The Influence of Ferrule Design and Pulpal Extensions on the Accuracy of Fit and the Fracture Resistance of Zirconia-Reinforced Lithium Silicate Endocrowns.

The study aimed to assess the marginal, axial, and internal adaptation, as well as the fracture resistance of zirconia-reinforced lithium silicate (ZLS) endocrowns with varying pulpal inlay extensions and marginal geometry. Sixty extracted maxillary first molar teeth were divided into six groups (n = 10) according to pulpal inlay extension and marginal configuration. The first three groups (J2, J3, and J4) utilized prepared teeth for endocrowns without ferrule design and 2 mm, 3 mm, and 4 mm pulpal extensions, respectively. The second three groups (F2, F3, and F4) utilized prepared teeth with 1 mm shoulder margins and 2 mm, 3 mm, and 4 mm pulpal extensions. The endocrowns were fabricated from ZLS blocks using CAD/CAM milling technology. After cementation, the specimens underwent thermal aging for 5000 cycles and were evaluated for marginal adaptation. Using a universal testing machine, the fracture resistance was tested under quasistatic loading (1 mm/min). Two-way ANOVA and the Tukey's post hoc test were employed for data analysis (p ≤ 0.05). The results of this study revealed that endocrowns without ferrule exhibited superior fracture strength than a 1 mm ferrule design p < 0.05, irrespective of the inlay depth. All designs with and without ferrule and all inlay depths showed clinically acceptable marginal and internal fit. The conventional endocrown design without ferrule and 2 mm inlay depth showed the lowest surface gap. The pulpal surface showed the highest discrepancy among all groups compared to the other surfaces. Endocrowns without ferrule are more conservative and have higher fracture strength than 1 mm ferrule designs; extending the inlay depth showed a significant increase in fracture resistance of the 1 mm ferrule design, but not for the conventional design without ferrule and 2 mm inlay depth. All groups exhibited a high auspicious fracture strength value for molar endocrown restorations.

AUTOGENOUS DENTIN GRAFTS HAVE COMPARABLE SHORT-TERM OUTCOMES TO OTHER GRAFT MATERIALS REGARDING IMPLANT STABILITY, PREIMPLANT MARGINAL BONE LOSS, AND COMPLICATION RATE.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Efficacy of the autogenous dentin graft for implant placement: a systematic review and meta-analysis of randomized controlled trials. Mahardawi, B., Jiaranuchart, S., Tompkins, K. A., & Pimkhaokham, A. International Journal of Oral and Maxillofacial Surgery 2022 SOURCE OF FUNDING: Not reported. TYPE OF STUDY/DESIGN: Systematic review and meta-analysis.

Impact of Acrylic and Silicone-Based Soft-Liner Materials on Biting Force and Quality of Life of the Complete Denture Wearers: A Randomized Clinical Trial.

This rerandomized clinical trial evaluated the influence of soft liners (SL) on biting force, pain perception, and the oral health-related quality of life (OHRQoL) of complete denture wearers. Twenty-eight completely edentulous patients complaining of ill-fitting lower complete dentures were selected to participate in the study from the Dental Hospital, College of Dentistry, Taibah University. All patients received new complete maxillary and mandibular dentures; then they were randomly divided into two groups (14 patients in each group): the acrylic-based SL group, in which the mandibular denture was lined with an acrylic-based soft liner, and the silicone-based SL group, in which the mandibular denture was lined with a silicone-based soft liner. OHRQoL and maximum bite force (MBF) were assessed in this study before denture relining (baseline), then at one month and three months after relining. The finding showed that both treatment modalities significantly improved the OHRQoL of included patients at one-month and three-month periods compared to baseline records (i.e., dentures before relining) with a statistically significant difference (p < 0.05). However, there is no statistical difference between groups at the baseline, one-, and three-month follow-up periods. Regarding maximum biting force, when acrylic-based SL is compared to silicone-based SL, there is no statistical difference between groups at baseline (75 ± 31 and 83 ± 32 N) and one-month follow-up periods (145 ± 53 and 156 ± 49 N); however, after three months of function, the silicone-based group recorded 166 ± 57 N statistically significant high biting force compared to the acrylic-based group that recorded 116 ± 47 N (p < 0.05). Permanent soft denture liners positively affect maximum biting force, pain perception, and OHRQoL more than conventional dentures. After three months, silicone-based SL outperformed acrylic-based soft liners in maximum biting force, which may indicate better long-term results.

Efficiency of the new reciprocating and rotary systems with or without ultrasonics in removing root-canals filling with calcium silicate-based sealer (MTA).

BACKGROUND: To compare the efficiency of endodontic rotary and reciprocating systems in removing calcium silicate-sealer based fillings and to investigate the impact of passive ultrasonic irrigation (PUI) on their efficiency. MATERIALS AND METHODS: 160 root-canals were instrumented, filled with gutta-percha and calcium silicate based-sealer and divided into 10 equal groups. Five groups in which the reciprocating systems (WaveOne-Gold, Reciproc-Blue and R-Motion) and rotary systems (Fanta-AF-One and Tango-Endo) were used to remove root-canals' fillings. In the other five groups the fillings were removed by the same systems then additionally with PUI. The times to complete retreatments procedures were recorded. Micro-computed tomography's analysis of the root-canals fillings' volume before and after retreatments was used to determine the remaining filling materials (RFMs) volumes. RESULTS: The RFMs after using rotary systems (10.1%) was greater than after using reciprocating systems (3.8%) (P < 0.001). The RFMs after using WOG (2%) and RB systems (2.6%) were less than those in the RM (6.8%), TE (9.5%) and FAFO (10.7%) systems [P < 0.05]. The times required to remove the filling materials using the TE (3.7 min), FAFO (4.1 min) and RM (4.1 min) systems were shorter than those required by the RB (5.4 min) and WOG (4.9 min) systems [P < 0.05]. Using PUI resulted in less RFMs (1.44%) when compared to using only rotary or reciprocating systems (6.27%) [P < 0.001]. CONCLUSIONS: Endodontic reciprocation systems were more effective, but needed longer times than rotary systems in removing calcium silicate based- sealers fillings. The PUI significantly improved removal of the root-canals' filling materials. CLINICAL RELEVANCE: Reciprocating systems and PUI are recommended whenever root-canals retreatment is considered regardless of using calcium silicate-based sealers.

Efficiency of reciprocating systems reciprocated at different angles in removing root-canals fillings with an MTA-type sealer: an Ex-vivo study.

BACKGROUND: There have been no reports on the impact of different reciprocating angles on retreatment performance of reciprocating files. This ex-vivo study compared the efficiency of three reciprocating systems in removing MTA-type sealer-based filling materials and investigated the influence of different reciprocating angles on their retreatment ability. METHODS: 140 root-canals were instrumented to a 35 apical size and filled with an MTA-type sealer and gutta-percha cones. Samples were scanned by micro-computed-tomography and the root-canals fillings volumes were measured. Samples were divided into 7 groups according to the reciprocating angles at which the WaveOne-Gold (WOG), Reciproc-Blue (RB) and R-Motion (RM) systems were reciprocated to remove the root-canals' fillings. The WOG-150/30, WOG-90/30, RB-150/30, RB-90/30, RM-150/30 and RM-90/30 groups in which the systems were reciprocated at 150/30 and 90/30 (counterclockwise/clockwise) angles. In the RB-270/30 group the RB system was reciprocated at 270/30 angles. Samples were re-scanned and the remaining filling materials' (RFMs) volumes were measured. The percentage of the RFMs volume and its mean value for each group were calculated and data were statistically analysed at 0.05 significance level. RESULTS: The WOG system resulted in less RFMs (2.24%) when reciprocated at 90/30 angles compared to that resulted from the 150/30 angles (4.96%) [P = 0.002]. The RB system reciprocated at 90/30 angles resulted in less RFMs (2.67%) compared to that resulted from the 270/30 angles (6.64%) [P = 0.001]. The RFMs after using RM system reciprocated at 90/30 (6.02%) and 150/30 (7.61%) were greater than those of WOG (2.24 and 4.96%) and RB (2.67 and 4.34%) reciprocated at the same angles (P < 0.05). The longest time required to remove the filling materials was recorded with the RB-270/30 group (6.06 min) [P = 0.00]. The times required when the WOG, RB and RM files reciprocated at 90/30 angles (3.59, 3 and 3.05 mins, respectively) were shorter than those when files were reciprocated at 150/30 angles (5.25, 4.98 and 3.67 min, respectively) [P < 0.05]. CONCLUSIONS: The WOG and RB systems removed more MTA-type sealer-based root-canals fillings than the RM system. Lower counterclockwise reciprocating angles improve the retreatment ability of reciprocating systems, especially the WOG system and can reduce the time required for retreatment procedures.

Awareness and Practice of Oral Health Measures in Medina, Saudi Arabia: An Observational Study.

The aim of this observational study is to investigate the oral health status and practices in the multicultural community of Medina, Saudi Arabia. A cross-sectional questionnaire was distributed that asked about oral health, dental and periodontal conditions, personal attitudes toward dental care, and smoking habits. Cross tabulation with chi-squared testing was carried out to investigate the association of toothbrush usage and smoking with several variables. Four-hundred and sixty subjects enrolled in the study. The majority of the respondents were students and Saudi males. More than 75% of the participants had neither a family dentist nor dental insurance; 7% were smokers, 84% used a toothbrush, 17% used dental floss and 34% used miswak (a teeth cleaning twig made from the Salvadora persica tree). Some of the individuals complained of tooth sensitivity, halitosis and bleeding gums. The main reason for dental visits was pain, with 23% of the participants having never visited a dentist. Tooth brushing was significantly associated with gender, nationality, occupation, education, marital status, having kids and dental insurance (p ≤ 0.05). Tobacco consumption was significantly associated with age, occupation, education level, marital status, having children, having bleeding gingivae and halitosis. Effective dental education programs are needed to improve dental knowledge and awareness in the Medina community.

Antibiotic Self-Medication for Oral Conditions: Characteristics and Associated Factors

Objective: To investigate the prevalence and contributing factors of antibiotic selfmedication for oral conditions in dental patients. Material and Methods: A questionnaire was distributed to 501 patients attending Taibah University Dental College and Hospital, Al Madinah, Saudi Arabia during late 2016. Questions were on socio-demographic characteristics, and pattern of antibiotic self-medication for oral disease. Statistical analysis was performed using IBM SPSS software version 21. Statistical significance level was set at p ≤.05. Results: Age range was 15-64 years (29.08±9.32 years) with 297 females (59.3%) and 204 males (40.7%). 135 patients (27%) self-medicated with antibiotics for oral disease. This practice was statistically significantly associated with the older adults (p=0.001), lack of medical or dental insurance (p=0.014 and 0.007, respectively), and poor dental attendance (p=0.021). A number of 26 (25.7%) perceived analgesics as antibiotics. Amoxicillin-clavulanic acid was the most commonly cited antibiotic by 18 patients (17.8%). Dental pain was the most frequently reported oral condition. Pharmacists were the most common source for antibiotic prescription cited by 58 (57.4%). Conclusion: Antibiotic self-medication for oral disease is associated with the use of broad-spectrum antibiotics for non-indicated clinical oral conditions. The practice was encouraged by lenient behavior of pharmacists, lack of health insurance, and poor dental attendance.

Factors affecting oral health determinants in female university students: a cross-sectional survey in Saudi Arabia.

Objective This study aims at investigating factors affecting oral health patterns, attitudes and health risk behaviors among female university students. Methods An online questionnaire was distributed to female university students in Al Madinah in the western region of Saudi Arabia. Students were requested to answer questions on demographic data, oral hygiene practices, dental attendance, smoking history, practice of sports and body weight and height. Results Two hundred and fourteen students participated with age range of 18-31 years (mean = 21.64 ± 1.72 years). Oral hygiene habits were reported by a percentage of 97.2%, 34.6%, 30.8% and 19.2% who used a tooth brush, dental floss, mouthwash, and a miswak (a teeth cleaning twig made from the Salvadora persica tree), respectively. The only factor that was significantly associated with a good oral hygiene level was a university major of non-healthcare specialties (p = 0.009). Conclusion It is concluded that female university students use various oral hygiene methods, however, dental attendance is poor and a number of health risk factors are noticed like smoking, lack of practicing sport and unhealthy body mass index (BMI).

Survey of Ocular Prosthetics Rehabilitation in the United Kingdom, Part 2: Anophthalmic Patients' Satisfaction and Acceptance.

AIM: Ocular prostheses are integral for anophthalmic patients. Part 1 of this study reported that patients' aetiology, opinions, and attitudes significantly affected their prosthetic eyes experience. Part 2 investigates the patient satisfaction and acceptance in light of some of the aetiological demographics reported in Part 1. METHODOLOGY: One hundred sixty questionnaires were delivered to anophthalmic patients attending oculoplastic clinic. Etiological aspects presented in the questionnaire were disseminated in part 1. Patient satisfaction was assessed through 8 closed-end statements reflecting aspects concerning patient's views on prosthesis comfort and appearance; patient's expectations, self-esteem, and perception; and cooperation with ocularist. Each statement had 3 categories as agree, moderately agree, and disagree. A total of 126 questionnaires were returned (response rate was 78.8%). Data was analyzed using SPSS software. Association coefficients and correlations between variables were also analyzed. RESULTS: Total number of responses for the 8 statements was 888, averaging of 111 (expected 126) respondent per statement. Overall, 95.4% of our patients agreed with all satisfaction statements presented echoing very high satisfaction rate with their ocular prosthetics. Having an eye replacement that covers the defect is associated with high satisfaction among patients regardless of ocular prosthetic type. Patient acceptance of prosthesis in relation to employment status was high but not the same among the different categories (P > 0.05). High satisfaction with ocular prosthetics was prevalent among both genders, but there were no statistically significant differences in percentages of agreement in all statements (P > 0.05). Satisfaction and acceptance with ocular prosthetics was the same among all age groups of 12 to 85 years old (P > 0.05). CONCLUSIONS: The patient satisfaction is associated with the interplay of different variables that is related to ocular prosthesis design and its ability to disguise disfigurement (ie, prosthesis shape, resemblance to existing contra-lateral eye, etc.); patients themselves (ie, gender, age, occupation, marital status, etc); and psychological well-being and social support provided. Anophthalmic patients of the north west of England are significantly happy with their ocular prosthetic rehabilitation and support they receive from their regional hospital. Ocular prosthetics enhances their psychological well-being and social interaction and factors like patients' sex, age, employment status, and type of ocular prosthesis have no effect on their acceptance and satisfaction.

Comparison of onset anesthesia time and injection discomfort of 4% articaine and 2% mepivacaine during teeth extractions.

OBJECTIVE: To investigate the speed of action and injection discomfort of 4% articaine and 2% mepivacaine for upper teeth extractions. MATERIALS AND METHODS: Forty-five patients were included in the articaine 4% group, and 45 in the mepivacaine 2% control group. After all injections, soft and hard tissue numbness was objectively gauged by dental probe at intervals of 15 s. Furthermore, the discomfort of the injections were recorded by the patients after each treatment on standard 100 mm visual analog scales, tagged at the endpoints with "no pain" (0 mm) and "unbearable pain" (100 mm). RESULTS: There were significant differences in the meantime of first numbness to associated palatal mucosa and tooth of patients between mepivacaine and articaine buccal infiltration (BI) groups P = 0.01 and 0.01. Patients in the articaine group recorded earlier palatal mucosa and teeth numbness than those in the mepivacaine group. With regards to the discomfort of the needle injections, palatal injection was significantly more painful than BI (t-test: P < 0.001). Articaine buccal injection was significantly more painful than mepivacaine buccal injection (t-test: P <0.001). However, articaine palatal injection was less painful than articaine BI. Clinically, anesthesia onset time was faster in anterior upper teeth than upper middle and posterior teeth. CONCLUSIONS: BIs with 4% articaine was faster in achieving palate and teeth anesthesia than 2% mepivacaine for extraction of upper maxillary teeth. Patients in mepivacaine BI and articaine palatal injection groups reported less pain with needle injection. Failure of anesthesia was noticeable with maxillary multiple-rooted teeth.

Oral diseases associated with fixed prosthodontic restorations.

[No Abstract Available].

A randomized control trial comparing the visual and verbal communication methods for reducing fear and anxiety during tooth extraction.

PURPOSE: To evaluate the value of using the visual information for reducing the level of dental fear and anxiety in patients undergoing teeth extraction under LA. METHODS: A total of 64 patients were indiscriminately allotted to solitary of the study groups following reading the information sheet and signing the formal consent. If patient was in the control group, only verbal information and routine warnings were provided. If patient was in the study group, tooth extraction video was showed. The level of dental fear and anxiety was detailed by the patients on customary 100 mm visual analog scales (VAS), with "no dental fear and anxiety" (0 mm) and "severe dental distress and unease" (100 mm). Evaluation of dental apprehension and fretfulness was made pre-operatively, following visual/verbal information and post-extraction. RESULTS: There was a substantial variance among the mean dental fear and anxiety scores for both groups post-extraction (p-value < 0.05). Patients in tooth extraction video group were more comfortable after dental extraction than verbal information and routine warning group. For tooth extraction video group there were major decreases in dental distress and anxiety scores between the pre-operative and either post video information scores or postoperative scores (p-values < 0.05). Younger patients recorded higher dental fear and anxiety scores than older ones (P < 0.05). CONCLUSION: Dental fear and anxiety associated with dental extractions under local anesthesia can be reduced by showing a tooth extraction video to the patients preoperatively.

Unconventional materials and substances used in water pipe (narghile) by smokers in central western region of Saudi Arabia.

OBJECTIVES: To investigate the use of unconventional substances and materials in water pipe among café water pipe smokers. METHODS: This was a questionnaire-based survey among subjects attending coffee shops in the region of Al Madinah, Saudi Arabia between February and March 2013. RESULTS: We invited 110 subjects, only 90 consented to participate in the study. A percentage of 1.1% used fluids other than water in the water pipe tank, 18.9% added other soft drinks to the tank, and 7.8% added flowers, spices or drugs to the tobacco mix placed in the head of the water pipe. A proportion of participants used fruits to replace the water pipe head (12.2%), or to replace water pipe tank (4.4%). Higher number of children the smokers had and cafe smoking were all significantly associated with unconventional practices. CONCLUSION: A substantial percentage of sample of water pipe smokers in Al Madinah, Saudi Arabia use unusual materials and/or substances in the water pipe and this is probably encouraged by cafe smoking.