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Addressing Supply Waste and Environmental Sustainability in the Dental School Environment
Manzoor, Leena M; Zinshteyn, Rachel; Grizzle, Adam; Baker, Paul R
PMID: 42170836
ISSN: 1930-7837
CID: 6041362
Mobile Imaging-Based Machine Learning for Dental Caries, Sealants, and Fluorosis: Protocol for a Cross-Sectional Model Development and Validation Study
Park, Sang Mok; Kwon, Semin; Hong, Shaun G; Ji, Yuhyun; Nagappa, Sreeram P; Leem, Jung Woo; Lin, Mei; Beltrán-Aguilar, Eugenio D; Griffin, Susan O; Kim, Young L
BACKGROUND:Assessing dental caries, sealants, and fluorosis is essential for public health surveillance, providing critical data to evaluate national prevention programs. Standard methods performed by dental professionals are often limited by affordability, accessibility, and scalability for both population-level and individualized assessments. Mobile health (mHealth) approaches to concurrently detect caries, sealants, and fluorosis have remained largely unexplored, especially at the population level. OBJECTIVE:This study leverages mHealth technologies that integrate computer vision using machine learning and deep learning with images captured by smartphone cameras and low-cost intraoral cameras. The primary objective is to develop and validate models for detecting caries lesions, identifying sealants, and quantifying fluorosis severity from standardized dental images, using standardized visual clinical examinations as the reference standard. METHODS:The proposed study population will include approximately 1000 adolescents in Colorado, United States, living in communities with naturally elevated fluoride levels in the public water system. Participants will undergo standardized clinical dental examinations and imaging using intraoral cameras and smartphones. Supervised learning models will incorporate reference chart-based color correction, radiomic spatial and textural features, and neural network classifiers. The reference standard will be standardized visual clinical examinations performed by trained and calibrated dental professionals. Two models will be developed and evaluated: one to detect caries lesions and sealants and another to assess fluorosis severity. Model performance will be evaluated against clinical assessments by dental professionals using stratified cross-validation and multiclass performance metrics while minimizing bias and accounting for confounders common to human examiners. RESULTS:A standardized dental examination, an intraoral imaging protocol, and a smartphone imaging protocol are used to assess all 8 permanent molars for caries and sealants, as well as the 6 upper anterior teeth for fluorosis severity. Pilot studies were conducted to test study logistics and calibrate 3 examiners in person, supplemented by debriefings, mobile app training, and a web-based calibration module. The study was funded in September 2022 with supplemental funding awarded in June 2024. The study launched in May 2024, and as of January 2026, data have been collected from approximately 300 participants. CONCLUSIONS:The integration of computer vision and mobile device imaging will enable affordable, scalable, population-level assessments for detecting caries and sealants and quantifying fluorosis severity among adolescents. mHealth technologies have been increasingly incorporated into dentistry for both clinical decision support and at-home use. This protocol will further help establish a structured methodological framework for acquiring, processing, and analyzing mobile imaging data for dental health surveillance and epidemiological studies. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)/UNASSIGNED:DERR1-10.2196/91239.
PMCID:13077280
PMID: 41911013
ISSN: 1929-0748
CID: 6041142
Authors' Response [Letter]
Benzian, Habib; Beltrán-Aguilar, Eugenio; Niederman, Richard
PMID: 41931070
ISSN: 1943-4723
CID: 6041262
Eponyms in Dentistry - Oral Surgery [Historical Article]
Glickman, Robert; Spielman, Andrew I
The development of oral and maxillofacial surgery advanced rapidly following the introduction of general anesthesia in 1846, evolving from simple tooth extractions to complex procedures involving the jaws and facial skeleton. Initially driven by general surgeons in Europe and later refined by specialists in the U.S. and elsewhere, this progress is reflected in enduring surgical eponyms. This paper highlights 23 pioneers associated with 21 foundational eponyms-procedures, instruments, and classifications-that remain central to oral surgical practice. These eponyms honor the innovators whose work shaped the field and continue to connect modern surgery to its historical roots.
PMID: 41926370
ISSN: 1089-6287
CID: 6041202
Eponyms in Dentistry - Endodontics [Historical Article]
Gutmann, James L; Spielman, Andrew I
This paper explores the historical evolution of dentistry through the lens of eponyms, focusing particularly on endodontics. From the era of extractions to the introduction of restorations by Pierre Fauchard and the development of prosthodontics and root preservation in the 19th century, dentistry has advanced in parallel with scientific breakthroughs in microbiology and technology. These innovations enabled the understanding and treatment of pulpal disease and the creation of effective root canal techniques. We highlight 31 key eponyms-32 individuals whose contributions to instruments, methods, materials, or classifications shaped modern endodontics and whose legacies remain embedded in practice.
PMID: 41926371
ISSN: 1089-6287
CID: 6041212
Updated trends in the global prevalence and burden of mental disorders, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023
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BACKGROUND:The 2023 iteration of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) estimated prevalence, incidence, and health burden for 375 diseases and injuries, including 12 mental disorders. We assess past, current, and emerging trends in the prevalence and burden of mental disorders across sexes and age groups, for 21 regions, 204 countries and territories, and by Socio-demographic Index (SDI) quintile, from 1990 to 2023. METHODS:Mental disorders included in GBD 2023 were anxiety disorders, major depressive disorder, dysthymia, bipolar disorder, schizophrenia, autism spectrum disorders, conduct disorder, attention-deficit hyperactivity disorder, anorexia nervosa, bulimia nervosa, idiopathic developmental intellectual disability, and a residual category of other mental disorders. A literature review identified epidemiological data for each disorder. These were analysed via a Bayesian meta-regression to estimate prevalence by disorder, sex, age, location, and year. Disorder-specific prevalence was multiplied by disability weights representing the severity of health loss associated with each disorder to estimate years lived with disability (YLDs). Deaths due to anorexia nervosa were assessed with a Cause of Death Ensemble modelling strategy to estimate deaths by sex, age, location, and year, and then multiplied by the standard life expectancy at age of death to estimate years of life lost (YLLs). YLDs equalled disability-adjusted life-years (DALYs) for all mental disorders except anorexia nervosa (the only mental disorder considered as an underlying cause of death in GBD), for which DALYs represented the sum of YLDs and YLLs. We presented prevalence, deaths, YLDs, YLLs, and DALYs as counts, age-specific rates per 100 000 population, and age-standardised rates per 100 000 population. FINDINGS/RESULTS:We estimated 1·17 billion (95% uncertainty interval 1·06-1·31) prevalent cases of mental disorders globally in 2023, equivalent to an age-standardised prevalence rate of 14 210·7 cases (12 849·5-15 940·1) per 100 000 population. These estimates represented a 95·5% (75·0-121·2) increase in prevalent cases and 24·2% (11·4-41·4) increase in age-standardised prevalence rate between 1990 and 2023. All mental disorders showed increases in prevalent cases between 1990 and 2023, while notable increases were seen in age-standardised prevalence rates for anxiety disorders, major depressive disorder, dysthymia, anorexia nervosa, bulimia nervosa, schizophrenia, and conduct disorder. There were an estimated 171 million (127-228) DALYs due to mental disorders globally across sex and age in 2023, equivalent to an age-standardised DALY rate of 2070·5 DALYs (1519·1-2750·5) per 100 000 population. Mental disorders contributed to 6·1% (4·8-7·6) of all-cause DALYs in 2023, making them the fifth leading cause of global DALYs (up from 12th in 1990). DALYs were almost entirely composed of YLDs. Mental disorders were the leading cause of YLDs in 2023 (up from second in 1990), explaining 17·3% (14·8-20·6) of all-cause global YLDs. Leading causes of mental disorder DALYs were anxiety disorders (ranked 11th among the 304 diseases and injuries at Level 4 of the GBD cause hierarchy), major depressive disorder (15th), and schizophrenia (41st). Globally in 2023, mental disorder age-standardised DALY rates were higher among females (2239·6 [1643·7-3014·1] per 100 000) than among males (1900·2 [1399·8-2510·8] per 100 000), and peaked in the 15-19 years age group (2617·3 [1850·6-3696·8] per 100 000). All locations showed increased mental disorder DALY rates in 2023 compared with 1990, ranging across countries and territories from 1302·4 (952·7-1683·7) per 100 000 in Viet Nam to 3555·8 (2661·9-4715·0) per 100 000 in the Netherlands. Across SDI quintiles, DALY rates ranged from 1853·0 (1352·1-2469·3) per 100 000 for middle SDI to 2184·1 (1606·1-2890·3) per 100 000 for high SDI. INTERPRETATION/CONCLUSIONS:A significant health burden was imposed by mental disorders in all countries and territories in 2023, irrespective of the health resources available. In some instances, this burden has increased over time and is unevenly distributed across populations. Stronger surveillance systems, particularly in low-income and middle-income countries, are required. Additionally, we need more coordinated and inclusive policies to reduce the burden through early treatment and prevention, tailored to sex and age differences across locations. Responding to the mental health needs of our global population, especially those most vulnerable, is an obligation, not a choice. FUNDING/BACKGROUND:Gates Foundation, Queensland Health, and University of Queensland.
PMID: 42167272
ISSN: 1474-547x
CID: 6041342
Doxycycline release from cyclodextrin oligomer-containing collagen gels
Trout, Eric; Palomo, Leena; von Recum, Horst A; Eppell, Steven J
This paper tests the hypothesis that oligomers of cyclodextrin small enough to remain soluble under aqueous conditions can be incorporated in a collagen gel during fibrillogenesis in a way that enhances prolonged release of a therapeutic. Native D-banded collagen fibril hydrogels are used as an intentionally fast-releasing matrix to examine how affinity-based interactions delay drug release. Doxycycline loading and release from a collagen hydrogel containing entrapped oligomers of γ-cyclodextrin (CD) is investigated. Mathematical modeling is used to separate the effects of the collagen matrix from the incorporated CD. Incorporating CD oligomers increased the releasable amount of doxycycline by 220% and reduced its release rate fivefold. These results demonstrate that affinity-based material design can substantially shift release kinetics even in diffusion-dominated systems. Use of this system to treat chronic peri-implantitis arising from infection and inflammation at the abutment/gingiva interface in dental implants is discussed. Current treatment strategies involve frequent administration of systemic antibiotics and collagenase inhibitors which complicates clinical management. Longer-acting local delivery, even over modest timescales, could reduce dosing frequency and reduce unwanted side effects, thus improving treatment efficacy. A localized controlled drug-release approach may offer a way to simplify this clinical management.
PMID: 42097227
ISSN: 1873-4995
CID: 6041402
Eponyms in Dentistry - Physiology and Pathology [Historical Article]
Kumar, Arthi; Spielman, Andrew I
Do you ever wonder who is behind the names, diseases, structures, procedures, or syndromes often taught in dental or medical school? For instance, the Cusp of Carabelli on a maxillary molar, the Wharton duct of the submandibular gland, or the Eustachian tube that gives the perception of a stuffed ear before landing are three structures named after individuals who first described them centuries ago. This is a long-overdue exploration of 60 names for 53 of the most relevant eponyms, many of whom have likely been forgotten.I.
PMID: 41926368
ISSN: 1089-6287
CID: 6041182
Eponyms in Dentistry - Prosthodontics [Historical Article]
Jahangiri, Leila; Spielman, Andrew I
This article highlights the significance of 20 dental eponyms in prosthodontics, emphasizing the enduring legacy of the individuals behind them. Each name represents a pivotal advancement and a foundational contribution to the history of dentistry and prosthodontics in particular. Understanding their lives and innovations fosters a deeper appreciation of today's clinical practice, which are built on past discoveries. As current technologies become tomorrow's historical artifacts, recognizing the evolution of the field helps contextualize modern dentistry and anticipate future directions. Honoring these pioneers is essential to preserving the continuity of knowledge and valuing the individual efforts that have shaped the profession.
PMID: 41926373
ISSN: 1089-6287
CID: 6041232
Prosthetic-surgical integration and robot-assisted implant placement for maxillary anterior fixed rehabilitation in the predoctoral clinic: A case report
Alnatsheh, Sohaib; Espinal, Carmen; Ardila, Juliana; Choi, Yoonsuk; Talib, Huzefa S; Wiedemann, Thomas G; Kim, Young K
This clinical report describes a prosthetically directed execution to maxillary anterior rehabilitation in a patient with congenitally missing lateral incisors, retained primary molars, and anterior segment spacing. The definitive tooth morphology and eccentric guidance were established before surgery through a diagnostic wax-up, intraoral mock-up, and conservative direct bonding to confirm esthetic and functional parameters. Implant placement at sites #5 and #12 was then completed using robotic-assisted intervention, allowing versatile mesial-angulation correction of the osteotomies to avoid the maxillary sinus floor while maintaining the restorative trajectory. Custom polyetheretherketone healing abutments were used to retain the peri-implant soft tissue phenotype, followed by the delivery of high-quality definitive prostheses for maxillary anterior fixed rehabilitation. Establishing prosthetic acquisition first transformed the surgical phase into two straightforward implant sites, allowing all treatment steps to be carried out predictably within the predoctoral clinic while maintaining precision and treatment quality.
PMID: 41979004
ISSN: 1532-849x
CID: 6041532