The impact of malocclusion on the oral health related quality of life of 11-14-year-old children.

BACKGROUND: The relationship between malocclusion and the oral health related quality of life (OHRQoL) of children needs to be explored further as existing literature presents conflicting evidence. This study aims to determine the association between malocclusion and OHRQoL of 11-14-year-old children. METHODS: This cross-sectional study was conducted among 250 caregiver/child dyads seeking orthodontic consultation at a tertiary care hospital. The OHRQoL was assessed using child perception questionnaire for 11-14-year-old children (CPQ11-14) and the severity of malocclusion was assessed using the Dental Aesthetic Index (DAI). CPQ11-14 scores ranged from 0 to 64, with lower scores representing better quality of life. Analysis of variance (ANOVA) was used to assess differences between domain and total CPQ11-14 scores. RESULTS: The mean CPQ11-14 score was 19.89 ± 9.8. Mean scores for the oral symptoms, functional limitations, emotional well-being, and social well-being domains were 5.26 ± 3.22, 3.67 ± 3.58, 3.98 ± 3.89 and 2.08 ± 2.98, respectively. Normal or slight malocclusion was seen in 37.6%, definite malocclusion was seen in 22.4%, severe malocclusion in 15.2% and handicapping malocclusion in 24.8% of the subjects. In comparisons by pairs, it was found that children with handicapping malocclusion had significantly (p < 0.05) higher scores for the social well-being domain as compared with children having normal/minor malocclusion, indicating a poorer quality of life. CONCLUSION: Handicapping malocclusion had a significant negative impact on the social well-being domain of OHRQoL among 11-14-year-old children in this population.

Oral health knowledge, attitude and practice among adolescents in Kuwait.

OBJECTIVES: Adequate knowledge about oral health at a young age is essential in establishing good oral health related behaviors and in developing a positive attitude towards oral health. This study aims to assess the oral health knowledge, attitude and practice of adolescent children aged 15-17 years in Kuwait. METHODS: This cross-sectional survey was conducted in 12 randomly selected public schools in Kuwait using a two-stage cluster sampling method. An Arabic questionnaire with 29 questions were distributed to the students from selected classes. The questionnaire was divided into four sections: the first section gathered information on the sociodemographic characteristics of the participants; the second section assessed the oral health knowledge of the respondents; the third section assessed the students' attitude towards professional dental care and the last section assessed the students' oral health behaviors and practice. Frequency distributions were obtained for each variable and the differences between genders were analyzed using chi-squared statistics and the mean difference in the knowledge and attitude scores were analyzed using independent sample t-test. RESULTS: A total of 3,091 students aged 15-17 years (52.8% girls) participated in this study. The mean (SD) knowledge score of the respondents was 8.62 (2.53) and this was significantly higher for girls compared to boys (p<0.001). Significantly higher percentage of girls than boys knew the role of diet and oral hygiene in preventing caries (p<0.001). Knowledge about dental plaque was very limited in this population. Majority of the respondents believed that regular dental visits were essential (87.1%). The mean (SD) attitude score of the respondents was 3.30 (2.72) and this was significantly higher for girls compared to boys (p<0.001). Majority of the students used toothbrush and toothpaste to clean their teeth (60%). CONCLUSION: Significant gender differences were observed in the oral health knowledge and attitudes in this population. School based oral health promotion programs can be effective in promoting good oral health attitudes and practice among children.

Recall Practice among Dental Practitioners in Riyadh, Kingdom of Saudi Arabia.

AIM: The study aims to assess recall practice among dental practitioners in Riyadh, Saudi Arabia. MATERIALS AND METHODS: A 24-item questionnaire was used to collect information about the general practice, knowledge of dental recall, and factors affecting dental recall from general dental practitioners in Riyadh. The questionnaire elicited data on personal information (8 items), practice information (3 items), knowledge about the dental recall (3 items), recall practice (6 items), and patient factors that might influence recall (4 items). A five-point Likert scale showed the level of agreement in cases that required recall visits, reasons for patients not returning for recall, and techniques to encourage return for recall. RESULTS: A total of 315 questionnaires were analyzed (response rate = 46.3%). The mean age of participants was 32.4 years old and 52.4% of participants were male. Eighty-four percent of respondents reported that they routinely perform regular recall with their patients. Recall practice was significantly associated with practitioner experience, country of graduation, and workplace. Practitioners who graduated from Saudi universities were found to be less likely to practice regular recall visits compared to others (p <0.01). On the other hand, practitioners who are working in university hospitals are more likely to practice dental recall compared to those who are working only in dental clinics (p = 0.02). CONCLUSION: A low percentage of dentists advocated and practiced regular recall visits in their private practice. Efforts should be undertaken to educate the practitioners on the importance of regular recall visits in their healthcare settings. CLINICAL SIGNIFICANCE: Scheduling appropriate recall visits is an essential component for achieving successful treatment outcomes. This study highlights the poor recall practice among dentists and the need to raise the awareness of the importance of recall visits.

Pattern of antibiotic prescription among dentists in Riyadh, Saudi Arabia.

AIM: The aim of the present study was to investigate the pattern of antibiotic prescription and dentists' awareness about the recent guidelines for antibiotic prescription. METHODS: This cross-sectional study was conducted among 282 dentists practicing in Riyadh, Saudi Arabia. The data were collected from 20 randomly-selected dental clinics from each of the five administrative blocks in Riyadh. In addition, data were also collected from four tertiary care centers and three academic universities. The questionnaire measured the antibiotic prescription pattern of the dentists and their choice of antibiotics for various dental conditions. RESULTS: Amoxicillin was the most commonly prescribed antibiotic. More than 70% of dentists prescribed antibiotics for dental patients with various cardiac conditions. Bivariate analysis showed that female dentists had significantly higher mean scores for ideal prescription pattern (P = .04) compared to male dentists. Saudi nationals, especially those working in the government sector were found to have better prescription pattern compared with others (P = .02). Dentists with higher educational qualifications (board certificate and above) had a more ideal prescription pattern than other dentists (P = .04). CONCLUSION: Inappropriate antibiotic prescription practice was highly prevalent in this population.

Oral Health Status and Oral Health-related Quality of Life among Hospitalized and Nonhospitalized Geriatric Patients.

INTRODUCTION: The purpose of this study was to compare the oral health status and its effect on the oral health-related quality of life (OHRQoL) of hospitalized and nonhospitalized elderly patients in a single community. The null hypothesis for the study states that there is no difference in the oral health status and OHRQoL between hospitalized and nonhospitalized elderly patients. MATERIALS AND METHODS: This study was conducted at the King Khalid Hospital and College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia. A total of 99 (43 - hospitalized and 56 - nonhospitalized) geriatric patients participated in this study. Oral health-related quality of life was estimated using the geriatric oral health assessment index questionnaire. Decayed, missing, and filled teeth (DMFT) index and plaque index were used to assess the oral health status of the study participants. RESULTS: The mean age of the study participants was 68.2 years; 17.2% were females and 82.8% were males. There was no significant difference between hospitalized and nonhospitalized patients in OHRQoL and DMFT index. However, the oral hygiene status was better among nonhospitalized patients as compared with hospitalized patients. CONCLUSION: There was a significant difference in the oral hygiene status between hospitalized and nonhospitalized geriatric patients. CLINICAL SIGNIFICANCE: Caregivers must be sensitized to the importance of oral health for the elderly population, and oral health should be considered an integral component of general health.

Evaluation of Periodontal Changes Adjacent to Extraction Sites during Upper Canine Retraction.

INTRODUCTION: There is an intimate relationship between orthodontic therapy and the periodontal changes that occur during tooth movement. MATERIALS AND METHODS: This prospective clinical trial aims at investigating the movement of both the free and attached gingiva, as well as the movement of the alveolar bone in the extraction site of the upper 1st premolars during the retraction of the upper canines. In this study, 17 patients (10 female, 7 male) requiring 1st premolar extraction before orthodontic tooth movement were selected and treated at the Department of Orthodontics in the Faculty of Dentistry in University of Hama, Hama, Syria. The upper 1st premolars were extracted, and the implant AutoTacs were applied on the alveolar bone afterward. Then, measurements between the center of the implant AutoTacs and the L-shape wire were taken, utilizing digital Vernier caliper. After 3 weeks of extraction, tattooing marked points were placed on the free and the attached gingival, and the measurements were taken using the same digital Vernier caliper. Closed coil springs made of nickel-titanium were used to retract the upper canines, and a force of 150 gm was applied. RESULTS: The results of this study showed significant differences between the movement of both the free and attached gingiva and the movement of the corresponding upper canines (p < 0.001). The movement of the free gingiva had formed about 77% of the amount of the movement of the upper canine retraction. No significant differences were detected between the place of implant AutoTac X1 and the L-shaped wire (W) during the retraction of the upper canine. On the contrary, significant differences were noticed between the place of implant AutoTac X2 and the L-shaped wire (W) during the retraction of the upper canine (p < 0.001). CONCLUSION: There is significant movement of hard and soft tissues during and after premolar extraction and orthodontic therapy. CLINICAL SIGNIFICANCE: The movement of supporting tissues of the teeth along with the alveolar bone during canine retraction is an important biological characteristic of the orthodontic tooth movement. Clinicians need to understand the role and importance of the supporting tissues during orthodontic treatment, which needs to be incorporated into their routine clinical evaluations.

Shear Bond Strength between Fiber-Reinforced Composite and Veneering Resin Composites with Various Adhesive Resin Systems.

PURPOSE: The aim of this research was to evaluate the shear bond strength of different laboratory resin composites bonded to a fiber-reinforced composite substrate with some intermediate adhesive resins. MATERIALS AND METHODS: Mounted test specimens of a bidirectional continuous fiber-reinforced substrate (StickNet) were randomly assigned to three equal groups. Three types of commercially available veneering resin composites - BelleGlass®, Sinfony®, and GC Gradia® were bonded to these specimens using four different adhesive resins. Half the specimens per group were stored for 24 hours; the remaining were stored for 30 days. There were 10 specimens in the test group (n). The shear bond strengths were calculated and expressed in MPa. Data were analyzed statistically, and variations in bond strength within each group were additionally evaluated by calculating the Weibull modulus. RESULTS: Shear bond values of those composites are influenced by the different bonding resins and different indirect composites. There was a significant difference in the shear bond strengths using different types of adhesive resins (p = 0.02) and using different veneering composites (p < 0.01). Belle-Glass® had the highest mean shear bond strength when bonded to StickNet substrate using both Prime & Bond NT and OptiBond Solo Plus. Sinfony® composite resin exhibited the lowest shear bond strength values when used with the same adhesive resins. The adhesive mode of failure was higher than cohesive with all laboratory composite resins bonded to the StickNet substructure at both storage times. Water storage had a tendency to lower the bond strengths of all laboratory composites, although the statistical differences were not significant. CONCLUSION: Within the limitations of this study, it was found that bonding of the veneering composite to bidirectional continuous fiber-reinforced substrate is influenced by the brand of the adhesive resin and veneering composite.

Shear bond strength between alumina substrate and prosthodontic resin composites with various adhesive resin systems.

BACKGROUND: With the increase in demand for cosmetics and esthetics, resin composite restorations and all-ceramic restorations have become an important treatment alternative. Taking into consideration the large number of prosthodontic and adhesive resins currently available, the strength and durability of these materials needs to be evaluated. This laboratory study presents the shear bond strengths of a range of veneering resin composites bonded to all-ceramic core material using different adhesive resins. METHODS: Alumina ceramic specimens (Techceram Ltd, Shipley, UK) were assigned to three groups. Three types of commercially available prosthodontic resin composites [BelleGlass®, (BG, Kerr, CA, USA), Sinfony® (SF, 3 M ESPE, Dental Products, Germany), and GC Gradia® (GCG, GC Corp, Tokyo, Japan)] were bonded to the alumina substrate using four different adhesive resins. Half the specimens per group (N = 40) were stored dry for 24 hours, the remaining were stored for 30 days in water. The bonding strength, so-called shear bond strengths between composite resin and alumina substrate were measured. Data were analysed statistically and variations in bond strength within each group were additionally evaluated by calculating the Weibull modulus. RESULTS: Bond strengths were influenced by the brand of prosthodontic resin composites. Shear bond strengths of material combinations varied from 24.17 ± 3.72-10.15 ± 3.69 MPa and 21.20 ± 4.64-7.50 ± 4.22 at 24 h and 30 days, respectively. BG resin composite compared with the other resin composites provided the strongest bond with alumina substrate (p < 0.01). SF resin composite was found to have a lower bond strength than the other composites. The Weibull moduli were highest for BG, which was bonded by using Optibond Solo Plus adhesive resin at 24 h and 30 days. There was no effect of storage time and adhesive brand on bond strength. CONCLUSION: Within the limitations of this study, the shear bond strengths of composite resins to alumina substrate are related to the composite resins.

Evaluation of adjunctive systemic doxycycline with non-surgical periodontal therapy within type 2 diabetic patients.

OBJECTIVES: To evaluate the effects of systemic doxycycline on clinical and microbiological parameters of diabetic subjects with chronic periodontitis. METHODS: This 9-month multi-center, randomized, parallel, single-blinded study was conducted from different hospitals in Riyadh, Saudi Arabia between April 2010 and December 2010. A total of 76 diabetic subjects with chronic periodontitis were randomized into 2 groups: control group (CG) received only scaling and root planing (SRP), and the treatment group (TG) receiving systemic doxycycline during the reevaluation visit 45 days after the completion of SRP. Probing pocket depth, clinical attachment level, gingival index, plaque index, and bleeding on probing were collected at baseline, 45 days after SRP, and one, 3, and 6 months  after the use of systemic doxycycline. Microbiological analysis comprised the detection of Tannerella forsythia (Tf), Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and Prevotella intermedia (Pi) by polymerase chain reaction method. RESULTS: Sixty-eight (33 CG and 35 TG) subjects completed the study. Greater reduction in the population of Tf, Pg, and Pi were observed in TG compared with CG in the first month after the administration of systemic doxycycline. The TG showed a significant improvement in gingival index scores compared with the CG (p<0.05) by the end of the first and 6 months after the administration of doxycycline. CONCLUSION: Adjunct systemic doxycycline can be associated with a reduction of Tf, Pg, and Pi in the first month after the administration of doxycycline with an improvement in the GI.