Self-reported preparedness of final year undergraduate dental students and interns in Saudi Arabia: a multi-institutional study.

BACKGROUND: Contemporary undergraduate dental education aims to equip the dental students with clinical competence, empathy, and professionalism to enable them to deliver safe and effective dental care to the communities. The purpose of this study was to assess the self-reported preparedness of final year dental students and interns at three Saudi dental institutions, using the pre-validated Dental Undergraduates Preparedness Assessment Scale (DU-PAS). METHODS: A cross-sectional study design was employed to assess the self-reported preparedness of the participants using the DU-PAS. Following ethics approval, a probability sampling technique was used to recruit undergraduate dental students and interns from three dental institutions in Saudi Arabia. The data was collected online on Google Forms and all participants provided their consent to participate in the study prior to providing their responses to DU-PAS. RESULTS: Responses were received from 397 participants including 171 males and 226 females yielding a response rate of 60.3%. The total mean score of the participants was 81.85 ± 13.11. Although higher scores were reported in males, the interaction between gender and DU-PAS scores were not significant. Interaction between DU-PAS scores and stage of education showed significant effect of the stage of education with interns reporting higher overall scores. The participants reported that they were able to perform most clinical procedures independently. However, low confidence was reported in performing multi-rooted endodontics, fabrication of removable dentures and orthodontic assessment. The participants also expressed their confidence in a wide range of behavioural attributes related to communication, teamworking and professionalism. However, lack of experience was noted in referral for oral cancer, interpreting research, and evaluation of new dental products using an evidence-based approach. CONCLUSION: The study provides useful insights into the self-reported preparedness of undergraduate dental students and interns in three dental institutions. While the overall preparedness of the participants was comparable to their international peers, the findings underscore the need for further enhancements to the teaching and training of undergraduate students particularly in multirooted endodontics, removable prosthodontics and orthodontics.

Comparison of Efficacy of Lidocaine and Articaine as Inferior Alveolar Nerve Blocking Agents in Patients with Symptomatic Irreversible Pulpitis: Randomized Controlled Trial.

Background and Objectives: Lidocaine Hydrochloride has been the standard choice for local anesthesia in dentistry and Articaine's unique structure and growing popularity make it a viable alternative. Due to contradictory results in prior research and a scarcity of trials conducted in the Pakistani population, this study aims to compare the anesthetic efficacy of Lidocaine with Articaine for inferior alveolar nerve blocks in patients with symptomatic irreversible pulpitis. Materials and Methods: This double-blinded, randomized controlled trial included 152 patients who were selected by consecutive non-probability sampling. The participants included patients who presented with symptomatic irreversible pulpitis in mandibular posterior teeth (molars and premolars) and depicted normal apical tissue radiographically. The patients were equally and randomly divided into two groups. The control group received 2% Lidocaine Hydrochloride injections, and the experiment group received 4% Articaine Hydrochloride injections. Participants scored their pain on the HP-VAS both before and after the administration of anesthesia. A value of 54 mm or less on the scale indicated effective anesthesia. The data obtained were analyzed using SPSS. Chi-square test was applied to analyze data for statistical significance. Results: There was no statistically significant difference in the efficacy of the two anesthetic agents. During access cavity preparation, Lidocaine demonstrated a success rate of 93%, whereas Articaine exhibited a slightly higher success rate of 97%. During initial instrumentation, the success rates for Lidocaine and Articaine were 72% and 71%, respectively. This suggests that both Lidocaine and Articaine were effective in achieving anesthesia during the dental procedure in patients with symptomatic irreversible pulpitis, with Articaine showing a slightly better success rate, although the difference was not statistically significant. Conclusions: The anesthetic efficacy of Articaine is similar to that of lidocaine in subjects with symptomatic irreversible pulpitis. Hence, Articaine can serve as an alternative to Lidocaine for local anesthesia administration in dentistry.

A Cone Beam Computed Tomography-Based Investigation of the Frequency and Pattern of Radix Entomolaris in the Saudi Arabian Population.

Background and Objectives: An understanding of the anatomical complexity of teeth is a significant factor for a successful endodontic treatment outcome. The aim of this study was to explore the frequency and pattern of distribution of radix entomolaris (RE) in mandibular first molars (MFMs) of a Saudi Arabian subpopulation using CBCT scans. Materials and Methods: This study was conducted at dental clinics of Qassim University from February to May 2023 by evaluating CBCT scans that were previously obtained for diagnostic purposes. Scans of Saudi national patients with bilaterally present MFMs and fully formed root apices were included. Conversely, scans with one/or two missing MFMs, MFMs with incomplete root apices, full- or partial-coverage prosthesis, endodontic treatment, and associated radicular resorption were excluded from study. A total of 303 CBCT scans with 606 bilateral MFMs were analyzed by two calibrated evaluators for the presence of, and type according to Song's typolgy of RE. The data were analyzed using SPPS-24. The descriptive variables were documented as frequencies and percentages. The chi-square test was used to determine the association between the prevalence of RE with the gender, jaw side and age group. Both inter-rater and intra-rater agreements were estimated for detecting and classifying RE using Cohen's kappa test. Results: The sample had 63.7% males and 36.3% females. The prevalence of RE was 6.6%, with Song's type III (57.5%) as the most common variant. Absolute agreement was noted between the raters about the presence of RE and very strong agreement was noted for the classification of the RE. Conclusions: RE is an uncommon finding among the mandibular first molars of the Saudi population without any gender and quadrant predilection. The clinicians' knowledge of the presence and Song's type of RE may contribute towards the enhancement of endodontic treatment outcomes.

Fracture Load of CAD/CAM Fabricated Cantilever Implant-Supported Zirconia Framework: An In Vitro Study.

The fracture resistance of computer-aided designing and computer-aided manufacturing CAD/CAM fabricated implant-supported cantilever zirconia frameworks (ISCZFs) is affected by the size/dimension and the micro cracks produced from diamond burs during the milling process. The present in vitro study investigated the fracture load for different cross-sectional dimensions of connector sites of implant-supported cantilever zirconia frameworks (ISCZFs) with different cantilever lengths (load point). A total of 48 ISCZFs (Cercon, Degudent; Dentsply, Deutschland, Germany) were fabricated by CAD/CAM and divided into four groups based on cantilever length and reinforcement of distal-abutment: Group A: 9 mm cantilever; Group B: 9 mm cantilever with reinforced distal-abutment; Group C: 12 mm cantilever; Group D: 12 mm cantilever with reinforced distal-abutment (n = 12). The ISCZFs were loaded using a universal testing machine for recording the fracture load. Descriptive statistics, ANOVA, and Tukey's test were used for the statistical analysis (p < 0.05). Significant variations were found between the fracture loads of the four ISCZFs (p = 0.000); Group-C and B were found with the weakest and the strongest distal cantilever frameworks with fracture load of 670.39 ± 130.96 N and 1137.86 ± 127.85 N, respectively. The mean difference of the fracture load between groups A (810.49 + 137.579 N) and B (1137.86 ± 127.85 N) and between C (670.39 ± 130.96 N) and D (914.58 + 149.635 N) was statistically significant (p = 0.000). Significant variations in the fracture load between the ISCZFs with different cantilever lengths and thicknesses of the distal abutments were found. Increasing the thickness of the distal abutment only by 0.5 mm reinforces the distal abutments by significantly increasing the fracture load of the ISCZFs. Therefore, an increase in the thickness of the distal abutments is recommended in patients seeking implant-supported distal cantilever fixed prostheses.

Radiologic versus Endoscopic Placement of Gastrostomy Tube: Comparison of Indications and Outcomes at a Tertiary Referral Center.

OBJECTIVES: Percutaneous gastrostomy tube placement is performed in patients requiring long-term enteral nutrition. Although both endoscopic and fluoroscopic techniques may be used, there are inherent risks and potential complications associated with both procedures that are not generally known to referring physicians. The purpose of this study was to compare and contrast indications for placement and procedurally related complications between fluoroscopic and endoscopic gastrostomy tubes techniques at a tertiary care facility. METHODS: A retrospective cohort study was performed. All consecutive patients with either percutaneous endoscopic (PEG) or percutaneous radiologic (PRG) gastrostomy tube placement between October 2011 and January 2013 were eligible for inclusion. Basic demographic information, American Society of Anesthesiologists score, procedure indication, laboratory data, and use of anticoagulation were recorded. Both direct and indirect procedural complications were documented if they occurred 30 days after gastrostomy tube placement, and were classified and scored based on severity and need for further intervention. RESULTS: A total of 297 patients met the inclusion criteria, 150 of whom had gastrostomy tubes placed fluoroscopically and 147 of whom had them placed endoscopically. There was no statistically significant difference in direct complications within the first 30 days (PEG 6.8% vs PRG 8%); however, the type of complication observed varied between the two groups. Although superficial wound infections and buried bumpers were more common in the PEG group, bleeding was more common in the PRG group. CONCLUSIONS: Placement of gastrostomy tubes either endoscopically or fluoroscopically is relatively safe with similar indications. Although the complication rate between the two groups was not significant, the types of procedural complications observed did vary.

Evaluation of in vitro urease and lipoxygenase inhibition activity of weight reducing tablets.

Enzyme inhibition is a significant part of research in pharmaceutical field in view of the fact that these studies have directed to the innovations of drugs having remarkable performance in diverse physiological conditions. The present study was aimed to assess urease and lipoxygenase inhibitory activity of weight reducing tablets. For evaluating the urease activity indophenol method was employed using Thiourea as the model urease inhibitor. The lipoxygenase inhibition was evaluated by measuring the hydroperoxides produced in lipoxygenation reaction using a purified lipoxygenase with lionoleic acid as substrate. When formulation of the weight reducing tablets was compared at various concentrations (50, 100 and 500µg/ml). The antiurease activity and lipoxygenase inhibition activity increased in a dose dependent manner. The formulations under test have an excellent antiurease and lipoxygenase inhibition potential and prospective to be used in the cure of a variety of complications associated with the production of urease and lipoxygenase enzymes.

Students' self-assessment: a learning tool and its comparison with the faculty assessments.

OBJECTIVE: This study compared the student's self-grades versus the examiners grades, inter examiner grades and grades of anterior with posterior teeth in a preclinical prosthodontic course. METHODS: 75 students and 2 examiners participated in the study. The students prepared one anterior (upper central incisor) and one posterior (lower first molar) teeth for full veneer crowns in allocated time of 2 hours and 30 minutes. After the preparations, the students self-graded their preparations based on criteria-based evaluation forms. The examiners also completed the grading for the prepared teeth. All the grades were recorded, comparisons were made using SPSS version 21 and results tabulated. RESULTS: The means of grades (8.32) by the students themselves were found to be higher compared to the examiners grades (7.3) for the anterior as well as posterior teeth. Comparison of the grades for the anterior/posterior teeth and the overall grades showed a statistically significant difference (p=0.000). A moderate correlation (0.399) and a strong correlation (0.601) were found between the grades of the faculty and the students for the anterior and posterior teeth respectively. The overall grading for the anterior and posterior teeth by the two faculty members showed no statistically significant difference (p=0.053) and a very strong correlation (0.784). The results of the test showed a significant difference (p=0.001) between the overall grading for anterior and posterior teeth. CONCLUSION: Students tended to grade their teeth preparations higher compared to the examiner grades, inter examiner variation in the grades existed and the grades of the anterior teeth were higher compared to the posterior teeth.

Comparison of Shade of Ceramic with Three Different Zirconia Substructures using Spectrophotometer.

OBJECTIVE: This study assessed how changing the Zirconia (Zr) substructure affected the color samples after they have been overlaid by the same shade of veneering ceramic. MATERIALS AND METHODS: Three commercial Zr materials were tested in this study: Prettau(®) Zirconia (ZirKonZahn, Italy), Cercon (Dentsply, Germany) and InCoris ZI (Sirona, Germany). For each system, 15 disk-shaped specimens (10 × 1 mm) were fabricated. Three shades of A1, A2 and A3.5 of porcelain (IPS e.MaxCeram, IvoclarVivadent, USA) were used for layering the specimens. Five specimens from each type of Zr were layered with same shade of ceramic. Color measurements were recorderd by a spectrophotometer Color-Eye(®) 7000A (X-Rite, Grand Rapids, MI). Mean values of L, a, b color coordinates and ΔE were recorded and comparisons were made. RESULTS: Differences in the ΔE were recorded for the same porcelain shade with different Zr substructures and affected the color of the specimens (p < 0.01, ANOVA). The maximum difference between the ΔE values for the A1, A2 and A3.5 shades with three types of Zr substructures was found to be 1.59, 1.69 and 1.45 respectively. Multiple comparisons of the ΔE with PostHoc Tukey test revealed a statistically significant difference (p < 0.05) between the three types of Zr, except between Type 2 Zr and Type 3 Zr for the Shade A1. The mean values of L, a, b and ΔE for the Prettau(®) Zirconia substructure were found to be the least among the three types. CONCLUSIONS: The brand of Zr used influences the final color of the all ceramic Zr based restorations and this has clinical significance.

Evaluation of medicinal interventions for the management of oral submucous fibrosis: a systematic review of the literature.

Oral submucous fibrosis is a chronic, progressive scarring disease associated with both significant morbidity including pain and limited mouth opening and an increased risk for malignancy. This systematic review evaluated the different medicinal (i.e. nonsurgical) interventions available for the management of oral submucous fibrosis. An automated literature searches of online databases from January 1960 to December 2013 were performed and only studies with high level of evidence based on the guidelines of the Oxford Centre for evidence-based medicine were selected. Thirteen studies (3 randomized controlled trials and 10 clinical trials/controlled clinical trials) were included and drugs like steroids, hyaluronidase, human placenta extracts, chymotrypsin and collagenase, pentoxifylline, nylidrin hydrochloride, iron and multivitamin supplements including lycopene were used. There is a clear lack of evidence on the available drug treatment for oral submucous fibrosis and further high quality randomized controlled trials are needed to evaluate the different therapeutic agents.

Patient's satisfaction with the dental care provided by dental students.

BACKGROUND: The success of an oral health service can be assessed by the degree of satisfaction of its patients. The objective of this study was to evaluate patient satisfaction following comprehensive dental treatment provided by final year dental students at college of dentistry, King Saud University, Riyadh, Saudi Arabia and to correlate the level of patient satisfaction with their post-treatment oral hygiene maintenance. METHODS: The required information for this cross-sectional was collected from patients using a self-answered questionnaire. A five point Likert scale was used (Strongly agree, agree, neither, disagree and strongly disagree) to evaluate the level of patient satisfaction. Clinical examination included assessment of oral hygiene status using 0111-S (Oral Hygiene Index-Simplified). RESULTS: Four hundred & forty-six patients who received comprehensive dental treatment at the student clinics during the past two years were contacted out of which 86 patient's (81% males and 19% females) participated. The overall patient's satisfaction score of 68.67±6.85 was highly satisfactory. The mean OHI-S score was 2.21±1.68. This showed a good to moderate level of oral hygiene among the participating patients. No statistically significant difference was found for the overall patient satisfaction score in relation to the age, gender, nationality and educational level. The post treatment oral hygiene status was significantly better in female patients compared to males. There was no statistically significant difference in OHI-S scores in relation to age, nationality and education level. The patient satisfaction scores and OHI-S score showed no correlation. CONCLUSION: The patients treated by the dental students at college of dentistry were highiy satisfied with their treatment. A good to moderate level f post treatment oral hygiene among the participating patients was recorded according to the

The Surface Roughness of Contemporary Indirect CAD/CAM Restorative Materials That Are Glazed and Chair-Side-Finished/Polished.

The surface roughness (Ra) of indirect computer-aided design/computer-aided manufacturing (CAD/CAM)-fabricated dental restorations is crucial for their long-term durability. This study intended to evaluate the Ra of five different types of contemporary indirect CAD/CAM restorative materials with varying compositions that were glazed and finished/polished. A total of 75 specimens, disc-shaped (10 mm × 2 mm), were obtained from five materials (n = 15) (Tetric CAD, IPS e.max CAD, IPS e.max ZirCAD, CELTRA Duo, and Vita Enamic) and fabricated by CAD/CAM. One of the two surfaces for each specimen was subjected to glazing, while the other surface was subjected to finishing/polishing. The Ra of the two surfaces in micrometers (µm) was evaluated using a Profilometer, while the surface topography was examined using a scanning electron microscope. Using SPSS, the Kruskal-Wallis, post hoc Conover, and Mann-Whitney tests were used to statistically evaluate the data. A comparison of the Ra for the finished/polished surfaces of the five test materials showed significant differences (p < 0.0001). Among the finished/polished surfaces, the mean rank values of Vita Enamic were significantly higher than the other four test materials (p < 0.0001). A comparison of the Ra of glazed surfaces among the five study materials revealed significant differences (p < 0.0001). The Ra for the IPS e.max ZirCAD material was significantly higher than the rest of the four materials (p < 0.001). A comparison of the Ra for two types of surface conditioning within each of the five test materials showed a significant difference (p < 0.05). Only for IPS e.max ZirCAD was the Ra of the glazed surface significantly higher than the finished/polished surface (p < 0.0001). Significant variations in the surface roughness (Ra) were exhibited between the finished/polished and glazed surfaces of the five test materials. Hybrid ceramics showed the highest Ra values for the finished/polished surfaces, and zirconia exhibited the highest Ra values among the glazed surfaces among the tested materials. The Ra values of either finished/polished or glazed surfaces of the test materials were within the clinically acceptable range (0.2-0.5 µm), except for the glazed surface of the zirconia ceramics (0.84 µm).

Comparative in-vivo bond failure rate of orthodontic brackets when bracket base is treated with micro-abrasive blasting vs. acid etching: eighteen month randomized control trial and scanning electron microscope study.

Background: The aim of this study was threefold. Firstly, it aimed to introduce and detail a novel method for chemically etching the bases of stainless-steel orthodontic brackets. Secondly, the study sought to investigate the structural alterations within the brackets' microstructure following chemical etching compared to those with sandblasted bases, using electron microscopy analysis. Lastly, the study aimed to evaluate and compare the long-term durability and survivability of orthodontic brackets with chemically etched bases versus those with sandblasted bases, both bonded using the conventional acid etch technique with Transbond XT adhesive, over an 18-month follow-up period. Methods: The study was a randomized clinical control trial with triple blinding and split-mouth study design and consisted of two groups. The brackets in the sandblasted group were prepared by sandblasting the intaglio surface of the base of the bracket with 50 µm SiO2 particles. Hydrofluoric acid was used to roughen the base in the acid-etched group. The bases of the brackets were viewed under an electron microscope to analyze the topographical changes. Results: A total of 5,803 brackets (3,006 acid-etch, 2,797 sandblasted) in 310 patients were bonded, in a split-mouth design by the same operator. The patients were followed for 18 months. The failure rate of 2.59% and 2.7% was noted in an acid-etched and sandblasted group, respectively. There was a close approximation of curves in the Kaplan-Meier plot, and the survival distribution of the two groups in the log-rank (Mantel-Cox) test was insignificant; x2 = 0.062 (P value = 0.804). Conclusion: Acid etching if the bases of the brackets can be used as an alternative to sandblasting furthermore acid etching can be performed on the chair side.

Perceiving Freedom: Civil Liberties and COVID-19 Vaccinations.

Why have some countries been more successful in their COVID-19 vaccine rollouts than others? Despite efforts by governments to vaccinate their adult populations against COVID-19, vaccination rates remain irregularly low in some countries. We suggest that a crucial piece of this puzzle lies in resistance against government directives from the public due to civil liberty protections. Countries with greater protections for civil liberties can be expected to have lower vaccinations administered than countries with fewer protections, as the public enjoys a sense of freedom regarding their private lives. In such countries, de jure constraints on government policies are complemented by the fear of public backlash, even in crises; consequently, beyond structural limitations, governments with high levels of civil liberty protections face an additional hurdle in managing the COVID-19 crisis. Evidence for this hypothesis is presented for 153 countries by combining civil liberty scores with newly available data on COVID-19 vaccinations.

Cancer Staging in Patients with Compromised Renal Function: Is PET/CT an Alternative to Contrast CT Scan?

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Evaluation of the Effect of Electronic Cigarette Devices/Vape on the Color of Dental Ceramics: An In Vitro Investigation.

The use of vaping or electronic cigarette devices (ECDs) has recently increased as an alternative to conventional tobacco smoking products. By recording the CIELAB coordinates (L*a*b*) and computing the total color difference (ΔE) values using a spectrophotometer, the effect of ECDs on contemporary aesthetic dental ceramics was investigated in this in-vitro study. A total of seventy-five (N = 75) specimens from five different (n = 15) dental ceramic materials (Pressable ceramics (PEmax); Pressed and layered ceramics (LEmax); Layered zirconia (LZr); Monolithic zirconia (MZr) and Porcelain fused to metal (PFM)) were prepared and exposed to aerosols produced by the ECDs. The color assessment was performed using a spectrophotometer at six time intervals (0 = baseline; 250-puff exposures; 500-puff exposures; 750-puff exposures; 1000-puff exposures; 1250-puff exposures; and 1500-puff exposures). By recording L*a*b* and computing total color difference (ΔE) values, the data were processed. A one-way ANOVA and Tukey procedure for pairwise comparisons were used to assess color differences between tested ceramics (p < 0.05). All test materials demonstrated significant color differences (ΔE) after exposure to vaping (p < 0.05). The LZr group displayed noticeably high ΔE values at all the distinct puff exposure intervals, with the highest ΔE value of (13.67) after 1500 puffs. The lowest (ΔE) values were observed in the PFM group after 250 and 500 puffs (0.85 and 0.97, respectively). With the exception of the group PEmax (p = 0.999), all groups produced readings of "ΔE" that indicated significant differences (p < 0.05) at various degrees of puff exposures. ECDs can noticeably alter the color of the dental ceramics affecting the esthetics of the patients. All the materials tested demonstrated significant color changes (ΔE > 3.33) above the clinically acceptable threshold, except for the PFM and PEmax group (ΔE < 3.33) which showed color stability after exposure to the ECDs.

Covid-19 Induced Catatonia: A Review Of This Rare Phenomenon.

BACKGROUND: Catatonia is a psychomotor syndrome characterized by numerous clinical features, a few being stupors which is the most common sign, posturing, forced grasping, echopraxia, etc. There have been cases documented in the literature of Catatonia occurring with COVID-19. This article will focus on the complete and brief overview of catatonia observed in patients with COVID-19 infection. METHODS: We outline the evidence of the pathophysiology of COVID-19 in the CNS system, the effect of the virus in inducing catatonia, and its outcome. The literature used in the article is mostly case reports from different parts of the world thus; we have generalized our review taking into consideration multiple factors. RESULTS: In patients with COVID-19, neuropsychiatric manifestations are very commonly appreciated. Catatonia has been documented in many patients along with respiratory symptoms such as fever, shortness of breath, and cough. There are multiple etiologies associated with this presentation which have been discussed in detail in this article. In many patients, there was no history of any psychiatric illness. The timing of presenting with catatonic features was also different for different individuals. CONCLUSIONS: COVID-19 has been believed to contribute to the presentation of catatonia. There is no specific timeline between the onset of symptoms and the presence of COVID-19 infection. However, coronavirus can be responsible in a few ways for inducing catatonia in patients with or without any previous psychiatric illness. Therefore, COVID-19 should be considered as one of the major factors in this complex psychiatric disease, catatonia.

Dental students' academic performance before and after the Covid-19 pandemic: A retrospective analysis.

Delivering quality education to students with fair assessment strategies is a key indicator of an excellent educational institution. The present study explored the impact of the COVID-19 pandemic on the academic performance of dental students in terms of the evaluations/grades awarded to them before and during the pandemic. The targeted groups were dental students, studying in the third year of 2018-2019 and 2020-2021 academic years. The sample size included all male and female students who enrolled and completed the following courses: pre-clinical fixed prosthodontics (SDS333), pre-clinical removal prosthodontics (SDS323), clinical operative dentistry-1 (RDS313), and pre-clinical endodontics (RDS323). Evaluations for students who did not complete the requirements were not included in the statistical analysis. Paired sample statistics were used for comparisons between the different groups at p < 0.05. Results revealed statistically significant differences (p ≤ 0.05) for all the course pairs. It was found that students' grades for all the courses during the pandemic year were higher compared to the grades before the pandemic. While female students demonstrated the highest mean difference (6.13) before and during the pandemic year for RDS323, males demonstrated the highest mean difference (8.14) for SDS323. However, both male and female students demonstrated the lowest mean difference (0.25 and 2.03, respectively) for SDS333. The grades were higher during the COVID-19 pandemic. Overall, female students achieved higher grades than male students.

Patients' Satisfaction and Oral Health-Related Quality of Life of Edentulous Patients Using Conventional Complete Dentures and Implant-Retained Overdentures in Saudi Arabia.

The aim of this study was to compare patients' satisfaction and quality of life (QoL) when using implant overdentures vs. conventional dentures. The QoL of Saudi patients who were provided mandibular implant-supported overdentures was assessed using a structured questionnaire. Overall satisfaction; ability to speak, eat, and chew food; comfort; esthetics; stability; and satisfaction of general oral health were measured. A total of 48.3% vs. 6.9% were, overall, very satisfied with their implant overdentures and conventional dentures, respectively. A total of 37.9% of the patients were very satisfied regarding speaking with their implant overdentures vs. 17.2% with conventional dentures. Furthermore, 41.4% were very comfortable with their implant overdentures vs. 5.2% were very comfortable using conventional dentures. However, only 15.5% were very satisfied with the esthetics of the conventional dentures compared to 43.1% being satisfied with implant overdentures. Only 1.7% were very satisfied with the stability of conventional dentures vs. 44.8% being satisfied using implant overdentures. About 8.6% of the candidates were very satisfied regarding chewing food with conventional dentures vs. 36.2% being very satisfied using implant overdentures. Approximately 10.3% were very satisfied with their general oral health using conventional dentures compared to 29.3% being very satisfied using implant overdentures. Mandibular implant overdentures had a strong impact on patients' quality of life over conventional complete dentures and should be considered the minimum standard of care provided to completely edentulous patients.

Roadmap for carbon neutrality: the mediating role of clean energy development-related investments.

Recently, the Japanese government has announced the national objective of turning the economy of Japan carbon-neutral by 2050. This declaration has therefore enhanced the imperativeness of replacing the use of unclean energy with cleaner alternatives so that the carbon-neutrality agenda can be attained in due course. Against this backdrop, this study aims to assess whether enhancing government investments in research and development for developing clean energy can help Japan curb its carbon dioxide emission figures. In addition, the analysis also controls for the environmental effects of clean electricity output, economic growth, international trade, financial globalization, and urbanization on Japan's carbon dioxide emission figures. The cointegration test results confirm long-run relationships between all these variables. Besides, the regression results showed that scaling-up research and development-related investments for clean energy development reduces carbon dioxide emissions only in the long run. Similar emission-inhibiting impacts are also evidenced to be associated with greater output of clean energy-fired electricity. Moreover, it is also observed that higher clean energy development-related investments play a mediating role in amplifying the carbon dioxide emission-reducing effects of clean electricity generation in the long run. In addition, economic growth is seen to dampen environmental quality by triggering higher emissions of carbon dioxide both in the short and long run. Simultaneously, enhancing openness to international trade and greater urbanization is found to boost the carbon dioxide emission figures of Japan. However, an influx of foreign direct investments is not observed to influence carbon dioxide emissions in Japan, neither in the short run nor in the long run. Accordingly, concerning the achievement of carbon neutrality goal by 2050, these findings emphasize the importance of boosting clean energy development-related investments, increasing clean electricity output, greening economic activities, reducing the trade of unclean commodities, adopting environmentally sustainable urbanization policies, and facilitating the influx of clean foreign direct investments within the Japanese economy.

An Evaluation of the Usefulness of YouTube® Videos on Crown Preparation.

BACKGROUND: You Tube is one of the most commonly used online sources for sharing information and knowledge. Academic topics or clinical data shared on this platform is not peer reviewed or evaluated by subject specialists for accuracy. No study was found in the literature examining the validity of crown preparation videos available at this platform. OBJECTIVE: To evaluate the authenticity of the content and quality of the crown preparation videos uploaded on the YouTube. METHODS: The systematic search for YouTube videos was carried out over a period of one year from January 2020 until February 2021. The keywords or phrases and tags used were crown preparation, PFM crown preparation, all ceramic crown preparation, and dental crown preparation. The videos were shortlisted on the basis of inclusion and exclusion criteria to select educationally useful videos in terms of content and quality. RESULTS: Three subject specialists evaluated the videos on crown preparation three times to shortlist only 12 (11%) educationally useful videos out of 109 relevant videos. These 12 videos met the preset inclusion criteria. CONCLUSION: Although YouTube is the most popular social media platform used as the source of information by the students, the majority of uploaded content lacks authenticity. This study found that crown preparation videos uploaded by the faculty members or subject specialists can be considered as the reliable source.