Assessing the effect of Artemisia sieberi extracts on surface roughness and candida growth of digitally processed denture acrylic materials.

BACKGROUND: Denture stomatitis, frequently encountered, is generally addressed symptomatically, with limited exploration of preventive approaches involving antifungal medicinal plants. OBJECTIVE: This study assessed the impact of Artemisia sieberi extracts on the candida growth of conventional and digitally processed acrylic materials. METHOD: Thirty acrylic resin discs (3 mm thickness × 10 mm diameter) were prepared by conventional or CAD/CAM technology (milling and 3D printing). The resin discs were exposed to simulated brushing, thermocycling, and immersion in Artemisia sieberi extract for 8 hours. The surface roughness of the discs was assessed at baseline and after immersion in Artemisia sieberi extract. Candida growth was quantified through colony-forming units (CFU/mL). Data was analyzed using SPSS v.22 (α⩽ 0.05). RESULTS: Irrespective of the material type, the post-immersion surface roughness was significantly higher compared to pre-immersion values (p< 0.05). Candida growth was significantly higher in conventional acrylic materials than digitally fabricated acrylics (p< 0.05). At × 3, Ra and CFU were found to be moderately positive and non-significantly correlated (R= 0.664, p= 0.149). At × 4, Ra and CFU were found to be weak positive and non-significantly correlated (R= 0.344, p= 0.503). CONCLUSION: Artemisia sieberi extracts had a notable impact on digitally fabricated denture acrylics, reducing candida albicans growth compared to conventional heat-cured acrylic. This suggests a potential role for these extracts in improving denture hygiene and preventing denture stomatitis, particularly in the context of digitally fabricated dentures.

Locus of Control and Self-Directed Learning Readiness of Nursing Students during the COVID-19 Pandemic: A Cross-Sectional Study from Saudi Arabia.

BACKGROUND: Coronavirus disease (COVID-19) has caused one of the worst global pandemics in recent decades. It has disrupted education systems worldwide, leading to a forced shift from traditional face-to-face to blended or fully distanced learning, requiring a higher level of student readiness for self-directed learning (SDL) and a more internal locus of control (LOC). OBJECTIVE: This study explored the relationship between locus of control and level of readiness for SDL among Saudi nursing students and whether the COVID-19 pandemic has impacted this relationship. METHODS: A cross-sectional correlational descriptive study was conducted to survey 277 Saudi nursing students enrolled in the bachelor program at one of the reputable universities in Saudi Arabia. An E-questionnaire containing two scales, the Self-Directed Learning Readiness Scale for Nursing Education, and the Locus of Control Scale, was used to collect data in addition to the selected participants' characteristics. RESULTS: Nursing students had a moderate-to-low level of readiness for SDL (mean = 144.0), and the majority had an external LOC. There was a significant association between locus of control and level of readiness for self-directed learning (r = 0.19 *, p = 0.001), and the internal locus of control was more significantly associated with self-directed learning (r = 0.22 *, p = 0.0001) than with external locus of control. CONCLUSION: The study findings indicate a propensity of respondents indicating an external locus of control, whereas most of the respondents' reported levels of readiness ranged between low and moderate across all dimensions of self-directed learning. This study was not registered.

Effect of Adding Silver-Doped Carbon Nanotube Fillers to Heat-Cured Acrylic Denture Base on Impact Strength, Microhardness, and Antimicrobial Activity: A Preliminary Study.

Poly (methyl methacrylate) (PMMA), is an acrylic polymer substance that is mostly used for denture base applications. The purpose of this laboratory study was to investigate the effect of adding 0.05 wt.% Ag-doped carbon nanotubes (CNT) to PMMA-based (PMMA and MMA) denture base material on the impact strength, microhardness, and antimicrobial activity. A total of 60 heat-cured acrylic resin specimens were prepared. The specimens were randomly divided into two main groups (n = 30/group), according to the powder used: (a) control group, using heat-cured PMMA; (b) treatment group, using a powder prepared by blending 0.05 wt.% silver-doped CNT nanoparticles with heat-cured PMMA. The impact strength, microhardness and anticandidal activity for each group were assessed via the Charpy, Vickers and agar diffusion tests, respectively (n = 10/test for each subgroup). Data were analyzed using independent-sample t-tests (p ≤ 0.05). The results of the impact strength test revealed that the treated heat-cured PMMA-MMA with Ag-doped CNT (2.2 kJ/mm2) was significantly higher than that of the control heat-cured PMMA (1.6 kJ/mm2). Similarly, the Vickers microhardness of the treatment group (52.7 VHN) was significantly higher than that of the control group (19.4 VHN). Regarding the agar diffusion test, after 24 h of incubation, the treated heat-cured PMMA with the Ag-doped CNT exhibited significantly higher anticandidal activity than that of the control group. Therefore, Ag-doped carbon nanotubes could be considered as promising fillers for the dental heat-cured acrylic resin to improve the resistance of the resultant denture against sudden fractures, scratching, and candida invasion.

Patients' perceptions of telehealth video visits experience in primary healthcare setting, Saudi Arabia.

Background: The widespread utilization of telehealth recently in Saudi Arabia is unprepared and may have a remarkable adverse effect on healthcare delivery. The study aimed to investigate attitude, satisfaction, and barriers of telehealth application among patients. Materials and Methods: A cross-sectional study was conducted at primary healthcare centers during the period of December 2021-January 2022. All Saudi patients (≥18 years) who were treated through telehealth programs in specialized polyclinic were eligible for study inclusion. A self-administered questionnaire was utilized and consists of four main parts: personal information, history of using telehealth, assessment of satisfaction with telehealth program, and attitude toward telemedicine. Results: A total of 641 participants were included. Females represented 57.3% of them. A majority (82.7%) of patients were satisfied with telemedicine services. Multivariate logistic regression analysis revealed that Bachelor/postgraduates were more likely to be satisfied with telemedicine services (P < 0.001), whereas patients reported no appointment slot in the clinic were less likely to be satisfied with telemedicine services (P = 0.042). A majority of patients (84.1%) expressed positive attitude toward telemedicine services. Multivariate logistic regression analysis revealed that older patients (P = 0.002) and widowed (P = 0.001) were less likely to have positive attitude toward utilization of telemedicine services, whereas Bachelor/postgraduates (P = 0.038) and patients with more than this time were more likely to have positive attitude toward telemedicine services (P = 0.001). Conclusion: Patients were overall satisfied and expressed positive attitude concerning the service of telemedicine consultation. However, more in-depth investigation is recommended to better understand the predictors of satisfaction with telemedicine and barriers for its proper application.

Effect of Different Wax Pattern Manufacturing Techniques on the Marginal Fit of Lithium Disilicate Crowns.

Purpose: The present study evaluated the marginal gap of lithium disilicate crowns fabricated through three different wax pattern techniques; Conventional, Milling and 3D-printing. Materials and Methods: Thirty stone models were replicated from a stainless-steel model representing a prepared tooth; ten were sent to make conventional wax patterns while the remaining were sent to a digital dental scanner. The computer aided design was completed and STL (Standard Tessellation Language) files were sent to either milling or 3D-printing machines. All wax patterns (n = 30) were pressed, and a stabilizing instrument was used to secure the crowns on the master model. The marginal gap was measured at 18 points for each crown using a digital microscope (µm) (n = 540) and compared using One-way ANOVA (p ≤ 0.05). Results: There was a significant difference in the marginal gap value between all three groups (p < 0.01) where the milled group showed the least mean gap (28.87 ± 30.18 µm), followed by 3D printed (47.85 ± 27.44 µm), while the highest mean marginal gap was found in the conventional group (63.49 ± 28.05 µm). Conclusion: Milled and 3D-printed wax patterns produced better fitting crowns compared to conventional techniques.

The effect of the digital manufacturing technique of cantilevered implant-supported frameworks on abutment screw preload.

PURPOSE: The purpose of this study was to investigate the misfit and screw preload at the implant abutment connection of implant supported fixed dental prosthesis with cantilever (ICFDP) manufactured using different digital manufacturing techniques and to compare the screw preload before and after cyclic loading. MATERIALS AND METHODS: Mandibular jaw model with four intra-foraminal implants was scanned using digital scanner. Stereolithography file was used to design a framework with nonengaging (NE) abutments and 10 mm cantilever distal to one terminal implant. Five frameworks were constructed using combined digital-conventional techniques (CAD-cast), and five frameworks were constructed using three-dimensional printing (3DP). Additional CAD-cast framework was constructed in a way that ensures passive fit (PF) to use as control. Scanning electron microscope (SEM) measured the implant abutment connection misfit. Sixty screws were used on the corresponding frameworks. Screws were torqued and pre-cyclic loading reverse torque value (RTV) was recorded. Frameworks were subjected to 200,000 loading cycles with a loading point 9 mm from the center of terminal implants adjacent to the cantilever and post-cyclic loading RTVs were recorded. RESULTS: Microscopic readings showed significant differences between frameworks. PF demonstrated the lowest measurements of 16.04 (2.6) µm while CAD-cast demonstrated the highest measurements of 29.2 (3.1) µm. In all groups, RTVs were significantly lower than the applied torque. Post-cyclic loading RTV was significantly lower than pre-cyclic loading RTV in PF and 3DP frameworks. Differences in RTVs between the three manufacturing techniques were insignificant. CONCLUSION: Although CAD-cast and three-dimensionally printed (3DP) both produce frameworks with clinically acceptable misfit, 3DP might not be the technique of choice for maintaining screw's preload stability under an aggressive loading situation.

The Direct Cytotoxic Effects of Different Hemostatic Agents on Human Gingival Fibroblasts.

PURPOSE: To evaluate the cytotoxic effects of different hemostatic agents (including Expasyl) on human gingival fibroblasts (HGFs) in vitro. MATERIALS AND METHODS: HGFs were cultured and exposed to either no medicament treatment or 1:200 dilution of six different hemostatic agents (Hemox-A, Hemodent, Astringedent, Vicostat, Expasyl, 3M ESPE) for 2, 5, 10 minutes, 1 hour, and 24 hours. Toxicity to HGFs was determined by lactate dehydrogenase activity (LDH) and colorimetric (WST-1) assays. Two-tailed t-test was used for statistical analyses with α level set at 0.05. RESULTS: The group-by-time interactions were significant for the LDH and WST-1 assays (p < 0.001). Evaluation of the cytotoxic effect of different hemostatic agents at different incubation time intervals on the cell membrane damage revealed that Astringedent showed the highest cytotoxic effect on HGFs compared to other agents with regards to untreated negative control cells at all incubation time intervals (p < 0.001). On the other hand, Expasyl showed the least cytotoxic effect with significant differences at 5 minutes and 1 hour (p < 0.001) in comparison to other agents. CONCLUSIONS: LDH and WST-1 assays of hemostatic agents showed significant cytotoxic effect on HGFs at different time intervals. The data suggest that the risk for permanent tissue damage might be less significant when Expasyl is used during final impression procedure compared to when Astringedent is used.

Deep venous thrombosis among diabetic patients in King Abdulaziz University (KAU) Hospital, Jeddah, Kingdom of Saudi Arabia.

BACKGROUND: Deep venous thrombosis (DVT) is a major cause of morbidity and mortality among hospitalized patients worldwide and, simultaneously, the most preventable. Studies revealed several risk factors of deep venous thrombosis in hospitalized patients. OBJECTIVE: to identify frequency and factors associated with occurrence of deep venous thrombosis among diabetic patients referred to King Abdulaziz University (KAU) Hospital, Jeddah, Kingdom of Saudi Arabia. METHODS: This cross-sectional hospital-based study was conducted from June to December, 2016. All diabetic patients referred to the hospital departments and who were suspected to have deep venous thrombosis (DVT) and subjected to Doppler examination were included in the study. A questionnaire was designed to obtain data about deep venous thrombosis frequency among participants and factors associated with the development of deep venous thrombosis among them. Data was collected through face to face interviews with patients included in the study. We used SPSS version 16 for data analysis through descriptive statistics and Chi-square test. RESULTS: DVT was detected in 14.7 % of the examined patients. There were significant and positive associations between age and DVT (X2=10.13, p=0.03) and between ischemic heart disease and DVT (X2=1.628, p=0.043) with the development of deep venous thrombosis among the studied patients. On the other hand, gender, other comorbidities, history of previous DVT, being bed ridden and using orthopedic casting were not significantly associated with the occurrence of deep venous thrombosis among the participants. CONCLUSION: DVT development rate among the participants was 14.7 %. Aging was significantly associated with DVT occurrence. Most of the studied factors and comorbidities had no significant role in DVT development among participants and only ischemic heart disease was significantly associated with DVT development.

Survey of awareness of diabetes mellitus among the Arar population, Northern Border Region of Saudi Arabia.

BACKGROUND: Diabetes Mellitus (DM) is one of the most widely prevalent diseases in Saudi Arabia. Health education is considered an essential component to improve knowledge and change behavior. People affected by diabetes often have inadequate knowledge about the nature of diabetes, its risk factors and associated complication. OBJECTIVES: The aim of this study was to assess the awareness of the Arar population with various aspects of diabetes mellitus. METHODS: A cross-sectional study was carried out in Arar city, the capital of the Northern Province of Kingdom of Saudi Arabia (KSA). The study was carried out on Saudi nationals from different age groups that were selected by systematic random sampling. Data was collected by means of personal interview with the participants using a pre-designed questionnaire which was administered by the medical students for each diabetic patient. Data were analyzed by SPSS version 15, using descriptive statistics and Chi-square test. RESULTS: A total of 702 participants were interviewed, among them 201 (28.6%) males and 501 (71.4%) females, and most of them (77.8%) had high educational level, 10.4% were diabetics, 78.9% did not have regular checkup visits to the doctor and 58.5% did not perform any regular exercises, including walking, 60% thought that DM was due to partial or total decrease in insulin secretion and 12.4% thought that it was due to excess sweet eating. Additionally, 48.7% of the respondents thought that lack of exercise and obesity were the major risk factors of DM, 33.2% thought that it was a genetic disease. The majority (86.3) of the participants believed that the treatment of DM was a combination of healthy diet, exercise and medication and more than half (63.1%) said that weight loss and modification of life style were the most important preventive measures of DM. Regarding participants' knowledge about DM complications, 24.5% knew about retinopathy and loss of vision, 8.3% knew about retinopathy, loss of vision, low sensation and numbness in extremities, 24.9% said that symptoms of DM were thirst and frequent urination. CONCLUSION: This study recommends that health policy makers conduct more effective health education sessions to increase knowledge of diabetic patients and their caregivers about diabetes and the importance of compliance with its treatment.

Reasons for not using Implants to retain Complete Denture: Patients' Survey.

OBJECTIVE: This study aimed to gain more information from complete denture (CD) wearers who did not receive dental implants, of the reasons preventing them from using implants to retain their CD in a selected sample of dental patients in Riyadh, Saudi Arabia. MATERIALS AND METHODS: A paper-and-pencil questionnaire containing 20 direct questions of the possible reasons preventing CD wearers from receiving implants to retain their dentures was distributed in three different places in Riyadh, Saudi Arabia. RESULTS: A total of 270 subjects were included in this survey. The results showed that 180 (66.7%) patients indicated that the fear of pain associated with implant placement was the main reason preventing them from receiving an implant treatment, followed by fear of the surgical procedure (175, 64.8%), fear of postoperative complications (166, 61.5%), information from other people about the various problems associated with implant treatment (154, 57%), and finally cost of the implant (141, 52.2%). CONCLUSION: Fear is the main reason preventing CD wearers from receiving implant treatment. Therefore, it is essential for dentists to be familiar with the reasons for implant refusal to overcome a common, yet an influential obstacle.