Aluminum zirconate nanoparticles in etch and rinse adhesive to caries affected dentine: An in-vitro scanning electron microscopy, elemental distribution, antibacterial, degree of conversion and micro-tensile bond strength assessment.

To incorporate different concentrations of Al2O9Zr3 (1%, 5%, and 10%) nanoparticles (NP) into the ER adhesive and subsequently assess the impact of this addition on the degree of conversion, µTBS, and antimicrobial efficacy. The current research involved a wide-ranging examination that merged various investigative techniques, including the application of scanning electron microscopy (SEM) for surface characterization of NP coupled with energy-dispersive x-ray spectroscopy (EDX), Fourier-transform infrared (FTIR) spectroscopy, µTBS testing, and microbial analysis. Teeth were divided into four groups based on the application of modified and unmodified three-step ER adhesive primer. Group 1 (0% Al2O9Zr3 NPs) Control, Group 2 (1% Al2O9Zr3 NPs), Group 3 (5% Al2O9Zr3 NPs), and Group 4 (10% Al2O9Zr3 NPs). EDX analysis of Al2O9Zr3 NPs was performed showing elemental distribution in synthesized NPs. Zirconium (Zr), Aluminum (Al), and Oxides (O2). After primer application, an assessment of the survival rate of Streptococcus mutans was completed. The FTIR spectra were analyzed to observe the characteristic peaks indicating the conversion of double bonds, both before and after the curing process, for the adhesive Etch and rinse containing 1,5,10 wt% Al2O9Zr3 NPs. µTBS and failure mode assessment were performed using a Universal Testing Machine (UTM) and stereomicroscope respectively. The µTBS and S.mutans survival rates comparison among different groups was performed using one-way ANOVA and Tukey post hoc (p = .05). Group 4 (10 wt% Al2O9Zr3 NPs + ER adhesive) specimens exhibited the minimum survival of S.mutans (0.11 ± 0.02 CFU/mL). Nonetheless, Group 1 (0 wt% Al2O9Zr3 NPs + ER adhesive) displayed the maximum surviving S.mutans (0.52 ± 0.08 CFU/mL). Moreover, Group 2 (1 wt% Al2O9Zr3 NPs + ER adhesive) (21.22 ± 0.73 MPa) samples displayed highest µTBS. However, the bond strength was weakest in Group 1 (0 wt% Al2O9Zr3 NPs + ER adhesive) (14.13 ± 0.32 MPa) study samples. The etch-and-rinse adhesive exhibited enhanced antibacterial activity and micro-tensile bond strength (µTBS) when 1% Al2O9Zr3 NPs was incorporated, as opposed to the control group. Nevertheless, the incorporation of Al2O9Zr3 NPs led to a decrease in DC. RESEARCH HIGHLIGHTS: 10 wt% Al2O9Zr3 NPs + ER adhesive specimens exhibited the minimum survival of S.mutans. 1 wt% Al2O9Zr3 NPs + ER adhesive samples displayed the most strong composite/CAD bond. The highest DC was observed in Group 1: 0 wt% Al2O9Zr3 NPs + ER adhesive.

PEEK surface treatment on surface roughness and bond integrity to composite resin utilizing Er: YAG, Rosebengal activated by PDT, and aluminum trioxide particles.

AIMS: To evaluate the impact of conditioning protocols, aluminum trioxide (Al2O3), Er:YAG laser (EYL), and Rosebengal (RB), on the surface roughness (Ra) and shear bond strength (SBS) of polyetheretherketone (PEEK) attached to composite restorations. METHOD: Eighty PEEK discs in total were produced and then divided into four groups (n = 20). Group1:Sulfuric acid (SA), Group 2: PDT (RB), Group 3: Al2O3, Group 4 EYL, respectively. The Ra of PEEK discs was evaluated using the surface profilometer. After being luted, the discs were attached to composite resin discs. After that, samples were put to SBS testing on a Universal testing apparatus. A stereo microscope was also used to evaluate the type of breakdown. The data were analyzed using Tukey's test and one-way analysis of variance. RESULTS: The SA treated group exhibited the highest Ra. Nevertheless, the RB specimens activated by PDT treatment had the lowest mean Ra score. The group that received the treatment of SA exhibited the highest average score of SBS. In contrast, specimens treated with PDT and activated by RB exhibited the lowest levels of bond fidelity. Cohesive failure emerges as the prevailing kind of fracture within the various groups subjected to testing. CONCLUSION: The utilization of Al2O3, RB activated by PDT, and EYL shows promise as a viable substitute for Sulfuric acid in enhancing the bond integrity of composite cement and surface roughness in PEEK materials.

Use of final irrigants MTAD, Salvedora Perscia, Malachite green, and Ti-sapphire laser on push-out bond strength of Zirconia post.

AIM: Evaluation of the push-out bond strength (PBS) of zirconia post-bonded to radicular dentin after using different final irrigants (MTAD, Malachite green (MG), Ti-sapphire laser and Salvadora persica (S.persica). MATERIAL AND METHOD: Forty human permanent single-rooted were decoronated above the cement-enamel junction. An experienced endodontist performed all the root canal instrumentation using ProTaper universal rotary files. Canals were irrigated using 5.25% NaOCl solution followed by EDTA as a final sterilant. Obturation with gutta-percha using AH Plus sealer was performed. Post-space preparation was completed using Gates Glidden and specimens were randomly assigned to four groups based on the final disinfectant received (n=10). Group 1: 5.25% NaOCl + MTAD, group 2: 5.25% NaOCl + MG, group 3: 5.25% NaOCl +Ti-sapphire laser, and group 4: 5.25% NaOCl + S. persica. The chemically polymerized resin was used to lute zirconia posts. PBS and failure mode analysis were performed using a universal testing machine and stereomicroscope at 40X magnification. Data were compared between the two groups with 95% CI using one-way analysis of variance (ANOVA) with the Tukey post hoc test. p=0.05. RESULTS: Group4(5.25% NaOCl+ S.persica) specimens demonstrated the maximum (8.94±0.14 MPa) bond strength. Conversely, the apical third of Group 2 (5.25% NaOCl+ MG) (2.87±0.15 MPa) samples revealed the minimum bond strength scores. Intergroup comparison exposed that Group 1 (1.3% NaOCl+ MTAD), Group 3 (5.25% NaOCl+Ti-sapphire laser), and Group 4 (5.25% NaOCl+ S. persica) at all three-thirds unveiled no significant difference in PBS (p<0.05). CONCLUSION: Ti-sapphire laser and Salvedora Persica possess the potential to be used as a final root canal irrigant to improve the push-out bond strength of zirconia post-to-root dentin.

Different cavity disinfectant efficacy against S.mutans and shear bond strength of caries affected dentin bonded to resin restoration.

AIMS: The existing study aimed to assess the survival rate of S.mutans and shear bond strength (SBS) of resin adhesive restoration bonded to carious affected dentin (CAD) after using different cavity disinfectants (Chitosan, Fotoenticine®, and CO2 laser) in comparison to Chlorhexidine (CHX). MATERIALS AND METHODS: The study included human mandibular molars assessed on International Caries Detection and Assessment System (ICDAS) score 4 and 5. The cusp part of the clinical crown was cut off until the reduction reaches the central fossa while being continuously supplied with water coolant till the tooth cementoenamel junction (CEJ). The root sections were embedded in polymethyl methacrylate acrylic resin followed by culturing S.mutans biofilm on the CAD surface. Specimens were arbitrarily allocated into four groups(n = 10) based on the type of disinfection. Group 1 (2% CHX), Group 2 (Chitosan), Group 3 (Fotoenticine), and Group 4 (CO2 laser). S.mutans survival rate was assessed and CAD was restored with a composite restorative material. Thermoocycling of the samples was performed and a universal testing machine (UTM) and Stereomicroscope were used to identify bond integrity and type of fracture. ANOVA and Tukey multiple comparison tests were used to assess SBS. Data on the survival rate of S. mutans were compared between groups using the nonparametric Kruskal-Wallis test RESULTS: Outcomes revealed that Group 1 (CHX) displayed the highest survival rate (0.65 ± 0.10). However, lowest survival rate was demonstrated by Group 3 (Fotoenticine) treated specimens (0.25 ± 0.06). It was also discovered that CHX unveiled highest bond strength values (21.48 ± 1.39 MPa). Nevertheless, Group 2 (Chitosan) showed lowest SBS (11.01 ± 1.00 MPa). Intergroup comparison analysis presented that group 1, and group 4 (Co2 laser) (17.76 ± 0.41 MPa) displayed no significant difference in their bond integrity achieved. (p > 0.05). However, group 3 (Fotoenticine) (16.28 ± 0.51 MPa) and group 2 demonstrated comparable outcomes of SBS. (p > 0.05) CONCLUSION: The use of CHX and CO2 lasers as disinfectants on the CAD surface resulted in a positive impact on the SBS of resin composite, according to the study's findings. However, it is worth noting that Fotoenticine exhibited better antimicrobial efficacy against S. mutans.

Efficacy of 5-aminolevulinic acid-mediated photodynamic therapy in patients with nicotine stomatitis.

AIM: This study aimed to treat smoker's palate (SP) using 5-aminolevulinic acid (5-ALA)-mediated photodynamic therapy (PDT). METHODS: A total of 24 patients with SP were divided into two groups: group-I (test group; n = 12); and group-II (control group; n = 12). Group-I patients were treated with 5-ALA-mediated PDT, while group-II patients were advised to cease the smoking habit during the entire duration of the study and later. PDT was repeated on days 3, 7, and 14 (i.e., a total of four sittings including day 0 [baseline]). Later, the participants were called for follow-up after week-4 (1st follow-up), week-6 (2nd follow-up), and week-8 (3rd follow-up) after the completion of the treatment. The SPSS version 22.0 was used for data analysis. RESULTS: Group-I patients showed a statistically significant improvement when all three time points were assessed (p < 0.0001). Similarly, the same trend was observed in the group-II participants (p < 0.001), however, the difference between both groups (i.e., group-I [test group] and group-II [control group]) was larger. CONCLUSION: The findings of this clinical trial indicated a promising and satisfactory decrease in the clinical features of the smoker's palate without any adverse impacts utilizing 5-aminolevulinic acid-mediated photodynamic therapy. Hence, 5-ALA-mediated PDT appeared to be a promising treatment option together with smoking cessation.

Disinfection of caries-affected dentin using potassium titanyl phosphate laser, Rose bengal and Ozonated water on shear bond strength of deciduous teeth.

AIM: To assess the efficacy of disinfection of caries-effected dentin (CAD) using KTP laser and different decontamination methods using ozonated water (OW), Rose Bengal photosensitizer (RBP), chlorhexidine (CHX), and Er, YAG laser on the shear bond strength (SBS) of adhesive resin bonded to deciduous teeth. MATERIAL AND METHODS: A total of 50 extracted and radiographically verified carious primary molars were collected and scrutinized according to ICDAS criteria. Specimens were allocated randomly into five groups (n = 10) as per the type of CAD disinfectants. KTP laser, OW, RBP, CHX (control), and Er, YAG laser. After cavity sanitization, a resin adhesive (prime and bond NT) was smeared on the dentinal exterior followed by incremental composite filling. SBS evaluation was performed by employing specimens in the universal testing machine. The debonded surface was assessed under 40x magnification in a stereomicroscope to ascertain fracture mode. Statistical analysis was done by using the ANOVA and the Post Hoc Tukey multiple comparison tests (p < 0.05). RESULTS: The highest SBS was exhibited by group 2 i.e., when OW was employed for CAD disinfection (10.25 ± 0.24 MPa). Whereas, the lowest SBS bond value was unveiled by samples in group 3 when RBP was applied for dentin surface sanitization (7.85 ± 0.59 MPa).CAD disinfection with KTP laser (8.25 ± 0.41 MPa), CHX (8.19 ± 0.73 MPa), and RBP displayed comparable bond values (p > 0.05). CONCLUSION: Ozonated water and Er, YAG laser could be employed as cavity disinfectants in primary teeth as they demonstrated better shear bond strength without jeopardizing the adhesive binding capacity of restorative resins bonded to caries-affected dentin.

Glass fiber post resistance to dislodgement from radicular dentin after using contemporary and conventional methods of disinfection.

AIM: The present study aimed to assess the bond integrity of curcumin photosensitizer (CPS) Photodynamic therapy (PDT) on fiber post disinfection bonded to radicular dentin in comparison to the conventional fiber post sterilant used. MATERIALS AND METHODS: Fifty human permanent single-rooted premolars were utilized with the crown part sectioned using up to the cementoenamel junction. Root canal preparation was performed followed by canal obturation with gutta-percha (GP) and resin-based sealer. The post space was prepared using peso reamers leaving 4 mm at the apical part of the post space. Fifty glass fiber posts (GFP) were divided into five groups based on the surface disinfectant (n = 10). group 1: Autoclave sterilization (AS) group 2: chlorhexidine digluconate (CHX dig), group 3: CPS solution, group 4: 35% phosphoric acid (PA) gel, and group 5: No disinfection. Cementation was performed using dual-cure self-etch resin cement. Each tooth was sectioned and placed on the universal testing machine. Failure mode was analyzed using a stereomicroscope at 40x magnification. Statistical analysis was performed using one-way analysis of variance (ANOVA) and Tukey multiple comparison tests. (p = 0.05). RESULTS: Intragroup comparison analysis demonstrated that group 2 in which 2% CHX dig was used as a post-surface disinfectant revealed the highest bond integrity at all three levels. Group 5 where no disinfectant was used to decontaminate the post surface exhibited the lowest bond values. In all the investigated groups, PBS values showed a downward trend from coronal to the apical third of the post space. Group 1 in which AS was used to sterilize the fiber post and group 3 in which CPS was smeared to decontaminate the GFPs surface-displayed comparable outcomes of PBS to group 5 specimens at all three levels. (p > 0.05). CONCLUSION: CHX dig and PA post-surface disinfection displayed a positive impact on bond strength with the radicular dentin. However, CPS and AS do not reveal any effect on the PBS when used for post-decontamination.

Noncarious cervical lesion pretreated using antimicrobial photodynamic therapy and diode laser in reducing dentin hypersensitivity bonded to different restorative material: Valuation of bond values and invitro dye leakage.

AIM: The present study aimed to appraise the effect of Diode laser (DL), riboflavin, and curcumin on the bond strength of adhesive restorative material and the effects of pretreatment on microleakage scores. MATERIAL AND METHODS: Ninety caries-free human permanent premolars were obtained and disinfected. All specimens were mounted till CEJ. To provide standardization, a 2 × 2 mm flat non-carious cervical lesion (NCCL) dentin surface was exposed. This was followed by dentin surface roughening/cervical groove preparation with a round bur. After tooth surface preparation, ninety specimens were divided arbitrarily into three groups. Group 1: NCCL exposed to DL; group 2: NCCL pretreated with riboflavin photosensitizer (RFP) and group 3 pretreated with curcumin photosensitizer (CP). All the three groups were further divided into two subgroups A1, A2, B1, B2, C1, and C2 based on the restorative material used (n = 15). Subgroup A1, B1, and C1 were restored with composite resin (CR). Subgroup A2, B2, and C2 were restored with RMGIC. Ten samples from each subgroup were evaluated for shear bond strength (SBS) testing under a universal testing machine (UTM). Five from each subgroup were evaluated for microleakage assessment. Bond strength and microleakage analysis were performed using analysis of variance (ANOVA) with a Post-hoc test (Tukey's post hoc test) at a significance level (p = 0.05). RESULTS: The group A1, DL-CR shows the highest SBS (16.41± 0.4 MPa). However, CP-RMGIC groups demonstrated the lowest bond integrity. RFP-CR and the DL-CR group displayed comparable outcomes of SBS (p>0.05). The highest microleakage was observed with CP-RMGIC. The least microleakage was displayed by DL-CR. CONCLUSION: Noncarious cervical lesions pretreated with diode laser and riboflavin photosensitizer showed better shear bond strength and reduced microleakage when bonded to composite resin than non-carious cervical lesions pretreated with curcumin.

Assessment of push-out bond strength of post-surface pretreatment before salinization using hydrogen peroxide, aluminum trioxide, and natural photosensitizers to radicular dentin.

OBJECTIVE: The study aimed to evaluate the effect of different post surface pretreatment methods i.e., 24% hydrogen peroxide (H2O2), riboflavin photosensitizer (RFP), curcumin photosensitizer (CP) and aluminum oxide (Al2O3), and silane only on the bond values of glass fiber post to resin cement MATERIALS AND METHODS: Fifty single-rooted human teeth were obtained and crowns were sectioned coronally to the cementoenamel junction (CEJ). Protaper universal file system was used for canal cleaning and shaping followed by obturation. Post space was prepared and all the posts were then randomly divided into five groups depending on the surface pretreatment used (n = 10). Group 1: 24% H2O2 + silane, Group 2: RFP + silane, Group 3: CP + silane, Group 4: Al2O3 + silane, Group 5: silane only. Post-surface treatment was followed by post-placement using a self-etch dual-cure cement Panavia F 2.0. Acrylic blocks were used to hold the specimens perpendicularly and all the samples were sectioned by slow-speed saw into coronal, middle, and apical third. The universal testing machine determines pushout bond strength and failure mode was analyzed by stereomicroscope. One-way analysis of variance (ANOVA) and Tukey multiple comparison tests were used to analyze data. RESULT: The coronal section of group 4 (Al2O3 + silane) displayed the highest PBS (8.23±0.14 MPa). Whereas, an apical third of group 2 (RFP + silane) exhibited the lowest PBS (2.02±0.12 MPa). PBS values in samples in group 1 surface treated with 24% H2O2 + silane displayed comparable outcomes to samples in group 4 at all three levels (p>0.05). Samples in group 2 (RFP + silane) group 3 (CP + silane) and group 5 (Silane Only) demonstrated comparable PBS (p>0.05). CONCLUSION: Glass fiber reinforced post-surface pretreatment method using hydrogen peroxide and aluminum trioxide along with silane improves push-out bond strength at all three levels (coronal, middle, and apical). The use of a silane coupling agent on glass fiber posts alone does not improve bond values. The practice of photosensitizer on post-surface needs to be investigated further.

Dental students and COVID 19: An online multinational survey on perception and knowledge.

Background: Coronavirus is an emerging respiratory pathogen that causes coronavirus disease-2019 (COVID-19), as per the Chinese Center for Disease Control and Prevention. Objective: This study aimed to assess the state of awareness and extent of knowledge about COVID-19 among dental students from India, Pakistan, and Saudi Arabia. Materials and Methods: The present descriptive cross-sectional study was conducted on 872 participants from December 2020 to January 2021. Random sampling was performed using an electronic questionnaire. One-way analysis of variance and independent sample t-test were performed to assess and compare the mean knowledge score between different demographic data. Results: Approximately 60% (n = 520) of the responders were women and 40% responders were men (n = 352). The responders were from Saudi Arabia (36.9%; n = 322), India (34.2%; n = 298), and Pakistan (28.8%; n = 252). The difference within the subgroups was statistically nonsignificant (P > 0.05), indicating that dental students of all subparameters possessed equal knowledge on COVID-19. Conclusions: Dental students possess sufficient knowledge about COVID-19, qualifying them at least to work in a medical ward. However, more emphasis must be placed on infection prevention and control policies such as hand hygiene, personal protective equipment, and pre- and postexposure prophylaxis.

RésuméContexte: Le coronavirus est un agent pathogène respiratoire émergent qui provoque la maladie à coronavirus-2019 (COVID-19), selon le Centre chinois chinois de contrôle et de prévention des maladies. Objectif: Cette étude visait à évaluer le degré de sensibilisation et l'étendue des connaissances sur le COVID-19 parmi les étudiants en médecine dentaire d'Inde, du Pakistan et d'Arabie Saoudite. Matériaux et méthodes: La présente étude descriptive transversale a été menée sur 872 participants de décembre 2020 à janvier 2021. Un échantillonnage aléatoire a été réalisé à l'aide d'un questionnaire électronique. Une analyse de variance à sens unique et un test t d'échantillon indépendant ont été réalisés pour évaluer et comparer le score moyen de connaissances entre les différentes données démographiques. différentes données démographiques. Résultats: Environ 60% (n = 520) des répondants étaient des femmes et 40% des répondants étaient des hommes (n = 352). Les répondants étaient originaires d'Arabie Saoudite (36,9% ; n = 322), d'Inde (34,2% ; n = 298) et du Pakistan (28,8% ; n = 252). La différence au sein des les sous-groupes était statistiquement non significative (P > 0,05), ce qui indique que les étudiants en médecine dentaire de tous les sous-paramètres possédaient les mêmes connaissances sur COVID-19. Conclusions: Les étudiants en médecine dentaire possèdent des connaissances suffisantes sur la COVID-19, ce qui les qualifie au moins pour travailler dans un service médical. Cependant, il faut mettre davantage l'accent sur les politiques de prévention et de contrôle des infections, telles que l'hygiène des mains, les équipements de protection individuelle, et la prophylaxie pré- et post-exposition. Mots-clés: Sensibilisation, maladie à coronavirus-2019, étudiants en médecine dentaire.

Radicular canal disinfection by photosensitizers activated by photodynamic therapy and Er, Cr: YSGG laser bonded to glass fiber post using different cement types. An Invitro study.

AIM: To assess the tensile bond strength (TBS) of conventional glass ionomer cement (GIC) and resin cemented fiber post to radicular dentin when disinfected with different photosensitizers methylene blue photosensitizer (MBP), curcumin photosensitizer (CP), and laser therapy Er, Cr: YSGG laser (ECYL) MATERIAL AND METHODS: Sixty carefully extracted, non-traumatic, non-carious, closed apex human mandibular premolars were collected. Periodontal fibers, plaque, or calculi were detached. Decoration of samples was executed up till the cementoenamel junction. Samples were embedded perpendicularly in a heat cure acrylic resin. Canals of all specimens were shaped and cleaned with Protaper universal NiTi system dehydrated with paper points and obturated with gutta-percha. Post space was prepared after the removal of gutta-percha via peso reamers. Post space was disinfected with MBPv100mg/L in group 1; group 2 500 mg/L and group 3 ECL. After sequential photo-irradiation therapies, fiber post was luted with resinous cement and GIC (n = 10 each). After post-cementation, all specimens were subjected to tensile strength in the universal testing machine in Newton. Failure analysis was assessed at 30x magnification.TBS determination was statistically analyzed by one-way variance analysis (ANOVA), followed by the Tukey test (p= 0.05) by parallelizing different groups. RESULTS: Fiber post cemented to radicular dentin with Rely X ARC resin cement and radicular canal disinfected with CP offered the highest TBS (289.25±3.27 N). Similarly, canal space disinfected with MBP and post-luted via Rely X ARC showed the lowest TBS (281.54±4.46 N). Intragroup comparison unveiled that there is no statistical difference between tensile strength sustained by two luting cement (p>0.05). CONCLUSION: Rely X ARC resinous cement bared the highest tensile bond strength for a post-dentine-cement bond with different photo-activated canal disinfectants (Methylene blue photosensitizer, Curcumin photosensitizer) and Er, Cr: YSGG then Vidrion C (GIC).

Use of Rose Bengal, Methylene blue and Curcumin Photosensitizers activated using light emitting diode on post space disinfection bonded to fiber post: An assessment of extrusion bond strength.

OBJECTIVES: To evaluate the effect of Rose Bengal (RB), methylene blue (MB) and curcumin used as a canal disinfectant on the extrusion bond strength (EBS) of FRCP (fiber reinforced composite resin) with canal dentin. METHODS: The present invitro study was completed in 90 days approved by Riyadh Elm University. Forty premolars were extracted disinfected and decoronated. Mechanochemical preparation was done of canal space using 10k file widening canals sequentially with a 25K file with constant saline irrigation. Canal was dried condensed with gutta percha and sealer. Post space was prepared using peso reamer. Based on canal disinfection samples were divided into four groups. Group-1 MBP+17%EDTA, Group-2 RBP +17%EDTA, Group-3 Curcumin+17%EDTA and Group-4 5.25% NaOCl +17% EDTA. Following disinfection, the canal space of all specimens was washed with 17% EDTA for 120 sec. Post was cemented in canal space and cured. Specimens were placed on Universal testing machine (UTM) for EBS. The type of bond failure was evaluated using stereomicroscope. ANOVA and Tukey multiple comparison test was used to compare means. RESULTS: Cervical third of Group-3 in which samples were disinfected with CP+17% EDTA displayed the maximum EBS (8.69±1.32 MPa). Whereas, the lowest EBS (3.30±0.54 MPa) was exhibited by the apical third of Group-4, where 5.25% NaOCl +17% EDTA was used as a canal disinfectant. The intragroup comparison demonstrated a declining trend of EBS from cervical to apical third in all investigated groups. CONCLUSION: Root canal dentin treated with different PS (MBP, CP, and RBP) demonstrated better EBS than the conventional disinfecting regime (NaOCl +17% EDTA). CP and RBP displayed better EBS than MBP.

COVID-19 Vaccine Intention among Healthcare Workers in Saudi Arabia: A Cross-Sectional Survey.

The COVID-19 pandemic has caused largescale morbidity and mortality and a tremendous burden on the healthcare system. Healthcare workers (HCWs) require adequate protection to avoid onward transmission and minimize burden on the healthcare system. Moreover, HCWs can also influence the general public into accepting the COVID-19 vaccine. Therefore, determining COVID-19 vaccine intention among HCWs is of paramount importance to plan tailor-made public health strategies to maximize vaccine coverage. A structured questionnaire was administered in February and March 2021 among HCWs in Saudi Arabia using convenience sampling, proceeding the launch of the vaccination campaign. HCWs from all administrative regions of Saudi Arabia were included in the study. In total, 674 out of 1124 HCWs responded and completed the survey (response rate 59.9%). About 65 percent of the HCWs intended to get vaccinated. The intention to vaccinate was significantly higher among HCWs 50 years of age or older, Saudi nationals and those who followed the updates about COVID-19 vaccines (p < 0.05). The high percentage (26 percent) of those who were undecided in getting vaccinated is a positive sign. As the vaccination campaign gathers pace, the attitude is expected to change over time. Emphasis should be on planning healthcare strategies to convince the undecided HCWs into accepting the vaccine in order to achieve the coverage required to achieve herd immunity.

Effect of Photodynamic therapy and Er,Cr: YSGG laser on bond strength of bleached enamel to composite resin.

OBJECTIVE: The purpose of the present study was bleached enamel reversal using conventional ascorbic acid (AA) and contemporary methods including Photodynamic therapy (PDT), Er, Cr: YSGG (ECL) on bond integrity to composite resin. MATERIAL AND METHOD: Forty sound permanent mandibular premolars were collected from a dental clinical setting and disinfected. All forty samples were mounted vertically in a rubber mold exposing only the clinical crown. All samples were bleached using Opalescence Boost Professional Teeth Whitening. After the bleaching procedure, each sample was randomly allocated into four groups according to surface treatment. Samples in group 1 were treated with methylene blue photosensitizer (MBP). Samples in group 2 were exposed to 10% sodium ascorbate. Samples in group 3 were treated with Er, Cr: YSGG laser (ECL). Samples in group 4 were not treated (control). All Samples were treated with 37% phosphoric acid and a bonding agent was applied. A bulk-fill composite was cured to all specimens and all samples were treated in a thermocycler. Specimens were placed in a universal testing machine for shear bond strength (SBS) testing. Descriptive statistics were associated by analysis of variance (ANOVA) and Tukey's post hoc test maintaining level of significance (p<0.05) RESULTS: The lowest SBS scores were achieved in the bleached enamel (BE) group (15.25±1.745 MPa). Whereas, the highest bond integrity was attained by AA group (32.23±1.854 MPa). Samples treated with ECL (31.87±1.659 MPa) and AA (32.23±1.854) were comparable (p>0.05). Samples treated with PDT exhibited significantly different SBS (22.41±1.258) compared to other experimental groups CONCLUSION: ECL showed a reversal effect of BE compared to AA and has the potential to be used in clinical settings. BE reversal using MBP needs further investigation.

Comparative analysis of flexural strength of abraded and polished porcelain surfaces - an in vitro study.

Typically, prosthodontists adjust ceramic restorations glazed surface by grinding prior to insertion. Such alterations of surfaces are necessary for the correction of occlusal interferences. We aimed to evaluate and compare the change in flexural strength of ceramic surfaces after re-glazing and polishing. This study included 40 samples of ceramic blocks that were fabricated and glazed, and then fired in accordance with the manufacturer's recommendations. The sample was randomly divided into four groups of 10 samples each. The first group was the control group with unaltered glazed samples. The second group was abraded with an extra-fine diamond bur followed by re-glazing, and the other two groups were polished with two commercially available polishing kits after abrading them with an extra-fine diamond bur. The samples were tested for their flexural strength using a universal testing machine. On the application of the F test on the means of all the groups, a value greater than 0.05 was found, which meant that there is no statistically significant difference in flexural strength values between the groups (P-value>0.05). Since the flexural strength values of the polished group were comparable to the other groups, polishing can be used instead of re-glazing for ceramic restorations. This reduces an additional clinical appointment for the patient and saves working time.

A Global Survey of COVID-19 Vaccine Acceptance Among Healthcare Workers.

Objectives: Even though several effective vaccines are available to combat the COVID-19 pandemic, wide disparities in vaccine distribution, and vaccine acceptance rates between high- and low-income countries appear to be major threats toward achieving population immunity. Our global descriptive study aims to inform policymakers on factors affecting COVID-19 vaccine acceptance among healthcare workers (HCWs) in 12 countries, based on income index. We also looked for possible predictors of vaccine acceptance among the study sample. Methods: A structured questionnaire prepared after consultation with experts in the field and guided by the "Report of the SAGE working group on vaccine hesitancy" was administered among 2,953 HCWs. Upon obtaining informed consent, apart from demographic information, we collected information on trust in vaccines and health authorities, and agreement to accept a COVID-19 vaccine. Results: Although 69% of the participants agreed to accept a vaccine, there was high heterogeneity in agreement between HCWs in low and lower-middle income countries (L-LMICs) and upper-middle- and high-income countries (UM-HICs), with acceptance rates of 62 and 75%, respectively. Potential predictors of vaccine acceptance included being male, 50 years of age or older, resident of an UM-HIC, updating self about COVID-19 vaccines, greater disease severity perception, greater anxiety of contracting COVID-19 and concern about side effects of vaccines. Conclusions: COVID-19 vaccine acceptance among HCWs in L-LMICs was considerably low as compared to those from UM-HICs. The lowest vaccine acceptance rates were among HCWs from the African continent. This underlines the need for the implementation of country-specific vaccine promotion strategies, with special focus on increasing vaccine supply in L-LMICs.

The Efficacy and Adverse Events of Delafloxacin for Treating Acute Bacterial Skin and Skin Structure Infections: A Systematic Review and Meta-Analysis.

BACKGROUND: Acute bacterial skin and skin structure infections (ABSSSI) cause significant morbidity and mortality in hospitalized patients and outpatients as well. Newer fluoroquinolones such as delafloxacin might be a useful medication for treating infections of skin caused by gram-positive bacterial species that are resistant. AIMS AND OBJECTIVES: The aim of this study was to evaluate all the literature on delafloxacin in databases and make comparisons of its efficacy with antimicrobial drugs routinely used to treat skin infections. MATERIALS AND METHODS: A detailed search on different databases was conducted using, Cochrane Central Register of Controlled Trials, PubMed, and Embase. Primary outcome was microbiological cure at the end of the follow-up period. Absence of the signs and symptoms at the termination of the follow-up period and clinical response to medications was regarded as the secondary outcome. RESULTS: The pooled efficacy of delafloxacin was at 80% (95% confidence interval 1.01 [0.97, 1.06]; P = 0.51). No statistically significant difference was found between intravenous delafloxacin and comparator drugs. CONCLUSION: The effectiveness of delafloxacin was found to be non-inferior to tigecycline and linezolid. Efficacy and pooled cure rate of delafloxacin was also found to be superior to vancomycin.

A bibliometric review of top 50 cited articles published in the Photodiagnosis and Photodynamic Therapy from 2004 to 2019.

BACKGROUND: The aim of the article was to identify the top 50 cited articles in the journal of Photodiagnosis and Photodynamic Therapy during 2004-2019. METHODS: The online search was conducted on Scopus database to retrieve all the articles published during 2004-2019 in the journal of Photodiagnosis and Photodynamic Therapy. The papers were identified and ranked as per the citation counts >42. Additionally the authors; institute and country of origin; type of study and availability of funding in these highly cited articles was identified. VOS viewer software was used to analyze the occurrence of most commonly used keywords by the authors. RESULTS: Majority of the highly cited studies published during last 15 years were literature reviews (n = 34) followed by the qualitative/quantitative studies (n = 15). The largest number of articles published were single nations without any collaborations (n = 45). The institutes publishing highest number of top cited articles included Massachusetts General Hospital, East Carolina University, 21 st Century Oncology, The Norwegian Radium Hospital and Trinity College Dublin. The country with largest number of top cited articles was USA. The keyword most commonly associated with the 50 top cited articles was 'Photodynamic therapy'. CONCLUSION: Extensively, various specialties of medicine and dentistry have been explored in the last 15 years in the journal of Photodiagnosis and Photodynamic Therapy. Based on citatations, we have highlighted those that can be considered as classic research.

Can human maxillary premolars discriminate between sexes in South Asian populations? / ¿Pueden los premolares maxilares humanos discriminar entre sexos en las poblaciones del sur de Asia?

The studies have illustrated odontometric analysis can be used to determine the sexual dimorphism effect on size of the teeth in various populations. The main aim of the study was to identify the inter-cuspal-, bucco-lingual -dimensions and weight of human upper-arch pre-molars in males and females of different South Asian populations. These metrics can distinguish sex which can have application in mass disasters, archaeology of mingled human remains and the in unidentified or several ancestry. The sample size consisted of 60 orthodontically extracted maxillary pre-molars from Pakistani and Saudi Arabian populations respectively. For male and female groups of each population fifteen first and second maxillary premolars were collected respectively, stored in PBS solution. The weight of the individual teeth was recorded. Later, digitally pictures were captured parallel to the occlusal surface to measure maximal bucco-lingual and inter-cuspal dimensions using Image-J software. The dimensions and weights were compared using Students' t-test between males and females respective Pakistani and Saudi Arabian first (P1) and second (P2) maxillary pre-molars. The dimensions for male P1 and P2 were statistically significantly larger than that for females in both populations. Furthermore, wet-weight of pre-molars in males is significantly greater than females in both populations. The findings demonstrate maxillary pre-molars can discriminate between the sexes in various populations.

Las investigaciones han ilustrado que el análisis odontométrico se puede utilizar para determinar el efecto del dimorfismo sexual en el tamaño de los dientes en varias poblaciones. El objetivo principal del estudio fue identificar las dimensiones y el peso entre cúspides, buco-linguales y el peso de los premolares de la arcada superior humana en hombres y mujeres de diferentes poblaciones del sur de Asia. Estas medidas pueden distinguir el sexo y ser importante en desastres masivos, arqueología de restos humanos entremezclados y en ancestros no identificados. El tamaño de la muestra consistió en 60 premolares maxilares extraídos ortodóncicamente de las poblaciones de Pakistán y Arabia Saudita, respectivamente. Para los grupos de hombres y mujeres de cada población, se recogieron quince primeros y segundos premolares superiores respectivamente, almacenados en solución de PBS. Se registró el peso de los dientes individuales. Posteriormente se capturaron imágenes digitales paralelas a la superficie oclusal para medir las dimensiones máximas buco-linguales e intercúspides utilizando software Image-J. Las dimensiones y los pesos se compararon mediante la prueba t de Student entre lo premolares maxilares (P1) y segundos (P2) de hombres y mujeres paquistaníes y saudíes. Las dimensiones para P1 y P2 de los hombres fueron estadísticamente significativos mayores que para las mujeres en ambas poblaciones. Además, el peso húmedo de los premolares en los varones era significativamente mayor que el de las mujeres en ambas poblaciones. Los hallazgos demuestran que los premolares maxilares pueden discriminar entre los sexos en varias poblaciones.

Functionally graded biomimetic biomaterials in dentistry: an evidence-based update.

Design and development of novel therapeutic strategies to regenerate lost tissue structure and function is a serious clinical hurdle for researchers. Traditionally, much of the research is dedicated in optimising properties of scaffolds. Current synthetic biomaterials remain rudimentary in comparison to their natural counterparts. The ability to incorporate biologically inspired elements into the design of synthetic materials has advanced with time. Recent reports suggest that functionally graded material mimicking the natural tissue morphology can have a more exaggerated response on the targeted tissue. The aim of this review is to deliver an overview of the functionally graded concept with respect to applications in clinical dentistry. A comprehensive understanding of spatiotemporal arrangement in fields of restorative, prosthodontics, periodontics, orthodontics and oral surgery is presented. Different processing techniques have been adapted to achieve such gradients ranging from additive manufacturing (three dimensional printing/rapid prototyping) to conventional techniques of freeze gelation, freeze drying, electrospinning and particulate leaching. The scope of employing additive manufacturing technique as a reliable and predictable tool for the design and accurate reproduction of biomimetic templates is vast by any measure. Further research in the materials used and refinement of the synthesis techniques will continue to expand the frontiers of functionally graded membrane based biomaterials application in the clinical domain.