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This study aimed to evaluate the incorporation of zirconia/silver phosphate nanoparticles to develop experimental dental adhesives and to measure their physical and mechanical properties. The nanoparticles were synthesized by the sonication method, and the phase purity, morphological pattern, and antibacterial properties with Staphylococcus aureus and Pseudomonas aeruginosa were assessed. The silanized nanoparticles were incorporated (0, 0.15, 0.25, and 0.5 wt.%) into the photoactivated dimethacrylate resins. The degree of conversion (DC) was assessed, followed by the micro-hardness and flexural strength/modulus test. Long-term color stability was investigated. The bond strength with the dentin surface was conducted on days 1 and 30. The transmission electron microscopy and X-ray diffractogram confirmed the nano-structure and phase purity of the particles. The nanoparticles showed antibacterial activities against both strains and inhibited biofilm formation. The DC range of the experimental groups was 55-66%. The micro-hardness and flexural strength increased with the concentration of nanoparticles in the resin. The 0.5 wt.% group showed significantly high micro-hardness values, whereas a non-significant difference was observed between the experimental groups for flexural strength. The bond strength was higher on day 1 than on day 30, and a significant difference was observed between the two periods. At day 30, the 0.5 wt.% showed significantly higher values compared to other groups. Long-term color stability was observed for all the samples. The experimental adhesives showed promising results and potential to be used for clinical applications. However, further investigations such as antibacterial, penetration depth, and cytocompatibility are required.
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INTRODUCTION: Physicians promote oral health by screening for oral pathologies, providing emergency help, and referring patients to dentists. The literature consistently reports a robust association between periodontal disease and systemic diseases. However, it is not fully known if physicians in Saudi Arabia are aware of the oral-systemic disease links. Therefore, the study aimed to evaluate physicians' awareness of the oral-systemic disease links and their association with patients' referral to dentists and patients' access to oral care. METHODS: This cross-sectional study was conducted (June 2019-January 2020) on physicians working in private and public hospitals in the Eastern province of Saudi Arabia. The physicians (n = 333) responded to a paper-based self-administered and pilot-tested questionnaire which inquired about their awareness of oral-systemic disease links and patient referral to dentists. The reliability of items of oral-systemic disease links was evaluated by calculating Cronbach's alpha (0.84). RESULTS: Most participants (92.8%) agreed/strongly agreed that oral health is associated with systemic health. Half of the sample (50.8%) referred patients to dentists during the last month. Almost 80.5% believed that more patients will be referred to the dentists because of their awareness of the oral-systemic disease links and 84% believed that more patients will access oral care services if patients were aware of the oral-systemic disease links. The participants who referred patients to the dentists during the last month (P = 0.038), believed that more patients will be referred (P = 0.001), and believed that more patients will access oral care (P = 0.003) demonstrated significantly higher oral-systemic disease links awareness score. The adjusted model showed patients' referral to dentist (OR = 1.96.10, P = 0.006) and believing in more patients accessing oral care (OR = 2.05, P = 0.044) were associated with significantly increased awareness of the oral-systemic disease links. CONCLUSION: Most physicians in the study were aware of the oral-systemic disease links. Increased awareness of the oral-systemic disease links was significantly associated with the referral of patients to dentists and belief in improved patients' access to oral care services.