bluuebunny/crossref_metadata_2025 huggingface dataset:
Current status of conservative treatment of deep carious lesions
Authors: Mattos Juliana , Soares Giulia Marins , Ribeiro Apoena de Aguiar
Published: August 2017

Traditionally, deep carious lesions are treated by removal of all carious tissue, which may lead to pulp exposure. To minimize this risk, conservative carious tissue removal techniques have been proposed, including partial removal and stepwise excavation. However, there is no consensus in the literature about which is the better technique. Thus, the aim of this article is to describe and discuss the main techniques for carious tissue removal, according to scientific evidence. It was observed that both stepwise excavation and partial carious tissue removal presented lower pulp exposure rates and higher success rates.

Clinical Relevance: Clinicians must be aware that conservative carious tissue removal techniques, such as stepwise excavation and partial carious tissue removal, present lower pulp exposure rates and higher success rates than traditional methods.
Smile analysis: what to measure
Authors: Batwa Waeil , Grewal Balpreet , Gill Daljit
Published: August 2017

Patients seek dental treatment to improve oral function as well as their attractiveness. In order to improve smile attractiveness, clinicians need to carry out a comprehensive smile assessment. The aim of this paper is to help clinicians to adopt a systematic approach toward smile assessment by introducing a smile assessment form.

Clinical Relevance: Smile analysis is an essential part of smile diagnosis. A smile assessment form will assist clinicians in identifying and recording smile features for diagnosis and treatment planning.
Post removal techniques part 1
Authors: Dickie Jamie , McCrosson John
Published: August 2017

Dismantling restorations from teeth which require endodontic re-treatment can be difficult. Many dentists are reluctant to remove posts through fear of weakening, perforating or fracturing the remaining root structure. A variety of techniques have been described and developed for post removal. This is the first in a series of two papers which provide an overview of these techniques. The rationale for endodontic re-treatment, pre-operative assessment and factors affecting post removal are discussed. Techniques are illustrated with clinical case reports.

The second paper describes the use of specific post removal devices and the removal of fibre posts.

Clinical Relevance: Endodontic re-treatment has a more successful long-term outcome than surgical treatment for failed root canal treatment. This may involve the removal of existing post restorations or portions thereof.
Dental implications of new oral anticoagulants for atrial fibrillation
Authors: Curtin Claire , Hayes Jamie M , Hayes S Jeremy
Published: August 2017

As dental professionals, we should all be familiar with the most common oral anticoagulant, warfarin, and how to manage our patients that are taking it. However, several new oral anticoagulants which have recently been approved by the National Institute for Health and Care Excellence (NICE) are now being prescribed for patients in the United Kingdom. These new oral anticoagulants fall into two different categories: a direct thrombin inhibitor dabigatran etexilate (Pradaxa® Boehringer-Ingelheim, Bracknell, Berkshire) and activated Factor X inhibitors rivaroxaban (Xarelto® Bayer HealthCare, Newbury, Berkshire) and apixaban (Eliquis® Bristol-Myers Squibb, Uxbridge, Middlesex). These new drugs will have potential consequences for how dental practitioners manage patients requiring dental treatment, especially extractions and minor surgical procedures.

Clinical Relevance: It is important that dentists are aware of new anticoagulants which are being prescribed for patients to ensure that they receive safe and appropriate dental treatment. As healthcare professionals we should also be aware of how and when to report adverse drug reactions.
In vivo exposure therapy for the treatment of an adult needle phobic
Authors: McDonnell-Boudra Dee , Martin Amy , Hussein Iyad
Published: August 2017

Dental anxiety is a widespread problem. Behavioural interventions are effective in reducing dental anxiety and dentists are well placed to carry out these interventions. This article aims to familiarize dentists with simple behavioural techniques that can be used to treat patients presenting with dental anxiety. A case study detailing the assessment and treatment of an uncomplicated needle phobia using in vivo graded exposure is included in order to demonstrate the use of these techniques.

Clinical Relevance: Familiarity with simple, behavioural interventions for dental anxiety will enable dentists to respond appropriately to patients who present with mild fear and anxiety. Early intervention may play a role in the reduction of phobic anxiety in the dental setting. Dentists with an interest in behavioural management may also wish to treat patients with uncomplicated dental phobia.
Local drug delivery in the management of periodontal diseases part 2: specific agents
Authors: Eastham Jane E , Seymour Robin A
Published: August 2017

Local drug delivery systems (LDDs) are mainly used as adjuncts to root surface instrumentation (RSI) in the management of periodontal disease. A range of antibacterial agents have been used for this purpose and include the tetracyclines, chlorhexidine, metronidazole, azithromycin, clarithromycin and moxifloxacin. More recently, other non-antibacterial agents have been incorporated into local delivery devices and include simvastatin, metformin and alendronate. This paper will review the effectiveness of such agents when used as an adjunct to conventional non-surgical periodontal therapy.

Clinical Relevance: The benefits of adjunctive use of local drug delivery in the management of periodontal disease will be discussed.
Comparative case report of segmental odontomaxillary dysplasia and regional odontodysplasia
Authors: Clark Stephanie L , Cairns Alison M , Hunter Keith D
Published: August 2017

The clinical and radiological features of segmental odontomaxillary dysplasia (SOD) are well described but the condition is probably under recognized owing to misdiagnosis as an atypical form of regional odontodysplasia (ROD). Two cases are compared to highlight the differences between SOD and ROD. The clinical, radiographic and histological findings are compared using case reports of a 6-year-old male with SOD and a 4-year-old girl with ROD. Treatment and follow-up for these patients is described, along with a comparative review of the major characteristics of these two rare conditions.

Clinical Relevance: To help the paediatric dentist distinguish between these two rare conditions.
Articaine hydrochloride: is it the solution?
Authors: Kakroudi Seyed Hamzeh Aghaie , Mehta Shamir , Millar Brian J
Published: August 2017

In recent times there has been raised interest regarding the use of articaine hydrochloride as a dental local anaesthetic solution. The use of articaine hydrochloride as a dental local anaesthetic agent has been reported to be safe and effective. Paraesthesia is a rare but unwanted adverse effect attributed to the use of this local anaesthetic in dentistry, particularly following the administration of a nerve block injection. There is no evidence to support the opinion that the use of articaine carries a greater associated risk of paraesthesia than with the use of any other local anaesthetic.

Clinical Relevance: The aim of this article is to review the relative merits of articaine hydrochloride against its documented potential drawbacks. The article will also aim to update readers on the use of articaine hydrochloride for local analgesia in dentistry, including the pharmacology, efficacy and safety concerns (including the risks of nerve paraesthesia) commonly associated with the administration of this agent.
Idiopathic radiographic apical root resorption in wind instrument players
Authors: Shafi Imran , Welbury Richard
Published: August 2017

Root resorption of the permanent teeth involves an elaborate interaction among inflammatory cells resulting in loss of dental hard tissues. This report describes three clinical cases where idiopathic root resorption occurred in wind instrument playing patients. These patients produce adequate non-orthodontic forces, while playing their instruments, to expose their teeth to root resorbing force. Careful clinical monitoring of patients' teeth should be undertaken, as the additive effects of orthodontic treatment and musical habits are unknown.

CPD/Clinical Relevance: This paper advises that questioning about wind instrument playing during case history-taking would be beneficial to clinicians. Furthermore, careful clinical monitoring of these patients' teeth during orthodontic treatment should be undertaken.
Case report: an unusual finding of a solitary bone cyst in a patient with a fractured mandible
Authors: Chell Melanie , Idle Matthew , Green Jason
Published: August 2017

Solitary bone cysts are uncommon. They have a reported incidence of 0.6% and are commonest in the mandible. The case of a 16-year-old patient who attended Accident and Emergency with a fractured mandible and the incidental finding of a solitary bone cyst is presented. Solitary bone cysts are usually asymptomatic and generally heal fully following surgical exploration.

CPD/Clinical Relevance: This case report aims to increase awareness of the general dental practitioner of solitary bone cysts as a possible finding in patients with pathological jaw fractures and radiolucencies of the jaws. It outlines the surgical management that is carried out on patients with solitary bone cysts.
Pain part 1: introduction to pain
Authors: Renton Tara
Published: August 2017

This series of papers aims to provide the dental and medical teams with an update in pain, both acute and chronic orofacial conditions, relevant to dentistry and medicine. Pain is the most common symptom for patients presenting to their dentist, and is increasingly commonly presenting to doctors as well, in general practice and A & E departments. Most of the dental team take for granted their knowledge and ability to manage acute dental pain. However, the education and preparation in managing patients with chronic pain conditions remains poor in many medical and dental schools. Conversely, medics are better educated and exposed to chronic pain during their undergraduate education, however, with regards to orofacial pain education, exposure is diminishing due to decreased exposure to dentistry, ENT, otolaryngology, OMFS and oral surgery. Thus many clinical teams remain disadvantaged when diagnosing and managing orofacial pain.

Clinical Relevance: Significant advances that have been made in understanding the pain mechanisms are not to be overlooked and have a huge impact on how we manage patients in pain.
The francis report – the importance of person-centred health and care
Authors: Maher Shaun
Published: August 2017

The relational elements of care are often described as ‘soft skills’ or ‘nice to have’ but not essential in the modern world of evidence-based healthcare. Whether intentionally or unintentionally, this type of language relegates person-centred approaches to a lower status compared to other key aspects of quality, such as safety or financial performance.

Person-centredness is a powerful underpinning philosophy that has the potential to transform the way we deliver care and support as well as enhancing the quality of services. However, our healthcare system will not become more person-centred of its own accord. Thoughtful, deliberate action is required to support this change.

Clinical Relevance: The person-centred approach is vital in achieving safe, effective, efficient care.
Case report: fractured needle in the pterygomandibular space following administration of an inferior dental nerve block
Authors: Bailey Edmund , Rao Jeethendra , Saksena Alka
Published: August 2017

Fortunately, needle fracture is a rare complication following the administration of dental local anaesthetic. We present a case of needle fracture following administration of an inferior dental nerve block. The fractured needle was retrieved successfully under general anaesthetic. We also provide some suggestions on how to prevent needle fracture, and advice on how to manage the situation should it arise.

Clinical Relevance: Dental practitioners are the largest user group of local anaesthesia in the UK. It is important that practitioners are aware of the risks to the patient of needle fracture, how to minimize the risk of this occurring and be aware of how to manage the situation should it arise.
Mouth cancer for clinicians part 2: epidemiology
Authors: Kalavrezos Nicholas , Scully Crispian
Published: August 2017

A MEDLINE search early in 2015 revealed more than 250,000 papers on head and neck cancer; over 100,000 on oral cancer; and over 60,000 on mouth cancer. Not all publications contain robust evidence. We endeavour to encapsulate the most important of the latest information and advances now employed in practice, in a form comprehensible to healthcare workers, patients and their carers. This series offers the primary care dental team, in particular, an overview of the aetiopathogenesis, prevention, diagnosis and multidisciplinary care of mouth cancer, the functional and psychosocial implications, and minimization of the impact on the quality of life of patient and family.

Clinical Relevance: This article offers the dental team an overview of the changing epidemiology of, and increases in, mouth cancer.
Regulators and regulations: who will guard the guards? (or ‘quis custodiet ipsos custodes’ as old juvenal used to say)
Authors: Kelleher Martin
Published: August 2017

Overbearing regulators with their various labyrinthine regulations have had adverse impacts on dentists and their teams' behaviours. This has produced the perverse outcomes of demoralizing dental teams as well as reducing their capacity and/or desire to deliver compassionate oral healthcare. These adverse outcomes do not seem to have benefited patients, or dentists, or their teams, in any sensible or measurable way.

CPD/Clinical Relevance: The vastly increased burdens on the UK dental profession of intrusive, bullying regulations, emanating from the various UK agencies, such as the supposedly fair and independent GDC, but including the increasingly politically controlled NHS and the CQC, have had unfortunate, perverse, effects on many dentists' clinical practices and affected dental teams' desires, or willingness, to be as compassionate as they used to be about helping to solve some patients' dental or oral problems.
Maintenance and monitoring of dental implants in general dental practice
Authors: Tarawali Karifala
Published: August 2017

A lot of effort has been directed towards developing dental implant surfaces which in turn have seen the increased success rate of osseointegration. Peri-implantitis and peri-implant mucositis are inflammatory conditions of implants that can lead to implant failure. Monitoring and maintaining implant restorations is aimed at preventing these complications.

CPD/Clinical Relevance: As the number of patients opting for dental implants after tooth loss is increasing, general dental practitioners will be treating patients who have already had dental implants and need to know how to maintain and treat complications associated with them.
Pain-related temporomandibular disorder – current perspectives and evidence-based management
Authors: Ghurye Supriya , McMillan Roddy
Published: August 2017

Pain-related temporomandibular disorder (TMD) is one of the top three most common chronic pain conditions, along with headaches and back pain. TMD has complex pathophysiology and significant associations with a variety of other chronic pain conditions, eg fibromyalgia, irritable bowel syndrome and migraine. Chronic TMD is associated with a negative impact upon quality of life and high levels of healthcare utility. It is important that clinicians are able to diagnose TMD correctly, provide appropriate management in keeping with current evidence-based practice, and identify when to refer patients to specialist care. The presence of risk factors, eg anxiety, depression, pain-related disability and chronic pain conditions elsewhere in the body, may help to identify which TMD patients require referral for multidisciplinary management. TMD should be managed using a holistic approach, incorporating patient education and encouragement towards self-management. TMD care pathways should consider using the three ‘pillars’ of pain management: physical therapies, pharmacotherapy and clinical psychology.

CPD/Clinical Relevance: TMD is associated with considerable comorbidity and significant negative impact upon quality of life. It therefore follows that dental practitioners should keep up-to-date with the recent scientific evidence and recommendations relating to the diagnosis and management of TMD.
The implications of the new GDC standards for dental professionals
Authors: Craig Aubrey
Published: August 2017

This article is about the publication by the General Dental Council in 2013 of the Standards expected of those members of the dental team who are registered with the Council, on each of their Registers, and discusses the implications of the new Standards for dental professionals.

CPD/Clinical relevance: It is important that all dental Registrants are familiar with the current Standards publications.
Juvenile hyaline fibromatosis: impact of periodontal care on quality of life and a patient perspective
Authors: Yonel Zehra , Parmar Sabrina , Chapple Iain LC
Published: August 2017

Juvenile hyaline fibromatosis (JHF) is a rare autosomal recessive inherited condition presenting early in life and characterized by the accumulation of hyaline-like tissue in the skin as well as various organs. Gingival overgrowth is a significant oral manifestation. This paper highlights how early and essential periodontal intervention may be necessary to improve mastication and subsequent weight gain, and to eliminate pain and improve the patient's quality of life. Here we highlight the key features of this condition and demonstrate how appropriate surgical management can have a significant impact on a patient‘s wellbeing.

CPD/Clinical Relevance: Juvenile hyaline fibromatosis has a significant impact on patient wellbeing and it is therefore important that clinicians are able to recognize the condition and ensure that patients receive appropriate care and management.
Intercollegiate advisory committee for sedation in dentistry: review of the guidelines published in april 2015
Authors: Holroyd Isabelle
Published: August 2017

This review article considers the development of the Intercollegiate Advisory Committee for Sedation in Dentistry (IACSD) guideline produced by the four dental faculties of the Royal Colleges and the Royal College of Anaesthetists for conscious sedation use in dentistry. An outline of the scope of the document, which aims to set definitive standards for conscious sedation provision within the dental environment, is given. The IACSD guideline sets a national standard for all aspects of dental conscious sedation provision, from training of the team, environment requirements and clinical delivery; it is therefore a requirement that all dentists, doctors and healthcare professionals providing, or supporting, dental conscious sedation are aware of the content.

CPD/Clinical Relevance: This article should help with the understanding of the development background, scope of the guideline and relevance to the dental practice of dental conscious sedation.
Modern endodontic planning part 2: access and strategy
Authors: Darcey James , Taylor Carly , Roudsari Reza Vahid , Jawad Sarra , Hunter Mark
Published: August 2017

Poor access and iatrogenic damage can result in failed root canal treatment. Understanding tooth anatomy improves access and ensures that the clinician is cleaning and shaping the whole root canal system. If a canal is missed treatment usually fails. This paper revisits tooth anatomy and discusses how to ensure that access is optimized, but not at the expense of precious tooth structure. The concept of multi-visit root canal treatment is also addressed with emphasis on the, often overlooked, aspect of temporization.

CPD/Clinical Relevance: Good anatomical knowledge of teeth is the cornerstone of endodontics. Once root treatment has begun the clinician must be logical about how many visits to take and how to temporize teeth between such visits.
Conservative prosthetic rehabilitation of medication-related osteonecrosis of the jaw (MRONJ)
Authors: Leven Alexandra Johanna , Preston Antony J
Published: August 2017

Osteonecrosis of the jaw associated with bisphosphonates and other medications is a growing problem facing dentists. It can have a significant and debilitating impact upon patients. Various treatment options ranging from surgical intervention to management with antibiotics and analgesics have been proposed. This article presents one method of conservative treatment and prosthetic rehabilitation in a patient with ongoing BRONJ of the maxilla unsuitable for surgical management.

CPD/Clinical Relevance: Dentists need to be able to identify patients who are at risk of developing BRONJ and have an awareness of the appropriate management as well as potential oral rehabilitation options for these patients.
Tooth decorations and modifications – current trends and clinical implications
Authors: Sanghavi Sonam M , Chestnutt Ivor G
Published: August 2017

Since earliest times, humans have felt the need to modify and beautify their bodies. Adornments in the form of tooth decorations have featured around the world for generations and continue to evolve. This paper describes current and forthcoming trends. It explores the use of tooth jewels, ‘dental grills’ and tooth tattoos which are not yet common in the UK, but are currently trending in the United States of America. This article reviews the literature and aims to describe the clinical effects each tooth decoration has on the dentition, along with appropriate management strategies. Owing to the lack of good quality studies, it is difficult to determine accurate effects on the dentition, but dental practitioners should focus on conservative and preventive management strategies.

CPD/Clinical Relevance: This paper describes modern day tooth decorations, explores the possible effects on oral health and suggests management strategies.
Overtreatment in caries management? a literature review perspective and recommendations for clinicians
Authors: Ghosh Indrajeet , Dayal Prakriti , Das Samiran
Published: August 2017

Dentistry, like various branches in the healthcare profession, is susceptible to overtreatment, especially in the management of dental caries, due to the adoption of an aggressive restorative approach. This philosophy provides no actual benefits to the patient in terms of arresting the disease process, which initially led to the carious lesions. Yet practitioners routinely continue to initiate restorative treatment procedures without attempting to understand and alter the biologic factors contributing to the caries process. This paper examines the available scientific literature in this regard and makes recommendations to the clinicians of today based on the available evidence.

CPD/Clinical Relevance: The paper provides clinicians an approach to avoiding overtreatment by adhering to established clinical guidelines and accepted operative strategies.
Tackling the use of supari (areca nut) and smokeless tobacco products in the south asian community in the united kingdom
Authors: Chande Milan , Suba Krishna
Published: August 2017

The use of supari (areca nut) and smokeless tobacco products are seen as a major risk factor for oral cancer. There are increasing rates of oral cancer across the United Kingdom, along with the increase of the use of these products. This article examines the uses of such products amongst the South Asian Community and explores sensitive issues associated with the cessation of their use. Evidence-based recommendations are provided on how to provide advice and treatment to patients that regularly use these products. A rethink is also suggested on the policy of taxation of such products.

CPD/Clinical Relevance: With the rates of oral cancer increasing across the United Kingdom, it is important for us as dental professionals to tackle the use of areca nut and smokeless tobacco products.
Informed consent: what's new?
Authors: Bayliss Claire Louise
Published: August 2017

Informed consent has long been tried in the English courts using the Bolam test. This primarily tested the degree of professional negligence against the collective opinions of medical professionals. This principle is now considered outdated and the test of materiality now gives the individual patient shared decision-making during the consent process. Obtaining valid consent that will stand in a court of law and hold strong now involves a little more thought and time from the prudent dentist.

CPD/Clinical Relevance: Obtaining valid consent is an extremely important risk minimizing application of time for a skilled health care professional (HCP). If undertaken skilfully it can lead to improved patient satisfaction, minimize patient complaints and ultimately lessen the risk of practising HCPs having a negligence case brought against them.
Periodontal treatment in patients with learning disabilities part 1: prevention
Authors: Kaka Shazia , Dickinson Chris
Published: August 2017

People with learning disabilities are reported to have a significantly increased incidence and severity of periodontal disease when compared to their non-disabled counterparts. The reasons for this are numerous and may include perpetuating medical conditions, personal and social circumstances, as well as poor dental access and education. Uncontrolled or advanced periodontal disease may not only cause tooth loss and its ensuing consequences but may also affect medical health, initiating or causing deterioration of systemic disease. Despite being a significant public health issue, very few data exist in current literature about the periodontal needs and treatment of patients with learning disabilities. This may largely be because research in this group is difficult and the spectrum of learning disabilities is vast. This paper aims to report on the available data in order to produce suggestions for care. This paper forms a two part series, the first of which explores preventive strategies that may be used by general dental practitioners, as well as specialists within the field, to reduce the burden of periodontal disease within this specific patient group.

CPD/Clinical Relevance: Large health inequalities exist across the population, with those with learning disabilities exhibiting much higher levels of periodontal disease and unmet dental need. Helping to reduce these inequalities is the responsibility of all dental professionals.
Hand-held dental x-ray equipment – an update
Authors: Drage Nicholas
Published: August 2017

Hand-held dental X-ray equipment is increasingly being purchased for use in general dental practice. The aim of this paper is to update the practitioner with recently published recommendations on the requirements for hand-held devices. The article discusses the concerns often raised with the use of hand-held equipment including safety issues for the operator and the patient.

CPD/Clinical Relevance: It is important for dentists to be aware of the current guidance if considering the use of hand-held X-ray devices in their practice.
Treatment planning for mandibular third molars
Authors: Barraclough James , Power Andrew , Pattni Amit
Published: August 2017

NICE guidance for mandibular third molars has been available since 2000. This was set up to limit the surgical treatment of these teeth to symptomatic patients. There are numerous risks involved with surgical treatment of mandibular third molars and these should be explained in detail to the patient. Common and serious complications of mandibular third molar surgery are damage to the inferior alveolar and lingual nerve. Predicting the risk of inferior alveolar nerve injury is useful for treatment planning. The orthopantomogram (OPT) is the baseline special test for assessing this and numerous signs on an OPT can predict an increased risk of injury to the nerve. Cone beam computed tomography (CBCT) is being more frequently used to assess this relationship further and can influence treatment planning. Coronectomy is a technique whereby the crown of the tooth is sectioned and removed leaving the roots in situ. This has proven to be a useful technique in high risk cases, but is not without its own complications. The increase in availability of CBCT imaging and the recent resurgence of coronectomy as a treatment modality can increase the number of treatment options available to patients. We have proposed an algorithm to aid the treatment planning and informed consent processes associated with mandibular third molar surgery.

CPD/Clinical Relevance: This article is relevant to primary and secondary care dental practitioners as it will aid the investigation, treatment planning, correct referral and management of patients with problematic mandibular third molars.
Virtual reality exposure therapy for treatment of dental phobia
Authors: Gujjar Kumar Raghav , Sharma Ratika , Jongh Ad De
Published: August 2017

Virtual Reality Exposure Therapy (VRET) has gained in popularity as an effective treatment for anxiety disorders. The purpose of this article is to determine the applicability of VRET in the treatment of dental phobia of two patients. Two case examples of female dental patients, aged 56 and 24 years, who met the criteria for dental phobia according to the Phobia Checklist, illustrate the use of VRET in the dental setting. VRET that is used as a psychological treatment for dental fear and dental phobia can potentially be given by a non-specialist (for example dental assistant), thereby making it a cost-effective therapy for the treatment of dental phobia.

CPD/Clinical Relevance: This article is the first of its kind to demonstrate Virtual Reality Exposure Therapy (VRET) in the treatment of dental anxiety.
The immune system: basis of so much health and disease: 4. immunocytes
Authors: Scully Crispian , Georgakopoulou Eleni A , Hassona Yazan
Published: August 2017

The immune system is the body's primary defence mechanism against infections, and disturbances in the system can cause disease if the system fails in defence functions (in immunocompromised people), or if the activity is detrimental to the host (as in auto-immune and auto-inflammatory states). A healthy immune system is also essential to normal health of dental and oral tissues. This series presents the basics for the understanding of the immune system, this article covers cells of the immune system (immunocytes).

Clinical Relevance: Modern dental clinicians need a basic understanding of the immune system as it underlies health and disease.
Forensic dentistry now and in the future
Authors: Manica Scheila , Forgie Andrew
Published: August 2017

Forensic dentistry (odontology) deals with the examination, handling and presentation of dental evidence for the legal system. In the UK this work mainly involves criminal cases but in many other countries its remit also extends to civil litigation. There are four main aspects to forensic dentistry: single body identification, Disaster Victim Identification (DVI), age estimation and bite mark identification and analysis. This article provides a brief introduction to the topics and discusses potential future developments that aim to reduce the subjectivity in the analysis process and simplify presentation of evidence to non-dental parties.

CPD/Clinical Relevance: This article highlights ways that dental practitioners can assist legal investigations and, in particular, forensic dentists.
Whistleblowing in the NHS – freedom to speak up: a summary
Authors: Berman Anthony , Ogden Graham
Published: August 2017

Health Professionals have a duty of care to raise a concern if they believe a patient is at risk of harm. However, these interventions are not always welcomed by authorities. Sir Robert Francis' review, ‘Freedom to Speak Up’, published in 2015, was designed to address the reporting culture in the NHS. A symposium, ‘Freedom to Speak Out’, held at the Royal College of Physicians and Surgeons in Glasgow in September 2016, considered various aspects of whistleblowing. This article discusses the issues raised and provides advice for people raising concerns. It concludes with some reflections on Sir Robert's review.

CPD/Clinical Relevance: Dentists and Dental Care Professionals need to be aware of their duty of care to raise concerns when patient safety is at risk.
The aetiology, diagnosis and management of mandibular asymmetry
Authors: Chia Matthew SY , Naini Farhad B , Gill Daljit S
Published: August 2017

An understanding of the aetiology of mandibular asymmetry and a thorough methodical diagnostic approach is essential for the appropriate management of patients presenting with dentofacial asymmetry.

The aim of this review article is to describe the developmental, pathological, traumatic and functional causes of mandibular asymmetry, to provide a guide to diagnosis through clinical examination and special investigations and, finally, to outline the management of patients presenting with a mandibular asymmetry, focusing particularly on the treatment of developmental asymmetries.
Orthodontics and root resorption part 1
Authors: Barker Christopher S , Parvizi Farnaz , Weiland Frank , Sandy Jonathan R , Ireland Anthony J
Published: August 2017

The first article in this series of two aims to outline the biological processes which form the basis of orthodontically-induced inflammatory root resorption (OIIRR). It will also provide an overview of patient-related factors associated with OIIRR.
Clinical photography in an orthodontic practice environment part 2
Authors: Sandler Jonathan , Murray Alison
Published: August 2017

The previous part of this article discussed why to take clinical photographs and the benefit of high quality pictures to the clinicians as well as the patients. The second part of the article will describe contemporary photographic equipment and the many essential accessory products, as well as how best to store the images. In addition ‘Top Tips' will be proposed to allow the best possible results to be reliably achieved.
Factors associated with discontinued and abandoned treatment in primary care orthodontic practice part 2: a practice-based study
Authors: McDougall Neil I , McDonald Jim , Sherriff Andrea
Published: August 2017

Discontinued and abandoned cases are an undesirable outcome of orthodontic treatment. Several patient and treatment variables have been identified as being associated with this treatment risk. The second paper of this two part series will describe a study that attempts to identify specific factors that are implicated in discontinued treatment within a specialist orthodontic practice.

CPD/Clinical Relevance: Discontinued treatment is an unwelcome risk of orthodontic practice. By having a better understanding of the factors that may be relevant, clinicians can be more careful in their selection and management of patients suited to the demands imposed by orthodontic treatment.
Evaluating Commercially Available Antibodies for Rat α7 Nicotinic Acetylcholine Receptors
Authors: Garg Brijesh K. , Loring Ralph H.
Published: August 2017

Alpha7 nicotinic acetylcholine receptors (α7 nAChRs) are important drug targets in neurological disorders and inflammation, making their detection and localization by validated antibodies highly desirable. However, tests in knockout animals raised questions about specificity of antibodies to mouse α7 nAChRs. To date, methods for validating antibodies for rat or human α7 nAChR have not been reported. We developed a gel-shift assay for western blots using GH4C1 cells expressing either native rat receptors or α7 nAChR-green fluorescent protein (GFP) chimeras to evaluate seven commercially available α7 nAChR antibodies. Blots with anti-GFP antibody detected GFP or α7 nAChR-GFP expressed in GH4C1 cells, and 125I-α-bungarotoxin binding and RNA analysis demonstrated α7 nAChR expression. Validated samples were used to evaluate α7 nAChR antibodies by western blot and immunofluorescence studies. These methods confirmed that two of seven α7 nAChR antibodies identify gel-shifts for α7 nAChR/nAChR-GFP but only one antibody demonstrated low background and significant immunofluorescence differences between wild-type and α7 nAChR expressing GH4C1 cells. However, that polyclonal antibody displayed lot-to-lot variability. Our findings suggest that careful validation methods are required for all α7 nAChR receptor species and antibody lots and that the gel-shift assay may allow for relatively rapid antibody screening.
Aspectos Psicossociais da Depressão Pós-Parto: Uma Revisão Sistemática
Authors: Porto Romenia Alves Ferreira , Maranhão Thercia Lucena Grangeiro , Félix Waleska Maria
Published: August 2017

O presente artigo teve o objetivo de realizar uma Revisão Sistemática da Literatura sobre os aspectos psicossociais da depressão pós-parto no período de 2011 a 2016. A busca de dados foi feita nas bases de dados: Scielo, BVS, Pepsic e Pubmed. A pesquisa parte do interesse em compreender as prováveis alterações psicológicas e sociais acerca do conteúdo e contribuir na atualização do panorama geral de uma determinada área de interesse. A metodologia aplicada foi a revisão sistemática da literatura de cunho qualitativo. Foram selecionados 15 trabalhos que compuseram a amostra desta pesquisa. Os resultados encontrados apontaram para quatro eixos temáticos que foram alocados em categorias, são essas: Antecedentes da DPP; Aspectos psicossociais e epidemiológicos; Consequências da DPP e Políticas de intervenção. Observou-se que a maioria das pesquisas que compunham a amostragem dos artigos foram realizados empiricamente o que possibilita uma visão aplicada sobre as mulheres com DPP no Brasil. Sugere-se que as pesquisas futuras enfatizem as possíveis formas de tratamentos da DPP considerando a saúde coletiva.
Christianity and Religious Syncretism in Early Twentieth-Century China
Authors: Wang Xiaoxuan
Published: August 2017

Christianity in China is known to have been influenced by Chinese popular religion. Yet it is less known how much Christianity has influenced other religions in China. This article examines the syncretic trend of the early years of Republican China, which aimed at reinventing Chinese religions. I argue that as early as the 1920s, followers of Chinese religious traditions were appropriating various aspects of Christianity – from its symbols and institutions to its values – for their own ends. This trend was crucial for Christianity to become a part of Chinese religion and society.
Narratives of trust: sharing knowledge as a second-order emotion
Authors: Belli Simone , Broncano Fernando
Published: August 2017

Our aim is to examine why trust can be considered a second-order emotion and how the way in which trust plays out differently in aesthetic and ordinary contexts can provide another mode of investigating second-order emotions. Our thesis is developed in three sections and a conclusion.

In the first section, we perform an example analysis to show why narratives are important for our emotions. In the second section, we examine how trust can be considered a second-order emotion and establish criteria for identifying it as a second-order emotion. In the third section, we present one of the aims of trust, i.e. sharing knowledge between agents, when a testimony-giver shares knowledge in an epistemic trust process with others. We show how the relationship construction between persons thanks to trust, a second-order emotion that represents emotional ties between agents to achieve a first-order emotion.
New Approaches to Identifying State Fragility
Authors: Milante Gary , Woolcock Michael
Published: August 2017

We offer an alternative approach to the identification of state fragility – and in turn an alternative foundation for fragility assessment. Current practice relies almost exclusively on a single aggregate metric updated annually, uninformed by change or rate of change in the metrics. Our alternative proposes a more pragmatic three-stage process: the use of existing quantitative country assessments to determine relatively clear lower regions of concern and upper bounds beyond which countries are of less concern; a combination of the component elements of the country assessments and history to gage the trajectory of recent change; and qualitative insights drawn from regularly-updated “fragility assessments” to ensure that the idiosyncrasies of each case are taken into account when crafting specific policy and programmatic responses. Our analysis here is based on historical CPIA data complemented by data on violent deaths and displacement, looking ex post at institutional trajectories for IDA countries from 2005 to 2015. The approach we propose is not without its own risks and limitations, but is offered in the spirit of widespread concerns in the development community that prevailing strategies for assessing state fragility have demonstrably reached the limits of their effectiveness.
“Mirar mal” y “el descanso”. Indicios de las dinámicas intersubjetivas en educación de jóvenes y adultos / “Mirar mal” and "descanso”. Intersubjective dynamics sings in youth and adult education
Authors: Martínez Darío Gabriel
Published: August 2017

En esta investigación se analizarán dos categorías nativas, “mirar mal” y “descanso”, para comprender las relaciones intersubjetivas de los estudiantes que asisten a espacios de educación de jóvenes y adultos. La perspectiva de análisis se sitúa en el campo de comunicación/ educación que pretende trascender el reduccionismo que sitúa a la comunicación en los medios y a la educación en la escuela. Con estas observaciones presentes, el artículo busca reflexionar acerca de los procesos de construcción de subjetividades que atraviesan los y las jóvenes que se encuentran finalizando sus trayectorias educativas en la ciudad de La Plata, Argentina. Por otra parte, se esbozan elementos de conceptualización para reflexionar acerca de las subjetividades contemporáneas en el contexto de la cultura mediática.
Periodismo Especializado. Tomo II.
Authors: Padilla Castillo Graciela
Published: August 2017

Periodismo especializado. Tomo IIBeatriz Peña Acuña y Juan José Jover López (Coord.)Editorial ACCI ediciones, Madrid, 2017
Trace elements in the sea surface microlayer: rapid responses to changes in aerosol deposition
Authors: Ebling Alina M. , Landing William M.
Published: August 2017

Natural and anthropogenic aerosols are a significant source of trace elements to oligotrophic ocean surface waters, where they provide episodic pulses of limiting micronutrients for the microbial community. However, little is known about the fate of trace elements at the air-sea interface, i.e. the sea surface microlayer. In this study, samples of aerosols, sea surface microlayer, and underlying water column were collected in the Florida Keys during a dusty season (July 2014) and non-dusty season (May 2015) and analyzed for the dissolved and particulate elements Al, Fe, Ni, Cu, Zn, and Pb. Microlayer samples were collected using a cylinder of ultra-pure SiO2 (quartz glass), a novel adaptation of the glass plate technique. A significant dust deposition event occurred during the 2014 sampling period which resulted in elevated concentrations of trace elements in the microlayer. Residence times in the microlayer from this event ranged from 12 to 94 minutes for dissolved trace elements and from 1.3 to 3.4 minutes for particulate trace elements. These residence times are potentially long enough for the atmospherically derived trace elements to undergo chemical and biological alterations within the microlayer. Characterizing the trace element distributions within the three regimes is an important step towards our overall goals of understanding the rates and mechanisms of the solubilization of trace elements following aeolian dust deposition and how this might affect microorganisms in surface waters.
Insights into the Evolution and Function of Auxin Signaling F-Box Proteins in Arabidopsis thaliana Through Synthetic Analysis of Natural Variants
Authors: Wright R Clay , Zahler Mollye L , Gerben Stacey R , Nemhauser Jennifer L
Published: August 2017

The evolution of complex body plans in land plants has been paralleled by gene duplication and divergence within nuclear auxin-signaling networks. A deep mechanistic understanding of auxin signaling proteins therefore may allow rational engineering of novel plant architectures. Toward that end, we analyzed natural variation in the auxin receptor F-box family of wild accessions of the reference plant Arabidopsis thaliana and used this information to populate a structure/function map. We employed a synthetic assay to identify natural hypermorphic F-box variants and then assayed auxin-associated phenotypes in accessions expressing these variants. To more directly measure the impact of the strongest variant in our synthetic assay on auxin sensitivity, we generated transgenic plants expressing this allele. Together, our findings link evolved sequence variation to altered molecular performance and auxin sensitivity. This approach demonstrates the potential for combining synthetic biology approaches with quantitative phenotypes to harness the wealth of available sequence information and guide future engineering efforts of diverse signaling pathways.
Implementación de un traje termo regulable para control de Confort Térmico a fin de mejorar el rendimiento en el trabajo
Authors: Meléndres Medina Edison , Ricaurte Ortiz Paúl , Arboleda Álvarez Luis
Published: August 2017

El presente trabajo de investigación explica la incidencia del confort térmico en el bienestar, salud y rendimiento de los trabajadores de la tenencia política de San Juan, considerando que las actuales condiciones ambientales son de exceso de frío, los trabajadores utilizan uniformes que no les permite mantener una temperatura adecuada, acentuando los malestares físicos y psicológicos propios de las bajas temperaturas que hace que el trabajador se mantenga en un estrés térmico permanente, esto afecta no solo al individuo sino al desempeño en las tareas asignadas; bajo este panorama se diseñó e implementó el uso de un traje termo regulable que permite mantener condiciones óptimas de temperatura adaptables a cada individuo utilizando dispositivos electrónicos, obteniéndose así resultados positivos de los usuarios que permite comprender que se ha cumplido con los objetivos propios de seguridad industrial, salud ocupacional y prevención de riesgos aportando de manera auténtica al desarrollo de las actividades laborales, teniendo como premisa al ser humano, su bienestar y desarrollo.
Desarrollo de un Modelo de Pruebas Funcionales de Software Basado en la Herramienta SELENIUM
Authors: Chinarro Morales Evelyn , Ruiz Rivera María Elena , Ruiz Lizama Edgar
Published: August 2017

Este proyecto se enfoca en presentar un modelo de referencia tomando herramientas ya creadas para automatizar el proceso de realización de las pruebas funcionales durante la fase de evaluación de la calidad del producto desarrollado. Esta automatización contempla la evaluación de ciertas herramientas automatizadas de administración de pruebas, así como la automatización de pruebas funcionales.

El desarrollo del software y el logro de un servicio informático de primera calidad es lo que actualmente se logra con las pruebas funcionales hechas en la etapa de desarrollo. Este proceso es una parte muy importante y crítica dentro del proceso de desarrollo de software, y debe realizarse con la mayor eficacia y la mejor eficiencia. Durante el proyecto se conocieron los procesos actuales que forman parte de la metodología de desarrollo de aplicaciones, tanto teórica como práctica. Se evaluaron herramientas y metodologías para automatización de pruebas. Se consideró muy importante que las soluciones tanto metodológicas como técnicas apoyen aspectos como: encontrar defectos en fases más tempranas del desarrollo, lograr mayor y mejor cobertura de funcionalidad durante las pruebas, la ejecución de las pruebas viables en costo y tiempo.