Smile aesthetics in Pakistani population: dentist preferences and perceptions of anterior teeth proportion and harmony.

BACKGROUND: This study aimed to evaluate dentist perceptions of attractive smiles in the Pakistani population, considering different dental proportions. METHODS: Maxillary casts and digital images were used to create symmetrical representations of anterior teeth. dentists' preferences for good and bad teeth proportions, width/height ratios, and various dental proportions (golden, recurring esthetic dental (RED), golden percentage, Preston, and local/observed) were assessed using one sample and paired t-test. The Chi-square test was used to determine the gender disparities and factors affecting smile attractiveness. A p-value of ≤ 0.05 was taken as significant. RESULTS: The RED proportion emerged as the preferred choice for normal-sized teeth, with specialists and general dentists favoring it over the golden proportion. For tall teeth, the golden proportion was predominantly preferred. The golden percentage received limited preference for aesthetic smile construction. CONCLUSIONS: The smiles created using the principles of RED proportion were opted as the most attractive by local dentists. Factors such as tooth arrangement, color, and midline were highlighted as essential considerations in aesthetic smile construction.

Analysis of shade-matching ability in dental students: a comparative study under clinical and correcting light conditions.

BACKGROUND: Selecting the ideal tooth shade is essential to the success of aesthetic dental restorations. Students' cognitive abilities are involved in the multifaceted and intricate process of shade matching. Hence, the present study aimed to assess and compare the shade-matching ability of undergraduate dental students in various years of dental education under clinical and correcting light. METHODS: This comparative cross-sectional study was instigated amongst male 4th, 5th, and 6th-year students of the dental complex of King Faisal University, Kingdom of Saudi Arabia. A total of 72 male dental students assessed the shade under clinical (fluorescent light) and correcting light (handheld Dental Base Light) by using VITA Classical shade guides. Statistical analysis was done using SPSS version 23 (Armonk, NY, USA). The Chi-square test was used to evaluate the association between correct and incorrect shade matching under correcting and clinical light. RESULTS: Out of 72 male students, 22(30.6%) were from the 4th year, 26(36.1%) were from the 5th year, and 24(33.3%) were from the 6th year, with a mean age of 22.92 ± 1.01 years. The majority of the 6th-year students selected shade of anterior tooth # 11 correctly under clinical and correcting light, and 3(12.5%) students selected incorrectly under clinical and correcting light, with a statistically significant association among them (p = 0.004). As far as the shade selection of the posterior tooth is concerned, a statistically significant difference was observed under clinical light among all clinical students (p = 0.008). CONCLUSION: The clinical performance of dental students in shade matching improved with advancing years of dental education. Additionally, the shade matching ability of all groups of dental students was superior under correcting light compared to conditions under clinical light.

The effectiveness of single antibiotic paste nitrofurantoin V/S double antibiotic paste in alleviation of post-operative pain of patients suffering from symptomatic irreversible pulpitis-A randomized controlled trial.

Objective: The present research evaluated and compared effectiveness between nitrofurantoin and double antibiotic paste in alleviating post-operative pain in patients suffering from symptomatic irreversible pulpitis. Methods: There were 60 subjects enrolled who were allotted among three groups: Group 1 - Nitrofurantoin, Group 2 - double antibiotic paste, and Group 3 - Control. Succeeding access opening and chemo mechanical preparation, intracanal medicament was placed in the root canals. Using a numerical pain scale, pain scores were measured at the following time intervals: preoperative, 12, 24, 48, and 72 h. One-way ANOVA and post hoc statistical analysis were conducted, with a p-value of ⩽ considered as statistically significant. Results: Preoperatively, most patients experienced moderate to severe pain. The patients in groups 1 and 2 reported considerable reduction in their pain scores (p ⩽ 0.001) on each time interval. However, patients in group 3 experienced a higher level of pain even at 72 h. No considerable distinction was found among participant's pain scores of groups 1 and 2 (p = 0.193). Conclusion: For effective pain-relieving, both nitrofurantoin and double antibiotic paste can be successfully used in patients suffering from symptomatic irreversible pulpitis. However, when calcium hydroxide was used, patients experience high levels of pain.

Assessment of Oral Health Knowledge, Attitude, Practice and DMFT Scores among Patients at King Faisal University, Al-Ahsa.

Background and Objectives: Oral health is one of the most significant issues in public health. The Decayed, Missing, and Filled Teeth (DMFT) Index is a useful tool for assessing and measuring the state of oral health in a community. This study aimed to evaluate oral health knowledge, attitudes, and practices among participants who visited a dental clinic at King Faisal University and to evaluate their DMFT scores. Materials and Methods: This cross-sectional, questionnaire-based study was conducted at the King Faisal University dental complex, Kingdom of Saudi Arabia, using a simple random sampling technique. The data were collected using a self-administered structured questionnaire in English and Arabic. All statistical analyses were carried out using the SPSS 20 software. A chi square and ANOVA test were used to assess the association. A p value of <0.05 was considered statistically significant. Results: There were a total of 260 participants, of whom 193 (74.2%) were male and 67 (25.8%) were female. Most participants, 173 (66.5%), were between the ages of 18 and 28. The majority of the participants 191 (73.5%) believed that bad oral hygiene led to gum disease. Additionally, major issues while visiting dental clinics, the importance of routine dental clinic visits, the existence of a connection between oral and general health, brushing time and frequency of change of used brush were significantly influenced by gender (p < 0.05). In terms of the DMFT index, mean numbers of decaying teeth (D) were 4.82 ± 4.15, mean numbers of missing teeth (M) were 1.56 ± 2.94, mean numbers of filled teeth (F) were 5.17 ± 5.28 and mean DMFT score was 11.56 ± 6.32, with a statistically significant difference observed (p < 0.001). Conclusions: This study concluded that, although some of the study participants neglected oral hygiene practices, the majority of participants had good knowledge and attitudes regarding the significance of oral hygiene. Owing to inadequate practices, the decayed, missing, and filled teeth scores increased with increasing age. Additionally, gender had no significant impact on the mean scores for decayed, missing, and filled teeth, although there were significant differences between age groups.

Effectiveness of precooling with ethyl chloride versus honey in alleviating intra-oral injection pain in adult patients: A randomized controlled trial.

Objective: The objective of the study was to assess and compare the effectiveness of precooling with ethyl chloride versus honey in alleviating the pain of dental injection. Methods: About 90 patients were recruited for this randomized controlled trial. In each of the following three groups, 30 patients were allocated: Group 1, precooling with ethyl chloride; Group 2, honey; and Group 3, control. The pain score of patients in each group was measured after injecting the dental local anesthesia using a visual analog scale. Paired t-test and multiple linear regression tests were used for statistical analysis. A p value of ⩽0.05 was considered to be as significant. Results: The mean pain scores of participants residing in different groups were as follows: Group 1: 2.83 ± 1.46, Group 2: 4.33 ± 1.62, and Group 3: 7.80. After administrating ethyl chloride, the majority of the 18 (60%) patients reported to suffer from "mild pain." Furthermore, in patients who were given honey in Group 2, most of the 21 (70%) patients reported suffering from "moderate pain." In Group 3 (control) where no anesthetic modality was used, the majority of the 25 (83.33%) patients experienced "severe pain." A significant difference was noted among the pain scores of three groups (p = 0.001). Conclusion: The administration of local anesthetic is part of almost all dental procedures. Precooling with ethyl chloride resulted in a greater reduction in pain scores than honey upon administration of local anesthesia injection.

CBCT Evaluation of Periapical Pathologies in Maxillary Posterior Teeth and Their Relationship with Maxillary Sinus Mucosal Thickening.

In modern dentistry, radiographic imaging is crucial for examining the connection between the maxillary sinus floor and the root apices of the maxillary posterior teeth, particularly when the periapical region is affected by pathology that could result in infectious, inflammatory, or traumatic changes in the maxillary sinus. This study aimed to investigate the prevalence of periapical pathologies in the maxillary posterior teeth and their relationship with maxillary sinus mucosal thickening by using cone-beam computed tomography scans. This retrospective study was conducted on 420 digitized CBCT images which were scanned in sagittal, axial, and coronal views. Out of 420 total images, 223 (53.1%) were of males and 197 (44.9%) were of females. The data were analyzed using SPSS version 28. A total of 2936 posterior maxillary teeth were tested for periapical pathology (PP), 1477 on the right side and 1459 on the left side. In terms of gender, there was no significant relationship between PP in maxillary posterior teeth on both sides and mucosal thickness of the maxillary sinus (p > 0.05). A significant relationship was found between PP in maxillary posterior teeth on both sides and maxillary sinus mucosal thickening (p < 0.05). This study concluded that the prevalence of periapical pathology in the maxillary posterior teeth was significantly associated with a rise in the incidence of maxillary sinus mucosal thickening. Moreover, the primary causative factor for the pathophysiology of the odontogenic maxillary sinus was the periapical pathology in both maxillary first molars.

Efficacy of Smear Layer Removal at the Apical One-Third of the Root Using Different Protocols of Erbium-Doped Yttrium Aluminium Garnet (Er:YAG) Laser.

Background and Objectives: Smear layer forms during cleaning and shaping can obstruct the entry of both irrigant and sealant into the dentinal tubules, resulting in the accumulation of the bacteria and their byproducts. To ensure effective adhesion and better periapical healing, it is strongly advised to remove the smear layer before proceeding with root canal obturation. This study was designed to compare the efficiency of laser-activated irrigation (LAI) in removing the smear layer and debriding the most apical third of the root canal. Materials and Methods: Sixty-five extracted human teeth with straight single roots were randomly and equally divided into four laser and one control groups. Root canals in all samples were shaped using prime size TruNatomy rotary files. During preparation, each canal was irrigated with 3 mL of 3% NaOCl and 3 mL of 17% EDTA alternately, followed by the irrigation with 10 mL of distilled water to avoid the prolonged effect of EDTA and NaOCl solutions. Final irrigation of 5 mL of 17% EDTA of the root canal was done to eliminate the smear layer and was subsequently activated by an endodontic ultrasonic tip for 20 s three times (control group), a flat-end laser tip (test groups 1 and 3) or a taper-end laser tip (test groups 2 and 4) for two cycles. The time of each cycle activation was 10 s (groups 1 and 2) or 20 s (groups 3 and 4) in which the Er:YAG laser of 2940 nm was used. The laser operating parameters were 15 Hz and 50 µs pulse duration. The samples were then split longitudinally and subjected to scanning electron microscopy (SEM). Results: The remaining smear layer at the apical part of the root canals was statistically significant between the control group and the laser groups 1 (p = 0.040) and 2 (p = 0.000). Within the laser groups, the exposed tubules count was greater in the laser with the flat tip as compared with the tapered tip (Laser 1 > Laser 2 and Laser 3 > Laser 4). Finally, no significant differences in the count of debris between the laser groups and control group were observed, except for laser 4 (p < 0.05), which had the highest count of debris. Conclusion: LAI to remove debris and smear layer at the apical third of the root canal is inferior to the current ultrasonic technique. However, when using the Er:YAG LAI, it is recommended to use a flat tip design for 10 s for two cycles to ensure maximum debridement of the apical dentin surface.

Faculty perceptions on one-best MCQ development.

OBJECTIVE: The aim of this study was to determine the perception of faculty of undergraduate medical and dental programmes in various private and public sector institutes regarding their Readiness, Attitude and Institutional support for developing high-quality one-best MCQs. METHODS: A validated questionnaire was designed for recording demographic data and responses related to Readiness, Attitude and Institutional support based on 5-point Likert scale and multiple options. Scores for items on Likert scale were categorised (Readiness: poor 0-12, good 13-24, Attitude: negative 0-12, positive 13-24, Institutional support: no support 0-12, highly supportive 13-24). The individual and overall scores related to Readiness, Attitude and Institutional support were compared to demographic characteristics using Independent samples and Paired samples t-test as appropriate. Data was analysed using SPSS version 25.0. P-value of <0.05 (two-sided) was considered significant. RESULTS: With a response rate of 87.5%, the mean scores for Institutional support were higher (14.45 ± 4.73) compared to those for Readiness (13.39 ± 4.51) and Attitude (12.54 ± 4.59). Responses to multiple choice items revealed that faculty considered MCQ writing workshops to be effective while facing most difficulty in formulating scenario and homogenous options. Most faculty reported no commitment issues but desired on-job protected time for item development. No significant association was found between the scores and age group, gender, qualification, institute type, department and designation of participants. CONCLUSION: Overall, the faculty were found to be motivated and committed to developing high-quality one-best MCQs. With continued institutional support, faculty can be expected to further engage in writing such items.

Smart Monochromatic Composite: A Literature Review.

Over the previous years of the 20th and 21st centuries, there has been a progression in the field of bonded esthetic restorations. At the present time, the inclination of dentists toward the smart monochromatic shade of composite is flourishing owing to the fact that it decreases the requirement of a range of composite shades, curtails the waste of unconsumed composite shades, lessens chair side interval, abolishes the shade selection, and decreases dependency on shade-selecting methods. Smart monochromatic composite is known to obtain the color of the adjacent tooth structure in which it is placed. Therefore, the current literature elucidates the several features of innovative and revolutionary monochromatic composites including color stability, mechanical and optical properties, and shade-matching capability that could have a positive impact potentially over other resin composites.

Oral healthcare-seeking behavior during the COVID-19 lockdown period: A cross-sectional study from Eastern Saudi Arabia.

Objective: To assess oral healthcare-seeking behaviors during the COVID-19 lockdown period in eastern Saudi Arabia. Methods: A cross-sectional questionnaire-based study was conducted from October 2020 to December 2020 at Dental Clinic Complex, College of Dentistry, King Faisal University Al Ahsa, Saudi Arabia. Three hundred and sixty patients who visited the Dental Clinic Complex after relaxation of lockdown and consented to participate were included in this study. Participants were instructed to complete a questionnaire on oral health and dental care during the lockdown period, consisting of five sections. Results: Out of 360 participants, 168 reported requiring dental help during the lockdown period; however, only 27 participants contacted a dentist to emergency advice on phone, and 102 participants visited a dentist. â€‹Most participants used â€‹toothpaste for sensitive teeth, followed by over-the-counter pain killers, and â€‹clove oil. In this regard, 72.8% of females used toothpaste for sensitive teeth. A considerable number of participants needed filling, followed by root canal treatment, â€‹denture repair, and dental extraction. Most participants were treated with pain killers, followed by antibiotics, and referral to a hospital. More than 80% of them expressed that regular visits to the dentist are beneficial. Conclusion: A substantial proportion of participants sought oral health care during the lockdown period, mainly for restorative treatment. This was mostly achieved by visiting a dentist, or via telephone consultation to a lesser extent. Analgesics were the most common prescriptions, followed by antibiotics. Dental patients should be encouraged to regularly visit dentists to mitigate the drawbacks that lockdowns may cause in the provision of oral healthcare services.

Comparison of Shade Matching Ability among Dental Students under Different Lighting Conditions: A Cross-Sectional Study.

Successful esthetic dentistry to meet patient satisfaction and produce a progressive impact on someone's personality cannot be succeeded without proper shade selection, both for direct or indirect restoration of dentition. The accurate shade selection is one of the most interesting phases of restoring the natural look of teeth. In clinical practices, dental students should be aware of the various light sources used for shade selection. The purpose of this research is to compare the shade matching ability of clinical and non-clinical students under clinical and correcting light. This comparative cross-sectional study was instigated amongst clinical and non-clinical students of the dental complex of King Faisal University, Kingdom of Saudi Arabia, after obtaining ethical approval from the Research Ethics Committee with reference number (KFU-REC-2022-MAR-EA000518). A total of 102 students assessed the shade under clinical (fluorescent light) and correcting light (handheld Dental Base Light) by using VITA Classical shade guides. Statistical analysis was done using SPSS version 23 (Armonk, NY, USA). The Chi-square test and t-test were used to evaluate the association between shade matching scores under correcting and clinical light. Out of 102 students, 41 (40.2%) were non-clinical and 61 (59.8%) were clinical, with a mean age of 21.66 ± 1.397 years. Shade matching scores were found significantly higher (p < 0.001) with the light-correcting device (2.29 ± 1.26) as compared to clinical light (1 ± 1.11) for non-clinical students. Similarly, clinical students also had significantly better (p < 0.001) shade matching with the light-correcting device (4.01 ± 1.34) in comparison to clinical light (2.47 ± 1.25). This study concluded that the shade matching scores under correcting light was significantly better than the results obtained by dental operatory light. Furthermore, it was also evidenced that clinical students' skills in matching shades were significantly improved under a correcting light source as compared to non-clinical students.

Evaluation of Root Canal Configuration of Maxillary and Mandibular First Molar by CBCT: A Retrospective Cross-Sectional Study.

Adequate knowledge of root canal morphology along with its probable variations is imperative to acquire successful endodontic treatment. This retrospective cross-sectional study aimed to investigate the root canal configuration of maxillary and mandibular first molar using Cone-Beam Computed Tomography (CBCT) among patients in Al-Ahsa region, Saudi Arabia. A total of 377 samples were included, out of which 123 CBCT (I-CAT Vision QTM) scans with intact all first permanent molars were selected in this study and scanned in sagittal, axial, and coronal views by using BlueSkyPlan software. The number of canals in each root and their configuration according to the Vertucci classification system was evaluated. Statistical analysis was analyzed using SPSS version 21 (IBM). Chi-square test was applied to evaluate the association of root canal morphology and mandibular and maxillary first molars with respect to gender. Out of 123 CBCT scans, 59 (48.0%) were males and 64 (52.0%) were females; the mean age was 26.95 ± 10.65 years. The mesiobuccal root of bilateral maxillary first molar had Type-I (87.0%) of Vertucci classification followed by Type-IV (9.8%). Additionally, all mesiobuccal roots (100%) of the left mandibular first molar had Type-I of Vertucci's classification. A significant association has been observed between gender and a number of canals in bilateral maxillary first molars. Females showed a significantly higher prevalence of three-root canal configuration in maxillary first molars of both sides compared four canals found most commonly in males (p = 0.004). This study concluded that the majority of maxillary and mandibular permanent first molars had three roots and three canals with Type-I Vertucci's classification in patients belonging to the Al-Ahsa region of the Saudi Arabia. It was also proved that gender is significantly associated with the number of canals in a bilateral maxillary molar.

Assessment of the Current Endodontic Practices among General Dental Practitioners in the Kingdom of Saudi Arabia.

A contemporary knowledge of root canal treatment (RCT) is a prerequisite for a successful outcome. Studies observed that General Dental Practitioners (GDPs) were not abreast of current endodontic knowledge due to a lack of continuing dental education, not following the treatment protocols that they had learned in their undergraduate program, and overlooking the evidence-based current endodontic practices. Therefore, this study was intended to assess the awareness, attitude, and clinical endodontic practices among General Dental Practitioners in Saudi Arabia. This cross-sectional questionnaire-based study was conducted among all 312 GDPs working in Saudi Arabia. The questionnaire consisted of socio-demographic details and 23 questions regarding current endodontic practices. The collected data was analyzed using the SPSS Version 21 (Chicago, IL, USA). The chi-square test was applied to explore the influence of gender, workplace, and the years of professional activity on the materials and techniques employed in the RCT procedure. The study results showed that of all respondents, 159 (51.0%) were males, 153 (49.0%) were females, and 286 (91.7%) were Saudi nationals. Most of the GDPs, i.e., 204 (65.4%) practiced in private hospitals or clinics whereas 108 (34.6%) practiced in Government hospitals. Root canal treatment on all teeth had been performed by 196 (62%) of the practitioners. Association of gender with demographic details and endodontic practices revealed a statistically significant difference between both genders with respect to region, nationality, type of RCT treated on the tooth, and the technique used to measure the working length (p < 0.05). Furthermore, years of professional experience and workplace significantly affect endodontic practices (p < 0.05). This study concluded that most of the general dental practitioners complied with quality standard guidelines showing a positive attitude toward endodontic practices. Furthermore, irrespective of gender, most of the steps in endodontic procedures revealed a significant association with years of professional experience and the workplace.

Effect of Sonic Activation on Push-Out Bond Strength of Fiber Post: An In Vitro Study.

This study aimed to evaluate the effectiveness of conventional and sonic activation techniques on push-out bond strength of fiber post cemented with two different monomers containing self-adhesive resin cement (SARC). Four groups (n = 19 each) were made based on the type of SARC (Rely X U200 and Panavia SA) and technique (conventional and sonic activation). After placing the fiber post, each root was sectioned into 2 mm coronal, middle, and apical portions, and a push-out bond strength test was performed using a universal testing machine. The least push-out bond strength (13.0 ± 0.9 MPa) was found in Rely X U200 conventional technique and highest with Panavia SA sonic activation technique (15.4 ± 0.9 MPa). A significant difference was found in push-out bond strength at coronal (p = 0.002), middle (p = 0.002), and apical (p = 0.001) root sections using Rely X U200 cement with sonic activation as compared to the conventional technique. However, no difference (p > 0.05) was noticed between conventional and sonic activation techniques in Panavia SA cement at any root level. Sonic activation can be used as an adjunct with a manual technique to increase bond strength. However, it was noted that 10-MDP monomer containing SARC performed well regardless of techniques.

The Efficacy of Little Lovely Dentist, Dental Song, and Tell-Show-Do Techniques in Alleviating Dental Anxiety in Paediatric Patients: A Clinical Trial.

INTRODUCTION: Dental anxiety is a common occurrence in patients undergoing dental treatments, especially in children. The success in paedriatric dental treatments and patient comfort depends on controlling the level of patient's anxiety in clinical settings. This study is aimed at evaluating the efficacy of different techniques applied for the reduction of dental anxiety in paediatric patients. Material and Methods. One hundred and sixty participants were divided into 4 groups; each group having 40 patients as follows: group I: mobile application "little lovely dentist," group II: YouTube® "dental video songs," group III "tell-show-do," and group IV "control." Dental prophylaxis treatments were provided to all the participants. Initial anxiety levels were noted during the patient's education phase by measuring heart rate with pulse oximeter and distress level with facial image scale, at the same time in each group, respectively. The postoperative anxiety was noted later with the same methods, after the application of anxiety reduction techniques. The data obtained were entered in the statistical package for the social sciences software, version 25. One-way ANOVA and paired t-test for matched groups were used to compare mean values of the 4 groups, in this study to determine their effectiveness. A p value of ≤0.05 was considered as statistically significant. RESULTS: The mean age of patients in group 1 was 6.8 ± 2.1 years, group 2: 8.15 ± 2.27 years, group 3: 7.5 ± 2.3 years, and group 4: 7.27 ± 1.68 years. The intragroup comparisons of heart rate and facial image scores have shown a significant difference in before and after dental treatment procedures. Marked reduction in heart rate and facial image scale scores were found in patients belonging to group 1 (mobile applications) and group 2 (dental video songs). An increase in heart rate and facial image scale scores was seen in group 3 (tell-show-do) and the control group. CONCLUSION: The paediatric dental anxiety is a common finding in dental clinics. Behavior modification techniques like smartphone applications, "little lovely dentist," and "dental songs" can alleviate dental anxiety experienced by paediatric patients. The "tell-show-do" technique although most commonly used did not prove to be beneficial in the reduction of the anxiety levels.

Dissemination of Aerosol and Splatter in Clinical Environment during Cavity Preparation: An In Vitro Study.

Dental health care workers around the world are in a constant state of fear and anxiety because they work in a constrained space of the dental practice. During routine dental procedures, they are exposed to aerosol and splatter. These airborne particles pose a great risk of transmitting contagious infections to health care workers and patients, especially in an era of social distancing due to COVID-19. The current study was conducted to evaluate contamination amount, duration, the distance of aerosol, and splatter produced after cavity preparation using a two-hole and four-hole handpiece. The study was performed on a dental manikin in a dental simulation laboratory at the College of Dentistry, King Faisal University Al Ahsa. The dental manikin was set to a reclined position to simulate the clinical operatory position of the patient for dental restorative procedures. Aerosol and splatter were collected on Grade 1 qualitative cotton cellulose filter paper. These were placed on adhesive tape extending from the headrest of the dental manikin in six different directions (2, 4, 6, 8, 10, and 12 o'clock) for up to 60 inches and on certain positions of the operator and assistant such as the chest, head, forearms, upper leg, and inside facemask. Class V cavity preparation was done by the principal investigator at a specific time of 3 min on tooth #11 using a two-hole high-speed handpiece, then on the next day, Class V cavity preparation was performed on tooth #21 by a four-hole handpiece. High volume suction was used throughout the cavity preparation. Immediately after cavity preparation, the first filter paper disc was replaced with new ones in all positions. The second set of filter papers was removed after 30 min. Transparent grids were used to count the contamination area on the filter paper disc. No statistically significant difference was found in the mean amount of aerosol and splatter produced by both handpieces, however, a statistically significant difference was found in an amount of aerosol and splatter produced at a 12, 24, and 36 inches distance immediately after cavity preparation and 30 min after cavity preparation, regardless of the type of handpiece used. It is advisable to refrain from removing the personal protective barriers immediately after the procedure within the vicinity of the dental practice. The use of other adjuncts such as high volume suction to reduce the spread of aerosol and splatter is also recommended.

Association of BMI, Diet, Physical Activity, and Oral Hygiene Practices with DMFT Index of Male Dental Students at King Faisal University, Al-Ahsa.

Despite sufficient knowledge of good oral hygiene habits, dental students still suffer from oral health problems owing to dietary habits, obesity, and a sedentary lifestyle. This cross-sectional study was conducted to evaluate an association of BMI (body mass index), diet, physical activity, and oral hygiene practices with DMFT (decayed, missing, and filled teeth) of male dental students and interns at King Faisal University, Saudi Arabia, from August to September 2020. One hundred and eighty-five male participants completed the study questionnaire. The questionnaire consisted of sociodemographic information and nineteen close-ended questions about current diet, physical activity, and oral hygiene practices. Students' height (cm) and weight (kg) were measured to calculate BMI. The principal investigator performed the oral clinical examinations for the DMFT status in the dental clinic. The chi-square test was used for the dichotomous variables and a t-test was used for the continuous variables. Linear and multinomial logistic regression were performed to detect the significant predictors of the DMFT score. The mean age of participants was 22.29 ± 2.13 years, and the BMI was 24.94 ± 3.36 (Kg/m2). Parents' higher education and income levels were significantly (p < 0.001) associated with a higher BMI. Most dietary variables, especially sugar products, and low physical activity, were significantly (<0.047) associated with higher BMI. All oral hygiene practices, except miswak and mouthwash, were significantly (<0.003) associated with higher BMI. Decayed and missing teeth were significantly (<0.001) higher in the overweight and obese. A simple linear regression analysis demonstrated association between BMI and decayed teeth, with an R = 0.35 (<0.001); BMI and missing teeth had an R = 0.12 (p = 0.867); BMI and filled teeth had an R = 0.15 (p = 0.033), and BMI with DMFT had an R = 0.33 ((<0.001). This study demonstrated a strong significant association of the decayed and missing teeth with higher BMI levels. In addition, BMI was significantly associated with diet and physical activity, despite acceptable oral hygiene practices.

Evaluation of Patient's Knowledge, Attitude, and Practice of Cross-Infection Control in Dentistry during COVID-19 Pandemic.

OBJECTIVES: The aim of this study was to evaluate the patient's knowledge, attitude, and practice of cross-infection control in dentistry during coronavirus diseases 2019 (COVID-19). MATERIALS AND METHODS: This cross-sectional observational study was conducted at Altamash Institute of Dental Medicine, Karachi from June 2020 to August 2020. A total of 775 patients participated to fill questionnaire. After scrutiny, 25 questionnaire forms were excluded due to incomplete information. Questionnaire was divided in to four sections. First section obtained patients sociodemographic information, while knowledge of patients regarding cross-infection control during COVID-19 pandemic was evaluated in second section. Similarly, the purpose of third section was to assess attitude and fourth section was designed to evaluate practice. Likert's 3-point scale was used for registration of participant's response. The reliability of questionnaire was assessed through Crohnbach's α (α = 0.74). Statistical analysis was performed after entering data in to SPSS version 25. Independent t-test was used to evaluate the difference in patients' knowledge, attitude, and practice. A p-value ≤ 0.05 was considered as statistically significant. RESULTS: Majority of the participants agreed that COVID-19 is a highly contagious disease (631, 97%) and daily screening of staff, dental assistants, dentists, and patients is necessary (568, 75.7%) along with proper sterilization of instruments and disinfection of dental operatory (650, 86.66%). A large number of participant also agreed that proper disposal of waste is utmost important for cross-infection control (601, 80.24%) and patient's waiting area should also be marked with social distancing sign (620, 82.66%). However, when asked about the common route of COVID-19 transmission in dentistry, 341 (45.5%) participants disagreed that it is not through aerosol (water droplets) generated during dental procedures. CONCLUSIONS: Dental health professionals should take additional measures to educate dental patients on mechanism of potential spread of COVID-19 through the aerosols and droplets generated during dental procedures. They should also encourage the dental patients to be vigilant and question the cross-infection control measures practiced by the dentist to whom they go for dental treatment, and to decrease their chances of acquiring an infection during their visit to the dental office.

Determination of Anesthetic Efficacy of Lidocaine Versus Bupivacaine in Single Visit Root Canal Treatment.

Objective: To compare the anesthetic efficacy of 2% Lidocaine with 1:80,000 epinephrine and 0.5% Bupivacaine with 1:200,000 epinephrine in one-visit root canal treatment in patients with symptomatic irreversible pulpitis. Methods: A total of 60 patients presenting with symptomatic irreversible pulpitis with normal periapical tissues on periapical radiography of mandibular 1st and 2nd molars, reporting moderate to severe pain as assessed by visual analogue scale (VAS) for at least 24 hours were included in this study. All patients received local anesthesia via the inferior alveolar nerve block technique by the investigator. These patients were randomly allocated into two groups in which first group received 2% lidocaine with 1:80,000 epinephrine and the second group received 0.5% bupivacaine with 1:200,000 epinephrine. Patients were instructed to rate the intensity of pain during root canal treatment which was then noted on visual analogue scale (VAS). Results: The average age of the patients was 34.15±9.49 years, in which 32 (53.3%) were male and 28 (46.7%) were female. The anesthetic efficacy was significantly high in bupivacaine as compared to lidocaine local anesthesia group (76.7% versus 40%; P=0.004). Conclusion: The administration of bupivacaine anesthetic agent for inferior alveolar nerve block (IANB) injections can be a better and appropriate pain management aid as compared to lidocaine during root canal treatment of patient with symptomatic irreversible pulpitis.

Influence of ultrasonic excitation on microhardness of glass ionomer cement.

BACKGROUND: Numerous researchers have attempted to improve the mechanical properties of glass ionomer cement since 1972. In this study, ultrasonic curing treatment was introduced during the mixing of glass ionomer cement (GC Fuji IX) to facilitate intimate mixing, compaction and adaptation of residual glass particle which consequently improves densification of the material. OBJECTIVE: To assess the influence of ultrasonic treatment on the microhardness of glass ionomer cement (GC Fuji IX) and compare it with the conventionally cured method. METHODS: A total of 40 specimens (2 × 2 mm) were fabricated and equally divided into two groups: Group I (conventional curing method) and Group II (ultrasonically cured). For Group II, an ultrasonic scaler was used which provides energy to ensure proper mixing of material without leaving any air bubbles or unmixed particles. Vicker's hardness test was employed to generate the average microhardness values by making three indentations at different points on each specimen. Statistical Package for Social Sciences (SPSS) Version 17 was used, employing independent samples T test to compare the difference in microhardness values between two curing groups. RESULTS: The average surface hardness value for conventional cured GIC was 62.21 ± 13.61 while ultrasonically cured GIC exhibited a higher mean microhardness value of 66.37 ± 12.83. Additionally, the average microhardness values produced by the two groups showed statistically significant differences (p value < 0.035). CONCLUSION: Ultrasonic excitation treatment leads to intimate mixing and accelerated hardening of glass ionomer cement thereby enhancing its microhardness and reducing early weakness.