The impact of an online intervention on the medical, dental and health sciences students about interprofessional education; a quasi-experimental study.

BACKGROUND: Interprofessional education (IPE) encompasses integration, communication, mutual trust and shared decision-making with a common goal of improved patient care and safety. Despite its crucial role, IPE has not gained its anticipated popularity. This study aims to determine the impact of an online educational intervention about IPE on medical, dental and health sciences students in the University of Sharjah (UoS). METHODS: This quasi-experimental research was conducted in three phases; a pre-intervention phase where the Readiness for Interprofessional Learning Scale (RIPLS) inventory was administered online to the medical, dental and health sciences students of UoS; an intervention phase where an online workshop was organized via Microsoft Teams®; and a post-intervention phase where RIPLS was used to gather the students' attitudes towards IPE. The independent t test was used to compare the responses between genders and junior and senior students. A paired sample t test was used to determine the impact of the intervention on the students' understandings and attitudes about IPE. RESULTS: Out of 800 invited students, 530 students responded to the pre-intervention RIPLS survey. A comparison of the pre-post intervention for the RIPLS subscales of teamwork and collaboration, professional identification, and professional roles showed a significant improvement of students' attitudes with p-values 0.03, 0.00 and 0.00, respectively. All workshop moderators scored a median of 4 or 5 to the essential elements of IPE during intervention except for a median of 3 for group dynamics. CONCLUSION: The present data, derived from the application of a brief online educational intervention, underpins the readiness and positive attitudes of undergraduate medical students towards IPE. The positive impact of online intervention necessitates the development of a structured and unified IPE curriculum to enhance the receptiveness and application of IPE in the medical field.

The effect of concha bullosa and nasal septal deviation on palatal dimensions: a cone beam computed tomography study.

INTRODUCTION: Nasal septal deviation (NSD) and concha bullosa (CB) are associated with airway obstruction in mouth breathers. Mouth breathing is associated with alterations in maxillary growth and palatal architecture. The aim of our study was to determine the effect of the presence of CB and NSD on the dimensions of the hard palate using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: A retrospective study was conducted using CBCT scans of 200 study subjects. The study subjects were divided into four groups based on the presence of CB and NSD. Septal deviation angle (SDA), palatal interalveolar length (PIL), palatal depth (PD) and maxillopalatal arch angle (MPAA) were measured in the study groups. RESULTS: The presence of NSD and CB was associated with significant (p < 0.001) differences in the palatal dimensions of the study subjects. The PIL and MPA (p < 0.001) were significantly reduced (p < 0.001), whereas the PD was significantly increased (p < 0.001) in study subjects with NSD and CB. There was no significant change in the palatal dimensions between the unilateral and bilateral types of CB. Among the palatal dimensions, the PIL had the most significant association (R2 = 0.53) with SDA and CB. There was a significant correlation between the palatal dimensions and SDA when CB was present along with NSD. CONCLUSION: Based on the results of this study, it can be concluded that the presence of NSD and CB have a significant effect on the palatal dimensions and, therefore, they may be associated with skeletal malocclusion.

Post COVID-19 lockdown: measures and practices for dental institutes.

Resuming regular clinical activities at dental premises after the COVID-19 lockdown period or post COVID-19 is likely to be a challenge for all dental institutes. When returning to the dental practice or training, staff and students alike should abide by the new rules and regulations. In the process of controlling viral spread, clinical dental facilities face a higher risk of disease transmission among patients as well as clinical and non-clinical staff. Aerosols formation and diffusion into the surrounding air can be a real concern of viral transmission, if no protective measures are established. We aim in this review to present the currently implemented measures and propose changes in clinical dental facilities to minimize the risk of transmission. Dental professionals should be prepared to treat every patient as a suspected COVID-19 carrier and be ready to receive and manage an overwhelming number of patients. We suggest that dental practices establish a sensible workforce shift schedule, improve ventilation levels, reduce dental aerosol generating procedures, and develop a comprehensive guidance to Healthcare Workers to reduce the risk of COVID-19 transmission.

Three-Dimensional Radiological Assessment of Alveolar Bone Volume Preservation Using Bovine Bone Xenograft.

INTRODUCTION: Alveolar bone is critical in supporting natural teeth, dental implants as well as a removable and fixed prosthesis. Alveolar bone volume diminishes when its associated natural tooth is lost. OBJECTIVE: The aim of this study is to evaluate the effectiveness of bovine bone granules on alveolar bone socket augmentation for ridge preservation following atraumatic tooth extraction. MATERIALS AND METHODS: Twenty medically fit patients (12 males and 8 females aged between 18 and 40 years) who needed noncomplicated tooth extraction of 1 mandibular premolar tooth were divided randomly and equally into 2 groups. In control group I, the empty extraction socket was left untreated and allowed to heal in a conventional way. In group II, the empty extraction socket wound was filled with lyophilized bovine bone xenograft granules 0.25 to 1 mm of size, 1 mL/vial. A resorbable pericardium membrane was placed to cover the defect. Clinical and 3-dimensional radiological assessments were performed at day 0, 3 months, and 9 months postoperative. RESULTS: There were no clinical differences in general wound healing between the groups. Comparisons within the groups showed a significant difference of bone resorption of 1.49 mm (95% confidence interval, 0.63-2.35) at 3 months, and further resorption of 1.84 mm (P ≤ 0.05) at 9 months in the control group. No significant changes of bone resorption were observed in group II during the same time interval. Comparison between groups showed a significant difference of bone resorption at 3 and 9 months (2.40 and 2.88 mm, respectively). CONCLUSION: The use of lyophilized demineralized bovine bone granules in socket preservation to fill in the extraction socket seems essential in preserving the alveolar bone dimension as it showed excellent soft and hard tissue healing. This study concludes that the alveolar bone socket exhibited a dynamic process of resorption from the first day of tooth extraction. Evidence shows the possibility of using bovine bone granules routinely in socket volume preservation techniques following tooth extraction.

CBCT analysis of bony changes associated with temporomandibular disorders.

OBJECTIVES: The aim of the present study was to compare cone-beam computerized tomography (CBCT) findings and joint space measurement in temporomandibular disorder (TMD) and non-TMD joints, and to correlate these findings with the clinical diagnosis. METHODS: The study was conducted on patients diagnosed with temporomandibular joint (TMJ) osteoarthritis or closed lock according to the Research Diagnostic Criteria for TMDs (Group IIb, IIc, and III). CBCT and clinical records of non-TMD patients who sought treatment for purposes other than TMD were used retrospectively as a control. The following radiographic criteria were assessed: flattening, osteophyte, Ely's cyst, condylar surface irregularities, and joints' space measurements. RESULTS: Osteoarthritic joints had significantly more condylar irregularities (P50.0), osteophytes (P50.0), and condylar flattening (P50.003) than non-TMD joints. Osteoarthritic joints had significantlymore superior surface irregularities (P50.0) and osteophytes (P50.006) than closed lock joints.Non-TMDjoints had significantlymore joint space (5.64+1.88) compared with osteoarthritic joints (4.57+1.97), (P50.025). The correlation among TMD, osteophytes, and flattening of the condylar surface was statistically significant (r50.331, Pv0.000). DISCUSSION: Cone-beam computerized tomography findings are significantly associated with the clinical diagnosis of TMD. Osteophytes and flattening of the condylar surface are common features of TMD.

Stylohyoid Ligament Calcification and Its Association With Dental Diseases.

OBJECTIVES: This research aimed at investigating the relationship between calcification of the stylohyoid ligaments (SHLs) and odontogenic inflammatory events. METHODS: Cone-beam computed tomography scans of 175 patients were retrospectively assessed for presence of SHL calcifications. Frequencies of 4 types of odontogenic inflammatory events were assessed using the same scans, namely dental extractions, root canal treatments, furcation lesions, and periapical lesions. Patients were telephone-interviewed and asked about histories of tonsillectomy and head and neck trauma. Mann-Whitney U and binary logistic regression tests were used to assess associations between SHL calcification and mean ranks of odontogenic inflammatory events. RESULTS: Calcification of SHLs was detected in 71 (41%) and 58 (33%) patients on the right and left sides, respectively. Tonsillectomy and trauma were reported in 14% and 10% of the sample, respectively. Amongst all inflammatory events, root canal treatments were significantly associated with SHL calcification (U = 2755; Z = -2.1; P = .035). This association was independent from patient age, tonsillectomy, trauma, and other inflammatory events (odds ratio, 1.2; 95% confidence interval, 1.0-1.4; P = .036). CONCLUSIONS: This study presents new evidence that intra-oral inflammatory events, particularly related to root canal treatments, have a stronger association with SHL dystrophic calcification than that associated with traditional predisposing factors (ie, old age, tonsillectomy, and trauma).

Analysis of the Volumetric Asymmetry of the Mandibular Condyles Using CBCT.

OBJECTIVES: The aim of this study was to analyse volumetric asymmetries between the right and left condyles in relation to age, gender, and dental status. MATERIALS AND METHODS: A retrospective analysis of 150 cone beam computed tomography (CBCT) scans was conducted. A single investigator performed the volumetric analysis of the CBCT scans using Vesalius 3D software. The volumetric data were analysed in relation to the gender, age, and dental status. RESULTS: The mean right condylar volume was significantly higher (P < .01) than the left condylar volume. Right and left condylar volumes were significantly higher (P < .01) in male study participants when compared to female study participants. There was no significant difference (P = .47) in the volumetric asymmetry between the male and female study participants. The volumetric asymmetry was significantly higher (P < .01) in the older age groups when compared to the younger age groups. The volumetric asymmetry was significantly higher (P < .01) in the partially and completely edentulous patients when compared to the dentate study participants. The condylar volume on the side having a partially edentulous area was significantly lower than the condylar volume of the contralateral dentate side (P < .001). CONCLUSIONS: The volumetric asymmetry between the right and left condyle significantly increases with age and edentulousness. The result of the study encourages the clinicians to perform volumetric evaluation of the condyles in cases of radiographically evident condylar asymmetries to obtain a more accurate diagnosis.

Large cemento-ossifying fibroma of the mandible involving the infratemporal and parapharyngeal spaces.

Cemento-ossifying fibroma is a benign fibro-osseous lesion of the jaws. Cemento-ossifying fibroma develops from the periodontal ligament and contains multipotent stem cells that can form cementum, lamellar bone, and/or fibrous tissue. These tumours occur in the third and fourth decades of life with higher predilection of occurrence in the female population and seldom attain a large size. We report a rare case of cemento-ossifying fibroma in a 45-year-old man involving the body of the mandible and extending into the para-pharyngeal and infratemporal region. This article describes the clinical, radiographic, and histological features of a large cemento-ossifying fibroma of the mandible.

Application of a Cone-Beam Computed Tomography-Based Index for Evaluating Surgical Sites Prior to Sinus Lift Procedures-A Pilot Study.

OBJECTIVES: Radiography-based indices can help surgeons perform detailed examinations of the surgical site and predict the surgical difficulty of cases. We aimed to develop and validate a novel CBCT-based index that can predict the surgical difficulty of sinus-augmentation procedures. MATERIALS AND METHODS: In the first stage, five experienced dental specialists performed a review of the literature and closed group discussions and designed the novel index. In the next stage, the index was validated. CBCT scans of 30 patients scheduled for sinus-augmentation procedures were evaluated and assigned presurgical CBCT evaluation scores (PSCESs) by five examiners. Subsequently, one oral surgeon performed sinus augmentation using the lateral antrostomy technique and assigned surgical difficulty scores (SDSs) to each of the 30 cases along with 2 observers. The PSCESs and SDSs were statistically analysed to determine the interrater reliability and validity of the index. RESULTS: The interrater agreement of the PSCES among the five presurgical evaluators was 0.85. The PSCES of the five evaluators had highly significant correlation (P < 0.001, r = 0.68 to 0.76) with the SDS. Regression analysis revealed that for every unit increase in the PSCES, there is 0.46 to 0.57 increase in the SDS value. CONCLUSION: The results of this pilot study revealed that a novel CBCT-based index can be used as a reliable tool for predicting the surgical difficulty of sinus-augmentation procedures. However, the novel index needs to be tested on a larger sample of patients and evaluators for a more concrete validity and reliability.

A study on the association between accessory maxillary ostium and maxillary sinus mucosal thickening using cone beam computed tomography.

BACKGROUND: Accessory maxillary ostium (AMO) has a major role to play in the aetiology of maxillary sinusitis. Mucosal thickening is one of the key radiographic features of chronic maxillary sinusitis. The aim of this study was to identify the location of the AMOs and investigate the association between Mucosal Thickening [MT] and AMO using Cone Beam Computed Tomography [CBCT]. METHODS: CBCT scans of 400 maxillary sinuses from the records of 200 patients who seeked various dental treatments at the Thumbay Dental Hospital, Gulf Medical University, Ajman, United Arab Emirates were evaluated. The incidence, anatomical position and maximal length of accessory maxillary ostia (AMO) in the maxillary antrum were reviewed using CBCT by two examiners. The association between MTs and AMOs were also analysed. RESULTS: Among the 200 CBCT scans, 131 belonged to male patients and 69 scans belonged to female subjects within the age group of 18-65 years (mean age 41.32 years). AMOs were found in 142 maxillary antra (35.5 %). The inter-observer reliability for using CBCT to detect AMO was (k = 0.83). There was no significant difference in the frequency of AMOs when the age (P = 0.19) and gender (P = 0.54) distribution were considered. Sinuses with AMOs, showed significantly greater frequency of MTs (p = 0.001). AMOs with maximal length of less than 1mm were most commonly observed (51.40 %). AMOs with larger greater maximal length were associated with higher degrees of MT. The location of the AMOs, were not affected by the degree of MT. CONCLUSIONS: The study demonstrates a clear association between degree of MT and occurrence of AMO in the maxillary sinus. However, the location of the AMO is independent of the degree of the MT. There is a greater probability of finding an AMO in the maxillary sinus if the MT in the sinus is more than 3 mm.

Cone Beam Computed Tomography Analysis of Root and Root Canal Morphology of First Permanent Lower Molars in a Middle East Subpopulation.

AIM: The aim of this study was to investigate variations in the number of roots and root canals in first permanent lower molars (FPLMs) using cone beam computed tomography (CBCT). MATERIALS AND METHODS: A total of 640 CBCT images were analyzed using SIDEXIS XG software version 2.62 (Sirona Dental Systems, Bensheim, Germany). The entire root anatomy of FPLMs was investigated in three dimensions and the number of roots, root canals, and the number of canals per root were recorded. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) software, version 24, (IBM Corporation, USA) to determine the relationship between root anatomy and gender, age, or tooth location (right or left side). RESULTS: The majority of FPLMs had two roots (96%), whereas the remaining 32 FPLMs (4%) had three roots. Almost two-thirds of the sample (62.7%) had three root canals, whereas only three cases (0.4%) of the FPLMs had six canals. When comparing bilateral differences in the distribution of root canals, it was determined that a quarter of FPLMs (24.1%) had an unequal number of canals. Moreover, there were differences in the number of additional canals between the mesial and distal roots with 17.5% of the former having three canals as compared with only 0.5% of the distal root. Interestingly, not more than one canal was observed in all additional root cases. No significant differences were observed in the number of canals between males and females or between right and left sides of the examined FPLMs (P > 0.05). CONCLUSION: Dental clinicians should be aware of the presence of an additional root in 4% of FPLMs, and about a quarter of the cases (27%) had an extra middle mesial canal in the mesial root, which was found to be more prevalent in middle age groups.

Prevalence of temporomandibular disorders discovered incidentally during routine dental examination using the Research Diagnostic Criteria for Temporomandibular Disorders.

OBJECTIVES: The aim of this study was to assess the prevalence of temporomandibular disorders (TMDs) discovered incidentally during routine dental examination, identify disease patterns, and evaluate patients' attitude toward accepting treatment. STUDY DESIGN: A total of 3009 patients were examined at the University Dental Hospital Sharjah (Sharjah, United Arab Emirates). Research Diagnostic Criteria for TMD (RDC/TMD) Axes I and II were used for assessment. Patients with acute/serious dysfunction symptoms underwent cone beam computed tomography examination. Magnetic resonance imaging was used to confirm the diagnosis of disk displacement. RESULTS: Non-self-reported TMD prevalence was 10.8% (n = 325). Among patients with TMDs, women were diagnosed more often (65.85%) (P < .05) and those between ages 25 and 45 years (65.54%) (P < .05). Axis I assessment revealed disk displacement with reduction (group IIa) was the most common (40.92%). Axis II chronic pain grade showed that 32.62% of patients with TMDs experienced chronic pain, whereas 66.77% had mild disability. Interest in pursuing treatment was indicated by 92.31% of patients. Cone beam computed tomography and magnetic resonance imaging assessments changed the primary diagnosis in 26.08% and 18.47% of cases, respectively. CONCLUSIONS: TMD screening during routine dental examination led to the diagnosis of non-self-reported TMDs, most commonly related to disk displacement with reduction. Radiographic assessment was important to confirm TMD diagnosis. Patients diagnosed with TMD during dental screening expressed interest in pursuing treatment.

Biomechanical and radiological assessment of immediate implants for alveolar ridge preservation.

BACKGROUND: The aim of this study was to evaluate the stability of immediate implant placement for alveolar bone augmentation and preservation with bovine bone graft following atraumatic tooth extraction. MATERIALS AND METHODS: This was a prospective interventional study with convenient sampling (n = 10). Thirty patients aged between 18 and 40 years, who needed noncomplicated tooth extraction of mandibular premolar tooth, were sequentially divided equally into three groups. In Group I, simple extraction was done and the empty extraction socket left to heal conventionally. In Group II, extraction sockets were filled with lyophilized bovine granules only. In Group III, immediate implants were placed into extraction sockets, and the buccal gap was also filled with bovine granules. All groups were subjected to cone beam computed tomography scan for radiological evaluation. Assessment of biomechanical stability (radiofrequency analysis [RFA] was performed at 9 months postoperative for Group III to assess the degree of secondary stability of the implants using Osstell. Repeated measure analysis of variance (ANOVA) test was applied when comparing within each group at three different time intervals, whereas one-way ANOVA was applied followed by post hoc-tukey test when comparing between groups. P < 0.05 was considered statistically significant. RESULTS: Radiological assessment reveals a significant difference of bone resorption in alveolar dimension within Group I; 1.49 mm (P = 0.002), and 0.82 mm (P = 0.005), respectively, between day 0 and 3 months. Comparison between Group I and III showed a highly significant difference of bone resorption in ridge width at 3 months 2.56 mm (P = 0.001) and at 9 months interval 3.2 mm (P < 0.001). High RFA values demonstrating an excellent biomechanical stability were observed in Group III at 9 months postoperatively. CONCLUSION: The insertion of immediate implants in extraction sockets with bovine bone augmentation of the buccal gap was able to preserve a greater amount of alveolar ridge volume.