Abstract Guidelines

Title: Dentin Biomodification Induced by a New Source of Proanthocyanidins

Objectives: Dentin biomodification with Rhodiola rosea (Rr) increase mechanical properties of the dentin matrix and consequently become suitable to enhance the adhesion of dental resins to dentin. To determine effects of fractions from Rr on dynamic mechanical properties of dentin matrix and dentin-resin microtensile bond strength.

Methods: Fractions containing different degree of polymerization of proanthocyanidins from Rhodiola rosea extract (Rr_crude) were produced by centrifugal partition chromatography (Rr₁, Rr₂, Rr_3, Rr₄ Dentin). Mid-coronal dentin of human molars (0.5 x 1.7 x 7 mm) was demineralized in 10% phosphoric acid and dynamic mechanical properties assessed at baseline and after 1h-treatment with Rr₁, Rr₂, Rr₃ and Rr₄ and Rr_crude; prepared at 0.65 w/v % at pH7.2. Two active fractions (Rr₂ and Rr₄) were selected for resin-dentin microtensile bond strength (TBS) test. Occlusal dentin surfaces (n=3) were etched (35% Glycolic Acid for 15 s), primed (6.5% w/v of Rr₂ and Rr₄ for 1 min) and bonded (experimental methacrylate resins). After 24 hr, specimens were tested under tensile at 0.5mm/min. Complex modulus and Tan ∆ were statistically analyzed by 2-way ANOVA and Games-Howell; and TBS by One-Way Anova and Tukey (α=0.05).

Results: Statistically significant differences were observed between groups Rr₁<Rr₂ (p=0.011), Rr₁<Rr_crude (p=0.011), Rr₂>Rr₄ (p=0.013), Rr₄<Rr_crude (p=0.01), all treatments>Control (p<0.05) in Complex Modulus. The Tan ∆ values increased after treatment with Rr, with Rr₂>Rr₄ (p=0.012), Rr₄<Rr_crude (p=0.012) and all treatments>Control (p<0.001). No differences in TBS were observed between Rr₂ and Rr₄; both pre-treatments resulted in statistically higher bond strength (p=0.021) as compared to control.

Conclusions: An average 10-fold increase in the complex modulus of dentin matrix were found for Rr_crude and Rr₂. Galloylated PAC Dimer and Trimer are likely the most bioactive PAC compounds. One-minute application of priming solutions from Rr fractions increased dentin-resin bond strength.

Research Approval: IRB Protocol 2011-0312

Research Funding: NIH R01 DE021040

Title: E-Typodont’s Enhancement of Patient’s Oral Health Literacy Regarding Dental Implant

Objectives: The purpose of this study is to investigate the understanding of implant treatment procedure, components, and sequences by using three teaching tools: implant website, typodont, and AR e-typodont for patient education. The Hypotheses are: 1) Patient knowledge regarding implant treatment procedure, components, and sequences increase after intervention with 3 different methods. 2) AR apps can significantly enhance patient’s oral health literacy regarding implant treatment procedure, components, and sequences compared to other methods.

Methods: Patients with dental treatment at the group practice and implant clinic at the UIC College of Dentistry were invited to enroll in this study. Inclusion criteria: Adult (>18 years), do not have any dental implants, speak and read English. A 5-point Likert scale survey was created and approved by the IRB Protocol. This survey was administered to patients before the dental procedure to determine their understanding of implant treatment procedures, components, and sequences.  The patient was then exposed to an intervention (AR e-typodont, typodont, or dental implant website) and allowed 15 minutes to study and interact with the intervention.  After 15 minutes, the subject was asked to fill out two surveys to assess the tool’s patient-perceived usefulness. Lastly, the patient was asked to fill the same post-Likert-scale survey.  Ninety subjects participated in the study.

Results: The Pre vs Post test scores revealed that the e-typodont had the highest increase in scores for understanding implant treatment, its components, and treatment sequences followed by the implant website, then the typodont.  The e-typodont also had the highest scores for perceived usefulness and patient perception.

Conclusions: E-typodont proves to be an excellent teaching tool for students and patients alike. Patients found the e-typodont to be the most interesting, interactive, educational, user friendly and “wow”. Patients reported the highest scores for learning about implant components and treatment sequences through the e-typodont platform.

Research Approval: IRB Protocol 2021-0010

Research Funding: None

Title: Assessing the Impact of Experiential Learning on Future Dental Careers

Objectives: Low educational status, income disparity, race discrimination, and social determinants are upstream factors that force millions of Americans to forgo dental treatment each year. The purpose of this study is to investigate the influence of experiential learning via extramural rotations on dental students’ intention to treat underserved populations after graduation. This submission continues from a previous study by considering data from two additional years, both during the height of the COVID-19 pandemic. We hypothesize that upon completion of extramural rotations, students will be significantly more inclined to provide care to underserved populations. Further, we expect to see an increased inclination to treat underserved populations after students experienced the COVID-19 pandemic.

Methods: Data for this report was collected through an anonymous survey that was administered to D4 and AS4 students prior to graduation in 2019, 2020, and 2022. Qualitative data was coded using an inductive technique for descriptive analysis. Quantitative data was recorded using a 5-point Likert scale and analyzed via bivariate analysis.

Results: Statistical analysis is currently underway. If the findings support our hypothesis, we would expect to see a statistically significant association between an increased number of rotations completed and an increased influence on plans to treat underserved populations. We would also expect this association to grow stronger as students experienced the COVID-19 pandemic. Lastly, we would expect to find that location and student loans continue to be primary barriers preventing students from serving this population.

Conclusions: Similar to the previous study, these results have the potential to support a call for increased experiential learning opportunities to be integrated into dental school curriculum. Further, the inclusion of responses from during the COVID-19 pandemic may provide insight on the impact that major public health events have on dental students and their inclination to work with underserved populations.

Research Approval: IRB protocol 2017-0767

Research Funding: ADEA ADCFP

Title: Appointment Adherence Following General Anesthesia in High-Risk Pediatric Dental Patients

Objectives: Children who receive dental care under general anesthesia (GA) for early childhood caries have historically high rates of caries recurrence and irregular preventive care. The purpose of this study was to evaluate post-operative follow-up appointment adherence following GA and its association with returning for preventive recall visits within 12 months of GA. We hypothesize that there will be an association with post-operative follow-up appointments and adherence to a subsequent preventative visit within 12 months. Specifically, patients who attend post-operative follow-up appointments will be more likely to return for a preventative recall.

Methods: This retrospective chart review included all children (ASA I or II) who had GA completed Sep-Dec 2020 in a post-graduate university-based surgical center. Demographics, post-operative follow-up adherence, and dental care received from the same clinic within 12 months following GA was collected. If patients returned, data were collected on caries recurrence and whether visits were preventive vs. emergency. Descriptive statistics and bivariate analysis (Chi-Square test) were used.   

Results: 122 children with a mean age of 4.98 years (SD 1.18) at the time of GA met inclusion criteria. Ninety-four patients (77%) attended post-operative follow-up visits (mean=14.15 days after GA); 65 patients in this subgroup never returned for a subsequent recall visit. Among the total sample, 34 patients (28%) attended a preventive visit and 6 (5%) had an emergency appointment within 12 months. There was no significant association between attending a follow-up visit and receiving subsequent preventive care (P=.233).  

Conclusions: The majority of patients adhered with the post-operative follow-up visit, but most did not return within 12 months for preventive care. Families may deem GA as curative and undervalue the need for subsequent preventive care or may utilize GA for tertiary care and return to a community provider.

Research Approval: IRB Protocol 2021-1250

Research Funding: None

Title: Implant Solutions for the Extreme Wear Patient: A Case Report

Objectives: Occlusal tooth wear holds significant importance in dentistry reflecting gradual loss of tooth structure due to various factors. Causes such as malocclusion, erosion, parafunctional occlusal habits and loss of posterior support lead to functional and esthetic concerns influencing treatment planning for full mouth rehabilitation. The severe wear of anterior teeth and collapse of posterior teeth present a substantial challenge when determining the most favorable restorative treatment option.

Methods: This case report outlines the surgical and prosthetic methodologies employed for the comprehensive full mouth implant rehabilitation of a 79-year-old male with a history of bruxism. The patient presented with a mutilated dentition, confirmed loss of occlusal vertical dimension and poor esthetics.

Results: The desired maxillary anterior tooth position and posterior esthetic plane were established with wax-rim. Upon confirming the compatibility of the new vertical dimension, CAD-CAM technology was used to design dual arch stackable surgical guides and to fabricate a PMMA full arch provisional. After osteotomy and implant placement with surgical guide, implant supported PMMA full arch provisional was immediately converted. Prototype based on optimized provisional as reference will be fabricated and tried in prior to the delivery of definitive milled full arch Monolithic Zirconia prosthesis.

Conclusions: The increasing prevalence of the severely worn dentition due to bruxism necessitates meticulous diagnosis and personalized treatment for predictable outcomes. The integration of a digital workflow from treatment plan to surgical and restorative process offers a synergistic approach for the rehabilitation of such patients to ensure predictable optimal esthetic and function outcomes with lasting efficacy.

Title: The Influence of Oral Inflammation on Timing of Dental Eruption

Objectives: To review the literature for studies evaluating whether oral inflammation causes early tooth eruption in obese children. To identify prospects for future research.

Methods: A search using Google Scholar, NCBI and PubMed databases was conducted using the MeSH terms “childhood obesity”, “dental exfoliation”, “pediatric dentistry”, and “growth and development”. Specifically defined inclusion and exclusion criteria were applied and 20 articles were selected for the final detailed review.

Results: Obesity is a growth-promoting process as evidenced by its effect on the timing of puberty. Although studies are limited, oral inflammation has been shown to affect the timing of tooth eruption. Both the timing and sequence of tooth eruption are important to overall oral health. Obese children may have differential patterns of jaw growth and higher levels of key pro-inflammatory biomarkers, which may correspond with increased tooth movement.

Conclusions: Obesity is a systemic disease with important effects on oral health. There is currently a lack of data on the impacts of oral inflammation on dentofacial growth. Data in today’s current literature indicate that childhood obesity and oral inflammation impact timing of dental maturation, specifically; obese children develop and erupt their teeth at younger ages than non-obese children do.

A Critically Appraised Topic (CAT) is defined as a “short summary of a search and critical appraisal of the best available evidence in literature related to a focused clinical question to help make clinical decisions”.  It is a short type of systematic review that provides an assessment of what is known about an intervention or issue by searching and appraising relevant studies.

A CAT is patient-centered and based on “real-life” clinical scenarios.  Critical appraisal is one of the key steps of evidence-based decision making, which involves assessing the strengths and limitations of the most relevant and best available research literature.  Evidence-based dentistry is an integration of best available evidence with clinical expertise and patients’ needs and preferences.  The primary objective of evidence-based practice is to improve the quality of healthcare and patient outcomes.  CATs are essential tools for busy clinicians who wish to practice evidence-based dentistry.  Utilizing CATs can bring evidence-based tools to the chairside to make patient-specific decisions.

Parts of a CAT: “Ask, Search, Appraise, Apply, and Evaluate”

1. Ask: Define a clear, concise, and focused question – Asking a focused and answerable question that translates uncertainty to an answerable question; use a search framework such as PICO to help.
2. Search: Develop a search strategy – Searching for the best, highest quality evidence available, identify search terms, work out how to combine them, and select a limited number of appropriate databases.  Include details such as date of search and number of reviewers among these methods. Identify the relevant studies that help answer your question.
3. Appraise: Critically appraise the located evidence – Critically appraising the evidence for validity and clinical relevance, describe and appraise the included studies such as the methodological appropriateness of each study.
4. Apply: Application of the results to clinical practice – Carefully consider the applicability/generalizability of the evidence to the clinical patient scenario.  Summarize and translate into clinically useful measures of accuracy, efficacy, or risk.
5. Evaluate: Evaluation of performance – Prepare a one-page summary evaluating the effects of the topic on improving patient care while sharing and spreading knowledge with colleagues:  What’s the “bottom line” suggested by the evidence?