The purpose of this retrospective study was to determine survival and peri-implant marginal bone loss of short and ultra-short implants placed in the posterior mandible. A total of 98 patients received 201 locking-taper implants between January 2014 and January 2015. Implants were placed with a two-stage approach and restored with single crowns. Clinical and radiographic examinations were performed at three-year recall appointments. At that time, the proportion of implant survival by length, and variations of crestal bone levels (mean crestal bone loss and mean apical shift of the “first bone-to-implant contact point” position) were assessed. Significance level was set at 0.05. The total number of implants examined 36 months after loading included: 71 implants 8.0 mm in length, 82 implants 6.0 mm in length and 48 implants 5.0 mm in length. Five implants failed. The overall proportion of survival was 97.51%, with 98.59% for the 8.0 mm implants, 97.56% for the 6.0 mm implants, and 95.83% for the 5.0 mm implants. No statistically significant differences were found among the groups regarding implant survival (p = 0.73), mean crestal bone loss (p = 0.31), or mean apical shift of the “first bone-to-implant contact point” position (p = 0.36). Single-crown short and ultra-short implants may offer predictable outcomes in the atrophic posterior mandibular regions, though further investigations with longer follow-up evaluations are necessary to validate our results.

Aim To determine cumulative success rate (CSR) of short and ultrashort implants in the posterior maxilla restored with single crowns. Patients and Methods We performed a retrospective study in 65 patients with 139 implants. 46 were ultrashort and 93 short. Implants were placed with a staged approach and restored with single crowns. Success rate, clinical and radiographic outcomes, and crown-to-implant ratio (CIR) were assessed after three years. Statistical analysis was performed by descriptive and inferential statistics. A log-binomial regression model where the main outcome was implant success was achieved. Coefficients and 95% confidence intervals were reported. Analyses were performed with Stata 13.2 for Windows. Results 61.54% of patients were female and mean overall age was 51.9 ± 11.08 years old. Overall CSR was 97.1% (95% CI: 92.4–98.9): 97.9 and 95.1% for short and ultrashort, respectively (P value: 0.33). Four implants failed. Covariates were not associated with CSR (P value > 0.05). Regression model showed coefficients correlated with implant success for ultrashort implants (0.87) and most of covariates but none were statistically significant (P values > 0.05). Conclusions Our results suggest that short and ultrashort implants may be successfully placed and restored with single crowns in the resorbed maxillary molar region.

BackgroundLinks between the demanding nature of studies in the health sciences, students’ personality traits and psychological distress have been well-established. While considerable amount of work has been done in medicine, evidence from the dental education arena is sparse and data from Latin America are lacking. The authors conducted a large-scale investigation of psychological distress among dental students in Colombia and sought to determine its curriculum and student-level correlates.MethodsThe Spanish version of the Derogatis’ Symptoms Checklist Revised (SCL-90-R) was administered to all students officially registered and attending classes or clinics in 17 dental schools in 4 geographic districts of Colombia between January and April 2012. Additional information was collected on participants’ socio-demographic information and first career choice, as well as school’s characteristics such as class size. The Global Severity Index (GSI) score, a measure of overall psychological distress, served as the primary analytical endpoint. Analyses relied on multilevel mixed-effects linear and log-binomial regression, accounting for study design and sample characteristics.ResultsA total of 5700 dental students completed the survey, a response rate of 67%. Pronounced gradients were noted in the association between socio-economic status and psychological distress, with students in higher strata reporting fewer problems. After adjustment for all important covariates, there was an evident pattern of increasing psychological distress corresponding to the transition from the didactic, to the preclinical and clinical phases of training, with few differences between male and female students. Independent of other factors, reliance on own funds for education and having dentistry as the first career choice were associated with lower psychological distress.ConclusionsLevels of psychological distress correlated with students’ socio-economic and study-level characteristics. Above and beyond the influence of person-level factors, variations in levels of distress paralleled specific transitional stages of the 5-year dental curriculum, providing opportunities for targeted interventions.

OES is a valuable instrument to measure the orofacial appearance construct for Spanish-speaking populations. OES was concluded to be unidimensional with excellent score reliability and sufficient convergent score validity when compared with other Orofacial Appearance measures. Our results suggest that OES could be used in Spanish-speaking patients, an important and growing population around the globe.

Key findings: Despite clear scope, most guidelines for SARS CoV-2 infections and for other care in the context of COVID-19 fell short of basic methodological standards. Only 4% were based on a systematic literature search and a structured consensus process by representative experts (classified as the highest methodological quality). Patients were included in the development of one guideline. A process for regular updates was described in 14%. What this adds to what is known: Our study explored if basic methodological standards of guideline development have been met in the published clinical practice guidelines related to COVID-19. What is the implication/what should change now: An insufficient consideration of appropriate methodologies in the guideline development process could lead to misleading information, uncertainty among the professionals, and potentially harmful actions for patients. This paper provides an important benchmark for the future assessment of the quality of COVID-19 guidelines. Abstract Objective: The number of published clinical practice guidelines related to COVID-19 has rapidly increased. This study explored if basic methodological standards of guideline development have been met in the published clinical practice guidelines related to COVID-19. Study Design and Setting: Rapid systematic review from February 1 st until April 27 th , 2020 using MEDLINE [PubMed], CINAHL [Ebsco], Trip and manual search, including all types of healthcare workers providing any kind of healthcare to any patient population in any setting. Results: There were 1342 titles screened and 188 guidelines included. The highest average AGREE II domain score was 89% for scope and purpose , the lowest for rigor of development (25%). Only eight guidelines (4%) were based on a systematic literature search and a structured consensus process by representative experts (classified as the highest methodological quality). The majority (156; 83%) was solely built on an informal expert consensus. A process for regular updates was described in 27 guidelines (14%). Patients were included in the development of only one guideline. Conclusion: Despite clear scope, most publications fell short of basic methodological standards of guideline development. Clinicians should use guidelines that include up-to-date information, were informed by stakeholder involvement, and employed rigorous methodologies.

Dental caries is characterized by a dysbiotic shift at the biofilm–tooth surface interface, yet comprehensive biochemical characterizations of the biofilm are scant. We used metabolomics to identify biochemical features of the supragingival biofilm associated with early childhood caries (ECC) prevalence and severity. The study’s analytical sample comprised 289 children ages 3 to 5 (51% with ECC) who attended public preschools in North Carolina and were enrolled in a community-based cross-sectional study of early childhood oral health. Clinical examinations were conducted by calibrated examiners in community locations using International Caries Detection and Classification System (ICDAS) criteria. Supragingival plaque collected from the facial/buccal surfaces of all primary teeth in the upper-left quadrant was analyzed using ultra-performance liquid chromatography–tandem mass spectrometry. Associations between individual metabolites and 18 clinical traits (based on different ECC definitions and sets of tooth surfaces) were quantified using Brownian distance correlations (dCor) and linear regression modeling of log2-transformed values, applying a false discovery rate multiple testing correction. A tree-based pipeline optimization tool (TPOT)–machine learning process was used to identify the best-fitting ECC classification metabolite model. There were 503 named metabolites identified, including microbial, host, and exogenous biochemicals. Most significant ECC-metabolite associations were positive (i.e., upregulations/enrichments). The localized ECC case definition (ICDAS ≥1 caries experience within the surfaces from which plaque was collected) had the strongest correlation with the metabolome (dCor P = 8 × 10−3). Sixteen metabolites were significantly associated with ECC after multiple testing correction, including fucose ( P = 3.0 × 10−6) and N-acetylneuraminate (p = 6.8 × 10−6) with higher ECC prevalence, as well as catechin ( P = 4.7 × 10−6) and epicatechin ( P = 2.9 × 10−6) with lower. Catechin, epicatechin, imidazole propionate, fucose, 9,10-DiHOME, and N-acetylneuraminate were among the top 15 metabolites in terms of ECC classification importance in the automated TPOT model. These supragingival biofilm metabolite findings provide novel insights in ECC biology and can serve as the basis for the development of measures of disease activity or risk assessment.

The genetic basis of oral health has long been theorized but little information exists on the heritable variance in common oral and dental disease traits explained by the human genome. We sought to add to the evidence base of heritability of oral and dental traits using high-density genotype data in a well-characterized community-based cohort of middle-age adults. We used genome-wide association (GWAS) data superimposed to clinical and biomarker information generated in the context of the Dental Atherosclerosis Risk In Communities (ARIC) cohort. Genotypes comprised SNPs directly typed on the Affymetrix Genome-Wide Human SNP Array 6.0 chip with minor allele frequency of >5% (n=656,292) or imputed using HapMap II-CEU (n=2,104,905). We investigated 30 traits including 'global' [e.g., number of natural teeth (NT) and incident tooth loss], clinically defined (e.g., dental caries via the DMFS index, periodontitis via the CDC/AAP and WW17 classifications), and biologically informed ones (e.g., subgingival pathogen colonization and 'complex' traits). Heritability (i.e., variance explained; h 2) was calculated using Visscher's Genome-wide Complex Trait Analysis (GCTA) approach, using a random-effects mixed linear model and restricted maximum likelihood (REML) regression adjusting for ancestry (10 principal components), age and sex. H 2 estimates were modest for clinical traits-NT=0.11 (se=0.07), severe chronic periodontitis (CDC/AAP)=0.22 (se=0.19), WW17 Stage 4 vs. 1/2=0.15 (se=0.11). "Severe gingival index" and "high red complex colonization" had h 2 >0.50, while a periodontal complex trait defined by high IL-1β GCF expression and Aggregatibacter actinomycetemcomitans subgingival colonization had the highest h 2 =0.72 (se=0.32). Our results indicate that all GWAS SNPs explain modest levels of the observed variance in clinical oral and dental measures. Subgingival bacterial colonization and complex phenotypes encompassing both bacterial colonization and local inflammatory response had the highest heritability, suggesting that these biologically informed traits are promising targets for the conduct of genomics investigations, according to the notion of precision oral health.

Early childhood caries (ECC) is an aggressive form of dental caries occurring in the first five years of life. Despite its prevalence and consequences, little progress has been made in its prevention and even less is known about individuals’ susceptibility or genomic risk factors. The genome-wide association study (GWAS) of ECC (“ZOE 2.0”) is a community-based, multi-ethnic, cross-sectional, genetic epidemiologic study seeking to address this knowledge gap. This paper describes the study’s design, the cohort’s demographic profile, data domains, and key oral health outcomes. Between 2016 and 2019, the study enrolled 8059 3–5-year-old children attending public preschools in North Carolina, United States. Participants resided in 86 of the state’s 100 counties and racial/ethnic minorities predominated—for example, 48% (n = 3872) were African American, 22% white, and 20% (n = 1611) were Hispanic/Latino. Seventy-nine percent (n = 6404) of participants underwent clinical dental examinations yielding ECC outcome measures—ECC (defined at the established caries lesion threshold) prevalence was 54% and the mean number of decayed, missing, filled surfaces due to caries was eight. Nearly all (98%) examined children provided sufficient DNA from saliva for genotyping. The cohort’s community-based nature and rich data offer excellent opportunities for addressing important clinical, epidemiologic, and biological questions in early childhood.