Evaluation of Knowledge and Attitude of Dental Hygienists and Dental Assistants Regarding People Living with HIV/AIDS and HIV-Associated Oral and Periodontal Lesions in Jeddah, Saudi Arabia.

BACKGROUND: Oral manifestations serve as important indicators of human immunodeficiency virus (HIV) infection, and dental healthcare practitioners play a pivotal role in preventing and managing HIV. This study aims to assess and compare the knowledge and attitude of dental assistants and dental hygienists concerning people with HIV/acquired Immunodeficiency syndrome (AIDS) patients in Jeddah province of Saudi Arabia. MATERIALS AND METHODS: This cross-sectional survey enrolled 160 dental hygienists and assistants practicing in Jeddah. Data was collected using a pretested, self-administered questionnaire comprising 50 questions that investigated knowledge about HIV/AIDS, awareness of HIV-associated oral and periodontal lesions, understanding of HIV transmission routes, and attitudes toward people with AIDS. RESULTS: In the study, 120 (75.0%) participants correctly recognized that individuals with HIV may appear healthy, while 123 (76.9%) participants admitted that HIV carriers have lower resistance to other diseases. Additionally, 126 (78.8%) participants confirmed an association between the virus and oral lesions, and 137 (85.6%) participants were aware of HIV transmission through blood. Moreover, 150 (93.7%) participants expressed their willingness to support, treat, and assist patients with AIDS, while only 10 (6.3%) participants expressed unwillingness. Notably, no statistically significant differences were found between dental assistants and hygienists in their knowledge and attitudes toward HIV/AIDS and people with AIDS. CONCLUSION: This study demonstrated that dental hygienists and assistants possess good general knowledge regarding HIV/AIDS and are well-informed about the disease's transmission routes. Moreover, a significant majority endorses the importance of treating and supporting AIDS patients.

A Comparative Evaluation of Antibacterial Efficacy of Moringa oleifera Leaf Extract, Octenidine Dihydrochloride, and Sodium Hypochlorite as Intracanal Irrigants against Enterococcus faecalis: An In Vitro Study.

Objectives: The aim of this study is to investigate and compare the microbial efficacy of Moringa oleifera leaf extract, octenidine dihydrochloride (OCT), NaOCl, and their combinations as intracanal irrigants against Enterococcus faecalis. Materials and Methods: Sixty single-rooted mandibular premolars were decoronated followed by root canal preparation. Each root specimen was autoclaved, inoculated with E. faecalis, and incubated at 37°C for 48 hr. Then, the specimens were divided into six groups based on the irrigation solution used: 2.5% NaOCl (Group 1), 0.1% OCT (Group 2), M. oleifera leaves extract (Group 3), a combination of M. oleifera extract and 1.25% NaOCl (Group 4), a combination of M. oleifera extract and OCT (Group 5) and normal saline (Group 6). Microbial samples were taken from each root canal before (S1) and after (S2) irrigation and the bacterial viability was assessed using colony-forming units (CFU) on bile esculin agar plates. Results: Comparing the number of CFU/ml before and after irrigation showed a significant reduction (P < 0.001) in all studied groups. Comparison between the CFU/ml after irrigation by NaOCl and each of the combination groups showed a significant difference. Conclusion: M. oleifera leaves extract and 0.1% OCT solutions have antibacterial effect against E. faecalis comparable to 2.5% NaOCl and might be used as root canal irrigants. The combination groups showed better antimicrobial activities than individual irrigants. However, further studies are required to investigate the biocompatibility and possible toxic effects of the tested irrigants.

Noninvasive Adaptation Appraisal of Antimicrobial Nano-Filled Composite.

OBJECTIVE: The aim of this research was to assess the effect of incorporating zein-coated magnesium oxide (zMgO) nanofillers to resin-based composite on the internal adaptation of the restorations using cross-polarisation optical coherence tomography (CP-OCT). METHODS: Thirty noncarious human molar teeth were used. Class V cavities (3 × 5 mm) were prepared on the buccal and lingual surfaces of each tooth. Clearfil SE Bond 2 was applied to all the cavities and then the teeth were divided into 3 groups (n = 10) as follows: group 1-restored with N-Flow composite; group 2 and group 3-restored with N-Flow composite mixed with different zMgO nanoparticle concentrations (0.3% and 0.5% by weight, respectively) and then light cured using an LED curing device. Specimens were examined for interfacial adaptation examination under CP-OCT. Characterisation of the dental composite incorporating zMgO was done by Fourier-transform infrared spectroscopy (FTIR), x-ray diffraction (XRD), and field emission scanning electron microscopy (FESEM). Results were analysed with Kruskall-Wallis test followed by Mann-Whitney U test, at a significance level of P < .05. RESULTS: XRD spectra exhibited the sharp peaks of zMgO in the composite enhanced with zMgO nanoparticles. FESEM analysis showed a uniform distribution of the zMgO nanoparticles in the composite and FTIR illustrated no change in the spectra. The gap percentage along the cavity floor was significantly lower in groups 2 and 3 in comparison to group 1 (P < .05). Also there was a significant difference in gap percentages between groups 2 and 3 (P < .05), with group 3 showing the lowest gap percentage. CONCLUSIONS: The incorporation of 0.3% and 0.5% zMgO nanoparticles in flowable composite assists in improving the internal adaptation of the composite to the tooth surface.

Overprescription of short-acting ß2 -agonists among patients with asthma in Saudi Arabia: Results from the SABINA III cohort study.

Despite near-universal health care and timely updates to treatment guidelines in Saudi Arabia, asthma control remains suboptimal, warranting deeper exploration of its management practices. This study describes asthma characteristics and prescription patterns of short-acting ß2 -agonists (SABAs) in the Saudi Arabia cohort of the SABA use IN Asthma (SABINA) III study. Patients with asthma (aged ≥12 years) from seven sites across Saudi Arabia participated in this cross-sectional study. Asthma severity was classified by study investigators, guided by the 2017 Global Initiative for Asthma (GINA) recommendations. Of 511 patients enrolled, 502 patients, treated by respiratory medicine specialists, were analyzed (mean [standard deviation] age, 47.5 [14.8] years; female, 68.5%). Most patients had moderate-to-severe asthma (89.6%, GINA treatment steps 3-5), were overweight/obese (78.9%), and received full health care reimbursement (83.4%). Asthma was partially controlled/uncontrolled among 64.3% of patients; 62.3% experienced ≥1 severe asthma exacerbation(s), and 60.6% and 41.2% were prescribed ≥3 (overprescription) and ≥10 SABA canisters, respectively, in the 12 months preceding study initiation. Additionally, 21.9% of patients purchased SABA over the counter (OTC), of whom 66.4% purchased ≥3 SABA canisters. Ninety-seven (88.2%) patients who purchased SABA OTC also received SABA prescriptions, and 80.4% and 56.7% of these were prescribed ≥3 and ≥10 SABA canisters, respectively. Overall, compared with SABINA III, a higher percentage of patients from Saudi Arabia were overprescribed SABA (60.6% vs. 38.0%, respectively) and purchased SABA OTC (21.9% vs. 18.0%, respectively), underscoring the need to align asthma treatment practices with current evidence-based recommendations and regulate SABA OTC sales in Saudi Arabia.

Impact of Nanoparticles Additions on the Strength of Dental Composite Resin.

Objective: This study aimed to evaluate the effect of nanoparticles, zirconium dioxide (ZrO2), titanium dioxide (TiO2), and silicon dioxide (SiO2), on flexural strength (FS), hardness, and wear resistance of light cured dental composite resin. Materials and Methods: 210 rectangular and disc-shaped composite resin specimens were fabricated with dimensions (25 × 2 × 2 ± 0.03 mm) and (6×4 ± 0.03 mm) for FS, hardness, and wear resistance, respectively (70/test). Specimens of each test were divided according to nanofillers into four groups, unmodified as control, ZrO2 (Z), TiO2 (T), and SiO2 (S) groups; each one was further subdivided into two subgroups according to nanoparticles concentration, 3wt.% and 7wt.% (Z3, Z7, T3, T7, S3, and S7), 10 specimens of each subgroup. A3-point bending test and Vickers hardness test were used for FS and hardness measurements, respectively. Wear resistance was evaluated by the differences in surface roughness of tested specimens before and after wear test. Two-way and 1-way ANOVA and Bonferroni's post hoc tests were done for data analysis (α = 0.05). Results: Two-way ANOVA for FS and wear resistance showed that there was a significant interaction between type of nanoparticles and concentration of nanoparticles (p < 0.001) while two-way ANOVA for hardness showed that both type of nanoparticles and concentration of nanoparticles had a significant effect (p < 0.001), while the effect of their interaction was not statistically significant (p=0.142). 1-way-ANOVA test showed significant increase in FS and wear resistance for all tested groups (p < 0.001 and p < 0.001, respectively) except T7 and S7. Also, there was a significant enhancement in hardness for all tested groups (p < 0.001). Conclusion: Modification of light cured composite resin with certain amounts of nanoparticles (3% and 7% of ZrO2 and 3% of TiO2 and SiO2) can be beneficial in improving flexural strength and wear resistance while hardness of composite resin was increased with all NPs additions.

Prevalence of eosinophilic, atopic, and overlap phenotypes among patients with severe asthma in Saudi Arabia: a cross-sectional study.

BACKGROUND: Eosinophilia is a significant factor in asthma severity; however, the prevalence of severe eosinophilic asthma in Saudi Arabia is largely unknown. We aimed to determine the prevalence of the eosinophilic (defined in this study as ≥ 300 cells/mm3 in blood), atopic (atopic phenotype 1, defined in this study as > 100 IU/mL total serum IgE; atopic phenotype 2, defined in this study as > 150 IU/mL), and overlap phenotypes among patients with severe asthma in Saudi Arabia. METHODS: A cross-sectional study was conducted in centers specialized in severe asthma management. Patients aged ≥ 12 years with severe asthma were enrolled. Study patients responded to the Global Initiative for Asthma 2018 assessment of asthma control questionnaire and provided study investigators with current information related to the study objectives. Additional medical record data and a blood sample for total serum IgE and complete blood count were collected. RESULTS: A total of 101 patients were enrolled; 83% were female and the mean (standard deviation) age was 48.7 (13.2) years. Forty-five (45%) patients had the eosinophilic phenotype, 50 (50%) had atopic phenotype 1, and 25 (25%) had phenotypic overlap (eosinophilic and atopic 1). Forty-one (41%) patients had atopic phenotype 2 and 23 (23%) had phenotypic overlap (eosinophilic and atopic 2). Asthma control and oral corticosteroid use patterns were similar and there were no significant differences in number of asthma exacerbations across phenotypes. CONCLUSIONS: In Saudi Arabia, 45% of patients with severe asthma had the eosinophilic phenotype, which is most likely an underestimation as no clinical features of eosinophilia were taken into account in the definition of eosinophilia. Approximately half of them had phenotypic overlap with the atopic phenotype. Trial registration NCT03931954; ClinicalTrials.gov, April 30, 2019.

Comparison between Integrated and Parallel Interlock Designs of an Extracoronal Attachment-retained Distal Extension Removable Partial Dentures: A Clinical Trial.

OBJECTIVE: Precision attachments may exert unfavorable stresses on abutments in distal extension bases. This study compared between two reciprocation designs in attachment removable partial dentures (RPDs). MATERIALS AND METHODS: Fourteen patients were allocated into two groups. Each patient received an attachment-retained RPD with one of the two types of attachments being studied. Group I received the integrated interlock type of reciprocation and group II received the parallel interlock type. Abutments were examined for modified plaque index, modified bleeding index, periodontal probing pocket depth, clinical attachment level, and modified papillary bleeding Index. RESULTS: Comparisons of periodontal parameters between mesial and distal abutments within each group revealed no statistically significant difference. Means of these parameters were used for the comparisons. There was a significant difference at P < 0.05 in all parameters between the two groups at time of insertion and at 3, 6, and 9 months of follow-up with values of group (II) higher than group (I). CONCLUSION: RPDs of both designs showed an increase in periodontal parameters. Integrated interlock design showed better scores. It is preferable to use the attachment-retained RPD with integrated interlock instead of parallel interlock design.

Effect of posterior span length on the trueness and precision of 3 intraoral digital scanners: A comparative 3-dimensional in vitro study.

PURPOSE: This in vitro study measured and compared 3 intraoral scanners' accuracy (trueness and precision) with different span lengths. MATERIALS AND METHODS: Three master casts were prepared to simulate 3 different span lengths (fixed partial dentures with 3, 4, and 5 units). Each master cast was scanned once with an E3 lab scanner and 10 times with each of the 3 intraoral scanners (Trios 3, Planmeca Emerald, and Primescan AC). Data were stored as Standard Tessellation Language (STL) files. The differences between measurements were compared 3-dimensionally using metrology software. Data were analyzed using 1-way analysis of variance with post hoc analysis by the Tukey honest significant difference test for trueness and precision. Statistical significance was set at P<0.05. RESULTS: A statistically significant difference was found between the 3 intraoral scanners in trueness and precision (P<0.05). Primescan AC showed the lowest trueness and precision values (36.8 µm and 42.0 µm; (39.4 µm and 51.2 µm; and 54.9 µm and 52.7 µm) followed by Trios 3 (38.9 µm and 53.5 µm; 49.9 µm and 59.1 µm; and 58.1 µm and 64.5 µm) and Planmeca Emerald (60.4 µm and 63.6 µm; 61.3 µm and 69.0 µm; and 70.8 µm and 74.3 µm) for the 3-unit, 4-unit, and 5-unit fixed partial dentures, respectively. CONCLUSION: Primescan AC had the best trueness and precision, followed by Trios 3 and Planmeca Emerald. Increasing span length reduced the trueness and precession of the 3 scanners; however, their values were within the accepted successful ranges.

In vitro antifungal susceptibility testing of fungi in patients with onychomycosis.

Onychomycosis is the most common nail disorder. To examine in vitro antifungal susceptibility of fungi among onychomycosis patients. The study included 68 patients with onychomycosis. Nail specimens were cultured on Sabouraud dextrose agar and Dermasel agar base-media. Isolated fungi were subjected to antifungal susceptibility tests against terbinafine, itraconazole, fluconazole, and griseofulvin. Candida species (Candida spp.) were detected in 32.4% of the cases of candidal onychomycosis (n = 37), 23.5% of the cases of distal and lateral subungual onychomycosis (n = 17), and 21.4% of the cases of total dystrophic onychomycosis (n = 14). Candida spp. were sensitive to fluconazole in 73.5%, itraconazole in 58.8%, and terbinafine in 5.9% of the cases. Aspergillus spp. were sensitive to itraconazole in all cases, and terbinafine in 87.5% of cases. Penicillium spp. were sensitive to itraconazole and terbinafine in 88.9% and 77.8% of cases, respectively. Trichophyton spp. were sensitive to terbinafine and resistant to itraconazole. Microsporum spp. were sensitive to itraconazole and resistance to terbinafine. All isolated fungi were resistant to griseofulvin. An increasing proportion of Candida spp. was observed among patients with different clinical varieties of onychomycosis. Candida spp. were highly sensitive to fluconazole and a lesser extent to itraconazole.

Isolation, Identification, and In Vitro Antifungal Susceptibility Testing of Dermatophytes from Clinical Samples at Sohag University Hospital in Egypt.

AIM: The objective of this study was to isolate, identify, and explore the in-vitro antifungal susceptibility pattern of dermatophytes isolated from clinically suspected cases of dermatophytosis (tinea infections) attending the Dermatology Outpatient Clinic. METHODS: This study was conducted at Sohag University Hospital from December 2014 to December 2015. Clinical samples (e.g., skin scrapings and hair stumps) were collected under aseptic precautions. The identification of dermatophytes was performed through microscopic examination using 10% potassium hydroxide (KOH) with 40% dimethyl sulphoxide (DMSO) mounts and culture on Sabouraud dextrose agar (SDA) and on Dermasel agar base media, both supplemented with chloramphenicol and cycloheximide. All dermatophytes isolates were subjected to antifungal susceptibility testing using the agar-based disk diffusion (ABDD) method against Clotrimazole, Miconazole, Fluconazole, and Griseofulvin. Data were analyzed via SPSS 16, using Chi square and a screening test (cross-tabulation method). RESULTS: A total of 110 patients of dermatophytosis were studied. The patients were clinically diagnosed and mycologically confirmed as having tinea capitis (49), tinea corporis (30), tinea pedis (16), tinea cruris (9), or tinea barbae (6). The dermatophytes isolates belonged to 4 species: Microsporum canis 58 (52.7%), Microsporum gypseum 23 (20.9%), Trichophyton mentagrophytes 18 (16.4%), and Microsporum audouinii 11 (10%). The most effective antifungal drugs tested were Clotrimazole, followed by Miconazole (95.5% and 84.5% of isolates were susceptible, respectively). CONCLUSION: Every patient with a tinea infection should be properly studied for a mycological examination and should be treated accordingly. Dermasel agar is more useful as an identification medium in the isolation of dermatophytes. The ABDD method appears to be a simple, cost-effective, and promising method for the evaluation of antifungal susceptibility of dermatophytes.