bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
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.
Christianity and Religious Syncretism in Early Twentieth-Century China
Authors: Wang Xiaoxuan 
Published: August 2017

AbstractChristianity 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

Abstract
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

AbstractWe 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.
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

Abstract
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.
Health Care Expenditures and Utilization for Children With Noncomplex Chronic Disease
Authors: Hoefgen Erik R. , Andrews Annie L. , Richardson Troy , Hall Matthew , Neff John M. , Macy Michelle L. , Bettenhausen Jessica L. , Shah Samir S. , Auger Katherine A. 
Published: August 2017

BACKGROUND:
Pediatric health care expenditures and use vary by level of complexity and chronic illness. We sought to determine expenditures and use for children with noncomplex chronic diseases (NC-CDs).

METHODS:
We performed a retrospective, cross-sectional analysis of Medicaid enrollees (ages 0–18 years) from January 1, 2012, through December 31, 2013, using administrative claims (the Truven MarketScan Medicaid Database). Patients were categorized by chronicity of illness by using 3M Health Information System’s Clinical Risk Groups (CRGs) as follows: without chronic diseases (WO-CDs) (CRG 1–2), NC-CDs (CRG 3–5), and complex chronic diseases (C-CDs) (CRG 6–9). Primary outcomes were medical expenditures, including total annualized population expenditure and per-member per-year expenditure (PMPY). Secondary outcomes included the number of health care encounters over the 2-year period.

RESULTS:
There were 2 424 946 children who met inclusion criteria, 53% were WO-CD; 36% had an NC-CD; and 11% had a C-CD. Children with NC-CDs accounted for 33% ($2801 PMPY) of the annual spending compared with 20% ($1151 PMPY) accounted for by children WO-CDs and 47% ($12 569 PMPY) by children with C-CDs. The median outpatient visit count by group over the 2-year period was 15 (interquartile range [IQR] 10–25) for NC-CD, 8 (IQR 5–13) WO-CD, and 34 (IQR 19–72) for C-CD.

CONCLUSIONS:
Children with NC-CDs accounted for 33% of pediatric Medicaid expenditures and have significantly higher PMPY and aggregate annual expenditures than children WO-CDs. The annual aggregate expenditures of the NC-CD group represent a significant societal cost because of the high volume of children, extrapolated to ∼$34.9 billion annually in national Medicaid expenditures.