The COVID-19 pandemic and its effects on follow-up of patients with early breast cancer: A patient survey.

PURPOSE: Despite limited evidence supporting its effectiveness, most guidelines recommend long-term, routinely scheduled in-person surveillance of patients with early breast cancer (EBC). The COVID-19 pandemic led to increased use of virtual care. This survey evaluated patient perspectives on follow-up care. METHODS: Patients with EBC undergoing surveillance were surveyed about follow-up protocols, perceptions, and interest in clinical trials assessing different follow-up strategies. RESULTS: Of 402 approached patients 270 completed the survey (response rate 67%). Median age 62.5 years (range 25-86) and median time since breast cancer diagnosis was 3.8 years (range < 1-33 years). Most (n = 148/244, 60%) were followed by more than one provider. Routine follow-ups with breast examination were mostly conducted by medical/radiation oncologists every 6 months (n = 110/236, 46%) or annually (n = 106/236, 44%). Participants felt routine follow-up was useful to monitor for recurrence, manage side effects of cancer treatment and to provide support/reassurance. Most participants felt regular follow-up care would detect recurrent cancer earlier (n = 214/255, 96%) and increase survival (n = 218/249, 88%). The COVID-19 pandemic reduced the number of in-person visits for 54% of patients (n = 63/117). Patients were concerned this reduction of in-person visits would lead to later detection of both local (n = 29/63, 46%) and distant recurrences (n = 25/63, 40%). While many felt their medical and radiation oncologists were the most suited to provide follow-up care, 55% felt comfortable having their primary care provider (PCP) conduct surveillance. When presented with a scenario where follow-up has no effect on earlier detection or survival, 70% of patients still wanted routine in-person follow-up for reassurance (63%) with the goal of earlier recurrence detection (56%). CONCLUSIONS: Despite limited evidence of effectiveness of routine in-person assessment, patients continue to place importance on regularly scheduled in-person follow-up.

Evaluation of Apixaban standard dosing in underweight patients with non-valvular atrial fibrillation: a retrospective cohort study.

BACKGROUND: Recent guidelines recommend using direct oral anticoagulants (DOACs) as first-line agents in patients with non-valvular atrial fibrillation (NVAF). Research is currently investigating the use of Apixaban in underweight patients, with some results suggesting altered pharmacokinetics, decreased drug absorption, and potential overdosing in this population. This study examined the effectiveness and safety of standard Apixaban dosing in adult patients with atrial NVAF weighing less than 50 kg. METHODS: This is a retrospective cohort study conducted at King Abdulaziz Medical City (KAMC); adult patients with a body mass index (BMI) below 25 who received a standard dose of Apixaban (5 mg twice daily) were categorized into two sub-cohorts based on their weight at the time of Apixaban initiation. Underweight was defined as patients weighing ≤ 50 kg, while the control group (Normal weight) comprised patients weighing > 50 kg. We followed the patients for at least one year after Apixaban initiation. The study's primary outcome was the incidence of stroke events, while secondary outcomes included bleeding (major or minor), thrombosis, and venous thromboembolism (VTE). Propensity score (PS) matching with a 1:1 ratio was used based on predefined criteria and regression model was utilized as appropriate. RESULTS: A total of 1,433 patients were screened; of those, 277 were included according to the eligibility criteria. The incidence of stroke events was lower in the underweight than in the normal weight group at crude analysis (0% vs. 9.1%) p-value = 0.06), as well in regression analysis (OR (95%CI): 0.08 (0.001, 0.76), p-value = 0.002). On the other hand, there were no statistically significant differences between the two groups in the odds of major and minor bleeding (OR (95%CI): 0.39 (0.07, 2.03), p-value = 0.26 and OR (95%CI): 1.27 (0.56, 2.84), p-value = 0.40, respectively). CONCLUSION: This exploratory study revealed that underweight patients with NVAF who received standard doses of Apixaban had fewer stroke events compared to normal-weight patients, without statistically significant differences in bleeding events. To confirm these findings, further randomized controlled trials with larger sample sizes and longer observation durations are required.

The Impact of Repeated Steam Sterilization Cycles on the Efficacy of Chairside Adjustment Kits for Polishing Monolithic Multi-Layered Zirconia Dental Restoration Material.

BACKGROUND Before insertion, chairside adjustment kits are heat sterilized for positioning and polishing dental restorations. This study aimed to evaluate the effects of 2 steam sterilization cycles on the efficacy of polishing highly translucent monolithic zirconia (HTMLZ) dental restoration material. MATERIAL AND METHODS 100 HTMLZ disc-shaped specimens were adjusted (grinding, finishing, polishing) with EVE Diacera kit. Two steam sterilization techniques [standard (Gp S), immediate/flash (Gp (F)] of CAK were further subgrouped based on number of sterilization cycles [cycle 1 (control), cycle 5, 10, 15, and 20 (experimental)] (n=10 each). Each subgroup accordingly was evaluated for average surface roughness (Ra) and root mean square roughness (Rq) using a profilometer. Mean and standard deviation of 5 subgroups were statistically analyzed using one-way ANOVA/post hoc Tukey's test. Scanning electron microscopy complemented Ra, Rq measurements. Statistical differences of P≤0.05 were considered significant. RESULTS HTMLZ specimens in both groups showed increased (Ra/Rq) values after repeated sterilization of EVE Diacera kit, with Gp F showing lesser increase than Gp S (20 cycles). Gp F at 10 cycles and Gp S at 15 cycles showed clinically unacceptable roughness threshold (0.25 µm). Differences between subgroups for Ra and Rq values were significant (P≤0.05) with less differences within groups observed in early cycles (1, 10). Results validate the manufacturer's recommendations of using flash sterilization/10 cycles for EVE Diacera kit. CONCLUSIONS Repeated sterilization reduces efficacy of chairside adjustment kit to produce smooth surfaces on HTMLZ. This study recommends flash sterilization to a maximum of 10 times to get the clinically acceptable results of Ra and Rq.

Dimensional stability of 3D-printed edentulous and fully dentate hollowed maxillary models over periods of time.

BACKGROUND: Dental casts made utilising digital workflow are becoming more common because to their speed and cost savings. However, studies on their dimensional accuracy over time with diverse designs are missing. OBJECTIVE: The aim of this in vitro study was to assess the dimensional stability of 3D-printed edentulous and fully dentate hollowed maxillary models with 50-micrometer resolution over 1 day, 14 days, and 28 days using surface matching software. METHODS: Scanned edentulous and fully dentate maxillary typodont models were used as references. The models were scanned by a desktop lab scanner of 15-micrometer accuracy (D900, 3Shape). Then, the files were used in designing software (Meshmixer, Autodesk) to create hollowed maxillary casts. Fifteen edentulous and 15 fully dentate (total of 30) models were printed using a DLP lab printer (Cara print 4.0, Kulzer). The 3D-printed models were scanned using the same desktop lab scanner of 15-micrometer accuracy at intervals of baseline days, 1 day, 14 days, and 28 days to assess the effect of aging (n = 120). The dimensional changes were quantified and compared using the root mean square (RMS) method, expressed in micrometres (µm). The study employed repeated measures analysis of variance (ANOVA) to assess and compare the root mean square (RMS) values across the variables. The data was analysed using SPSS (26, Chicago, Illinois, USA). RESULTS: The RMS of the edentulous models rapidly increased from a mean value of 0.257 at the beginning of the study to 0.384 after twenty-eight days. However, the mean RMS values for the dentate models did not change much over the four intervals. It varied only from 0.355 to 0.347. The mean values for edentulous patients increased from 0.014 to 0.029 during the period from baseline to twenty-eight days. However, the mean average values decreased for the dentate models from 0.033 to 0.014 during this period. By utilizing ANOVA, mean RMS values increased insignificantly till one day but significantly to fourteen and twenty-eight days. Dentate model mean values differed insignificantly across four intervals. Repeated measures ANOVA for combined and separated data showed no significant differences across edentulous, dentate, and total models over times. CONCLUSION: The study revealed changes in the dimensions of 3D-printed edentulous models over a span of 3 and 4 weeks. Caution should be applied when using 3D-printed dental master models for constructing definitive prostheses on edentulous models over a period of 3 to 4 weeks.

Assessment of dimensional stability of novel VPES impression material at different time intervals with standard disinfectants.

BACKGROUND: Vinyl polyether silicone (VPES) is a novel impression biomaterial made of a combination of vinyl polysiloxane (VPS) and polyether (PE). Thus, it is significant to assess its properties and behaviour under varied disinfectant test conditions. This study aimed to assess the dimensional stability of novel VPES impression material after immersion in standard disinfectants for different time intervals. METHODS: Elastomeric impression material used -medium body regular set (Monophase) [Exa'lence GC America]. A total of 84 Specimens were fabricated using stainless steel die and ring (ADA specification 19). These samples were distributed into a control group (n=12) and a test group (n=72). The test group was divided into 3 groups, based on the type of disinfectant used - Group-A- 2% Glutaraldehyde, Group-B- 0. 5% Sodium hypochlorite and Group-C- 2% Chlorhexidine each test group was further divided into 2 subgroups (n=12/subgroup) based on time intervals for which each sample was immersed in the disinfectants - subgroup-1- 10 mins and Subgroup 2- 30 mins. After the impression material was set, it was removed from the ring and then it was washed in water for 15 seconds. Control group measurements were made immediately on a stereomicroscope and other samples were immersed in the three disinfection solutions for 10 mins and 30 mins to check the dimensional stability by measuring the distance between the lines generated by the stainless steel die on the samples using a stereomicroscope at x40 magnification. RESULTS: The distance measured in the control group was 4397.2078 µm and 4396.1571 µm; for the test group Group-A- 2% Glutaraldehyde was 4396.4075 µm and 4394.5992 µm; Group-B- 0. 5% Sodium hypochlorite was 4394.5453 µm and 4389.4711 µm Group-C- 2% Chlorhexidine was 4395.2953 µm and 4387.1703 µm respectively for 10 mins and 30 mins. Percentage dimensional change was in the range of 0.02 - 0.25 for all the groups for 10 mins and 30 mins. CONCLUSIONS: 2 % Glutaraldehyde is the most suitable disinfectant for VPES elastomeric impression material in terms of dimensional stability and shows minimum dimensional changes as compared to that of 2% Chlorhexidine and 0.5% Sodium hypochlorite.

Telephone completion of patient self-reporting health history documents by registered nurses: a survey to evaluate its effectiveness and strategies for improvement.

AIM: Prior to the COVID-19 pandemic, cancer patients would complete their self-reporting health history documentation at their initial consultation visit. With the increase in virtual care, a program was established; whereby, a registered nurse (RN) would complete the self-reporting history with the patient by telephone prior to the initial consultation. A survey of RNs and oncologists evaluating the effectiveness of this program is presented. METHODS: Outpatient RNs and medical and radiation oncologists were surveyed at a single Canadian cancer center. The surveys collected demographic information and perceptions around the successes and challenges of this program. RESULTS: Responses were received from 31/42 (74%) RNs and 29/48 (60%) oncologists. RNs reported calling an average of 4 patients/week, and the median time for each call was 20 min. For responding RNs, 21/31 (68%) felt patients were satisfied with the process, and 18/31 (58%) were satisfied with the quality and efficacy of care they were delivering. 25/31 (81%) RNs felt the telephone calls improved care when the patient came to the clinic. All (100%) oncologists were aware of the program, and 86% (25/29) felt it saved time at the consult visit. Areas for improvement included patients completing the forms themselves and including information on current symptoms and drug insurance status. CONCLUSION: COVID-19 has resulted in many changes in oncology practice. Completion of patient self-reported health history documentation by an RN over the telephone prior to consultation visit received positive feedback from both RNs and oncologists. However, this process has considerable RN resource implications.

Comparative Evaluation of Dimensional and Occlusal Accuracy of Non-Working Antagonist Casts: A Study on Different Impression Materials and 3D Printing.

BACKGROUND The aim of this study was to assess and compare the vertical/horizontal dimensions and occlusal accuracy of non-working/opposing casts obtained from three different impression materials and 3D print cast. MATERIAL AND METHODS Dentulous Master models simulating a case of a fixed dental prosthesis were mounted on an articulator (control group). Opposing mandibular casts obtained from three different impression materialsand 3-dimensional print constituted test groups , ,and , respectively. Three points, anterior vertical (AV), posterior vertical (PV), and anteroposterior (AP) were compared for dimensional accuracy among casts. Occlusal accuracy was analyzed on Medit Link software at 3 teeth (#13, #17, and #27). After calculating means for each group, the differences were calculated at probability value of P≤0.05 using the single-sample t test, ANOVA, and Tukey test. RESULTS The dimensions were significantly different from those of the mounted master models except in Gp AL(E) and Gp AL(F) at AV dimension and Gp AL(E) at AP dimension (P>0.05). A statistically significant difference of the error of means among the 4 tested groupswere detected only at 2 dimensions (AV and PV) between the Gp AL(E) and Gp 3D-C and between Gp AL(F) and Gp 3D-C groups. Other groups showed no significant differences. CONCLUSIONS The opposing casts obtained from the extended-pour alginate and alginate alternative impression materials showed higher occlusal accuracy compared to conventional alginate and 3D printed casts.

Influence of different surface treatment on bonding of metal and ceramic Orthodontic Brackets to CAD-CAM all ceramic materials.

BACKGROUND: Developing efficient bonding techniques for orthodontic brackets and all-ceramic materials continues to pose a clinical difficulty. This study aimed to evaluate the shear bond strengths (SBS) of metal and ceramic brackets to various all-ceramic CAD-CAM materials, such as lithium disilicate CAD (LDS-CAD), polymer-infiltrated ceramic (PIC), zirconia-reinforced lithium silicate glass ceramic (ZLS), and 5YTZP zirconia after different surface treatments and thermal cycling. MATERIALS AND METHODS: The samples were divided into two groups to be bonded with ceramic and metal lower incisor brackets. Each group was subdivided into a control group devoid of any surface treatment, 10% HF acid (HFA) etching, ceramic etch & prime (MEP), Al2O3 air abrasion, and medium grit diamond bur roughening. After surface treatment, brackets were bonded with composite resin cement, thermal cycled, and tested for shear bond strength. The failed surfaces were evaluated with a digital microscope to analyse the type of failure. The data were statistically analysed using a one-way ANOVA and Tukey HSD tests at p < 0.05. RESULTS: The highest mean bond strengths were found with HFA etching in LDS-CAD (13.17 ± 0.26 MPa) and ZLS (12.85 0.52 MPa). Diamond bur recorded the lowest mean bond strength roughening across all the ceramic groups. There were significant differences in mean shear bond values per surface treatment (p < 0.001) and ceramic materials. CONCLUSION: Among the surface treatment protocols evaluated, HFA etching and MEP surface treatment resulted in enhanced bond strength of both ceramic and metal brackets to CAD-CAM all ceramic materials.

Clinical Trial to Assess Physiology and Activity of Masticatory Muscles of Complete Denture Wearer Following Vitamin D Intervention.

Background and Objectives: Little information is available on the role of Vitamin D as a micro-nutrient deficiency with masticatory muscle efficiency and its effect on the function of removable prosthesis. The aim of this study was to evaluate the role of vitamin D on masticatory muscle activity among completely edentulous patients and its effect on the retention of removable complete dentures (RCDs). Materials and Methods: A non-randomized clinical control trial was conducted on completely edentulous patients (60.53 ± 7.01 years) in the Indian population between 2017 and 2019. Subjects were evaluated for temporomandibular disorders according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Serum Vitamin D (S Vit D) levels, Ultrasonography (USG), and surface Electromyography (sEMG) readings of the masseter muscle were recorded at enrolment (Level 0), after 3 months of Vitamin D therapy (Level 3), and after consecutive 3 months of maintenance therapy, i.e., after 6 months from baseline (Level 6). The fabrication of new RCDs was done for all after the enrolment, and the retention of RCDs was assessed by asking a question regarding denture retention and asking respondents to mark their satisfaction on a 5-point Likert scale. Data were analysed using ANOVA, Paired'-test and Pearson correlation coefficients. A p-value less than 0.05 indicated a statistically significant association. Results: Between enrolment and a six-month follow-up, S Vit D levels showed an increase from 16.03 ± 5.68 ng/mL to 31.35 ± 9.28 ng/mL, showing an increase of 15.32 ± 9.38 ng/mL (95.57% rise). Statistically significant values were observed for USG and sEMG. Conclusions: Results showed that S Vit D affects masticatory muscle activity by improving its thickness and boosting its tonicity. Healthy muscles assist in the retention of RCDs, consequently aiding in mastication, speech, and phonetics, hence improving patient satisfaction. Clinical implication: Acknowledging the fact that the prevalence of Vitamin D deficiency is worldwide. We suggest Vitamin D therapy as a nutritional intervention among the elderly completely edentulous population, following dietary counselling, and consider Vitamin D therapy to be an adjunct to nutritional counselling for improving masticatory muscle activity and efficiency, which aids in RCD retention and stability. Consequently, improving oral health-related quality of life for individuals.

Patterns of adverse drug reactions (ADRs) in Saudi Arabia.

BACKGROUND: Pharmacovigilance enhances post-market drug safety. However, analytical reports of a pattern of adverse drug reactions (ADRs) experienced by patients in Saudi Arabia are demanded. OBJECTIVE: To describe patterns of ADRs submitted to the Saudi Central National Pharmacovigilance and Drug Safety Center (NPC), Saudi Food and Drug Administration (SFDA), from its inception in 2015 until the end of 2017 to understand the pattern of ADR reporting in Saudi Arabia. METHODS: In this retrospective study, data from cases reported to the NPC were used to determine ADRs and identify the most common associated drug classes based on anatomical therapeutic chemical (ATC) classification system. RESULT: A total of 17,730 ADR cases were reported during study period. An annual increase in ADRs was clearly evident. Approximately 54% of the total ADRs reported were serious. Most commonly reported ATC drug classes were anti-infective agents for systemic use (22.27%), antineoplastic and immunomodulating agents (21.49%), alimentary tract and metabolism (15.48 %), cardiovascular system (11.11%) and nervous system (10.23%). Vancomycin (2.7%), ceftiraxone (1.8%), fingolimod (1.4%) and paracetamol (1.4%) were the most common drugs associated with serious ADRs. CONCLUSION: This study provide valuable insights in hypothesis generation for future studies on drug-event interactions and amplification studies. The NPC educational programs and awareness campaigns to promote systematic reporting of ADRs among healthcare professionals and general public should be continued.

EFFICACY OF LASER THERAPY FOR ALVEOLAR OSTEITIS: A SYSTEMATIC REVIEW OF THE AVAILABLE EVIDENCE.

OBJECTIVE: Alveolar osteitis (commonly known as dry socket) is a very common painful complication of dental extraction with no definitive cure. This systematic review assessed the efficacy of laser therapy in the management of alveolar osteitis. METHODS: PubMed, Scopus, Web of Science, Embase, Cochrane Central, and China National Knowledge Infrastructure (CNKI) were searched for all studies published till July 2021 using relevant keywords. All clinical trials that assessed the efficacy of laser in the management of alveolar osteitis were included. Due to missing some numerical data and the substantial heterogeneity across the studies, no meta-analysis was performed. RESULTS: Out of the 296 identified articles, 14 clinical trials comprising 981 patients were included. The laser wavelengths, power output, and energy fluence showed a great variability across the included studies: 632.8 - 2940 nm, 16 mW - 10 W, and 0.2 - 85.7 J/cm2, respectively. All included studies found laser to be efficacious in alleviating pain and accelerating healing in patients with alveolar osteitis. Of the 14 included studies, 13 studies reported superior outcomes in favor of laser therapy as compared to conventional therapies. CONCLUSION: The available evidence suggests a good efficacy of laser therapy in reducing signs and symptoms of alveolar osteitis. However, owing to the marked methodological heterogeneity and the substantial variations in laser parameters among the included studies, more well-designed clinical trials with adequate sample sizes and standardized laser parameters are highly recommended. CLINICAL SIGNIFICANCE: Laser therapy can be applied for the management of dry socket.

Assessment on the Precision of the Orthodontic Bracket Slot Dimensions Using Micro-computed Tomography (Micro-CT).

AIM: To evaluate the precision of the orthodontic bracket slot dimensions of 0.022 inch and to compare them with those of the manufacturers' specifications. MATERIALS AND METHODS: The slots of upper-right central incisor brackets (n = 5) from 11 commercial bracket systems of three different manufacturers (3M Unitek: Victory Mini Metal, Clarity, SmartClip, Clarity SL; ORMCO/SYBRON: Mini Diamond Twin, Damon Q, Damon Clear; Dentsply/GAC: Ovation, Mystique, In-Ovation R, In-Ovation C) were measured. The orthodontic brackets were scanned using micro-computed tomography (micro-CT), and the bracket slots were measured using micro-CT images. The slot was measured at four different surfaces (occlusal, gingival, base, and face) for both mesial and distal sites. Data were subjected to ANOVA and unpaired t-tests. A p-value of ≤0.05 was considered statistically significant. RESULTS: All brackets had slot dimensions that were significantly larger (p < 0.05) than the stated 0.022 inch. 3M-victory were 11.99% larger (0.02509 inch) and the closest to the stated dimension and the ORM-Damon C were 24.07% larger (0.02948 inch) than the quoted slot size of 0.022 inch. Comparison between mesial and distal sides showed that 91% of the bracket slots were asymmetrical at their bases and 100% asymmetrical at their faces. All of the bracket system showed divergent walls from base to face with values ranging from 1.96 (3M-SmartClip) to 26.58% (ORM-Damon C). CONCLUSION: The actual measurements of 11 bracket systems from three different manufacturers were more substantial than the manufacturers' specifications, and the walls of the slots diverged from the bracket bases in all of the tested bracket system. CLINICAL SIGNIFICANCE: Orthodontic bracket slots vary significantly from that of the manufacturers' specification. The orthodontist should anticipate such shortcomings and be able to modify treatment mechanics through additional wire bending in three spatial planes.

Efficacy of Yttrium (III) Fluoride Nanoparticles in Orthodontic Bonding.

Our study evaluated the adhesion strength and antibacterial effect of a conventional orthodontic composite resin blended with yttrium fluoride (YF3) nanoparticles. Yttrium fluoride nanoparticles (NP) were added to the conventional orthodontic composite resin (Transbond XT) at concentrations of 1%, 2%, and 3% (w/w), and the blended composite resins were labeled as NP1, NP2, and NP3, respectively. A total of 60 extracted human premolars was randomly allocated to four groups of 15 samples (n = 15). Orthodontic brackets were bonded using the conventional (control) and experimental composite resins (NP1, NP2, and NP3). The adhesion strengths of the composite resins were determined using a universal testing machine. The debonding sites were assessed and scored using the adhesive remnant index (ARI). The antibacterial effect of YF3 nanoparticles against Streptococcus mutans was assessed by the viable cell counting method. For the same, 40 composite disc specimens were prepared using the control and experimental composite resins (n = 10). The data was analyzed by one-way ANOVA and Tukey's post hoc analysis. In all the tests, the significance level was determined to be 0.05. The highest adhesion strength values were found in the control group (11.61±0.23) and the lowest values were found in the NP3 group (10.49±0.17). A significant difference was observed between the control and experimental groups, NP2 and NP3 (P < 0.05). NP1 group showed insignificant (P = 0.388) adhesion strength values compared with the control group. There was no significant difference between the ARI scores of the conventional and experimental groups (P > 0.05). The highest colony forming units (CFU) were found in the control group (75.85±1.15) and the lowest CFU were found in the NP1 group (2.24±1.14). A significant difference between the mean CFU of the conventional and experimental composite groups was observed (P < 0.05). Despite higher antibacterial activity in the NP1 group compared with NP2 (P = 0.146) and NP3 (P = 0.117), the difference was not significant. Similarly, no significant difference was observed between NP2 and NP3 groups (P = 0.97). Our results suggested that yttrium fluoride nanoparticles, blended with a conventional resin at 1% concentration, demonstrated significant antibacterial effect and did not compromise adhesion strength.

Changes in the mandibular dental arch during the late mixed dentition stage: Experimental study.

OBJECTIVE: To determine the dimensional changes in the mandibular arch of untreated subjects during the late mixed dentition stage. METHODS: The cross-sectional study was conducted over three years starting March 2013 at the College of Dentistry, King Saud University, Riyadh, Saudi Arabia, and comprised consecutive models taken annually of subjects seeking dental treatment. They were aged 9 years at baseline and dimensional changes were calculated at 9, 10 and 11 years of age. Measurements taken each year were overjet, overbite; inter-canine width, canine length, inter-first deciduous molar width, inter-first premolar width, inter-first permanent molar width, arch length, molar depth, incisor irregularity, and available anterior space. SPSS 16 was used for data analysis. RESULTS: Of the 15 subjects, 10(66.6%) were girls and 5(33.3%) were boys. Of all the variables, the mean values of overbite (p=0.006) and inter-canine width (p=0.001) increased significantly over the period, while the mean irregularity index values decreased significantly (p<0.0001).. CONCLUSIONS: An increase in overbite and inter-canine width, and a reduction in the irregularity index of teeth was detected during the mixed dentition phase.

Factors associated with glycemic control in type 2 diabetic patients in Saudi Arabia.

OBJECTIVE: To identify factors associated with glycemic control in type 2 diabetes mellitus patients in tertiary academic hospital. RESEARCH DESIGN AND METHODS: This was a retrospective cross-sectional study of adults with type 2 diabetes mellitus. Data were extracted from the electronic health record (EHR) database for the period from 1st of January to 31st of December 2016. Participants were considered to have a glucose control if the HbA1c level was less than 7% [53 mmol/L]. Descriptive analysis and multivariable logistic regression model were performed to assess the factors associated with glycemic control. RESULTS: A total of 728 patients were included in the study for which (65%) were female, and about 60% of the sample size was between 45 and 60 years old. Multivariate logistic regression model showed participants older than the age of 65 were less likely to have controlled diabetes compared to the younger participants (OR: 0.53 [CI: 0.30-0.93]). Moreover, those who had hypertension (OR: 0.61 [CI: 0.43-0.86]) and dyslipidemia (OR: 0.53 [CI: 0.38-0.74]) were less likely to have controlled diabetes, while those with asthma (OR: 2.06 [CI: 1.16-3.68]) were more likely to have controlled diabetes. The model also showed that vitamin D deficiency was not associated with glycemic control in type 2 diabetes patients (OR 0.80 [95% CI 0.58-1.12]). CONCLUSION: These findings highlighted the need for appropriate management in older adult patients to prevent the complication of type 2 diabetes. Furthermore, attention should be exercised for patients with factors associated with poor glycemic control such as hypertension and dyslipidemia.

Measuring the quality and completeness of medication-related information derived from hospital electronic health records database.

OBJECTIVE: Electronic Health Records (EHRs) database is a great source for pharmacoepidemiological research as thousands of patients' clinical and medication information is stored in the database. However, the use of EHRs database for research purposes depends greatly on the accuracy and completeness of the data being used. This study mainly aimed to assess the completeness of EHRs patients' medication-related information. DESIGN: A retrospective cross-sectional study using data extracted from the EHRs database was conducted. SETTING: The EHRs data was obtained from a single tertiary hospital in Saudi Arabia. MAIN OUTCOME MEASURES: The completeness of data was measured considering if a patients' record contains all desired types of data (i.e., patients' demographics, clinical diagnosis, and medication-related information). RESULTS: A total of 23,411 unique individuals were identified after extracting the data from the EHRs. The study found that 89.9% of the patients had a complete data (i.e., age, gender, marital status, nationality, encounter type, and clinical diagnosis). Further, 83.1% of the patients had complete medication-related information. Subgroup analysis by the encounter type indicated that the data was 91.0% complete for outpatient encounter and 93.2% complete for inpatient encounter. CONCLUSION: The study findings indicate that the completeness of the data varies by the desired types of data. EHRs can be a potentially great resource to conduct research to assess medication use. Further studies focusing on the content and completeness of EHRs for a specific patient population and evaluate other dimensions of EHRs data quality are needed.

Prosthodontic rehabilitation with monolithic, multichromatic, CAD-CAM complete overdentures in an adolescent patient with ectodermal dysplasia: A clinical report.

Ectodermal dysplasia is a rare, hereditary, congenital disease that affects the normal development of certain tissues and structures of ectodermal origin. The disease is manifested to different degrees of severity and may involve the nose, eyes, hair, nails, sweat glands, and enamel. This report describes a 14-year-old boy with ectodermal dysplasia, rehabilitated with monolithic, multichromatic maxillary and mandibular computer-aided design and computer-aided manufacturing (CAD-CAM) acrylic resin complete overdentures.

Partial Explantation of Failed Dental Implants Placed in Mandibular Canal: A Case Report.

One of the most important concerns during posterior mandibular implant placement is avoiding the mandibular canal. Nerve injury can be very disturbing to the patient, possibly causing mild paresthesia to complete anesthesia. Explantation of a dental implant that gas violated the mandibular canal is the most recommended treatment. However, an osseointegrated implant that placed in the mandibular canal can be left if the patient shows no symptoms. In this case report, we describe a technique to maintain the apexes of the implants while partially removing fractured osseointegrated implants previously placed in the mandibular canal.

Learning preferences among dental students using the VARK questionnaire: A comparison between different academic levels and gender.

OBJECTIVE: To examine the learning style preferences of undergraduate dental students and determine the influence of gender on their selection. METHODS: This descriptive, cross-sectional study was conducted at the College of Dentistry, King Saud University, in Riyadh, Saudi Arabia, from September 2016 to January 2017.The Arabic version of visual, audio, read/write, and kinaesthetic questionnaire was administered to students from the first to the fifth academic year. Data was analysed using SPSS 21. P<0.05 was considered significant. RESULTS: Of the 491 students, 368(75.1%) completed the questionnaire. Of them, 269(73.1%) were males and 99(26.9%) were females. Significant differences were found when learning styles were compared (p<0.05). No significant differences could be found when the models were assessed as in the unimodal, bimodal, trimodal or quadmodal methods (p>0.05). A significant difference was found between genders when learning styles were compared (p=0.05). Males preferred the unimodal style, while females preferred the bimodal and quadmodal styles almost equally (p<0.05). CONCLUSIONS: Most dental undergraduate students preferred multi-modal learning.

Prosthodontic Rehabilitation for a Patient with Down Syndrome: A Clinical Report.

Patients with Down syndrome can present with a variety of oral manifestations such as hypodontia, periodontal disease, premature tooth loss, reduced salivary flow, crowding of teeth in both arches, and decreased occlusal vertical dimension. The intellectual ability of people with Down syndrome varies widely. They present with a mild-to-moderate intellectual disability that restricts their ability to communicate and adjust to their environment, which can add complexity in the overall dental treatment. There is little information in the literature regarding the prosthodontic rehabilitation for patients with Down syndrome in combination with dental implant placement. An implant-assisted removable partial dental prosthesis can be a cost-effective treatment alternative for carefully chosen patients with Down syndrome. This article presents the treatment of a 44-year-old male patient with Down syndrome and a moderate intellectual disability who presented with congenital and acquired tooth loss with significant occlusal discrepancies. The treatment included a prosthodontic approach that used a single dental implant, which will be described and illustrated in this article.