Toward esthetically and biomechanically reliable anterior resin composite restorations: Current clinical experiences among dental practitioners in Saudi Arabia.

Background: Esthetic anterior composite restorations are very challenging. They constitute a main part of the clinical practice of restoring teeth with resin composites. Distinctive variations in composite material selection and technique of application in anterior teeth exist when compared to the practice of restoring posterior teeth with resin composites. In a continuation of a previous assessment of class II resin composite practice,  a cross-sectional survey study was performed to determine the awareness of general dental practitioners in Saudi Arabia about resin composite restorations in anterior teeth and to provide evidence-based recommendations to improve their practice. Methods: A total of 500 dental practitioners from different provinces in Saudi Arabia were invited to participate in an online questionnaire which comprised four domains and included a total of sixteen questions addressing aspects regarding the selection of resin composites, cavity configuration, etching protocol, light-curing technique, liner application, application of poly-chromatic composite, as well as finishing and polishing procedures. Chi square testing and descriptive statistics were used to analyze the attained data. Results: From 250 respondents, the greatest participation was from the Eastern and Middle provinces of Saudi Arabia. Female dentists participated less than males. There was no general agreement between participants regarding the resin composite material or the employed technique of application in restoring anterior tooth defects. Respondents indicated that discoloration and hypersensitivity were the most common reasons for patient's dissatisfaction with resin composites in anterior teeth. Conclusions: Dental practitioners are highly encouraged to improve their clinical practice of restoring anterior teeth using resin composites with the focus upon continuous education programs, online webinars, and workshops.

Effect of eucalyptus oil on Streptococcus mutans and Enterococcus faecalis growth.

OBJECTIVES: There is a significant apprehension in medicine and dentistry concerning the emergence of antibiotic-resistant pathogens, as it composes a significant threat to global health, particularly oral health. The growing concern that oral pathogens may develop resistance against standard preventive measures raises the need for alternative measures to prevent these pathogens' growth without inducing microbial resistance. Therefore, this study aims to assess the antibacterial properties of eucalyptus oil (EO) against two main oral disease pathogens, Streptococcus mutans, and Enterococci faecalis. METHODS: S. mutans and E. faecalis biofilms were initiated using brain-heart infusion (BHI) broth supplemented with 2% sucrose with and without diluted EO. After 24 h of biofilm formation, total absorbance was measured via spectrophotometer; then, the biofilm was fixed, stained with crystal violet dye, and measured at 490 nm. An Independent t-test was used to compare the outcomes. RESULTS: Diluted EO revealed significant total absorbance reduction against S. mutans and E. faecalis compared to the control (p ≤ 0.001). For the biofilm measurement, S. mutans and E. faecalis biofilms were reduced by around 60- and 30-fold, respectively, compared to the group with no EO (p ≤ 0.001). CONCLUSION: Based on this study's results, using EO as an organic compound could be considered an adjunctive tool in preventing the growth of oral pathogens causing dental caries and endodontic infection.

Inorganic Compounds as Remineralizing Fillers in Dental Restorative Materials: Narrative Review.

Secondary caries is one of the leading causes of resin-based dental restoration failure. It is initiated at the interface of an existing restoration and the restored tooth surface. It is mainly caused by an imbalance between two processes of mineral loss (demineralization) and mineral gain (remineralization). A plethora of evidence has explored incorporating several bioactive compounds into resin-based materials to prevent bacterial biofilm attachment and the onset of the disease. In this review, the most recent advances in the design of remineralizing compounds and their functionalization to different resin-based materials' formulations were overviewed. Inorganic compounds, such as nano-sized amorphous calcium phosphate (NACP), calcium fluoride (CaF2), bioactive glass (BAG), hydroxyapatite (HA), fluorapatite (FA), and boron nitride (BN), displayed promising results concerning remineralization, and direct and indirect impact on biofilm growth. The effects of these compounds varied based on these compounds' structure, the incorporated amount or percentage, and the intended clinical application. The remineralizing effects were presented as direct effects, such as an increase in the mineral content of the dental tissue, or indirect effects, such as an increase in the pH around the material. In some of the reported investigations, inorganic remineralizing compounds were combined with other bioactive agents, such as quaternary ammonium compounds (QACs), to maximize the remineralization outcomes and the antibacterial action against the cariogenic biofilms. The reviewed literature was mainly based on laboratory studies, highlighting the need to shift more toward testing the performance of these remineralizing compounds in clinical settings.

Different cavity disinfectant efficacy against S.mutans and shear bond strength of caries affected dentin bonded to resin restoration.

AIMS: The existing study aimed to assess the survival rate of S.mutans and shear bond strength (SBS) of resin adhesive restoration bonded to carious affected dentin (CAD) after using different cavity disinfectants (Chitosan, Fotoenticine®, and CO2 laser) in comparison to Chlorhexidine (CHX). MATERIALS AND METHODS: The study included human mandibular molars assessed on International Caries Detection and Assessment System (ICDAS) score 4 and 5. The cusp part of the clinical crown was cut off until the reduction reaches the central fossa while being continuously supplied with water coolant till the tooth cementoenamel junction (CEJ). The root sections were embedded in polymethyl methacrylate acrylic resin followed by culturing S.mutans biofilm on the CAD surface. Specimens were arbitrarily allocated into four groups(n = 10) based on the type of disinfection. Group 1 (2% CHX), Group 2 (Chitosan), Group 3 (Fotoenticine), and Group 4 (CO2 laser). S.mutans survival rate was assessed and CAD was restored with a composite restorative material. Thermoocycling of the samples was performed and a universal testing machine (UTM) and Stereomicroscope were used to identify bond integrity and type of fracture. ANOVA and Tukey multiple comparison tests were used to assess SBS. Data on the survival rate of S. mutans were compared between groups using the nonparametric Kruskal-Wallis test RESULTS: Outcomes revealed that Group 1 (CHX) displayed the highest survival rate (0.65 ± 0.10). However, lowest survival rate was demonstrated by Group 3 (Fotoenticine) treated specimens (0.25 ± 0.06). It was also discovered that CHX unveiled highest bond strength values (21.48 ± 1.39 MPa). Nevertheless, Group 2 (Chitosan) showed lowest SBS (11.01 ± 1.00 MPa). Intergroup comparison analysis presented that group 1, and group 4 (Co2 laser) (17.76 ± 0.41 MPa) displayed no significant difference in their bond integrity achieved. (p > 0.05). However, group 3 (Fotoenticine) (16.28 ± 0.51 MPa) and group 2 demonstrated comparable outcomes of SBS. (p > 0.05) CONCLUSION: The use of CHX and CO2 lasers as disinfectants on the CAD surface resulted in a positive impact on the SBS of resin composite, according to the study's findings. However, it is worth noting that Fotoenticine exhibited better antimicrobial efficacy against S. mutans.

Effectiveness of Morinda citrofolia, Sapindus mukorossi, and curcumin used in curry spice, to the radicular canal irrigant in improving bond integrity of glass fiber post.

AIM: Evaluation of the push-out bond strength (PBS) of glass fiber reinforced post (GFRP) bonded to root dentin after canal disinfection using food-based root canal irrigants i.e., Curcumin photosensitizer (CP), Riboflavin photosensitizer (RFP), Morinda ctrifolia juice (MCJ) and Sapindus mukorossi (SM) along with MTAD as a final irrigant. MATERIAL METHODS: Fifty human single-rooted premolar teeth were decoronated. Endodontic preparation was performed along with 2.25% sodium hypochlorite NaOCl solution followed by EDTA solution. Canals were dried and obturated followed by post-space preparation by removing GP. Specimens were allocated into five groups based on different food-based disinfection regimes (n = 10). Group 1: 2.25% NaOCl + MTAD (Control), Group 2: 6% MCJ + MTAD, Group 3: SM + MTAD, Group 4: CP + MTAD and Group 5: RFP + MTAD. All GFRP were bonded to radicular dentin. Root sectioning was performed followed by PBS and failure analysis using a universal testing machine (UTM) and stereomicroscope respectively. The data were analyzed using a one-way analysis of variance (ANOVA) test and the Post Hoc Tukey HSD test (p = 0.05). RESULTS: Samples disinfected with(MCJ+MTAD) at coronal third demonstrated maximum PBS (9.41 ± 0.51 MPa). However, the apical third of group 5 (RFP + MTAD) exhibited the minimum values (4.06 ± 0.23 MPa). Intergroup comparison analysis unveiled that group 2 (MCJ +MTAD) and group 3 (SM+MTAD) displayed comparable outcomes of PBS at all three-thirds. Similarly, samples in group 1 (2.25% NaOCl + MTAD), group 4 (CP + MTAD), and group 5 (RFP + MTAD) exhibited comparable PBS. CONCLUSION: Fruit-based irrigants Morinda citrifolia and Sapindus mukorossi have the potential to be used as root canal irrigants with a positive influence on bond strength.

Clinical efficacy of 5-aminolevulinic acid-mediated photodynamic therapy versus topical antifungal agent and surgical excision for the treatment of hyperplastic candidiasis.

BACKGROUND: Hyperplastic candidiasis (HC) is a chronic infection of oral mucosa caused by Candida. Owing to its potential for malignant transformation, its intervention requires attention. Conventional surgical resection might lead to irreversible damage and impact the patient's quality of life. Hence, this study aimed to evaluate the clinical efficacy of 5-aminolevulinic acid (5-ALA)-mediated photodynamic therapy (PDT) alone and in combination with topical antifungal therapy (i.e., nystatin [combination therapy]) in comparison with nystatin and surgical resection for the treatment of HC. METHODS: Forty subjects with clinical and histopathological diagnoses of HC were included in the study. Four study groups, with 10 participants each, were formed as follows: Group-I - receiving antifungal agent [nystatin]; Group-II - receiving surgical resection; Group-III - receiving PDT; and Group-IV - receiving 5-ALA-mediated PDT and nystatin [combination therapy]. Salivary and mucosal samples were collected for the quantification of Candida albicans and the treatment responses to different interventions were recorded at week-4, week-6, and week-8 after finishing therapies. RESULTS: At the 3rd follow-up (i.e., at end of the 8th week after the interventions), complete improvement in 3 (30%), 2 (20%), 1 (10%), and 5 (50%) patients in group-I, group-II, group-III, and group-IV, respectively was observed. A statistically significant difference was obtained when the intervention responses were compared at week-4 (p<0.01), week-6 (p<0.01), and week-8 (p<0.0001) follow-ups in group-I, group-II, and group-IV subjects. At the 8-week follow-up regarding the salivary and mucosal samples, the lowest colony-forming units/milliliter score of C. albicans was observed in group-IV subjects. CONCLUSION: The application of 5-ALA-mediated PDT in combination with nystatin gel possesses the potential as a well-tolerated and safe therapeutic modality for the treatment of patients with HC.

Caregivers' Perception about the Relationship between Oral Health and Overall Health in Individuals with Disability in Qatif, Saudi Arabia: A Cross-Sectional Study.

Background: In Saudi Arabia, there are many people with disabilities that do not receive adequate healthcare, especially in the field of dentistry. Objective: This study focused on assessing caregivers' perception of the relationship between oral healthcare and the overall health status of individuals with special healthcare needs (SHCN) in Qatif, Saudi Arabia. Methodology Design. This cross-sectional study was conducted using a questionnaire that was divided into two sections. The first part included demographic information such as the age and gender of both the caregiver and the person with a disability and the type of disability. The second part investigated the systemic health of the individual with a disability and the caregivers' perception of the relationship between the management and treatment of systemic health and oral healthcare in relation to the overall health status. The results of descriptive analyses were summarized using frequency distribution tables. Bivariate analyses (chi-square test) were also performed. Significant differences were considered at a p value of 0.05. Setting. Initiated in school setting. Results: A total of 186 caregivers participated in the study. As much as 83.3% agree that oral health affects overall health, and 48.9% agreed that untreated dental problems could affect cardiac health. Age was the only factor found to be significantly associated with caregiver perception as younger caregivers were more likely to rightly understand the relationship between oral health and general health (p < 0.05). Conclusion: This study has shown the extent to which caregivers of individuals with special care needs to understand the role of oral health in the general health of an individual. Three-quarters of the caregivers agree that dental health affects overall health, and age is a factor that might influence this understanding.

Toward a Clinically Reliable Class II Resin Composite Restoration: A Cross-Sectional Study into the Current Clinical Practice among Dentists in Saudi Arabia.

Objective: The aim of this study was to evaluate the current clinical practice of general dentists in Saudi Arabia in restoring class II cavities using direct resin composites and to set evidence-based practice recommendations of concern. Methods: An online survey formed of 20 questions and classified into four domains was developed. 500 dentists in 5 Saudi provinces were invited to join the survey anonymously and voluntarily using poster announcements and e-mail invitations. Descriptive statistics were used to analyze participants' responses. Results: 343 responses were received. Dentists in Saudi Arabia vary in their clinical practices and techniques of insertion of resin composite in class II cavities. 67% of participants use cotton rolls for isolating the field while 32% use rubber dam isolation. 33% and 28% of respondents use circumferential matrix (Tofflemire) and AutoMatrix, respectively. Fracture, followed by recurrent caries and open proximal contacts, was the received main reason of failure of class II direct resin composite restorations. Conclusion: Diversity of class II resin composite practices exists among dentists in Saudi Arabia. For ensuring optimum quality outcomes and high standards of restorative dentistry healthcare, several dentists in Saudi Arabia need to reconsider their clinical practice and modify their clinical procedures of direct class II resin composites. Several evidence-based practice guidelines are recommended to dentists in this article to improve their practice and enhance the clinical reliability and longevity of class II direct resin composite restorations.

Current Scientific Research Trends on Salivary Biomarkers: A Bibliometric Analysis.

Salivary biomarkers are indicators of many biological and pathological conditions and provide further information regarding the early detection of diseases. This bibliometric analysis aims to identify and evaluate the scientific literature addressing salivary biomarkers from a dental perspective, to identify the most prolific organizations, authors, journals, countries, and keywords used within this research domain. An electronic search was performed using Elsevier's Scopus database. From a total of 587 retrieved papers (published between 1997 and 2021), 399 were selected. For the data analysis and its visualization, the title of the articles, year of publication, countries, authors, journals, articles, and keywords were analyzed using Microsoft Excel and VOSviewer (a bibliometric software program). An increase in the number of publications was identified from 1997 to 2021. The United States (U.S.) published the most papers (84) and received the highest citations (3778), followed by India and Brazil. The Journal of Periodontology published the highest number of articles (39) that received the highest citations. The University of Kentucky from the U.S. published most of the papers related to salivary biomarkers that received the highest citations. Timo Sorsa published the most papers (14 papers), while Craig Miller was the highest cited author (754 citations). Concerning the highly cited papers, a paper by Micheal et al., published in 2010, received the highest citations (487 citations). "Saliva", followed by "human", were the most common keywords used by the authors in the papers related to salivary biomarkers. The findings of this analysis revealed an increase in salivary biomarker-related publications that positively influenced the number of citations each paper received. The U.S. produced the most publications that received the highest citations, and the University of Kentucky, U.S., was the most prominent. The articles were mostly published in the Journal of Periodontology and received the highest number of citations.

Assessment of push-out bond strength of post-surface pretreatment before salinization using hydrogen peroxide, aluminum trioxide, and natural photosensitizers to radicular dentin.

OBJECTIVE: The study aimed to evaluate the effect of different post surface pretreatment methods i.e., 24% hydrogen peroxide (H2O2), riboflavin photosensitizer (RFP), curcumin photosensitizer (CP) and aluminum oxide (Al2O3), and silane only on the bond values of glass fiber post to resin cement MATERIALS AND METHODS: Fifty single-rooted human teeth were obtained and crowns were sectioned coronally to the cementoenamel junction (CEJ). Protaper universal file system was used for canal cleaning and shaping followed by obturation. Post space was prepared and all the posts were then randomly divided into five groups depending on the surface pretreatment used (n = 10). Group 1: 24% H2O2 + silane, Group 2: RFP + silane, Group 3: CP + silane, Group 4: Al2O3 + silane, Group 5: silane only. Post-surface treatment was followed by post-placement using a self-etch dual-cure cement Panavia F 2.0. Acrylic blocks were used to hold the specimens perpendicularly and all the samples were sectioned by slow-speed saw into coronal, middle, and apical third. The universal testing machine determines pushout bond strength and failure mode was analyzed by stereomicroscope. One-way analysis of variance (ANOVA) and Tukey multiple comparison tests were used to analyze data. RESULT: The coronal section of group 4 (Al2O3 + silane) displayed the highest PBS (8.23±0.14 MPa). Whereas, an apical third of group 2 (RFP + silane) exhibited the lowest PBS (2.02±0.12 MPa). PBS values in samples in group 1 surface treated with 24% H2O2 + silane displayed comparable outcomes to samples in group 4 at all three levels (p>0.05). Samples in group 2 (RFP + silane) group 3 (CP + silane) and group 5 (Silane Only) demonstrated comparable PBS (p>0.05). CONCLUSION: Glass fiber reinforced post-surface pretreatment method using hydrogen peroxide and aluminum trioxide along with silane improves push-out bond strength at all three levels (coronal, middle, and apical). The use of a silane coupling agent on glass fiber posts alone does not improve bond values. The practice of photosensitizer on post-surface needs to be investigated further.

Effects of Iron Deficiency and Its Indicators on Lymphocyte Subsets: A Study at King Fahd Hospital of the University, Saudi Arabia.

BACKGROUND: Iron deficiency plays an important role in our body's immunity. Several studies have shown that it is frequently associated with infections. OBJECTIVE: This study aimed to discover the effect of iron deficiency on immunity by demonstrating changes occurring in lymphocyte subsets among patients with an established diagnosis of iron deficiency. METHODS: A total of 64 iron-deficient patients and 19 healthy controls were included. Complete blood counts, serum iron, ferritin, and total iron-binding capacity were assessed. Lymphocyte subsets were evaluated by flow cytometry. RESULTS: Among iron-deficient patients, the anemic ones (Hb ≤11 g/dL) showed significantly lower absolute lymphocyte counts (p=0.013), lower relative and absolute NK-cell counts (p=0.025 and p=0.003, respectively), higher relative T-cell and CD4+-cell counts (p=0.026 and p=0.002, respectively). B cells and CD8+ T cells were not affected by any iron-deficiency indicators. Iron-deficient anemia patients showed a three- to fourfold increase in risk of having recurrent infections. CONCLUSION: Iron deficiency has an obvious effect on lymphocyte subsets. Changes in lymphocyte subsets started mainly in response to decreased hemoglobin, rather than decreased ferritin and/or iron. Synchronously decreased hemoglobin and increased total iron-binding capacity led to absolute decreases in total lymphocytes, mainly NK cells, and relative increases in T cells, mainly the helper ones. Monitoring changes in lymphocyte subsets may be helpful in identifying patients at risk of recurrent infections.

Evaluation of the Antimicrobial Effect of Thymoquinone against Different Dental Pathogens: An In Vitro Study.

This study aimed to evaluate the antimicrobial effect of Thymoquinone (TQ) on four different oral microorganisms. Minimum Bactericidal Concentration (MBC), Minimum Inhibition Concentration (MIC), Broth microdilution, and Well diffusion tests were used to determine the optimum antimicrobial concentrations of TQ against Streptococcus salivarius, Streptococcus oralis, Streptococcus mutans, and Staphylococcus aureus over 1, 3, 6, 12 and 24 h. Chlorhexidine 0.12% was selected as a positive control. The inhibitory effect of TQ on bacterial growth was most noticeable with S. salivarius, while the least affected was S. aureus. TQ's MBC and MIC for S. oralis and S. aureus were comparable 2 mg/mL and 3 mg/mL, respectively. S. salivarius was most resistant to TQ and displayed a value of 5 mg/mL and 4 mg/mL for MIC and MBC, respectively. The viable count of different strains after exposure to TQ's MBC values was most noticeable with S. aureus followed by S. oralis and S. mutans, while S. salivarius was least affected. This study emphasized the promising antimicrobial effect of TQ against the four main oral microorganisms. It has a potential preventive effect against dental caries as well as other oral diseases.

Application of Er,Cr:YSGG laser versus photopolymerization after silver diamine fluoride in primary teeth.

Examine the effect of dental curing light and laser treatments applied after Silver Diamine Fluoride (SDF) on dentin hardness in carious primary molars. This in-vitro study consisted of 30 extracted primary molars with caries extending into dentin without pulpal involvement. The collected teeth were randomly divided into three groups: group 1: received SDF then Sub-ablative low-energy of Er,Cr:YSGG laser, group 2: received SDF followed by application of curing light for 40 s, group 3: had SDF treatment only. In all groups, 38% Ag (NH3)2F SDF was used. Vickers hardness test was performed on sound dentin below carious lesion. Kruskal-Wallis Test was used to determine the mean difference in dentin hardness of the groups at 5% Significance level using SPSS software. Surface hardness of sound dentin below the carious lesion was statistically significantly higher in the laser + SDF group (891.24 ± 37.33 kgf/mm2) versus the two other groups (Light cure + SDF = 266.65 ± 90.81 kgf/mm2 and SDF only = 117.91 ± 19.19 kgf/mm2) with p-value ≤ 0.001. Although Photopolymerization of SDF increases the surface hardness of sound dentin below the carious lesion, applying laser after SDF has the highest surface hardness due to the laser's sub-ablation of dentin.

Bridging the gap: Engagement of family and community physicians in digital networks for health issues.

BACKGROUND: The use of social media (SM) is unlocking infinite opportunities for healthcare disciplines and is fast becoming the preferred medium of communication. This underlines the importance of meeting the challenges of this new era. The aim of this study was to assess the readiness of Saudi family medicine physicians to the use of SM in health promotion and to explore their prospective attitudes toward its use professionally. MATERIALS AND METHODS: The two largest hospital-based primary care centers in the Eastern Province of Saudi Arabia were used for the quantitative analysis. All known physician bloggers in Saudi Arabia from seven different cities were invited to participate in the qualitative aspect of this study. The quantitative component of this study was conducted in the Eastern Province at two main hospitals. A 37-item questionnaire was distributed to all family physicians practising at these hospitals. The qualitative component of this study covered all of Saudi Arabia, and 11 in-depth interviews were held with family physician bloggers, followed by verbatim transcription, content analysis, and coding of the results. Chi-squared and independent t-tests were used. All physicians at the two largest hospitals in the Eastern Province were invited to participate in the quantitative aspect of the study. The response rate was 86.2% (n = 159). RESULTS: Study included 136 primary care physicians; majority were <50 years old (96.3%) with 58.8% females. About 60% were residents and 27.2 % consultants, and 76.5% were were family medicine physicians. Ninety-six percent physicians had SM accounts, the mean use of 3 h per day, 46.3% of the family physicians had good knowledge of SM ethics, and 69.9% used SM professionally for medical issues. Most of the responses showed a strong positive attitude; more than 60% of the participants responded as "agree" or "strongly agree" to the positive statements. CONCLUSION: Organizations urgently need to design their own bioethical guidelines and rules on the safe use of SM by healthcare professionals.

Evaluation of the Water Sorption and Solubility Behavior of Different Polymeric Luting Materials.

Objective: The study evaluated the water sorption (WSP) and water solubility (WSL) characteristics of different luting agents over a 180-day water storage period. Materials and Methods: Nine luting materials, i.e., conventional resin cement: Panavia F (PF), Rely X ARC (RA), self-adhesive resin cement: Rely X Unicem (RU), Breez (BZ), Maxcem Elite (MX), BisCem (BC) and resin-modified glass ionomer cement: FujiCem (FC), FujiPlus (FP) Rely X luting plus (RL) were assessed and fifty-two-disc specimens of each material were fabricated. All specimens were desiccated until a constant weight (W0) was reached. Thirteen specimens for each luting material were then randomly assigned to one of the four water immersion periods (7, 30, 90, and 180 days). After each period, the specimens were removed from the water and weighed to get W1. The samples were again desiccated for a second time and W2 was measured. Both WSP and WSL were determined by the following equations: WSP (%) = (W1 - W2) × 100/W0 and WSL (%) = (W0 - W2) × 100/W0. Assessments were performed following ISO standards. ANOVA was used to assess the effect of luting agent and time period on water sorption and solubility. Pair-wise comparisons were adjusted using Tukey's multiple comparison procedure. A significance level of 0.05 was used for all statistical tests. Results: The highest mean WSP and WSL (WSP/WSL) were demonstrated by resin-modified glass-ionomers (RL 18.32/3.25, FC 17.08/4.83, and FP 14.14/1.99), while resin luting agents showed lower WSP and WSL results (PF 1.6/0.67 and RA 1.76/0.46), respectively. The self-adhesive agents exhibited a wide range of WSP and WSL values (RU 1.86/0.13, BZ 4.66/0.93, and MX 3.68/1.11). Self-adhesive cement showed lower WSP and WSL compared with the resin-modified glass-ionomers (p < 0.05). All the materials reached equilibrium after 90-days. Conclusions: Resin-based luting materials have the lowest sorption and solubility. Rely X Unicem self-adhesive luting materials were comparable to resin luting materials for WSL and WSP. Resin-modified glass-ionomer showed the highest water sorption and solubility compared with both resin and self-adhesive materials.

Dental Care in the Arab Countries During the COVID-19 Pandemic: An Infodemiological Study.

BACKGROUND: Twitter is a powerful platform which could be used to reflect on the demand and supply of dental services during a pandemic. The aim of this study was to examine the nature and dissemination of COVID-19 information related to dentistry on Twitter platform Arabic database during the COVID-19 pandemic. METHODOLOGY: One hundred and fifty independent searches with a combination of keywords for both COVID-19 and dentistry from a preselected Arabic keyword were carried out for the period from the 2nd of March (first confirmed cases of COVID-19) to the 6th of July 2020. Tweets were filtered to remove duplicate and unrelated tweets. The suitable tweets were 1,150. After calibration, two examiners coded the tweets following two main themes: COVID-19 and oral health-related information. Tweets were then compared with COVID-19 daily events in the Arab countries as reported by the World Health Organization (WHO). Descriptive analysis was performed to present the overview of the findings using Microsoft Excel. RESULTS: The most retweeted information was the help with urgent consultation or emergency dental treatment during COVID-19 tweeted by a dentist. There were 673 retweets and 1,116 likes of this tweet. The most common tweets related to oral health were needs of dental treatment (n=462, 39.5%) of which, toothaches or wisdom tooth problems constituted 48% of the related tweets. CONCLUSION: Based on the results of this study, it is obvious that social media users reacted to the COVID-19 threat to dental practices. Twitter as one of the social media platforms served as a connection between dental health professionals and patients.

The use of social media for professional purposes among dentists in Saudi Arabia.

AIM: To investigate the dentists' opinions towards social media (SM) use in daily practice and the expected limitations from its use in Saudi Arabia. METHODS: An electronic survey was carried out throughout May-June 2020 among a sample of dentists in Saudi Arabia. The survey covered three parts: the first part covered professional and demographic information, the second part covered the use of mobile phones and SM in dental practice, while the third part assessed dentists' opinion on SM use. Descriptive statistics included frequency distributions and percentages and independent t test/ANOVA test for the relationship between the mean of dentists' opinion towards SM and demographic variables. A p value of 0.05 or less was considered statistically significant. RESULTS: The majority of respondents (80%) believe that SM plays an active role in patients' decisions regarding the selection of a healthcare provider. The mean dentists' opinion scores on the use of SM were significantly lower among participants working more than 50 h per week compared with other participants (p = 0.014). CONCLUSION: The majority of sampled dentists believe that SM plays an active role in patients' decisions regarding the healthcare provider's selection. Directed campaigns can help dentists optimize the use of SM for both professional and personal purposes.

Teledentistry awareness among dental professionals in Saudi Arabia.

BACKGROUND: Teledentistry is believed to improve dentalcare provided to patients and time management efficiency. In addition, teledentistry can be a useful tool for peer education, consultations and ensures proper channeling for referrals. OBJECTIVE: This study aimed to explore Saudi Arabian dental professionals' perceptions of teledentistry's benefits in improving dental practice and patient care. METHODS: A descriptive cross-sectional study involving an electronic survey of a sample of Saudi Arabian dental professionals. A validated 26-item, 5-point Likert-scale questionnaire was used to assess perceptions of dental professionals in four domains: usefulness of teledentistry for patients, the usefulness of teledentistry for dental practice; the potential of teledentistry to improve practice; and existing concerns about the use of teledentistry. Statistical analyses involved descriptive statistics, bivariate analysis using SPSS software. Significant differences were considered at a p-value of 0.05. RESULTS: With an overall response rate of 28.6%, 286 dental professionals participated in the study. More than 70% of respondents agreed or strongly agreed that teledentistry would improve dental practice through enhancing communication with peers, guidance and referral of new patients. A substantial proportion of respondents (60-70%) expressed uncertainty with technical reliability, privacy and diagnostic accuracy. The participants' qualification was statistically significant with usefulness of teledentistry for patients (p = 0.027), while work experience in years was statistically significant with both usefulness of teledentistry for dental practice and patients (p = 0.046 and <0.0001 respectively). CONCLUSION: Generally, the feedback gained by this study showed readiness of the dental professionals to be engaged in the teledentistry approach. Further investigation of the business model of teledentistry is needed to understand the readiness and challenges. Directed campaign to educate dentists and the public of the technology and it is potential is necessary.

A bibliometric review of top 50 cited articles published in the Photodiagnosis and Photodynamic Therapy from 2004 to 2019.

BACKGROUND: The aim of the article was to identify the top 50 cited articles in the journal of Photodiagnosis and Photodynamic Therapy during 2004-2019. METHODS: The online search was conducted on Scopus database to retrieve all the articles published during 2004-2019 in the journal of Photodiagnosis and Photodynamic Therapy. The papers were identified and ranked as per the citation counts >42. Additionally the authors; institute and country of origin; type of study and availability of funding in these highly cited articles was identified. VOS viewer software was used to analyze the occurrence of most commonly used keywords by the authors. RESULTS: Majority of the highly cited studies published during last 15 years were literature reviews (n = 34) followed by the qualitative/quantitative studies (n = 15). The largest number of articles published were single nations without any collaborations (n = 45). The institutes publishing highest number of top cited articles included Massachusetts General Hospital, East Carolina University, 21 st Century Oncology, The Norwegian Radium Hospital and Trinity College Dublin. The country with largest number of top cited articles was USA. The keyword most commonly associated with the 50 top cited articles was 'Photodynamic therapy'. CONCLUSION: Extensively, various specialties of medicine and dentistry have been explored in the last 15 years in the journal of Photodiagnosis and Photodynamic Therapy. Based on citatations, we have highlighted those that can be considered as classic research.