Efficacy of adjunct photodynamic therapy on Candida growth and oral health quality of life in denture stomatitis patients with type 2 diabetes mellitus wearing implant-retained overdentures: A randomized clinical study.

AIM: The aim of the present clinical trial was to study the efficacy of combined miconazole and PDT in the improvement of quality of life and levels of Candida species in chronic hyperglycemic patients with denture stomatitis (DS). METHODS: One hundred patients were randomly divided into five groups; 20 each in the miconazole, PDT, miconazole+ PDT, CHX and distilled water groups. Methylene blue mediated irradiation was conducted using 600 nm diode laser with power, energy density and radiance as 100 mW, 3527 mW/cm2 and 9 J, respectively. Patients were advised to apply 2.5 ml of 2% topical miconazole four times a day. The existence of Candida spp. was detected by means of microbiological culture technique. Candida colony counts from the palates and dentures surfaces, quantified as colony forming unit (CFU)/mL were evaluated at baseline, end of 14 days, 28 days and 60 days. Oral health related quality of life was assessed with the help of a questionnaire. RESULTS: The quality of life showed significant improvement in the group where combination treatment was executed. The overall CFU/mL values were greater in the dentures in comparison to those from the palates of the patients of all the five groups. During all time periods of the study, the CFU/mL values obtained from combination treatment group showed significant differences. Candida albicans was the most predominant yeast. CONCLUSION: This study showed the effectiveness of methylene blue- PDT in combination with miconazole in improving oral health related quality of life and significantly reducing Candida CFU counts to resolve palatal inflammation in diabetic individuals with implant-supported complete dentures.

Knowledge and Practice of Burn Management Among Physicians Using Burn Manikin in Ha'il, Kingdom of Saudi Arabia.

Background Burn is a skin injury that results in the death of the impacted cells. Burn injuries are frequently unintentional and very avoidable. With proper management, the outcome is improved, and the need for surgical intervention is reduced. This article discusses healthcare providers' knowledge and practice of burn first aid and management to highlight the need for the enhanced practice of burn management and first-aid skills. Objective This study aims to assess the knowledge and practice of burn injuries management among healthcare workers in different specialties in Hail city. Methods  A cross-sectional study was conducted via an interviewer-administrated face-to-face questionnaire and video recording of a simulated case of burn injury collected from our skill lab at Hail University and evaluated by a board-certified plastic surgeon. Result The study analyzed 119 physicians (mean age = 36.3 years, SD = 6.7) managing burn cases. Of these, 59.7% were male, and 40.3% were female. The mean evaluation score was 7.71 (SD = 2.84). None of the factors studied, including gender (p = 0.353), age (p = 0.970), education level (p = 0.127), specialty (p = 0.871), professional experience (p = 0.118), working sector (p = 0.178), nationality (p = 0.742), or participation in burn management course (p = 0.131), had a significant effect on burn management skills of physicians. However, some groups had higher mean evaluation scores than others. Further research is needed to explore potential reasons for the observed differences in mean evaluation scores among different groups of physicians. Conclusion We discovered that most physicians were found to have poor practical knowledge of proper burn management, and most of them had not engaged in a burn first aid training, therefore more courses targeting physicians who may meet burn patients are required.

The Psychological Impact of COVID-19 Pandemic on Persons with Multiple Sclerosis in Saudi Arabia.

OBJECTIVES: To evaluate, in a Saudi Arabian context, how the COVID-19 pandemic psychologically impacted persons with multiple sclerosis (PwMS). METHODS: A cross-sectional study was undertaken during the period from October 2021 to March 2022. 738 participants resident in the Kingdom of Saudi Arabia (KSA) completed a self-administered online questionnaire. The research focused on persons diagnosed with MS. RESULTS: Participant ages spanned from 18 to over 55. The mean was 36.1±12.9 years old. Four hundred eighty-nine (66.3%) of the 738 participants were female. Two hundred sixty-four (35.8%) were single. Four hundred twelve (55.8%) were married. Six hundred eighty-five (92.8%) had received a COVID-19 vaccine. Regarding MS duration, 117 (15.9%) had been diagnosed for less than 2 years, 171 (23.2%) for 2-5 years, while 251 (34%) had the condition for 10 or more years. Regarding psychological health, 11.2% of participants complained of minimal/no depression, 33.3% of mild depression, 28.3% of moderate depression, and 27.1% of moderately severe to severe depression symptoms. Concerning anxiety, 17.2% of participants reported minimal anxiety, 36.9% mild, 23.3% moderate, while 22.6% suffered from severe anxiety symptoms. CONCLUSION: A high prevalence of depression and anxiety was found, along with high prevalence of co-occurrence of these disorders among PwMS.

Thyroid Disorders Spectrum in Pediatric Endocrine Clinic; Seven-Year Experience of a Teaching Hospital in Saudi Arabia.

Thyroid disorders constitute one of the major endocrine disorders in pediatric service. It includes a range of congenital versus acquired anatomic and/or functional thyroid diseases in growing children that has a spectrum of severity from severe intellectual disability effect to subclinical mild pathologies. This study was designed to analyze the demographic characteristics, clinical pattern, and severity of thyroid disorders in the pediatric endocrine clinic patients at the teaching hospital of the university over a 7-year duration. A total number of 148 patients with thyroid disorders were seen in pediatric Endocrine clinic during the time between January 2015 and December 2021. Female patients constitute 64% of them. Acquired Hypothyroidism was the commonest disorder; 34% of the cases followed by the congenital hypothyroidism (CH), then Hashimoto's thyroiditis, and 5.8% for others. While a very small percentage was acquired hyperthyroidism. The majority of referrals were from dermatology and other service for the screening of thyroid disease as association with other autoimmune diseases with percentage of 28.3%. Next was neck swelling manifestation in 22.6%. Thyroid disorders in children, both congenital and acquired, constitute an important medical issue for pediatricians to be aware of its variable presentations, and its potential serious health consequences on the affected children if not diagnosed and treated earlier. Acquired hypothyroidism constitutes more percentage of the thyroid disorders followed in the pediatric endocrinology outpatient clinics. Congenital hypothyroidism is the second most common thyroid disorder in the outpatient unit, having the most potential complications. These results support the international studies with the female predominance in most of thyroid disorders.

Push-Out Bond Strength of Endodontic Posts Cemented to Extracted Teeth: An In-Vitro Evaluation.

(1) Background: An ideal bond strength between endodontic posts and root canal dentin is essential for optimal retention and good prognosis. This study aimed to evaluate the push-out bond strength (PBS) of prefabricated fiber and metal posts, luted with resin cement to natural dentin. (2) Methods: Extracted premolars with similar root dimensions were assigned into two groups of 30 each for the metal and fiber posts. Teeth were mounted in acrylic blocks exposing 2 mm of the coronal root. Teeth were subjected to endodontic treatment and post-space preparations. Two groups were further subdivided into three sub-groups (n = 10) according to the size of the posts (# 4, 5 and 6). Posts were cemented with resin cement. Specimens were sectioned into 4 mm slices and subjected to the PBS test. (3) Results: The mean PBS was similar for the metal and fiber posts bonded with resin cement, showing a statistically significant result. An increase in post size increased the bond strength initially, but a further increase in size did not show any marked difference. A total of 71.66% of tested specimens failed with the adhesive failure mode. (4) Conclusions: Metal posts showed slightly higher retention compared to the fiber posts, although the p-value was similar for both types. An increase in the size of posts showed increased retention. The most common mode of failure was adhesive failure between cement and dentin.

Evaluation of the Shear Bond Strength of Four Bioceramic Materials with Different Restorative Materials and Timings.

The objectives of this study were to evaluate the shear bond strength (SBS) of a resin composite (RC) and a resin-modified glass ionomer (RMGI) to four different bioceramic materials and to compare the effects of the immediate vs. delayed placement of restoration on the SBS. A total of 160 Teflon blocks and 40 blocks/material, were randomly filled with one of the bioceramic materials (NeoPUTTY®, NeoMTA2®, TotalFill® BC RRM™ Fast Set Putty, and ProRoot® MTA). The restoration was performed immediately or in a delayed time frame (after 7 days) using a Filtek™ Z350 XT Flowable composite (bonded to the bioceramic materials using Single bond universal 3M) or GC Fuji II LC® RMGI. The SBS test was performed at a crosshead speed of 1 mm/min, and the failure mode was evaluated under a digital microscope by one blinded examiner. One-way analysis of variance (ANOVA) with the Games-Howell post hoc test was used to compare the mean SBS between the groups. The mean SBS of the bioceramic materials to RC was significantly higher than to RMGI except for ProRoot MTA (p-value 0.65). The SBS values to RC were as follows: ProRoot MTA (7.64 MPa); NeoMTA2 (8.57 MPa) which was significantly higher than both NeoPUTTY (4.04 MPa) and TotalFill® BC RRM™ Fast Set Putty (4.38 MPa). For RMGI groups, ProRoot MTA showed the highest SBS (7.18 MPa), followed by NeoMTA2 (4.15 MPa), NeoPUTTY (1.62 MPa), and TotalFill® BC RRM™ Fast Set Putty (1.54 MPa). The delayed timing restoration showed a significantly higher SBS than the immediate, except for the immediate RMGI restoration with MTA. To conclude, the SBS of RC to the bioceramic materials was significantly higher than RMGI, except for ProRoot MTA. Both restorative materials had a significantly higher SBS to the MTA groups in comparison to premixed bioceramics. Delayed RC restoration had a higher SBS than immediate restoration. Similarly, delayed RMGI restoration had a higher SBS than immediate restoration with premixed bioceramic but not with MTA.

Awareness about the relation of noise induced hearing loss and use of headphones at Hail region.

BACKGROUND: Noise induced hearing loss is the one of the most preventable causes of hearing loss in all age groups. Occupational, environmental, infectious and genetic factors all play a role in determining the level of hearing loss. However, the use of headphones and personal listening devices is now very common, especially in younger generations. Healthy habits are needed to prevent them from developing hearing loss over time. We aim to assess the awareness level of hearing loss among residents of Hail region and its relation to personal listening devices. METHODOLOGY: This is a cross-sectional survey based study that was conducted in 2021 over a duration of four months. The survey purpose was to assess the level of awareness about the Relation of Noise-Induced Hearing Loss and Use of Headphones. The questionnaire had a total of 37 questions which were divided into 6 categories. All data was analyzed using SPSS 21, and a p-value of <0.05 was deemed significant. RESULTS: The study included a total of 1086 participants. Sampled population age ranged from 18 to 55 years with a mean age of 24.8 ± 12.6 years old. Meanwhile, 636 (58.6%) of the participants were females and 1074 (98.9%) were Saudi. Hearing problems were significantly higher among those who were exposed to noise at work setting than others (26% vs. 15.9%, respectively; P = .001). Duration of the listening session/per day for more than 5 h was significantly associated with higher rates of hearing problems among participants (33.9% vs. 16.5%, respectively = .001). Typical level of TV or radio volume of 90-100 was associated with hearing problems among 32% compared to 11.2% for 0-49% (P = .001). CONCLUSION: There is a low awareness level of hearing loss and its causes among the population with more than half of the respondent having unhealthy habits in listening to sounds through their personal devices. Factors related to develop hearing loss included age, volume level and duration of weekly sessions.

Application of ß-Tricalcium Phosphate in Adhesive Dentin Bonding.

The study aimed at synthesizing ß-tricalcium phosphate (ß-TCP) nanoparticles and comparing the mechanical properties and dentin interaction of two adhesives: experimental adhesive (EA) and EA with 5 wt.% ß-TCP nanoparticles (ß-TCP-5%). These filler nanoparticles were synthesized and then characterized with scanning electron microscopy (SEM) and micro-Raman spectroscopy. The ß-TCP nanoparticles were incorporated in the adhesives to form two groups: gp-1: EA (control) and gp-2: ß-TCP-5%. These adhesives were characterized by SEM, energy-dispersive X-ray (EDX) spectroscopy and were also assessed for their micro-tensile bond strength (µTBS) with (TC) and without thermocycling (NTC). Fourier Transform Infrared (FTIR) spectroscopy was performed to evaluate the degree of conversion (DC) of two adhesives. The ß-TCP filler was seen as irregularly shaped agglomerates on SEM. The micro-Raman spectra revealed characteristic peaks associated with ß-TCP nanoparticles. Both adhesives presented suitable dentin interaction, which was demonstrated by the formation of resin tags of variable depths. The EDX analysis verified the existence of calcium (Ca) and phosphate (P) for the ß-TCP-5% group. The greatest µTBS values were shown by ß-TCP-5% group samples when they were non-thermocycled (NTC) (ß-TCP-5%-NTC: 34.11 ± 3.46) followed by the thermocycled (TC) samples of the same group (ß-TCP-5%-TC: 30.38 ± 3.66), compared with the EA group. Although the DC presented by ß-TCP-5% group was comparable to the EA group, it was still lower. The addition of ß-TCP nanoparticles in the adhesive improved its µTBS and resulted in a suitable dentin interaction, seen in the form of hybrid layer and resin tag formation. Nonetheless, a decreased DC was observed for the ß-TCP-5% adhesive. Future studies probing the effect of different filler concentrations on various properties of the adhesive are warranted.

Efficacy of porphyrin derivative, Chlorhexidine and PDT in the surface disinfection and roughness of Cobalt chromium alloy removable partial dentures.

AIM: The present study aimed to evaluate the effect of different cleansers and photodynamic therapy (PDT) on disinfection of Co/Cr removable partial denture colonized with C. albicans, S.aureus and S.mutans. MATERIAL AND METHODS: Twenty-five Co/Cr removable partial dentures were constructed. and inoculated by American Type Culture Collection (ATCC) of Candida albicans, S.aureus, and S.mutans in an in-vitro setup. Co/Cr removable partial dentures were randomly allocated into five groups and framework was immersed in 15 mL of contaminated culture medium broth. Based on the cleansing method, disinfected dentures in group 1 were cleansed with porphyrin derivative; group 2 was exposed to 0.12% chlorhexidine digluconate; samples in group 3 and group 4 were subjected to sodium perborate enzyme and citric acid respectively. Through a surface analyzer, the surface roughness of Co/Cr and methacrylate resin was measured in 3 different zones in micrometers before and after disinfection. Two-way ANOVA and Tukey's test was used to analyze the data. Levene test was used to assess the normal distribution of data. Significance level p< 0.05 RESULTS: The results of metal roughness displayed that Co/Cr used as an alloy did not exhibit significant difference when exposed to different chemical disinfectants and photosensitizer (p > 0.05). Similarly, surface roughness (Ra) of heat polymerized acrylic resin using cleansers and PDT demonstrated no significant difference. Intergroup comparison showed that, hematoporphyrin derivative displayed comparable cleansing property against S. aureus, C.albicans, and S. mutans compared to to 0.12% CHX digluconate (p>0.05). The intragroup comparison showed hematoporphyrin derivative and CHX were equally effective against all bacteria (p>0.05). CONCLUSION: CHX digluconate and hematoporphyrin derivative demonstrated high antimicrobial activity against S.aureus, S.mutans, and C.albicans with minimum Ra of an acrylic denture and Co/Cr metallic framework.

Maxillary anterior teeth dimension and relative width proportion in a Saudi subpopulation.

OBJECTIVES: Achieving a natural smile while restoring anterior teeth is challenging. Selecting appropriate dimensions of teeth is important for aesthetics. This study aims to measure and analyse the dimensions of the maxillary anterior teeth and their relative width proportions in a Saudi subpopulation. METHODS: One hundred and eighty patients (112 men and 68 women) with intact maxillary anterior teeth (age range = 20-30 years) participated in this research. Maxillary impressions (Vinyl Polysiloxane) were created and poured. A digital caliper was used to record the length and width of maxillary anterior teeth in millimetres (mm) from the dental casts, and the casts were digitally photographed to calculate relative width ratios. RESULTS: The mean width for central incisor was 8.74 mm (men = 8.89 mm, women = 8.60 mm), lateral incisor 6.64 mm (men = 6.79 mm, women = 6.49 mm) and canine 7.82 mm (men = 8.01 mm women = 7.63 mm). The recorded mean lengths for these teeth were 9.84 mm (men = 10.04 mm, women = 9.64 mm), 8.09 mm (men = 8.30 mm, women = 7.89 mm) and 9.08 mm (men = 9.48 mm, women = 8.69 mm). The mean values of apparent width/width ratio measured on the cast photographs were 63.69 mm for the lateral incisor/central incisor and 78.35 mm for canine/lateral incisor. No statistically significant difference was found between the mean values of the apparent width/width ratio of the right and left sides and between men and women. CONCLUSIONS: This study showed a minor asymmetry between left and right side anterior teeth among the participants. The width to length ratio of the central and lateral incisors was similar for both genders, with minor differences in the canines. A squarish form of anterior teeth for the Saudi population with dimensional similarities to the Turkish population was found.

Analysis of enamel and material wear by digital microscope: an in-vitro study.

The objective of the study was to analyze the surface area (SA) of the wear caused by simulated chewing on human enamel and opposing restorative material, namely: composite resin (CR), porcelain fused to metal (PFM), lithium disilicate (LD), or monolithic zirconia (MZr). Forty-eight premolars were selected as enamel specimens and divided randomly into 4 groups (n = 48; n =12) used as antagonists in chewing simulation (250,000 loading cycles) against one of the four selected test materials. Enamel and material specimens were scanned and evaluated under digital microscope, and wear SA (mm2) were recorded. Descriptive statistics, paired t-test, one-way ANOVA, and post-hoc Tukey-HSD tests were used for statistics (p < 0.05). The smallest and largest SA were exhibited by enamel against LD (0.80 mm2) and PFM (1.74 mm2), respectively. PFM (3.48 mm2) showed the largest SA and CR (2.28 mm2) showed the smallest SA. Paired t-test for SA values showed significant difference (p < 0.05) in all wear comparisons between materials and enamel antagonists. The wear of materials were greater than that of their respective enamel antagonists (p < 0.05). One-way ANOVA of the logarithmic means of wear SA revealed significant differences (P<0.05). Post-hoc Tukey test revealed significance for PFM (p < 0.05) with other materials. Wear of all test materials was greater compared to the wear of enamel antagonists. PFM and LD caused the largest and the smallest enamel wear, respectively. CR, LD, and MZr are more resistant than PFM to wear after simulated chewing against enamel.

Analysis of enamel and material wear by digital microscope: an in-vitro study

Abstract: The objective of the study was to analyze the surface area (SA) of the wear caused by simulated chewing on human enamel and opposing restorative material, namely: composite resin (CR), porcelain fused to metal (PFM), lithium disilicate (LD), or monolithic zirconia (MZr). Forty-eight premolars were selected as enamel specimens and divided randomly into 4 groups (n = 48; n =12) used as antagonists in chewing simulation (250,000 loading cycles) against one of the four selected test materials. Enamel and material specimens were scanned and evaluated under digital microscope, and wear SA (mm2) were recorded. Descriptive statistics, paired t-test, one-way ANOVA, and post-hoc Tukey-HSD tests were used for statistics (p < 0.05). The smallest and largest SA were exhibited by enamel against LD (0.80 mm2) and PFM (1.74 mm2), respectively. PFM (3.48 mm2) showed the largest SA and CR (2.28 mm2) showed the smallest SA. Paired t-test for SA values showed significant difference (p < 0.05) in all wear comparisons between materials and enamel antagonists. The wear of materials were greater than that of their respective enamel antagonists (p < 0.05). One-way ANOVA of the logarithmic means of wear SA revealed significant differences (P<0.05). Post-hoc Tukey test revealed significance for PFM (p < 0.05) with other materials. Wear of all test materials was greater compared to the wear of enamel antagonists. PFM and LD caused the largest and the smallest enamel wear, respectively. CR, LD, and MZr are more resistant than PFM to wear after simulated chewing against enamel.

Evaluation of different esthetic smile criteria.

PURPOSE: The aim of this study was to evaluate the existence of different esthetic smile criteria as determined on the smiles of celebrities, which were considered by lay people to be beautiful. MATERIALS AND METHODS: An Internet search for "best smile" and "female celebrities" in the years 2007 and 2008 identified 50 celebrities who were voted to have beautiful smiles. Another search was made for images of these celebrities that showed the entire face with an open smile. The images were analyzed using Digimizer image analysis software for different esthetic smile criteria. RESULTS: Eighty percent of the sample was classified as having an average upper lip position, 62% showed upward upper lip curvature, and 78% had a parallel smile line. Forty-two percent of the images showed the maxillary anterior teeth not touching the lower lip, while 34% were touching, and 24% slightly covered it. Sixty percent displayed up to the second premolar, and 32% displayed up to the first molar when smiling. Midline deviation was detected in 36% of the sample. Diastema and golden proportion were not seen in any of the subjects. CONCLUSION: Female celebrities voted to have the best smile by lay people showed most of the esthetic smile criteria with slight variations, except for the golden proportion. The opinions and perceptions of lay people about beauty should be studied and evaluated.