Can traditional oral hygiene methods compete with conventional toothbrushes in effectiveness?

DESIGN: The study was designed as a single-blinded, parallel, randomized controlled trial to compare the effectiveness of the Salvadora persica toothbrush (MTB), Salvadora persica chewing stick (MCS), and a standard toothbrush (STB) in controlling plaque and gingivitis. A total of 78 participants were randomly divided into three groups and instructed to use their assigned oral hygiene tool in a standardized manner for three. CASE SELECTION: Participants were non-dental students and staff of Universiti Kebangsaan Malaysia, Kuala Lumpur Campus, selected through convenience sampling. They met specific inclusion criteria, such as being systemically healthy, having ≥20 teeth, and having a Basic Periodontal Examination score of 0, 1, or 2, with no periodontal pockets greater than 5.5 mm. DATA ANALYSIS: Clinical outcomes were measured using the Plaque Index (PI) and Periodontal Inflamed Surface Area (PISA) at baseline, one-, and three-weeks post-intervention. Data analysis was performed using mixed-model analysis of variance for continuous variables and Fisher's exact test for categorical variables. RESULTS: All three groups showed significant improvements in plaque levels and severity of gingivitis from baseline to three weeks post-intervention. The MCS group demonstrated a significant improvement in mean PISA values of the anterior teeth compared to the MTB and STB groups. However, there was no significant difference in plaque level reduction or overall gingivitis severity among the three groups. This indicates that when used correctly, Salvadora persica toothbrushes and chewing sticks are as effective as standard toothbrushes in plaque control and gingival health. CONCLUSIONS: The study concludes that both Salvadora persica toothbrushes and chewing sticks can serve as effective alternatives to the standard toothbrush for plaque control and gingival health. This showcases the beneficial anti-plaque and anti-gingivitis properties of Salvadora persica. However, the effectiveness of these oral hygiene tools is contingent upon the correct usage techniques.

Intracanal calcification following regenerative endodontic treatment: a systematic review and meta-analysis.

OBJECTIVES: Calcification is a common finding in endodontic cases after regenerative endodontic therapy (RET). We aimed to identify the prevalence of intracanal calcification after RET and to compare intracanal calcification outcomes in RET using either calcium hydroxide [Ca(OH)2] or antibiotics. MATERIALS AND METHODS: We searched PubMed, Web of Science, ProQuest Dissertations & Theses, and Scopus databases for clinical, cross-sectional, case-control, and cohort RET studies published until May 2020 in the English language and reporting a calcified case after RET. The Cochrane risk-of-bias tool for randomized trials and Risk of Bias In Non-randomized Studies of Interventions were used for bias assessment. Meta-analyses were performed, overall and separately, for intracanal medicaments using a random-effects model with weighted inverse variance methods. Subgroup analysis was performed according to the calcification type. RESULTS: Eight studies were included. The overall prevalence of intracanal calcification after RET was 30.7% (95% confidence interval [CI]: 0.15-0.45,[Formula: see text]=92.6%), 46.5% with Ca(OH)2 vs. 25.8% with antibiotic-based intracanal medicaments. Subgroup analyses for complete calcification outcome showed a higher prevalence of complete calcification in the Ca(OH)2 group (46.5%, 95% CI: 0.17-0.68,[Formula: see text]%) than in the antibiotic group (10%, 95% CI: - 0.04-0.43,[Formula: see text]%). CONCLUSIONS: Based on the studies included, available evidence shows a statistically significant association between complete calcification and Ca(OH)2 paste as an intracanal medicament. Other contributing factors, such as blood clot formation and follow-up time, might also play an essential role in forming intracanal calcification. CLINICAL RELEVANCE: This study highlights the significant association between complete calcification and Ca(OH)2 paste.

A Scientometric Study of Saudi PubMed-Indexed Endodontic Research.

Scientometric studies play a crucial role in quantitatively assessing the impact and quantity of scholarly articles, providing a basis for policy-making and informed decision-making processes. Given the ongoing transformation within the Saudi scientific community across various domains, it is essential to establish a baseline for high-quality endodontic research. A comprehensive search in the PubMed database, using the keywords ["Saudi" OR "Saudi Arabia"] within the time frame of 2014 to 2021. The screening process involved evaluating the title and abstract of each article, with only those classified as endodontic articles included for analysis in this study. The analysis included factors such as the type of paper, the authors, the citations, and the year of publication. Featuring one or more authors affiliated with a Saudi dental institution, 70 papers were specifically categorized as endodontic papers. The most prevalent type of paper was case reports, accounting for 27 articles (28%), followed by literature reviews with 13 articles (18%). The number of authors ranged from one to ten, with a general trend of increasing publication rates over the years. In terms of citations, only four papers received more than 20 citations, while the majority of papers garnered between one and ten citations. Most articles in the field of endodontics exhibited low-level evidence. Therefore, it is recommended that the quality of research output and evidence be enhanced.

A Pharmacy-Based Cross-Sectional Study to Assess the Antibiotic Prescription Pattern by Medical and Dental Practitioners in Saudi Arabia.

Introduction: The misuse and overuse of antibiotics in dental practice are well known and have become widespread worldwide. Its potential effect and high risk of serious reaction have emphasized the need to reduce and limit the precipitation. In this study we aimed to identify the prevalence, type, dose, and duration of antibiotics prescribed by general medical and dental practitioners in Saudi Arabia. Materials and Methods: This cross-sectional study was performed from April 2020 to December 2020. A total of 45,100 antibiotic prescriptions were collected from different governmental and private pharmacies and screened to be included in this study. Data extraction from all prescriptions followed a standardized form that included the following information: Doctor specialty, type of antibiotic, duration, and dose of antibiotic. Results: A total of 38,175 antibiotic prescriptions prescribed by licensed doctors practicing in governmental or private hospitals were included in this study. Thirty-five thousand one hundred and seventy-eight (92%) outpatient antibiotics were prescribed by medical practitioners, and 2997 (8%) antibiotics were prescribed by dentists. The most commonly prescribed antibiotic was Augmentin (60%), followed by metronidazole and amoxicillin (35%). The most common dose and duration prescribed by dentists for Augmentin was 625 mg, 3 times per day for 5 days, whereas that of metronidazole was 500 mg, 3 times per day for 7 days. Prescribed dose and duration of amoxicillin was 500 mg, 3 times per day for 7 days. Conclusions: This study helps in understanding healthcare practitioners' patterns and adds to the knowledge on how to deal with odontogenic infections. Further national studies are recommended to include more regions in Saudi Arabia and to illustrate the misuse of outpatient antibiotics.

Endodontic Management of a Fused Mandibular Third Molar with Supernumerary Tooth Using Cone-Beam Computed Tomography: A Case Report.

BACKGROUND Dental fusion is a developmental dental anomaly that clinicians must be aware of and able to identify. It results from the union of 2 adjacent tooth germs affecting the normal dentition and leads to a decrease in the number of permanent teeth. Clinically, the fused teeth show excessive width and irregular anatomy and can complicate any endodontic intervention. CASE REPORT A 26-year-old male patient presented to the clinic with severe pain related to the lower right mandibular area. The dental examination revealed a large tilted and irregular fused third molar with the fourth molar. The endodontic findings suggested a diagnosis of symptomatic irreversible pulpitis with symptomatic apical periodontitis. An intraoral periapical radiograph revealed fused molars with an irregular morphology and a wide mesiodistal width. Cone beam computed tomography (CBCT) was performed after obtaining consent from the patient. The morphology of the involved tooth was obtained in sagittal, coronal, and axial CBCT slices of 0.13 mm. The pulp chamber was continuous, and the number of canals was 5 in the 3-dimensional view before initiating endodontic treatment. After we discussed the options with the patient, he decided to proceed with nonsurgical root canal treatment for the fused molar. A successful management of a fused third molar with a supernumerary tooth was performed, and a 6-month follow-up radiograph showed normal apical tissue with absence of tenderness on percussion or palpation. No clinical swelling or sinus tract swelling was observed. CONCLUSIONS This case report indicates that a proper treatment plan ensures predictable outcomes by the use of all available diagnostic tools.

Radicular canal disinfection by photosensitizers activated by photodynamic therapy and Er, Cr: YSGG laser bonded to glass fiber post using different cement types. An Invitro study.

AIM: To assess the tensile bond strength (TBS) of conventional glass ionomer cement (GIC) and resin cemented fiber post to radicular dentin when disinfected with different photosensitizers methylene blue photosensitizer (MBP), curcumin photosensitizer (CP), and laser therapy Er, Cr: YSGG laser (ECYL) MATERIAL AND METHODS: Sixty carefully extracted, non-traumatic, non-carious, closed apex human mandibular premolars were collected. Periodontal fibers, plaque, or calculi were detached. Decoration of samples was executed up till the cementoenamel junction. Samples were embedded perpendicularly in a heat cure acrylic resin. Canals of all specimens were shaped and cleaned with Protaper universal NiTi system dehydrated with paper points and obturated with gutta-percha. Post space was prepared after the removal of gutta-percha via peso reamers. Post space was disinfected with MBPv100mg/L in group 1; group 2 500 mg/L and group 3 ECL. After sequential photo-irradiation therapies, fiber post was luted with resinous cement and GIC (n = 10 each). After post-cementation, all specimens were subjected to tensile strength in the universal testing machine in Newton. Failure analysis was assessed at 30x magnification.TBS determination was statistically analyzed by one-way variance analysis (ANOVA), followed by the Tukey test (p= 0.05) by parallelizing different groups. RESULTS: Fiber post cemented to radicular dentin with Rely X ARC resin cement and radicular canal disinfected with CP offered the highest TBS (289.25±3.27 N). Similarly, canal space disinfected with MBP and post-luted via Rely X ARC showed the lowest TBS (281.54±4.46 N). Intragroup comparison unveiled that there is no statistical difference between tensile strength sustained by two luting cement (p>0.05). CONCLUSION: Rely X ARC resinous cement bared the highest tensile bond strength for a post-dentine-cement bond with different photo-activated canal disinfectants (Methylene blue photosensitizer, Curcumin photosensitizer) and Er, Cr: YSGG then Vidrion C (GIC).

The planetary health effects of COVID-19 in dental care: a life cycle assessment approach.

Aims COVID-19 has significantly impacted the safety guidelines for personal protective equipment (PPE) within dental services. We quantified and compared the environmental impact of different forms of PPE.Methods The PPE items were divided into three categories: 1) the body protection category, which included disposable and reusable gowns; 2) the eye protection category, which included a visor with a disposable face shield and a reusable visor; and 3) the respiratory protection category, which included respirator FP2SLw, respirator FFP2 and surgical masks. The OpenLCA software was used for analysing and comparing the environmental impact of all PPE products in the three categories.Results The life cycle assessment results of this study showed that damage to human health was more significant for the reusable gown than the disposable gown for the body-protection-category PPE. A visor with a disposable face shield had a higher environmental footprint than the reusable visor across all impact categories for the eye protection category. In addition, a visor with a disposable face shield released five times more carbon dioxide equivalent emissions and used four times more dissipated water and three times more fossil fuels than the reusable visor. A disposable gown used four times more dissipated water and three times more fossil fuels than reusable gowns. For respiratory PPE, the FP2SLw respirator had the highest burden in all 16 categories, followed by the FFP2 respirator and then the surgical mask.Conclusion The environmental impact of PPE is notable and could be reduced through using less damaging domestic products and increased usage of reusables. In addition, the selection of PPE that are reusable and made of recyclable materials can help to minimise the environmental impact and reduce environmental resource depletion.

The Validity of Pulp Tests on Crowned Teeth: A Clinical Study.

OBJECTIVE: The aim of this study was to evaluate the sensitivity and specificity of electric pulp testing (EPT) using the bridging technique in comparison to a cold test on crowned teeth. METHODS: Thirty teeth were included in this study. Only one crowned tooth from each subject was included. The adjacent teeth served as controls. The crowned teeth were tested for pulp vitality using a bridging EPT technique and cold test. Vitality was confirmed upon access based on bleeding or lack of bleeding from detected root canal systems. The data was statistically analyzed using the McNamara test (P<0.05). RESULTS: The sensitivities of the cold test and bridging EPT were 87% and 66% respectively. Accuracy for cold and bridging EPT were 87% and 67% respectively. The cold test demonstrated a statistically significant higher accuracy and sensitivity than the bridging EPT. However, no significant difference was detected in the specificity between the two tests. CONCLUSION: Both EPT and cold test should be considered as an adjunctive diagnostic tool when determining pulp status in a crowned tooth. Pulp sensitivity tests are essential but the results should be interpreted in combination with other clinical signs/symptoms.

Regenerative Endodontics: A Systematic Analysis of the Failed Cases.

INTRODUCTION: The aim of this systematic review was to analyze failed cases of regenerative endodontic treatment (RET) reported in the literature in terms of etiology, diagnosis, treatment protocols, signs of failure, and additional endodontic interventions. METHODS: Electronic searches were performed in PubMed, Web of Science, and ProQuest Dissertations & Theses databases. All in vivo publications in humans that reported at least 1 failed case of RET were included in this systematic review. Failed RET cases were defined in the current study as any case that required an additional endodontic intervention or extraction after the completion of the initial RET. RESULTS: A total of 28 studies that reported 67 failed cases of RET were included in this review. A total of 37 failed RET cases reported the etiology that resulted in the initiation of RET; 59% of these cases were caused by dental trauma, and 30% were caused by dens evaginatus. A total of 26 (39%) failed RET cases were detected at least 2 years after the initiation of RET. A total of 53 (79%) failed RET cases were presented with signs and/or symptoms of persistent infection. CONCLUSIONS: Persistent infection was the main presentation in 79% of failed RET cases. Furthermore, 39% of failed RET cases were identified after more than 2 years of follow-up. Future studies should include a detailed description of the etiology, preoperative variables, intraoperative protocols, and postoperative follow-up to provide a better understanding of failed cases after RET.