Comparative evaluation of weighted mean and composite score for combining assessments.

OBJECTIVES: Approaches for combining scores have been based on weighted mean (WM) without consideration for psychometric characteristics of each individual assessments. This study evaluates consequences of WM and composite score (CS) approach. METHODS: Data from two longitudinal cohorts (n = 219) were utilized for performance in three Operative Dentistry courses as basis to compare the two score-combining methods. Four assessments (two written and two practical exams) from each course were combined using WM and CS approaches. WM scores were calculated by multiplying the score by its weight and summing across assessments. The CS approach follow a modification of the Kane and Case method, by standardizing scores, taking into account the reliability and associations between each assessment score. t-Tests and Pearson's correlation were used to evaluate the consequences of the WM and CS approaches. In addition, changes in each student's rank across WM and CS were determined. RESULTS: Combining scores using CS method produced lower scores and higher percentage failure in all courses compared to WM. Students ranks were changed significantly when CS was used with only 15% of the cohorts retained their ranks. CONCLUSIONS: CS produced a composite that is correlated with WM but still being substantively different providing meaningful and psychometrically rigorous information.

Evaluation of Resin Infiltration, Fluoride and the Biomimetic Mineralization of CPP-ACP in Protecting Enamel after Orthodontic Inter-Proximal Enamel Reduction.

BACKGROUND: This study investigated the effect of using different agents for protecting enamel proximal surfaces against acidic attack after interproximal reduction (IPR) using the trans micro radiography technique. METHODS: Seventy-five sound-proximal surfaces were obtained from extracted premolars for orthodontic reasons. All teeth were measured miso-distally and mounted before being stripped. The proximal surfaces of all teeth were hand stripped with single-sided diamond strips (OrthoTechnology, West Columbia, SC, USA) followed by polishing via Sof-Lex polishing strips (3M, Maplewood, MN, USA). Three-hundred micrometers of enamel thickness was reduced from each proximal surface. The teeth were randomly divided into 5 groups: group 1 (control un-demineralized) received no treatment, group 2 (control demineralized) had their surfaces demineralized after the IPR procedure, group 3 (fluoride) specimens were treated with fluoride gel (NUPRO, DENTSPLY, Charlotte, NC, USA) after the IPR, group 4 (Icon) resin infiltration material (Icon Proximal Mini Kit, DMG, Bielefeld, Germany) was applied after IPR, group 5 (MI varnish) specimens were treated with Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) containing varnish (MI Varnish, G.C, USA, St. Alsip, IL, USA) after the IPR. The specimens in (groups 2-5) were stored in a 4.5 pH demineralization solution for 4 days. The trans-micro-radiography (TMR) technique was conducted to evaluate the mineral loss (∆Z) and lesion depth of all specimens after the acid challenge. The obtained results were analyzed statistically using a one-way ANOVA at a significance level of α = 0.05. RESULTS: The MI varnish recorded significant ∆Z and lesion depth values compared to the other groups p > 0.05. There was no significant difference in ∆Z and lesion depth between the control demineralized, Icon, and fluoride groups p < 0.05. CONCLUSION: The MI varnish increased the enamel resistance to acidic attack, and thus can be considered an agent capable of protecting the proximal enamel surface after IPR.

Bonding of Clear Aligner Composite Attachments to Ceramic Materials: An In Vitro Study.

Background: We aim to evaluate the effect of surface conditioning, bonding agents and composite types on surface roughness (SR) and shear bond strength (SBS) of clear aligner composite attachments bonded to ceramics. Methods: One hundred and eighty IPS e.max CAD specimens were prepared. For SR, 60 specimens were divided according to surface conditioning (n = 15) into four groups: control, 9.6% hydrofluoric acid (HFA), 37% phosphoric acid (PhA), air abrasion (AA). SR was measured using a Profilometer and Atomic Force Microscopy. For SBS, 120 specimens were divided according to conditioning methods (n = 40) (9.6% HFA and 37% PhA or AA), then according to bonding agents (n = 20) (Assure universal bond (AUB) or Single bond universal (SBU)) and then according to composite type (n = 10): Filtek™ Z350 and Filtek™ Z350 XT flowable composite. SBS was measured using Instron testing machine. Descriptive and group comparison were calculated (p < 0.05). Results: AA had the highest SR, while the control had the lowest SR (p < 0.05). HFA had the highest, but insignificant SBS, followed by AA (p > 0.05). AUB had higher SBS than SBU (p < 0.001). Filtek™ Z350 produced higher SBS than Filtek™ Z350 XT flowable composite (p < 0.01). Conclusion: The combination of AA, AUB, and Filtek Z350 produced the highest SBS, followed by HFA, AUB, and Filtek Z350.

Adaptational changes in clear aligner fit with time.

OBJECTIVES: To analyze adaptational changes in clear aligner fit after intraoral usage at different sets of time. MATERIALS AND METHODS: Eight Invisalign appliances (Align Technology, San Jose, California, USA) were collected after intraoral usage. Acrylic imprints of the lower incisor region were constructed for each appliance at T0 (unused appliance). Two appliances were then used intra-orally for each of the following defined periods of time: 3 days, 7 days, 10 days, or 15 days. Used aligners were adapted on its T0 imprint and both were sectioned buccolingually from the distal surfaces of each incisor at the attachment area. Eight surfaces were collected for each set of time (n = 32 surfaces). Microphotographs of obtained sections and micrometric measurements of aligner fit were recorded at five different levels using scanning electron microscopy (SEM). Mean values of the fit changes (gap width) and group comparisons were statistically analyzed using analysis of variance and Tukey's post hoc tests. Significance level was set at P < .05. RESULTS: Highly significant differences in aligner fit were found at the different time points assessed (P < .001) with the least mean gap width at 15 days (176 ± 98 µm) and the highest at 7 days (269 ± 145 µm). Significant differences in aligner fit at different attachment levels were also found (P < .01) with the least mean gap width at the middle of the labial surface of the attachment (187 ± 118 µm). CONCLUSIONS: The 15-day period of intraoral aligner wear might still be recommended as it showed the best adaptation and least gap width between the aligner and the attachment.

Mandibular symphysis dimensions in different sagittal and vertical skeletal relationships.

BACKGROUND: The aim of this cross-sectional study was to compare the dimensions of mandibular symphysis (MS) between gender and the different sagittal and vertical skeletal relationships. MATERIAL AND METHODS: Pre-treatment records of orthodontic patients were divided according to gender, sagittal (Class I, II and III) and vertical (decreased, average and increased mandibular plane [MP] angle) skeletal relationships. Measurements of MS parameters were performed on lateral cephalograms using IMAGEJ software. Comparisons between MS parameters and gender and the different skeletal relationships was performed using multifactorial and one-way ANOVA, and independent sample t-tests. RESULTS: A total of 104 records (25 males and 79 females) fulfilled the inclusion criteria. Males had significantly greater MS surface area, dentoalveolar length, skeletal symphysis length, total symphysis length, vertical symphysis dimension and symphysis convexity (p < 0.05). Skeletal Class II patients had significantly greater dentoalveolar and skeletal symphysis lengths while Class III had greater chin length, vertical symphysis dimension and symphysis convexity (p < 0.05). Patients with decreased vertical dimension had greater skeletal symphysis length (p = 0.026) and those with an average vertical relationship had greater chin length (p < 0.001). CONCLUSIONS: The morphology of the mandibular symphysis is affected by gender, sagittal and vertical skeletal patterns. Males had increased mandibular symphysis surface area and linear dimensions. Class II patients had greater dentoalveolar length. Chin length was greater in patients with an average MP angle.

Inhibitory effect of Salvadora persica extract (Miswak) on collagen degradation in demineralized dentin: In vitro study.

BACKGROUND/PURPOSE: Root dentin is vulnerable to acid attack, suggesting a higher risk of demineralization than coronal enamel. This study aimed to evaluate the inhibitory effect of Miswak extract on collagen degradation of demineralized dentin lesion. MATERIALS AND METHODS: Demineralized bovine root dentin specimens were treated for 1 h by 20% Miswak extract and 0.12% Chlorehexidine (CHX) as a positive control group, and then subjected to collagenolytic attack (clostridium histolyticum 0.5 CDU/mL, 16 h). These cyclic treatments were repeated for 3 days. After the cyclic treatment, the images of the specimens were captured with a light microscope and the lesion depth of degraded collagen layer of all specimens was measured. The mean lesion depth was calculated and compared between the groups using descriptive and One-way ANOVA followed by Post hoc Tukey's tests. Significant level was set at p < 0.05. RESULTS: The mean lesion depth of CHX (28.6 ±â€¯3.37 µm) had the least value, followed by Miswak (37.5 ±â€¯4.01 µm) then the control (78.4 ±â€¯18.43 µm) group. There was a significant difference in the mean lesion depth among the three groups (p = 0.000). CONCLUSION: Miswak aqueous extract from S. persica was found to preserve the dentin collagen matrix from collagenase enzyme. This could be due to the organic compounds like flavonoids, saponins, alkaloids, tannins, and others which have been reported in literature. Present finding suggests that Miswak might play a positive effect in dentin caries prevention.

The effect of various mechanical and chemical surface conditioning on the bonding of orthodontic brackets to all ceramic materials.

BACKGROUND/PURPOSE: Increasing the bond strength between the orthodontic brackets and all-ceramic materials is one of the challenges facing orthodontists. The purpose of this study is to assess the shear bond strength (SBS) of metal brackets to two types of all ceramic materials using various surface mechanical and chemical conditioning methods. MATERIALS AND METHODS: Sixty ceramic blocks were prepared using two types of all ceramic materials (IPS e.max and VITA Suprinity® PC) and treated with 3 surface treatments; surface etching with 9.6% hydrofluoric acid (HFA) for 2 mins; surface roughening with Sof-Lex finishing discs; and surface roughening with Sof-Lex finishing discs and etching with HFA. Metal brackets were attached to the surface of the ceramic blocks using light cure orthodontic adhesive. Samples were subjected to 2000 thermo-cycles (5-50 °C) and the SBS was assessed using Instron machine. The adhesive remnant index (ARI) was evaluated under light microscope. Descriptive and group comparison were calculated using Two-way ANOVA, Post-hoc Tukey's and Chi-square tests and significance level set at (P < 0.05).Results: surface roughening of both ceramic materials with Sof-Lex discs and HFA resulted in a significant increase in SBS compared to other experimental groups (P < 0.05). However, VITA Suprinity ceramic prepared with Sof-Lex discs only showed the lowest SBS. The distribution of the ARI scores was significantly different between the groups (P < 0.05). CONCLUSION: Surface preparation of all ceramic materials with Sof-Lex discs and hydrofluoric acid combination produces the highest SBS to metallic orthodontic brackets.

Effect of Salvadora persica Extract (Miswak) on the Dentinal Tubules of Sound Root Dentin: Scanning Electron Microscope Study.

BACKGROUND/PURPOSE: Root dentin is vulnerable to a higher risk of demineralization than coronal enamel. This study aimed to evaluate the effect of miswak extract on the dentinal tubules of sound root dentin. MATERIALS AND METHODS: Twenty bovine root dentin blocks, approximately 2 mm × 3 mm × 3 mm (width × length × depth) in dimensions, were prepared from freshly extracted sound bovine incisors. The sample was divided into two groups: control and miswak group. The control group had sound root dentin block and the miswak test group was treated with miswak extract 20% for 24 h. The two groups of all specimens were subjected to ultrasonication for 10 min. Scanning electron microscope images were analyzed for surface typography. RESULTS: Fifty percent of the control group had surface particles (SPs), while the other 50% had no SPs. For the dentinal tubules, all (100%) the control group had a mixture of opened and partially opened dentinal tubules. On the other hand, for the miswak group, all (100%) the sample had SPs and blocked dentinal tubules. CONCLUSION: Miswak showed total blocking of the dentinal tubules compared to the control group. This might indicate that miswak has a role in reducing dentinal hypersensitivity of exposed root dentin.

Comparison between Characteristics of Maxillary Right and Left Central Incisors: A Cone-beam Computed Tomography Study.

AIM: To compare the angulation of maxillary left (UL) and right (UR) incisors and the width of alveolar bone. MATERIALS AND METHODS: This study was conducted using archived cone-beam computed tomography (CBCT) images of 50 male and 50 female patients. The UL and UR incisors were compared in terms of incisor/palatal plane angle, collum angle, labiopalatal crown-root position, and alveolar bone width (ABW). The comparison, with reference to gender and age, was analyzed using one-way analysis of variance and independent sample t test. RESULTS: There is no substantial variance in the average differences of the assessed variables for UR and UL central incisors (p > 0.05). No significant association was found between crown labial to root and root labial to crown positions for both central incisors (p > 0.05). Statistical analyses revealed that tooth type has no significant association with the central incisors-related variables. Alveolar bone width, at various areas assessed, showed significant relation to gender. On the other hand, incisor/palatal plane angle and ABW at the cementoenamel junction and at level of Point A (subnasale) were significantly affected by age. CONCLUSION: Gender can significantly affect the development of ABW. Also, incisor/palatal plane angle and ABW at certain areas are correlated with age. CLINICAL SIGNIFICANCE: Understanding the similarities or differences between right and left maxillary central incisors may give better indication if cephalometric images are accurate in attaining such measurements. This in turn will also help orthodontist to choose the proper tool for treatment decision-making related to incisor tooth movement.

Sealants and White Spot Lesions in Orthodontics: A Review.

AIM: This literature review aims to update the evidence for prevention of white spot lesion (WSL) using orthodontic sealants among patients with fixed orthodontic appliances. BACKGROUND: As a major issue among orthodontists, prolonged treatment duration increases the risk of plaque development around orthodontic brackets and bands. In consequence, this can lead to heightened risk for caries development and higher possibility of WSL development around fixed orthodontic brackets. RESULTS: Increased prevalence of WSLs generally occurs during orthodontic treatment. This review explored various products of orthodontic sealants used to prevent WSL. Orthodontic sealants do not require patient compliance and thus will further lessen the burden among orthodontists as well as support enamel surface for a long period of time during treatment. Certain factors, however, are considered important in the efficacy of these sealants, such as antibacterial activity, color stability, resistance to acid and brush abrasion, and their effect on shear bond strength (SBS). CONCLUSION: The review showed that the use of orthodontic sealants in preventing WSLs during and after fixed orthodontic treatment is significantly effective. However, the bioactive glass is deemed more effective against WSL development due to its ability to immediately repair enamel surface, low cytotoxicity, and high biocompatibility. Moreover, clinical studies on bioactive glass are still needed to determine its acceptability among patients with fixed orthodontic appliance. CLINICAL SIGNIFICANCE: Development of WSL around the orthodontic brackets during treatment is a difficult task among orthodontists. As such, this review explored various strategies to effectively combat WSL development for good oral health and esthetics during orthodontic treatment.

Young Adults' Preferences and Willingness to Pay for Invasive and Non-invasive Accelerated Orthodontic Treatment: A Comparative Study.

To evaluate the preference of young adult patients and their willingness to pay for the different approaches accessible to accelerate orthodontic tooth movement. A cross-sectional survey was conducted in Jeddah, Saudi Arabia from September to December 2019. Young adult orthodontic patients from 18 to 45 years old were interviewed via online survey regarding their perception to the extent of treatment, acceptability of non-invasive (customized appliances and medications) and invasive (surgery) approaches accessible to accelerate orthodontic treatment and increase in fees they were willing to pay. Statistical analyses were performed, and gender difference was calculated at P < .05. There are 100 respondents: 70% aged between 18 to 25, 50% male, and 56% with annual income <10 000 SR. About 72% of the respondents decided that treatment takes longer period and 51% wished it would last for less than 6 months. Customized appliances were reported to be the most convenient to use (58%) and to pay (44%), followed by medications (48%). On the other hand, surgery was reported to be the most inconvenient to use (58%) and to pay for (55%). About 70% of the respondents were unwilling to pay more than 10% to 20% for all procedures assessed; considerable variation was not observed in responses between gender at 95% confidence level. Majority of the respondents believed that orthodontic treatment is taking lengthy duration. Less invasive, nonsurgical techniques and procedures were more preferred. Likewise, financial factors play vital role in the selection of their preferred approach. Most of them agrees to provide up to 20% increment of the fee for additional procedures.

Predictive Factors Affecting the Maxillary Alveolar Bone Thickness: A Cone-Beam Computed Tomography Study.

PURPOSE: Many important structures are associated with the maxillary alveolar bone and should be considered during orthodontic tooth movement. The purpose of this study was to investigate the correlation between the anterior maxillary alveolar bone thickness (AMABT), inclination of the central incisors, and the incisive canal (IC), as well as changes in the thickness based on age and sex of the patients. METHODS: This cross-sectional study was conducted using archived cone-beam computed tomography (CBCT) records categorized according to age and sex. The parameters measured were; AMABT at three levels: alveolar crest, mid-root, and apex; incisor to palatal plane (Inc/PP) angle and IC width at palatal opening. OnDemand 3D Imaging software was utilized for image reconstruction and measurement. Data were analyzed using linear regression analysis and Mann-Whitney test. A P-value of <0.05 was considered significant. RESULTS: Out of the 300 CBCT images assessed, only 135 images (70 males and 65 females; age range=17-63 years) fulfilled the inclusion criteria. The Inc/PP angle had a significant effect on the AMABT at the alveolar crest and mid-root levels (P<0.01). Width of the IC at palatal opening had a significant effect on AMABT at the mid-root and apex level (P<0.01). Age had a significant effect on AMABT at three levels (P<0.05). Males demonstrated significantly greater AMABT at all levels than females (P<0.01). CONCLUSION: There was an association between AMABT and the Inc/PP angle, width of the IC at palatal opening, age, and sex of the patients.

Prevalence of malocclusion and orthodontic treatment needs among young adults in Jeddah city.

OBJECTIVE: To assess the prevalence of malocclusion and orthodontic treatment needs in a Saudi sample of Jeddah city. MATERIALS AND METHODS: A cross-sectional (descriptive) study was performed in 2017 among 3016 subjects (1507 females and 1509 males) selected according to stratified random sampling design. The inclusion criteria were Saudi students aged between 14-18 years with no craniofacial deformities or syndromes and no orthodontic treatment carried out. Malocclusion was assessed using the modified Bjork et al. system, and Angle's classification and orthodontic treatment need to be evaluated by using the IOTN (DHC). Descriptive, associations and gender differences were assessed by one-way ANOVA, Chi-square, and Fisher exact tests. Data was analyzed using STATA version 13.0 (StataCorp, College Station, Texas, USA). Statistical significance was set at P < 0.05. RESULTS: Approximately 12% of the participants had normal occlusion, 57% had Class I malocclusion, 17% had Class II malocclusion, and 14% had Class III malocclusion. The highest prevalence of malocclusion traits was for displacement, followed by a crossbite. The IOTN results revealed slight need for orthodontic treatment in (n = 795-26%) moderate/borderline in (n = 1166-39%), and great need in (n = 1055-35%). Class II and III malocclusion, OJ, reverse overjet, scissor bite, open bite, midline discrepancies, and crowding were significantly higher in males than females (P < 0.05). CONCLUSION: Overall, there was a high prevalence of malocclusion and high orthodontic treatment need. The most common malocclusion was Class I. The most common orthodontic treatment need was moderate to borderline.

E-learning Readiness among Dental Students and Faculty Members Pre-COVID-19 Pandemic.

PURPOSE: The purpose was to assess students' and faculty readiness toward online dental education in Saudi Arabia. MATERIALS AND METHODS: This is a cross-sectional study using a 5-point Likert scale questionnaire distributed to students (undergraduates and postgraduates) and faculty at King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia, in 2018. It assessed individual characteristics, system competency needs, social influence, institutional support, overall readiness, and the needed technical support in using e-learning for personal as well as teaching and learning (T&L) purposes. The readiness response scale for each domain was categorized as follows: low (mean value = 1-<3), acceptable/moderate (mean value = 3-<4), and high readiness level (mean value = 4-5). Descriptive and group comparisons were conducted using Pearson's Chi-square test, paired sample t-test, independent sample t-test, one-way ANOVA, and Tukey's post hoc test. The statistical significance level was set at P < 0.05. RESULTS: the total completed response rate was 400/550 (72.7%) comprising undergraduates (n = 312), postgraduates (n = 38), and faculty (n = 50). The results showed an acceptable level of online skills with no statistically significant difference between the groups (P > 0.05). A statistically significant difference between the two categories of uses, personal and T&L, was found (P < 0.05). The undergraduate students reported statistically significantly lower readiness level in online English literacy, perceived impact of online technology on education, technology accessibility, importance of institutional support, overall readiness, and the need for technical support (P < 0.05). CONCLUSION: Significant differences between students' and faculty readiness for e-learning adoption in dental education were reported. The current study captured the prepandemic e-readiness of students and faculty as a baseline for future assessment of pandemic effect on education.

Patients' Perceptions To Reduced Orthodontic Treatment Time In Saudi Arabia.

PURPOSE: To evaluate patients' perceptions regarding orthodontic treatment duration, cost, and willingness to undergo different procedures and techniques available to accelerate orthodontic tooth movement in Saudi Arabia. PATIENTS AND METHODS: A cross-sectional survey was conducted in Saudi Arabia from January to March 2019. Patients from multiple centers were electronically surveyed regarding their perception of orthodontic treatment duration, acceptance of appliances and techniques available to shorten the duration of orthodontic treatment, and how much increase in fees they were willing to pay for those appliances and techniques. Descriptive and group comparison statistics were conducted, and the significance level was set at p<0.05. RESULTS: The response rate was 200/400 (50%): 50.5% were (>18-25 years old), 67.5% female, 80% Saudi, 67.5% self-pay and 52% with annual income <10,000 SR. A total of 83% of the participants agree that orthodontic treatment takes too long, and 55.5% wish it takes less than 6 months. The preferences for additional procedures were ranked in the following order: customized wires ranked 1 by 52.5%, followed by FDA (Food & Drug Administration) approved teeth vibrators by 40.5%, FDA approved drug injections by 33.5%, piezocision by 32.5%, and corticotomies by 46% of the participants. No significant differences in ranking between the groups according to age and annual income (p>0.05). 47.5% of the participants were able to pay for additional procedures. An increase in treatment fees was reported for up to (30-40%) for FDA approved teeth vibrators by 59% of the participants, followed by FDA approved drug injections by 33% of the participants. A significant difference in responses between the groups was reported according to gender and annual income (p<0.05). CONCLUSION: Most of the patients strongly agreed that orthodontics treatment takes too long. The highest percentages of patients perceived customized wires as the most acceptable technique to undergo to shorten orthodontic treatment duration, followed by teeth vibrators.

Adult Perceptions of Different Orthodontic Appliances.

Introduction: Pursuing an esthetically-pleasing orthodontic outcome, orthodontic patients must consider and choose from the different available options of orthodontic appliance. Practitioners need to be better informed of their customers' preferences to make better practice management decisions and satisfy their patients' needs. PURPOSE: To explore adult laypeople's perceptions of the attractiveness, acceptability, preference and economic value of different orthodontic appliances when they consider these appliances for themselves and for their children. PATIENTS AND METHODS: This cross-sectional survey included 199 adults (110 females). The average age of participants was 27.7 years. Participants answered a questionnaire evaluating and comparing multiple smiling images of an adult wearing different orthodontic appliances. Participants rated each appliance for: (1) attractiveness on a Likert scale; (2) acceptability of having the appliance placed for themselves and their children (with a yes/no response); (3) preference (by ranking all appliances in order); and (4) economic value (by providing the additional amount they are willing to pay for each appliance for themselves and their children). RESULTS: We found a statistically significant difference in the attractiveness scores between the different orthodontic appliances (p< 0.0001). The most attractive appliances were clear aligners and lingual brackets. The least attractive appliances were colored o-tied-brackets followed by shaped-brackets. Clear aligners were the most acceptable appliances among our participants to have placed on themselves (86.9%) and their children (84.9%). Shaped brackets were the least acceptable appliances among our participants to have placed on themselves (24.1%) and their children (36.2%). The most preferred appliances were lingual brackets (39.2%), followed by clear aligners (34.17%). The least preferred appliances were colored o-tied-brackets (4%). Participants varied with regards to how much more they were willing to pay for each of the different orthodontic appliances. The majority were willing to pay more for clear aligners and lingual brackets to have them placed on themselves but not to have them placed on their children. CONCLUSION: Adults preferred more innovative esthetic appliances over traditional ones and were willing to pay more to have them placed on themselves but not on their children.

Impact of Dental Visits on Oral Health Awareness in Saudi Arabia.

AIM: The aim of this study is to assess the impact of dental visits on oral health awareness among the Saudi population. MATERIALS AND METHODS: A cross-sectional survey was conducted in Saudi Arabia. An online self-administered questionnaire was distributed from January 2011 to June 2013. The questionnaire consisted of 21 multiple choice questions which was categorized into four: demographic data, dental care status, oral hygiene behavior, and oral health knowledge (OHK). Responses to the questions in the OHK category were grouped and scored according to their percentage of correct answers: 1 = very poor (0 to <25% correct), 2 = poor (25% to <50% correct), 3 = acceptable (50 to <75% correct), and 4 = good (75-100% correct). The sample was divided based on dental visit behavior into poor, average, and good dental visitors. Descriptive statistics, group comparisons, correlations, and linear regressions were conducted using SPSS (V16.0). A significance was set at p < 0.05. RESULTS: A total of 845 participants were included: 73.4% were females, 85.1% were older than 19 years, 76.9% had a college-level education, and 75.3% were from western Saudi Arabia. A total of 14.1% were poor dental visitors, 67.5% were average dental visitors, and 18.5% were good dental visitors. The good dental visitor group showed significantly better results than the other two groups in terms of dental services received, brushing habits, interdental cleansing habits, use of miswak, and OHK (p < 0.05). The best predictors with significant but weak effects on dental visit habits were brushing habits, interdental cleansing habits, use of miswak, and OHK (F(8,836) = 7.212, R2 = 0.065, p < 0.0001). CONCLUSION: Dental visits were significantly correlated with OHK. However, the impact of dental visits on oral health awareness was found to be weak. CLINICAL SIGNIFICANCE: Well-designed preventive and educational dental visit programs need to be widely implemented as part of the governmental oral health plans.

Students' perception, attitudes, and readiness toward online learning in dental education in Saudi Arabia: a cohort study.

PURPOSE: The purpose of this study was to assess students' perception, attitudes, and readiness toward online dental education in Saudi Arabia. MATERIALS AND METHODS: This is a longitudinal study using a 5-point Likert scale questionnaire distributed to a cohort group of undergraduate dental students at King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia, during their fourth year (T1) and internship year (T2). It assessed technological access, computer skills, online skills, and motivation level in using e-learning for personal and learning purposes; and overall readiness for e-learning adoption in dental education. The response scale for each domain was categorized as follows: low readiness level (mean value=1-<3), acceptable/moderate readiness level (mean value=3-<4), and high readiness level (mean value=4-5). Descriptive and group comparisons were conducted using the chi-squared test, Fisher's exact test, and paired and independent samples t-test. The significance level was set at P<0.05. RESULTS: The respondents were as follows: T1 group (n=72; 36 males [M], 36 females [F]) and T2 group (n=50; 20 M, 30 F). The results indicated high levels of computer skills, technology access, and perceived importance of online technology with no significant difference between the groups (P>0.05). They also showed acceptable levels of e-learning experience and social influence on e-learning adoption with no significant difference between the groups (P>0.05). A significant difference was reported in using e-learning for personal compared to learning purposes (P<0.05). The T2 group reported significantly lower levels of online English literacy (P<0.01), perceived impact of e-learning on dental education, and readiness for e-learning (P<0.001). Multiple technical and content development supports were reported. CONCLUSION: This study showed acceptable levels of individual characteristics and system competency levels as well as the perceived importance of using technology in dental education among the participants. However, the perceived impact of and readiness for e-learning were found to be less acceptable as students matured. The need for much support in some skills was also reported.

Dentoskeletal effects of the forsus™ fatigue resistance device in the treatment of class II malocclusion: A systematic review and meta-analysis.

OBJECTIVE: The aim of this systematic review and meta-analysis is to quantitatively compare previous studies that evaluated skeletal and dentoalveolar effects of the Forsus™ Fatigue Resistance Device (FRD) in the treatment of Class II malocclusion with a matched untreated control group. MATERIALS AND METHODS: Four electronic searches PubMed, Web of Science, Cochrane Library, and Science Direct that were limited to articles on human studies comparing the effect of Forsus appliance with a matched control group in the treatment of Class II malocclusion from the year (2000-2017). An additional manual search was carried out by examining the references of the included articles, SEARCH terms included; Forsus and Class II malocclusion. The quality of the included studies was assessed using the modified methodological score for clinical trials. The data were analyzed using Michael Borenstein's Comprehensive Meta-Analysis Software (V3.3.070, Biostat, Inc., US). RESULTS: Seven studies were included comprising 273 participants (Forsus group = 142; control group = 131). The results indicated a statistical significant skeletal effect of the Forsus appliance on increasing the occlusal plane only (P < 0.001). The results also indicated a statistical significant (P < 0.001) dentoalveolar effects of the Forsus appliance on the following outcomes; protruding, proclining, and intruding lower incisors; retroclining upper incisors, distalizing and intruding upper molars, as well as reducing overjet and overbite. CONCLUSIONS: The Forsus™ showed positive effects on the maxillary incisors and first molars as well as overjet and overbite. However, multiple negative effects were reported on the occlusal plane and lower incisors that need to be considered when using such appliance in treating Class II malocclusion.

Scholar outcomes for dental internship research program in Saudi Arabia: A qualitative evaluation.

OBJECTIVE: To explore the potential, challenges and needs for internship research activities in achieving scholar outcomes among graduates. METHODS: A qualitative general needs assessment and evaluation of an internship research program was conducted at King Abdulaziz University, Faculty of Dentistry (KAUFD), KSA, from December 2014 to February 2015 using focus groups and interviews. The participants included: administrates, faculty, and internship students. Data were transcribed and analyzed following the grounded theory. RESULTS: The participants were two administrative personnel, 21 faculty members, and 16 internship students. Results were clustered around five main domains; curriculum design, faculty, students, administrative, and institutional domain. Reported potentials included: a multi-faceted educational intervention approach, and building evidence-based skills and inquiry minds among graduates. Time, load, and incentives were major challenges reported by faculty. Interesting and achievable research topics were major challenges reported by students. Areas that needed development included: equipped research personnel, aligned administrative and institutional support, faculty skills, students' knowledge and skills, aligned curriculum, and clear program goals, objectives, and outcomes. CONCLUSION: Curriculum design, faculty and students' skills; as well as administrative and institutional support were found to play major roles in the success of the current internship research program at KAUFD.