Comparative Evaluation of Push-out Bond Strength of Conventional Mineral Trioxide Aggregate, Biodentine, and Two Novel Antibacterial-enhanced Mineral Trioxide Aggregates.

AIM: To evaluate the push-out bond strength of two newly modified mineral trioxide aggregates (MTAs) with conventional MTA and biodentine. MATERIALS AND METHODS: Material preparation: Two commercially available bioactive bioceramics: Group I: Mineral trioxide aggregate; Group II: Biodentine; and two newly formulated modified MTAs: Group III: Doxycycline incorporated MTA formulation; Group IV: Metronidazole incorporated MTA formulation was used in the present study. All the test materials were then carried using a plastic instrument to the desired experimental design. Teeth sample preparation: A total of 120 teeth samples were collected and divided into four groups of test materials with 30 teeth samples per group. Single-rooted permanent teeth, that is, incisors were collected and stored in saline until the study was performed. Sectioning of the teeth into 2.0 ± 0.05-mm thick slices was performed perpendicular to the long axis of the tooth. The canal space was instrumented using Gates Glidden burs to achieve a diameter of 1.5 mm. All four prepared materials were mixed and placed in the lumen of the slices and placed in an incubator at 37°C for 72 hours. Push-out test and bond failure pattern evaluation: The push-out test was performed using a universal testing machine. The slices were examined under a scanning electron microscope (SEM) at 40× magnification to determine the nature of bond failure. All the collected data were recorded and statistically analyzed. RESULTS: The mean push-out bond strength was found to be the highest for group II (37.38 ± 1.94 MPa) followed by group III (28.04 ± 2.22 MPa) and group IV (27.83 ± 1.34 MPa). The lowest mean push-out bond strength was noticed with group I (22.89 ± 2.49 MPa). This difference was found to be statistically significant (p = 0.000). Group I samples had the predominantly adhesive type of failure (86.4%), while group II samples showed the cohesive type of failure (94.2%). Both the modified MTAs (groups III and IV) primarily showed mixed types of failures. CONCLUSION: Both the antibacterial-enhanced MTAs had better pushout bond strength compared to conventional MTA but did not outperform biodentine. Hence, it could serve as a substitute for conventional MTA due to its augmented physical properties. CLINICAL SIGNIFICANCE: Carious pulp exposure and nonvital open apices pose a critical challenge to pediatric dental practitioners. In such circumstances, maintaining the vitality of pulp and faster healing would help in a better prognosis. Novel MTAs without any cytotoxic components, and enhanced antibacterial contents with augmented physical properties can help in treating such clinical conditions. How to cite this article: Merlin ARS, Ravindran V, Jeevanandan G, et al. Comparative Evaluation of Push-out Bond Strength of Conventional Mineral Trioxide Aggregate, Biodentine, and Two Novel Antibacterial-enhanced Mineral Trioxide Aggregates. J Contemp Dent Pract 2024;25(2):168-173.

Investigating the role of internet-based educational application in the dental sciences.

The study intended to identify the significance of the online information retrieval system (IRS) in evidence-based dentistry (EBD). Thus, the researchers apply a set of pre-and post-tests to evaluate the current knowledge of clinicians and students on online IRS. Materials and Methods: The researchers followed repeated measure design in this study. They applied random sampling technique for conducting pre-and post-test assessment. Five scenarios based EBD were developed to evaluate the performance of the participants. The researchers employed two phases in order to achieve the study's objective. In the first phase, 98 clinicians and 70 students were invited to attend three out of five clinical scenarios using IRS. In the second phase, the participants were invited to participate in a 15-min lecture presented by the researchers on the searching strategies and guidelines to apply keywords for searching the evidence using IRS. A significant level of p < 0.05 was obtained from the statistical analysis using the SPSS program version 16. Results: Of the 98 clinicians, only 37 responded to the questionnaire, with a response rate of 37.8 %. On the other hand, out of 70 students, 23 responded to the questionnaire, with a response rate of 32.8 %. In the pre-test, clinicians and students correctly answered 58.3 % of scenario questions. However, the data analysis outcome revealed that only 40.5 % of participants provided a relevant evidence source after an internet search. The students spent an average of 9 min to complete the task, whereas clinicians spent 16 min. After the completion of the lecture, 23 students and clinicians responded to the pre-test, whereas 10 responded to the post-test. Most students believed that the lecture was helpful and recommended similar types of lectures to be presented in the curriculum. The study findings highlight that the percentage of evidence provided in the "pre-test" was 60 %, which was improved in the post-test to 73.3 %. Conclusion: The experimental outcome suggests that internet-based educational applications enhance students' learning strategies. Additionally, the IRS supports clinicians in retrieving effective materials for treating their patients. Furthemore, there is a demand for extracurricular activity to improve the search strategies of clinicians and students to strengthen EBD.

Parents and guardians perceptions of primary school students accessibility to dental health services in Riyadh City, Saudi Arabia: A cross-sectional study.

The success of healthcare delivery systems depends on accessibility. This study aimed to assess parental and guardian perceptions of dental health service accessibility among primary school students in Riyadh, Saudi Arabia. A descriptive cross-sectional survey was conducted among the parents and guardians of primary school students. A 23-item questionnaire was developed on the basis of previous studies. Demographic information, accessibility details, and barriers to dental services were recorded. A total of 385 participants responded to the questionnaire. Approximately 46.2 % of students encountered barriers to accessing dental services. Eighty (20.8 %) male students visited dental facilities more often than female students (72 [18.7 %]) within a 6-month period. Approximately 21 % of students had never visited a dental facility. The lowest number of preventive treatments were administered (15.4 %). Parents and guardians reported that private dental facilities were more accessible (185 [48 %]) than government dental facilities. There was an association between dental facilities and difficulties in accessing dental care services (χ2(4) = 42.753; p < 0.001). In conclusion, parents and guardians reported experiencing difficulties accessing dental services. However, parents and guardians must change their perspectives on accessibility, particularly for preventative care, because primary school children received the lowest.

Application and Performance of Artificial Intelligence (AI) in Oral Cancer Diagnosis and Prediction Using Histopathological Images: A Systematic Review.

Oral cancer (OC) is one of the most common forms of head and neck cancer and continues to have the lowest survival rates worldwide, even with advancements in research and therapy. The prognosis of OC has not significantly improved in recent years, presenting a persistent challenge in the biomedical field. In the field of oncology, artificial intelligence (AI) has seen rapid development, with notable successes being reported in recent times. This systematic review aimed to critically appraise the available evidence regarding the utilization of AI in the diagnosis, classification, and prediction of oral cancer (OC) using histopathological images. An electronic search of several databases, including PubMed, Scopus, Embase, the Cochrane Library, Web of Science, Google Scholar, and the Saudi Digital Library, was conducted for articles published between January 2000 and January 2023. Nineteen articles that met the inclusion criteria were then subjected to critical analysis utilizing QUADAS-2, and the certainty of the evidence was assessed using the GRADE approach. AI models have been widely applied in diagnosing oral cancer, differentiating normal and malignant regions, predicting the survival of OC patients, and grading OC. The AI models used in these studies displayed an accuracy in a range from 89.47% to 100%, sensitivity from 97.76% to 99.26%, and specificity ranging from 92% to 99.42%. The models' abilities to diagnose, classify, and predict the occurrence of OC outperform existing clinical approaches. This demonstrates the potential for AI to deliver a superior level of precision and accuracy, helping pathologists significantly improve their diagnostic outcomes and reduce the probability of errors. Considering these advantages, regulatory bodies and policymakers should expedite the process of approval and marketing of these products for application in clinical scenarios.

Prevalence and Patterns of Orofacial Clefts among Children from Different Regions of Saudi Arabia: A Systematic Review.

Aim and objective: To report on the prevalence and patterns of orofacial clefts (OFC) among Saudi Arabian children by analyzing the results of the studies that have been reported in the literature. Materials and methods: A data search was carried out for the articles that had reported on the prevalence of OFC among the Saudi Arabian population in databases like Web of Science, PubMed, Google Scholar, Scopus, and Saudi Digital Library. Articles that were published over the last 15 years were included in this study, following which 13 studies were assessed for qualitative data. Newcastle-Ottawa Quality Assessment Scales for cross-sectional studies were used for analyzing the methodological quality of these studies. Results: The prevalence of OFC was within the range of 0.65-1.9/1,000 live births. The highest was witnessed in the Medina region. Parent's consanguinity was the most common risk factor in OFC cases in the included studies. OFC was found to be higher among the male population in comparison with the female. Conclusion: The prevalence of OFC in Saudi Arabian children follows the global patterns of OFC. Isolated cleft lip (CL) and cleft palate (CP) are the most common forms of OFC. The prevalence of orofacial anomalies was reported more among children born to parents who had consanguineous marriages. Considering the higher rate of consanguinity among this population, there is an urgent need of developing educational and counseling programs to address the genetic consequences. How to cite this article: Albalawi F Alsaeed S, Alalola B, et al. Prevalence and Patterns of Orofacial Clefts among Children from Different Regions of Saudi Arabia: A Systematic Review. Int J Clin Pediatr Dent 2023;16(1):124-130.

Resin-based dental materials containing 3-aminopropyltriethoxysilane modified halloysite-clay nanotubes for extended drug delivery.

OBJECTIVE: To synthesize and characterize a novel resin-based dental material containing 3-aminopropyltriethoxysilane (APTES) surface-modified halloysite-clay nanotubes (HNTs) for long-term delivery of guest molecules. METHODS: The optimal concentrations of HNT (10, 15, 20 wt.%) and silane (0, 2, 4 vol.%sil) to be incorporated into the resin-based materials were determined (15 wt.%HNT, 4 vol.%sil) after assessment of the mechanical properties (DC%, degree of conversion; FS, flexural strength; FM, flexural modulus; and UTS, ultimate tensile strength). The HNTsil-powder was loaded with chlorhexidine (CHX) to evaluate the effect of the silanization on drug release. Resin-discs were prepared for the following groups: RES (resin), HNT (resin+15 wt.%HNT), HNTsil (resin+15 wt.%HNT silanized), HNT-CHX (resin+15 wt.%HNT loaded with chlorhexidine), HNTsil-CHX (resin+15 wt.%HNTsil-CHX), and 0.2 vol.%CHX (resin+0.2 vol.%CHX solution). Specimens were stored in water for 1, 3, 5, 10, and 15 days at 37 °C. Aliquots from each time point and the final 15-day specimens were evaluated for the zone of inhibition (ZOI) against Streptococcus mutans. CHX release was analyzed using spectrophotometry at absorbance of 300 nm. Data were statistically analyzed (α = 0.05). RESULTS: All materials presented similar DC%. Reduced FS but increased FM was detected for 20 wt.%HNT-4%APTES. Groups with 15 wt.% and 20 wt.%HNT with/without APTES presented higher values of UTS. Agar diffusion data indicates that the HNTsil-CHX had a greater ZOI than all other groups over 15 days. HNTsil-CHX had the highest absorbance for day 1 but presented similar values to other groups every time point after. SIGNIFICANCE: Silanization of nanotubes followed by encapsulation of chlorhexidine is a promising technique for long-term delivery of guest molecules.

Chlorhexidine-modified nanotubes and their effects on the polymerization and bonding performance of a dental adhesive.

OBJECTIVES: The purpose of this study was to synthesize chlorhexidine (CHX)-encapsulated aluminosilicate clay nanotubes (Halloysite®, HNTs) and to incorporate them into the primer/adhesive components of an etch-and-rinse adhesive system (SBMP; Scotchbond Multipurpose, 3M ESPE) and to test their effects on degree of conversion, viscosity, immediate and long-term bonding to dentin. METHODS: CHX-modified HNTs were synthesized using 10% or 20% CHX solutions. The primer and the adhesive components of SBMP were incorporated with 15wt.% of the CHX-encapsulated HNTs. Degree of conversion (DC) and viscosity analyses were performed to characterize the modified primers/adhesives. For bond strength testing, acid-etched dentin was treated with one of the following: SBMP (control); 0.2%CHX solution before SBMP; CHX-modified primers+SBMP adhesive; SBMP primer+CHX-modified adhesives; and SBMP primer+CHX-free HNT-modified adhesive. The microtensile bond strength test was performed after immediate (24h) and long-term (6 months) of water storage. Data were analyzed using ANOVA and Tukey (α=5%) and the Weibull analysis. RESULTS: DC was greater for the CHX-free HNT-modified adhesive, whereas the other experimental adhesives showed similar DC as compared with the control. Primers were less viscous than the adhesives, without significant differences within the respective materials. At 24h, all groups showed similar bonding performance and structural reliability; whereas at the 6-month period, groups treated with the 0.2%CHX solution prior bonding or with the CHX-modified primers resulted in greater bond strength than the control and superior reliability. SIGNIFICANCE: The modification of a primer or adhesive with CHX-encapsulated HNTs was an advantageous approach that did not impair the polymerization, viscosity and bonding performance of the materials, showing a promising long-term effect on resin-dentin bonds.