Complete denture palatal rugae design impact on satisfaction and quality of life.

OBJECTIVES: To compare the impact of three complete denture palatal rugae designs on participants' satisfaction and oral-health-related quality of life. BACKGROUND: Complete dentures palatal rugea are usually polished to a smooth finish, which can affect the patient's adaptation. Roughening or keeping an opening in the rugae area to replicate the natural sensation of the palatal rugae has been suggested but lacks clinical evidence. METHODS: This randomised crossover trial included participants with complete dentures randomly allocated to six sequences. Each sequence alternated between polished, roughened, and open rugae designs. Participants evaluated general and domain-specific satisfaction (eating, taste, speaking, phonetics, and ease of cleaning) on a 100-mm visual analogue scale. They also completed the Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT) and indicated their preferred design at the end. Repeated-measure ANOVA compared satisfaction, and one-way ANOVA with Tukey's test compared OHIP-EDENT scores. RESULTS: Forty-two participants were randomised. Seven dropped out. General satisfaction ratings were comparable for the polished (Mean = 80.2, SD = 19.7) and roughened designs (Mean = 79.5, SD = 20.2). However, the open design had a significantly lower satisfaction rating (Mean = 41.1, SD = 32.2). OHIP-EDENT scores for the open design (Mean = 44.9, SD = 17.5) were significantly worse than those for the polished (Mean = 36.1, SD = 12.7) and roughened designs (Mean = 36.2, SD = 13.3). Two-thirds of the participants chose the polished design. One-third chose the roughened design; of those, 83% were first-time denture wearers. CONCLUSIONS: Complete dentures with polished and roughened rugae designs were perceived similarly. Both designs could be recommended based on the patient's preference. However, the open design should be avoided due to negative perception.

Oral health status, oral health-related quality of life and personality factors among users of three-sided sonic-powered toothbrush versus conventional manual toothbrush.

OBJECTIVES: This longitudinal within subject controlled randomized observational investigation studied the impacts of three-sided sonic-powered toothbrush versus conventional manual toothbrush on oral health- and oral health-related quality of life (OHRQoL) and assessed the relationship between personality factors and OHRQoL. METHODS: A total of 96 participants (48 females and 48 males; mean age = 22.61 years, SD = 1.21) were recruited into this investigation and were randomly allocated into two groups. The participants were instructed to control oral hygiene for 1 month using either a three-sided sonic brush (Triple Bristle, Dayton, Tennessee, USA) (sonic group) or a conventional manual toothbrush (manual group). Dental plaque was assessed via Turesky-Modified Quigley-Hein Plaque Index (TMQHPI). Bleeding on probing (BOP) was recorded as 1 if present and zero if absent. The NEO Five-Factor Inventory (NEO-FFI) and Oral Health Impact Profile (OHIP-14) were used to assess personality factors and OHRQoL, respectively. TMQHPI, BOP and OHIP were assessed at study baseline and 1 month later. RESULTS: The TMQHPI, BOP and OHIP-14 scores were reduced after 1 month in both groups (p < 0.05), and were more reduced among the three-sided sonic brush users (p > 0.05). Higher neuroticism scores were associated with worse OHRQoL (p < 0.05) in both groups after 1 month. CONCLUSIONS: The three-sided sonic-powered toothbrush was associated with superior oral health and OHRQoL in comparison with the conventional manual toothbrush. Utilizing three-sided sonic toothbrush, less plaque deposits and lower neuroticism scores contributed towards and predicted better OHRQoL after 1 month of oral hygiene maintenance.

Self-harm, dentofacial features, and bullying.

INTRODUCTION: Self-harm is a growing public health problem. The study aimed to investigate the prevalence of self-harm among a representative sample of school children and the contribution of dentofacial appearance and being bullied because of dentofacial appearance to self-harm. METHODS: This was a cross-sectional study in which a representative sample of eighth-grade students (aged 13-14 years) from randomly selected schools was asked to complete anonymous questionnaires distributed in the classroom. The final sample size was 699 children (339 girls, 360 boys) with a mean age of 13.3 years, representing 1.26% of the target population. RESULTS: The prevalence of self-harm was 26.9% (n = 188), with no statistically significant gender differences (P >0.05). Among all the subjects who reported self-harm, 47.9% (n = 90) reported self-harm because of dentofacial features. A total of 41 subjects reported self-harm because of bullying targeted at dentofacial features, representing around one fifth of subjects who reported self-harm. The 3 most common dentofacial features contributing to self-harm and self-harm as a result of bullying were tooth color and shape, spacing between the teeth or missing teeth, and prominent maxillary anterior teeth. CONCLUSIONS: This study demonstrated a relatively high experience of self-harm reported by adolescent school children, with many reporting self-harm as a result of their dentofacial appearance and bullying because of dentofacial features. The present study provides baseline data to better understand the relationship between self-harm and dentofacial features.

COVID-19 and Dentistry: An Updated Overview of Dental Perspectives and a Recommended Protocol for Dental Care and Emergency Dental Treatment.

AIM AND OBJECTIVE: This manuscript aims to provide an overview of the coronavirus disease-2019 (COVID-19) pandemic from dental perspectives, and presents standards and guidelines of dental care provision based on available research in this field as well as clinical experience and practice. BACKGROUND: The current COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is spreading around the globe and interferes with the provision of dental care for many individuals from different communities and backgrounds. A search for the literature on PubMed, ISI Web of Science, Scopus, EMBASE, and Cochrane Library from March 1, 2020 to December 30, 2020 was conducted. Also, the bibliographies included in the indicated articles were used to identify further literature. Recommendations by health authorities in different countries were also consulted. RESULTS: COVID-19 is causing many fatalities and is disrupting people's daily life and the economy in many countries around the world. Due to the potential of cross-infection through dental treatments, especially dental aerosol generation procedures, the dental profession has been disrupted during this pandemic. Dental care provision has been ceased completely or partially (limited to emergency or urgent treatment) in most countries around the world. Until this pandemic is controlled by new suitable treatments and/or vaccination, there is an urgent need to adopt immediate guidelines and standards for the safe provision of dental care to meet patients' demands, especially for the dental aerosols. CONCLUSION: Guidelines and standards for dental treatment amidst the COVID-19 pandemic are required. This manuscript provides an overview of the COVID-19 pandemic from dental perspectives and presents standards and guidelines of dental care provision based on available research in this field as well as clinical experience and practice. CLINICAL SIGNIFICANCE: This manuscript provides guidelines and standards for dental treatment and clinical management within dental settings amidst the COVID-19 pandemic, and resembles part of the quest to set the golden standards for dental care during the current circumstances. How to cite this article: AL-Omiri MK, Al-Shayyab MH, Al Nazeh AA, et al. COVID-19 and Dentistry: An Updated Overview of Dental Perspectives and a Recommended Protocol for Dental Care and Emergency Dental Treatment. J Contemp Dent Pract 2021;22(5):572-586.

Impacts of the Triple bristles three-sided sonic powered toothbrush on tooth shade, plaque control and gingival health.

OBJECTIVES: To evaluate the efficacy of the Triple bristles three-sided sonic powered toothbrush in plaque removal and its impact on tooth shade and gingival health, and to compare this with a conventional manual toothbrush. METHODS: Fifty two participants (26 males and 26 females; mean age [SD] = 22.48 [1.52], SE = 0.210, 95% CI = 22.06-22.90) were recruited into this controlled within-subject, randomized, two-treatment, 1-month crossover and examiner-blinded observational study between October 2020 and January 2021 in the School of Dentistry, University of Jordan. Within each participant, the upper and lower jaws were randomized to receive a brushing protocol either with the Triple bristles three-sided sonic brush or with a soft manual standard toothbrush with flat trimmed bristles. Tooth shades were recorded for upper and lower anterior and premolar teeth. The Turesky-Modified Quigley-Hein Plaque Index (TMQHPI) and bleeding on probing (BOP) were evaluated at study baseline, 1 week and 1 month after applying the brushing protocol. RESULTS: Both tested brushes were associated with significant reduction in plaque scores and BOP (p < 0.05). The Triple bristles brush was more effective in reduction in plaque and BOP in the lower jaw and among females than the manual brush (p < 0.05). CONCLUSIONS: The Triple bristles brush was more superior for reduction in plaque and probing on bleeding in the lower jaw and among females.

RETRACTED: Muscle activity and masticatory efficiency with bilateral extension base removable partial dentures with different cusp angles.

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article has been retracted at the request of the author due to unintended duplicate submission of a paper that was published in J Prosthet Dent 2017 Jan;117(1):55-60; https://doi.org/10.1016/j.prosdent.2016.05.017.

Muscle activity and masticatory efficiency with bilateral extension base removable partial dentures with different cusp angles.

STATEMENT OF PROBLEM: Whether masticatory efficiency and electromyographic activity are influenced by type of artificial teeth and food is unclear. PURPOSE: The purpose of this clinical study was to evaluate the influence of extension base removable partial dentures (RPDs) with different cusp angles: anatomic (33 degrees), semianatomic (20 degrees), and nonanatomic (0 degrees) teeth on masticatory efficiency and muscle activity during the mastication of test foods with different textures. MATERIAL AND METHODS: Twelve participants with RPDs were selected to perform masticatory efficiency and electromyographic tests. Surface electromyograms (EMGs) were used to record the activities of the masseter and temporalis muscles during the mastication of different types of test foods. The maximal voltage and duration were measured on the integrated EMG signal in each muscle during food mastication, and the mean reading of both sides was then recorded. Analysis of variance and the Tukey post hoc test were used to perform statistical analyses (α=.05). RESULTS: The masticatory efficiency of RPDs with nonanatomic teeth was significantly inferior to that of RPDs with anatomic and semianatomic teeth (P<.05). However, masticatory efficiency did not differ between anatomic and semianatomic teeth (P>.05). Also, muscle activity (according to EMG) with RPDs with NA teeth was significantly higher than that with anatomic and semianatomic teeth (P<.05). CONCLUSIONS: RPDs with NA teeth were associated with higher EMG muscle activity and reduced masticatory efficiency than anatomic or semianatomic teeth.

Comparison of dental bleaching effects of ozone and hydrogen peroxide: An ex vivo study.

PURPOSE: To compare the efficacy of using ozone versus hydrogen peroxide (H2O2) for tooth bleaching. METHODS: 90 extracted teeth were allocated into two groups. Teeth in Group 1 (n= 45) were exposed to ozone for 60 seconds; ozone was produced by healOzone x4 machine (healOzone x4), and was applied to teeth through special disposable silicone cups. The silicone cups allowed total seal and avoided gas escape as the machine is devised to work only if the cup guarantees perfect seal and thus secure the safety of the machine for human use. Teeth in Group 2 (n= 45) were treated with 38% H2O2 for 20 minutes. The shade of teeth was recorded for both groups at base line, after application of ozone in Group 1, and after application of H2O2 in Group 2. The reading for L* a* b* values and Vita Classic shades were recorded using the Colorimeter Konica-Minolta CR-400. The statistically significant differences were set at P≤ 0.05. RESULTS: The teeth in both groups acquired lighter shades after bleaching (P< 0.001). In addition, baseline L* shade values were increased and b* shade values were decreased (means lighter shades) after bleaching in both groups (P< 0.01). However, baseline a* shade values were not significantly changed after bleaching with ozone in Group 1 (P= 0.682). In contrast, a* shade values were significantly decreased after bleaching with H2O2 in Group 2 (P= 0.005). Furthermore, final shades achieved after bleaching were not significantly different between groups (P> 0.05). In conclusion, application of ozone for 60 seconds or application of 38% of H2O2 for 20 minutes resulted in teeth with lighter shades. Bleaching by application of ozone for 60 seconds would result in similar outcomes to bleaching with 38% H2O2. CLINICAL SIGNIFICANCE: This is the first study to compare bleaching effects of ozone and hydrogen peroxide on natural human teeth. It might be suitable to consider ozone for dental bleaching since comparing to H2O2 it could potentially reduce the time, side effects and cost of treatment. Also, application of ozone is better controlled and more convenient and measurable as it is delivered by a machine that can manage the concentration, volume, delivery site and timing of delivered ozone.

Relationship between impact of maxillary anterior fixed prosthodontic rehabilitation on daily living, satisfaction, and personality profiles.

STATEMENT OF PROBLEM: Personality profiles may affect the impact of dental treatment on daily living and patient satisfaction. PURPOSE: The purpose of this clinical trial was to evaluate the impact of maxillary anterior fixed prosthodontic rehabilitation on daily living and the satisfaction of patients and to investigate its relationship with personality profiles. MATERIAL AND METHODS: Fifty-nine participants (25 men and 34 women; mean age 32.4 ± 6.9 years) received maxillary anterior partial fixed dental prostheses. The clinical success of the prostheses was evaluated following specific criteria. The Dental Impact on Daily Living (DIDL) questionnaire was used to measure satisfaction with the prostheses and their impact on daily living. The Neuroticism-Extraversion-Openness Five-Factor Inventory (NEO-FFI) was used to measure patients' personality profiles. The paired sample t test was used to compare satisfaction and personality scores before and after treatment (α=.05). RESULTS: Participants' total satisfaction and their satisfaction with appearance, pain tolerance, oral comfort, general performance, and eating improved after treatment (P<.05). Before treatment, women were less satisfied with general performance (P=.047) and scored higher on the Neuroticism score (P=.039); however, after treatment, women were more satisfied with appearance (P=.004). Age and sex had no significant correlation with personality profiles after treatment. Before treatment, Neuroticism, Openness, and Conscientiousness scores were associated with dental satisfaction and impact on daily life (P<.05). After treatment, Neuroticism, Openness, and Extraversion scores were associated with dental satisfaction and impact on daily life (P<.05). CONCLUSIONS: Patient satisfaction with their oral condition improved after partial fixed dental prosthetic rehabilitation in the maxillary anterior esthetic zone. Psychological profiles (Neuroticism, Extraversion, Openness, and Conscientiousness) may be involved in and explain the impact on daily living and the degree of patient satisfaction with their prostheses.

Recurrent aphthous stomatitis (RAS): a preliminary within-subject study of quality of life, oral health impacts and personality profiles.

BACKGROUND: RAS may affect quality of life and impacts oral health and daily activities; consequently, psychological factors, dental needs and patients' perceptions. Professionals should understand this relation to adequately manage oral ulcers. This study aimed at investigating the relationship between oral health impacts, oral health-related quality of life and psychological profiles in patients with recurrent aphthous stomatitis (RAS). METHODS: Fifty-three patients (30 men and 23 women, mean age: 31.1 ± 10.1 years) with RAS participated in this study. During ulcer episodes, participants completed Hospital Anxiety and Depression Scale (HAD), Neuroticism-Extraversion-Openness Five Factor Inventory (NEO-FFI), Oral Health Impact Profile (OHIP-14) and United Kingdom Oral Health-Related Quality of Life measure (OHQoL-UK) proformas. Patients completed OHIP-14 and OHQoL-UK again when they were ulcer-free. The statistically significance levels were set at P ≤ 0.05. RESULTS: During ulcer episodes, patients reported worse oral health impacts and an inferior quality of life in comparison with ulcer-free times (P < 0.0001). Higher OHIP scores were significantly associated with higher HAD depression (P = 0.036) and anxiety (P = 0.012) scores. NEO-FFI scores had no significant relations with OHIP and OHQoL-UK scores (P > 0.05). During ulcer-free periods, no relationships were detected between OHIP, OHQoL-UK, HAD and NEO-FFI scores (P > 0.05), except between OHQoL-UK and conscientiousness scores (P = 0.05). CONCLUSIONS: RAS increased the negative oral health impacts on patients and consequently lowered their quality of life. Stressful situations and conditions (including anxiety and depression), rather than inherent personality profiles and stable psychological traits, were related to oral health impacts and quality of life in patients with RAS.

Antifungal prescribing pattern and attitude towards the treatment of oral candidiasis among dentists in Jordan.

AIM: The aim of this study was to evaluate the attitude of Jordanian dentists towards the treatment of oral candidiasis and their current antifungal prescribing habits, shedding more light on the possible influence of their socio-professional factors on the pattern of prescribing and practice. METHODS: A structured validated questionnaire was developed and tested; it was then emailed to a random sample of 600 Jordanian dental practitioners during the period of this cross-sectional survey. The questionnaire recorded practitioners' personal details and their attitude and prescribing of antifungal therapy for oral candidiasis. Statistical significance was based on probability values of <0.05 and was measured using the chi-square and Fisher's exact tests. Multiple logistic regression analysis was used to analyse the influence of respondents' socio-professional factors on their attitude towards oral candidiasis. RESULTS: Of the 423 questionnaires returned, only 330 were included. The attitude of respondents was significantly influenced by their experience [odds ratio (OR) = 0.14; P < 0.001] and workplace (OR = 4.70; P < 0.001). Nystatin was the most commonly prescribed antifungal agent (78.2%), followed by miconazole (62.4%), which was prescribed for topical use. Systemic antifungals were prescribed by 21.2% of respondents, with a significant (P < 0.05) association with the country in which their qualification was obtained. CONCLUSION: The attitude towards the treatment of oral candidiasis is much better among the least-experienced dentists working in private practice. Nystatin and miconazole are the most popular choices of antifungal agents among Jordanian dentists.

Intraoral versus extraoral measurement of the height of the interproximal contact area in maxillary anterior teeth.

OBJECTIVES: This study aimed to clinically quantify the apicoincisal height of the upper interproximal areas directly in patients' mouths compared to measurements on stone models. SUBJECTS AND METHODS: One hundred and fifty participants (75 females and 75 males, age range 20-45 years) were recruited for this study. A digital caliper was used to measure the anterior maxillary interproximal contact areas directly in patients' mouths and on stone models. The digital caliper accuracy was up to 0.01. The Statistical Package for Social Sciences software (SPSS, version 19.0, Chicago, Ill., USA) was used for statistical analysis. Statistical significance was based on probability values <0.05. RESULTS: The intraoral measurement of proximal contacts as well as the measurement on stone models showed that the dimensions of interproximal contacts on both sides of each tooth were significantly different (p < 0.001) and that the dimension of the mesial contact point was larger than that of the distal contact point of each tooth. The largest contact point was the one between the central incisors (direct intraoral measurement = 2.9-6.49 mm; model measurement = 3.31-6.91 mm). On the other hand, the contact point between the canine and first premolar was the smallest on both sides of the arch (0.63-2.52 mm intraorally, 0.98-2.88 mm on models). The intraoral measurement of contact points was more accurate than model measurements, and the differences were statistically significant (p < 0.001). CONCLUSIONS: The clinical evaluation of contact point dimensions using a digital caliper was more precise than measuring contact points on stone models; hence, it is a viable, quick and adequate method to be used routinely.

Position of Fovea Palatinae relative to the vibrating line in various soft palate classifications among Jordanian edentulous population.

This study aims to examine the relationship between the locations of Fovea Palatinae and the posterior vibrating line in different classes of soft palate angulation (House Classification), accordingly determine its reliability as a landmark and a tool for determining the posterior limit of the maxillary complete denture. 280 completely edentulous patients with normal healthy mucosa from both genders were randomly selected. The House classification of the soft palate angulation was identified and recorded as Class I, II, or III. Phonation was used to determine the position of the vibrating line. The Fovea Palatinae was then marked. Then, the distance between the Fovea Palatinae and the vibrating line was measured and recorded. Finally, the relative position of the Fovea Palatinae to the vibrating line was recorded as being anterior, posterior, or on the vibrating line. The Chi Square test, the effect size measures (Eta and Cramer's V tests), The Spearman's Rho rank correlation test, and multinominal logistic regression analysis were utilized to analyse the data. House classification percentages were measured among people whose Fovea Palatinae was detectable; Class II palate was the most prevalent (47.14%), followed by Class I (43.93%), and then Class III (8.93%). Based on vibrating line position, 129 (58%) had a vibrating line anterior to Fovea Palatinae, 57 (26%) on the Fovea Palatinae, 36 (16%) posterior to Fovea Palatinae, and in 58 (21%) Fovea Palatinae were not detected. The mean distance between the vibrating line and Fovea Palatinae was 3.66 ± 1.6 mm anteriorly and 2.97 ± 1.36 mm posteriorly. No significant differences were found between males and females in regard to House classification and vibrating line position. The odds of having the fovea posterior to the vibrating line would increase by 5% for each year increase in the age (P = 0.035, odds ratio = 1.050). Class II House classification of the soft palate was found to be the most prevalent among the study participants. Also, the vibrating line was anterior to the Fovea Palatinae in the majority of cases. The odds of having the fovea posterior to the vibrating line would increase by age. The Fovea Palatinae could be considered a useful guide for locating the vibrating line.

Salivary oxidative stress biomarkers in periodontitis-free smokers: a cross sectional study.

BACKGROUND: Salivary oxidative stress has been extensively studied with attempts to correlate changes in the oxidative stress markers with local and systemic factors, including smoking. The objective of this study was to evaluate the influence of two forms of smoking, cigarettes and waterpipe smoking (WPS), on selected oxidative stress biomarkers in saliva. METHODS: Three groups of participants were enrolled into the study, controls (never smokers), cigarette smokers and WPS. Participants were clinically free from periodontitis and systemic conditions known to affect the saliva constituents. Unstimulated whole saliva samples were collected according to a standard protocol and concentrations of 8-hydroxy-2'-deoxyguanosine (8-OHdG), myeloperoxidase (MPO), malondialdehyde (MDA), total antioxidant capacity (TAC), and cortisol. The one-way ANOVA test was used to compare the levels of each oxidative stress biomarker between the three study groups and the hierarchical linear regression analysis was used to test the levels of salivary cortisol for prediction of other oxidative stress biomarkers. Significance levels were set at 95% confidence intervals and probability values ≤0.05. RESULTS: 8-OHdG was highest in WPS group (mean±SE 11,030.35±1829.16 pg/mL) while MDA and cortisol levels were highest in the cigarette smokers group (mean±SE 3.33±0.52 µM and 3.99±0.48 ng/mL, respectively) and MPO was highest in the control group (mean±SE 7.760±1.55 ng/mL). WPS group showed the highest TAC (mean±SE 0.3±0.03 mM). However, none of the tested makers reached a statistically significant difference. CONCLUSIONS: Despite subtle changes in some biomarkers, the salivary oxidative stress does not appear to be significantly influenced by smoking habits in periodontitis-free smokers.

Stress experienced by dental students performing clinical training in different dental disciplines: a cross-sectional study.

OBJECTIVES: To assess the stress level, the impact of stress factors, and discrepancies between fourth- and fifth-year undergraduate clinical students at the University of Jordan. METHODS: A cross-sectional study was conducted in the academic year 2022/2023. The study group included fourth- and fifth-year dental students at the University of Jordan (n = 382) who were asked to voluntarily fill in an online dental environment stress (DES) questionnaire. Analysis was conducted using Mann-Whitney U test, independent t-test, χ2 test, and Spearman ρ rank correlations. Statistical significance was inferred when P < .05. RESULTS: Fourth-year students reported higher levels of nervousness before treating patients for the first time. Fifth-year students faced more difficulty, higher stress, and/or fear regarding the amount of assigned work, provided treatment, completed requirements, failing the course, time to finish assignments, patient comprehensive care, and financial expenses of the course. Comparison between groups revealed that the fifth-year students scored higher levels of stress on the total DES score and all partial DES scores. Furthermore, the total DES questionnaire scores were significantly correlated with grade point average (GPA) among the total study sample and the prosthodontics clinical course marks among the fourth-year students' group. CONCLUSIONS: The stress level among students in clinical courses was influenced by their academic performance, gender, year level, and the type and time needed for the provided treatment. Completing course requirements was among the most commonly faced stressors. Future research endeavors might be considered to study each clinical factor, its impact on students' stress level, and how to manage and positively improve these factors.

Relationships between perception of black triangles appearance, personality factors and level of education.

This analytical cross-sectional study evaluated the perception of black triangles (BT) and examined the relationships between the perception of BT, personality factors, different educational backgrounds and demographic factors. 435 participants were included and divided into four groups: dentists, clinical (4th and 5th year) dental students, pre-clinical (3rd year) dental students, and laypeople. Participants' perception of the attractiveness of smile profiles of maxillary and mandibular anterior dentition with BT was rated using a ten-point VAS scale with 0 being the least, and 10 being the most attractive smile profile. The personality was assessed using the NEO-FFI personality questionnaire. The smile profile with multiple large BT was rated the least attractive for the maxillary (mean = 3.6) and mandibular (mean = 3.9) tested profiles. The smile profile without BT was rated the most attractive for the maxillary (mean = 9.1) and mandibular (mean = 8.8) tested profiles. The dental professionals perceived the maxillary smile profile with multiple large BT as less attractive than the non-dental participants (t = - 2.715, P = 0.007). Being a male, having dental education, having lower Neuroticism scores, as well as having higher Openness, Agreeableness, Conscientiousness, and Extraversion scores predicted and contributed more towards perceiving various tested smile profiles as more attractive. These findings show that black triangles negatively impacts the perception of smile attractiveness, and that personality traits and having dental education impact the perception of smile attractiveness for smiles with black triangles.

The knowledge regarding the impacts and management of black triangles among dental professionals and laypeople.

This study aimed to assess the knowledge regarding impacts, causes and management of black triangles (BT) among participants from different educational backgrounds including dental students, dentists and laypeople. This descriptive cross-sectional observational research included 435 participants who comprised 4 groups: pre-clinical (3rd year) dental students, clinical (4th and 5th year) dental students, dentists, and laypeople. A constructed self-reported questionnaire was utilized to assess participants' demographic data and their knowledge of the impacts, causes and management of BT. The VAS scale was used to assess participants' ratings for the impacts of BT on esthetics, with 0 meaning no impact and 10 meaning very severe negative impacts. The most reported treatments for BT were "cannot be treated" 99.3% and "non-surgical periodontal treatment" 67.1%. Meanwhile, the least reported was "modify the porcelain" 41.8%. The most reported cause of BT was "periodontal disease" 85.1%. However, the least reported were "parafunction" and "deep implants" 33.1% each. Dental professionals had better knowledge of the causes (t = 8.189, P < 0.001) and management (t = 8.289, P < 0.001) of BT than the non-dental participants. The dentists had the best knowledge, while the laypeople had the least knowledge of the causes (F = 62.056, P < 0.001) and treatment (F = 46.120, P < 0.001) of BT. The knowledge of the causes (t = 0.616, P = 0.538) and treatment (t = 1.113, P = 0.266) for BT was not significantly different between males and females. Age was not significantly related to the total knowledge about the causes (r = -0.034, P = 0.475) or treatment (r = -0.034, P = 0.482) for BT. Dental professionals had better knowledge of the impacts, causes and management of BT than the non-dental participants. The dentists were the best, while the laypeople were the worst in this regard. Age and gender had no relationships with the knowledge of causes or management of BT.

Multiple lingual cusps trait on mandibular premolars and hypoconulid reduction trait on mandibular first molar in living Jordanian population. Intra- and inter-trait interactions.

The objective was to determine the expression and fluctuating asymmetry of two dental morphological traits in the living Jordanians: The lingual cusp number on the lower premolars (LP1 and LP2) and the hypoconulid (distal cusp) reduction on the lower first molar (LM1). In addition, both intra- trait and inter- trait interactions were analyzed. Three hundred school children (15.5 +/- 0.4 years) were involved. Impressions for the mandibular dental arches were taken, and dental casts were reproduced. The above-mentioned traits were observed. Paired sample t test and nonparametric correlation analysis were used for data analysis. Three-cusped LP1 was found in 11.40 % of the examined students, while the two-cusped LP1 was found in 88.60%. In comparison, the Three-cusped LP2 was found in 61.40% while the two-cusped LP2 was found in 38.60% of the observed subjects. The frequencies of the 4-cusped and 5-cusped LM1 were found to be 8.65% and 91.35%, respectively. Nonparametric correlation analysis revealed positive and statistically significant association between the expression of two lingual cusps on LP1 and on LP2 in both genders (p < 0.01), while there was no significant correlation between expression of two lingual cusps on either LP1 or LP2 and the hypoconulid loss on LM1 in both genders (p > 0.05). Bilateralism was highly significant in the tested traits in both genders (p < 0.001). This finding might be a sign of relatively low environmental stresses experienced by the living Jordanians and/or great ability of its individuals to buffer the adverse effects of such stresses on dental development. This study is a useful addition to the existing literature in that it examines a previously poorly characterized population and assists in placing the contemporary Jordanian population within the current framework of human population groups globally.

An in vivo study to determine the effects of early preflaring on the working length in curved mesial canals of mandibular molars.

AIM: To evaluate the effects of a preflaring method on the determination of working length in the curved mesial canals of mandibular molars. MATERIALS AND METHODS: Ninety mandibular molars with apical curvature of 30 to 40° were selected and randomly divided into two groups; each containing 45 teeth. In the first group, the initial instrumentation was performed with preflaring on the mesiobuccal canal (preflared group), and in the second group; the instrumentation was performed without preflaring on the mesiobuccal canal (nonpreflared group). A size 15 K-file was inserted in the mesiobuccal canals until the apical constriction could be felt by tactile sensation and a radiograph was taken to identify the distance between the file tip and radiographic apex. The location of the tip was classified as (a) within 1 mm of the radiographic apex, (b) more than 1 mm of the radiographic apex, or (c) overextended beyond the radiographic apex. The collected data was statistically analyzed and probability value was set to be ≤0.05. RESULTS: The file tip was significantly closer to the true working length in the canals with early preflaring compared to the canals without early preflaring (p < 0.005). In the preflared group; 75.5% of the cases had the file tip in location 'a', 13.3% in location 'b', and 11.1% in location 'c'. In the nonpreflared group; 33.3% of the cases had the file tip in location 'a', 53.3% in location 'b' and 13.3% in location 'c'. CONCLUSION: Preflaring the coronal portion of curved canals greatly improved the access to the apical constriction, and thus enhanced correct working length determination. If the coronal portion of the curved canals is not preflared, the clinician cannot discern the accuracy of what they feel apically. Thus, preflaring is a highly recommended procedure especially in curved canals for better determination of correct working length.

Flare-up rate in molars with periapical radiolucency in one-visit vs two-visit endodontic treatment.

PURPOSE: The objective of this study was to compare postobturation flare-ups following single and two-visit endodontic treatment of molar teeth with periapical radiolucency. MATERIALS AND METHODS: A total of 100 patients with asymptomatic molar teeth with periapical radiolucency were selected. They were randomly allocated into two groups. Fifty patients received complete endodontic treatment in one-visit. Fifty patients received treatment by debridement and instrumentation at the first visit followed by obturation at the second visit. RESULTS: 10% of patients had flare-ups in the single visit group and 8% of patients had flare-ups in the two-visit group. Number of visits did not affect the success of endodontic treatment (p>0.05). Age, gender and tooth type had no effects on the occurrence of flare-ups regardless the number of visits (p>0.05). CONCLUSION: One-visit endodontic treatment was as successful as two-visit endodontic treatment as evaluated by rate of flareups in asymptomatic molar teeth with periapical radiolucency.