Oral Presentation
2:30 pm–2:45 pm 19 June
CC, Room 212
Title: 0279 – Application of precision medicine for dental care recommendation
Authors:
Dr. Man Hung (Presenter)
Roseman University of Health Sciences
Megan Rosales, University of Utah
Weicong Su, University of Utah
Evelyn Lauren, University of Utah
Bianca Ruiz-Negrón, University of Utah
Julie Xu, University of Utah
Maren Voss, University of Utah
Yao He, University of Utah
Wei Li, University of Utah
Frank Licari, Roseman University of Health Sciences
Abstract:
Objectives: In the era of big data, precision medicine is ideally positioned to advance our understanding in dental intervention and prevention. New tools are needed to assist health professionals in providing recommendations for individuals to seek dental care and improve their overall health. This study aimed to apply precision medicine to develop recommendations for dental care in a large nationally representative sample.
Methods: The data were obtained from the 2013-2014 National Health and Nutrition Examination Survey to perform predictive analytics. A total sample size of 10,175 and 2,365 variables were present in the complete database. Feature selection was done to determine a smaller set of suitable variables for inclusion into several supervised machine learning models to develop algorithms for making recommendations for dental care. These machine learning models included logistic regression, support vector machine, random forest, and classification and regression tree. The data were split into training and validation sets with model performance being evaluated.
Results: Feature selection along with the inclusion of additional clinically relevant variables identified several top features associated with recommendation for dental care. The top three features included gum health, number of prescription medications taken, and race. Gum health showed a significantly higher relative importance compared to other features. The machine learning algorithms demonstrated very high accuracy, precision, and sensitivity at over 0.84 and specificity at 0.92.
Conclusions: This study identified demographic, healthcare access, and general health variables as top predictors relating to receiving dental care. It demonstrated feasibility and benefits of precision medicine as an innovative approach to develop new model of dental care that takes into account of individual needs and differences. Incorporation of our algorithms into computerized screening tool can assist clinical decision-making and achieve more efficient and personalized treatment in oral care. It has huge public health impact.
This abstract is based on research that was funded entirely or partially by an outside source:
NIH 5UL1TR001067
Poster Presentation
11:00 am–12:15 pm 20 June
CC, West Exhibition Hall B
Title: 0606 – Assessing Silver Diamine Fluoride Treatment Efficacy in Root Caries
Authors:
Hiba Zaku (Presenter)
Roseman University of Health Sciences
Chelsea Mitchell, Roseman University of Health Sciences
Zac Hansen, Roseman University of Health Sciences
Joell Chen, Roseman University of Health Sciences
Monica Ghandi, Roseman University of Health Sciences
Chet Masura, Roseman University of Health Sciences
Cherish Dunshee, Roseman University of Health Sciences
Andrew Gross, Roseman University of Health Sciences
David Prince, Roseman University of Health Sciences
Abstract:
Objectives: Dental caries is one of the most significant health problems facing older adults, with loss being the most significant oral health-related negative variable effecting quality of life for the elderly. The aim of the study was to characterize and assess the effectiveness of Silver Diamine Fluoride (SDF) in carries arrest and preservation of teeth in elderly adults ages 55 and above with localized root caries.
Methods: An IRB approval was obtained, and patient consents were obtained prior to treatment. Clinical patients at Roseman University College of Dental Medicine, 55 and older, who had received comprehensive exams, health and dental histories, and caries risk assessment, who presented with teeth with root decay lesions were assessed by the students and faculty trained in SDF study protocol for treatment of the lesions. Lesions were treated following the UCSF clinical protocols. Patients were instructed to return in 6 months for evaluation of treatment using DIAGNOdent, visual and tactile methods. Data collected was analyzed using the Mann-Whitney U test.
Results: A total of 90 patients participated in the study. 250 teeth of which 350 surfaces were examined and treated using SDF. Nearly 90% treated subjects have retained their teeth, DAGNOdent reading ranged 30-99 before treatment and 10-30 post SDF application (0-10 is healthy tooth structure). That enabled the providers to prolong the longevity of tooth retention in patients’ mouths. Additional to DIAGNOdent reading, visual and tactile exploration reflected an arrest and remineralization of the lesions. The remaining 10% of treated subjects’ teeth were either fractured and extracted or the decay worsened or patient deceased.
Conclusions: Our results revealed regular application of SDF aids in arrest of the progression of root carries and promotes remineralization in decayed root surfaces. Additionally, SDF aids in preservation of non-restorable teeth in patients 55 and older.
Poster Presentation
11:00 am–12:15 pm 20 June
CC, West Exhibition Hall B
Title: 0776 – Association of Oral Health, General Health, and Well-being in Geriatrics
Authors:
Gagandeep Gill (Presenter)
Roseman University
Frank Licari, Roseman University
Ryan Moffat, Roseman University
Evelyn Lauren, University of Utah
Bianca Ruiz-Negron, University of Utah
James Richey, Roseman University
Man Hung, Roseman University
Abstract:
Objectives: Due to advancements in healthcare, life expectancy is increasing in favor of an aging population. Therefore, the study of geriatric health and well-being is becoming more important. Though previous studies examined relationships between oral and overall health, few studies focused on the elderly. The purpose of this study was to investigate the association of oral health and overall health and well-being of the aging population in the United States.
Methods: Data from the 2015-2016 National Health and Nutrition Survey were used in this study. Weighted prevalence estimates were reported on mean, standard deviation, and percentages for the following: demographics, self-reported oral health status, and overall health and well-being. Logistic regressions were done to predict oral health status from overall health and various aspects of well-being. Odds ratio (OR), 95% confidence interval, and Chi-square tests were also performed.
Results: This study sample represented a total of 47.8 million elderly at 65 years or older in the United States; of which, 56.3% were female and 43.7% were male. Results showed statistically significant relationships between oral health and general health (χ2=200; p<0.05), work limitation (χ2=50; p<0.05), depression (χ2=80; p<0.05), energy levels (χ2=60; p<0.05), and appetite (χ2=70; p<0.05). Associations between good oral health and better general health (OR=0.480; p<0.05), mental health (OR=0.613; p<0.05), appetite (OR=0.559; p<0.05) and higher energy levels (OR=0.613; p<0.05) were also found.
Conclusions: This nationally representative sample highlights an important relationship between oral health and overall health and well-being in older people. This then suggests a need to provide more and better oral healthcare services to the elderly, especially in helping them to improve their general health and well-being.
Student Presenter
Poster Presentation
11:00 am–12:15 pm 20 June
CC, West Exhibition Hall B
Title: 0843 – Data-Centric Approach for Prediction of Root Caries through Machine Learning
Authors:
Evelyn Lauren (Presenter)
University of Utah
Frank Licari, Roseman University of Health Sciences
Bianca Ruiz-Negron, University of Utah
Megan Rosales, University of Utah
Weicong Su, University of Utah
Julie Xu, University of Utah
Maren Voss, University of Utah
Jerry Bounsanga, University of Utah
Man Hung, Roseman University of Health Sciences
Abstract:
Objectives: Root caries is one of the most prevalent oral health problems. Data-centric approach can be used to provide early intervention and preventive measures to mitigate risk of root caries in individuals, leading to better oral health outcomes. We utilized machine learning approach to generate risk prediction of root caries in order to improve oral health care delivery.
Methods: The dataset was obtained from the 2015-2016 National Health and Nutrition Examination Survey. Python 3.7.0 and Weka 3.8.2 were used to construct a tool that was capable of classifying the presence and absence of root caries from various demographic, socio-behavioral, clinical and lifestyle factors using supervised machine learning algorithms. Accuracy, sensitivity, specificity and area under the receiver operating curve were computed.
Results: Of the machine learning algorithms, support vector machine demonstrated the best performance with a predictive accuracy of 97.1%, precision of 95.1%, sensitivity of 99.6%, and specificity of 94.3% for detecting root caries. The area under the receiver-operating characteristic curve was 0.997. Age was the feature most strongly associated with root caries. Fifteen variables consisting of demographic, oral health, and lifestyle variables are top predictors of root caries.
Conclusions: The machine learning algorithms developed in this study perform well and provide opportunity for clinical implementation and utilization by dental and non-dental professionals. Potential benefits of a data-centric approach include cost savings and attainment of precision dental medicine. Clinicians and policy makers are encouraged to adopt the results for early intervention and treatment of root caries in the United States and across the world.
Student Presenter
This abstract is based on research that was funded entirely or partially by an outside source:
NIH 5UL1TR001067
Poster Presentation
3:45 pm–5:00 pm 20 June
CC, West Exhibition Hall B
Title: 1164 – E-Cigarette Knowledge And Usage Among Professional Baseball Players
Authors:
Dean Bartlett (Presenter)
Roseman University
Blaise Curcio, Roseman University
Nadine Ayouty, Roseman University
Victoria Nguyen, Roseman University
Rachana Hegde, Roseman University
Kamran Awan, Roseman University
John Wisniewski, Roseman University
Abstract:
Objectives: The use of electronic cigarettes has become increasingly more popular in the United States. Contrary to previous belief, E-cigarettes are no longer considered a healthy alternative to smoking combustible cigarettes. The purpose of this study was to understand the minor league baseball players cultural background with knowledge, attitude, and usage of E-cigarettes.
Methods: The minor league professional baseball players (MLPBPs) from four major league franchises participated in this study. Athletic trainers distributed the surveys to their MLPBPs during 2018 spring training physical. The players completed the surveys voluntarily and anonymously. Data were managed with an Excel program and interpreted via standard descriptive statistical analysis.
Results: A total number of 414 minor league professional baseball players (MLPBPs) participated in this study (n=414). The cultural distribution of MLPBPs completing the survey was: Caucasian-53%(n=218), Hispanic-40%(n=163), African American-6%(n=25), Asian-1%(n=5). Among these MLPBPs, 34% “thought E-cigarettes caused less harm than combustible cigarettes”. Specifically, the cultural distribution of players who were of the opinion that the “usage of E-cigarettes was less harmful than combustible cigarettes” were the following: Caucasian-46%, African American-32%, Hispanic-21%. Among players who had indicated “previously tried/past usage of E-cigarettes” were: Caucasian-26%, African American-20%, Hispanic-12%. The distribution of MLPBPs who responded that they have “friends/peers who are current users of E-cigarettes” were following: Caucasian-50%, African American-44%, Hispanic 34%. Among the total group of MLPBPs who completed the survey, 44% “have never heard of Electronic cigarettes”. Specifically, the cultural distribution of players who have not heard about “E-cigarettes” were: Hispanic-65%, African American-64%, Caucasian-29%.
Conclusions: Educational programs regarding E-cigarette hazard awareness need to be preventative for African American and Hispanic MLPBPs. However, E-cigarette hazard awareness programs for Caucasian MLPBPs need to be not only be preventative but also interventional in nature.
Poster Discussion Session
3:57 pm–4:09 pm 20 June
CC, West Exhibition Hall B
Title: 1604 – Correlation of RAGE signaling and inflammation in oral epithelial cells following exposure to e-cigarette flavoring
Authors:
Michael Rhees (Presenter)
Roseman University of Health Sciences
Anthony Lepre, Roseman University of Health Sciences
Jordy Geiler, Roseman University of Health Sciences
Janet Ajdaharian, Roseman University of Health Sciences
Daniel Epperson, Roseman University of Health Sciences
Kolten Astle, Roseman University of Health Sciences
Kelsey Hirschi, Brigham Young University
Kary Tsai, Brigham Young University
Juan Arroyo, Brigham Young University
Paul Reynolds, Brigham Young University
Abstract:
Objectives: Over the past several years, the derivation of electronic cigarettes (eCig) has given rise to a new, largely unregulated market within the smoking industry. eCigs rely on vapor produced by heating oil-based (e-liquid) to deliver flavored nicotine, and while initially considered to be less harmful than traditional tobacco cigarette smoke, little is known about the cellular impact of these electronic devices. The oral environment is anatomically positioned as a significant gateway for exposure to environmental toxicants including eCig. We hypothesize that such exposure specifically compromises oral health by orchestrating inflammation via RAGE signaling, an axis we’ve previously characterized as commonplace in cells and tissues exposed to traditional tobacco smoke. The purpose of this study was to determine the effects of eCig liquid on oral health by examining the expression of several pro-inflammatory molecules.
Methods: Gingival (Ca9-22) and tongue (Cal-27) epithelial cells were exposed to Red Hot or Green Apple flavored eCig solution with or without nicotine over a broad time course and compared to cells exposed to fresh media only. After exposure, total RNA and protein were isolated and conditioned media was retained.
Results: We discovered quantitative and qualitative increases in RAGE. We also confirmed elevated activity of RAGE signaling molecules such as p38, a key MAPK, and nuclear translocation of active NF-κB following exposure. A protein array revealed differential expression of key inflammatory mediators of periodontal disease such as IL-1α, IL-6, IL-8, and a key inflammatory protease, MMP-13. Intriguing differences between cell type, flavor, and nicotine concentration were noted in the array.
Conclusions: Together, these results provide important understanding relative to the inflammatory profile of exposed cells in the oral mucosae. While RAGE signaling coincides with eCig-mediated inflammation, important additional steps must be taken to clearly elucidate to what extent RAGE signaling is required for inflammatory disease progression.
This abstract is based on research that was funded entirely or partially by an outside source:
This work was supported by a grant from the Flight Attendant’s Medical Research Institute (FAMRI, PRR and JAA) and by institutional research funds from Roseman University of Health Sciences.
Poster Discussion Session
4:09 pm–4:21 pm 20 June
CC, West Exhibition Hall B
Title: 1605 – Potential role for RAGE in the development of secondhand smoke-induced chronic sinusitis
Authors:
Kolten Astle (Presenter)
Roseman University of Health Sciences
Daniel Epperson, Roseman University of Health Sciences
Anthony Lepre, Roseman University of Health Sciences
Michael Rhees, Roseman University of Health Sciences
Jordy Geiler, Roseman University of Health Sciences
Janet Ajdaharian, Roseman University of Health Sciences
Juan Arroyo, Brigham Young University
Paul Reynolds, Brigham Young University
Abstract:
Objectives: Inflammation observed in chronic sinusitis (CS) is characterized by pro-inflammatory exudates, mucus, and edematous mucosal tissue. It was recently determined that CS affects approximately one in seven adults and estimates suggest up to 15% of the general U.S. population may be affected. Importantly, CS accounts for over 20% of all office visits to allergy and immunology specialists and there are an estimated 18 million cases and 30 million courses of antibiotics delivered each year. We sought to delineate molecular mechanisms regulated by RAGE, an inflammatory progression factor we’ve identified in tissues exposed to secondhand smoke (SHS). Such research may clarify causes of CS and possible identification of molecular targets.
Methods: Wild type and RAGE over-expressing mice (RAGE TG) were maintained in room air or exposed to SHS via a nose-only delivery system (Scireq Scientific, Montreal, Canada) five days a week for 30 days. Sections of sinus epithelium were stained for RAGE or Alcian blue (to characterize mucus) and tissue lysates were assayed by qPCR or immunoblot for caspase 3 (to detect apoptosis), cytokines (to evaluate inflammation) or matrix metalloproteases (to detect tissue degradation).
Results: We discovered increased sinus RAGE expression following smoke exposure in wild type mice and elevated expression in sinuses from RAGE TG mice. Goblet cell hyperplasia was detected in both smoke-exposed wild type mice and transgenic mice exposed to room air. Cleaved caspase-3, cytokines (IL-1β and TNF-α), and MMP-9/MMP-13 were induced by SHS and in tissues procured from RAGE TG mice.
Conclusions: Together, these results expand the inflammatory role of RAGE signaling, an axis considered a key culprit in lung disease progression observed in smokers. In this relatively unexplored area, enhanced understanding of RAGE signaling during voluntary and involuntary smoking may help to elucidate potential therapeutic targets that may attenuate the progression of smoke-related chronic sinusitis.
Poster Discussion Session
4:33 pm–4:45 pm 20 June
CC, West Exhibition Hall B
Title: 1607 – Gingival cell invasiveness is differentially regulated by e-cigarette flavor and nicotine levels
Authors:
Janet Ajdaharian (Presenter)
Roseman University of Health Sciences
Jordy Geiler, Roseman University of Health Sciences
Michael Rhees, Roseman University of Health Sciences
Anthony Lepre, Roseman University of Health Sciences
Daniel Epperson, Roseman University of Health Sciences
Kolten Astle, Roseman University of Health Sciences
Kelsey Hirschi, Brigham Young University
Kary Tsai, Brigham Young University
Juan Mejia, Brigham Young University
Paul Reynolds, Brigham Young University
Juan Arroyo, Brigham Young University
Abstract:
Objectives: OSSC is a common disease affecting 30,000 people in the United States each year and a major cause is exposure to tobacco smoke. The electronic cigarette (eCig) has given rise to a new, largely unregulated market within the smoking industry. Generally supposed to be less harmful than traditional smoking, knowledge about the toxicity of the e-liquid in electronic devices is still scarce. We sought to determine the impact of eCig flavoring and nicotine ongingival cell carcinoma invasion.
Methods: Ca9-22 and Cal-27 OSCC cells were incubated in the presence or absence of Red Hot or Green Apple flavored eCig solution with and without nicotine. RAGE is a cell surface progression factor that perpetuates inflammatory signaling in cells and tissues exposed to tobacco. Immunofluorescence of cultured cells determined eCig-induced RAGE expression and the degree of real time cellular invasion was assessed over a 24 hour time course.
Results: Compared to controls we observed: 1) increased cell invasion in the Red Hot eCig Ca9-22 treated cells with or without nicotine (2.3-fold, 3.6-fold; p<0.0002); 2) decreased cell invasion in the Green Apple Ca9-22 treated cells with or without nicotine (1.7-fold, 2.66-fold; p<0.0002) 3) decreased cell invasion in the Red Hot Cal-27 eCig treated cells in the presence or absence of nicotine (1.7-fold, 2.7-fold; p<0.002); and 4) no differences in cell invasion for the Cal-27 Green Apple eCig treated cells. We observed flavor and nicotine dependent increases in RAGE following treatment, suggesting a plausible mechanism that influences cellular invasion.
Conclusions: We can conclude that eCig flavorings and nicotine orchestrate differential regulation of cell invasion. Invasive differences correlate with the expression of the inflammatory receptor RAGE. This study provides an important initial step in dissecting RAGE-mediated mechanisms of cancerous invasion and may be helpful in determining key molecular avenues of invasion employed by OSCC
Poster Presentation
11:00 am–12:15 pm 21 June
CC, West Exhibition Hall B
Dr. Frank Licari (Presenter)
Title: 1799 – Evidence Linking Oral and Systemic Diseases in the United States
Authors:
Ryan Moffat, Roseman University of Health Sciences College of Dental of Medicine
Evelyn Lauren, University of Utah
Gagandeep Gill, Roseman University of Health Sciences College of Dental of Medicine
Bianca Ruiz-Negron, University of Utah
James Richey, Roseman University of Health Sciences College of Dental of Medicine
Frank Licari (Presenter)
Roseman University of Health Sciences College of Dental of Medicine
Man Hung, Roseman University of Health Sciences College of Dental of Medicine
Abstract:
Objectives: With the elderly population projected to triple to 1.5 billion worldwide by 2050, understanding the impact of systemic diseases on the oral health outcome of the elderly is becoming more important. The purpose of this study was to investigate the association between systemic diseases and oral health of the elderly in the United States.
Methods: Data for this study were obtained from the 2015-2016 National Health and Nutrition Examination Survey. Descriptive statistics were performed on demographics, oral health outcome and systemic disease conditions using mean, standard deviation, and proportion as appropriate. The oral health outcome variable described one’s health of the teeth and gingiva. Chi-square tests were conducted to examine the relationship between oral health outcome and ten systemic diseases (e.g., high blood pressure, diabetes, asthma, arthritis, coronary heart disease, congestive heart failure, thyroid problem, chronic bronchitis, liver condition and cancer). Survey weights were added for all analyses to obtain nationally representative results.
Results: There were approximately 48 million elderly who were 65 years or older representative of the United States’ population reported in this study. Out of the ten systemic diseases being investigated, six of them were associated with oral health outcome. Specifically, older individuals who had poor oral health also had diabetes (χ2=17.489; p < 0.05), coronary heart disease (χ2=21.459; p < 0.05), congestive heart failure (χ2=12.077; p < 0.05), high blood pressure (χ2=9.3185; p < 0.05), asthma (χ2=2.8009; p < 0.05) and liver condition (χ2=9.0851; p < 0.05).
Conclusions: This large national study provided strong empirical evidence that oral health is a critical part of an individual’s general health, particularly in the elderly. Poor oral health is associated with different disease conditions in our body. Dental schools, therefore, need to educate students on oral-systemic diseases and encourage co-management of diseases with other healthcare providers.
Poster Presentation
11:00 am–12:15 pm 21 June
CC, West Exhibition Hall B
Title: 1976 – Tactile and Virtual Learning on Student Engagement and Comprehension
Authors:
Brian Hadfield (Presenter)
Roseman University College of Dental Medicine
Alexa McAneney, Roseman University College of Dental Medicine
Inderdeep Kaur, Roseman College of Dental Medicine
Chris Bernard, Roseman University College of Dental Medicine
Evelyn Lauren, University of Utah
Lourdes Peralta, University of Utah
Man Hung, Roseman University of Health Sciences College of Dental of Medicine
Frank Licari, Roseman University of Health Sciences
David McMIllan, Roseman University College of Dental Medicine
Abstract:
Objectives: Tactile or hands-on learning has been postulated to increase student engagement levels and comprehension. This study investigated the differences in student engagement and comprehension utilizing actual tooth models compared to virtual images of the tooth models in learning dental histology.
Methods:
One hundred first-year dental students were given two active-learning experiences in both tooth enamel and dentin histology. For the enamel portion, teams in Group A were given five human tooth models along with an informational PowerPoint. Teams in Group B were given five digital images of the human tooth models and the same PowerPoint. Both groups were given the same worksheet which was completed by each student within their group. Both groups of students took a formative assessment on the concepts learned.
This same format was also used with the dentin portion of the course, except Group A used the images and Group B used the actual models. Students then took a formative assessment on the concepts learned in dentin histology. Upon completion, students took a survey to determine their levels of engagement and perceptions.
Results: Results show that there was no significant difference in the amount of engagement and learning comprehension when students used virtual images or actual tooth models.
Conclusions: Tactile learning may be advantageous in a variety of learning situations. However, this study showed that tactile learning had no significant advantage over virtual learning, suggesting that virtual or online learning may be as effective and offer financial and time savings. More research needs to be done to determine how and when utilization of tactile learning would be of greatest benefit to learners.
Poster Presentation
3:45 pm–5:00 pm 21 June
CC, West Exhibition Hall B
Title: 2411 – HPV Literacy And Its link to Oropharyngeal Cancer Among University Healthcare Students
Authors:
Inderdeep Kaur (Presenter)
Roseman College of Dental Medicine
Hiba Zaku, Roseman College of Dental Medicine
Aisha Sadaf, Roseman College of Dental Medicine
Hilary Mazzone, Roseman College of Dental Medicine
Shahrukh Khan, University of Tasmania
Kamran Habib Awan, Roseman University of Health Sciences
Abstract:
Objectives: There is a need for future healthcare professionals to have adequate knowledge on the link between HPV and oropharyngeal cancer in order to better treat and educate patients. The purpose of this study was to assess the knowledge, perception and attitude of dental and pharmacy students towards HPV and associated risk factors.
Methods: A cross-sectional survey was conducted with a peer-reviewed and pilot tested questionnaire that was approved by the IRB (1154261-1). The voluntary questionnaire was distributed to dental and pharmacy students from August to December 2018, during a classroom break. Prior to administering the survey, the aim of the study was stated thoroughly. Data collected was analyzed using the Mann-Whitney U test, with the level of significance set to p < 0.01.
Results: A total of 547 students participated in the study (dental=262; pharmacy =285). The majority of students’ reported that they have heard of HPV (dental 96.2%; pharmacy 96.1%). However, 38.7% of dental and 58.3% of pharmacy students did not report a link between HPV and oral cancer (p=0.001). In addition, only half of the students (dental 62.84%; pharmacy 46.3%) consider HPV-16 to increase the risk of oropharyngeal cancer (p=0.001). In regards to attitude, dental and pharmacy students did not feel confident asking the patients’ their sexual history (dental 48.7%; pharmacy 63.5%; p=0.001) and discussing risks of head and neck cancers (dental 50.6%; pharmacy 14.7%; p=0.001). In terms of perceptions of HPV and associated risk factors, both dental and pharmacy students agree that patients are not fully informed and healthcare professionals should provide a source of information for patients, discuss issues related to HPV while recommending the vaccination (p=0.001).
Conclusions: Our results revealed low knowledge and perception among respondents about the health problems associated with HPV, its prevention, modes of transmission, and detection.
Poster Presentation
3:45 pm–5:00 pm 21 June
CC, West Exhibition Hall B
Title: 2573 – Machine learning (ML) – an Innovative Technology to Study Head and Neck Oncology
Authors:
Dr. Kamran Habib Awan (Presenter)
Roseman University of Health Sciences
Shankargouda Patil, College of Dentistry,Jazan University
A. Thirumal Raj, Sri Venkateswara Dental College and Hospital
Abstract:
Objectives: The objective of the study was to understand the extent and purpose of ML use in the field on head and neck oncology. In addition, we also evaluated different ML techniques used.
Methods: We present a review of recent ML approaches employed in the field of head and neck oncology. PubMed, EMBASE, Scopus, Web of Science, and grey literature from January 1990 up to and including May 2018 were searched. Two independent reviewers performed the study selection according to eligibility criteria.
Results: A variety of machine learning techniques, including Support Vector Machines (SVMs), Artificial Neural Networks (ANNs), Bayesian Networks (BNs) and Decision Trees (DTs) are used in cancer research to develop predictive models to make decision making process more accurate and effective. Although it is evident that machine learning techniques provide increased understanding of the cancer, appropriate validation is needed before they can be implemented in routine clinical practice.
Conclusions: ML techniques can play a significant role in the field of head and neck oncology.
Poster Discussion Session
11:24 am–11:36 am 22 June
CC, West Exhibition Hall B
Title: 3404 – Effect of Repeated Loading on Force Decay of Aligners
Authors:
Dr. Prashanti Bollu (Presenter)
Roseman University of Health Sciences
Andrew Dinh, Roseman University of Health Sciences
Glen Roberson, Roseman University of Health Sciences
Kishore Chaudhry, Roseman University of Health Sciences
Ching-Chang Ko, University of North Carolina
Abstract:
Objectives: Orthodontic treatment with aligner therapy is gaining popularity. Intraorally aged aligners have been shown to express different mechanical properties than originally received aligners. The purpose of this in-vitro study is to evaluate the force decay over time and displacement of Invisalign-aligners after repeated loading from simulated insertion and removal.
Methods: Twenty duplicate Invisalign aligner sets of the fully aligned stage from same patient were printed for study purposes. The sample was divided into two groups (D1 & D2) based on displacement (n=10 each). Using the Instron E-1000 dynamic universal testing machine, the amount of force required to deflect the gingival margin of the aligners (1mm in D1, 1.5mm in D2) was measured. To replicate dynamic repeated loading (of insertion and removal) similar to a 2-week aligner usage standard estimated insertion removal of 7 times/day, aligners in each group were subjected to loading by 196 times (14days x 14 times). Force decay of aligners was calculated using percentage increase/decrease of initial deflection force (F0) to the final deflection force (F1). Statistical analysis was performed using SPSS v23.0.
Results: The mean initial maximum force (F0 was much higher for the D2 group (17.71mm±1.06mm) compared to the D1 group (11.82mm±1.01mm). Statistically significant (p<0.05) differences in force decay were noted based on displacement (D2 group: 23.05%) compared to the D1 group (15.52%). It was also found that the force decay from repeated cycling was exponential, decaying most rapidly during the first ten cycles.
Conclusions: Frequency of removal and the amount of deflection required to remove an aligner has an effect on the force decay. Repeated loading during insertion and removal of aligners had a significant impact on the force decay of the Invisalign aligner material.
This abstract is based on research that was funded entirely or partially by an outside source:
Align Technology
Oral Presentation
2:45 pm–3:00 pm 22 June
CC, Room 224
Title: 3500 – Assessing a Pediatric Dental Prevention Approach to Reduce Non-preventive Cost
Authors:
Dr. David Stewart (Presenter)
Roseman University Of Health Sciences College of Dental Medicine
Joseph Cheever, Roseman University of Health Sciences College of Dental of Medicine
Evelyn Lauren, University Of Utah
Frank Licari, Roseman University of Health Sciences College of Dental of Medicine
Ryan Moffat, Roseman University of Health Sciences College of Dental of Medicine
Lourdes Peralta, Roseman University of Health Sciences College of Dental of Medicine
Michael Stewart, Roseman University of Health Sciences College of Dental of Medicine
Man Hung, Roseman University of Health Sciences College of Dental of Medicine
Abstract:
Objectives: To assess preventive versus non-preventive dental costs in a prevention oriented pediatric dental practice.
Methods: A longitudinal, retrospective study was conducted using data from a suburban, prevention oriented, pediatric-dental-provider’s database containing data from years 2003-2015. Criteria for study inclusion were that a patient had at least two years of preventive services rendered by the practice or the patient had been seen in the practice and had other siblings that had received preventive services from the practice. Descriptive statistics on age of first visit, preventive cost, non-preventive cost and total cost were calculated. Pearson correlation between the age at first visit and the total non-preventive cost was reported. Patients were divided into two groups for comparison of total non-preventive cost [Those without siblings in the practice versus the youngest sibling of those who had siblings treated in the same dental practice]. Independent samples t-test was conducted for this comparison.
Results: The total sample size for this study was 200. Patients’ age at first visit ranged from 0 to 18 years old [mean(SD)4.4(0.2)years]. The average non-preventive procedure cost per patient increased as the age at first visit decreased [r=-0.19,p<0.05]. There was a significantly lower average non-preventive cost for patients with siblings($360) than patients without siblings in the practice($528)[p<0.05].
Conclusions: Having an older sibling cared for under a preventive dental program has the potential to decrease the non-preventive procedure cost for the younger sibling. Future research can be conducted to adjust for inflation and examine various dental costs in detail.
Poster Presentation
3:45 pm–5:00 pm 22 June
CC, West Exhibition Hall B
Title: 3814 – Incidence of Oral Cancers is High in all Continents
Authors:
Dr. Kishore Chaudhry (Presenter)
Roseman University of Health Sciences
Prashanti Bollu, Roseman University of Health Sciences
Deepika Mishra, All India Institute of Medical Sciences
Om Kharbanda, AIIMS
Abstract:
Objectives: Planning for oral cancer control programs should be based on the annual magnitude of new cases, which is depicted by crude incidence rate (CR). The study was undertaken to compare the CR of oral (ICD codes C00-C06) and oropharyngeal (ICD codes C09-C10) cancers, for 435 population based registries all over the world for the period 2008-2012, as reported in Cancer Incidence in Five Continents.
Methods: The freely available de-identified data was obtained from website of the International Agency for Research on Cancer, Lyon, France. The CR of oral cancers and Oropharyngeal cancers in different continents was compared. CRs in different continents were divided into high or low categories, the cut-off points being the half of maximum CR reported from anywhere in India. Data was analyzed using IBM SPSS v25.
Results: The Maximum CR for oral cancer was observed in Australia for both genders. The CR of oral-plus-oropharyngeal cancers was observed to be maximum in Europe or Australia for both genders. Globally for oral cancers, 16 registries among males and 3 registries among females showed higher CR than the maximum reported CR from India, considered as high-oral-cancer-burden country. Combined CR of oral and oropharyngeal cancers was also higher than India, in 12 registries for males and 2 registries for females. After categorization of registries in High/Low CR, statistically significantly higher proportion was observed from USA/ Europe/ Australia in high-CR category as compared to Asia and Africa. The distribution of CR categories in USA or Europe was statistically similar to India. Based on the national estimates by NIH, USA and ICMR, India, the per-unit-population magnitude of oral cancers was 12.5% less in USA than India.
Conclusions: Oral and oropharyngeal cancers are a globally important disease entity and efforts on its control (including screening) should be considered by all countries.