Abstract
Influence of anti-rheumatic agents on the periodontal condition of patients with rheumatoid arthritis and periodontitis: A systematic review and meta-analysis
Zhang J, Xu C, Gao L, et al. J Periodontal Res. 2021;56(6):1099–1115. doi: 10.1111/jre.12925.
ABSTRACT
To evaluate the influence of diverse anti-rheumatic agents on the periodontal condition and to provide clinical medication guidance for patients with rheumatoid arthritis (RA) and periodontitis.
In recent years, the correlation between RA and periodontitis has become a hot research topic, but no medication recommendations for patients with RA and periodontitis are available at present.
The protocol of this review was registered in advance with PROSPERO (CRD42021248827). Electronic search and manual searches up to March 20, 2021 were conducted. The inclusion criteria for the studies were as follows: included patients diagnosed with periodontitis and RA submitted to anti-rheumatic agent therapy; with a control group receiving no anti-rheumatic agent therapy; with outcomes including at least one periodontal parameter. Probing depth (PD) and clinical attachment loss (CAL) were pooled using weighted mean difference (WMD) and 95% confidence intervals (CI) while gingival index (GI)/modified gingival index (MGI) was analyzed by standardized mean difference (SMD) and 95% CI.
One thousand four hundred and seventy-eight studies potentially related to the aim of this review were screened, but only 463 patients from 14 studies were included in the qualitative analysis, and 146 patients from 4 studies were included in the meta-analysis. Statistically significant reductions were observed among the subjects who received anti-rheumatic agents for PD [WMD = −0.20; 95% CI (−0.33, −0.07); effect p = .003; I2 = 50%; p = .11], CAL [WMD = −0.4; 95% CI (−0.66, −0.15); effect p = .002; I2 = 57%; p = .07] and GI/MGI [SMD = −0.61;95% CI (−0.94, −0.27); effect p = .0004; I2 = 26%; p = .25]. Consistent with the above results, this systematic review produced promising results that PD, CAL, GI/MGI, and bleeding on probing (BOP) decreased when patients with RA and periodontitis were treated with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), anti-B lymphocyte agents, anti-IL-6R agents, or JAK inhibitors. PD and CAL declined after the administration of anti-TNF-α agents; most studies reported decreased GI/MGI and BOP, while 2 studies reported increased GI/MGI and BOP.
These results revealed that csDMARDs, anti-B lymphocyte agents, anti-IL-6R agents, anti-TNF-α agents, and JAK inhibitors had potential positive effects in improving the periodontal condition of patients with RA and periodontitis. However, future research is needed to elucidate whether anti-TNF-α agents have a side effect of increased gingival inflammation.
Copyright © 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. Reproduced with permission.
Preparedness of recent dental graduates and final-year undergraduate dental students for practice amidst the COVID-19 pandemic
Pandarathodiyil AK, Mani SA, Ghani WMN, et al. Eur J Dent Educ. 2022. doi: 10.1111/eje.12779. Online ahead of print.
ABSTRACT
Dental education involves performing clinical procedures on patients under expert supervision. The COVID-19 pandemic has disrupted routine face-to-face teaching-learning-assessment dynamics world over. This study assessed the self-perceived preparedness of dental undergraduate students for practice, whose clinical training was interrupted by the COVID-19 pandemic from dental schools across Malaysia.
This cross-sectional web-based questionnaire survey was done among new dental graduates of the academic year 2019–2020 and the final year undergraduate students (academic year 2020–2021) from dental schools in Malaysia, using the Dental Undergraduates Preparedness Assessment Scale (DU-PAS), from 6th to 26th April 2021. The questionnaire addressed clinical skill competence, and cognitive and behavioral attributes. The number of respondents needed to achieve a confidence level of 95% with margin of error of 5% was 306.
A total of 453 (243 final year students and 210 new graduates) responded from dental schools nationwide, with a response rate of 30.6%. The overall mean score for preparedness for dental practice was 76.3±14.7, for clinical skills 39.7±7.3, and behavioral and cognitive attributes 36.5±9.1. New graduates had significantly higher mean preparedness score (78.6±14.4) as compared to students in their final year (74.2±14.7). Performing endodontic treatment on multi-rooted teeth had the lowest perceived competency (29.8%), followed by assessing treatment needs of patients requiring orthodontics (37.1%), prescribing drugs (46.6%) and providing crowns using principles of tooth preservation (48.1%).
Satisfactory scores were obtained for most attributes. The final-year cohort was significantly less prepared for dental practice compared to the newly graduated cohort.
Copyright © 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. Reproduced with permission.
The impact of the COVID-19 pandemic on oral health inequalities and access to oral healthcare in England
Stennett M, Tsakos G. Br Dent J. 2022;232(2):109–114. doi: 10.1038/s41415-021-3718-0.
ABSTRACT
While the impact of the coronavirus disease (COVID-19) pandemic on health inequalities is documented, oral health has been absent from this discussion. This commentary highlights the potential impacts of the COVID-19 pandemic on oral health inequalities in England in February 2021. It includes a literature review, Public Health England and Kantar Worldpanel sales data on health behaviours and analysis of NHS dental services data. Purchasing data indicate, except for smoking, increases in health-compromising behaviours. Since the resumption of dental services, NHS general dental service use modestly recovered among adults but not children by October 2020. There are clear inequalities among children and older adults, with more deprived groups having lower uptake of dental service use than more affluent groups. Oral cancer referrals and hospital admissions for tooth extractions in children dramatically declined, with the latter primarily affecting children in more deprived areas. Many oral health programmes in schools and care homes were disrupted or suspended throughout this period. All these indicate that oral health inequalities have widened due to the COVID-19 pandemic. An oral health plan of action requires prioritising long-term investment in public health programmes and transforming commissioning pathways to support those with the greatest needs to access oral healthcare services.
Copyright © 2022 The Author(s), under exclusive licence to the British Dental Association. British Dental Journal, published by Springer Nature. This is an open access article distributed under the terms of the Creative Commons CC BY license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0.
Academic performance and attitudes of dental students impacted by COVID-19
Hayes C, Mears M, Rowan S, et al. J Dent Educ. 2022 Feb. doi: 10.1002/jdd.12897. Online ahead of print.
ABSTRACT
Previous studies only focused on attitudes and behaviors of US dental students without examining direct effects of the COVID-19 pandemic on academic performance. This study examined effects of COVID-19 pandemic on dental students’ academic performance, self-reported attitudes, behavior, and service utilization. We hypothesized that the pandemic provided more beneficial learning environments.
This mixed study design implemented a cross sectional survey with retrospective extraction of students’ academic grades. A survey of 274 predoctoral students assessed self-reported attitudes/behaviors and service utilization. First year Doctor of Dental Medicine (DMD1) 2021–2024 students’ academic performance data were extracted. Independent t-test and chi-square crosstab analyses were conducted assessing differences between pre-COVID and post-COVID cohorts.
Participants’ academic grades identified statistically significant associations between pre-/post-COVID grades in five of 12 DMD1 courses. Grade percentages identified increased average grades in four of 12 DMD1 courses, with one of 12 courses demonstrating decreased grade percentage. Half of survey participants were female (n = 37/72, 51.4%), 79.2% were 25–34 years old, and 44.4% (n = 32) were DMD 2024. About 1/5 (20.8%, n = 15) sought counseling/therapy. Students agreed staying home allowed more time to study (66.7%, n = 48), while 59.2% (n = 42) reported increased financial concerns. A majority reported lacking in-person group studying decreased performance, and 55.6% (n = 40) reported feeling depressed.
Students performed better overall in courses delivered remotely with clinical application and team-based engagement. Students performed equally overall; however, the majority had concerns regarding finances, group studying, and mental health challenges. This highlights the need for more readily available resources at institutions.
Copyright © 2022 American Dental Education Association. Reproduced with permission.
Association between Rheumatoid Arthritis and Apical Periodontitis: A Cross-sectional Study
Karataş E, Kul A, Tepecik E. Eur Endod J. 2020;5(2):155–158. Doi: 10.14744/eej.2019.52824.
ABSTRACT
The present cross-sectional study aimed to investigate possible association between Rheumatoid Arthritis (RA) and Apical Periodontitis (AP).
In table one it is mentioned 48 patients diagnosed with RA were included in the experimental group. Another 48 healthy age- and gender-matched participants who reported no history of any systemic disease were selected to form the control group. All the patients were examined radiographically and clinically to diagnose the presence of AP. The following data was recorded for all patients; the number of teeth present, the number o
A total of 1026 teeth were examined in the RA group and 45 of them was diagnosed as AP. In the control group, 1025 teeth were examined and 21 teeth were diagnosed as AP. It was found that the prevalence of teeth with AP (4.3%) was significantly higher in the RA group than the control (2%) (odds ratio [OR]=2.193, P=0.003). Logistic regression analysis showed that RA is significantly f teeth with AP, the number of patients with AP, the number of patients with root canal treated teeth (RCT) and the number of patients with RCT+AP. The chi-square test and logistic regression analysis were used to determine the possible association between RA and AP. associated with AP.
It can be concluded that patients with RA can be more prone to develop AP.
Copyright © 2020 European Endodontic Journal. Published by Kare Publishing. Reproduced with permission.