2017 Articles

JADA December 2017
No evidence-based guidelines exist for preventive dental care before radiation therapy (RT) in patients with head and neck cancer (HNC). An ongoing multicenter, prospective cohort study, Clinical Registry of Dental Outcomes in Head and Neck Cancer Patients (OraRad), is addressing this knowledge gap. The authors evaluated the level of dental disease before RT in the OraRad cohort, factors associated with dental disease, and dental treatment recommendations made before RT. As part of OraRad, the authors assessed caries, periodontal disease, dental recommendations, and dental interventions performed before RT.

Key Words: Radiation therapy; dentistry; caries; periodontal diseases; head and neck neoplasms.

JADA December 2017
The authors updated a previously published systematic review to assess the effects of low-level laser therapy (LLLT) on reducing complications after the removal of impacted mandibular third molars. The authors searched for randomized clinical trials in which the investigators evaluated the efficacy of LLLT compared with that of placebo or no treatment. Two reviewers independently screened studies, extracted data, and assessed risk of bias. The authors used random effects model meta-analysis and the Grading of Recommendations Assessment, Development and Evaluation approach to rate the certainty of evidence.

Key Words : Impacted mandibular third molar; systematic review; postsurgical complications; pain; swelling; trismus.

JADA December 2017
A lesion on an occlusal tooth surface with no cavitation and no radiographic radiolucency but in which caries is suspected owing to surface roughness, opacities, or staining can be defined as a suspicious occlusal carious lesion (SOCL). The authors’ objective was to quantify the characteristics of SOCLs and their relationship to lesion depth and activity after these lesions were opened surgically. Ninety-three dentists participated in the study. When a consenting patient had an SOCL, information was recorded about the tooth, lesion, treatment provided, and, if the SOCL was opened surgically, its lesion depth. The Rao-Scott cluster-adjusted c2 test was used to evaluate associations between lesion depth and color, roughness, patient risk, and luster.

Key Words: Evidence-based dentistry; carious lesions; dentin.

JADA November 2017
This six article annual JADA supplement explores the benefits of baking soda and oral health. This supplement has been sponsored by Church & Dwight Co., Inc. All content has been peer reviewed by the designated editors of The Journal of the American Dental Association (JADA). The opinions or views expressed in this supplement are those of the authors, and do not necessarily reflect the opinions or views of The Journal, Church & Dwight Co., Inc., or those of the American Dental Association.

JADA November 2017
Objectives were to determine the likelihood that a clinician accepts an impression for a single-unit crown and document crown remake rates. The authors developed a questionnaire that asked dentists about techniques used to fabricate single-unit crowns. The authors showed dentists photographs of 4 impressions and asked them to accept or reject each impression. The authors correlated answers with dentist and practice characteristics. Other questions pertained to laboratory use and crown remake rates.

Abstract:

Part 4: Leading Your Patients- In this webinar, the dentist and team will discover the keys to converting a tenuous new patient inquiry to a committed first appointment and beyond. Patients will pay any fee if they like you, understand why treatment is being diagnosed and are committed to their care, because they felt partnered with and listened to!

JADA November 2017
In this systematic review and metaanalysis, the authors evaluated the pain during scaling and root planing with use of topical anesthetic versus that with the use of injected anesthetic in adult patients. The authors searched 6 databases for randomized clinical trials in which the investigators compared the clinical effectiveness of intrapocket and injectable anesthetics. The primary outcome was the risk of developing pain or intensity of pain. Quality assessment followed the guidelines from the Cochrane Collaboration’s risk-of-bias tool. The authors performed meta-analyses on studies considered at low and unclear risk of bias.

JADA November 2017
The authors examined the relationship between education debt and career choice, particularly dentists’ decisions to specialize, participate in public health insurance programs, and join dental management service organizations (DMSOs). The authors used data from the American Dental Association 2015 office database, which contains dentist demographic information and identifies dentists who participate in public health insurance programs for pediatric dental care services. The authors merged this database with the 2002-2015 American Dental Association Survey of Dental Graduates, which contains information about education debt, to assess the relationship between education debt and career choices. The authors used probit and multinomial logit models to determine the relationships among education debt, demographic characteristics, and dentist career choices.

JADA October 2017
An expert panel convened by the American Dental Association (ADA) Council on Scientific Affairs and the Center for Evidence-Based Dentistry conducted a systematic review and formulated clinical recommendations to inform primary care clinicians about the potential use of adjuncts as triage tools for the evaluation of lesions, including potentially malignant disorders (PMDs), in the oral cavity. This is an update of the ADA’s 2010 recommendations on the early diagnosis of PMDs and oral squamous cell carcinoma. The authors conducted a systematic search of the literature in MEDLINE and Embase via Ovid and the Cochrane Central Register of Controlled Trials to identify randomized controlled trials and diagnostic test accuracy studies. The authors used the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty in the evidence and to move from the evidence to the decisions.

JADA October 2017
Dentin hypersensitivity (DH) is a condition commonly encountered in clinical dental practice. The authors conduct a study to identify the treatments recommended to manage DH among dentists in the United States. The authors conducted a multicenter study of 1,862 patients with DH who received a diagnosis and were treated by 171 dentists with The National Dental Practice-Based Research Network.

JADA October 2017
In this study, the authors investigated whether extension of a tooth crack into the root can be predicted by the appearance of the crack in the crown in vitro. The authors obtained 22 cracked teeth from 22 patients who underwent extraction, and they scanned the teeth using microcomputed tomography. The length and width of the crack on the occlusal surface (LOS and WOS, respectively) and the length of the crack on the proximal surface (LCPS) were measured on 3-dimensional reconstruction images. The pulp chamber roof was penetrated and removed. A crack line visible under the microscope only on the access cavity wall rather than extending to the bottom of the pulp chamber was termed a “nonroot crack.” A crack seen at the bottom of the pulp chamber or root wall was termed a “root crack.” The authors analyzed the data using Pearson correlation coefficients and receiver operating characteristic curves.