Congenitally missing teeth (CMT), or as usually called hypodontia, is a highly prevalent and costly dental anomaly. Besides an unfavorable appearance, patients with missing teeth may suffer from malocclusion, periodontal damage, insufficient alveolar bone growth, reduced chewing ability, inarticulate pronunciation and other problems. Treatment might be usually expensive and multidisciplinary. This highly frequent and yet expensive anomaly is of interest to numerous clinical, basic science and public health fields such as orthodontics, pediatric dentistry, prosthodontics, periodontics, maxillofacial surgery, anatomy, anthropology and even the insurance industry. This essay reviews the findings on the etiology, prevalence, risk factors, occurrence patterns, skeletal changes and treatments of congenitally missing teeth. It seems that CMT usually appears in females and in the permanent dentition. It is not conclusive whether it tends to occur more in the maxilla or mandible and also in the anterior versus posterior segments. It can accompany various complications and should be attended by expert teams as soon as possible.

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Reports on post-surgical pain are a few, controversial and flawed (by statistics and analgesic consumption). Besides, it is not known if chlorhexidine can reduce post-extraction pain adjusting for its effect on prevention of infection and dry socket (DS). We assessed these. A total of 90 impacted mandibular third molars of 45 patients were extracted. Intra-alveolar 0·2% chlorhexidine gel was applied in a split-mouth randomised design to one-half of the sockets. None of the included patients took antibiotics or analgesics afterwards. In the first and third post-operative days, DS formation and pain levels were recorded. Predictive roles of the risk factors were analysed using fixed-effects (classic) and multilevel (mixed-model) multiple linear regressions (α = 0·05, β≤0·1). In the first day, pain levels were 5·56 ± 1·53 and 4·78 ± 1·43 (out of 10), respectively. These reduced to 3·22 ± 1·41 and 2·16 ± 1·40. Pain was more intense on the control sides [both P values = 0·000 (paired t-test)]. Chlorhexidine had a significant pain-alleviating effect (P = 0·0001), excluding its effect on DS and infection. More difficult surgeries (P = 0·0201) and dry sockets were more painful (P = 0·0000). Age had a marginally significant negative role (P = 0·0994). Gender and smoking had no significant impact [P ≥ 0·7 (regression)]. The pattern of pain reduction differed between dry sockets and healthy sockets [P = 0·0102 (anova)]. Chlorhexidine can reduce pain, regardless of its infection-/DS-preventive effects. Simpler surgeries and sockets not affected by alveolar osteitis are less painful. Smoking and gender less likely affect pain. The role of age was not conclusive and needs future studies.

Background and objectiveDiode lasers are becoming popular in gingival treatment following orthodontic treatments. Despite their merit and clinical implications, postoperative pain and bleeding after surgery with diode lasers are not assessed except in few controversial studies.MethodThis controlled clinical trial was conducted on 30 healthy orthodontic patients aged 17–29 years, needing esthetic-only gingivectomy in the anterior maxilla. The patients were randomly divided into two groups of 15 each: experimental (laser-assisted surgery) and control (traditional surgery using scalpels). The bleeding rate following the surgery was assessed using the bleeding criteria established by the World Health Organization. The postsurgical pain level was recorded using visual analog scales immediately after the surgery and in patients who consumed analgesics, also 2 h after the analgesic consumption. The data were analyzed using the independent-samples t, Mann-Whitney U, and chi-square tests (α = 0.05).ResultsThe average bleeding rates were 1.15 and 0.36 in the conventional and laser groups, respectively (Mann-Whitney U P < 0.05). Experimental patients had no postsurgical pain (VAS1 and VAS2 = 0). In the control group, the average VAS1 pain was 5.2 out of 10. The difference between VAS1 values in the control/experimental groups was significant (Mann-Whitney U P < 0.001).Conclusion940-nm diode laser seems promising in reducing postoperative bleeding and pain of patients needing cosmetic smile lift surgeries.

Dentists' self-reported attitudes towards patients with HIV/AIDS might not reflect their actual behaviour. In this study 2 observers posed as HIV-positive patients and directly evaluated the behaviour of 300 dentists in Tehran, Islamic Republic of Iran. Two months later another observer interviewed the same dentists at their offices regarding AIDS-related knowledge and self-reported attitudes. Only 14.9% of dentists agreed to treat the simulated HIV-positive patients, 78.5% referred and 6.6% rejected them. Older age, longer work experience, graduation from a non-Iranian university and not having additional degrees were significantly related to adverse behaviours. Mean scores were 8.3 (SD 9.7) (out of 18) for knowledge and 17.5 (SD 7.1) (out of 39) for attitude. There were no significant correlations between dentists' knowledge and attitude or between knowledge and behaviour, but there was a weak positive correlation between self-reported attitude and observed behaviour ‬ ‫امللحوظ‬ ‫السلوك‬ ‫وبني‬ ‫املواقف‬ ‫عن‬ ‫الذايت‬ ‫اإلبالغ‬ ‫بني‬ ‫شوهد‬ ‫الذي‬ ‫الضعيف‬ ‫اإلجيايب‬ ‫الرتابط‬ ‫باستثناء‬ ‫وسلوكهم،‬ ‫معارفهم‬Connaissances et attitudes autodéclarées des dentistes à Téhéran par rapport au VIH/sida et disposition observée à soigner les patients se présentant comme positifs pour le VIH RÉSUMÉ Il est possible que l'attitude autodéclarée des dentistes vis-à-vis des patients atteints du VIH/sida ne corresponde pas à leur comportement en situation réelle. Dans le cadre de cette étude, deux observateurs se sont fait passer pour des patients séropositifs pour le VIH et ont directement évalué le comportement de 300 dentistes de Téhéran (République islamique d'Iran). Deux mois plus tard, un autre observateur a interrogé les mêmes dentistes dans leur cabinet au sujet de leurs connaissances et de leur attitude autodéclarées à propos du sida. Seuls 14,9 % des dentistes ont consenti à traiter les patients ayant déclaré une séropositivité fictive, 78,5 % les ont orientés vers d'autres confrères et 6,6 % ont refusé de les soigner. Un âge plus avancé, une expérience professionnelle plus longue, des études suivies dans une université non iranienne et le fait de ne pas avoir de diplômes supplémentaires étaient des facteurs significativement associés à des comportements de refus. Les scores moyens étaient de 8,3 (E.T. 9,7) (sur 18) pour les connaissances et de 17,5 (E.T. 7,1) (sur 39) pour l'attitude. Aucune corrélation significative n'a été observée entre les connaissances et les attitudes des dentistes ni entre les connaissances et le comportement, mais une faible corrélation positive a été retrouvée entre l'attitude autodéclarée et le comportement observé.‫املتوسط‬ ‫لرشق‬ ‫الصحية‬ ‫املجلة‬ ‫عرش‬ ‫الثامن‬ ‫املجلد‬ ‫التاسع‬ ‫العدد‬ 929

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