Finishing and polishing procedures of composite restorations by Saudi dentists: a cross-sectional study.

AIM: The purpose of this study was to assess the knowledge and practices of Saudi dentists in finishing and polishing composite restorations. MATERIALS AND METHODS: A cross-sectional questionnaire-based study was conducted among 306 Saudi dentists from March to April 2012. The collected data were analyzed using Microsoft Excel 2010 program and descriptive statistics were obtained. RESULTS: Completed questionnaires were returned by 191 participants, giving a response rate of 62.4%. 115 (65.7%) respondents are using fine diamond finishing burs for finishing occlusal surfaces, 82 (48%) used fine aluminum oxide finishing discs for finishing facial surfaces, 130 (76%) used diamond finishing strips for finishing interproximal surfaces.121 (63.4%) respondents were of the view that the type of filler content has a major influence in providing color stability to the composite restoration and 137 (72.1%) believed nano-composites provided enhanced color stability. CONCLUSION: Dentists in Saudi Arabia are aware of the benefits of proper finishing and polishing of composite restorations. They however need to use finishing and polishing burs, disks, strips and pastes in a sequential series. Usage of composite polishing pastes and composite surface sealants should be emphasized in undergraduate curriculum.

Frequency of Color Vision Deficiency among Saudi Dental Students: A Cross-Sectional Study.

OBJECTIVE: The current research was conducted to evaluate the frequency of color-vision deficiency among dental students of King Khalid University College of Dentistry, Saudi Arabia. MATERIALS AND METHODS: A cross-sectional study was performed among 203 dental students working as interns at male and female dental clinics of King Khalid University College of Dentistry (KKUCOD), Saudi Arabia. The Ishihara color-vision deficiency (CVD) test with 24 plates was used for diagnosis of the problem. Analysis of the data was done by performing Chi-square tests using SPSS software version 20. RESULTS: The frequency of total CVD was found to be 3.9%. While the association of gender with total CVD was observed to be statistically nonsignificant, a statistically significant relation was drawn with red-green color deficiency. Out of the total of 203 patients, 44 males were identified with red-green color deficiency, whereas only three females were found to have this condition, therefore revealing that CVD is more prevalent in males. Age was found to have a significant association with red-green color vision deficiency, protanopia, and total CVD. CONCLUSION: A total of 20.19% male dental students had red-green color vision deficiency compared to 1.4% in female students. The dental students must be aware of their congenital color vision deficiency and its impact on their professional life. Screening of such dental students and professionals is quite important so that they can tackle the color vision problems well without having detrimental effect on their future dental practice.

Clinical periodontal, bacterial, and immunological outcomes of antimicrobial photodynamic therapy in orthodontic treatment-induced gingival enlargement.

AIM: The aim of the present clinical trial is to evaluate the clinical, bacterial, and immunological outcomes of photodynamic therapy (PDT) in adolescent patients with orthodontic treatment-induced gingival enlargement (OTGE). MATERIALS AND METHODS: A total of 26 adolescent patients, 16 girls and 10 boys, of mean age 16.8 years, undergoing fixed orthodontic treatment for at least 6 months (mean duration in months, 8.3 ± 1.9) and presenting with GE were included in the clinical trial. All patients undergoing fixed orthodontic treatment with clinical diagnosis of OTGE were divided into two groups: Patients receiving full-mouth periodontal debridement (FMPD) 'Group-FMPD' and 'Group-PDT' included participants receiving methylene blue-assisted PDT in the selected area along with FMPD. Clinical periodontal assessments included the evaluation of plaque scores (PS), bleeding on probing (BOP), probing depth (PD) and hyperplastic index (HI). The total bacterial counts of Porphyromonas gingivalis (P. gingivalis), Treponema denticola (T. denticola), and Tannerella forsythia (T. forsythia) were estimated and expressed as log CFU/mL of each bacteria. Cytokines including interleukin (IL)-1ß and IL-6 were analyzed using enzyme-linked immunosorbent assay (ELISA) kit. RESULTS: The mean percentage of PS and BOP statistically significantly reduced with both FMPD and PDT from baseline to 4 weeks (p < 0.05). Although mean PD significantly reduced in both the groups at all time points, there was significantly higher reduction with PDT as compared to FMPD at 2 weeks post treatment (p < 0.05). Inter-group comparison showed PDT demonstrated significantly higher HI at 2- and 4-weeks post treatment (p < 0.05). The mean log CFU/mL of P. gingivalis and T. forsythia showed statistically significantly higher reduction with PDT than FMPD (p < 0.05) at both 2-and 4-weeks follow-up. T. denticola reported significantly reduced levels at 2 weeks follow-up period only with PDT (p < 0.05). No statistically significant difference appeared when both treatment modalities were compared with one another (p > 0.05). Four weeks after periodontal treatment, IL-6 significantly reduced with PDT compared to FMPD (p < 0.05). CONCLUSION: PDT assisted in reducing bacterial counts and improving hyperplastic index in OTGE.

Evaluation of Clinical and Radiographic Parameters as Dental Indicators for Postmenopausal Osteoporosis.

PURPOSE: In the early stages, osteoporosis is relatively a silent disease characterised by low bone density with microarchitectural deterioration of the bone tissue leading to enhanced bone fragility. The objective of this study was to evaluate the relationship between age, body mass index, oral signs, and osteoporosis among postmenopausal women. MATERIALS AND METHODS: The study included postmenopausal women who were divided into two groups of subjects. The osteoporotic group comprised 30 patients with osteoporosis who were diagnosed using dual-energy X-ray absorptiometry, and the non-osteoporotic group (control group) comprised 30 subjects with no evidence of osteoporosis. Panoramic radiography was performed, followed by the acquisition of two direct digital intraoral periapical radiographs from the mandibular premolar-molar region. RESULTS: Chi-square test revealed a statistically significant difference (p = 0.001) in the mandibular cortical shape index between the two groups. However, a statistically non-significant difference in cortical width, the panoramic mandibular index, mandibular alveolar bone resorption degree, fractal dimension, and mean number of teeth was found between the two groups. A statistically significant difference was observed in the mean age between the osteoporotic and non-osteoporotic groups. CONCLUSION: The mandibular cortical index findings (MCI) on panoramic radiograph are effective indicators of osseous changes in postmenopausal osteoporosis, thereby determining early prediction of osteoporotic fracture risk and reducing its related morbidity.

Unique tooth dislocation into submental space during a pan facial trauma - Importance of an orthopantomogram.

BACKGROUND: There are certain reported cases of unusual displacements of teeth involved in a maxillofacial trauma to the maxillary sinus, nasal cavity, gastrointestinal tract or the airway, if worst. All these usually lead to complication the worst being death. So enquiring about them is a very essential part of surveying a maxillofacial trauma patient involving dentition. CASE: This patient was referred to our department for a dental consultation for his ill-defined firm, mildly tender, non-suppurative, submental swelling unresponsive to medication. He had undergone a polytrauma involving his face two months back. An orthopantomogram was ordered which showed a lower central incisor from the fracture site had slipped through the fracture gap into the submental space possibly missed by the CT scan. There was also a lower border splaying at the fracture site. A layer-wise dissection was done extra-orally to retrieve the tooth. CONCLUSION: This case envisages the importance of an OPG as an adjuvant to the basic radiographic study, in the emergency room, for a patient with oral and maxillofacial trauma. It also establishes the importance of a meticulous secondary survey, including counting the number of teeth and establishing a correct occlusion to avoid a complication and re-operation. Besides, a medical negligence lawsuit can also arise as some teeth may slip to lungs even.

Application of photodynamic therapy against periodontal bacteria in established gingivitis lesions in adolescent patients undergoing fixed orthodontic treatment.

BACKGROUND: The aim of this 4 week follow up randomized controlled clinical trial is to evaluate the effectiveness of photodynamic therapy (PDT) as an adjunct to ultrasonic scaling (US) in the reduction of gingival inflammatory parameters and periodontal pathogens in established gingival inflammation in adolescent patients undergoing fixed orthodontic treatment. MATERIALS AND METHODS: A total of 22 adolescent patients (mean age: 17.5 years) undergoing fixed orthodontic treatment and presenting with persistent local gingival inflammation were randomized into two groups: Group-US: patients receiving ultrasonic scaling (US) with usual oral hygiene instructions and Group-PDT: in which patients received adjunctive PDT with US. Dichotomous recording for plaque scores (PS) and bleeding on probing (BOP) was used to assess the clinical inflammatory status. The total bacterial counts of P. gingivalis and T. forsythia were estimated and were expressed as log CFU/mL. All assessments were performed at baseline, 1 week and 4 weeks. For intergroup comparisons, student's t-test was computed along with Bonferroni correction for post hoc multiple comparisons. To identify differences between repeated follow-ups, ANOVA multiple rank test was used. RESULTS: Both treatment modalities reported statistically significant reduction in PS and BOP in patients undergoing fixed orthodontic treatment (p < 0.05). However, there was no significant difference in PS and BOP when US was compared with PDT (p > 0.05). Group-US showed statistically significant reduction in T. forsythia at 1 week only (p < 0.05). Group-PDT showed statistically significant reduction in P. gingivalis and T. forsythia from baseline to 1 week and 4 weeks (p < 0.05). This was also significant when compared with US on both the time points (p < 0.05). CONCLUSION: PDT was effective in significantly reducing periodontal pathogens in established gingivitis lesions in adolescent patients undergoing fixed orthodontic treatment in short term.

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.

Changes in salivary pH following consumption of different varieties of date fruits.

OBJECTIVE: Consumption of date fruits leads to chemical changes in saliva, including variations in pH values. We conducted this study to assess the effect of the consumption of different types of dates on salivary pH. METHODS: We recruited 15 children (aged 6-15 years) who were instructed to consume one piece of specific types of dates (Safree, Nabtat Seif, Khalas, Sukkari, and Segae) for 5 consecutive days. On the 6th and 7th days, the children consumed a quarter of a grapefruit (positive control) and chewed on a sterilised cotton pellet (negative control), respectively. Salivary samples from unstimulated kids were collected at least 1 h after breakfast every day and the salivary pH was recorded. RESULTS: When compared with the pH values before date consumption, the lowest mean salivary pH value among the date-consuming groups 5 min after salivary stimulation was noted after the consumption of Khalas (6.26), followed by those after consumption of Safree (6.31), Nabtat Seif (6.36), Segae (6.44), and Sukkari (6.45). The highest difference in mean values was observed for Khalas (.47), followed by those for Sukkari (.45), Nabtat Saif (.44), Segae (.38), and Safree (.35). The pH of saliva collected after grapefruit consumption was the lowest, whereas chewing cotton pellets led to an increased salivary pH. CONCLUSION: This study showed a decrease in the salivary pH following date consumption, but not to a value as low as the critical value. These findings suggest that dates do not have detrimental effects on salivary parameters.

Clinical Evaluation of Solitary Median Maxillary Central Incisor Syndrome.

Solitary median maxillary central incisor (SMMCI) is a rare dental anomaly. It is estimated to occur in 1 : 50,000 live births. The SMMCI tooth differs from the normal central incisor in that the crown form is symmetric and it develops and erupts precisely in the midline of the maxillary dental arch in both primary and permanent dentitions. The presence of SMMCI with hemifacial microsomia (HFM) is a very rare clinical condition. We report a case of SMMCI in a female of African ethnic origin, who presented with SMMCI in permanent dentition with mild nasal stenosis. An early diagnosis of SMMCI is important, since it may be a sign for other severe congenital or developmental abnormalities. Therefore, systematic follow-up and close monitoring of the growth and development of SMMCI patients are crucial.

Knowledge of Pregnant Women about Pregnancy Gingivitis and Children Oral Health.

OBJECTIVE: A cross-sectional questionnaire-based study was carried out among 251 pregnant women to assess their level of knowledge and perception regarding pregnancy gingivitis and the oral health of new born children. MATERIALS AND METHODS: A self-administered validated questionnaire was distributed among pregnant women visiting the Child and Maternity Hospital, Ministry of Health, Aseer, Saudi Arabia. The questionnaire included the questions related to their knowledge/awareness about cause, treatment, preventive measures, and the adverse effects of gingivitis on oral health of a woman. STATISTICAL ANALYSIS: The data was entered into Microsoft excel sheet and put to statistical analysis using SPSS (version 17). Descriptive analysis and also chi-squared test was used for comparison. RESULTS: Majority of pregnant women were found unaware about developing of pregnancy gingivitis as well as the cause, effects, treatment, and preventive measures for the same. Most of the subjects agreed that it was essentially required to have oral health education before their pregnancy term would start. CONCLUSION: Most of the pregnant women said that they were unaware about pregnancy gingivitis, though few reported of being aware about it. It is inferred that the collaborative efforts between general dentists, pediatric dentists, public health dentists, and medical professionals are needed to raise awareness among pregnant women regarding timely dental care to avoid the adverse pregnancy related outcomes due to gingivitis and periodontitis.

Efficacy of self-designed intraoral appliances in prevention of cheek, lip and tongue bite after local anesthesia administration in pediatric patients.

BACKGROUND: The occurrence of self-inflicted soft tissue injuries following administration of local anesthesia in pediatric patients who have received dental treatment has been reported. Aim: To evaluate the attitudes and knowledge regarding cheek, lip, and tongue bite post administration of local anesthesia among dental practitioners in Saudi Arabia. Additionally, the efficacies of three types of intraoral appliances on the prevention of self-harm were evaluated in pediatric patients. MATERIAL AND METHODS: A total of 301 practitioners were provided with a questionnaire consisting of 9 items. In addition, three types of intraoral appliances made of polyethylene terephthalate were designed as follows: design 1 (consisted of an anterior extension with numerous perforations); design 2 (had a buccal flap extension); and design 3 (comprised of serrated borders). The appliances were placed in the oral cavities of 45 children (age, 3-15 years) immediately after the completion of the dental procedure. The patient was asked to retain the appliance for 3 h. After 24 h, both parents and children were required to respond to a checklist to evaluate the effectiveness the appliances. RESULTS: Almost half of the dental practitioners had never encountered self-inflicted soft tissue injury in children after local anesthesia administration. About 60% of the dentists were of the opinion that provision of adequate instructions after treatment could prevent the occurrence of lip, cheek, and tongue biting. Furthermore, among the three appliances used, design 1 was most well accepted. CONCLUSIONS: Intraoral appliances used in this study may be considered for use to prevent self-inflicted soft tissue trauma in children following administration of local anesthesia. Key words:Cheek biting, lip biting, intraoral appliance, local anesthesia.

Knowledge, Attitude, and Behavior Related to Use of Miswak (Chewing Stick): A Cross-Sectional Study from Aseer Region, Saudi Arabia.

AIM: The aim of this study was to assess the oral health knowledge, behavior, and practices related to use of miswak (chewing stick) in population of Aseer Region, Saudi Arabia. SUBJECTS AND METHODS: Of the 2023 participants, 1666 (83.3%) were females and 334 (16.7%) were males. The questionnaires having 10 online questions were used to assess the knowledge of oral hygiene methods, including frequency, reason, and methods for miswak use. STATISTICAL ANALYSIS USED: The survey data were collected and organized into Microsoft Excel spreadsheets (Microsoft Inc., USA) and were statistically analyzed utilizing the Statistical Package for the Social Sciences version 20.0 software (IBM Inc., USA). The statistical test used here was the Chi-square test, and P < 0.05 was considered to be statistically significant (P < 0.05). RESULTS: Participants responded regarding the primary oral hygiene methods; 46.5% respondents used toothbrushes, 44.5% used both toothbrushing and miswak, and 8% used only miswak as their primary tooth cleaning method. 28.2% respondents cleaned their teeth with tooth brush or miswak at least once a day, 37.6% twice, 28.4% whenever required, and 5.9% infrequently. Majority of the participants, i.e. 70.2% were using miswak with taper and as a brush to clean all tooth surfaces. About 84.7% feel fresh, and teeth are whiter after the use of miswak. Nearly, 84.7% prefer to continue using miswak in combination with other teeth cleaning methods, which may have more benefits. CONCLUSIONS: In our study, most common type of oral hygiene method employed is toothbrush and in combination with miswak. Chewing stick use was common among participants with religious advice being the dominant reason for usage.

First dental visit: Age, reason, and experiences of Saudi children.

OBJECTIVE: A study was conducted among parents/guardians of children attending the Outpatient Department of King Khalid University College of Dentistry, Abha, to assess the attitude and knowledge regarding children's first dental visit and related aspects. MATERIALS AND METHODS: A cross-sectional questionnaire-based study was conducted among a convenient sample of 320 parents/guardians. All the parents/guardians willing to participate in the study and whose children visiting the dentist for the first time were included in the study. Children's behavior was assessed using Frankl's scale. RESULTS: Majority (29%) of the children visited the dentist for the first time at the age of 3-6 years, while the least percentage (8%) visited the dentist for the first time at the age of 0-1 year. A statistically significant difference was found between the responses (P ≤ 0.05). Most (72.67%) of the children were being accompanied by parents during their first dental visit. About 40.33% of the parents said that overall experience of the first visit of their children was good. About 39.67% of the children had positive behavior during their first dental visit. About 37.33% of the participants said that pain was the main reason for them to get their children to dentist. CONCLUSION: It was concluded that bulk of the parents were unaware about the appropriate age of their children's first dental visit. Most of the parents brought their children to dentist after their children experienced pain or suffered from dental caries. There is a need to raise awareness among masses regarding the importance of taking oral health care of their children quite seriously at the earliest budding stage of their life.

Gingival enlargement in different age groups during fixed Orthodontic treatment.

BACKGROUND: During fixed orthodontic therapy, adolescents tend to have higher chances of gingivitis and gingival enlargement (GE) compared to adults. A cross sectional study was undertaken to evaluate the above hypothesis, by assessing GE in patients of different age groups receiving fixed orthodontic therapy. MATERIALS & METHODS: Patients undergoing orthodontic treatment were selected by simple random sampling from the King Khalid University College of Dentistry out patient's clinic of preventive dental sciences division to form the study group. Participant's were divided into three age groups and GE was graded as 0, 1 and 2 as per the classification of the American Academy of Periodontology. Data were analyzed by using IBM SPSS version 16.0 (Statistical Package for Social Services, Chicago, IL, USA) and descriptive statistics were obtained. Differences in proportions were compared using the Chi-square test and the significance level was set at p ≤ 0.05. RESULTS: 62.3% (n=33) were males and 37.7% (n=20) were females. Group 1 had 21 patients (39.7%); Group 2 had 24 patients (45.3%) and Group 3 had 8 patients (15.1%).The highest frequency (48%) of GE was observed among the Group 1 age group (10-19 years). Differences in frequency of GE according to age groups were found to be statistically significant (p=0.046).Differences in GE according to the frequency of practicing oral hygiene measures were statistically significant (p<0.001). CONCLUSION: Highest frequency of GE was observed among the adolescents. The patients who practiced oral hygiene measures more than three times daily did not have any GE. On the other hand, those who brushed and flossed only once daily had the highest percentage of grade 2 GE. How to cite the article: Eid HA, Assiri HA, Kandyala R, Togoo RA, Turakhia VS. Gingival enlargement in different age groups during fixed Orthodontic treatment. J Int Oral Health 2014;6(1):1-4.

Benign osteoblastoma involving maxilla: a case report and review of the literature.

Background. Osteoblastoma is a rare benign tumor. This tumor is characterized by osteoid and bone formation with the presence of numerous osteoblasts. The lesion is more frequently seen in long bones and rarely involves maxilla and mandible. Due to its clinical and histological similarity with other bone tumors such as osteoid osteoma and fibro-osseous lesions, osteoblastoma presents a diagnostic dilemma. Case Report. Very few cases of osteoblastomas involving maxillofacial region have been reported in the literature. This case report involves osteoblastoma involving right maxilla in an 18-year-old male patient. Following detailed clinical examination, radiological interpretation, and histopathological diagnosis, surgical excision was performed. The patient was followed up for a period of 3 years and was disease free. Summary and Conclusion. Benign osteoblastoma involving jaw bones is a rare tumor. There is a close resemblance of this tumor with other lesions such as fibro-osseous lesions and odontogenic tumors and thus faces a diagnostic challenge. Surgical excision with a long-term follow-up gives good prognosis to this lesion-Benign Osteoblastoma.