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.

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.

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.

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.

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.

Treatment of symptomatic, deep, almost cariously exposed lesions using ozone.

The aim of this controlled randomized crossover study was to assess post-treatment pain and the need for root canal treatment after the use of a traditional caries removal method followed by restoration, or after an ozone method of more conservatively managing the deep caries and a restoration. 84 participants (42 males and 42 females, mean age ± SD = 23.9 ± 2.0 years) were randomly allocated to receive either a traditional (n = 42, 21 males and 21 females) or ozone (n = 42, 21 males and 21 females) method. The ozone method only differed from the traditional method by leaving the deep leathery caries on the pulpal floor and then treating this with 20 s of ozone from the healozone X4 (Curozone, Germany). All caries was removed in the traditional group. A conventional glass ionomer cement (Riva Self Cure High Viscosity, SDI, Australia) was placed followed by a bonded composite resin restoration (Filtek Z250 Universal Restorative, 3 M ESPE, USA) in each cavity. The visual analogue scale was used to assess pain scores before treatment and after 24 h. The participants were then followed up for 2 years to assess the need for root canal treatment. Statistical significance levels were set at α ≤ .05. Both groups were associated with significant reduction of pain scores 24 h after treatment (p < .0001). The ozone treatment was associated with less pain 24 h after treatment (p < .0001) and less need for root canal treatment (p = .014), after 2 years follow up, than the conventional treatment. In conclusion, treatment of symptomatic, deep carious lesions by ozone following partial removal of caries was accompanied with less pain and occurrence of RCT after treatment compared to traditional complete caries removal.

COVID-19 and Personality: A Cross-Sectional Multicenter Study of the Relationship Between Personality Factors and COVID-19-Related Impacts, Concerns, and Behaviors.

Background: This cross-sectional observational study aimed to evaluate coronavirus disease 2019 (COVID-19)-related precautions to avoid COVID-19 infection, distress and behavioral changes, fears and concerns, and effects on opinions and beliefs among participants from different backgrounds and also to identify the relationships between personality factors and COVID-19-related changes and impacts. Methods: One thousand and three hundred nineteen participants (744 females and 575 males, mean age ± SD = 32.7 ± 11.6 years) completed a three-section survey collecting data regarding demographic information, personality factors [using the NEO Five-Factor Inventory (NEO-FFI)], and COVID-19-related issues (using the VAS scale). Findings: COVID-19 was associated with changes related to precautions to avoid COVID-19 infection, distress and behavioral changes, fears and concerns, and effects on opinions and beliefs (P < 0.05). Higher neuroticism scores were associated with more negative COVID-19-related changes and impacts (P < 0.05). Higher extraversion, agreeableness, and conscientiousness scores were associated with more acceptance of COVID-19 containment measures as well as less COVID-19-related changes and impacts (P < 0.05). Conclusions: Personality factors were associated with COVID-19-related impacts. These findings demonstrate the importance of the relationship between personality factors and COVID-19-related changes.

Relationship between oral health impacts and personality profiles among orthodontic patients treated with Invisalign clear aligners.

This within subject clinical experiment assessed oral health impacts before and after Invisalign orthodontic treatment and their relationships with personality characteristics. 50 patients (26 females and 24 males; mean age = 27.62 ± 8.25 years, SE = 1.17, 95% CI = 24.71-29.89 years) were assessed before and after treatment with Invisalign orthodontic treatment. Treatment clinical success was evaluated according defined clinical guidelines. Oral health impacts before and after Invisalign orthodontic treatment were measured via the Oral Health Impact Profile (OHIP). Personality features were measured via the NEO Five-Factor Inventory (NEO-FFI). Probability of α = .05 was utilized to identify significant findings. Females scored less OHIP scores after treatment (had less negative impacts) in comparison to baseline OHIP scores (t = 3.782, df = 25, P = .001, 95% CI of mean difference = 2.750-9.327). Among males, openness scores (R2 = .911, B = 5.235, 95% CI for B = 0.062-10.407, t = 2.601, P = .048) were able to predict OHIP scores before treatment; meanwhile, extraversion (R2 = .959, B = - 8.224, 95% CI for B = - 14.605-1.843, t = - 3.313, P = .021), openness (R2 = .959, B = 21.795, 95% CI for B = 10.737-32.853, t = 5.067, P = .004), and conscientiousness (R2 = .959, B = 10.293, 95% CI for B = 4.796-15.790, t = 4.813, P = .005) scores were useful to predict OHIP scores after treatment (R2 = .959, P < .05). NEO-FFI scores were not useful to predict OHIP scores before or after treatment among females (P > .05). These findings demonstrate that oral health impacts of Invisalign orthodontic treatment and personality profiles contribution to oral health impacts were different between genders.

Serum levels of 25-hydroxy-vitamin D in patients with oral squamous cell carcinoma: Making a case for chemoprevention.

OBJECTIVES: Serum level of vitamin D has been used as a predictor for cancer development. We intend to measure the baseline vitamin D level in patients with oral squamous cell carcinoma (OSCC) and to compare same with non-cancer controls to determine any association. MATERIALS AND METHODS: Patients with OSCC presenting to our clinics were included in this study. Their baseline serum vitamin D levels were measured prior to cancer treatment after obtaining their consents. These patients were then matched with at least 2 cancer-free subjects to serve as controls and whose serum vitamin D levels were also measured. The serum vitamin D levels obtained for the two groups were then categorized into normal (>35 ng/ml), mild deficiency (25-35 ng/ml), moderate deficiency (12.5-25 ng/ml), and severe deficiency (<12.5 ng/ml). The data were analyzed statistically and the two groups compared. RESULTS: A total of 51 patients with OSCC (Male 22 [43%] and female 29 [57%]) and 113 cancer-free controls (Male 36 [31.86%] and female 77 [68.14%]) were included in the study. The commonest site for OSCC was the tongue, accounting for 45% of the cancer cases. Mean age for cancer patients was 59.33 years ±12.54 and 49.24 years ±15.79 for the control. Among the OSCC patients, 74.51% had moderate to severe vitamin D deficiencies, whereas only 20.35% had a moderate deficiency in the control group with no severe deficiency. CONCLUSION: Logistic regression analysis shows a positive association between vitamin D deficiency and OSCC risk especially in levels below 25 ng/ml. This further corroborates the assertion that vitamin D deficiency may be a useful indicator of OSCC. It may, therefore, be necessary to routinely prescribe vitamin D supplements to subjects with moderate to severe deficiencies in order to decrease the chances of OSCC development.

Randomized clinical trial on the comparison of bleaching outcomes using either ozone or hydrogen peroxide.

OBJECTIVE: To evaluate the efficacy of in-office tooth bleaching following application of either ozone (O3) or hydrogen peroxide (H2O2). METHOD AND MATERIALS: 32 participants were randomly distributed into two groups (n = 16 each). Participants' maxillary anterior teeth were treated with ozone (produced via a healOzone X4 device; Curozone) for 60 seconds in Group 1, or with 38% H2O2 for 20 minutes in Group 2. Tooth shades were evaluated by means of a colorimeter (CR-400, Minolta) measuring Vita classic shades in addition to L*a*b* shade values before and following bleaching in each group. A visual analog scale was used to evaluate tooth sensitivity before and after bleaching. Statistically significant differences were identified at P < .05. RESULTS: Teeth obtained lighter shades (increased L* and reduced a* and b* values) following bleaching in both groups (P < .001). Both groups revealed comparable bleaching outcomes (P > .05). However, bleaching with ozone did not result in tooth sensitivity, whilst using H2O2 was accompanied with significantly increased bleaching sensitivity (P < .001). CONCLUSION: Similar bleaching outcomes and lighter tooth shades (both for Vita shades and L*a*b* values) were obtained following in-office bleaching with either 60 seconds of ozone or 20 minutes of 38% H2O2. Notwithstanding, tooth sensitivity was significantly increased following bleaching with H2O2 in comparison to ozone. Ozone obviously does reduce the regularly clinically observed inconveniences of bleaching by means of H2O2; thus, ozone would seem worth considering for patients asking for in-office tooth bleaching.

Randomized controlled clinical trial on bleaching sensitivity and whitening efficacy of hydrogen peroxide versus combinations of hydrogen peroxide and ozone.

The clinical efficacy regarding bleaching sensitivity and tooth shade lightening using a standard hydrogen peroxide (H2O2) bleaching gel was compared with the additional use of ozone either before or after application of H2O2. Using computer-generated tables, 45 participants were randomly allocated into three groups (n = 15 each) in this investigator-driven, single-centre trial. In Group 1, upper anterior teeth were bleached using ozone (produced via a healOzone X4 device) for 60 seconds, then 38% H2O2 for 20 minutes; in Group 2, 38% H2O2 application (20 min) was followed by ozone (60 s); air produced by the healOzone machine (60 s) followed by 38% H2O2 (20 min) was used in Group 3 (control). Bleaching sensitivity was evaluated via visual analogue scales, and a treatment-blinded reader objectively recorded tooth shades using a colorimeter before and 24 hours after bleaching (at α = 0.05). The H2O2/ozone combination did not result in pain sensations, while both ozone/H2O2 and H2O2 alone increased bleaching sensitivity (p < 0.001). Teeth achieved lighter shades (higher L*/lower b* values) after bleaching in all groups (p < 0.001), while Ozone boosted lighter tooth shades, irrespective of its use before or after H2O2 (p < 0.05). Due to the complimentary effects, applying ozone after H2O2 seems preferable for bleaching.