Investigating the role of internet-based educational application in the dental sciences.

The study intended to identify the significance of the online information retrieval system (IRS) in evidence-based dentistry (EBD). Thus, the researchers apply a set of pre-and post-tests to evaluate the current knowledge of clinicians and students on online IRS. Materials and Methods: The researchers followed repeated measure design in this study. They applied random sampling technique for conducting pre-and post-test assessment. Five scenarios based EBD were developed to evaluate the performance of the participants. The researchers employed two phases in order to achieve the study's objective. In the first phase, 98 clinicians and 70 students were invited to attend three out of five clinical scenarios using IRS. In the second phase, the participants were invited to participate in a 15-min lecture presented by the researchers on the searching strategies and guidelines to apply keywords for searching the evidence using IRS. A significant level of p < 0.05 was obtained from the statistical analysis using the SPSS program version 16. Results: Of the 98 clinicians, only 37 responded to the questionnaire, with a response rate of 37.8 %. On the other hand, out of 70 students, 23 responded to the questionnaire, with a response rate of 32.8 %. In the pre-test, clinicians and students correctly answered 58.3 % of scenario questions. However, the data analysis outcome revealed that only 40.5 % of participants provided a relevant evidence source after an internet search. The students spent an average of 9 min to complete the task, whereas clinicians spent 16 min. After the completion of the lecture, 23 students and clinicians responded to the pre-test, whereas 10 responded to the post-test. Most students believed that the lecture was helpful and recommended similar types of lectures to be presented in the curriculum. The study findings highlight that the percentage of evidence provided in the "pre-test" was 60 %, which was improved in the post-test to 73.3 %. Conclusion: The experimental outcome suggests that internet-based educational applications enhance students' learning strategies. Additionally, the IRS supports clinicians in retrieving effective materials for treating their patients. Furthemore, there is a demand for extracurricular activity to improve the search strategies of clinicians and students to strengthen EBD.

Managing Cardiac Patients: Dentists' Knowledge, Perceptions, and Practices.

OBJECTIVES: Dental patients may require invasive treatment, and awareness of their medical conditions is essential for optimal care. We assessed the knowledge, perceptions, and attitudes of dentists practicing in Saudi Arabia (SA) and their associations with managing patients with common cardiac conditions. METHODS: A national survey of knowledge and attitudes of practicing dentists towards patients with common cardiac conditions was conducted from May 2019 to July 2020 in SA. The survey comprised a newly developed, validated, electronic, self-administered English questionnaire. RESULTS: Overall, 282 dentists completed the survey, of whom 45.5% perceived cardiac patients as difficult to manage, while 64.5% stated that they refer these patients to cardiologists before dental intervention. Regarding knowledge about cardiac conditions, 72% achieved an overall knowledge score <55%; however, their infective endocarditis scores were better. Consultants and specialists (P < .001), those with a PhD/board certification (P = .013), dentists with prior education on cardiac patient management (P = .002), and those working with a cardiologist (P = .016) scored higher on knowledge. Conversely, private dentists (P = .003) and those referring patients to cardiologists before treatment (P = .003) scored lower. Dentists' knowledge of cardiovascular diseases in women was low; only those who believed women experience a greater risk of cardiac complications achieved a higher score. Approximately 90.1% wished to receive education regarding cardiac patient management. CONCLUSIONS: Knowledge of cardiac patient management was suboptimal in this study. Dentists perceived cardiac patients as difficult to manage, but wished to learn more regarding optimal management. Thus, postgraduate education programmes that promote optimal dental management strategies for cardiac patients are necessary.

Corrigendum to "Endodontic and Restorative Treatment Patterns of Pulpally Involved Immature Permanent Posterior Teeth".

[This corrects the article DOI: 10.1155/2018/2178535.].

Creation and Evaluation of an Endodontic Diagnosis Training Software.

OBJECTIVE: The purpose of the study is to evaluate a user-friendly, comprehensive, fully integrated web- and mobile-based application that was specifically developed to guide learners and help them practice and train in pulpal and periapical diagnosis. METHODS: The software was designed for assistance in the diagnosis of the pulpal and the periapical area. The software contained questions and tests, e.g., presence or absence of signs and symptoms, cold test, percussion, palpation, and radiographic examination that the user must answer to arrive at the final diagnosis. An electronic survey was prepared to evaluate the effectiveness, productivity, and accurateness of the software. The software and the electronic evaluation survey were sent by e-mail to dental students, endodontist, general dentists, and dental interns who study or work in four Saudi dental colleges. Data was analyzed using descriptive statistics. RESULT: A total of 203 questionnaires were completed. Results showed that 29% of the participants were highly satisfied with the software; 40% gave a very good rating about the application satisfaction, while only 2% reported a poor degree of satisfaction with the software. Results also showed that students accurately selected the correct diagnosis but received relatively low diagnostic proficiency scores because they did not request diagnostic data in a pattern similar to experts. CONCLUSION: In conclusion, the software is promising as an effective and efficient tool for teaching and assessing the diagnostic skills of learners.

Knowledge, Attitude, and Practice (KAP) of Radiographic Protection by Dental Undergraduate and Endodontic Postgraduate Students, General Practitioners, and Endodontists.

The aim of this study is to evaluate the knowledge, attitude, and perception of radiation hazard and preventive measures among dental undergraduate students, general practitioners, endodontic postgraduate students, and endodontists in Saudi Arabia. Multiple choice questions questionnaires were distributed among undergraduate and endodontic postgraduate dental students, general practitioners, and endodontists in the colleges of dentistry in Saudi Arabia, government hospitals, and private clinics. The questionnaire included sociodemographic data, assessment of the knowledge of radiation physics and biology, assessment of the practice of dental radiography, and assessment of knowledge of radiation protection. Chi-square test was used for individual and multiresponse analysis. Level of statistical significance was set at P ≤ 0.05. Three hundred and twenty-nine responded to the questionnaire. More than half of the respondents agreed that dental X-ray is hazardous to health (60.79%), and 68.1% were familiar with ALARA (as low as reasonably achievable) principle. However, only 34% are familiar with the recommendations of the National Council on Radiation Protection (NCRP) and International Commission on Radiological Protection (ICRP). The use of lead apron and thyroid collar for patients' protection from X-ray radiation was practiced among endodontic postgraduate students more frequently as well as those who are proactive in the academic field. Undergraduate students, endodontic postgraduate students, and endodontists in the academic field were the most aware towards radiation reduction measures. The use of the preventive measures needs to be emphasized more among general practitioners, endodontic postgraduate students, and endodontists especially in governmental hospitals and private sectors.

Dentinal Microcrack Formation after Root Canal Instrumentation by XP-Endo Shaper and ProTaper Universal: A Microcomputed Tomography Evaluation.

AIM: To evaluate dentinal microcrack formation on root canals instrumented, continuously in the body temperature, with XP-endo shaper (XPES) and ProTaper Universal (PTU), by means of microcomputed tomographic (micro-CT) analysis. Methodology. Nineteen mesial roots with two separate canals (Vertucci Type IV) of extracted mandibular molars were used in this study. The root canals (N = 38) were divided into 2 groups. Group 1 (n = 19): all MB canals were instrumented with XPES. Group 2 (n = 19): all ML canals were instrumented with PTU. All roots were scanned with micro-CT before and after instrumentation. Two precalibrated examiners evaluated the cross-sectional images of each sample with DataViewer program. The dentinal microcracks (complete and incomplete) were counted in each third of the root for the preinstrumentation and the postinstrumentation images. Wilcoxin signed-rank and Mann-Whitney U tests were used for statistical analysis at a significance level of P < 0.05. RESULTS: The number of microcracks increased significantly (P < 0.05) after instrumentation with XPES in the middle and cervical thirds. The number of microcracks increased significantly (P < 0.05) after instrumentation with PTU in the cervical third only. There was no significant difference between the groups in the cervical and apical thirds. In the middle third, the XPES induced more incomplete microcracks than PTU (P < 0.05). CONCLUSION: Within the limitations of this study, there was no significant difference in the dentinal microcrack formation between XPES and PTU in the apical and cervical thirds of the root. However, XPES instrumentation induced more incomplete microcracks than PTU in the middle third of human roots.

Awareness of Dental Esthetic Standards Among Dental Students and Professionals.

PURPOSE: This study investigated the level of esthetic awareness of dental students and professionals. MATERIAL AND METHODS: Photographs depicting facial and smile features that deviate from universally accepted esthetic standards were presented in a questionnaire. Participants were asked to rate the images and to identify the main discrepant criteria. Eight hundred questionnaires were distributed to dental students, and clinicians. The data were analyzed using chi-square tests, Student's t-test and one-way ANOVA with Tukey's post hoc tests for multiple comparisons. RESULTS: Students had 45.2% correct answers compared to 51.6% for clinicians. Among students, the highest awareness was found among 5th year students, followed by interns, 4th year and 3rd year students. The difference in the percentage of correct answers between clinicians and students overall was significantly higher for some criteria than for others, such as gingival esthetics, lip features, smile zone (incisal plane), facial features, and buccal corridor. Among clinicians, specialists responded correctly more often than did general practitioners in most of the investigated aspects. CONCLUSION: The ability of different group samples to diagnose discrepancies of smile esthetics was refined and enhanced with increased clinical experience and knowledge.

Antibacterial efficacy of silver diamine fluoride as a root canal irrigant.

Objectives: Conventional disinfectants and medicaments have not been able to achieve and maintain sterilization of root canals. The purpose of the study was to evaluate the antibacterial efficacy of 3.8% silver diamine fluoride (SDF) in comparison with 2% chlorhexidine (CHX) against Enterococcus faecalis biofilm. Materials and methods: Extracted human teeth were used to make 70 dentin discs that were then inoculated with E. faecalis to generate a 3-week-old biofilm model. The discs were subjected to treatment with 3.8% SDF, 2% CHX, sodium hypochlorite (NaOCl), or saline for 10 min. After exposure, the dentin discs were examined with a confocal laser scanning microscope to verify the percentage of live versus dead cells within the biofilm. Univariate one-way analysis of variance and Tukey-honestly significant difference post hoc analysis (p < .05) were performed to detect significant differences. Results and conclusion: The NaOCl group showed the greatest percentage of dead cells (62.26%) among all groups (p < .05). The SDF group showed a significantly higher percentage of dead cells (57.39%) than the 2% CHX and saline groups (p < .05). SDF possessed higher antimicrobial activity than 2% CHX against E. faecalis biofilms.

Comparison of bacterial removal from dentinal tubules with different irrigant agitation techniques: An in vitro study.

AIM: This investigation was conducted to assess the ability of various irrigant agitation devices to eradicate Enterococcus faecalis from the dentinal tubules of extracted teeth. METHODOLOGY: Fifty roots of extracted human teeth were instrumented to size 30 k with a 0.04 taper. The roots were autoclaved and then injected with E. faecalis. The canals were assigned to one of four intervention groups and disinfected using (A) standard needle irrigation, (B) EndoUltra® Ultrasonic Activator, (C) the EndoActivator system, or (D) EDDY sonic activation and to two control groups that were (E) treated with saline and (F) not inoculated with any bacteria. The roots were split in half, dyed with a LIVE/DEAD Back Light Bacterial Viability Kit, and then scanned with a confocal laser scanning microscope (CLSM) to identify live/dead bacteria in the dentinal tubules. RESULTS: CLSM images revealed differences among the groups. Both the EndoUltra® Ultrasonic Activator group and the EDDY group had a combination of dead and live bacteria, while the EndoActivator group had mostly dead bacteria, in contrast to single needle irrigation which had mostly live bacteria. Activation of the irrigating solution resulted in more dead bacteria than standard needle irrigation at the coronal, middle, and apical parts of the roots. Overall, the EndoActivator system was superior to all other techniques in reducing live bacteria within the root canal. CONCLUSION: Activation of sodium hypochlorite with sonic and ultrasonic systems dramatically reduced live bacteria contamination in the dentinal tubules of infected root canals.

Comparison of perceived pain and patients' satisfaction with traditional local anesthesia and single tooth anesthesia: A randomized clinical trial.

BACKGROUND: Contemporary innovations in the area of local anesthesia have attempted to provide an absolutely pain free experience for patients. Since the introduction of Computer-Controlled Local Anesthetic Delivery Systems to dentistry, many studies have compared its efficacy and safety to conventional anesthesia. However, very few studies have compared single tooth anesthesia (STA) and traditional local anesthesia. AIM: To compare pain rating, changes in blood pressure, and heart rate during the local anesthetic injection. The secondary objectives were to measure the patients' level of satisfaction and the differences in anesthetic efficiency between the STA system and traditional local infiltration. METHODS: A randomized controlled trial was conducted and a total of 80 patients with dental restorative needs were enrolled for the study. The patients were evaluated for their general physical status and oral clinical findings before enrollment. Information regarding perceived pain, changes in heart rate and blood pressure, and patients' satisfaction was collected using an electronic data form and was analyzed using paired and unpaired t-tests. RESULTS: No significant difference was noted in perceived pain (P = 0.59) and systolic blood pressure (P = 0.09) during anesthetic injection using both traditional and STA techniques. STA patients had a significantly higher heart rate during anesthesia, although a statistically significant difference was noted among the traditional anesthesia and the STA groups even before anesthesia. During the restorative procedure, less pain was perceived by STA patients on the Wong-Baker FACES pain scale, which was statistically significant (P < 0.001). Analyses of post-procedure patient responses showed that STA patients had a significantly better treatment experience and preferred to have the same method of injection in the future (P = 0.04). CONCLUSION: STA system can provide less painful and more comfortable restorative treatment procedures in comparison to the traditional infiltration technique.

Comparison of Cyclic Fatigue Resistance of 5 Heat-treated Nickel-titanium Reciprocating Systems in Canals with Single and Double Curvatures.

INTRODUCTION: The goal of this study was to compare the cyclic fatigue resistance of 5 heat-treated nickel-titanium files in reciprocating movement with the same tip size and different cross sections. METHODS: Five groups (WaveOne [Dentsply, Ballaigues, Switzerland], WaveOne GOLD [Dentsply], RECIPROC [VDW, Munich, Germany], RECIPROC BLUE [VDW GmbH, Munich, Germany], and TF [Sybron Endo, Glendora, CA] Adaptive) of 24 files each of the rotary files were examined. Cyclic fatigue resistance was compared between groups by determining the time needed to fracture and the number of cycles to failure in a cyclic fatigue testing device with 2 different curvatures, the first with a 5-mm radius of curvature and a 60° angle and the second with a double curvature, coronal curvature of 60° angle and a radius of 5 mm, and an apical curvature of 70° angle and a 2-mm radius. Scanning electron microscopic evaluation was performed at the fracture sites to investigate the types of fracture. RESULTS: RECIPROC BLUE group had a higher mean time to fracture followed by RECIPROC and WaveOne GOLD for both single and double curvature. WaveOne had a higher mean time to fracture in a single curvature canal than TF Adaptive, whereas the opposite was true for a double curvature canal. Both RECIPROC groups were significantly greater in cyclic fatigue resistance in comparison with all other groups (P < .05). WaveOne GOLD was significantly greater than the WaveOne and TF Adaptive groups (P < .05). CONCLUSIONS: RECIPROC BLUE files exhibited significantly greater cyclic fatigue resistance compared with other files tested in an S-shaped artificial canal.

Comparison of the Antibacterial Efficacy of Commiphora molmol and Sodium Hypochlorite as Root Canal Irrigants against Enterococcus faecalis and Fusobacterium nucleatum.

OBJECTIVE: The investigation aims to compare antimicrobial efficacy of the extract of Commiphora molmol, against Enterococcus faecalis and Fusobacterium nucleatum, with sodium hypochlorite (NaOCl). DESIGN: T he dehydrated oleo-gum resin of Commiphora molmol was extracted by using 70% ethanol and was suspended in 99.8% dimethyl sulfoxide (DMSO) as a dissolving agent in a 1:2 volume to produce an aqueous solution at room temperature. Agar-well diffusion and broth microdilution methods assay were utilized to determine both the antimicrobial activity and minimum inhibitory concentration, of alcoholic extract of Commiphora molmol against E. faecalis and F. nucleatum. The values of the inhibition zones were determined based on the concentration of the investigated material. One hundred and forty extracted human premolar teeth were instrumented and immersed in bacterial suspension of E. faecalis or F. nucleatum (70 teeth in each species suspension). Prepared teeth were then immersed in the myrrh extract solution, 2.5% NaOCl, DMSO, or Cefotaxime and incubated for 30 and 60 minutes. RESULTS: The largest inhibition zone diameter for both bacterial species was obtained by the 100mg/100µL concentration. The minimum inhibitory concentration (MIC) was 0.03mg/300µL for both E. faecalis and F. nucleatum. The minimum bactericidal concentration (MBC) results showed that 0.03mg/µL myrrh extract and 2.5% sodium hypochlorite significantly reduced bacterial growth at both 30 and 60 minutes of different treatments of root canals, compared to DMSO group (negative control) and the antibiotic group (positive group). CONCLUSION: Myrrh extract was proven to have considerable antibacterial activity against both F. nucleatum and E. faecalis.

Cutaneous draining sinus tract of odontogenic origin. A case of chronic misdiagnosis.

This is a case of a patient with a buccal cutaneous sinus tract, originally misdiagnosed, with delayed healing and potential malpractice. An odontogenic cutaneous sinus tract is a pathologic canal that initiates in the oral cavity but opens externally at the cutaneous surface of the face or neck. It is frequently misdiagnosed, leading to inappropriate treatment. Once correct diagnosis is made, definitive treatment, through oral therapy to eliminate the source of infection, is simple and effective. This case was initially misdiagnosed as a sebaceous cyst and laceration of parotid gland. The case was correctly diagnosed through detailed examination and evaluation, using tracing and advanced imaging technology (cone beam imaging). Endodontic treatment was performed, which resulted in rapid resolution of the case, followed by dermatologic treatment with fractional laser to treat the scar formed.

Effectiveness of PBL methodology in a hybrid dentistry program to enhance students' knowledge and confidence. (a pilot study).

BACKGROUND: Knowledge and self-confidence are two critical determinants of future success of dental students. The present pilot study was conducted with an objective to simultaneously assess both knowledge and confidence gained by dental undergraduate students in the Head and Neck Anatomy course by employing didactic lecture-based and problem-based learning methods. METHODS: A paper-based assessment tool comprising of 30 Multiple choice questions to assess knowledge, followed by a Likert's scale to assess students' confidence to answer the given knowledge question was designed. This tool was used in a cohort of first year dental students before the commencement of Head and Neck Anatomy course (Pre-course), immediately after the completion of Head and Neck Anatomy course (Post-course), and again in third year before the same cohort entered their clinical courses (Pre-clinics). The difference in students' knowledge and confidence through both pedagogies was evaluated by Paired 't' test. Pearson correlation analysis was done to determine the correlation between knowledge scores and self-reported confidence. RESULTS: A statistically significant increase (p < 0.05) was noted in the mean knowledge and confidence scores in the post-course evaluation, through both didactic lecture-based and problem-based learning methods. On the other hand, a significant decrease (p < 0.05) in the mean knowledge and confidence scores of didactic lecture-based items in comparison to problem-based items was noted in the pre-clinics evaluation.. The post-course evaluation results yielded a Pearson correlation coefficient of r = 0.514, p = 0.002 for lecture-based items and r = 0.495, p = 0.003 for problem-based items, denoting a positive moderate correlation between the knowledge and confidence scores for both lecture-based and problem-based methods. CONCLUSION: A significant improvement in both knowledge and self-reported confidence demonstrated at the end of Head and Neck Anatomy course proves both didactic lectures and problem-based learning methods to be equally effective in a hybrid dentistry program in the short term. However, the non-significant reduction in the pre-clinics knowledge and confidence scores among the PBL lessons proves it to be a potent learning tool for long term retention of knowledge, and sustainability of confidence.

Endodontic and Restorative Treatment Patterns of Pulpally Involved Immature Permanent Posterior Teeth.

OBJECTIVE: The study aims at investigating the treatment patterns for young permanent posterior teeth with pulp involvement. MATERIALS AND METHODS: A random sample of 1793 dental records of patients aged 6-18 years old who had received dental treatment was investigated. 663 permanent posterior treated teeth had pulp involvement. Demographic and treatment data were gathered from patients' records. RESULTS: Prevalence of young permanent teeth with pulp involvement was 36.9%. Treatments received significantly increased as patients' age increased (P=0.001). The first mandibular molar had the most pulp involvement among all teeth (43.89%). Temporary restoration was the most received restoration (59%). The most common pulpal diagnosis, leading to treatment, was irreversible pulpitis (43.04%). Only 19.8% of treated teeth received completed root canal treatment. CONCLUSION: There is a high percentage of children and adolescents with immature permanent posterior teeth with pulp involvement. Similarly, a variety of treatment patterns is present, with a small percentage of completed root canal treatment. CLINICAL RELEVANCE: The study has identified the need to provide guidelines to provide high-quality root canal treatments for young permanent posterior teeth that have pulpal involvement. Only 21.8% of root canal treatments were completed, while 24% of teeth were extracted, and 59% of patients received temporary restorative treatments. This suggests that there might be several factors that might prevent completion of the dental treatment, such as patient preference, insurance coverage, or dentist capability. These factors and guidelines for patient care should be investigated and resolved.

Educational environment as perceived by dental students at King Saud University.

OBJECTIVES: Main objectives of the present study were to develop a baseline information about dental students' perception of their educational environment at the College of Dentistry, King Saud University (KSU) in Riyadh; and to investigate the role of four different variables on the students' perception. METHODS: Dundee Ready Education Environment Measure (DREEM) questionnaire was distributed among 497 undergraduate dental students, in the second week of the first semester of the academic year, from second year students to interns studying in the College of Dentistry of King Saud University (KSU). RESULTS: Response rate was 60.73%. Mean for the total DREEM scores was 108.42/200. DREEM subscales mean were above 50% of the total score. DREEM overall score showed no significant statistical difference among the four variables investigated, except the academic year, where the second year students scored significantly higher (118.36 ±â€¯15.8) compared to the interns (105 ±â€¯21.3). CONCLUSION: Students' perception of educational environment in the KSU College of Dentistry was satisfactory. However, several weak areas were identified which need some attention and consideration.

Developing a Dental Curriculum for the 21st Century in a New Dental School in Saudi Arabia.

The aims of this study were to develop, implement, and assess a contemporary dental curriculum that would be competitive internationally and take into consideration the specific needs of the community in a newly established all-female dental school in Saudi Arabia: Princess Nourah bint AbdulRahman University College of Dentistry (PNUCD). A six-step approach to curriculum development was used. Problem identification, general needs, and target needs were identified, and goals, objectives, and educational strategies were defined. The new curriculum emphasizes producing competent dentists focused on prevention and geared toward the needs of women and children. Leadership attributes, patient-centered care, and research are emphasized in the curriculum. Contemporary educational methods are used to implement the curriculum. In the assessment part of the study, evaluations of the curriculum by students, faculty, and external stakeholders (part-time instructors, program evaluators, and patients) have been mainly positive. Overall, PNUCD provided the opportunity to develop a curriculum that reflects the explosion of scientific knowledge, based on principles of modern educational theory in a unique cultural environment.

Interprofessional learning experiences: Exploring the perception and attitudes of Saudi Arabian medical and dental students.

OBJECTIVE: The objective of this study is to evaluate the awareness and attitudes of medical and dental students regarding interprofessional learning (IPL). METHODS: A cross-sectional study was conducted with 278 female undergraduate Medical and Dental students from Princess Nourah bint Abdulrahman University, Riyadh. These students undertook IPL in the Foundation block, in basic science teaching, clinical skills' laboratories and in professionalism and learning skills' modules. A modified, validated RIPLS questionnaire with four subscales and 29 items was used to collect data regarding their perception and attitudes towards shared learning. A five-point Likert scale was used with a value ranging from 1 (strongly disagree) to 5 (strongly agree) for each item. Factor analysis was done using Varimox rotation. Student's t test was applied to detect difference between mean scores of medical and dental student's responses Results: The mean age of respondents was 19.8 ± 1.7 years with the majority in the second year of each program. There was no difference in mean responses of the medical and dental students. The respondents favored shared learning in the areas of professional skills and patient care. They agreed that IPL helps to develop respect, trust and appreciation for other professions; however, both groups preferred to learn uni-professionally with regard to developing discrete professional identities and roles. CONCLUSIONS: There is an overall positive response towards IPL and the value of team work; however, more attention needs to be paid to enabling students to learn about the specific roles of each profession in the healthcare team.

Influence of Iatrogenic Gaps, Cement Type, and Time on Microleakage of Cast Posts Using Spectrophotometer and Glucose Filtration Measurements.

PURPOSE: To determine the influence of iatrogenic gaps, type of cement, and time on microleakage of cast posts using spectrophotometer and glucose filtration measurements. MATERIALS AND METHODS: Forty-eight single-rooted teeth were divided into eight groups of six teeth each. Teeth were instrumented and obturated, and a cast post was fabricated. In addition to two control groups (positive and negative), a total of six groups were prepared: In four groups, an artificial 2- to 3-mm gap was created between post and residual gutta percha (GP), and two groups were prepared with intimate contact between post and residual GP. Posts were cemented with either zinc phosphate cement or resin cement. Leakage through the post after 1, 8, 14, and 20 days was measured using a glucose penetration model with two different reading methods. Mixed analysis of variance tests were performed to analyze the data. RESULTS: The presence of a gap between the apical end of the post and the most coronal portion of the GP remaining in the root canal after post space preparation increased microleakage significantly. However, microleakage was significantly less when the gap was refilled with GP compared to no gap. There was no difference in leakage between luting cements used. CONCLUSION: It was concluded that none of the cements were able to prevent microleakage. However, the addition of GP to residual GP did increase the sealing ability.

Survey of perceived stress-inducing problems among dental students, Saudi Arabia.

OBJECTIVE: This study was conducted to assess the problems related to stress encountered by Saudi dental students. METHODS: One thousand and thirty questionnaires were distributed in four dental schools to all students from 2nd year level up to the internship level. The questionnaire contained 66 items organized into four categories: personal and administrative, theoretical, preclinical and clinical. The relationship between the demographic variables and students' academic performance with the investigated items was also assessed. RESULTS: The response rate was 53%. Saudi dental students showed high levels of perceived stress. The clinical training issues imposed the highest level of stress on the students. Some significant relationships between the investigated variables and the level of the perceived stress were found. CONCLUSIONS: Female students had higher mean overall problem scores compared to male students, and second-year students showed lower perceived problems compared to other students.