Comparison of postoperative hypersensitivity between Total-etch and Universal adhesive system: a randomized clinical trial.

The objective was to determine the postoperative hypersensitivity of two-step Total-etch as compared to one-step Universal adhesives followed by composite restorations on 100 patients by applying Total-etch on one tooth and Universal adhesive on another tooth. The bonds and teeth were randomly selected. Postoperative hypersensitivity was recorded by visual analog scale before, immediately after, and 24 h after the restoration using cold stimulus. The Mann-Whitney test was applied for statistical comparison of postoperative hypersensitivity between the two bonds as well as for any significant difference in genders with each bond. No significant difference was found between postoperative hypersensitivity of the two adhesives before (p-value = 0.57), immediately after (p-value = 0.604), and 24 h after (p-value = 0.728) the restoration. Males showed more hypersensitivity with Total-etch as compared to females before (p-value = 0.037), immediately after (p-value = 0.047), and 24 h after the restoration (p-value = 0.022). No significant difference was found between gender and Universal adhesive at all three stages (p-value > 0.05). The results suggest no significant difference in postoperative hypersensitivity between the two materials when good sample size and proper technique were observed along with the removal of bias like different patients having different pain perceptions and multiple operators having different operating skills. Males showed more hypersensitivity to Total-etch.Trial registration number: Australian New Zealand Clinical Trials. Registry number: ACTRN12622001213730. (Retrospectively registered: 09/09/2022).

Validation and Reliability Testing of the Child Oral Impacts on Daily Performances (C-OIDP): Cross-Cultural Adaptation and Psychometric Properties in Pakistani School-Going Children.

Background: This study aimed to develop an Urdu version of Child-Oral Impact on Daily Performance (C-OIDP) and assess its reliability and validity for children's oral health-related quality of life (OHRQoL) assessment in Pakistan. Methods: A total of 200 school-going children aged 11−14 were recruited from two public schools. For the adaptation process, the original English version of C-OIDP was translated into Urdu, reviewed by an expert committee, back-translated into Urdu, and then reviewed again by the same expert committee and pilot tested on 10 children. A clinical examination was carried out to record dental and gingival status followed by a face-to-face interview to measure oral health-related quality of life in children using C-OIDP-U. Reliability, internal consistency, construct and discriminant validity were assessed. Results: The Cronbach's alpha for C-OIDP-U was 0.69, the mean C-OIDP-U score was 10.2 ± 8.1 and 77.3% of the children reported at least one oral impact. Eating (40.3%) and difficulty in cleaning mouth (38.7%) were the two most impacted daily performances. For construct validity, the associations were significant between the C-OIDP-U score and all subjective oral health measures (p < 0.001). For discriminant validity, a significant association was observed between the C-OIDP-U score and clinical oral variables, children with DMFT + dmft ≥ 1, Gingival index > 1 and having malocclusion reported a higher C-OIDP-U score when compared to their counterparts. Conclusion: This study showed that C-OIDP is a valid, reliable and efficient instrument of OHRQoL for use in Pakistani children.

Comparison Of Anaesthetic Efficacy Of Articaine And Lidocaine In Nonsurgical Endodontic Treatment Of Permanent Mandibular Molars With Symptomatic Irreversible Pulpitis. A Randomized Clinical Trial.

BACKGROUND: Inferior Alveolar Nerve Block (IANB) with Buccal Infiltration (BI) anaesthesia is required to completely anesthetize the mandibular molars with symptomatic irreversible pulpitis. 4% Articaine and 2% Lidocaine provide local anaesthesia during the nonsurgical endodontic treatment of mandibular molars with symptomatic irreversible pulpitis. Objective of the study was to compare the effect of Articaine and Lidocaine in the combination of Inferior alveolar nerve block with buccal infiltration anaesthesia during the nonsurgical endodontic treatment of mandibular molars with symptomatic Irreversible Pulpitis. METHODS: One hundred and sixty participants with Symptomatic Irreversible Pulpitis of permanent mandibular molars were divided randomly in two groups. Group A was given Articaine 4% IANB along with BI whereas group B was given Lidocaine 2%. Pain was assessed after 15 minutes of administration of local anaesthesia. Anaesthetic success of the agents is defined as, absence of pain or mild pain first during the access cavity preparation then instrumentation of the canals of tooth. Chi-square test was applied to analyse data for statistical significance. RESULTS: Anaesthetic success of Articaine was 96.2% during access cavity preparation compared to Lidocaine (86.2%). Success during instrumentation of canals was also found to be high in Articaine (90.2%) compared to Lidocaine (76.2%). This difference of anaesthetic efficacy between Articaine and Lidocaine was found statistically significant. (p=0.02). CONCLUSIONS: Articaine is found to be better than Lidocaine regarding anaesthetic efficacy and hence, it can be a safer alternative to Lidocaine.

The role of Pakistani dentists in tobacco cessation.

OBJECTIVE: To assess Pakistani dentists' ability, willingness and perceived barriers to carry out tobacco cessation activities for their patients in the dental office. The study is limited to the smoking form of tobacco use. METHOD: Using a structured questionnaire for a cross sectional study, 239 full time or part time practising licensed dentists based in Islamabad and Rawalpindi were recruited by two sampling techniques; convenience and cluster sampling. Participation rate was 66.2%. RESULT: Based on the characteristics, the study population is assumed representative of the average Pakistani dentist. Prevalence of smoking amongst dentists was 20.3%. Only one-third rated their knowledge and ability regarding tobacco cessation messages as good/excellent. The majority of the dentists considered tobacco cessation activity as peripheral to their profession. The main barrier to performing tobacco cessation interventions was cited as gender. CONCLUSION: Dentists exhibit a superficial approach to delivery of smoking cessation care. It is recommended that dentists be trained in delivering effective tobacco dependence intervention, using the WHO/FDI advocacy guide for oral health professionals, modified to incorporate gender oriented culturally sensitive doctor-patient interaction. Tobacco cessation clinics should also be set up in private and public sectors to augment the dentists' participation.