Dental caries prevalence among Type 1 diabetes mellitus (T1DM) 6- to 12-year-old children in Riyadh, Kingdom of Saudi Arabia compared to non-diabetic children.

OBJECTIVE: The aim of this study was to compare the prevalence of dental caries among groups of 6-12-year-old children with and without Type 1 diabetes mellitus (T1DM) in Riyadh, Saudi Arabia, taking into account oral health behaviour, diet, and salivary parameters. METHODS: The study was designed as a comparable study of dental caries experience between T1DM and non-diabetic groups of children. The total sample size of 209 participants consisted of 69 diabetic and 140 non-diabetic children. Oral hygiene, diet and socio-economic status were collected using a pre-tested questionnaire. Caries was recorded in terms of decayed and filled permanent and primary teeth (DFT/dft). Salivary microbial counts and pH levels were recorded using Caries Risk Test (CRT) kit. Student's t-test, the chi-squared test, linear regression and one-way analysis of variance were performed P-value of 0.05 considered significant. RESULTS: The mean dft scores for the diabetic and non-diabetic groups were 3.32 ± 0.78 and 3.28 ± 0.71 (mean ± SD), respectively (p = 0.458). The mean DFT scores for the diabetic and non-diabetic groups were 1.62 ± 0.65 and 1.96 ± 0.65, respectively (p = 0.681). Diabetic children visited dentists more often than non-diabetic children did (p = 0.04), and had lower consumption of both sweets (p = 0.003) and flavoured milk (p = 0.002) than the non-diabetic group. Furthermore, analysis showed that the diabetic children had medium oral pH levels (pH = 4.5-5.5), whereas the non-diabetic children tended to have high (pH ≥ 6.0) oral pH; this difference was statistically significant (p = 0.01). In addition, the diabetic group had higher Lactobacillus levels than the non-diabetic group (p = 0.04). CONCLUSION: The difference in caries prevalence between the diabetic and non-diabetic children was not statistically significant. The CRT analysis revealed a higher frequency of "critical" pH values (pH = 4.5-5.5) and higher Lactobacillus counts in diabetic children than in non-diabetic children, which indicated a higher caries risk in the former group.

Comprehensive Comparison of Amnion Stromal Cells and Chorion Stromal Cells by RNA-Seq.

Mesenchymal stromal cells derived from the fetal placenta, composed of an amnion membrane, chorion membrane, and umbilical cord, have emerged as promising sources for regenerative medicine. Here, we used next-generation sequencing technology to comprehensively compare amniotic stromal cells (ASCs) with chorionic stromal cells (CSCs) at the molecular and signaling levels. Principal component analysis showed a clear dichotomy of gene expression profiles between ASCs and CSCs. Unsupervised hierarchical clustering confirmed that the biological repeats of ASCs and CSCs were able to respectively group together. Supervised analysis identified differentially expressed genes, such as LMO3, HOXA11, and HOXA13, and differentially expressed isoforms, such as CXCL6 and HGF. Gene Ontology (GO) analysis showed that the GO terms of the extracellular matrix, angiogenesis, and cell adhesion were significantly enriched in CSCs. We further explored the factors associated with inflammation and angiogenesis using a multiplex assay. In comparison with ASCs, CSCs secreted higher levels of angiogenic factors, including angiogenin, VEGFA, HGF, and bFGF. The results of a tube formation assay proved that CSCs exhibited a strong angiogenic function. However, ASCs secreted two-fold more of an anti-inflammatory factor, TSG-6, than CSCs. In conclusion, our study demonstrated the differential gene expression patterns between ASCs and CSCs. CSCs have superior angiogenic potential, whereas ASCs exhibit increased anti-inflammatory properties.

Exosomes Secreted from Amniotic Membrane Contribute to Its Anti-Fibrotic Activity.

Amniotic membranes (AM) have anti-fibrotic activity. Exosomes (nano-sized vesicles) function as conduits for intercellular transfer and contain all the necessary components to induce the resolution of fibrosis. In this study, we tested the hypothesis that the anti-fibrotic activity of AM is mediated by exosomes. AM-derived exosomes or amniotic stromal cell-derived exosomes were isolated and characterized. Anti-fibrotic activity of exosomes was evaluated using human hepatic stellate cells (LX-2), an in vitro model of fibrosis. Exosomes isolated from AM tissue-conditioned media had an average size of 75 nm. Exosomes significantly inhibited the proliferation of TGFß1-activated LX-2 but had no effect on the proliferation of non-activated LX-2 cells. Exosomes also reduced the migration of LX-2 in a scratch wound assay. Furthermore, exosomes reduced the gene expression of pro-fibrotic markers such as COL1A1, ACTA, and TGFß1 in LX-2 cells. Interestingly, exosomes isolated from AM tissue under hypoxic conditions seemed to show a stronger anti-fibrotic activity than exosomes isolated from tissue under normoxic conditions. Exosomes released by in vitro cultured AM stromal cells were smaller in size compared with tissue exosomes and also showed anti-fibrotic activity on LX-2 cells. In conclusion, AM-tissue-released exosomes contribute to the anti-fibrotic activity of AM. This is the first report of isolation, characterization, and functional evaluation of exosomes derived from amniotic tissues with the direct comparison between tissue-derived exosomes and cultured cell-derived exosomes.

Structural and Functional Equivalency Between Lyopreserved and Cryopreserved Chorions with Viable Cells.

Objective: Clinical studies have demonstrated that the use of cryopreserved amnion or trophoblast (TR)-free chorion, containing viable cells, in the treatment of chronic wounds results in high rate of wound closure. Recently, a new lyopreservation method has been developed for preservation of amnion that also retains the endogenous viable cells. The objective of this study was to use this method for lyopreservation of TR-free chorionic membrane (viable lyopreserved chorionic membrane [VLCM]) and compare it with the viable cryopreserved chorionic membrane (VCCM). A second objective was to investigate the immunogenicity of chorion, an important question that has not been fully addressed. Approach: Chorion immunogenicity was tested in vitro in a mixed lymphocyte reaction and lipopolysaccharide (LPS) challenge assay, and in vivo in a mouse subcutaneous pocket implantation model. VLCM tissue structure was assessed histologically, growth factor content by multiplex assay, and cell viability by LIVE/DEAD cell fluorescent staining. Inhibition of tumor necrosis factor α secretion by LPS-activated THP-1 cells and endothelial cell tubule formation assays were performed to evaluate the anti-inflammatory and proangiogenic properties, respectively. An in vivo rabbit abdominal adhesion model was used to evaluate the antifibrotic properties. Results: Chorionic membrane without trophoblast (CM) was shown to be nonimmunogenic. Tissue architecture, growth factors, and cell viability of fresh CM were maintained in VLCM and VCCM. In vitro studies showed that anti-inflammatory and angiogenic properties were retained in VLCM. Furthermore, VLCM prevents formation of postsurgical adhesions in a rabbit abdominal surgical adhesion model. Innovation: Characterization of structural and functional properties of VLCM is reported for the first time. Conclusion: Similar to VCCM, VLCM retains native components of fresh CM, including collagen-rich extracellular matrix, growth factors, and viable cells. In vitro and in vivo models demonstrate that VLCM is anti-inflammatory, proangiogenic and antifibrotic. Results of this study support the structural and functional equivalency between VLCM and VCCM.

A Flowable Placental Formulation Prevents Bleomycin-Induced Dermal Fibrosis in Aged Mice.

Fibrosis, the thickening and scarring of injured connective tissue, leads to a loss of organ function. Multiple cell types, including T-cells, macrophages, fibrocytes, and fibroblasts/myofibroblasts contribute to scar formation via secretion of inflammatory factors. This event results in an increase in oxidative stress and deposition of excessive extracellular matrix (ECM), characteristic of fibrosis. Further, aging is known to predispose connective tissue to fibrosis due to reduced tissue regeneration. In this study, we investigated the anti-fibrotic activity of a flowable placental formulation (FPF) using a bleomycin-induced dermal fibrosis model in aged mice. FPF consisted of placental amnion/chorion- and umbilical tissue-derived ECM and cells. The mice were injected with either FPF or PBS, followed by multiple doses of bleomycin. Histological assessment of FPF-treated skin samples revealed reduced dermal fibrosis, inflammation, and TGF-ß signaling compared to the control group. Quantitative RT-PCR and Next Generation Sequencing analysis of miRNAs further confirmed anti-fibrotic changes in the FPF-treated group at both the gene and transcriptional levels. The observed modulation in miRNAs was associated with inflammation, TGF-ß signaling, fibroblast proliferation, epithelial-mesenchymal transition and ECM deposition. These results demonstrate the potential of FPF in preventing fibrosis and may be of therapeutic benefit for those at higher risk of fibrosis due to wounds, aging, exposure to radiation and genetic predisposition.

A Viable Lyopreserved Amniotic Membrane Modulates Diabetic Wound Microenvironment and Accelerates Wound Closure.

Objective: Wound healing is a complex process involving the dynamic interplay of various types of cells and bioactive factors. Impaired wound healing is characterized by a loss in synchronization of the process, resulting in non-healing chronic wounds. Human amniotic membrane (AM) has been shown to be effective in the management of chronic wounds. Recently, a viable lyopreserved AM (VLAM) has been developed. The VLAM retains the structural, molecular, and functional properties of fresh AM with the advantage of a long shelf life for living tissue at ambient temperatures. The objective of this study was to evaluate the effects of VLAM on the impaired wound microenvironment and wound closure in db/db mice. Approach: VLAM or saline gel (control) was applied weekly to 7-mm excisional wounds in diabetic (db/db) mice. Wound appearance and size were assessed weekly. Inflammation and redox state in wounds were tested by cytokine gene and protein expression, and by catalase and glutathione peroxidase activities, respectively. Wound tissue granulation and neovascularization were assessed histologically. Results: Diabetic wounds treated with VLAM closed faster than control wounds. On an average, VLAM-treated wounds closed 4 days faster than the control wounds, with a significantly faster rate of closure at days 7 and 14 as compared with control wounds. The faster closure correlated with a decrease in the expression of proinflammatory factors and oxidative stress, and an increase in angiogenesis and dermal thickness. Innovation: Effects of VLAM on a chronic wound microenvironment and underlying molecular mechanisms were investigated for the first time. Conclusion: VLAM accelerates wound closure in db/db mice by decreasing inflammation and oxidative stress and supporting wound tissue granulation, neovascularization, and re-epithelialization.

Properties of viable lyopreserved amnion are equivalent to viable cryopreserved amnion with the convenience of ambient storage.

Human amniotic membrane (AM) has a long history of clinical use for wound treatment. AM serves as a wound protective barrier maintaining proper moisture. AM is anti-inflammatory, anti-microbial and antifibrotic, and supports angiogenesis, granulation tissue formation and wound re-epithelialization. These properties of AM are attributed to its native extracellular matrix, growth factors, and endogenous cells including mesenchymal stem cells. Advances in tissue preservation have helped to overcome the short shelf life of fresh AM and led to the development of AM products for clinical use. Viable cryopreserved amnion (VCAM), which retains all native components of fresh AM, has shown positive outcomes in clinical trials for wound management. However, cryopreservation requires ultra-low temperature storage and shipment that limits widespread use of VCAM. We have developed a lyopreservation technique to allow for ambient storage of living tissues. Here, we compared the structural, molecular, and functional properties of a viable lyopreserved human amniotic membrane (VLAM) with properties of VCAM using in vitro and in vivo wound models. We found that the structure, growth factors, and cell viability of VLAM is similar to that of VCAM and fresh AM. Both, VCAM and VLAM inhibited TNF-α secretion and upregulated VEGF expression in vitro under conditions designed to mimic inflammation and hypoxia in a wound microenvironment, and resulted in wound closure in a diabetic mouse chronic wound model. Taken together, these data demonstrate that VLAM structural and functional properties are equivalent to VCAM but without the constraints of ultra-low temperature storage.

Effectiveness of oral health education intervention among female primary school children in Riyadh, Saudi Arabia.

OBJECTIVE: This study aimed to examine the effectiveness of oral health intervention on the improvement in knowledge and self-reported oral health behavior among 6-8 year old female primary school children in Riyadh, Saudi Arabia. MATERIALS AND METHODS: The sample consisted of 1661 girls in primary schools who are 6 to 8-year-olds (first, second and third graders). The children's level of knowledge was assessed by a self-administered questionnaire that was formulated for this specific age and divided into two parts; oral health knowledge and self-reported oral health behavior. There were seven multiple choice questions and one true/false question with five underlying parts in the questionnaire which contained basic information about oral health knowledge, oral hygiene practices and certain habits that affect teeth. The questionnaires were distributed before and six weeks after implementation of the oral health educational program to measure the level improvement of knowledge regarding oral health among these children. RESULTS: All the questions showed statistically significant improvement in knowledge and self-reported behavior in the post intervention group. There was a significant increase in the level of knowledge by 11.24% and level of self-reported behavior by 25% after intervention (P < 0.001). The highest net change in the knowledge due to intervention was noted among third graders (13.3%), whereas for self-reported oral health behavior, it was noted among first graders (28.3%). CONCLUSION: The results of this study showed that an easy-to-organize and inexpensive school-based intervention can, on a short-term basis, be effective in improving the knowledge and self-reported oral health behavior of children.

A survey of pediatric dentists' caries-related treatment decisions and restorative modalities - A web-based survey.

OBJECTIVE: To identify current practices and the preferred caries-related treatment decisions and restorative modalities of primary teeth among pediatric dental practitioners in Saudi Arabia. MATERIALS AND METHODS: This was a web-based cross-sectional survey conducted among licensed pediatric dental practitioners in Saudi Arabia. Following the retrieval of the email addresses from the Saudi Dental Council, an email explaining the purpose of the study and a link to SurveyMonkey electronic survey consisting of 23 questions was sent to all the members registered under the pediatric dentistry practitioners, starting in September till December 2013. The data obtained was analyzed using descriptive statistics and chi square with and without tabulation processes. The level of significance was set at p < 0.05. RESULTS: A total of 108 [54 (50%) male and 54 (50%) female] pediatric dental practitioners responded to the survey out of 308 targeted individuals for an overall response rate of 35.1%. About 65% of the respondents reported that they have never considered pre-veneered or Zirconia crowns as a restorative option for carious vital anterior primary teeth. About 40% reported doing pulpectomy and restored with composite strip crowns at all times. About 86% of the respondents reported doing pulpotomy and stainless steel crown for restoring carious vital posterior primary teeth whereas 73.8% reported restoring with composite resin. However, 83.1% of the respondents reported that they never used pre-veneered or Zirconia crowns after pulpotomy for restoring carious vital posterior primary teeth. A significantly higher number of male participants reported that they used esthetic pediatric crowns in their practice compared to female participants (p < 0.001). CONCLUSION: The prevalence of use of composite resin to restore primary teeth was higher compared to glass ionomer cements and amalgam whereas a limited use of esthetic pediatric crowns was found among the sample surveyed. Esthetic pediatric crowns were more utilized by male compared to female participants.

Dental specialty, career preferences and their influencing factors among final year dental students in Saudi Arabia.

OBJECTIVE: The purpose of this study was to investigate evolving trends in dental post graduate specialty preferences and career aspirations among final year dental students in Saudi Arabia. MATERIALS AND METHODS: A cross sectional survey using a self-administered questionnaire was conducted among final year dental students from seventeen universities in Saudi Arabia. The questionnaire enquired about socio-demographic details and the ranking of three of their best preferences among the list of specialties/general dentistry and career options. They were also enquired about their opinion regarding the total time required to become a dentist and their intention to go for further studies abroad. The questionnaire assessed factors influencing their choices using a 5 point Likert scale ranging from extremely important to not important. Binary logistic regression to examine the combined effect of several independent variables on the likelihood of choosing a dental specialization/general dentistry and career option were analyzed. RESULTS: The overall response rate was 64.6%. Restorative and Aesthetic Dentistry was the most preferred specialty (n = 98; 17.7%) followed by Endodontics (n = 78; 14.1%); Prosthodontics (n = 65; 11.7%) and Orthodontics (n = 63; 11.4%). The two most preferred careers were 'Civilian dentist in public sector' followed by 'Academic services dentist'. Overall, students reported that the influence of family members in the dental profession, preference for private practice and specific interest in patient population as the most important factors in choosing a specialty/general dentistry. Intellectual content of the specialty was ranked the least important. On the other hand, the most important factors for choosing a career were variety of non-clinical duties, access to child care facilities and research opportunities. CONCLUSION: The results of this study show the top preferred specialties and career choices which can be a baseline for establishing national policies and for the improvement of graduate programs. There seems to be a need to promote mentoring activities and provide guidance and encouragement to pre-doctoral dental students in selecting the most appropriate specialty within their capability domain.

Prevalence and Heritability of Early Childhood Caries Among Monozygotic and Dizygotic Twins.

Deciphering the relative importance of genetic and environmental factors, which play a major role in the prevalence of early childhood caries (ECC), can help clinicians with planning a long-term preventive treatment. The objective of the study was to determine the prevalence and heritability of ECC among monozygotic (MZ) and dizygotic (DZ) twins in Chennai, India, in the year 2013. A cross-sectional study was designed to estimate the prevalence of ECC among twins. Zygosity classification for the survey framework was adapted from a highly accurate parental report questionnaire pertaining to the physical similarity between twins. The associated heritability index was estimated. The Decayed, Missing, Filled Surface (DMFS) Index was used as the diagnostic criterion for dental caries. The prevalence of ECC was estimated at 18.7%. The correlation coefficient between the twin pair showed significant correlation. The heritability index for ECC was estimated at 15% higher prevalence of ECC found among children in the age group 25-36 months. The heritability estimate indicated a relatively low genetic influence for early childhood caries among twins. There was no significant difference detected in the concordance rate for the MZ and DZ twins. Further research could be directed toward the prevalence of ECC among higher age group children to explore the role of genetic and environmental factors.

Antimicrobial Efficacy of Salvadora persica Extracts on a Monospecies Biofilm on Orthodontic Brackets In Vitro.

PURPOSE: The oral cavity is a rich ecosystem with a plethora of microorganisms, and different components of fixed orthodontic appliances may contribute to a shift in the balance of oral ecology. The purpose of this study was to investigate the antimicrobial potential of hexane and ethanol extracts of Salvadora persica on a monospecies biofilm model established on orthodontic brackets in vitro. MATERIALS AND METHODS: Streptococcus mutans biofilm was formed on mini diamond orthodontic brackets following three days of anaerobic incubation at 37˚C. The bacterial cell viability of this biofilm was measured after their exposure to saline, hexane extract of S. persica, ethanol extract of S. persica and 0.2% chlorhexidine using 3-(4, 5-dimethylthiazol- 2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulphophenyl)-2H-tetrazolium (MTS) assay. On half of the brackets, the colony forming units (CFU) were counted. Both experiments were performed in triplicate. RESULTS: The absorbance values obtained from the MTS reduction assay after exposure to the different test agents showed a decline in the bacterial cell viability of the S. mutans biofilm as follows: chlorhexidine (+)0.05). The CFU counts of S. mutans obtained from chlorhexidine exposure were lower than from hexane and ethanol extracts. CONCLUSION: S. persica extracts were found to have antimicrobial effects on S. mutans biofilm established in vitro on orthodontic brackets suggestive of its potential use as an oral antimicrobial agent for orthodontic patients.

Knowledge about permanent tooth avulsion and its management among dentists in Riyadh, Saudi Arabia.

BACKGROUND: There is a lack of adequate information on dentists' knowledge about tooth avulsion and its management in Saudi Arabia. The aim of this study was to evaluate the level of knowledge about permanent tooth avulsion and its management among dentists working in Riyadh, Saudi Arabia. METHODS: A total of 550 dentists were contacted to request their participation in this 19-item questionnaire survey over a three-month period starting in January 2015 using convenience sampling methodology. A questionnaire consisting of demographic items and multiple-choice questions regarding knowledge of avulsion and its management was used. The level of knowledge was assessed using a scoring system that assigned one point for each correct answer and zero points for wrong answers, with a maximum possible score of ten points. An independent t-test was used to compare the level of knowledge (mean score) based on particular variables, such as sex, nationality, type of practice, current employment, working hours and whether the respondents had attended a continuing dental education (CDE) programme on avulsion management. The level of significance was set at P< 0.05. RESULTS: A total of 470 completed questionnaires were collected with data suitable for statistical analysis. The majority of the respondents were Saudi (n = 331; 72.1 %) and general practitioners (n = 278; 59.3 %). Most of the participants correctly responded to the knowledge-based questions, except the questions regarding the best storage medium (milk: 24.1 %) and the duration of follow-up by clinical and radiographic examination (5 years: 15.6 %). The mean knowledge score was 5.94 ± 1.57. Gender (P = 0.001), current employment (P = 0.045) and working hours per day (P = 0.020) had a significant effect on the mean knowledge score. CONCLUSIONS: The surveyed dentists were found to have a moderate knowledge of avulsion and its management, although a relative lack of knowledge was observed regarding the duration of follow-up after replantation.

Factors Affecting the Shear Bond Strength of Orthodontic Brackets - a Review of In Vitro Studies.

The adhesive material used to bond orthodontic brackets to teeth should neither fail during the treatment period, resulting in treatment delays, untoward expenses or patient inconvenience nor should it damage the enamel on debonding at the end of the treatment. Although the effectiveness of a bonding system and any unfavorable effects on the enamel may be studied by conducting in-vivo studies, it is nearly impossible to independently analyze different variables that influence a specific bonding system in the oral environment. In-vitro studies, on the other hand, may utilize more standardized protocols for testing different bonding systems and materials available. Thus, the present review focused attention on in-vitro studies and made an attempt to discuss material-related, teeth-related (fluorotic vs non-fluorotic teeth) and other miscellaneous factors that influences the shear bond strength of orthodontic brackets. Within the limitations of this review, using conventional acid-etch technique, ceramic brackets and bonding to non-fluorotic teeth was reported to have a positive influence on the shear bond strength of orthodontic brackets, but higher shear bond strength found on using ceramic brackets can be dangerous for the enamel.

The efficacy of Salvadora persica extracts in preserving the viability of human foreskin fibroblasts.

OBJECTIVE: To evaluate the efficacy of Salvadora persica hexane and ethanol extracts in preserving the viability of human foreskin fibroblasts. MATERIALS AND METHODS: Normal human foreskin cells were cultivated in Dulbecco modified Minimum Essential Medium (D-MEM) supplemented with 10% fetal bovine serum and 2 mM of l-glutamine. Cell pellets were suspended in the following test solutions: (1) Hank's Balanced Salt Solution (HBSS); (2) homogenized milk; (3) hexane extract of S. persica; or (4) ethanol extract of S. persica. D-MEM with no serum was used as a positive control. For each condition, cell count was adjusted to 8 × 10(5) cells/ml, and the cells were incubated in the solutions for either 30, 60, or 120 min. Subsequently, the nonviable cells were separated from the viable cells using the trypan blue dye stain. The ratio of viable to nonviable cells was recorded using a cell counter. Statistical analysis of the data was accomplished by one-way analysis of variance using SPSS Version 16. The level of significance was 5% (p < .05). RESULTS: We did not detect a significant difference when comparing the percentage of viable cells in test solutions at the three incubation periods (30 min, p = 0.478; 60 min, p = 0.606; 120 min, p = 0.091). Homogenized milk preserved the viability of foreskin fibroblasts better than all other tested solutions. Incubation of cells in S. persica hexane and ethanol extracts resulted in a similar percentage of viable cells to incubation of cells in HBSS for each incubation period. CONCLUSIONS: S. persica hexane and ethanol extracts should be considered an alternative storage medium to HBSS.

Bioactivity and Surface Characteristics of Titanium Implants Following Various Surface Treatments: An In Vitro Study.

This study compared the surface topography, hydrophilicity, and bioactivity of titanium implants after 3 different surface treatments (sandblasting and acid etching, modified sandblasting and acid etching, and thermal oxidation) with those of machined implants. One hundred indigenously manufactured threaded titanium implants were subjected to 3 methods of surface treatment. The surface roughness of the nontreated (Group A) and treated samples (Groups B through D) was evaluated with a scanning electron microscope (SEM) and profilometer. The wettability was visually examined using a colored dye solution. The calcium ions attached to the implant surface after immersing in simulated body fluid (SBF) were assessed on days 1, 2, and 7 with an atomic electron spectroscope. The data were analyzed statistically. The SBF test allowed the precipitation of a calcium phosphate layer on all surface-treated samples, as evidenced in the SEM analysis. A significantly higher amount of calcium ions and increased wettability were achieved in the thermally oxidized samples. The mean roughness was significantly lower in Group A (0.85 ± 0.07) compared to Group B (1.35 ± 0.17), Group C (1.40 ± 0.14), and Group D (1.36 ± 0.18). The observations from this in vitro study indicated that surface treatment of titanium improved the bioactivity. Moreover, results identified the implants that were sandblasted, acid etched, and then oxidized attracted more calcium ions.

The prevalence of malocclusion and its association with dental caries among 12-18-year-old disabled adolescents.

BACKGROUND: To assess the prevalence of malocclusion among 12-18-year-old disabled adolescents in Chennai, Tamil Nadu, India, by using the Dental Aesthetic Index (DAI) and to determine the association of malocclusion with dental caries. METHODS: This cross-sectional study included 243 children with various mental disabilities with or without physical infirmities. The Dental Aesthetic Index (DAI) and the dentition status were recorded using the World Health Organization Oral Health Surveys - Basic Methods (1997) Pro-forma. The Decayed (D), Missing (M) and Filled (F) components of the DMF index were calculated using the Dentition Status and Treatment Need (DSTN). A Chi-square test, ANOVA, and t-test were used to derive inferential statistics. RESULTS: The mean DAI score ± standard deviation was 39.0 ± 12.3. A total of 123 (50.6%) participants (74 males and 49 females) had DAI scores of 36 and above, which indicated a handicapping malocclusion requiring mandatory orthodontic treatment. Sixty-nine (28.4%) adolescents (36 males and 33 females) had DAI scores between 31 and 35, which indicated severe malocclusion, for which orthodontic intervention was desirable. Incisal segment crowding (84.8%) was the most common aspect of the malocclusion. The mean DMFT score was 4.36 ± 3.81, and 82.8% of the participants had a DMFT score > 0. There was no statistically significant correlation between the mean DAI and DMFT scores (r = 0.090, p = 0.15). Only 16 (6.6%) of the adolescents had minor or no anomaly not needing orthodontic treatment. CONCLUSIONS: The prevalence of malocclusion and dental caries was found to be high. However, there was no positive correlation between the severity of malocclusion and dental caries among the surveyed disabled adolescents.

Knowledge about tooth avulsion and its management among dental assistants in Riyadh, Saudi Arabia.

BACKGROUND: Studies evaluating dental assistants' knowledge about tooth avulsion and its management are rare. The purpose of this study was to evaluate the level of knowledge about tooth avulsion and its management among dental assistants in Riyadh, Saudi Arabia and to assess its relationship with their educational background. METHODS: A convenience sampling methodology was employed for sample selection. Over a period of four months starting in February, 2013, 691 pretested 17-item questionnaires were distributed. A total of 498 questionnaires were returned for an overall response rate of 72.1%. Six questions were related to knowledge about permanent tooth avulsion and one question was related to knowledge about primary tooth avulsion. Correct answers to these questions were assigned one point each, and based on this scoring system, an overall knowledge score was calculated. An analysis of covariance was used to test the association between the level of knowledge (total score) and the educational qualifications of the respondents (dental degree and others). A P-value of 0.05 was considered the threshold for statistical significance. RESULTS: The majority of the respondents (n = 387; 77.7%) were non-Saudis (377 were from the Philippines), and 79.1% (n = 306) of the Filipinos had a dental degree. The question about recommendations for an avulsed tooth that is dirty elicited the highest number of correct responses (n = 444; 89.2%), whereas the question about the best storage media elicited the lowest number of correct responses (n = 192; 38.6%). The overall mean score for knowledge about tooth avulsion was 6.27 ± 1.74. The mean knowledge score among the respondents with a dental degree was 6.63 ± 1.37, whereas that among the respondents with other qualifications was 5.71 ± 2.08. CONCLUSIONS: The educational qualifications of the surveyed dental assistants were strongly correlated with the level of knowledge about tooth avulsion and its management.

Factors affecting job satisfaction and their correlation with educational standards among dental assistants.

A disparity exists in the educational qualifications of dental assistants working in various public and private institutions in Riyadh, Saudi Arabia. The aim of this study was to assess the influence of professional and personal characteristics on job satisfaction among dental assistants. A cross-sectional survey was performed among dental assistants using a 24-item self-administered questionnaire. Multinomial logistic regression was used to assess the relationship between overall job satisfaction and other variables. The overall response rate was 72.1%. Factor analysis suggested that five underlying factors were related to job satisfaction. The mean score for overall job satisfaction was 3.86 (satisfied) out of 5. Among the work environment factors, the highest mean score, 4.26 (satisfied), was obtained for quality of service, and the lowest mean score, 2.78 (neutral), was obtained for the perception of income. The income and general prospects of the profession was significantly associated with overall job satisfaction. This study suggests that for dental assistants, professional and personal life, quality of service, perception of income and prestige and self-respect are important factors for job satisfaction. Despite differences in professional formation standards, in general, the study participants were considerably satisfied with their jobs.

Oral health survey of 6-12-year-old children with disabilities attending special schools in Chennai, India.

BACKGROUND: The dental literature is replete with reports on the oral health surveys of normal children. Relatively few data exist for the oral conditions of mentally challenged children and adolescents with multiple disabilities in India. AIM: To assess the oral hygiene practices and treatment needs among 6-12-year-old disabled children attending special schools in Chennai, India, between 2007 and 2008. DESIGN: A cross-sectional study data were collected using WHO criteria, a questionnaire (for the parents/guardians) regarding demographic data and oral hygiene practices, medical record review, and clinical examination. RESULTS: Among 402 disabled children, majority of the children brushed their teeth once daily (89.7%) and with assistance from the caregiver (64.4%). The utilisation of the dental services was minimal (extractions 14.4%, oral prophylaxis 1.7%, and restorations 1.7%). There was significant difference between residents and non-residents for the mean dft/DMFT. The periodontal health was comparatively better among the residents of the institutions than the non-residents (P < 0.001). Regression analysis revealed that various variables were significantly associated with dft/DMFT and Community Periodontal Index (CPI). CONCLUSION: This study gives sufficient evidence to suggest that the oral health status of this disabled population was poor and there was an increased unmet dental treatment needs.