Virtual reality simulation of panoramic radiographic anatomy for dental students.

PURPOSE: This work aimed to utilize virtual reality (VR) in dental radiographic anatomical interpretation in junior dental students and test if it can enhance student learning, engagement, and performance. METHODS: VR software for panoramic anatomy was developed. Sixty-nine first-year dental students were divided into a control group (lecture-based) and an experimental group (VR) to learn panoramic radiographic anatomy. Both groups were then tested on knowledge via a 20-question quiz. Student feedback on VR experience was collected via an online survey. RESULTS: There was a statistically significant difference between lecture-based and VR students in the correct identification of anatomical landmarks. Lecture-based students scored higher in identifying the ear lobe, hyoid bone, condylar neck, and external oblique ridge, whereas VR students scored higher in identifying zygoma (Chi-squared test, p < 0.005). The VR group reported high evaluation on all perception items of the online feedback survey on their experience (Student t-test, p < 0.005). CONCLUSIONS: Lecture-based students generally showed better performance in panoramic radiographic anatomy. Several structures were not correctly identified in both groups of novice students. The positive feedback of VR experience encourages future implementation in education to augment conventional methods of radiographic anatomy in dentistry with considerations to repeated exposures throughout undergraduate dental education.

Oral health status among transgender young adults: a cross-sectional study.

BACKGROUND: Transgender and gender nonconforming (TGNC) people are a marginalized set of the population that continues to experience health care inequalities. This study aimed to assess oral health parameters including Candida growth and intensity among TGNC adults. METHODS: This cross-sectional study recruited two subgroups: 40 transgender and 40 control adults. Consented participants were interviewed and clinically examined. Data using the WHO oral health assessment forms were obtained. Samples for Candida growth and intensity analysis were collected from the dorsum surface of the tongue. RESULTS: 27.5% of the transgender group was HIV seropositive. Oral nicotine stomatitis and leukoplakia are reported to be the most prevalent intra-oral lesions showing a prevalence of 27.5% and 20%, respectively. The dental and periodontal health parameters of the transgender group were worse than those of the control group. The intensity of Candida colonies was significantly higher in the test group (p = 0.014). CONCLUSION: Poor oral health and significant oral mucosal disorders were reported in transgender adults that have shown a higher rate of behavioral risk factors such as tobacco and alcohol consumption. Further longitudinal studies in different world regions are warranted to understand the barriers to good oral health in transgender adults and how to implement effective prevention and management strategies.

Diagnostic Accuracy of Oral Cancer and Suspicious Malignant Mucosal Changes among Future Dentists.

This study aimed to assess the ability of dental students and recent graduates to detect and recognize mucosal changes that are suggestive of oral cancer and potentially malignant disorders. In this cross-sectional study, a questionnaire was administered to dental students and recent graduates of Ajman University (n = 132). Completed questionnaires were received from 84 (63.6%) females and 48 (36.4%) males which included fifth-year students (n = 80), interns (n = 39), and dental practitioners (n = 13). This questionnaire was designed to assess the respondent's ability to detect and recognize different types of oral lesions, as well as their knowledge of oral cancer appearance and malignancy potential. The overall accuracy of diagnosis was 46%. The participants correctly identified normal variations, benign tumors, malignant tumors, and premalignant lesions at rates of 60.3%, 31.0%, 55.7%, and 33.4%, respectively. There was no significant difference between the two genders in their ability to recognize and detect correct answers (females, 48.3%; males, 47.2%). According to education level, interns provided the highest percentage of correct answers (52.5%), followed by newly dental practitioners (51.9%) and fifth-year students (44.1%). Conclusion: The respondents of this survey did not exhibit a satisfactory diagnostic capability in recognizing mucosal changes consistent with the clinical presentation of oral cancer. Thus, a need exists for improved and updated educational methods for undergraduate students regarding oral cancer and potentially malignant disorders. Meanwhile, practitioners should look for oral abnormalities to provide better diagnosis and management. Practitioners should also stay up to date on the oral malignancy topic by attending workshops and clinicopathological conferences.

A Survey of Dentists' Perception of Chair-Side CAD/CAM Technology.

The application of computer-aided design and computer-aided manufacturing (CAD/CAM) technology in dentistry has rapidly expanded. This survey aimed to investigate attitudes and current practice of dentists in Riyadh, Saudi Arabia regarding chair-side CAD/CAM technology. An online questionnaire was prepared and sent to a convenience sample of dentists in Riyadh. Questions related to practice aspects of chair-side CAD/CAM system, attitudes and training were presented. A total of 114 questionnaires were completed (77.6% response rate). Study population comprised dentists of a wide range of clinical experience who are working in the various regions of Riyadh city, Saudi Arabia. Of the participants, 27.2% indicated the presence of a chair-side CAD/CAM system at their current workplace and 57% used the chair-side CAD/CAM in the fabrication of dental crowns. The vast majority of participants (81%) believe that the overall quality of chair-side CAD/CAM restorations is at least as good as those fabricated by a lab technician or much better. Most responding dentists considered the chair-side CAD/CAM system as important in terms of time saving, boosting the number of visiting patients and income improvement. The willingness to dedicate the time and effort to learn the chair-side CAD/CAM technology was apparent amid a high proportion of dentists (75.4%). The findings of this pilot survey reflect broad satisfaction and positive attitude among the surveyed dentists towards use and outcome of chair-side CAD/CAM technology in the dental clinical practice. It seems that the CAD/CAM technology has infiltrated into the workflow of Saudi dental practices with speculations of growing implementation among the wider sector of dental practitioners in the future.

Molecular identification and diversity analysis of dental bacteria in diabetic and non-diabetic females from Saudi Arabia.

Periodontal disease is a chronic infectious disease, which is characterized by the damaged dental hard tissue by lactic acid generated by microorganisms after the fermentation of carbohydrates rich diet. The risk of periodontal disease is known to be higher in diabetic patients. We compared the diversity of five commonly occurring dental bacteria including Porphyromonas gingivalis, Tannerella forsythia, Capnocytophaga ochracea, Prevotella intermedia, and Aggregatibacter actinomycetemcomitans in 14 type-2 diabetic patients and equal numbers of healthy controls. The subgingival samples were collected using sterile paper points. We used 16S rRNA sequence specific primers for PCR-based identification of dental bacteria. Our results showed that A. actinomycetemcomitans was completely absent in control subjects but present in 43% of diabetic patients. C. ochracea was highly prevalent in diabetic patients (100%) as compared to controls (28.5%). The frequency of other three bacterial species was also higher in diabetic patients than control subjects. These findings indicate that dental bacteria are highly prevalent in subgingival pockets of diabetic patients. Therefore, proper monitoring of diabetic patients for dental care is important to prevent bacterial growth and its sequela in risky individuals. Further case-control studies using larger sample size would help in validating the association between oral diseases and diabetes.

Methicillin-resistant Staphylococcus aureus (MRSA) screening of hospital dental clinic surfaces.

We assessed the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) strains on surfaces of hospital dental clinics. Specimens were obtained from 5 clinically symptoms-free patients of five different specialties clinics (Implantology, Pediatric Dentistry, Prosthetics, Restorative Dentistry, and Oral Medicine) of the Dental Clinic Hospital of King Saud University before and after each patient. A Q-tip swabs were used from 10 surfaces in each clinic (Arm rest of dental chair, floor beneath dental chair, sink/faucet, towel dispenser, instrument table handle, light handle, X-ray viewer, paper dental records, head rest, and bench). Specimens were cultured in CHROMagar MRSA medium. Prevalence of MRSA colonization was compared between periods before and after patients visited each clinic for treatment. The results showed that the prevalence of MRSA was remarkably increased after patients visited the area. The results indicate that dental clinics should be considered as possible reservoirs of MRSA in the hospital setting.

Mixed connective tissue disease in young Saudi patient with recurrent dental abscess: A case report.

Mixed connective tissue disease (MCTD) or overlap syndrome is a rare disease. It has overlapping features of more than one autoimmune disease with high titer of anti-ribonucleoprotein antibodies against U1. We present a 12-year-old Saudi male patient who was presented to the dental clinic complaining from non-healing oral ulcers and multiple periapical abscesses that not responsive to extractions and the use of oral antibiotics, these symptoms were accompanied with persistent fever, headache, muscle weakness, general malaise, and painful bilateral cervical lymphadenopathy. After a thorough investigation, he was diagnosed with (MCTD) and was managed dentally and medically accordingly.

Knowledge, attitudes, and practice behavior of dental hygienists regarding the impact of systemic diseases on oral health.

OBJECTIVES: To assess the knowledge levels of dental hygienists in Saudi Arabia regarding the association between systemic and oral disease in addition to evaluating their attitude about integrating this knowledge into clinical practice. Methods: This was a cross-sectional survey using a questionnaire of 102 items among 192 randomly selected dental hygienists practicing in Riyadh, Saudi Arabia by individual interview. The research tool was pilot tested among 12 dental hygienists (8 females and 4 males) to obtain feedback about clarity and objectivity. Results: The response rate was 83%, and the majority of respondents were female (77.5%). The respondents' knowledge about the risk factors of cardiovascular diseases was better than other conditions. The level of education was considered to be a significant predictor in many items related to risk factors. More than the half, rated the evidence linking periodontal disease and diabetes mellitus as strong; however, the knowledge level of oral-systemic evidence was less than expected. A high percentage of the respondents were confident and comfortable managing patients with systemic conditions. Most agreed that dental hygienists must be prepared efficiently to manage medically compromised patients. Conclusion: Dental hygienists in Riyadh, Saudi Arabia have low level of knowledge about the oral-systemic disease relationship. This study suggests that greater emphasis should be placed on this association in current and continuing education programs.

Evaluation of effect of high frequency electromagnetic field on growth and antibiotic sensitivity of bacteria.

This study was aimed to evaluate the impact of high frequency electromagnetic fields (HF-EMF at 900 and 1800 MHz) on DNA, growth rate and antibiotic susceptibility of S. aureus, S. epidermidis, and P. aeruginosa. In this study, bacteria were exposed to 900 and 1800 MHz for 2 h and then inoculated to new medium when their growth rate and antibiotic susceptibility were evaluated. Results for the study of bacterial DNA unsuccessful to appearance any difference exposed and non-exposed S. aureus and S. epidermidis. Exposure of S. epidermidis and S. aureus to electromagnetic fields mostly produced no statistically significant decrease in bacterial growth, except for S. aureus when exposure to 900 MHz at 12 h. Exposure of P. aeruginosa to electromagnetic fields at 900 MHz however, lead to a significant reduction in growth rate, while 1800 MHz had insignificant effect. With the exception of S. aureus, treated with amoxicillin (30 µg) and exposed to electromagnetic fields, radiation treatment had no significant effect on bacterial sensitivity to antibiotics.

Influence of body mass index on severity of dental caries: cross-sectional study in healthy adults.

BACKGROUND: The relationship between body mass index (BMI) and dental caries is still undetermined. OBJECTIVE: This study aimed to assess the relationship between the dental status by decayed, missed, filled teeth index (DMFT), and BMI by age and gender among healthy adults. DESIGN: Analytical, cross-sectional study. SETTINGS: University dental hospital in Riyadh. SUBJECTS AND METHODS: Healthy adults aged between 18 and 35 years were recruited during the 10-month period from March 2015 to December 2015. Dental caries severity was estimated using the DMFT index. MAIN OUTCOME MEASURE: The prevalence of overweight/obesity and the association of BMI category with the DMFT index. RESULTS: The mean age of 502 subjects was 24.3 (4.9) years. The caries severity of the study population was considered moderate according to the WHO caries severity scale (mean [standard deviation] DMFT 13.3 [3.8]). The mean (SD) DMFT of male and female subjects was 13.1 (4.0) and 13.36 (3.7), respectively. No significant association was seen between dental caries and BMI. Logistic regression analysis showed that males had two times more risk of developing dental caries compared to females. In addition, the risk of caries development was increased by about 5 times for every year of age. CONCLUSION: Dental caries was not associated with BMI but age significantly influenced the DMFT index and gender was associated with more missing teeth. Further longitudinal studies with larger cohorts from several geographic regions are warranted. LIMITATION: Convenience sampling and recruitment from a single dental center may have some impact on the generalization of data.

Oral Kaposi Sarcoma in HIV-seronegative Saudi patient: Literature review and case report.

Kaposi Sarcoma (KS) is an intermediate neoplasm affecting the endothelial cells of mucous membranes and skin. It arises most commonly among HIV-infected individuals. We present an intra-oral KS in an 80-year-old Saudi male patient, who is HIV-seronegative, non-immunosuppressed, and with no history of organ transplantation. The patient was treated with fractionated radiation therapy, and had no recurrence in the 48 months of follow-up. The clinical disease, histologic features, and treatment modality used, as well as the relative literature are presented in this paper.

Knowledge and Attitude among General Dental Practitioners towards Minimally Invasive Dentistry in Riyadh and AlKharj.

INTRODUCTION: Minimally Invasive Dentistry (MID) emphasizes conservative caries management strategies resulting in less destruction of tooth structure, a deviation of the traditional GV Black's restorative principles. However, there seems to be either deficiency in knowledge or little intention by general dental practitioners to adopt these principles. AIM: The aim of this study was to assess the knowledge and attitude among general dental practitioners towards minimally invasive dentistry in Riyadh and AlKharj cities of Saudi Arabia. MATERIALS AND METHODS: Self-administered structured questionnaires were handed to general dental practitioners (GDPs) in the cities of Riyadh and AlKharj in Saudi Arabia. Several questions, including Likert-type scale response categories (1-5), were used. The questions assessed the respondents' levels of agreement regarding diagnostic, preventive and restorative techniques such as use of caries risk assessment, use of high fluoride tooth paste, Atraumatic Restorative Treatment and tunnel preparations. RESULTS: Out of 200 respondents, 161 GDPs with overall response rate of 80.5% completed the questionnaires. The GDPs showed significantly different approach with regards to the use of sharp explorer for caries detection (p = 0.014). Almost 60% of the participants had received no special education regarding minimally invasive procedures. Moreover, GDPs who had received MID training showed significantly better knowledge and attitude in adopting minimally invasive techniques for both diagnosis and treatment of dental caries. CONCLUSION: Although GDPs possess knowledge about the benefits of MID; however, study showed deficiencies in their attitudes towards caries detection methods and application of minimally invasive dentistry procedures.

The potential role of microbes in oncogenesis with particular emphasis on oral cancer.

For over a century, non-virus microorganisms, notably bacteria have been implicated as causal agents of cancers, a relatively small number of researchers have provided evidence to support the so-called "cancer germ" hypothesis. With the exception of the link between Helicobacter pylori and stomach cancer, other supposed links have been ignored. A wide range of bacteria and other non-virus microbes, including fungi, have been implicated over the years in oncogenesis, as well as the ability to induce inflammation, which may cause cancer. It seems that there is no single "cancer germ," as most bacteria can apparently induce cancer. Here, the role of bacteria and other non-virus microorganisms and oral cancers will be discussed. By ignoring bacteria as a causal agent of cancer, we set back our understanding of this crucially important disease and, as a result, have hindered the development of potential cures.

What if Fleming had not discovered penicillin?

What would have happened had Alexander Fleming not discovered penicillin in 1928? Perhaps the obvious answer is that, someone else would have discovered penicillin during 1930s and the Oxford group, would still have purified it sometime in the early 1940s. Here, however, in this counterfactual account of the penicillin story, it is argued that without Fleming, penicillin might still be undiscovered and the antibiotic age would never have dawned. As a result, many of the recent developments in medicine, such as organ transplantation, might have been delayed or, at best, made more hazardous. Penicillin might have come onto the scene a few years later but, had Fleming overlooked the discovery, it seems certain that penicillin would not have saved countless Allied lives, during and after D-Day. Instead of having enjoyed fifty and more years of the antibiotic age, it is argued here, that we would have had to rely upon highly developed sulphonamides, so-called "supasulfas", and other chemically-derived antibacterial drugs. Indeed, it might be the case that, even well into this new millennium, the antibiotic age has yet to dawn, and medicine is still waiting for someone to chance upon penicillin. Here we discuss what might have happened had Fleming not discovered penicillin and come to the conclusion that the medical armoury available today would have been far different and might have relied solely upon highly developed varieties of sulphonamides or similar, synthetic, non-antibiotic antibacterial agents.

Recurrent lip swelling as a late presentation of Kawasaki disease: Case report and review of literature.

Kawasaki Disease (KD) is an acute systemic vasculitis of unknown etiology. In many developed countries, KD has replaced rheumatic heart disease as the leading cause of acquired heart disease in children. Among the classical criteria for a diagnosis of KD are oral manifestations such as strawberry tongue, erythematous cracked lip, and oropharyngeal mucositis. We report the case of a 24-year-old Saudi female with a history of Kawasaki disease who presented to our oral medicine clinic with recurrent painless swelling of the upper lip. As lip swelling has not previously been reported as an oral manifestation of KD, this case represents a novel presentation of recurrent Kawasaki disease in an adult female.