Barriers and challenges faced by orthodontists in providing orthodontic care and implementing new innovative technologies in the field of orthodontics among children and adults: a qualitative study.

Orthodontic treatment requires the cooperation of patients as well as orthodontists. Therefore, the aim of the study was to investigate and address the challenges and barriers orthodontists have in achieving the desired orthodontic results, as well as make recommendations for ways to address the stated problems and introduce new innovative technologies to the area of orthodontics. This qualitative study wasbased on the grounded theory. Twelve orthodontists participated in face-to-face interviews, which were primarily comprised of open-ended questions. Data analysis was carried out manually using the "by hand" method. Orthodontists between the age group of 29-42 were interviewed. The answers varied depending on the years of experience of the interviewees. Teenagers and boys were found to be most non-compliant with the treatment. The average treatment span ranged between 6 months for mild cases up to 3 years for severe orthodontic cases occurring most commonly in government hospitals. Patient compliance plays a major role in orthodontics. Poor oral hygiene maintenance, brackets breakage by patients, and missed appointments were the major concerns mentioned by participants and hindered getting the desired results. Patients' main worries were related to the cost of therapy, premolar extractions, the length of treatment, and the possibility of relapse. Patient counseling and reinforcement at the start of the treatment can help to overcome the challenges and barriers in orthodontics since patient motivation is a very important factor in obtaining the desired results. It is recommended to conduct more training sessions for the orthodontists in order to introduce them to new technological paradigms.

Psychometric properties of the Urdu version of the Geriatric Oral Health Assessment Index (GOHAI) and oral health-related quality of life in the elder Pakistani population.

OBJECTIVE: The study aimed to translate the English version of the Geriatric Oral Health Assessment Index, assess its reliability and validity, and demonstrate its psychometric properties with regard to OHRQoL in the elder Pakistani population. MATERIAL AND METHODS: In this cross-sectional study, 408 elder people were randomly recruited from three day-care centres. In the translation process, the translated Urdu version was reviewed by a committee of experts, followed by back-translation into English and re-reviewed by the same committee of experts. The questionnaire sought information about socio-demographic characteristics information and self-perception of oral, general health and treatment needs. OHRQoL was examined using GOHAI-U, and intraoral examination recorded the decayed, missing, and filled teeth. Reliability, internal consistency, convergent and discriminant validity of GOHAI-U were examined. RESULTS: The mean GOHAI-U score was 40.2 (SD = 5.7, range = 20-55). The Cronbach's alpha for GOHAI score was 0.71, item-scale correlation coefficients ranged from 0.63 to 0.76, and test-retest correlation ranged from 0.59 to 0.74. Three factors supported the theoretical construction in the component factor analysis of the index. For convergent validity, there was a significant relationship between the GOHAI score and self-perceived oral, general health and treatment needs (P < .05). For discriminant validity, a significant correlation was found between the GOHAI score and clinical measures of dental health status except with the carious teeth. CONCLUSION: The GOHAI-U has sufficient reliability and constructs validity to be used as an efficient measure of oral health-related quality of life in the Pakistani elder population.

The relationship between psychosocial distress and oral health status in patients with facial burns and mediation by oral health behaviour.

BACKGROUND: There is limited discussion on the influence of psychosocial factors on the oral health of patients with a facial burn injury. This report investigated the relationship between oral health and psychosocial distress in patients with facial burns and the role of oral health behaviour in mediating the relationship. METHODS: The data were part of a cross-sectional study that had systematically and randomly selected patients with > 10% total burn surface area from a burn centre in Pakistan. The oral health status (DMFT, CPI, OHI-S) and severity of facial disfigurement were assessed. Validated instruments in the Urdu language were self-administered and information relating to oral health behaviour (brushing and dental visits), oral health-related quality of life (OHIP-14), satisfaction with appearance, self-esteem, anxiety and depression, resilience, and social support were collected. The statistical analyses included simple linear regression, Pearson correlation, t-test, and ANOVA. Mediation analysis was carried out to examine the indirect effect by oral health behaviour. RESULTS: From a total of 271 participants, the majority had moderate to severe facial disfigurement (89%), low self-esteem (74.5%), and moderate to high levels of social support (95%). The level of satisfaction with appearance was low, whereas anxiety and depression were high. Disfigurement and satisfaction with appearance were associated with lower self-esteem and social support (p < 0.05). Greater severity of disfigurement, higher levels of anxiety and dissatisfaction with appearance, and lower levels of self-esteem and social support were associated with greater DMFT and OHIP-14 scores, worse periodontal and oral hygiene conditions, and less frequent tooth brushing and dental visits (p < 0.05). The main barriers to oral healthcare utilization were psychological and social issues (p < 0.05). The indirect effect by oral health behaviour was not significant for anxiety but was significant for disfigurement, satisfaction with appearance, self-esteem, and social support. CONCLUSION: There is an association between the psychosocial factors and oral health of patients with facial burns through a direct effect and mediation by oral health behaviour.

The severity of facial burns, dental caries, periodontal disease, and oral hygiene impact oral health-related quality of life of burns victims in Pakistan: a cross-sectional study.

BACKGROUND: A burn to the face and neck area leaves a visible scar that impacts the victims physically and psychologically. This report was aimed to examine the factors associated with oral health-related quality of life (OHRQoL) in patients with a facial burn injury. METHODS: Patients with facial burn who attended the Burn Care Centre in Islamabad, Pakistan were systematically and randomly invited to participate in this cross-sectional study. They underwent extra- and intra-oral examinations and, completed self-administered instruments in the Urdu language. The severity of disfigurement, dental caries experience (DMFT), periodontal disease (CPI) and oral hygiene (OHI-S) statuses were assessed. The validated instruments collected information relating to sociodemographic background, oral health behaviours, OHRQoL and satisfaction with appearance (SWAP). Information relating to the time of the incident, cause and severity (type, TBSA) of the burn were obtained from medical records. The OHRQoL prevalence of impact and severity measures were derived and analysed using simple and multiple, logistic and linear regression. RESULTS: A total of 271 patients had participated in the study. The OHIP-14 prevalence of impact was 94% with mean severity score = 37 unit (sd = 8.5). The most impacted domains were physical pain (87%), psychological disability (87%), social disability (85%) and physical discomfort (83%). The main determinants of oral health-related quality of life were poor clinical oral conditions - particularly caries, and severity deformity. Other risk factors included poor oral health behaviours, psychological distress and longer time elapsed since the incident, and sex (p < 0.05). CONCLUSION: Dental caries, the severity of the facial deformity, oral health behaviour and time are associated with oral health-related quality of life of patients with facial burns. Oral health behaviour improvement can lower the risk of developing dental problems and oral health-related quality of life impact.

Dental health status and oral health behaviours of patients with facial burn in Pakistan.

BACKGROUND: There is a limited understanding about the oral health of patients with facial burn, hence the aim was to describe the oral health status and the related risks factors. METHODS: This cross-sectional study had randomly and systematically recruited facial burn patients from the Burn Care Center, Pakistan Institute of Medical Sciences, Islamabad, from June of 2016 to July of 2017. Intraoral examination recorded the DMFT, CPI and OHI-S. Information on the socio-demographic status, self-perceived oral health, oral health behaviours were collected using a self-administered questionnaire and; the burn characteristics were obtained from the patients' medical record. The t-test, ANOVA, SLR, and chi-square test were used to examine the relationship between oral health and each factor. A parameter was derived from the clinical indices using the principal component analysis and used in the multiple linear regression analysis to determine the important factors associated with oral health status. RESULTS: A total of 271 burn patients (69% female and 31% male) had participated in the study. All of the participants had caries with mean DMFT = 10.96 (95%CI: 10.67, 11.25). There were 59.0% (95%CI: 53.15, 64.93%) and 66.1% (95%CI: 60.38, 71.73%) of the participants who had periodontitis and poor oral hygiene respectively. About 79 and 80% of the participants rated their dental and periodontal status as poor. About 78% reported brushing once daily and 89% did not practice regular dental visit. The DMFT, CPI and OHI-S were associated with the burn characteristics and oral health behaviours (p < 0.05). Dental anxiety, cost and social issues were the most cited reasons for not utilising oral health services. Greater burn severity, the longer time elapsed since the burn incident, and dental anxiety were associated with poorer oral health status and; brushing twice or more and regular dental visit, with better status (p < 0.01). CONCLUSION: Patients with oro-facial burn injury had a generally poor oral health and, the risks are greater in those with a more severe and wider area of injury, the longer time elapsed since the burn incident and dental anxiety; but a good oral hygiene practice and regular dental visits were protective against the risk.

The Association Between Economic Status and Religious Identity With Oral Health Disparities and Inequalities Around the World.

INTRODUCTION: The inequalities in oral health remain one of the current issues in the global public health agenda. The number of studies investigating health disparity by religious identity is limited and there is currently no such report relating to oral health. Similarly, there is compelling evidence for oral health disparities between socioeconomic statuses, education levels, and ethnic groups. This ecological study aimed to explore the disparity in oral health-related outcomes between Muslim and non-Muslim countries and country income status. METHODS: Publicly available data related to oral health measures, country income status, and membership in the Organization of Islamic countries were used. Five oral health-related measures were examined: caries experience (decayed, missing, and filled teeth (DMFT)), percentage of the population with no periodontal disease, and disability-adjusted life years (DALY) attributed to oral conditions, and mouth and oropharynx cancer. One-way analysis of variance (ANOVA) and Kruskal-Wallis tests were used to compare the oral health parameters by country income status and simple linear regression was used to compare the parameters between the non-member countries (n-MC) and member countries (MC). For the significant parameters, adjusted coefficients were obtained using multiple linear regression. RESULTS: From 170 countries included, 53 (31%) were MC and 117 (69%) were n-MC. Analysis showed that the mean DMFT in adults aged 35-44 years was significantly higher in the n-MC compared to MC after adjusting for country income status (p<0.05) but the latter was the stronger explanatory predictor of the outcome. The strength of the effect of country membership classification (standardized coefficient ß: DMFT35-44-year-old = -0.16) was smaller than country income status (ß = -0.60) in the multiple regression. CONCLUSION: There is significant but weak evidence from the available data to support the claim that economic status and religion contribute to oral health disparity.

Comparative in-vivo bond failure rate of orthodontic brackets when bracket base is treated with micro-abrasive blasting vs. acid etching: eighteen month randomized control trial and scanning electron microscope study.

Background: The aim of this study was threefold. Firstly, it aimed to introduce and detail a novel method for chemically etching the bases of stainless-steel orthodontic brackets. Secondly, the study sought to investigate the structural alterations within the brackets' microstructure following chemical etching compared to those with sandblasted bases, using electron microscopy analysis. Lastly, the study aimed to evaluate and compare the long-term durability and survivability of orthodontic brackets with chemically etched bases versus those with sandblasted bases, both bonded using the conventional acid etch technique with Transbond XT adhesive, over an 18-month follow-up period. Methods: The study was a randomized clinical control trial with triple blinding and split-mouth study design and consisted of two groups. The brackets in the sandblasted group were prepared by sandblasting the intaglio surface of the base of the bracket with 50 µm SiO2 particles. Hydrofluoric acid was used to roughen the base in the acid-etched group. The bases of the brackets were viewed under an electron microscope to analyze the topographical changes. Results: A total of 5,803 brackets (3,006 acid-etch, 2,797 sandblasted) in 310 patients were bonded, in a split-mouth design by the same operator. The patients were followed for 18 months. The failure rate of 2.59% and 2.7% was noted in an acid-etched and sandblasted group, respectively. There was a close approximation of curves in the Kaplan-Meier plot, and the survival distribution of the two groups in the log-rank (Mantel-Cox) test was insignificant; x2 = 0.062 (P value = 0.804). Conclusion: Acid etching if the bases of the brackets can be used as an alternative to sandblasting furthermore acid etching can be performed on the chair side.

Evaluating Case-Based Learning to Enhance Dental Student Performance in Cavity Preparation: A Pilot Study.

Background The transition from theoretical knowledge to clinical competency in operative dentistry is an ongoing challenge in dental education. Undergraduate students often face a significant gap between understanding theory and applying practical skills for diagnosing and preparing cavities, which leads to decreased confidence, increased stress, and potential errors in clinical practice. Case-based learning (CBL), an active learning strategy that emphasizes real-world scenarios, has shown promise for improving clinical skills and knowledge retention in other healthcare disciplines. This pilot study explored the potential of CBL to address the theory-practice gap and enhance confidence among undergraduate dental students in performing cavity preparations. Methods This pilot study utilized a pre and post-intervention design and involved 30 second-year dental students. Participants completed confidence surveys at three points: before CBL activity, immediately after CBL activity, and following their first clinical cavity preparation procedure. The CBL activity consisted of two components: interactive case discussions and hands-on laboratory exercises designed to simulate real-world dental procedures. The interactive discussions focused on diagnostic and treatment planning while laboratory exercises provided practical experience in cavity preparation. Data were analyzed using repeated-measures analysis of variance (ANOVA) to assess the changes in confidence levels across the three survey points. Results CBL significantly increased students' confidence across multiple dimensions (p < 0.05). Confidence in modifying cavity preparations increased from a mean of 2.91 (SD = 0.292) before CBL to 5.12 (SD = 0.331) post-CBL and further to 5.52 (SD = 0.556) after clinical practice. Similarly, confidence in understanding the basic concepts of caries removal improved from 4.82 (SD = 0.528) pre-CBL to 5.45 (SD = 0.564) post-CBL, and to 5.61 (SD = 0.556) post-clinic. However, confidence in performing cavity preparations without faculty guidance remained relatively low, increasing from a baseline mean of 2.67 (SD = 0.478) to 2.91 (SD = 0.384) post-CBL and 3.64 (SD = 0.603) post-clinic. Conclusion Incorporating CBL into the curriculum can significantly improve undergraduate students' confidence in performing cavity preparation. This approach may help bridge the theory-practice gap and better prepare students for the clinical environment. This pilot study provides promising initial data, and further research is needed to determine the long-term impact of CBL and the optimal implementation strategies.

Changes in complacency to adherence to COVID-19 preventive behavioral measures and mental health after COVID-19 vaccination among medical and dental healthcare professionals.

Medical and dental professionals should continue to adhere to preventive measures after COVID-19 vaccination due to their increased risk of exposure to the virus, particularly as new variants emerge that may heighten their risk perception and susceptibility. Therefore, this study aimed to explore the effects of COVID-19 vaccination on complacency to adherence to COVID-19 preventive behavioral measures and mental health among medical and dental professionals. In this cross-sectional study 410 medical and dental professionals were recruited from different medical and dental hospitals in Islamabad, Pakistan. The data was collected using a valid and reliable questionnaire comprising of three sections (socio-demographic, information of preventive behaviors performance against COVID-19 after vaccination, mental health status). A chi-square test and ordinal logistic regression were used for analysis. Post COVID-19 vaccination there was decrease in the frequency of use of hand washing, sanitizers (70.2%), and social distancing (60.5%), however greeting with a handshake (58.8%) and use of public transport (45.9%) seen upward trend among participants. Only face mask usage post-vaccination was statistically significant (p < .05) in association with age, marital status, and years of working Experience. The greatest decrease in the usage of masks after COVID-19 vaccination was seen in age group of 10-30 (41.7%) and working experience group of 0-5 years (39.7%). All the preventive behaviors are statistically significant (p < .05) associated with the mental status of the participants except online shopping and use of public transport. These results indicate the presence of vaccination-induced complacency in adherence to COVID-19 preventive behavioral measures among healthcare professionals.

Caries risk assessment by Caries Management by Risk Assessment (CAMBRA) Protocol among the general population of Pakistan-a multicenter analytical study.

Background: Caries risk (CR) assessment tools are used to properly identify individuals with caries risk and to improve preventive procedures and programs. A tool such as CAMBRA determines the precise protective factors of caries and identifies an individual's specific therapeutic intervention. The purpose of this study was to assess the caries risk using the CAMBRA protocol among the general population of Pakistan. Methods: This multicentre analytical study was conducted in ten dental hospitals in different provinces of Pakistan and the caries risk assessment was carried out using a questionnaire that was designed using the Caries Management by Risk Assessment (CAMBRA) protocol. All 521 participants were intra-orally examined to assess oral hygiene status and the presence of disease. Multiple logistic regression test was performed for analysis. Results: A higher number of participants (61.2%) were found to be in the moderate risk category of caries risk assessment. The males are 51% less likely to have caries compared to the females (AOR = 0.49, P = 0.081). The majority of participants (71.3%) had one or more disease indicators, with white spots and visible cavities. Those with visible, heavy plaque were 13.9 times more likely to have caries compared to those without (AOR = 13.92, P < 0.001). Those using calcium and phosphate during the last 6 months were 90% less likely to have caries compared to those not using them (AOR = 0.10, P < 0.001). There was no significant interaction between all eight risk factors retained in the final model (P > 0.05), the Hosmer and Lemeshow Test P < 0.001, classification accuracy = 87.1%, and AUC = 91.2%. Conclusion: The caries risk among the general population of Pakistan is moderate, with significant variation among age groups, education levels, and socioeconomic status.

Microleakage Assessment of Different Preparation Techniques and Pit and Fissure Sealants in Permanent Molars.

BACKGROUND: This study aimed to evaluate the predisposition of microleakage in permanent molar teeth following different preparation techniques for pits and fissure sealants. METHODS: In this cross-sectional analytical study, a dye penetration method was employed to evaluate microleakage in dental restorations. A total of 104 extracted molars were randomly assigned into two groups and further subdivided into two subgroups based on a class of sealant (filled/unfilled resin) containing 26 teeth each. Teeth in one group were prepared by a conventional method using pumice and acid etching with 37% phosphoric acid, and teeth in the other group were prepared with a 1/4-round carbide bur in a low-speed handpiece and then acid etched. In each group, 26 teeth were sealed with a filled sealant, and 26 teeth with an unfilled sealant. The chi-square test was used for the comparison of microleakage between the groups. RESULTS: Unfilled sealants prepared with bur preparation showed the lowest degree of microleakage. The greater number of teeth (17) showed no microleakage in the group of teeth prepared using the bur preparation technique. Furthermore, in dye penetration analysis, the subgroup of teeth that were filled with unfilled sealants showed a greater number of teeth (57.6%), with zero penetration, and the dye penetration scores were statistically significant among the groups with different preparation techniques (p=0.002). CONCLUSION: Teeth whose pits and fissures were prepared through 1/4 carbide bur and filled with unfilled pits and fissure sealants show less microleakage than those prepared with the conventional method and filled with filled sealants. Therefore, the choice of surface preparation technique for pit and fissure sealants can influence the effectiveness of the sealant in preventing microleakage.

Comparison of the elastic recovery and strain-in-compression of commercial and novel vinyl polysiloxane impression materials incorporating a novel crosslinking agent and a surfactant.

This study aims to formulate experimental vinylpolysiloxane (VPS) impression materials and compare their elastic recovery and strain-in-compressions with three commercial VPS materials (Aquasil, Elite, and Extrude). Five experimental materials (Exp), two hydrophobic (Exp-I and II) and three hydrophilic (Exp-III, IV and V) were developed. Exp 1 contained vinyl-terminated poly-dimethyl siloxane and a conventional cross-linking agent (poly methylhydrosiloxane), while Exp- II contained a novel cross-linking agent that is tetra-functional dimethyl-silyl-ortho-silicate (TFDMSOS). Exp III-V (hydrophilic materials) were formulated by incorporating different concentrations of non-ionic surfactant (Rhodasurf CET-2) into Exp II formulation. Measurement of elastic recovery and strain-in-compression for commercial and experimental materials were performed according to ISO4823 standard using the calibrated mechanical testing machine (Tinius Olsen). One-way analysis of variance (one-way ANOVA) and Tukey's post-hoc (HSD) test were used for statistical analysis and a p-value of ≤ 0.05 was considered significant. Exp-I has statistically similar values to commercial VPS. The Exp-II showed the highest elastic recovery, while % elastic recovery was reduced with the addition of the non-ionic surfactant (Rhodasurf CET-2). The % reduction was directly related to the concentration of Rhodasurf CET-2. In addition, Exp II had significantly higher strain-in-compression values compared to Exp-I and commercial materials. These values were further increased with the addition of a non-ionic surfactant (Rhodasurf CET-2) was added (Exp-III, IV and V).

Dimensional changes of commercial and novel polyvinyl siloxane impression materials following sodium hypochlorite disinfection.

BACKGROUND: Dental impressions are used to record anatomy of teeth and surrounding oral structures. Impression materials become contaminated with saliva and blood requiring disinfection, which may have negative impact on dimensional stability of materials. OBJECTIVE: Comparatively evaluate linear dimensional changes of synthesized Tetra-functional (dimethylsilyl) orthosilicate (TFDMOS) containing Polyvinylsiloxane (PVS) impressions following sodium hypochlorite disinfection. METHODS: Percentage dimensional changes of three commercial PVS (Elite HD Monophase, Extrude and Aquasil Ultra Monophase) and five experimental PVS impression materials were measured. Experimental material contained novel cross-linking agent (TFDMOS) and a non-ionic surfactant (Rhodasurf CET-2) that is Exp-A (without TFDMOS), Exp-B (with TFDMOS), Exp-C (TFDMOS+ 2% Rhodasurf CET-2), Exp-D (TFDMOS+ 2.5% Rhodasurf CET-2) Exp-E (TFDMOS+ 3% Rhodasurf CET-2). Samples were made using rectangular stainless-steel molds (40 × 10 × 3 mm3) and linear dimensional changes were measured using a calibrated travelling microscope at 10× magnification after immersion in distilled water (D.W) and 1% Sodium Hypochlorite solution at two different time intervals i.e., 30 min and 24 h. RESULTS: Samples immersed in 1% NaOCl showed significant (p < 0.05) dimensional changes after 30 min of immersion. Exp-E showed significantly greater dimensional changes than their control (Exp-A and Exp-B). In distilled water, there were no significant difference among the tested materials. Aquasil exhibited highest expansion (0.06%) in both solutions. At 24 h, among the commercial materials, Extrude had the greatest expansion followed by Aquasil and Elite in DW while Aquasil showed the greatest expansion followed by Extrude and Elite in NaOCl. CONCLUSION: Experimental PVS had linear dimensional changes within the ISO 4823; 2015 recommended range. However, extended immersion can negatively affect the linear dimensions.

Risk analysis of factors in clinical anxiety among undergraduate and postgraduate students in dentistry.

BACKGROUND: When anxiety is persistent among dental students, the consequence could be poor academic performance, ill health, lack of empathy, and exhaustion. OBJECTIVE: This study aimed to determine the level of anxiety along with anxiety-provoking factors among clinical dental students. METHODS: This study included dental undergraduate and postgraduate clinical students from a public university. A modified version of the self-administered Moss and McManus questionnaire, which consisted of 50 items, was utilized to evaluate the levels of anxiety. The results were analyzed using SPSS® version 24. The significance level was set at p < 0.05. RESULTS: Within 180 participants, 140 (77.77%) were undergraduate students, while 40 (22.22%) were postgraduate dental students. Overall, the top clinical anxiety-provoking factor included failure to pass the final examination, whereas the least clinical anxiety-provoking element was communicating with the opposite gender. Significant differences existed among male and female participants in the seven anxiety-provoking factors among the participants namely dealing with elderly patients, fail to pass finals, arresting post-extraction bleeding, patients asking difficult questions, fear of accidental pulp exposure, dealing with a child or non-cooperative patient, and fear of taking an incorrect impression. Postgraduate students showed lower anxiety scores in various clinical tasks as compared to undergraduate students. CONCLUSIONS: Postgraduate dental students share largely the same perspectives with undergraduate dental students on the clinical anxiety-provoking situations with slight variations. Being the future healthcare providers, dental students must learn techniques to help them manage their dental anxiety and fear as well as deal with anxiety related to treating patients.

Physico-Mechanical Properties of Commercially Available Tissue Conditioner Modified with Synthesized Chitosan Oligosaccharide.

This study aims to compare the hardness, sorption and solubility of commercially available tissue conditioner [TC] modified with chitosan [CS] and synthesized chitosan oligosaccharide [COS] in antifungal concentration. COS was synthesized by acid hydrolysis and characterized by FTIR and XRD. Experimental materials were formulated by incorporating each per gram of TC powder with effective antifungal concentration of chitosan 1.02 mg (Group 1: TC-CS) and 0.51 mg COS (Group 2: TC-COS). A commercially available TC was used as control (Group 0: CTC). Shore A hardness test was performed according to ASTM D 2240-05 (2010) standards on samples stored in dry environment, distilled water (DW) and artificial saliva (AS) at 37 °C (n = 5 per group). Percent weight changes (n = 5 per group) after storage in DW and AS was used to record sorption and solubility. One-way Anova with post hoc Tukey's test was applied. FTIR and XRD confirmed low molecular weight and amorphous nature of COS. Experimental groups had higher Shore A hardness values; however, these changes were not significant. Greatest variations in durometer values (p ≤ 0.05) were observed during the first 24 h. Experimental groups had higher (p ≤ 0.05) percentage sorption and solubility. Samples stored in DW had significantly higher (p = 0.019) sorption, whereas material had higher (p = 0.005) solubility in AS. Mean solubility values in both immersion mediums was highest for Group 2, followed by group 1 and group 0. In addition, significant (p ≤ 0.05) increase in solubility upon aging was noted for each material. Experimental tissue conditioner had higher hardness, sorption and solubility. However, these changes are not substantial to interfere with their tissue healing property. Therefore, these materials may be considered and explored further as potential antimicrobial drug delivery agent for denture stomatitis patients.

The Impact of COVID-19 Pandemic on the Psychological Health and Dental Practice of Oral Healthcare Workers: A Scoping Review.

This study aims to identify the impact of the COVID-19 pandemic on the psychological health and dental practice of oral health-care workers (OHCWs). The search for relevant literature was carried out online using PubMed, Web of science, and science direct databases from January 2020 to February 2021. Those articles were included that provided complete information about the impact of the COVID-19 pandemic on oral health-care workers during covid-19 and were original articles and reviews. Those articles were excluded from the current study that was not in English Language and involved case reports/book chapters/short communications. Finally, only 8 articles were selected for the scoping review considering that complete information regarding the provision of dental care in the time of COVID-19 was provided. Increased psychological distress (especially those with existing comorbidities) was noted among the OHCWs during this pandemic. They had enough knowledge about COVID-19 and showed concern regarding the future of dentistry. Either complete or partial closure of dental clinics had introduced financial constraints among them. However, the majority of them did not switch their profession. The institutions were not prepared for any such situation and no training was conducted to control the spread of COVID-19 infection. OHCWs are fully aware of the knowledge regarding COVID-19 and showed concerns for dentistry and dental health-care workers during this pandemic. Complete or partial closure of dental clinics has had adverse effects on the future of dentistry, economically as well as psychologically. Institutions need to upgrade and strengthen their systems to cater to any such situation efficiently. Proper counseling sessions should be conducted for the OHCWs to monitor, identify and treat the cases found.

Work-Related Musculoskeletal Disorders and Their Associated Risk Factors among Pakistani Dental Practitioners: A Cross-Sectional Study.

Background: Work-related musculoskeletal disorders (WMSDs) have a negative impact on quality of life, and dentists are at risk of WMSDs due to the nature of work being static, repetitious, and for a long duration. The study was aimed at measuring the prevalence and distribution of work-related musculoskeletal disorders and determining the risk factors associated with affliction among Pakistani dentists. Methods: An online cross-sectional survey was conducted using a validated questionnaire consisting of four sections. The first section had questions related to sociodemographic information, the second section had questions that assessed the intensity and frequency of musculoskeletal pain (MSP), third section questions were concerned with the effect of MSP on the respondents' daily life, while the last section contained questions on whether they perceived their work in the dental clinic as a cause of their pain. Chi-square and one-way ANOVA tests were used for the analysis of the data in SPSS-23. Results: A total of 600 completely filled questionnaires were received with a response rate of 76.4%, and about 87% of the dental practitioners had some sort of MSD. The intensity and frequency of WMSDs were statistically significant (p < 0.05) in association with all the sociodemographic characteristics. The lower back area was the most reported site of WMSD pain (51.3%) followed by the neck/upper back (21.3%) and shoulder (17.6%). The site of pain was statistically significant (p < 0.05) in association with all the sociodemographic characteristics except gender (p = 0.11). A majority of participants (95.4%) had sought medical treatment and taken sick leaves (70%) due to WMSDs pain during their life. Participants attributed a number of working years and working posture as the two main reasons behind WMSDs. Conclusion: Considering the high prevalence of WMSDs among dentists, preventive strategies that minimize the occurrence of WMSDs should be adopted by dental professionals. The impact of WMSDs can be reduced by maintaining good posture, taking breaks and rest in between work, doing regular exercise, and improving the work environment.

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 the Hardness of Novel Experimental Vinyl Poly Siloxane (VPS) Impression Materials with Commercially Available Ones.

PURPOSE: To determine the hardness and Young's moduli of both commercial and experimental vinyl poly siloxane (VPS). METHODS: The purpose of this study was to develop a medium-bodied experimental (Exp-I, II, III, IV, and V) VPS impression materials and to analyse their effects on hardness and Young's modulus and compare them with three commercial VPS materials (Aquasil, Elite, and Extrude) using Shore A hardness tester. Measurements were recorded after 1, 24, 72, and 168 hours of mixing. The results were analysed with one-way ANOVA and post hoc Tukey's test using the SPSS PASW statistical 22 software. RESULTS: Commercial and experimental vinyl polysiloxane exhibited higher Shore A hardness values with time (i.e., 1 hour after mixing, 24 hours after mixing, 72 hours after mixing, and 1 week after mixing). All Comml and Exp VPS demonstrated a significant increase (ANOVA, p < 0.05) in hardness at increasing time points. Generally, all commercial VPS exhibited significantly higher values for Shore A hardness compared to all Exp formulations. For commercial products, Elt M presented significantly highest values at all-time points followed by Aq M then Extr M. Exp-I was significantly harder than all other Exp VPS at all-time points. Young's modulus values were directly related to Shore A hardness; materials with higher Shore A hardness values had higher Young's moduli. CONCLUSION: Continued polymerisation of elastomeric impression materials results in increased hardness over time. Hardness, Young's moduli, and rigidity of the set commercial and experimental VPS materials were within the required limits. Shore A hardness and Young's moduli were directly proportional to each other, and commercial and experimental materials had enough rigidity to contain the stone during pouring.

Evaluating a linkage between obesity and the occurrence of dental caries among school going children in Sakaka, Al Jouf, Kingdom of Saudi Arabia.

Background: Obesity and dental caries are global public health problems. There are conflicting reports about the relationship between caries and obesity. The aim of this study was to analyze the type of relationship between the dental caries and obesity among school children in Al-Jouf region of Saudi Arabia. Methods: This cross-sectional study was conducted among 400 participants aged 6 to 14 years. The study involved measuring caries (dmft/DMFT), assessing body mass index (BMI), and administering a self-completion questionnaire. An independent t-test, one-way ANOVA, and multivariate logistic regression analyses were performed. Results: Out of 400 participants, 380 agreed to participate in the study. Overall caries prevalence among the participants was 76.1% and mean DMFT and dmft values were 2.8 ± 1.0 and 3.7 ± 1.6. Among the factors associated with mean caries scores, relation between DMFT scores and frequency of consumption of sugar was statistically significant (F = 3.82,0.01). Regression models has identified children with increased BMI values has 3.2 times more risk of getting dental caries in permanent teeth (P = 0.001). Conclusion: There was a positive association between obesity and dental caries in school going Saudi Arabian children. Comprehensive multidisciplinary approach by health professionals is recommended for preventive public health issues related to caries and obesity in teenagers.