Background/Objectives: Fixed orthodontic appliances interfere with oral hygiene and contribute to plaque retention, gingival inflammation and demineralization of enamel. Standard techniques for keeping oral hygiene (tooth brushing, mouthwashes, dental floss, interdental brush, etc.) are not sufficiently effective. The aim of this study was to investigate the effectiveness, safety, tolerability, and influence on quality of life of an electrolysis device being added to standard techniques of oral hygiene in orthodontic patients, compared to standard methods only. Methods: This 6-month study was designed as an observational prospective-cohort investigation. Primary outcomes of the study were indices of gingival inflammation and bleeding, dental plaque indices, the number of white spots on enamel, and safety (incidence of adverse events). Secondary outcomes were quality of life and overall costs of keeping oral hygiene. Results: The addition of the Neo Pill device to standard oral hygiene maintenance measures was associated with improvements in oral health indices after 6 months; however, given the non-randomized, preference-driven design, these findings reflect an association and should not be interpreted as evidence of causal efficacy. After 6 months, the primary outcomes of the study were significantly reduced compared to the application of only standard oral hygiene methods (from 21 to 55% reduction); the quality of life related to oral health was higher (for 14%), the tolerability of maintaining oral hygiene was the same as with standard measures and the costs of maintaining oral hygiene consumables were lower in the Neo Pill group (median difference 30%); however, this figure excludes the acquisition cost of the device itself, which was donated to all participants by the manufacturer, and the 95% confidence interval for this difference includes zero. Conclusions: The addition of an electrolysis device to standard oral hygiene maintenance measures in people wearing fixed orthodontic appliances was associated with improvements in gingival inflammation, papillary bleeding, and dental plaque indices-outcomes measured with established clinical instruments. Apparent reductions in white-spot lesion counts were also observed but should be considered exploratory given the absence of calibrated or blinded lesion assessment. These findings are preliminary and do not establish causal efficacy.
Background: Hand Hygiene (HH) plays a crucial role in preventing Hospital-Acquired Infections (HAIs), yet compliance and technique often remain inadequate. To our knowledge, this study is among the first large-scale Semmelweis Scanner-based evaluations of hand hygiene technique among both medical and non-medical students in Uzbekistan and the wider Central Asian region. Methods: A cross-sectional study was conducted between March 2024 and July 2025 at the Tashkent Medical Academy and the Tashkent State Technical University, resulting in 4191 data scans and 16,764 pictures analyzed. Hand surface coverage was evaluated using the Semmelweis digital monitoring system, which provides image-based feedback on insufficiently covered areas. Adequate performance was defined as achieving at least 95% hand surface coverage. Results: The findings showed that only 43.4% of hand hygiene measurements achieved the ≥95% hand coverage threshold, while 56.6% showed incomplete coverage. The sixth WHO-recommended step, i.e., rotational rubbing of the thumb and fingertips was identified as the most frequently missed moment. Significant variation was observed across faculties and departments, with bachelors achieving the highest success (n = 1012, 51.8%) and Ph.D. students reaching the lowest (18.4%). Conclusions: Hand hygiene technique among students in Uzbekistan is highly variable and frequently inadequate when evaluated using scanner-based digital assessment. The findings suggest that incomplete hand surface coverage, rather than the absence of sanitization attempts, is the principal challenge. Digital hand hygiene monitoring systems can provide an effective complementary tool for technique-focused education and can support infection prevention practices in both medical and non-medical training environments.
Poor food hygiene practices among food handlers contribute significantly to food-borne diseases and public health burden. Therefore, it is of interest to assess the food hygiene behavior of food suppliers working within the campus of Gandhi Medical College and Hamidia Hospital to determine the difference between pre- and post-test scores. This was a quasi-experimental pre- and post-educational intervention study conducted on the campus of Gandhi Medical College and Hamidia Hospital in Bhopal over 3 months. Descriptive statistics were depicted and McNemar's test was calculated on pre- and post-test proportions. The educational intervention significantly improved food handlers'understanding of food hygiene behavior, which is crucial for minimizing the risk of foodborne illnesses. Thus, we show that the food handlers exhibited inadequate food hygiene practices during the study.
This historical study examines the contribution of the Italian physician and anthropologist Paolo Mantegazza (1831-1910) to the early understanding of the relationship between sugar and dental caries. In his Elementi d'Igiene (1864), one of the most influential Italian manuals of public health, Mantegazza conducted a series of laboratory experiments to investigate whether sugar could chemically damage teeth. His results led him to conclude that sugar exerts no direct chemical action on enamel, but that its harmful effects depend on fermentation processes - an interpretation that anticipated, decades in advance, the modern microbiological explanation of caries. This work highlights Mantegazza's pioneering empirical approach, which reflected the emergence of experimental hygiene in 19th century Italy, even in the field of dentistry, and his broader commitment to promoting scientific knowledge as a tool for public education and preventive medicine.
The objective was to investigate associations among oral hygiene behaviors, periodontal awareness, and self-reported periodontal symptoms among adults using a cross-sectional questionnaire and an internally consistent awareness scoring system. This cross-sectional questionnaire study was conducted between October 2025 and February 2026 among adults aged 18-65 years. Of 412 returned questionnaires, 386 complete and eligible forms were analyzed. The 42-item questionnaire assessed sociodemographic variables, oral-hygiene behavior, dental attendance, previous periodontal care, awareness of periodontal signs, and self-reported symptoms during the previous six months. Awareness was scored from 0 to 20. Descriptive statistics, chi-square tests, t tests, one-way ANOVA with Tukey post hoc tests, and multivariable logistic regression were used. Mean age was 31.8 ± 9.6 years, and 58.0% of participants were women. Twice-daily toothbrushing was reported by 56.0%, and interdental cleaning by 38.6%. Mean awareness score was 12.7 ± 3.8. Awareness was higher among participants with university/postgraduate education, regular dental attendance, and interdental cleaning habits (all p < 0.001). Gingival bleeding was the most frequently reported symptom (47.4%). In the adjusted analysis, complaint-based dental attendance (OR = 2.43; 95% CI: 1.46-4.03; p = 0.001), current smoking (OR = 1.96; 95% CI: 1.17-3.29; p = 0.011), and no interdental cleaning (OR = 2.08; 95% CI: 1.31-3.30; p = 0.002) were independently associated with reporting at least one periodontal symptom. Within the limits of this observational survey, preventive attendance and interdental cleaning were associated with higher awareness and lower self-reported symptom burden.
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Hand hygiene remains one of the most important measures for preventing healthcare-associated infections, yet its implementation in routine clinical practice remains suboptimal. This study aimed to evaluate whether repeated hand hygiene retraining combined with adenosine triphosphate (ATP) bioluminescence feedback was associated with reduced ATP-assessed residual organic contamination on the hands of healthcare workers in a real-world hospital setting. We conducted a single-center before-and-after interventional study in 2025 at the County Emergency Hospital of Deva, Romania. Hand contamination was assessed using ATP bioluminescence testing, and results were categorized as low residual contamination (≤20 RLU), intermediate residual contamination (21-59 RLU), or high residual contamination (≥60 RLU). One ATP assessment was performed before and one after a repeated hand hygiene retraining program delivered during 2025. The primary outcomes were the change in mean ATP values and the change in ATP-defined contamination categories between baseline and post-intervention assessment. Mean ATP values decreased from 842 ± 210 RLU before the intervention to 312 ± 118 RLU after the intervention, corresponding to a 62.9% relative reduction (p < 0.01). At baseline, 17.1% of participants were classified as having low residual contamination, 25.7% as intermediate residual contamination, and 57.1% as high residual contamination. After the intervention, these proportions changed to 62.9%, 22.9%, and 14.3%, respectively (p < 0.01). Improvement was observed across all professional categories. Physicians showed the highest post-intervention proportion of compliant results (85.0%), followed by nurses (61.1%) and auxiliary staff (35.7%). ATP values decreased significantly in all seven departments, with relative reductions ranging from 61.0% to 63.4%. Repeated hand hygiene retraining combined with ATP bioluminescence feedback was associated with a substantial reduction in ATP-assessed residual hand contamination among healthcare workers in this hospital setting. The intervention was followed by both a marked reduction in ATP values and a favorable shift in ATP-defined contamination categories across departments and professional groups. Because ATP is an indirect and device-dependent marker of residual organic material, these findings should be interpreted cautiously and primarily as evidence of improved ATP-assessed hand cleanliness within the study setting rather than as direct evidence of WHO-defined hand hygiene compliance or microbiological decontamination.
This study aims to compare the effect of meibomian gland expression (MGX) combined with lid hygiene versus lid hygiene alone on the meibomian gland's morphology and function for obstructive meibomian gland dysfunction (oMGD). In this assessor-masked, parallel-group, randomized controlled trial, 64 oMGD patients with mild and moderate meibomian gland (MG) dropout were randomly allocated 1:1 into the MGX and control groups. All participants were informed to do lid hygiene once daily, while the intervention group received MGX every 2 weeks. The primary outcome was the change in MG dropout. Secondary outcomes included the Ocular Surface Disease Index (OSDI), tear stability, MG functions, changes in tear cytokine levels, and safety of MGX in a 12-week follow-up. Sixty-two eyes of sixty-two patients were enrolled in this study. The dropout area of MG decreased significantly in both groups following treatment at all time points. The recovery was faster in the MGX group at 4 weeks (p<0.001). However, no significant difference was observed between the groups after 8 to 12 weeks. Additionally, the MGX group also showed better improvement in OSDI and meibum quality than the control group, while no significant differences were observed between groups for other measures. No adverse events were reported, and the pain level was mild. MGX combined with lid hygiene results in a 13% reduction in MG dropout in the upper and lower eyelids. Moreover, the rate of improvement in MG morphology was faster in patients who underwent additional MGX than in those who performed lid hygiene alone.
This study aimed to evaluate the oral health and self-perceived status of juvenile female inmates. A cross-sectional study was conducted among 100 female juvenile inmates aged 11-14 years, selected through convenience sampling. Data were collected using a self-administered questionnaire covering sociodemographics, Decayed, Missing, and Filled Teeth (DMFT), Oral Hygiene Index-Simplified (OHI-S), and the Child Perceptions Questionnaire (CPQ11-14) for self-perceived oral health. Statistical analysis was performed using the Pearson correlation coefficient. Decayed, Missing, and Filled Tooth scores were significantly associated with CPQ categories, with 63.3% of caries-free children reporting excellent oral health-related quality of life (OHRQoL). As DMFT increased, OHRQoL declined-only 25.8% with DMFT = 2 reported excellent OHRQoL, while 12.9% rated it poor. Similarly, better oral hygiene was linked to higher OHRQoL: 55.6% of children with good hygiene reported excellent OHRQoL, compared to 40.6% with fair hygiene. Poorer clinical status correlated with lower self-perceived OHRQoL. The study highlights a clear link between poor oral health and negative self-perception among female juvenile inmates. Integrating oral health care with education and psychological support in detention settings is crucial to improve their overall well-being, self-esteem, and rehabilitation outcomes.
Background/Objectives: Gingival phenotype is considered an important factor influencing periodontal tissue response during orthodontic treatment; however, the association between orthodontic treatment history and gingival phenotype remains unclear. This study aimed to compare gingival phenotype between orthodontically treated individuals and untreated controls and to evaluate the factors associated with gingival phenotype, including periodontal status and oral hygiene habits. Methods: This cross-sectional comparative study included 180 individuals aged 18-35 years, who were divided into two groups according to orthodontic treatment history (history of orthodontic treatment, n = 90; untreated controls, n = 90). Gingival phenotype was assessed using the transparency method at the mid-buccal aspect of the mandibular central incisor. Periodontal parameters, including Plaque Index (PI), Gingival Index (GI), probing depth (PD), and keratinized gingival width (KGW), were recorded. Oral hygiene habits and behavioral factors were also evaluated. Binary logistic regression analysis was performed to identify factors associated with gingival phenotype. Statistical significance was set at p < 0.05. Results: No significant association was found between orthodontic treatment and gingival phenotype (p > 0.05). Periodontal parameters were comparable between groups; however, orthodontically treated individuals demonstrated significantly better oral hygiene habits (p < 0.05). Logistic regression analysis revealed that male sex (OR = 6.54, p < 0.001) and increased KGW (OR = 1.668, p = 0.003) were independently associated with a thick gingival phenotype. Conclusions: The findings indicate that gingival phenotype appeared to be more strongly associated with intrinsic anatomical factors, particularly sex and KGW, rather than orthodontic treatment. It was concluded that individualized assessment of gingival phenotype and controlled orthodontic tooth movement may contribute to periodontal preservation.
Introduction: Epidermolysis Bullosa (EB) is a rare genetic condition with skin and mucosal fragility. Patients with EB present extra- and intraoral manifestations that can limit their access to dental treatment, including orthodontic treatment. This research aims to determine the barriers, benefits and complications of orthodontic treatment reported by a group of patients living with EB. Materials and Methods: This observational study included n = 101 patients with a genetic diagnosis of EB. After their regular dental consultation, they were interviewed about factors they considered barriers to accessing orthodontic treatment. Those who underwent orthodontic treatment (n = 24) reflected about their perceived benefits and complications from the therapy. Data were analysed with descriptive statistics and multiple Fisher's exact tests with false discovery rate (FDR) correction. Results: The most prevalent barrier was that most patients with EB had never been evaluated by an orthodontist (74.3%), even if the teams had an orthodontist. Other barriers included distance to the treatment centre (42.6%), poor oral hygiene (27.7%) and poor oral health status (26.7%). Patients with limited mouth opening perceived greater treatment benefit compared to those without this limitation (φ = -0.28, p = 0.0242), while an increasing age was associated with a reduced perception of treatment benefit (Cramér's V = 0.29, p = 0.0404). Among those who underwent orthodontic treatment, the most prevalent benefits of orthodontic treatment were aesthetic improvement (62.5%), oral hygiene improvement (20.8%) and occlusal stability (12.5%), while the most prevalent complications were wounds and ulcers (75.0%), gingivitis (54.1%), poor oral hygiene (41.6%) and caries (33.3%). Discussion: People living with EB reported different barriers to orthodontic treatment relating to psychosocial and professional aspects, which vary according to the EB type and severity. The involvement of orthodontists in multidisciplinary special care teams and the reduction in access barriers to dental specialities can be facilitated by a more comprehensive understanding of conditions such as EB.
Background: Custom-made subperiosteal implants have re-emerged as a valuable option for the rehabilitation of patients with severe maxillofacial atrophy and post-oncological defects. Despite advances in digital workflows and implant design, their unique anatomical, biological, and prosthetic characteristics pose specific challenges for long-term maintenance, and no dedicated standardized guidelines are currently available. Methods: This narrative review critically appraises the available literature on implant maintenance and related fields. A comprehensive search was conducted across PubMed, Scopus, and Web of Science, including studies on peri-implant maintenance, supportive periodontal therapy, full-arch and zygomatic implant rehabilitations, and subperiosteal implants. Due to the lack of direct evidence, a qualitative narrative synthesis was adopted to develop preliminary clinical considerations for maintenance of custom-made subperiosteal implants. These considerations should be interpreted as an expert-informed perspective rather than validated clinical guidelines. Results: Conventional maintenance protocols developed for endosseous implants are not directly transferable to subperiosteal implants due to differences in the implant-tissue interface, biomechanics, diagnostic parameters, and hygiene accessibility. Key challenges include the absence of a conventional peri-implant sulcus, possible implant exposure, complex prosthetic geometries, and potential susceptibility to biofilm accumulation in areas with limited access. Evidence from related fields highlights the importance of structured maintenance, individualized risk-based follow-up, effective biofilm control, and patient-specific home-care strategies. Conclusions: Preliminary evidence-informed clinical considerations for the maintenance of subperiosteal implants are proposed, with emphasis on plaque control, individualized follow-up, descriptive clinical monitoring, and hygiene-oriented prosthetic and surgical planning. These considerations are not intended as validated guidelines, but as a practical starting point for clinical reasoning in an area where dedicated evidence remains limited.
To assess and compare the effectiveness of two educational approaches for oral health among visually impaired adolescents aged 10-21 years in Tamil Nadu. A randomized controlled trial with a double-blind, parallel-arm design was carried out among visually impaired adolescents, with an estimated sample size of 370. Participants were randomly assigned to group A (Braille and audio aids) or group B (Braille, audio, Audio Tactile Performance technique, and Novel Tactile Graphics). Assessments were conducted at baseline, 3 months, and 6 months, including the improvement in plaque score, gingival score, and oral health knowledge. Data were analyzed using Student's t-test and Chi-squared test, with p < 0.05 considered statistically significant. When compared to group A, group B demonstrated a significant reduction in plaque and gingival index scores at follow-ups compared to baseline (p < 0.05), indicating improved oral hygiene, gingival health, and plaque control, which was statistically significant p < 0.05, underscoring the superior efficacy of the intervention. Mean plaque scores post intervention were 1.46 ± 0.48 (group A) and 1.44 ± 0.74 (group B); mean gingival scores were 1.54 ± 0.45 (group A) and 1.36 ± 0.32 (group B), with statistically significant differences (p < 0.05). The intragroup comparisons showed statistically significant differences from baseline to 6 months for both groups. The findings of this study revealed that the oral health education techniques, like audio-tactile performance (ATP), tactile graphics, were more effective than the traditional combination of Audio and Braille text in promoting proper oral hygiene among visually impaired children. Visually impaired adolescents face barriers to oral health education. The use of ATP with Novel Tactile Graphics offers an effective, accessible, and user-friendly educational tool to improve oral health among visually impaired adolescents. These results highlight the importance of multisensory, interactive approaches in overcoming educational barriers and improving health outcomes in special-needs populations.
Dental caries is a significant public health burden in Brazil, with regional disparities deeply affecting children in the North and Northeast. This study assessed the prevalence and severity of dental caries in preschool children from Balsas (MA) and investigated its association with fluoride concentrations in the public water supply. A cross-sectional study was conducted with 256 children (aged 3-5 years) enrolled in municipal schools. Schools were selected using a stratified sampling strategy based on the water network, with exposure validated via chemical analysis. Calibrated dentists performed examinations using the FOA-UNESP risk scale, assessing biofilm and gingivitis as objective clinical proxies for hygiene. Fluoride levels were analyzed using an ion-selective electrode. Statistical analysis included Fisher's exact test, Kruskal-Wallis, and Multiple Correspondence Analysis (MCA). Caries prevalence was 60.16%, with 41.8% of children in severe risk categories (F: 27.0%; G: 14.8%). Water analysis revealed universal hypofluoridation (0.02-0.34 µg F/mL). A significant association was found between residual fluoride (0.02 µg F/mL) and greater caries severity (p = 0.04). Poor hygiene markers (biofilm and gingivitis) were significantly associated with a higher number of decayed teeth (p < 0.05). MCA identified a cluster linking residual fluoridation to severe clinical conditions and social vulnerability. High caries prevalence associated with inadequate fluoridation highlights critical regional health inequalities in Balsas. These findings underscore the urgent need for policies ensuring universal water fluoridation and strengthening school-based preventive strategies to mitigate the impact of social determinants on child development.
Home mechanical ventilation is crucial for treating conditions such as obstructive sleep apnea, and its use has increased exponentially. A possible link exists between poor equipment hygiene and the risk of respiratory infections, due to healthcare-related practices; however, the exact effect is unknown. The aim of this study is to determine the level of bacterial and fungal contamination in home continuous positive airway pressure (CPAP) devices. This prospective, cross-sectional study will be conducted at the Burgos University Hospital Complex (CAUBU), Spain. Twenty-five patients undergoing home CPAP treatment for at least six months will be recruited. Microbiological samples will be taken from each patient at critical points of the CPAP device: CPAP housing, tubing, internal filter, interface, and humidifier. Analyses will be performed at the CAUBU Microbiology Department, which is certified under UNE-EN ISO 9001:2015. In addition to microbiological analysis, clinical variables and determinants of patient health will be collected to study potential factors associated with contamination. It is known that 30% of healthcare-associated infections are preventable, so this study aims to improve prevention strategies, health education, and nursing care to reduce the risk of pathogenic contamination related to home respiratory therapy.
Recent outbreaks of infectious diseases on dairy farms, with workers becoming ill, have focused attention on the potential for zoonotic disease transmission of pathogens between animals and humans in dairy production. While many dairy farms have a biosecurity plan and protocols in place to reduce the possibility of cow-cow transmission of pathogens such as foot-and-mouth disease, previous surveys have indicated that few farms have organized ongoing infection‑prevention programs to prevent the spread of infection to workers. The purpose of the current study is to describe knowledge, attitudes, and practices surrounding infection control and prevention by job tasks among dairy workers and to assess the influence of the COVID-19 pandemic on infection prevention behaviors. Study findings can inform research aimed at implementing sustainable infection control and prevention strategies on dairy farms. We conducted a cross-sectional analysis of baseline survey data from an observational study of dairy workers that began in 2017, with enrollment continuing through 2022. We restricted the analysis to dairy workers who had worked on a dairy farm for at least 6 months and who spoke Spanish or English. Bilingual study staff administered the questionnaires in Spanish or English based on the participants' preferred language. The survey questions included self-reported job tasks as well as reported use of preventive measures such as hand hygiene and personal protective equipment (PPE) on dairy farms. We calculated proportions of reported behaviors for different job tasks such as milking or herd health. We found that a low level of concern about getting disease from animals or giving disease to animals was associated with lower odds of handwashing after glove use. Frequency of self-reported PPE use varied by task. Proportions of self-reported measures of handwashing were 20% or higher among participants whose data collection occurred during the COVID-19 pandemic compared to participants whose data collection occurred before COVID-19. Conclusion: Efforts to increase infection prevention and control on dairy farms need to address workers' perceptions about the risk of pathogen transmission between workers and cows, since this appears to affect both PPE use and handwashing frequency.
Gastrointestinal parasitic infections constitute a major constraint to equine health and productivity, particularly in tropical regions where climatic and environmental conditions favor parasite survival and transmission. In Côte d'Ivoire, epidemiological data regarding gastrointestinal parasites in horses remain limited, especially in urban and peri-urban settings such as the district of Abidjan. This study aimed to determine the prevalence, diversity, and associated risk factors of gastrointestinal parasites affecting horses in the study area. A descriptive and analytical cross-sectional study was conducted from September 2024 to February 2025 among 277 horses originating from 19 equine facilities, including 8 riding schools and 11 breeding farms, located in the district of Abidjan. Fresh fecal samples were collected and analyzed using four coprological techniques: direct examination, flotation, the simplified Ritchie concentration method, and Ziehl-Neelsen staining. Statistical analyses, including chi-square tests and logistic regression, were performed to identify factors significantly associated with parasitic infections at a significance threshold of p ≤ 0.05. The overall prevalence of gastrointestinal parasites was 88.80%, indicating widespread circulation of equine gastrointestinal parasites within the study area. Fifteen parasite species were identified, with predominance of Strongylus spp. (48.37%), Parascaris equorum (40.07%), cyathostomins (Cyathostominae) (30.68%), Fasciola hepatica (29.24%), and Cryptosporidium parvum (28.51%). Nematodes represented the predominant parasitic group. Significant associations were observed between parasitic infections and management-related factors, particularly feeding practices and type of equine activity. Horses from riding schools appeared more exposed to certain parasitic infections compared with horses raised on breeding farms. The high prevalence and diversity of gastrointestinal parasites observed among horses in the district of Abidjan highlight an important equine health concern in Côte d'Ivoire. These findings emphasize the need to strengthen integrated parasite control strategies, including regular parasitological monitoring, improved hygiene and management practices, rational use of anthelmintics to reduce the risk of resistance, and targeted deworming programs. Reinforcing veterinary surveillance and increasing awareness among horse owners and managers could substantially contribute to improving equine health and productivity in the study area.
Hydro-meteorological and geological disasters can pose serious harm to community health, such as an increased risk of infectious diseases and related mortality. We conducted a scoping review to compile the available literature on the effects of hydro-meteorological and geological disasters on routine immunisation and vaccine-preventable disease (VPD) outbreaks among children and adolescents under 18 years. We searched Medline, Embase, Global Health, Scopus, and Web of Science for original studies and systematic reviews on the topic published by the 21st of October 2024. We included studies that quantitatively analysed the effect of any of the thirty Emergency Events Database (EM-DAT) recognised hydro-meteorological and geological disasters (or those fitting EM-DAT criteria) on a comprehensive list of World Health Organization (WHO)-recommended vaccines and the 23 diseases against which they prevent. We included 26 studies, of which 19 concerned with vaccine-preventable disease outbreaks and seven focused on routine immunisation disruption.. Our review indicates that floods, cyclones, droughts, extreme temperatures, tsunamis, and earthquakes may result in vaccine-preventable disease outbreaks and routine immunisation disruption, and identified young children and refugees as at-risk populations. Flooding was reported to be associated with water-borne and vector-borne vaccine-preventable disease outbreaks such as malaria. Poor water, sanitation and hygiene (WASH) were further recognised as facilitating conditions for vaccine-preventable disease outbreaks after disasters. The vaccination studies reported reduction in routine immunisation rates in the months following a disaster, considering infrastructural damage to health facilities and vaccine storage issues as common causes. Finally, there was significant knowledge gap on the effects of specific disasters (e.g., wildfires and volcanic eruptions) and diseases (e.g., influenza, yellow fever, malaria, and dengue).In conclusion, our review reinforce the need for better policies to ensure vaccine equity, resilient health system and safe WASH to prevent vaccine-preventable disease (VPD) outbreaks following hydro-meteorological and geological disasters.
Implant-supported prostheses are widely accepted treatment modalities for replacing missing teeth in partially or completely edentulous patients. Prosthetic complications in implant dentistry can be challenging for long-term success. Insufficient hygiene care, residual cement, and poor prosthetic design are issues linked to peri-implantitis and peri-implant mucositis. Patient satisfaction is further jeopardized by aesthetic problems such as soft-tissue recession and color mismatch. Thus, we review the prevalence, factors related to complications, and the clinical impact.
Lingual orthodontic appliances meet growing esthetic demands and are replacing traditional labial systems, yet they pose challenges to patient comfort and treatment efficiency that require comparative evaluation. Therefore, it is of interest to compare lingual versus labial fixed appliances in orthodontic patients, assessing pain perception, speech impairment, tongue irritation, oral hygiene, alignment rate, visit frequency and total duration during adaptation and follow-up phases. Patient comfort parameters and treatment efficiency metrics were collected at baseline and regular intervals and analyzed statistically across both groups. Lingual appliances showed greater initial discomfort but equivalent long-term alignment and duration outcomes to labial systems with proper case selection. Thus, we report the viability of lingual orthodontics as an esthetic alternative when patient motivation and individualized selection balance early adaptation challenges.