University Of Bristol Dental Hospital

Compare the diagnostic accuracy of measuring gingival recession (GR) using a digital ruler on intraoral scans with clinical measurements using a UNC-15 probe. A prospective, observational, examiner-blinded, single-arm, cross-sectional, single-site study in adults aged 18+ with minimum of 20 teeth. All participants underwent an intraoral scan. Clinical GR was recorded on 6-sites (non-molar teeth) and 8-sites (molar teeth) by the principal examiner. Anonymised scans were assessed by the principal examiner twice (Ex1a, 1b) and two additional examiners (Ex2 and 3). 109 participants were assessed; all had at least one site of buccal GR. Ex1a on-scan measurements compared to clinical measurements showed 66.9% sensitivity and 92.5% specificity. There were considerable differences between central and proximal sites, central sites showed greater sensitivity 77.0% and specificity 81.4% compared to proximal sites 38.5% and 97.2% respectively. Diagnostic precision was robust, agreement for intra-examiner variability (Examiner-1a vs 1b) was 98.5% (95% CI 98.1%-98.8%). Inter-examiner variability was 78.9% (95% CI, 77.0%-80.6%) for Ex-1a-Ex-2 and 86.2% (95% CI, 84.8%-87.5%) for Ex-1a-Ex-3. Intraoral scan measurements are reproducible and can be utilised with accuracy. Measuring GR clinically is the current gold standard despite the limitations, intraoral scans can be utilised to overcome these limitations.

New dental graduates are expected to have acquired the skills and behaviours to provide dental care for the population they serve. An ageing population and advances in medicine mean that there are increasing numbers of patients who may require Special Care Dentistry. Special Care Dentistry is the branch of dentistry concerned with access to equitable oral healthcare for people with disabilities and those who are disadvantaged. This study aimed to explore the teaching of Special Care Dentistry (SCD) within undergraduate (UG) dental curricula in the UK and Ireland. A cross-sectional online survey was distributed to all SCD teaching leads within 18 universities delivering undergraduate dental curricula in the UK and Ireland. Respondents described their curriculum, teaching and assessment, as well as the barriers and facilitators they faced. Qualitative responses were collected as open-ended text within the survey and coded independently by two authors. From 12 respondents (67% response rate), the average time given to SCD during training over the whole UG programme was reportedly 47.4 h. While 83% (n = 10) reported that students observed treatment delivery for special care patients, only 50% (n = 6) reported actual student-delivered care. Almost all (n = 10) applied the International Association of Disability and Oral Health curriculum, as recognised by the Association of Dental Education Europe (ADEE). Attitudes towards SCD from academic staff outside of the specialty were seen as the biggest barrier to SCD teaching, whereas the availability of academic staff and emphasis on SCD within the curriculum were facilitators. The teaching of SCD in dental schools in the UK and Ireland is markedly varied, with respondents highlighting barriers to the delivery of teaching and learning in this area. There is a persistent need to standardise undergraduate exposure to patients requiring Special Care Dentistry across Ireland and the UK. This will equip the future dental profession to adequately and equitably care for the whole of society, regardless of ability.

Scars resulting from surgical repair of cleft lip and palate provide a unique model in humans for studying factors that affect the severity of scarring. Anatomically, clefts of the lip and palate are consistent in location and are treated surgically with similar methods and timing. This contrasts with the considerably greater variability observed in traumatic injuries, burns or emergency surgical procedures and the scars resulting from these cause tissue damage. Clinical audit protocols for cleft lip and palate ensure that data on outcomes for appearance, function and wellbeing are collected at standard points in a child's development and are followed-up over time, permitting cross sectional and longitudinal analysis of scarring. Therefore, enhancing our understanding of the impact of genetics and environmental factors on scar severity following surgical repair of clefts can provide information on factors that may be associated with scarring from other insults, where uniform data are not available. Animal models offer opportunities to investigate factors that could influence scar severity and overall repair quality. In this review, we will discuss the possibilities for scarring research in cohorts of children born with cleft defects and the advantages of using different animal models for studying the mechanistic drivers of variation in scar severity.

The online version contains supplementary material available at 10.1007/s12187-025-10294-y.

Mini-screw-assisted rapid palatal expansion (MARPE) has become a popular approach for arch expansion in cases with maxillary transverse deficiency. Minimal high-quality studies were found regarding MARPE. There was a great degree of heterogeneity among the studies with regards to age of use, expansion protocol, appliance design and mini-screw dimensions and placement. There is a suggestion that MARPE is best performed on those under the age of 30. The literature suggests the degree of buccal tipping of teeth is comparable to that of rapid maxillary expansion (RME) and surgically assisted rapid palatal expansion (SARPE). However, other side effects included root resorption, periodontal damage and loss of buccal alveolar bone height. Studies on upper airway volume suggested there may be a positive correlation between MARPE and upper airway volume, but future clinical studies are required to make more definitive conclusions about MARPE. CPD/Clinical Relevance: A review of the literature regarding mini-screw-assisted rapid palatal expansion is reported and includes design protocols and clinical considerations.

Adiposity has been associated with an increased risk of head and neck cancer (HNC). Although body mass index (BMI) has been inversely associated with HNC risk among smokers, this is likely due to confounding. Previous Mendelian randomization (MR) studies could not fully discount causality between adiposity and HNC. Hence, we aimed to revisit this using the largest genome-wide association study (GWAS) of HNC available, which has more granular data on HNC subsites. We assessed the genetically predicted effects of BMI (N=806,834), waist-to-hip ratio (WHR; N=697,734) and waist circumference (N=462,166) on the risk of HNC (N=12,264 cases) and its subsites using a two-sample MR framework. We used inverse variance weighted (IVW) MR and multiple sensitivity analyses, including multivariable MR (MVMR), to explore the direct effects of the adiposity measures on HNC, while accounting for smoking behaviour (a well-known HNC risk factor). In univariable MR, higher genetically predicted BMI increased the risk of overall HNC (IVW OR = 1.17 per 1-SD higher BMI, 95% CI 1.02-1.34). However, the IVW effect was attenuated when smoking was included in the MVMR model (OR accounting for comprehensive smoking index = 0.96 per 1-SD higher BMI, 95% CI 0.80-1.15). Furthermore, we did not find a link between genetically predicted WHR (IVW OR = 1.05 per 1-SD higher WHR, 95% CI 0.89-1.24) or waist circumference and HNC risk (IVW OR = 1.01 per 1-SD higher waist circumference, 95% CI 0.85-1.21). Our findings suggest that adiposity does not play a major role in HNC risk. FMB was supported by a Wellcome Trust PhD studentship in Molecular, Genetic and Lifecourse Epidemiology (224982/Z/22/Z). RCR was supported by a Cancer Research UK grant (C18281/A29019). MCB is supported by a University of Bristol Vice Chancellor's Fellowship, the British Heart Foundation (AA/18/1/34219) and the UK Medical Research Council (MC_UU_00032/5). GDS works within the MRC Integrative Epidemiology Unit at the University of Bristol, which is supported by the Medical Research Council (MC_UU_00032/1). CLR was supported by the Medical Research Council (MC_UU_00011/5) and by a Cancer Research UK (C18281/A29019) programme grant (the Integrative Cancer Epidemiology Programme). SV was funded by an EU Horizon 2020 grant (agreement number 825771) and NIDCR National Institutes of Dental and Craniofacial Health (R03DE030257). JK works in a unit that receives support from the University of Bristol, a Cancer Research UK grant (C18281/A29019) and the UK Medical Research Council (grant number: MC_UU_00032/7).

The General Dental Council's Safe Practitioner Framework sets out the required behaviours and learning outcomes for UK graduates across four domains, and social accountability is a new competency in the domain of professionalism. Community engagement is a type of community-based education, which has been advocated as a promising pedagogical approach to help institutions produce socially accountable graduates. It is conceptualised as a form of experiential education which uses community exposure educational programmes or activities (i.e., students are exposed to the population/community of interest usually in a non-clinical setting) to highlight and address community health care needs. Community engaged education can help students appreciate the role of the social determinants of health in shaping oral health; provide opportunities to improve empathy, cultural competence and sensitivity; improve interpersonal skills and communication; and may open the eyes of new graduates into the importance of social justice and health equity in their future professional practice. This paper will describe the key terms involved in social accountability and will discuss some of the benefits of community engaged education in the context of the Safe Practitioner Framework reflecting on the evidence from the international healthcare literature.