A Critical Evaluation of the Undergraduate Endodontic Teaching in Dental Colleges of Saudi Arabia.

BACKGROUND: The purpose of the research was to evaluate the content and delivery of the undergraduate endodontic curriculum. METHODS: A needs assessment survey was distributed among the Deans of all the dental colleges in Saudi Arabia. RESULTS: The response rate was 72%. All the colleges include foundational and advanced topics in their curriculum. Didactic lectures, clinical cases, self-directed learning assignments and projects, and videos are the most common teaching methods, whereas virtual learning and reading list are the least popular methods. The average staff-to-student ratio for preclinical and clinical training is 1:6 and 1:7, respectively. Eighty-six percent of colleges utilize dedicated endodontic clinics supervised by specialized endodontists. Eighty percent of colleges use simple cases for canal preparation and obturation. Most colleges do not use magnification and ultrasonic instruments. Saline and sodium hypochlorite are preferred irrigation solutions, whereas calcium hydroxide is the preferred inter-visit medicament. Many use MTA as an advanced material, calcium hydroxide as an inter-visit medicament, and provisional restoration after RCT. CONCLUSION: The content and delivery of the endodontic undergraduate curriculum are primarily uniform. The use of specialist endodontists dedicated endodontic clinics, rotary instruments, and advanced materials have emerged as curricular strengths. However, diversification of teaching strategies, use of magnification instruments, and an increase in the minimum number of endodontically treated teeth are leading areas demanding curricular improvement.

Structural Changes in Primary Teeth of Diabetic Children: Composition and Ultrastructure Analysis.

Diabetes affects the developing enamel by altering the mineralization process, which can have a detrimental effect on oral health. The objectives of this study were to examine the ultrastructure and composition of surface enamel in primary teeth of diabetic children and its clinical implications. Hundred extracted primary teeth from diabetic children (Test group: n = 50) and healthy children (Control group: n = 50), between 6 and 12 years of age, were subjected to scanning electron microscopy to qualitatively examine the enamel surface. Energy dispersive X-ray (EDX) analysis was performed to investigate the mass percentage of calcium (Ca) and phosphorous (P) in the surface enamel. Ultrastructural aberrations of surface enamel were observed in the test group teeth. Additionally, prism perforations were seen at the junction of rod and inter-rod enamel and the prisms were loosely packed. An even aprismatic layer of surface enamel was evident in the control group teeth. There was a statistically significant difference (p < 0.05) of Ca and P mass percentage between the test and control group teeth. The mean mass percentage rates of Ca and P were 33.75% and 16.76%, respectively. A poor surface characteristic and elemental composition of the enamel surface of primary teeth is observed in diabetic children. Therefore, appropriate caries preventive measures are mandatory to maintain the structural integrity of the tooth in these patients.

Detection of Dental Caries' and Dermatoglyphics' Association with Relative Enamel Thickness Using CBCT Images in Saudi Subpopulation: A Novel Approach.

BACKGROUND: Dental caries is the localized destruction of dental hard tissues (enamel and dentine). Decayed, Missing, and Filled Teeth (DMFT) index is the most commonly used dental caries index. Thickness of the outermost part of the tooth called the enamel is determined by the rate of deposition of enamel proteins. Relative enamel thickness (RET) gives a measure of enamel thickness with respect to dentine. Dental caries is influenced by a genetically determined factor called dermatoglyphics (DG). As the genes responsible for RET and DG lie on the same chromosome and develop during the same time of intrauterine life, it is biologically plausible to correlate RET and DG. AIMS: This study consists of two primary aims: (1) to assess RET using cone beam computed tomography images and correlate it with caries and (2) to correlate RET with DG. MATERIALS AND METHODS: 148 dental subjects were assessed for DMFT caries score and were categorized as Group 1 with DMFT = 0 and Group 2 with DMFT ≥ 1. Following this, their DG pattern was recorded digitally. The CBCT images of these subjects were assessed for RET, and the data were analyzed statistically. RESULTS: Mean RET in our sample population is 18.45 (SD 3.79) while mean DMFT is 5.34 (SD 5.13). Mean RET in Group 1 subjects was 19.82 (SD 4.05) while that in the Group 2 was 17.68 (SD 3.43). RET and DMFT showed a statistically significant negative correlation (p = 0.007). The "Single Loop" DG characteristic showed a statistically significant difference between males and females (p = 0.031). The "Simple Arch" type of DG was positively correlated with RET. CONCLUSION: This is the first in vivo study to assess RET using CBCT images and correlate with DMFT and DG. RET is inversely related to DMFT while directly proportional to the "Simple arch" DG pattern. Males and females differed in their "Single Loop" DG characteristic.

High altitude as a possible factor for dysbiosis of salivary microbiome in orthodontic patients.

BACKGROUND: External stressors such as high altitude and low oxygen are known to affect the human microbiome, and in light of the increased occurrence of dental caries and periodontitis in orthodontic patients, the effect of high altitude and the altered oral environment in orthodontic patients on the oral salivary microbiome was researched. MATERIALS & METHODS: 31 orthodontic patients from high altitude, Aseer region and 25 orthodontic patients, residing at sea level, as controls were included. DNA isolation was done from the saliva collected from the study participants. V3 area of 16s RNA was targeted by universal primers through PCR to decipher the salivary microbiome in both the groups. RESULTS: A total of 11 genera belonging to 4 phyla of bacteria were identified in both groups. The most abundant microbiome at the phylum level was: Firmicutes, Bacteroidetes Proteobacteria, and Cyanobacteria. The salivary microbiome was more diverse in sea level controls compared to that of the orthodontic patients at high altitude wherein the presence of only two main phyla: Firmicutes and Proteobacteria were seen. The controls revealed Firmicutes, Proteobacteria, Bacteroidetes and Cyanobacteria. CONCLUSIONS: The findings of the study suggest that the biodiversity of the salivary microbiome is severely perturbed under the cumulative influences of high altitude and presence of fixed orthodontic appliance. Under these circumstances, a strict and meticulous oral hygiene regimen should be recommended and followed to avoid harmful effects on the periodontal tissues.

Teaching and learning strategies of oral histology among dental students / Estrategias de enseñanza y aprendizaje de histología oral en estudiantes de odontología

Dental education is in a continuous state of development to adapt to the changing learning strategies of the millennial students. The introduction of electronic learning resources (ELR) is a good example, which has added immense value to the traditional methods of teaching oral histology. The main purpose of the study was to analyze the dental students' perception of learning oral histology the way it was taught. A pre-approved questionnaire survey was electronically distributed to 129 students who had completed the oral histology course. The majority of the students viewed oral histology course to be difficult and irrelevant to their dental career. Similarly, most of them preferred studying alone and used ELR in place of books and atlases. More than three quarters believed using a microscope in practical training sessions will make the oral histology course easier and more interesting. The results of this study will be used to formulate recommendations to be implemented in oral histology course.

La educación dental se encuentra en un estado de desarrollo continuo para adaptarse a las cambiantes estrategias de aprendizaje de los estudiantes milenios. La introducción de recursos de aprendizaje electrónico (RAE) es un buen ejemplo, el cual ha agregado un valor importante a los métodos tradicionales de enseñanza de histología oral. El objetivo principal del estudio fue analizar la percepción de los estudiantes de odontología de aprender histología oral de la forma en que se enseñó. Una encuesta de cuestionario preaprobada se distribuyó electrónicamente a 129 estudiantes que habían completado el curso de histología oral. La mayoría de los estudiantes consideraron que el curso de histología oral era difícil e irrelevante para su carrera dental. Del mismo modo, la mayoría de ellos preferían estudiar solos y usaban RAE en lugar de libros y atlas. Más de las tres cuartas partes creen que usar un microscopio en sesiones de capacitación práctica, permitiría que el curso de histología oral sea más fácil e interesante. Los resultados de este estudio se utilizarán para formular recomendaciones que se implementarán en el curso de histología oral.

Developmental association of palatal dimensions and palatal rugae characteristics in Angle´s classes I, II and III of malocclusion / Asociación de desarrollo de las dimensiones palatinas y las características de las rugas palatinas en las clases I, II y III de maloclusión de Angle

During development, bony changes in the palate are reflected in the palatal rugae. Therefore, we hypothesized that the palatal dimensions (PD) influence the shape and number of palatal rugae (PR). The objectives were to record the palatal rugae characteristics (PRC) and palatal dimensions (intercanine distance (ICD), intermolar distance (IMD), palatal height (PH) and palatal area (PA) in Classes I, II and III malocclusion patients and investigate their interrelationship, and statistically examine the possibility of predicting PRC with the PD. Four hundred eighty-one pre-orthodontic study casts of healthy patients with normal palate anatomy were grouped as Classes I, II and III and scanned using 3D cast scanner. The PRC, ICD, IMD, PH, and PA were recorded digitally using 3D enabled software. The data was statistically analyzed. A strong statistically significant difference was observed between PA and number of straight and wavy rugae. ICD and the number of straight rugae were also related. A weak correlation exists between malocclusion classes and PA. The remaining rugae characteristics did not exhibit any relation with palatal dimensions. PA is positively related to the number of straight rugae and negatively related to the number of wavy rugae. Bigger palates have more straight rugae and less number of wavy rugae. A weak correlation between PA and Angle's class I malocclusion exists. We also propose that PA has a developmental association with the number and shape of PR.

Durante el desarrollo, los cambios óseos en el paladar se reflejan en las rugas palatinas. Por lo tanto, planteamos la hipótesis de que las dimensiones palatinas influyen en la forma y el número de las rugas palatinas. Los objetivos fueron registrar las características de las rugas palatinas y las dimensiones palatales (distancia intercanina, distancia intermolar, altura palatina y área palatina) en pacientes con maloclusión de clases I, II y III e investigar su interrelación, y examinar estadísticamente la posibilidad de predecir las características de las rugas palatinas con las dimensiones palatinas. Cuatrocientos ochenta y un estudios pre-ortodónticos de pacientes sanos con anatomía normal del paladar se agruparon como Clases I, II y III y se escanearon con un escáner de emisión 3D. La distancia intercanina, distancia inter molar, altura palatina y área palatina se registraron digitalmente utilizando el software 3D. Los datos se analizaron estadísticamente. Se observó una diferencia estadísticamente significativa entre la altura palatina y el número de rugas rectas y onduladas. Se registró también la distancia intercanina y el número de rugas rectas. Existe una correlación débil entre las clases de maloclusión y la altura palatina. Las características restantes de las rugas palatinas no mostraron ninguna relación con las dimensiones palatinas. El área palatina está relacionada positivamente con el número de rugas rectas y negativamente relacionada con el número de rugas onduladas. Los paladares más grandes tienen más rugas rectas y menor cantidad de rugas onduladas. Existe una correlación débil entre el área palatina y la clase I de maloclusión de Angle. También proponemos que el área palatina tiene una asociación de desarrollo con el número y la forma de rugas palatinas.

Three-dimensional palatal anatomic characteristics' correlation with dermatoglyphic heterogeneity in Angle malocclusions.

OBJECTIVES: To assess correlation of dermatoglyphic (DG) pattern with quantitative palatal anatomic parameters measured using three-dimensional (3D) scanning of dental casts and to explore the possibility of utilizing these to predict future occurrence of malocclusion. MATERIALS AND METHODS: Pretreatment casts of 477 Saudi Arabian patients were divided into Class I, II, and III malocclusion groups. Fingerprints were recorded for all hand digits using a digital biometric device. Maxillary arch analysis was accomplished including intercanine, intermolar distance, palatal height, and palatal area. The results were statistically analyzed. RESULTS: The mean surface area of the palate was highest in Class II malocclusion. The DG pattern was not significantly associated with the type of malocclusion, except in the instance of the double loop characteristic (P = .05). There was a strong correlation, however, between DG characteristics like simple arch, loop, and double loop and palatal dimensions (intercanine, intermolar distance, and palatal height). Heterogeneity of DG pattern could be reliably used to predict palatal dimensions. Logistic regression revealed that only tented arch, symmetrical, spiral DG patterns and palatal area were significant but weak predictors of Angle malocclusion (P < .05). CONCLUSIONS: A novel correlation of DG pattern with 3D palatal anatomic characteristics was assessed in different Angle malocclusion classes. Few of the DG characteristics and palatal dimensions showed significant correlations. However, only some of these were significant predictors of Angle malocclusion.

Salivary 1,5-Anhydroglucitol and Vitamin Levels in Relation to Caries Risk in Children.

The objective of this study was to evaluate the association between salivary 1,5-anhydroglucitol (AG), vitamins A (VA), C (VC), and E (VE), and caries risk in children. 100 healthy children aged between 6 and 13 years were divided into two equal groups of caries-free (DMFS/dmfs=0) and caries active (DMFS/dmfs>3). Unstimulated midmorning saliva was collected from all the children and the levels of salivary AG and vitamins A, C, and E were measured. Caries risk assessment was done using American Academy of Pediatric Dentistry Caries Assessment Tool. Analysis of salivary AG and vitamins was performed using a commercially available ELISA kit. Low levels of AG were present in caries active and high caries risk groups compared to caries-free and low/medium caries risk groups. This difference is statistically significant (p < 0.05). A strong negative correlation between AG and caries activity was observed in the caries active group. VA was not related to caries activity, while VC and VE displayed a statistically significant correlation (p < 0.05). Similarly, a strong negative correlation was observed between the levels of AG and high caries risk group. Salivary AG, VC, and VE together are related to caries risk in caries active children. These salivary parameters can act as indicator of caries status in children.

Use of herbal extract from Artemisia herba-alba (Shih) in pharmaceutical preparations for dental hygiene.

Antibiotic resistance in bacterial species is opening new avenues to search for alternative modes of antimicrobial treatment, medicinal plant extracts being one among them. The aim of this study was to access the possibility of medicinal plant extract from Shih in the manufacture of pharmaceutical preparations for oral hygiene specifically for the prevention and treatment of dental caries due to Streptococcus mutans. Antimicrobial effects of crude organic extract of Shih on S. mutans isolated from the saliva were examined by taking S. mutans with culture media only (-ve control); S. mutans treated with the antibiotic gentamicin (+ve control) and S. mutans treated with Shih. Minimal Inhibitory Concentration (MIC) and Minimal Bactericidal Concentration (MBC) were Determination by Iodonitrotetrazolium chloride (INT) colorimetric assay Time-kill dynamic assay was performed using broth microdilution method. The metabolic reason behind the bacteriostatic and bactericidal effect were studied by measuring the glucose utilization by the microbes, pH as a measure of acid production, nucleic acids quantitation to check the DNA status and inhibition of water-insoluble glucan synthesis were undertaken. Shih MIC for S. mutans was at 2.5 mg/ml and MBC was 4 mg/ml. S. mutans bacterial population started reclining within 60 min of incubation with Shih at MBC. Utilization of added glucose was very high at MIC due to bacteria overcoming the stress, whereas at MBC its utilization was less. Accordingly pH also became acidic to 2.9 with MIC and 4.03 with MBC. There was a great degree of inhibition in the formation of nucleic acids indicating this crude extract interferes with DNA replication. Inhibition of glucan synthesis was to the tune of 45% as compared to control. Thus we conclude that Shih has potentially effective antibacterial activity hence it can be proposed as a potentially effective antiplaque and anticariogenic agent in the form of mouth wash or gum paint. However, the cytotoxicity of the extract needs to be evaluated in in-vitro and in-vivo conditions before it is considered as a safe antiplaque and anticariogenic agent.

Conversion of palatal rugae pattern to scanable Quick Response code in an Arabian population.

BACKGROUD/PURPOSE: Palatal rugae (PR) are situated in the anterior part of the hard palate and possess unique and stable characteristics that can be used in human identification. Their pattern of orientation is established early in life and remains stable thereafter. The purposes of this study were to convert PRP into alphanumeric codes in order to generate scanable Quick Response (QR) codes, to demonstrate uniqueness of PRP using the codes in the study population, and to determine the sexual dimorphism of PRP in the study population. MATERIALS AND METHODS: Orthodontic dental casts of 256 Saudi male and female patients were photographed after ensuring standardization. Individual rugae characteristics, strength and their displacement from incisive papilla and midpalatine raphe were recorded in the form of an alphanumeric code which was subsequently converted to a QR code. Computer assisted check was performed for possible match in the 256 alpha numeric codes while QR codes were scanned using a bar code scanner to determine uniqueness. Sexual dimorphism of palatal rugae (PR) was also analysed. RESULTS: All alphanumeric codes of the study population were unique. Mean number of PR in males and females differed significantly (P = 0.0001). Differences in rugae characteristics and strengths in males and females were also present. CONCLUSION: The alphanumeric and QR code of the rugae pattern are unique for each individual and can be used for digital record keeping and person identification. A high degree of sexual dimorphism in PR exists in the studied Arab population studied.

The role of gingival melanin pigmentation in inflammation of gingiva, based on genetic analysis.

BACKGROUND: Aim of the study was to investigate the relationship of melanin pigment and inflammatory process within gingival tissues based on clinical and genetic analysis by differential display technique and DNA sequencing. MATERIALS AND METHODS: Seventy gingival biopsy specimens were taken from individuals with melanin pigmentation as well as healthy and inflamed gingiva. Specimens were examined by differential display technique using six different arbitrary primers. Cloning, sequencing and sequence analysis for six different genes were performed. RESULTS: Gingival specimens with hyperpigmentation (clinical melanin score = 3) showed presence of both, down- and up-regulatory genes when compared with the gingival specimen with clinical melanin score 0. These genes may have a role in curtailing the progress of gingival inflammation associated with melanin hyperpigmentation. CONCLUSION: Melanin hyper pigmentation may possess a defensive role against progress of gingival inflammation How to cite this article:Eid HA, Syed S, Soliman AN. The Role of Gingival Melanin Pigmentation in Inflammation of Gingiva, Based on Genetic Analysis. J Int Oral Health 2013; 5(4):1-7.

Evaluation of methyl methacrylate monomer cytotoxicity in dental lab technicians using buccal micronucleus cytome assay.

Methyl methacrylate (MMA) monomer, a primary component of dental resins, is known to induce cytotoxicity, dermatitis, and neuropathy. The objective of this study was to assess the incidence of micronuclei (MN) in buccal mucosal cells of dental technicians exposed to MMA using Buccal Micronucleus Cytome (BMCyt) assay. The Risk Group (RG=13) consisted of all the technicians working in the prosthetic production laboratory of KKU-College of Dentistry. The Control Group (CG=14) consisted of healthy students and doctors matching the age of RG subjects. Buccal mucosa scrapes obtained from all the 27 RG and CG subjects were stained with Papanicolaou stain and observed under oil immersion lens (100×) for the presence of MN. There were no significant differences in the incidence of MN between RG and CG (p>0.05).