Dental students' attitudes and perceptions about intraprofessional collaboration/education.

Objectives: To investigate dental students' attitudes and perceptions about intraprofessional collaboration/education (IPC/IPE) and shared learning, and to explore the impact of IPC/IPE on the personal and professional development of participating students. Methods: A custom-designed questionnaire was used in this cross-sectional study. The questionnaire comprised 17 questions targeting to capture the student's perceptions about IPC/IPE using three factors: (1) dental students' preference/opinion about the IPC/IPE; (2) dental students' experience about the impact of IPC/IPE on learning outcomes and professional development; and (3) students' feedback about the significance of IPC/IPE in clinical/clinical simulation labs and workplace setting. The students rated each of the 17 statements on the 5-point Likert scale (range: 1 = strongly disagree to 5 = strongly agree). Results: A total of 259 responses were analysed (response rate = 65%). All students were aware of IPC/IPE in the field of dentistry (mean score = 4.22). The students preferred collaborative/shared learning with their own classmates. There was a consensus among students about the positive impact of IPC/IPE on enhanced learning, enhancement of communication skills, and enrichment of professional relationships with supporting staff as well as with the patients. There was also improved analytical and psychomotor skills, understanding of complex problems in the clinic, and understanding of strengths and limitations leading to self-improvement and increased efficiency and productivity. Conclusion: IPC/IPE had a compelling, powerful, and positive impact according to the experience of the participating dental students. It is recommended that a standardized curriculum be designed and guidelines set for IPC/IPE at dental institutions for effective interactions among students of all stages.

Nickel oxide nanoparticles synthesis using plant extract and evaluation of their antibacterial effects on Streptococcus mutans.

Dental decay is known in the world as the most common human infectious disease. Ascending process of dental caries index in the world shows the failure of oral disease prevention. Streptococcus mutans bacteria cause acid damage and tooth decay by producing acid over time. Nanomaterials with suitable functionality, high permeability, extremely large surface area, significant reactivity, unique mechanical features, and non-bacterial resistance can be considered as promising agents for antimicrobial and antiviral applications. In this study, nickel oxide (NiO) nanoparticles with size range from 2 to 16 nm containing Stevia natural sweetener were eco-friendly synthesized via a simple method. Additionally, their various concentrations were evaluated on S. mutans bacteria by applying the broth dilution method. The results demonstrated that these spherical NiO nanoparticles had efficient bacteriostatic activity on this gram-positive coccus.

Poly(ethylene-Co-vinyl Alcohol)/Titanium Dioxide Nanocomposite: Preparation and Characterization of Properties for Potential Use in Bone Tissue Engineering.

A series of poly(ethylene-co-vinyl alcohol)/titanium dioxide (PEVAL/TiO2) nanocomposites containing 1, 2, 3, 4 and 5 wt% TiO2 were prepared by the solvent casting method. These prepared hybrid materials were characterized by Fourier-transform infrared (FT-IR), X-ray diffraction (XRD), differential scanning calorimetry (DSC), thermogravimetric analysis (TGA) and scanning electron microscopy (SEM). The pores and their interconnections inside these nanocomposites were created using naphthalene microparticles used as a porogen after having been extracted by sublimation under a high vacuum at temperatures slightly below the glass transition temperature. A cellular activity test of these hybrid materials was performed on human gingival fibroblast cells (HGFs) in accordance with ISO 10993-5 and ISO 10993-12 standards. The bioviability (cell viability) of HGFs was evaluated after 1, 4 and 7 days using Alamar Blue®. The results were increased cell activity throughout the different culture times and a significant increase in cell activity in all samples from Day 1 to Day 7, and all systems tested showed significantly higher cell viability than the control group on Day 7 (p < 0.002). The adhesion of HGFs to the scaffolds studied by SEM showed that HGFs were successfully cultured on all types of scaffolds.

Correlation of Blood and Salivary pH Levels in Healthy, Gingivitis, and Periodontitis Patients before and after Non-Surgical Periodontal Therapy.

Periodontitis is an infectious illness which leads to the inflammation of protective tissues around the teeth and the continuous loss of alveolar bone and conjunctive tissue. Biomarker analysis in serum and saliva helps in the evaluation of disease progression and activity. It is also established that every inflammatory change along with resultant damage of tissues ends up in altered pH values in the fluids and tissues. AIM: To correlate the connection of pH levels in both blood as well as saliva in healthy, periodontitis, and gingivitis patients. MATERIALS AND METHODS: The current research involved 145 subjects amidst the age of 20 and 55 years. The subjects were split into three different groups: healthy (Group A), gingivitis (Group B), and finally chronic periodontitis (Group C). The recording of clinical parameters was done by gingival index (GI), probing depth (PD), and plaque index (PI). pH of saliva and blood was analyzed with the help of digital single electrode pH meter. Subjects have gone through scaling and root planning (SRP) coupled with the instructions of oral hygiene. They were recalled post 4 weeks, and saliva and blood samples were gathered for analyzing pH. RESULTS: Clinical parameters GI and PI were statistically important in both group C as well as group B post SRP. A crucial change has been observed in attachment levels (AL) and PD in the case of periodontitis group post SRP. The difference in the salivary pH values were significant between group B vs. C and A vs. C before the treatment because the values for group C were acidic, whereas in groups B and A the pH was alkaline. After the treatment, the values were still significant because the pH has become more alkaline compared to preoperative value in both group B and C. Saliva's pH levels have demonstrated a statistically significant reduction in group C post SRP. CONCLUSION: Salivary pH levels and blood evidently became alkaline in the group C patients post SRP and there is a positive correlation between them and the clinical parameters.

Eugenyl-2-Hydroxypropyl Methacrylate-Incorporated Experimental Dental Composite: Degree of Polymerization and In Vitro Cytotoxicity Evaluation.

The aim of this study was to evaluate the properties of new dental formulations containing eugenyl-2-hydroxypropyl methacrylate (EgGMA) monomer, as restorative dental material, in terms of their degree of photopolymerization and cytotoxicity. The target model composites (TBEg0, TBEg2.5, and TBEg5) were prepared by mixing 35% organic matrix (TEGDMA/BisGMA (50/50 wt%) of which 0, 2.5, and 5 wt%, respectively, were replaced with EgGMA monomer) with 65% filler (silanized hydroxyapatite (HA)/zinc oxide (ZnO2), 4:3 by weight). The vinylic double-bond conversion (DC) after light-curing was studied using Fourier transform infrared technique whereas cell viability was in vitro tested using primary human gingival fibroblasts cells over 7 days by means of AlamarBlue colorimetric assay. The obtained data were statistically analyzed using ANOVA and Tukey post-hoc tests. The results revealed no significant difference in DC between TBEg2.5 (66.49%) and control (TBEg0; 68.74%), whereas both differ significantly with TBEg5, likely due to the inhibitory effect of eugenol moiety at high concentration. The cell viability test indicated that all the composites are biocompatible. No significant difference was counted between TBEg2.5 and TBEg5, however, both differed significantly from the control (TBEg0). Thus, even though its apparent negative effect on polymerization, EgGMA is potentially safer than bisphenol-derived monomers. Such potential properties may encourage further investigations on term of EgGMA amount optimization, compatibility with other dental resins, and antimicrobial activity.

A Modified Approach in Lip Repositioning Surgery: A Prospective Study in a Twin Population with a 3-Year Follow-up.

This study evaluated long-term clinical and patient satisfaction outcomes following a modified lip repositioning technique that utilized periosteal sutures in a twin population. Twin sisters diagnosed with maxillary lip hypermobility were randomly assigned to either the control group (original LipStaT technique) or test group (addition of periosteal sutures). The participants (n = 12; 6 per group) were evaluated at intervals for up to 3 years postoperative. Clinical measurements, digital images, and patient satisfaction surveys were collected. Descriptive statistics were used to assess outcome variables: average lip width at rest (ALW), vertical lip translation (VLT), and average gingival display (AGD). Student t test, one-way analysis of variance, and Spearman rank correlation tests were used to compare mean values of variables at five time points for both groups. The level of significance was α = .05. In the control group, mean VLT and AGD values showed statistically significant decreases from baseline (14.8 mm and 7.0 mm, respectively) to 2 years (5.7 mm and 2.4 mm, respectively), but a slight increase was seen at 3 years (7.5 mm and 5.0 mm, respectively; P < .0001). In the test group, mean VLT and AGD values showed statistically significant decreases from baseline (14.8 mm and 6.9 mm, respectively) to 3 years (5.5 mm and 3.5 mm, respectively; P < .0001). A higher participant satisfaction score at 3-year follow-up was observed in the test group. The modified lip repositioning technique in a population of twins resulted in more stable outcomes that lasted up to 3 years postoperatively.

Comparison of Polymeric Cyanoacrylate Adhesives with Suturing in Free Gingival Graft Stability: A Split Mouth Trial.

The aim is to compare the use of Cyanoacrylate adhesives (CAA) to the conventional suturing technique in terms of free gingival grafts (FGG) stability and healing in lower anterior and premolar regions. A split mouth design was initiated on 22 participants. Each side (from 2nd premolar to central incisor) was randomized to either the control or test groups. In the control group, sutures were used to stabilize the FGG, while, in the test group, the FGG was stabilized with butyl-cyanoacrylate. Full-periodontal clinical parameters were employed to assess the periodontal health. FGG-related parameters assessed included the keratinized tissue width (KTW), gingival tissue thickness (GTT), FGG shrinkage% and pain using the VAS score. No significant differences in the mean values of the KTW nor FGG shrinkage% across six time points (p < 0.05) were observed, whereas highly significant differences in the mean values of GTT across six time points (F = 3.32; p = 0.008) were observed. The use of CAA in FGG stability and healing is comparable to conventional suturing for soft tissue grafts in terms of success outcomes. With its cost effectiveness, lesser time consumption, post-operative pain and comparable graft stability and dimensions, the use of CAA may be a promising alternative for conventional and microsurgical techniques for the stabilization of FGG in the oral cavity.

Analysis of Prosthetic Factors Affecting Peri-Implant Health: An in vivo Retrospective Study.

OBJECTIVE: To investigate and compare the various restorative and prosthetic parameters affecting peri-implant tissues' health following dental implant placement and functional loading. METHODS: A total of 484 dental implants (length>6mm, non-turned, 2-3 piece, titanium - Straumann) were evaluated for patients (male=271; female=213). Study variables such as patient's age, gender, implant restoration/crown type, crown retention, and implant crown status were assessed against various periodontal parameters (periodontal pocket depth (PPD), plaque index (PI), bleeding on probing (BOP), gingival color, and crestal bone level). All the data were analyzed using the SPSS software. RESULTS: Out of all the investigated dental implants, 201 (42%) of the implants investigated presented with BOP > one-site of the peri-implant mucosa (peri-implant mucositis), 115 (23.76%) presented with peri-implant marginal bone loss. PPD value was significantly lower in good crown status (p<0.0001). Majority of the patients with good crown status had no plaque accumulation based on the PI scores (52.7%). Only 35% of the patients whose crown status was good were having BOP when compared with 65% who did not have any BOP recorded. Gingival color (pale pink and red) showed statistically significant association with crown type (porcelain fused to metal v/s all ceramic) (p=0.005). Most of patients with crown status good had no change in their radiographic findings (94%) compared to only 6% who had implant threads exposed (p<0.0001). CONCLUSION: Optimal design of Implant prosthetic factors are vital for avoiding the development of peri-implant mucositis/peri-implantitis and must be considered during treatment planning while restoring dental implants.

Anterior loop of the mental nerve in Saudi sample in Riyadh, KSA. A cone beam computerized tomography study.

BACKGROUND: The portion of inferior alveolar nerve (IAN) existent anterior to the mental foramen, before parting the canal, is referred to as the anterior loop (AL) of the IAN. The presence of AL is important when placing the implant interforaminal area of the mandible. These anatomical discrepancies can be assessed by cone-beam CT (CBCT), for evaluating its position and exact location. The AL is classified into Types I, II and III. In Type I, Y-shaped anatomy; in Type II, anatomy is T-shaped; and in Type III, Y-shaped anatomy is seen, and the incisive branch is thicker as compared to the main branch. AIM: In this study, we aim to analyse the prevalence of different types of AL of the IAN in Saudi sample population. MATERIALS AND METHODS: The present study is a retrospective analysis of 149 (86 female & 63 male) CBCT images of patients records from 2018 June to 2018 September in the department of implant dentistry, KSMC, Riyadh. The age range of the patients who participated in the study was 30-60 years. The mean age of female participants is 42.5 ± 5.8, for the male participants is 48.6 ± 11.4 years respectively. RESULTS: The most frequent type of AL of mental nerve noticed on the right side was of type I (59.1%), followed by type II (27.5%) and type III (13.4%). The most frequent type of AL of mental nerve noticed on the left side was type I (61.7%), followed by type II (26.8%) and type III (11.4%). CONCLUSION: The results of the study encourage the usage of CBCT for planning implant treatment. We also suggest that it is obligatory for professionals to categorise the presence of AL and to measure them appropriately when planning for the procedures in the interforaminal region.

Alkaline phosphatase and acid phosphatase levels in saliva and serum of patients with healthy periodontium, gingivitis, and periodontitis before and after scaling with root planing: A clinico-biochemical study.

Periodontitis is commonly diagnosed based on clinical parameters. However, the analysis of a few unique biomarkers of the disease process present in the saliva and blood can further assist the estimation of the rate of disease progression. AIM: The present study attempted to correlate the alkaline phosphatase (ALP) and acid phosphatase (ACP) levels in saliva and serum between patients with healthy periodontium, gingivitis, and chronic periodontitis. MATERIALS AND METHODS: The present study was conducted in 135 subjects between 20 and 55 years of age. The subjects were divided into three groups, namely healthy (Group A), gingivitis (Group B), and chronic periodontitis (Group C). The clinical parameters were recorded using the plaque index (PI), gingival index (GI), and probing depth (PD). Saliva and serum were analyzed for ALP and ACP levels using an auto analyzer. All patients underwent scaling and root planning (SRP) along with oral hygiene instructions. Patients were then recalled after four weeks, and blood and saliva samples were collected to estimate ALP and ACP levels prior to clinical examination. RESULTS: The clinical parameters exhibited a statistically significant decrease in the PI and GI in both group B and group C after SRP. A significant change in the PD and attachment levels (AL) was observed in the periodontitis group after SRP. The mean salivary & serum ALP levels exhibited a statistically significant decrease in group B & C after SRP. The mean serum ACP levels exhibited a statistically significant decrease in group B & C after SRP However, the salivary ACP levels decrease after SRP was only statistically significant in group C. CONCLUSION: Serum and salivary ALP and ACP levels were markedly decreased in the gingivitis and periodontitis groups after SRP and were positively correlated with the clinical parameters.

The Association of Matrix Metalloproteinase Gene Polymorphisms and Periodontitis: An Overview.

Periodontitis is a multifactorial inflammatory disease, pathogenic bacteria being the primary etiological agents. The host response and the severity of clinical manifestation are determined by genetic and environmental factors. There is some evidence that the individual response to environmental variations in the immune response in periodontitis is associated with genetic factors. Matrix metalloproteinases (MMPs) are a family of proteolytic enzymes located in the extracellular matrix. Their primary function is the breakdown of connective tissue components. Their role in the oral cavity is very vital. In this literature review, we summarized the contemporary knowledge on the function of MMPs in oral cavity and periodontal disease.

Assessment of nosocomial bacterial contamination in dental unit waterlines: Impact of flushing.

PURPOSE: This study evaluated the extent of bacterial contamination in water from dental unit waterlines (DUWLs). METHODOLOGY: Water samples were collected (before flushing, 1 min post-flushing, and 3 min post-flushing) from 24 clinics (Group A: no disinfection, Group B: citric acid disinfectant) of a Government Dental College. Bacterial counts, identification, antibiotic sensitivity tests, determination of endotoxin levels, and scanning electron microscopy (to confirm the presence of biofilm) were performed. RESULTS: The most common opportunistic bacteria were P. aeruginosa (95%), S. aureus (58%), S. auricularis (49%), P. fluorescens (44%), and A. baumannii (20%). Approximately 50% of the bacterial isolates were resistant to two or more antibiotics. Flushing for 3 min did not reduce the contamination of water from Group A clinics which exceeded the recommendation of ≤500 CFU/ml. No bacterial growth was seen in Group B samples. Endotoxin levels were >5.00 endotoxin units (EU)/ml in Group A and ranged from 1.33 to 5.00 EU/ml in Group B clinics. Scanning electron microscopy images showed bacterial biofilms on the surfaces of the tubes. CONCLUSIONS: DUWL contamination is a serious issue in dentistry, and the microbiological quality of the water must be monitored regularly. Further studies on endotoxin exposure and prevention are therefore necessary.

Effect of iatrogenic factors on periodontal health: An epidemiological study.

INTRODUCTION: Periodontitis is a multifactorial disease. Among conglomerate etiological factors, overhanging interproximal restorations are viewed as contributing factors causing gingival inflammation due to their retentive capacity for bacterial plaque leading to periodontal destruction. Hence this study is intended to determine the prevalence of overhanging restorations and its effect on periodontal status of the teeth and to assess the iatrogenic effects of overhanging margins on periodontal health. MATERIALS AND METHODS: A total of 100 subjects of 15-65 years of age were recruited for this study. Dental restorations which affect periodontal health like amalgams, composite or glass ionomer restorations (overhanging margins proximally), fixed prosthesis, cervical abrasions, class V restorations extending sub-gingivally were included in the study. Patients with known systemic diseases, smokers, and on any medication in past 6 months were excluded from the study. Various parameters like bleeding on probing, probing depth, clinical attachment loss, biological width, gingival recession, duration of restoration were assessed according to the site of the restorations. STATISTICAL ANALYSIS: A commercially available SPSS version 20.0 Software, was used to perform the statistical analysis. The data were distributed normally and it was investigated using paired t-test. The prevalence of overhanging restorations was done through percentages comparison between restorative sites with non-restorative sites. RESULTS: The presence of sub-gingival restorations was greater in males than in females. This can be attributed to the oral hygiene maintenance of the subjects. The prevalence of sub-gingival restorations was more prevalent in the age groups between 35 and 45 years of age. CONCLUSION: This study clearly identified a higher prevalence, 50.8% of sub-gingival restorations causing gingivitis and has shown significant influence on periodontal status of the tooth.