron

The experience gained in using a piezosurgery device for several interventions on rabbits in a research study for the University of Hadassah in Jerusalem, Israel, makes me come back to you on piezosurgery. I have decided to present to you a new piezosurgery device, produced by the well-known company Mectron S.P.A. (via Loreto 15 / A, 16042 Carasco (Ge), Italy), which in 2001 introduced a revolutionary technology for bone surgery, namely piezosurgery.[…]

Florin-Eugen Constantinescu
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