A bibliometric analysis of scientific literature in digital dentistry from low- and lower-middle income countries.

OBJECTIVE: Bibliometric analysis and citation counts help to acknowledge influence of publications. The aim of this study was to conduct bibliometric and citation analysis of top-cited articles, from low- and lower-middle income countries, on use and application of digital technology in dentistry. METHODOLOGY: A search strategy based on "Digital Dentistry", "Low Income Countries", and "Lower-Middle Income Countries" was used in October 2023 using Scopus database to retrieve articles relevant to digital dentistry, with citation count of 10 or more. From 44 included articles, bibliometric information was analyzed on SPSS version 23. Network analysis based on co-citations, keywords, and number of citations was conducted on VOS software (version 1.6.20). RESULTS: Most relevant articles were published in 2021 (n = 8), with 52.3% original articles, out of which 40.9% were in vitro studies. India had the highest number of articles (n = 24), with most publications in The Journal of Indian Prosthodontic Society (n = 4), and in the domain of General Dentistry (n = 15, 34.1%). Co-authorship network analysis was not significant, but country-wise co-authorship analysis revealed India with the greatest link strength (4.0). Highest occurring keyword was 3D printing (link strength 5.0), and the citation analysis revealed Journal of Prosthetic Dentistry with the most number of published documents (3), having a citation count of 275. Bibliographic coupling for sources revealed Journal of Indian Prosthodontic Society to have the highest link strength of 15.33. CONCLUSION: This analysis uncovers interesting bibliometric and citation based information including key thematic trends, emphasizing crucial role of technologies like 3D printing, CAD/CAM, and CBCT in digital dentistry. The study underscores the imperative for increased original research efforts in low- and lower middle-income countries.

Navigating challenges and opportunities: AI's contribution to Pakistan's sustainable development goals agenda - a narrative review.

Sustainable Developmental Goals (SDGs) were introduced by the United Nations to ensure the sustainable progress of mankind through various domains. Pakistan, a low-middle-income country, faces many challenges in achieving SDGs. Artificial Intelligence is a rapidly evolving technology presenting significant importance in achieving SDGs. Therefore, this narrative review aimed to evaluate the artificial intelligence technologies that have been utilized globally and nationally which can be implemented in Pakistan focusing on Goal 3 (Good Health and Well-being) of SDGs. AI has been utilized primarily in high-income countries aiming to improve healthcare, thereby progressing towards achieving different targets of Goal 3 of SDGs. Pakistan lacks such initiatives with modest to no improvement across different SDGs. Therefore, Pakistan can adapt initiatives undertaken by resourceful countries to achieve its own SDGs.

The Analysis of Intermolar Width and Skeletal Base Class as a Predictor of Potential Maxillary Canine Impaction in Permanent Dentition: A Cross-Sectional Study.

Objectives. This study aimed to analyze the inter-molar width and skeletal base class to predict maxillary canine impaction in permanent dentition. Methods. This cross-sectional study was carried out between September 2021 to March 2022. Patients aged between 13 and 20 years were recruited. These patients' cone-beam computer tomography(CBCT), lateral cephalogram, and dental casts were collected and analyzed. For statistical analysis, T-test and Chi-square tests were applied. Results. A total of 92 patients were enrolled in this study. Inter-molar width was significantly decreased in patients with impacted canine(P < .001). The skeletal base classification was statistically significant when compare with intermolar width(P < .05). The location of impaction (P = .060), type of impaction(P = .435), and side of impaction(P = .239) were determined to be statistically insignificant. Conclusion. The Inter-molar width was decreased in patients with impacted canine; therefore, it may be a potential risk factor. The skeletal classification was found to affect inter-molar width in impacted canine patients.

The efficacy of iatrosedation and music listening techniques in attenuating dental anxiety in patients undergoing dental crown preparation: A randomized clinical trial.

Dental anxiety is a common problem encountered in dental clinics that affects both patients and dentists. Adequate management of dental anxiety is critical for optimal treatment outcomes for the patient. This study aims to assess the efficacy of two anxiety-reduction techniques (iatrosedation and music listening) for dental crown preparation in adult patients. In this clinical trial, 60 patients were randomly assigned to three groups: Group 1, iatrosedation; Group 2, music listening; and Group 3, control. Patients in all three groups underwent dental crown preparation. To measure the anxiety levels of the patients, heart rate was calculated using a pulse oximeter, and verbal rating scale scores were assessed. One-way analysis of variance, post hoc analysis, and Spearman's correlation were used to compare the mean values of the three groups. Significant differences were observed in the heart rate and verbal rating scale scores among individuals in the study groups. A more substantial reduction in anxiety levels was found in patients exposed to iatrosedation (Group 1), which was followed by music listening (Group 2). Recorded heart rate and verbal rating scores were the highest in the control group patients. The iatrosedation technique significantly reduced dental anxiety for patients undergoing dental crown treatment; however, music listening was less effective than iatrosedation. Educating patients regarding the dental care they are about to receive is vital for reducing their anxiety.

Impact of high-speed handpiece noise-induced dental anxiety on heart rate: analyzing experienced and non-experienced patients - a comparative study.

BACKGROUND: Dental anxiety is very much common among the patients and could be due to different factors like the behavior of the dentist, past experiences, Needle phobia, or word of mouth from other patients. According to recent studies, a strong association between sound and anxiety has been found, so this observational study has been conducted to find out the link between the activation of anxiety with the sound of a handpiece between experienced patients, who have already gone through the dental treatments and non-experienced patients. METHODS: Total of 297 participants were part of this study. These participants were divided into 2 groups according to the experienced and non-experienced dental patients. The researcher first filled out the CORAH Dental Anxiety Scale (DAS) form to mark the anxiety level of the patients, and then noted the readings of the heart rate in 3 intervals which were before during, and after the treatment with the pulse oximeter. Later the data was analysed using the SPSS independent t-test. RESULTS: Results show that patients in group 1 who have gone through the dental treatment before were less anxious and had a lesser effect on their heart rate than the patient who were having the treatment for the first time who were in group 2. Another interesting factor was noticed that in both the groups female were found to be more anxious than male participants. Participants with younger age were found to be more anxious than older age patient in both groups CONCLUSIONS: The sound of the handpiece can provoke anxiety in the patient, affecting the heart and increasing the heart rate. Participants who were experienced were found to be less anxious than the participants who were inexperienced.

Research and application of artificial intelligence in dentistry from lower-middle income countries - a scoping review.

Artificial intelligence (AI) has been integrated into dentistry for improvement of current dental practice. While many studies have explored the utilization of AI in various fields, the potential of AI in dentistry, particularly in low-middle income countries (LMICs) remains understudied. This scoping review aimed to study the existing literature on the applications of artificial intelligence in dentistry in low-middle income countries. A comprehensive search strategy was applied utilizing three major databases: PubMed, Scopus, and EBSCO Dentistry & Oral Sciences Source. The search strategy included keywords related to AI, Dentistry, and LMICs. The initial search yielded a total of 1587, out of which 25 articles were included in this review. Our findings demonstrated that limited studies have been carried out in LMICs in terms of AI and dentistry. Most of the studies were related to Orthodontics. In addition gaps in literature were noted such as cost utility and patient experience were not mentioned in the included studies.

Analysis of impact of consumption of proton pump inhibitor on osseo integration of dental implants to the alveolar bone: A systematic critical appraisal.

Proton pump inhibitors are one of the most frequently prescribed medicines primarily for reducing the production of gastric acid. Every medicine has some adverse effects associated with it, including effects on the bone tissues. Dental implant is one of the most preferred options for teeth replacement. The current literature review was planned to evaluate the association between intake of proton pump inhibitors and its impact on the bone around the dental implant. Literature review entailed search on Google Scholar, Web of Science and PubMed databases using a range of search terms. Chronic intake of proton pump inhibitors has been associated with decrease in the density of bone, which eventually leads to increased risk of dental implant failure. However, since limited studies have been carried out, further research is required, especially clinical trials, to evaluate the relationship between the intake of proton pump inhibitors and the failure of dental implants.

Parental Knowledge, Attitude and Practices Toward Dental Sealants as Preventive Strategy for Dental Caries in Children: A Cross Sectional Study.

Aim. This study aimed to evaluate the knowledge, attitude, and practices of parents residing in Pakistan toward pits and fissure sealants in children. Materials and Methods. This descriptive, cross-sectional study was carried out between November 2022 to March 2023. An online questionnaire was distributed through various social media platforms. Independent t-test and Multiple Linear Regression analysis were performed. Results. A total of 570 participants were recruited. For protection against tooth decay, most of the participants 456(80%) believed that fissure sealants should be placed to protect teeth from decay. Placement of fissure sealants was considered to be a cost-effective measure by majority of the 480 (84.2%) respondents. Conclusion. Fissure sealants are one of the most effective preventive measures against tooth decay. The knowledge, attitude and practice of parents were some being aware of fissure sealants and some were not. It appeared to support the placement of fissure sealants for their children.

Comparison of triamcinolone with pentoxifylline and vitamin E efficacy in the treatment of stage 2 and 3 oral submucous fibrosis: A randomized clinical trial.

Objective: The objective of this study was to assess the effectiveness of triamcinolone in combination with pentoxifylline and vitamin E in the treatment of patients with level two and three oral submucous fibrosis. Methods: The study aimed to compare the efficacy of corticosteroid injections (triamcinolone) versus pentoxifylline and vitamin E in the therapy of patients with stage two and three oral submucous fibrosis. A total of 42 participants with indications and features of oral submucous fibrosis were enrolled between January 2020 and September 2021. The patients' age and mouth opening were evaluated, and descriptive statistics and paired t-test were used for analytical investigation. Results: The study showed a statistically significant improvement in both treatment groups (p = 0.001) concerning pre- and post-treatment deviations. However, when comparing the standard differences in treatment outcomes between the two study groups, only mouth opening exhibited a statistically significant difference (p = 0.001). Conclusions: The findings indicate that a treatment regimen combining pentoxifylline and triamcinolone can significantly alleviate oral submucous fibrosis symptoms, including mouth opening, pain, and flaring agitation, thereby enhancing the affected individual's quality of life.

An insight into perceptions of general pathologists about the need for oral pathology services: An observational study.

Objective: The objective of this study was to identify the degree of perception of oral pathology as a specialty among the general pathologists and the need of utilizing oral pathologists in assisting to identify oral lesions in diagnostic challenges. Methods: A questionnaire-based survey was conducted among qualified general pathologists to collect the data. The survey items focused on various aspects, including the analysis of oral pathology as a specialty, the importance of employing oral pathologists for identifying oral lesions in diagnostic challenges, and the difficulties encountered in managing such lesions. The data collected was analyzed using descriptive and inferential statistics. For comparing the relationship between work experience and the referral of odontogenic cysts and tumors cases, a Chi-square test was employed. A significance level of p ⩽ 0.05 was deemed as statistically significant. Results: Two hundred and fifty general pathologists responded to the questionnaire. Two hundred and thirty two (92.8%) participants showed awareness of oral pathology as a specialty. For the diagnosis of oral, jaws, and salivary glands pathologic lesions, the majority 198 (79.2%) respondents believed that oral pathologists are required for the diagnosis. Regarding the referrals of lesions to oral pathologists, 137 (54.8%), participants did not refer. In terms of training in oral pathology, all of the participants agreed that they would undertake short-term posting in oral pathology. For challenging cases, all the general pathologists believed that oral pathologists should be part of the team. Conclusion: The general pathologists recognized oral pathology as a specialty and feel the need for an oral pathologist opinion in diagnosis. However, most of the general pathologists did not refer the complex cases to oral pathologists. Therefore, it is of paramount importance to encourage oral pathologists and their hiring at histopathology laboratories that are diagnosing complex head and neck cases.

Cryoanesthesia with ethyl chloride spray versus 5% lidocaine gel in alleviating oral local anesthetic injection pain for buccal anaesthesia: A randomized clinical (controlled) trial.

Background: Numbing the area of oral mucosa with cold application prior to administration of regional anesthesia has been widely used by various dentists in alleviating pain caused by needle prick. Cryoanesthesia using Endo-ice as topical anesthesia has been studied as a replacement to prevail the fallibility of topical anaesthetics. This study aimed to evaluate and compare effectiveness of ethyl chloride spray with 5% lidocaine gel in alleviating buccal anesthesia injection pain. Methods: Total of 90 outpatients were randomly divided into 3 groups as follows: Group 1 - cryotherapy with ethyl chloride at the anesthetic site preceding before administration of local anesthesia; Group 2 - topical application of 5% LIDOCAINE GEL preceding before administration of local anesthesia; and group 3 - control that did not receive any topical agent preceding before administration of local anesthesia. Visual analogue scale (VAS) was used to document pain immediately after injection prick. Results: About comparison of pain scores, significant difference was found between group 1 (ethyl chloride) and group 2 (topical lidocaine) patients (P=0.001). For group 1, about 15 (50%) patients suffered from mild pain, followed by 14 (46.67%) patients suffering from moderate pain. However, majority of the 21 (70%) patients in group 2 suffered from moderate pain. All the patients in group 3 suffered from severe pain. Conclusion: Importance of alleviating fear of needle injection phobia amongst patients is of paramount importance. Ethyl chloride was found to be more effective than topical lidocaine in alleviating needle injection pain before administration of local anesthetic injection.

Anti-fungal efficacy of Miswak Extract (Salvadora Persica) and commercial cleaner against Candida albicans on heat cured polymethylmethacrylate denture base.

AIM: The aim of the study was to compare the antifungal efficacy between commercial cleaner (Corega) and Miswak extract (Salvadora persica) against Candida albicans on heat cured Polymethyl methacrylate (PMMA) acrylic denture base resin. MATERIALS AND METHODS: Forty-eight samples of heat cured PMMA acrylic denture base resin were fabircated in the study. The sterile acrylic resin specimens were immersed in standardized cell suspension of Candida albicans and incubated for 60 min at 370°C for cell adhesion and 2 h at 370°C for biofilm formation. After 24 h biofilm was evaluated by cell viability (CFUs) on SDA and cell counting of Candida albicans under light microscope at 400× magnification. The fungicidal effect of commercial cleaner and Miswak extract on Candida albicans biofilm was then evaluated by colony-forming units on SDA and cell counting under light microscope at 400× magnification. RESULTS: Screening test agar disk-diffusion assay showed mean inhibitory zone of 3 mm for commercial cleaner as compared to Miswak extract, which showed mean inhibitory zone of 2 and 1 mm for different concentrations. Broth microdilution method showed 31 mg/ml MIC and 62.5 mg/ml Minimal Fungicidal Concentration (MFC) values for commercial cleaner as compared to Miswak extract that showed 125 mg/ml MIC and 250 mg/ml MFC values against Candida albicans. A significant difference (p < 0.05) was observed between pre and post treatment of both commercial cleaner and Miswak extract, for CFUs and cell count for Candida albicans. CONCLUSION: Commercial denture cleaner (Corega) showed better antifungal (C albicans) activity than Miswak extract (Salvadora persica) on heat cured PMMA acrylic denture base resin.

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.

Oral health related quality of life and the prevalence of ageusia and xerostomia in active and recovered COVID-19 Patients.

Background: Salivary disturbance is associated with patients who either have an active coronavirus disease 2019 (COVID-19) or have recovered from coronavirus infection along with loss of taste sensation. In addition, COVID-19 infection can drastically compromise quality of life of individuals. Objective: This study aimed to analyze xerostomia, ageusia and the oral health impact in coronavirus disease-19 patients utilizing the Xerostomia Inventory scale-(XI) and the Oral Health Impact Profile-14. Methods: In this cross-sectional survey-based study, data was collected from 301 patients who suffered and recovered from COVID-19. Using Google Forms, a questionnaire was developed and circulated amongst those who were infected and recovered from coronavirus infection. The Xerostomia Inventory (XI) and Oral Health Impact Profile-14 were used to assess the degree and quality of life. A paired T-test and Chi-square test were used to analyze the effect on xerostomia inventory scale-(XI) and OHIP-14 scale scores. A p-value of 0.05 was considered as statistically significant. Results: Among 301 participants, 54.8% were females. The prevalence of xerostomia in participants with active COVID-19 disease was 39.53% and after recovery 34.88%. The total OHIP-14 scores for patients in the active phase of infection was 12.09, while 12.68 in recovered patients. A significant difference was found between the mean scores of the xerostomia inventory scale-11 and OHIP-14 in active and recovered COVID patients. Conclusion: A higher prevalence of xerostomia was found in COVID-19 infected patients (39.53%) compared to recovered patients (34.88%). In addition, more than 70% reported aguesia. COVID-19 had a significantly higher compromising impact on oral function of active infected patients compared to recovered patients.

Comparison of General Anxiety among Healthcare Professionals before and after COVID-19 Vaccination.

Vaccination plays a crucial role in controlling the rate of coronavirus transmission and infectivity. Healthcare professionals are, in fact, at the greatest risk of contracting coronavirus due to their proximity and prolonged exposure to infected patients; this certitude alone enhances the stress and anxiety among patients and professionals alike. In this study, we aimed to assess the levels of anxiety experienced by healthcare professionals in their practices before and after getting vaccinated. This cross-sectional study was carried out in 2021. An electronic survey was distributed among the non-vaccinated and vaccinated healthcare workers. The survey consisted of the following parts: demographic characteristics, coronavirus-related questions, questions related to the specific field of healthcare professions, general anxiety questions, and working-hour-related questions. The Modified General Anxiety Scale (GAD-7) was used along with the paired t-test, Mann-Whitney U test, and Spearmen's test for comparison. p ≤ 0.05 was considered statistically significant. A total of 798 healthcare professionals participated in the study. In this study, the majority of participants were females, with 598 (74.9%) being between the ages of 21 and 30, and 646 (80.9%) participants were graduates, with the majority being dentists. Non-vaccinated healthcare professionals had severe anxiety (30.9%), whereas, in vaccinated participants, anxiety levels were minimal (56.9%). A statistically significant correlation was discovered when comparing the scores of the vaccinated and non-vaccinated individuals as well as when comparing the professions of vaccinated participants, whereas no association was found with the gender and education level of participants. Vaccination is necessary for all entitled individuals to control the spread of coronavirus. It was discovered that there was an increase in anxiety levels before the vaccination was introduced. The anxiousness was greatly lessened following mass immunizations. Our research will help to raise public awareness of stigmatized mental health disorders in the healthcare industry.

Impact of Social Media on Aesthetic Dentistry: General Practitioners' Perspectives.

The objective of this study was to investigate general dentists' observations of various aesthetic dental procedures among social media users. A cross-sectional study was conducted at the Department of Prosthodontics, Altamash Institute of Dental Medicine, over a duration of six months. Data were collected using a well-structured questionnaire comprising 21 predefined responses. The questionnaire was uploaded and disseminated through Google Surveys by forwarding web page links through emails and WhatsApp. The data collected were analysed through Statistical Package for Social Sciences (SPSS-Version 25). The majority (90.7%) of the dental practitioners surveyed believed that there is an increase in the demand for aesthetic dental procedures and social media is a major contributor to it. Moreover, most of the 377 (81.8%) participants agreed that social media is a beneficial platform enabling them to educate, advertise, and communicate with patients. Concerning popular aesthetic procedures, teeth whitening (54.7%), Hollywood smile (17.1%), dental veneers (11.9%), and Invisalign (10.4%) were the most commonly demanded aesthetic procedures. The patients showed desire for these procedures because they were trending on social media platforms. Almost half of the general dental practitioners used social media to post their content related to aesthetic dentistry and to promote their work. They preferred using before and after pictures (48.6%) for advertising their content related to aesthetic dentistry. Within the limitations of the study, it is concluded that the demand for aesthetic dentistry is rapidly growing, and social media is the main driving force behind this revolution as the general population has direct access to the profiles of celebrities and influencers, who all appear to have 'the perfect smile'. This shift in people's self-image has created a surge in patients seeking cosmetic treatments.

A Comparative Evaluation of Dentogingival Tissue Using Transgingival Probing and Cone-Beam Computed Tomography.

Background and Objective: Gingival biotype can be assessed using a variety of invasive and non-invasive procedures, such as direct probing, transgingival probing, ultrasound-guided approaches, and, for the more sophisticated, cone-beam computed tomography. The aim of this study was to evaluate gingival biotype in relation to transgingival probing and cone-beam computed tomography (CBCT). Materials and Methods: This study included a total of two hundred healthy individuals. Gingival thickness was assessed and measured from the right and left maxillary central incisor teeth using CBCT and transgingival probing of the attached gingiva. The measurements were analyzed with regard to tooth type (central incisor). Linear measurements for gingival biotype were measured using both methods. Correlations and differences between measurement methods were assessed. Results: The mean age of study participants was 32.49 ± 8.61 years. The radiographic measurements on CBCT were 1.34 ± 0.17 mm for the right central and 1.28 ± 0.21mm for the left central. The transgingival probing measurements were 1.31 ± 0.18 for the right central and 1.22 ± 0.21mm for the left central. Conclusion: As per the results of this study, there is a significant positive correlation between transgingival probing and CBCT measurements of gingival biotypes.

Evaluation of Social Media Usage by Dental Practitioners of Pakistan for Professional Purposes - A Cross-Sectional Study.

Background: In the past couple of years, the use of social media has been on a tremendous rise with greater attention in the field of healthcare, including dentistry. The use of social media for professional purposes is emphasized as unprofessional use can be detrimental. This study aims to evaluate the use of social media by dentists for professional purposes. Materials and Methods: This cross-sectional study was carried out between December 2021 and March 2022. An online questionnaire was formulated using Google Forms and distributed to the dental professionals through various social media platforms such as Twitter©, Facebook©, Instagram©, Snapchat©, WhatsApp©, and Email©. The questionnaire consisted of two parts: demographic characteristics and questions about the use of social media for professional purposes. For data analysis, SPSS version 25.0 was used, where a multiple linear regression test was used to compare the responses of the participants with their demographic characteristics. A p-value of ≤0.05 was considered to be statistically significant. Results: A total of 404 dentists participated in this study with a response rate of 89.7%. The majority of the 276 (68.3%) dentists believed to have a professional account to use social media for professional purposes. Most of the 280 (69.3%) dentists agreed social media improved knowledge and communication skills with the patients. About 248 (61.4%) dentists considered the use of social media for general purposes during clinical hours led to wastage of time. About 160 (39.6%) dentists considered connecting with patients on social media to be inappropriate. Conclusion: The use of social media is on the rise at a tremendous rate in different fields of work, including dentistry. Social media is a great tool for dentists to help expand and grow their clinical practice. However, the professional use and ethics whilst using social media should be considered by the dentists.