The impact of malocclusion on the oral health related quality of life of 11-14-year-old children.

BACKGROUND: The relationship between malocclusion and the oral health related quality of life (OHRQoL) of children needs to be explored further as existing literature presents conflicting evidence. This study aims to determine the association between malocclusion and OHRQoL of 11-14-year-old children. METHODS: This cross-sectional study was conducted among 250 caregiver/child dyads seeking orthodontic consultation at a tertiary care hospital. The OHRQoL was assessed using child perception questionnaire for 11-14-year-old children (CPQ11-14) and the severity of malocclusion was assessed using the Dental Aesthetic Index (DAI). CPQ11-14 scores ranged from 0 to 64, with lower scores representing better quality of life. Analysis of variance (ANOVA) was used to assess differences between domain and total CPQ11-14 scores. RESULTS: The mean CPQ11-14 score was 19.89 ± 9.8. Mean scores for the oral symptoms, functional limitations, emotional well-being, and social well-being domains were 5.26 ± 3.22, 3.67 ± 3.58, 3.98 ± 3.89 and 2.08 ± 2.98, respectively. Normal or slight malocclusion was seen in 37.6%, definite malocclusion was seen in 22.4%, severe malocclusion in 15.2% and handicapping malocclusion in 24.8% of the subjects. In comparisons by pairs, it was found that children with handicapping malocclusion had significantly (p < 0.05) higher scores for the social well-being domain as compared with children having normal/minor malocclusion, indicating a poorer quality of life. CONCLUSION: Handicapping malocclusion had a significant negative impact on the social well-being domain of OHRQoL among 11-14-year-old children in this population.

Peri-implant mucosal response to implant-supported overdentures: A systematic review and meta-analysis.

OBJECTIVES: To systematically review and evaluate the effects of different types of attachments, implant numbers and loading protocols on the peri-implant mucosa of implant-supported overdentures (ISODs). BACKGROUND: The impact of peri-implant tissue health on the ISOD treatment outcome is unclear, and current evidence is inadequate on this aspect. MATERIALS AND METHODS: A systematic literature search for randomised controlled trials or prospective studies was conducted in indexed databases from 1995 to April 2020. The focused question was as follows: How does the peri-implant mucosa respond to implant-supported or implant-tissue-supported complete overdentures based on different types of attachments, implant numbers, and loading protocols, in terms of clinical outcomes achieved [plaque index (PI), gingival index (GI), probing pocket depth (PD) and bleeding index (BI)]? A random- or fixed-effects model was applied to measure the significance of standardised mean differences (SMD) of PD between the groups. RESULTS: Seventeen studies met the eligibility criteria. The SMD for PD between splinted/bar and unsplinted/stud attachments was 0.10 mm (95% CI: -0.27 to 0.47; P = .60) and between 2- and 4-implant groups was 0.15 mm (95% CI: -0.16 to 0.45; P = .34), which were not statistically significant. Significant difference (P = .003) was observed between immediate/early loading and delayed loading (SMD = 0.46 mm [95% CI: 0.16 to 0.75]). CONCLUSIONS: Probing depth for the immediate loaded implants was significantly higher than for the delayed loading group. No attachment type, implant number or loading protocol seemed to have a clear advantage over the other, in terms of other peri-implant mucosal outcome measures.

Utilization of dental services among low and middle income pregnant, post-partum and six-month post-partum women.

BACKGROUND: This study aims to explore the difference in the utilization pattern of dental services among pregnant, post-partum and six-month post-partum women. METHODS: This cross-sectional questionnaire survey was performed at two maternity and child care hospitals in India that primarily cater to middle and low income communities. Data were collected from 3 groups: 1) pregnant women in their first trimester; 2) post-partum women (< 48 h after delivery); and 3) six-month post-partum women. The primary outcome of interest was dental service utilization during pregnancy. Self-perceived oral health (SPOH) was calculated based on the four global dimensions- knowledge, function, quality of life and social. Multiple logistic regression analysis was carried out to assess the effect of each independent variable after adjustment for the effect of all other variables in the model. RESULTS: Responses of 450 (150 pregnant, 150 post-partum and 150 six-month post-partum) women were analyzed (response rate = 72%). Significant differences in the dental attendance pattern was observed between the study groups (p < 0.01). Dental attendance among pregnant and six-month post-partum women were 60 and 75%, respectively, however, only about 15% of the post-partum women reported to have sought dental care within the 6 months prior to the study. Post-partum women had the highest SPOH scores, indicating poor self-perceived oral health, followed by pregnant and then six-month post-partum women, which was statistically significant (p < 0.05). A significantly higher percentage of post-partum women reported to have poor oral and general health, as compared to both, pregnant and six-month post-partum women (p < 0.01). Higher percentage of women reporting 'good' oral and general health had sought dental care compared with others (p < 0.01). After adjusting for all the other variables in the model, women with lower levels of education (ORa = 1.42; 95% CI: 1.01-2.00), women with poor self-perceived oral health (ORa = 1.08; 95% CI: 1.02-1.14) and post-partum women (ORa = 0.15; 95% CI: 0.09-0.24) were found to be less likely to seek regular dental care. CONCLUSION: Pattern of dental service utilization among women in this population varied according to their pregnancy status, level of education and self-perceived oral health.

Oral Health-Related Quality of Life and Periodontal Status of Pregnant Women.

Aim The purpose of this study was to assess the difference in the oral health related quality of life (OHRQoL) and the oral health status between pregnant and non-pregnant women. Methods This cross-sectional study included 150 pregnant women (mean age 23.8 ± 3.01) and 150 non-pregnant women (mean age 25.2 ± 3.35). Data were collected through a self-administered structured questionnaire, followed by an oral examination. Oral health impact profile-49 (OHIP-49) questionnaire was used to capture the individual's perceived OHRQoL. The periodontal disease assessment was based on the pocket depth (PD) and clinical attachment loss (CAL) measured with the cemento-enamel junction as the reference point. Decayed (D), Missing(M) and Filled (F) teeth (DMFT) index was used to measure the caries experience. Results The overall OHIP score for pregnant women (47.33 ± 8.56) was significantly (p = 0.03) higher, when compared to non-pregnant women (37.87 ± 9.61). Higher scores indicate a poorer OHRQoL among the pregnant women. Fourteen items of the OHIP-49 were higher for pregnant women and the subgroups that were significantly different between the two groups were: 'functional limitation', 'physical pain', 'psychological discomfort', 'psychological disability' and 'handicap'. The mean PD and CAL for pregnant women was significantly higher than that of non-pregnant women (p < 0.01). Dichotomized DMFT scores (≤6 and >6) showed significant difference (p < 0.01) between the two groups. Multivariate regression model showed that periodontitis (p = 0.01) and pregnancy status (p < 0.01) had a positive linear relationship with OHIP-49 scores after adjusting for all other variables. Conclusion The periodontal health and OHRQoL of pregnant women was poorer than non-pregnant women.

Radiographic Diagnosis of Periapical Status and Quality of Root Canal Fillings in a Saudi Arabian Subpopulation.

PURPOSE: To assess the prevalence of apical periodontitis (AP), as determined by orthopantomograms (OPGs), and its correlation with the quality of root fillings and coronal restorations. MATERIALS AND METHODS: This cross-sectional study evaluated a random sample of 193 patients--112 (58%) females and 81 (42%) males--who presented as new patients at the Division of Endodontics. Digital OPGs were independently examined by two reliability-calibrated endodontists. The total number of teeth present, the location of the root canalfilled teeth, and the presence or absence of AP were recorded for each radiograph. The results were statistically analysed using the chi-square test followed by model building using multiple logistic regression. RESULTS: A total of 324 endodontically treated teeth from the 193 selected radiographs were analysed. The mean number of teeth per patient was 25.5 ± 4.6, with an average of 1.64 root canal treatments per subject. Radiographically detected AP was associated with 190 (58.6%) root canal-treated teeth. The logistic model shows that the quality of endodontic treatment (adjusted odds ratio [ORa] = 1.82; 95% confidence interval [CI]: 1.40-3.17), status of coronal restoration (ORa = 1.77; 95% CI: 1.20-2.61) and the type of material used for coronal restorations (ORa = 1.39; 95% CI: 1.03-1.87) were significantly related to the periapical health of the teeth. CONCLUSIONS: The quality of endodontic treatment, status of coronal restoration and the type of coronal restorative material were found to be the most important factors influencing the health of periradicular tissue.

Shear Bond Strength between Fiber-Reinforced Composite and Veneering Resin Composites with Various Adhesive Resin Systems.

PURPOSE: The aim of this research was to evaluate the shear bond strength of different laboratory resin composites bonded to a fiber-reinforced composite substrate with some intermediate adhesive resins. MATERIALS AND METHODS: Mounted test specimens of a bidirectional continuous fiber-reinforced substrate (StickNet) were randomly assigned to three equal groups. Three types of commercially available veneering resin composites - BelleGlass®, Sinfony®, and GC Gradia® were bonded to these specimens using four different adhesive resins. Half the specimens per group were stored for 24 hours; the remaining were stored for 30 days. There were 10 specimens in the test group (n). The shear bond strengths were calculated and expressed in MPa. Data were analyzed statistically, and variations in bond strength within each group were additionally evaluated by calculating the Weibull modulus. RESULTS: Shear bond values of those composites are influenced by the different bonding resins and different indirect composites. There was a significant difference in the shear bond strengths using different types of adhesive resins (p = 0.02) and using different veneering composites (p < 0.01). Belle-Glass® had the highest mean shear bond strength when bonded to StickNet substrate using both Prime & Bond NT and OptiBond Solo Plus. Sinfony® composite resin exhibited the lowest shear bond strength values when used with the same adhesive resins. The adhesive mode of failure was higher than cohesive with all laboratory composite resins bonded to the StickNet substructure at both storage times. Water storage had a tendency to lower the bond strengths of all laboratory composites, although the statistical differences were not significant. CONCLUSION: Within the limitations of this study, it was found that bonding of the veneering composite to bidirectional continuous fiber-reinforced substrate is influenced by the brand of the adhesive resin and veneering composite.

Shear bond strength between alumina substrate and prosthodontic resin composites with various adhesive resin systems.

BACKGROUND: With the increase in demand for cosmetics and esthetics, resin composite restorations and all-ceramic restorations have become an important treatment alternative. Taking into consideration the large number of prosthodontic and adhesive resins currently available, the strength and durability of these materials needs to be evaluated. This laboratory study presents the shear bond strengths of a range of veneering resin composites bonded to all-ceramic core material using different adhesive resins. METHODS: Alumina ceramic specimens (Techceram Ltd, Shipley, UK) were assigned to three groups. Three types of commercially available prosthodontic resin composites [BelleGlass®, (BG, Kerr, CA, USA), Sinfony® (SF, 3 M ESPE, Dental Products, Germany), and GC Gradia® (GCG, GC Corp, Tokyo, Japan)] were bonded to the alumina substrate using four different adhesive resins. Half the specimens per group (N = 40) were stored dry for 24 hours, the remaining were stored for 30 days in water. The bonding strength, so-called shear bond strengths between composite resin and alumina substrate were measured. Data were analysed statistically and variations in bond strength within each group were additionally evaluated by calculating the Weibull modulus. RESULTS: Bond strengths were influenced by the brand of prosthodontic resin composites. Shear bond strengths of material combinations varied from 24.17 ± 3.72-10.15 ± 3.69 MPa and 21.20 ± 4.64-7.50 ± 4.22 at 24 h and 30 days, respectively. BG resin composite compared with the other resin composites provided the strongest bond with alumina substrate (p < 0.01). SF resin composite was found to have a lower bond strength than the other composites. The Weibull moduli were highest for BG, which was bonded by using Optibond Solo Plus adhesive resin at 24 h and 30 days. There was no effect of storage time and adhesive brand on bond strength. CONCLUSION: Within the limitations of this study, the shear bond strengths of composite resins to alumina substrate are related to the composite resins.

Smoking Status of Faculty and Their Tobacco Cessation Counselling Advisory.

INTRODUCTION: Health professionals' own beliefs and practices, especially their smoking status, has been described to strongly influence their willingness to provide brief tobacco interventions (5 A's) to their patients. This study examines the association between the smoking status of faculty members in US dental programmes and (1) practice pattern; (2) perceived confidence; and (3) perceived educational preparedness of new graduates in providing the 5 A's to their patients. METHODS: This study presents data from the National Tobacco Survey of Personnel in Dental and Allied Academic Programs (TSPDAP) conducted in 2018. Faculty members in US dental/allied dental schools were invited to participate in this survey. Data were stratified based on the smoking status of the respondents as "never" and "ever" smokers (smoked <100 and ≥100 cigarettes during their lifetime, respectively). Multiple logistic regression models were used to calculate the adjusted odds ratios (aORs) and 95% confidence intervals (CIs). RESULTS: Data of 1896 participants were analysed, of whom 1032 (54.4%) were categorised as "ever" smokers. In the final regression model, low perceived barrier score was significantly associated with high practice pattern (aOR, 0.94; 95% CI, 0.92-0.97), high perceived confidence (aOR, 0.92; 95% CI, 0.90-0.95), and high perceived educational preparedness (aOR, 0.97; 95% CI, 0.94-0.98) in delivering the 5 A's to patients. Similarly, high perceived effectiveness was significantly associated with high practice pattern (aOR, 1.08; 95% CI, 1.05-1.11), high perceived confidence (aOR, 1.10; 95% CI, 1.06-1.13), and high perceived educational preparedness (aOR, 1.06; 95% CI, 1.03-1.09) in delivering the 5 A's to their patients. The smoking status of the dental personnel did not show any significant association with practice pattern, perceived confidence, or perceived educational preparedness in delivering the 5 A's to their patients. CONCLUSIONS: The smoking status of oral health care personnel was not significantly associated with their participation in tobacco cessation interventions.

Influence of Lifestyle on Dental Health Behavior.

BACKGROUND: Lifestyle is a general way of living, which is based on the interplay between living conditions, and individual patterns of behavior as determined by socio-cultural factors, and personal characteristics. There is a paucity of studies assessing the role of various factors, including lifestyle, on the dental health behavior. The present study aims to determine the factors that influence the dental health behavior among a subgroup of adult patients attending a tertiary care center in Riyadh, Saudi Arabia. METHODS: This cross-sectional questionnaire survey was conducted at King Abdulaziz Medical City, Riyadh, Saudi Arabia. The questionnaires were distributed to a convenient sample of 300 individuals, which gathered information on the socio-demographic data, lifestyle and dental health behaviors. Bivariate analyses were used to explore the associations between each of the covariates and p-value < 0.05 was considered to be statistically significant. Multivariate logistic regression model was built using backward stepwise method for the dependent variable 'dental behavior'. RESULTS: Of the 300 questionnaires that were distributed, 279 were returned completed (response rate = 93%). The majority of our samples were Saudis (73.1%) and females (54.1%), with more than half the respondents having completed baccalaureate degree (55.2%) and about a quarter with either Masters or PhD. The mean age ± SD of the respondents was 35 ± 9.1 and the median age of '32 years' was used to categorize the age (≤32 and > 32). Multivariate logistic regression analysis showed that gender (ORa = 2.84; 95% CI: 1.63-4.95), age (ORa = 0.51; 95% CI: 0.3-0.87) and lifestyle (ORa = 1.4; 95% CI: 1.18-1.68) were independently associated with dental behavior after adjusting for all the other variables. Age, gender and nationality were also found to be significantly associated with lifestyle (p < 0.01). CONCLUSION: Older adults, women and individuals with a healthy lifestyle were found to be significantly associated with positive dental behaviors.

Perception of general dentists and laypersons towards altered smile aesthetics.

OBJECTIVES: This study aimed to evaluate how dental practitioners and laypersons differ in their perception of altered smile aesthetics based on viewing images of a digitally manipulated smile. MATERIALS AND METHODS: A photograph with close to ideal smile characteristics was selected and digitally manipulated to create changes in buccal corridor space (BCS), midline diastema, gingival display, and midline shift. These altered images were rated by two groups: dental practitioners and lay persons using a visual analogue scale. The mean ± standard deviation (SD) of both groups were calculated and the Student's t-test was used to identify any statistically significant differences between the groups. Data analysis was done using the Statistical Package for Social Science (version 23.0; SPSS Inc., Chicago, Illinois, USA). RESULTS: The dentists were more sensitive to changes in the midline shift than laypeople and provided lower scores. There were no significant differences between the two groups when the gingival display alteration was ≤3 mm. However, for gingival display of 4 mm and 5 mm, there was significant difference between the two groups, with dentist rating them poorer as compared with the laypeople (P < 0.001). Dentists were more sensitive than the laypeople for midline diastema of 2 mm and 3 mm (P < 0.001 and P = 0.005 respectively). Changes in the BCS had minimal impact on the overall esthetic score for both the groups. CONCLUSIONS: Perception of smile esthetics differed between dentists and laypersons.

Effects of myrrh on the strength of suture materials: an in vitro study.

The present in vitro study sought to determine the effects of myrrh-containing solutions on common suture materials used in periodontal surgery. Three commonly used suture materials (silk, polyglactin 910, polytetrafluoroethylene) were immersed in four thermostatically controlled experimental media to simulate daily oral rinsing activity, namely -artificial saliva, normal saline solution with 0.2% Commiphora myrrh, full-concentration (100%) Commiphora myrrh oil, and a myrrh-containing commercial mouthwash. Tensile strength was measured at the end of each day using an Instron tensile testing machine. Silk sutures were susceptible to tensile strength loss when exposed to 0.2% myrrh solution once daily for 5 days. Myrrh-containing commercial mouthwash had no effect on tensile strength, but all three suture materials lost tensile strength when exposed to 100% myrrh oil. For patients that routinely use myrrh mouthwashes postoperatively, findings of this study suggested that silk sutures might not be the optimal material choice.

Marginal adaptation of mineral trioxide aggregate (MTA) to root dentin surface with orthograde/retrograde application techniques: A microcomputed tomographic analysis.

BACKGROUND: Achieving a good apical seal for root canals is known to be associated with good mineral trioxide aggregate (MTA) adaptation to dentin. AIMS: This study aims to compare the marginal adaptation of MTA with root dentin between orthograde and retrograde application techniques using microcomputed tomography (micro-CT) analysis. SETTINGS AND DESIGN: Fifty-two single-rooted human teeth were divided into four equal groups: (Group 1) Retrograde MTA (RMTA), (Group 2) Orthograde MTA (OMTA), (Group 3) Etched RMTA (ERMTA), and (Group 4) Etched OMTA (EOMTA). MATERIALS AND METHODS: For Group 1, 3-mm retrograde cavities were prepared and filled with MTA. For Group 2, the apical 6 mm of the canals were filled with MTA and sealed with sealer cement and warm gutta-percha. In Groups 3 and 4, canals were treated the same as Groups 1 and 2, respectively, except that before placing the MTA, canals were irrigated with 17% ethylenediaminetetraacetic acid (EDTA). After 48 hours, all the teeth were analyzed using a micro-CT scanner. STATISTICAL ANALYSIS: Mean dentin-MTA contact and the mean length and width of each gap was analysed using one-way analysis of variance (ANOVA). Statistical significance was set at an α level of 5%. RESULTS: No significant difference in gap volumes was observed in the dentin-MTA adaptation in both orthograde and retrograde application techniques. However, significant difference in the gap volumes was observed between RMTA and ERMTA (P = 0.045). Etching significantly improved the MTA-Dentin adaptation (P < 0.05). The type of application technique did not significantly improve the dentin-MTA adaptation, instead with the use of 17% EDTA, a significant improvement could be achieved. CONCLUSION: Within the limitations of the present study, it concludes that MTA adaptation to dentin tooth structure is not significantly different between an orthograde and retrograde approach. However, the use of EDTA significantly improved the MTA-Dentin adaptation.

The effect of orthodontic therapy on periodontal health: a review of the literature.

Objectives. This review aims to evaluate the effect of orthodontic therapy on periodontal health. Data. Original articles that reported on the effect of orthodontic therapy on periodontal health were included. The reference lists of potentially relevant review articles were also sought. Sources. A literature search was conducted using the databases, Medline, EMBASE, Cochrane Library, Web of Science, Google Scholar, and Scopus databases for relevant studies. The search was carried out by using a combined text and the MeSH search strategies: using the key words in different combinations: "periodontal disease," "orthodontics" and "root resorption." This was supplemented by hand-searching in peer-reviewed journals and cross-referenced with the articles accessed. Articles published only in English language were included. Letters to the Editor, historical reviews and unpublished articles were not sought. Conclusions. Within the limitations of the present literature review, it was observed that there is a very close inter-relationship between the periodontal health and the outcome of orthodontic therapy.

Prevalence of malocclusion and its relationship with caries among school children aged 11 - 15 years in southern India.

OBJECTIVE: To assess the prevalence of malocclusion and its relationship with dental caries among school children in southern India. METHODS: This cross-sectional study included 1,800 students aged 11 - 15 years whose Dental Aesthetic Index (DAI) and dentition status were recorded and analyzed. The chi-square test, ANOVA, and Spearman's correlation tests were carried out. RESULTS: The mean DAI score ± the standard deviation was 18.61 ± 6.1. Approximately 85% of the students (83.0% males, 86.8% females) had DAI scores of < 26 and were classified as not requiring orthodontic treatment. One tenth of the sample had mean DAI scores between 26 - 30 (indicating definite malocclusion and elective treatment), while about 3% had mean scores between 31 - 35 (indicating severe malocclusion and treatment desirability). Only 29 children (1.6%; 16 boys, 13 girls) had a DAI score of > 35, which suggested very severe or handicapping malocclusion requiring mandatory treatment. The mean decayed, missing, filled teeth (DMFT) was 2.28 ± 1.47. A DMFT of > 0 was observed in 91.8% of the study subjects. Children with a DAI score of > 35 were found to have significantly (p < 0.001) higher caries experience as compared to other children. Moreover, the DAI scores showed a significant correlation with the mean DMFT scores (r = 0.368, p < 0.05). CONCLUSIONS: A positive correlation was found between the severity of malocclusion and dental caries.