Comparing nanoleakage between class II bulkfill and incremental composite restorations using snowplow technique.

Purpose: To compare the nanoleakage between bulkfill and incremental-fill resin composites in class II slot preparations for primary and permanent teeth restored by the snowplow technique. Materials and Methods: Class II slots were prepared in 32 M (16 exfoliated/extracted primary and 16 permanent molars). Optibond All-InOne self-etching adhesive was applied and cured. A flowable composite, Premise, was then injected into the gingival seat without curing using the snowplow technique. Cavities were restored using Sonicfill/bulkfill or microhybrid Herculite composites. Energy dispersive X-ray spectrometry was used to assess nanoleakage as silver deposition percentages along the axial and cervical walls. Multivariate analysis of variance was used to assess the effect of tooth type (primary and permanent teeth) and placement technique (bulkfill and incremental techniques) on nanoleakage at the axial and cervical walls. Results: Bulkfill restorations had significantly greater nanoleakage than incremental restorations at the cervical walls in primary and permanent molars (mean = 1.21 vs 0.49 in primary molars and 0.76 vs 0.24 in permanent molars). Equivalent results were observed at the axial walls of the restorations (mean = 0.66 vs 0.14 in primary molars and 0.28 vs 0.08 in permanent molars, with a P value of<0.001). Conclusions: Less nanoleakage was observed in class II slot/snowplow resin-composite restorations using the incremental technique compared to bulkfill in both dentitions. However, greater nanoleakage was detected on the cervical walls when compared with the axial walls.

Pediatric Dental Fluorosis and Its Correlation with Dental Caries and Oral-Health-Related Quality of Life: A Descriptive Cross-Sectional Study among Preschool Children Living in Belagavi.

AIM: This study aims to assess the prevalence of dental fluorosis and its association with dental caries, oral health behaviors, oral-health-related quality of life and parents' perceptions among preschool children in the 3-5-year-old preschool children living in the Belagavi district of Karnataka, a non-endemic fluorosis region. METHODS: A descriptive cross-sectional questionnaire-based study was conducted among 1200 individuals of the preschool population from 48 government-sponsored child-care development centers in Belagavi, Karnataka, over a three-month period. They were examined following the Dean's fluorosis index (1942) and dmft (decayed, missed, and filled) scores of the participants were also recorded. Parents' perception of oral health was assessed using the self-administered Early Childhood Oral Health Impact Scale (ECOHIS). SPSS software (version 20) was used for statistical analysis. Chi-square test computed categorical data. One-way ANOVA test was used for multiple group comparisons. p < 0.05 was considered statistically significant. RESULTS: Of the 1200 children examined, 10 (0.83%) children exhibited dental fluorosis. Of the 10 children having fluorosis, six had fluorosis present on two or more of their primary teeth, and four had fluorosis on four or more teeth. The mean dmft score was 3.01 ± 1.38 to 3.60 ± 1.72 in 3-5-year-old children, respectively, with statistical significance difference (p < 0.001). The mean score of oral health-related quality of life was 10.74 ± 2.06, which was significantly correlated to the child's age and parents' education level (p < 0.05). CONCLUSION: The study shows a negligible amount of prevalence of dental fluorosis in the non-endemic fluorosis residential district. It also elucidates that children from lower and lower-middle socioeconomic status are more prone to suffer from dental fluorosis as compared to other groups. The mean score of ECOHIS increased proportionally with the caries experience, indicating a significant relationship between the dmft and ECOHIS score. Deciduous dentition fluorosis is often neglected, especially in areas that are not considered endemic for fluorosis and with only optimum fluoride levels in their groundwater, which supports the disease's nature as multi-factorial and shows that a broader perspective is of prime importance to assess, diagnose, and prevent dental fluorosis among the preschoolers, thereby appraising their overall health and hygiene status.

Evaluation of salivary parameters and Streptococcus' Mutans count in children with cerebral palsy in Egypt: a case control study.

BACKGROUND: Children with cerebral palsy (CP) are at high risk for dental caries. Alteration of some salivary properties encountered among them compared to healthy children, could play a role in this elevated risk. OBJECTIVES: The aim of the present study was to assess salivary physicochemical properties; including total antioxidant (TAC), flow rate, viscosity, pH and buffering capacity, as well as Streptococcus mutans level among children with CP, also to correlate these variables to their caries experience. MATERIALS AND METHODS: This case control study included 80 children with CP, study group (SG) and matched number of healthy children for control group (CG). Interview-based questionnaire, clinical examination, salivary biochemical and microbiological investigations using MALDI-TOF were done. RESULTS: In SG, the caries experience in primary teeth dmft and S. mutans log value were significantly higher than CG (P = 0.039, P = 0.002) while unstimulated salivary flow rate, buffering capacity and salivary TAC were significantly lower (P < 0.0001). Multivariate linear regression showed that the presence of CP was significantly associated with the greatest variation in caries experience in the primary teeth and permanent teeth. Higher unstimulated salivary flow rate, or an increase in buffering capacity by 1 ml of acid/ml of saliva were associated with lower number of the affected primary and permanent teeth. On the other hand, One-unit increase in S. mutans log count and higher salivary TAC were associated with higher caries experience. CONCLUSION: Children with CP have higher caries experience (dmf) due to lower salivary protective factors and higher S. mutans counts.

Assessment of Parental Knowledge towards Space Maintainer as an Essential Intervention after Premature Extraction of Primary Teeth.

This study assessed parents' knowledge about space maintainers as an interceptive strategy after premature loss of primary teeth. Methods and Material: A cross-sectional questionnaire-based descriptive study was conducted on a sample of 600 parents; 456 (76%) were females, and 144 (24%) were males, recruited from an outpatient dental clinic at Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia. The questionnaire consisted of two sections; the first section collected sociodemographic data of participants, and the second section gathered parental knowledge of space maintainers. The research ethics committee granted ethical approval, and informed consent was obtained before participation. Results: 600 parents participated in this study. The total mean knowledge score regarding space maintainers was 7.97 ± 3.38. The mean knowledge score was 7.06 ± 2.99 for male parents and 8.26 ± 3.45 for female parents. The difference in the mean knowledge score between female and male parents was statistically significant (p < 0.001). Additionally, there was a statistically significant difference in the knowledge score and parents' age groups, with parents having the highest knowledge in the 30−40 age group (p = 0.0197). There was a positive correlation between knowledge scores and the number of children. Parents with one child showed less knowledge than those with two to four children (p = 0.0121). Conclusions: Participants' knowledge regarding space maintainers was 49.8%, which is considered inadequate. It was deemed essential to increase knowledge among parents about space maintainers as an interceptive approach after premature loss of primary teeth.

Child discomfort and parental acceptability of silver diamine fluoride and alternative restorative treatment: A randomized controlled clinical trial.

OBJECTIVES: To compare pain perception of young children treated with SDF and ART, as well as their parents' acceptability of both modalities. METHODS: Eighty, 3 to 8-years old children, having at least one deciduous asymptomatic tooth with active caries, as defined by the ICDAS II scores 4, 5, 6 were randomly assigned into two groups; SDF for caries arresting in the test group, and ART for caries removal in the control group. Pain perception was assessed using Sound, Eye, Motor scale (SEM), whereas parental acceptability was assessed using a self-administered questionnaire. RESULTS: Patients treated with SDF reported significantly less discomfort and pain compared to the ART group, with a mean SEM of 3.70 ± 1.47 and 6.18 ± 3.06, respectively (p < 0.001). A significantly higher mean parental acceptability score was detected for SDF treatment (31.85 ± 2.30) than ART treatment (26.75 ± 3.60), p < 0.001, with regard to the treatment duration, child comfortability and quality of treatment (p < 0.001). The only dimension showing more satisfaction for the ART treatment was esthetics of anterior teeth (p= 0.01). CONCLUSIONS: Parental acceptability was higher for the SDF caries treatment of primary teeth compared to ART treatment, especially in relation to the shorter intervention time, child comfortability and acceptance as well as quality of treatment. CLINICAL SIGNIFICANCE: The shorter average time needed and the ease of application of SDF on cavitated primary lesions, in addition to parental acceptability, place SDF in an advantageous position over the ART on clinical level.

Using Machine Learning Algorithms to Predict People's Intention to Use Mobile Learning Platforms During the COVID-19 Pandemic: Machine Learning Approach.

BACKGROUND: Mobile learning has become an essential instruction platform in many schools, colleges, universities, and various other educational institutions across the globe, as a result of the COVID-19 pandemic crisis. The resulting severe, pandemic-related circumstances have disrupted physical and face-to-face contact teaching practices, thereby requiring many students to actively use mobile technologies for learning. Mobile learning technologies offer viable web-based teaching and learning platforms that are accessible to teachers and learners worldwide. OBJECTIVE: This study investigated the use of mobile learning platforms for instruction purposes in United Arab Emirates higher education institutions. METHODS: An extended technology acceptance model and theory of planned behavior model were proposed to analyze university students' adoption of mobile learning platforms for accessing course materials, searching the web for information related to their disciplines, sharing knowledge, and submitting assignments during the COVID-19 pandemic. We collected a total of 1880 questionnaires from different universities in the United Arab Emirates. Partial least squares-structural equation modeling and machine learning algorithms were used to assess the research model, which was based on the data gathered from a student survey. RESULTS: Based on our results, each hypothesized relationship within the research model was supported by our data analysis results. It should also be noted that the J48 classifier (89.37% accuracy) typically performed better than the other classifiers when it came to the prediction of the dependent variable. CONCLUSIONS: Our study revealed that teaching and learning could considerably benefit from adopting remote learning systems as educational tools during the COVID-19 pandemic. However, the value of such systems could be lessened because of the emotions that students experience, including a fear of poor grades, stress resulting from family circumstances, and sadness resulting from a loss of friends. Accordingly, these issues can only be resolved by evaluating the emotions of students during the pandemic.

Clinical presentation and outcome of retinoblastoma among children treated at the National Cancer Institute (NCI) in Gezira, Sudan: a single Institution experience.

BACKGROUND: Retinoblastoma (RB) is a rare and unique cancer that affects the eyes of very young children. There are few reports on RB in Sudan. MATERIALS AND METHODS: We performed a retrospective study of data from patients diagnosed with retinoblastoma between January 1999 and December 2009 at the National Cancer Institute in Gezira (NCI-Gezira). RESULTS: Of the 519 cases of childhood cancer treated at NCI-Gezira during the study period, 25 (4.8%) were retinoblastoma. Of these 25 patients with retinoblastoma, there were 13 boys and 19 cases were unilateral. The median age at diagnosis was 36 months (range, 8-60 months). The disease was localized in 9 patients, regional in 5 patients, and metastatic in 11 patients. The most frequent symptoms were enlarged eye (n = 14) and leukocoria (n = 8). Nine patients (36%) have been lost to follow-up; 9 were alive at last follow-up (7 in remission, 2 progressed); and 7 have died (5 from disease and 2 from unrelated causes). Twenty-two eyes were enucleated in 16 patients (6 bilateral and 10 unilateral). Pathologic examination of the enucleated eyes could only be completed in 11 patients. Diagnostic imaging in the form of computerized tomography scans or ultrasonography of the brain and orbit was done for 10 patients (40%). CONCLUSIONS: Although these findings are not surprising, and similar to reports from other developing countries, we hope our work will provide a foundation for strategies to improve outcome for retinoblastoma in our center such as proper training, public awareness, team approach, and twinning.

Reliability of serum procalcitonin concentrations for the diagnosis of sepsis in neonates.

The evaluation of tests for neonatal sepsis is important because the infection may present a very serious threat to the baby. Extensive literature exists on single laboratory test or combinations of tests, as well as tests used together with risk factors and/or clinical signs, to diagnose neonatal sepsis. In many instances, the results of the evaluations have been conflicting. It has recently been suggested that serum procalcitonin (PCT) is of value: in the diagnosis of neonatal sepsis, with varying results. This study was designed to determine the reliability of PCT concentrations as a new marker for the diagnosis of early neonatal sepsis of vertical transmission comparing to the traditional inflammatory mediators, such as interleukin-6 (IL-6) and C-reactive protein (CRP) values. The current study included 69 newborn babies. After full history and clinical examination, they were classified into 2 groups: Group 1, included 27 of asymptomatic newborn infants admitted during the first 24 h of life to the neonatal unit because of prematurity, low birth weight. They had no clinical signs of sepsis during their first week of life and had a negative blood culture, and they did not receive antibiotic treatment. The second group: Group 2, included 42 symptomatic neonates who were admitted to the neonatal care unit and were evaluated for sepsis during the first 48 h of life, they were subclassified into twosubgroups: group 2A; included 22 neonates of confirmed vertical neonatal sepsis, defined as they had at least three clinical signs of infection with culture proven sepsis, and group 2B included 20 neonates of vertical clinical sepsis (they had at least three clinical signs of infection) with negative blood culture. Blood sampling for blood culture, complete blood count, blood gases and blood chemistry, additionally, CRP, serum IL-6 and PCT were measured. The microbial organisms isolated from the blood culture of group 2A; Escherichia coli was isolated from 9 cases, staphylococcus aureus from 6 cases, staphylococcus epidermidis from 2 cases, group B streptococci (GBS) from 2 cases, ureaplasma from 2 cases and one case was GBS positive mother. The comparison between the studied groups revealed that, white blood cell counts (WBCs) and CRP levels were significantly increased in group 2A more than in group 1 and group 2B. While in group 2B the WBCs not differed from group 1 but CRP differed from group 1. IL-6 and PCT values were significantly increased in group 2A more than in group 1 and group 2B. Furthermore in group 2B both were significantly increased as compared to group 1. For the diagnosis of neonatal infection, at cutoff >1.5 ng/ml, PCT give a sensitivity of 92.9%, specificity of 85.2%, positive predictive value (PPV) of 84.8%, and negative predictive value (NPV) of 76.7%. At a cutoff >140 ng/ml, IL-6 gives a sensitivity of 76.2%, speCificity of 70.4%, PPV of 64%, NPV of 63.3%. However, at a cutoff >12 mg/L, CRP gives a sensitivity of 88%, specificity of 77.8%, PPV of 77.1%, NPV of 70%. We conclude that the serum PCT concentration showed a good diagnostic value for the early detection of neonatal sepsis of vertical transmission comparing with the other traditional markers of inflammations, thus may facilitate early therapeutic intervention in those high risk group.