DENTAL RESEARCH DAY
Ahmed Jamleh, Khalid Alfouzan, Abdulmohsen Alfadley, Lubna Alkadi, Abdullah Alhezam. College of Dentistry, King Saud bin Abdulaziz for Health Sciences, Riyadh, Saudi Arabia
Introduction
The root canals of the maxillary first and second molars have been described as having the most intricate morphology of all maxillary teeth [1]. This is attributed to the high prevalence of a second mesiobuccal canal (MB2) in their mesiobuccal roots that is highly variable in its location [2]. Failure to locate MB2 in maxillary molars has been associated with an increased treatment failure rate [3].
Objectives
The aim of this study was to determine MB2 canal detectability in maxillary first and second molars obtained from a Saudi population using microcomputed tomography (micro-CT)
.
Methods
Ethical approval for this experiment was obtained from the institutional review board of King Abdullah International Medical Research Center (RC10/043). Maxillary first (n = 35) and second (n = 30) molar teeth, with intact MB roots and fully formed apices, were selected and scanned at an isotropic resolution of 13.6 microns with micro-CT technology (SkyScan 1172, Bruker microCT, Kontich, Belgium).
The acquired images were reconstructed into cross-sectional slices. The slices in the MB root were observed starting from the pulp chamber floor level until the apex.
The number of canals was recorded. In case of having more than one canal, the presence of extra-canal was categorized based on the level they were first detected at as follows: 0 level (chamber floor), 1 mm level (1 mm apical from the floor), 2 mm level (2 mm apical from the floor), and greater than 2 mm level (more than 2 mm apical from the floor). The images were analyzed by three calibrated endodontists.
Results
The reconstructed MB roots and their cross sections were analyzed (Figure 1). Table 1 shows number of canals in the MB root of maxillary first and second molars.
Further analysis was performed on the MB roots which have more than one canal. The MB2 canal was detected at the chamber floor in 70% and 61% of the maxillary first and second molars, respectively. At 1 mm depth, the MB2 canal was found in 15% and 18% of the maxillary first and second molars, respectively. At 2 mm depth, the MB2 canal was found in 3% and 18% of the maxillary first and second molars, respectively. The remaining four maxillary first molars and one maxillary second molar had the second MB canal at levels deeper than 2 mm (Table 2).
Conclusion
The high prevalence of MB2 in maxillary molars, which are often undetected and missed during root canal treatment, creates a significant clinical challenge [3]. This micro-CT study might provide dental practitioners with the fact that extra MB canals are found at deeper levels in the maxillary molars. The micro-CT is now considered the gold standard in tooth morphology studies [1, 4]. Its advent has facilitated interactive image manipulation and enhancement to reconstruct and visualize the area of interest as a 3D volume from various angles.
Abdulrahman Alharbi, Faisal Alkahmis, Yazeed Al Naser, Ahmad Alquraishi, Abdulwahab Aldubyan, Malek Alotaibie,1 Saud Aliedy, Abdulmajeed Alahmry, Nawaf Aljahdali, Omar Almutairi, Abed Al-Hadi Hamasha,. College of Dentistry, King Saud bin Abdulaziz for Health Sciences, Riyadh, Saudi Arabia.
Objectives
Dentine hypersensitivity is dental pain which is sharp in character and of short duration, arising from exposed dentin surfaces in response to stimuli, typically thermal, evaporative, tactile, osmotic, chemical or electrical; and which cannot be ascribed to any other dental disease. The aim of the present study was to explore the prevalence of dentine hypersensitivity among adults living in Riyadh city, Saudi Arabia, and assess the related risk indicators for this condition.
Methods
The present study is a cross-sectional observational, analytical study of the prevalence of dentine hypersensitivity and its associated factors. The sample size was 550 participants. Participants were asked to sign consent forms before the interviews and clinical examination. The inclusion criteria were Saudi participant and 18 age and above. On the other hand, the exclusion criteria were children, edentulous participants, subjects with systemic syndromes, subjects who are wearing fixed orthodontic appliance, subject who have fixed prosthesis and subject with teeth bleaching within the last 6 months.
Results
The prevalence of dentin hypersensitivity among Saudi population in Riyadh city is 51,3%. No significant association between dentine hypersensitivity with demographic, behavioral, dietary and medical variables were observed except with intermediate education and teeth brushing.
Discussion:
The present study is the first study to assess dentine hypersensitivity among adult dental patient in Saudi Arabia. The number of patients examined for dentine hypersensitivity was high, thus give more confidence in our study. All examinations were conducted in the dental clinics of the College of Dentistry, which give more accuracy in assessing the condition with proper illumination and the use of 3-in-one syringe.
However, generalizability of the result should be considered with caution, since the sample is a convenient sample and dental patient might not be a representative to all Saudi patients. Inter-examiner variation was assessed, however, having multiple examiners is a source of bias itself.
Conclusion
About 51.3% of Saudi examined suffered from dentine hypersensitivity. The mean number of teeth with dentine hypersensitivity was significantly related to less education and excessive tooth brushing..
Abdullah M. Alonazi,1 Ziyad M. Alosaimi,1 Mohammed M. Aldosari,1 Abdulaziz H. Fakih,1 Rakan B. Aldosari,1 Prof. Abed Al-Hadi Hamasha. College of Dentistry, KSAU-HS, Riyadh, Saudi Arabia
Objectives:
To measure the prevalence of dental fear and associated factors among male students at National Guard schools
Methods:
A cross-sectional study was conducted among students aged 10-17 years. The assessment tool of this study was a self-reported questionnaire filled by students or their legal guardians. The questionnaire included 33 questions including students' demographics and experience in dental fear. Also, questions about the most frightening factors as well as factors that make students feel better in the dental clinics were included.
Data analysis was conducted using SPSS software. Frequency distributions with numbers and percentages of demographics, frightening factors and comforting factors were conducted. Chi-square tests were used to assess the relationship between the presence of fear among different categories of age, income, and educational status. The p-value was considered significant if it is less than 0.05.
Results:
The response rate was 87% (427 from 491). Dental fear was reported by 29.1% of the participants. Tooth extraction feared the worst (49%) followed by root canal treatment (16%), gum treatment (9.3%) and tooth filling (9.1%). The main sources of fear were related to dental procedures and noise from drilling teeth. The fear was originated from childhood experience (41%) and only 13% of participants related their fear to what they heard from other people's experience. Female dentists (73%), the good reputation of the dentist (55%), and elegance and cleanness of the clinic (47%) were found to reduce fear. The good appearance and neatness of the dentist, attitude of the receptionist, and decreased waiting time were not considered as major factors in reducing dental fear.
Conclusion:
Dental fear was present in about one third of students of the National Guard schools. The most fearful dental procedure was tooth extraction. The procedure of dental treatment and the drilling noise feared worst from inside the clinic. The students' fear was originated from their previous painful and annoying experiences. A good reputation of the dentist, clinic cleanliness and female gender of dentists were reported as helping factors in reducing dental fear.
Ikram Ul Haq, Khalid Al-Fouzan. College of Dentistry, King Saud bin Abdulaziz for Health Sciences, Riyadh, Saudi Arabia
Objectives
Citation impact (CI) calculates the number of citations received in scholarly publications. It represents the total number of citations to articles divided by the number of articles. Further, the citation analysis can be applied on a single article, published work of an author, on an academic journal, research productivity of an institution, and total scholarly output of the specific specialty and country. The main aim of this report is to analyze the CI of dental research produced by Saudi Arabian affiliated authors published during the last ten years from 2009 to 2018.
Methods
Data for this study have been retrieved from Web of Science (WoS) database. WoS classified dental research under "Dentistry Oral Surgery Medicine". Research productivity in dental sciences by Saudi Arabia with CI produced during 2009-2018 has been searched and downloaded for analysis.
Results
WoS produced the list of 1,771 documents produced by Saudi Arabian researchers on dentistry during the period of 2009-2018 with an average of 177 publications per year. These publications received 10,320 citations with the CI of 5.83. The analysis of data by year reveals that older publications have higher CI. The subcategory of "Engineering biomedical" in dentistry got maximum impact factor. Review articles received the highest citations as compared to Original research articles. Organization-wise data shows that the research carried out in the hospital sector have the highest number of citations as compared to teaching institutions. Impact factor journals especially Q1 received high citations. Dr. Khalid Al-Hezaimi publications have received the CI of 16.36, even higher than some US researchers. The research collaboration by Saudi Arabian authors with the researchers of the University of Michigan, USA got maximum citations while by country analysis shows that research collaboration with Italy, Germany and Japan have more citations as compared to the US, Egypt and England.
Conclusion
The findings of this report will guide the Saudi Arabian dental researchers that they should write on novel and innovative ideas. They should try to publish their research in Q1 impact factor journals and with the collaboration of talent-rich countries.
Sarah Bin Muharib, Mashael Althunayan, Latifa Algudaibi, Amal Alzahrani, Ghaida Almugbel, Bahija Basheer. College of Dentistry – King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
Introduction:
Some complications in the teeth cannot be solved except with tooth extraction which cause partial Edentulism, and unfortunately represent the beginning of new problems.1,2 Various changes could be observed in the size as well as the shape of the mandible with progressive development in the growth and function of the jaws that differ on the basis of age, gender, and dental status. 3,4
Objectives
The aim of this study was to measure and evaluate the morphological changes of the mandible, with respect to age and gender in partially edentulous and fully dentate subjects using panoramic radiographs.
Methods
The study included 150 partially edentulous patients and 150 fully dentate patients who were enrolled in College of Dentistry, KSAU-HS between January, 2015 and December, 2018. The panoramic radiographs were taken using digital Planmeca machine. Five mandibular morphological and anatomical parameters were measured; Condylar height (CH), gonial angle (GA), ramus height (RH), antegonial notch depth (AND), and ramal notch depth (RND).
- Gonial Angle (GA): the angle between the imaginary tangential line along the posterior border of the mandibular ramus and the inferior border of the mandible.
- Condylar Height (CH): the distance between line perpendicular to the ramus tangent line at the level of the most lateral image of the condyle and the line perpendicular to the ramus tangent line at the level of the most superior image of the condyle. CH will be the perpendicular distance between the lines.
- Ramus Height (RH): the distance between line perpendicular to the ramus tangent line at the level of the most lateral image of the ramus. RH will be the distance between the lines.
- Antegonial Notch Depth (AND): the distance along a perpendicular line from the deepest point of the antegonial notch concavity to a tangent to the inferior cortical border of the mandible.
- Ramal Notch Depth (RND): the distance along a perpendicular line from the deepest point of the ramus notch concavity.
Descriptive statistics, including the mean and standard deviation were calculated for all the measurements in both the test and control groups. Chi-square analysis to assess the relationship between dental status with respect to age and gender of the participants. Independent t-test was used to compare morphological measurements of the mandible with age, gender and dental status. The level of significance was set at P value less than 0.05
Results
There was a statistically significant difference in the mean values of GA between the test and control groups (p value= 0.00). However, no significant differences were observed in RH, RND, CH and AND between the groups (figure 2). A statistically significant increase in the mean values of GA in partially edentulous subjects was observed in the study which coincides with many studies which concludes that there will be an increase of GA in the area of tooth loss.5 Regarding the gender differences, female showed larger mean values for all variables except for AND, but the difference was not significant (table1). GA is significantly larger among younger age group, but there was no significant difference in the CH, RH, RND and RND between the two age groups (Table2).
.
Conclusion
This study concluded that there is no association between the changes in the morphological measurements with respect to age and gender except in GA where younger subjects has higher GA values. Also, it concludes that GA, was significantly higher in partially edentulous group compared to fully dentate. It highlights the consequences of tooth loss on the mandibular morphology, and it can be useful as standards for further comparison studies between fully dentate, partially and completely edentulous subjects.
Khalid AlDeraa, Afra El Rashid, Hamad Alissa, Suliman Alrafaa, Waad Almadhi, Sarah Alsougi, Hadeel Bawazir.
Objectives
Endodontic treatment considered as significant part of daily dental practice. Since 1960 endodontics started to be recognized as a separate specialty in most countries Over the years, armamentarium of root canal therapy continues to evolve, and many technologies have been introduced in order to facilitate endodontic procedures and for favorable outcomes. The aim of this study is to gather information regarding endodontic practice and attitude of general dental practitioners and endodontists in Riyadh city, Kingdom of Saudi Arabia
.
Methods
In this cross-sectional study a self-administered questionnaire was distributed in 2018 to 400 of general dental practitioners and endodontists working in private hospitals in Riyadh city regarding their routine practice in endodontic treatment. Riyadh city is divided into five areas according to the city municipality zones map. Randomly selected private dental clinics from each district and each clinic received hand-delivered questionnaires. The questionnaires were hand-collected at the same day.
Results
The questionnaire was distributed to 400 general practitioners and endodontists who working in private clinics in Riyadh city, Saudi Arabia. Completed replies were obtained from 258 of them giving response rate of 64.5%. 45% (n=109) of the GPs were mostly used barbed broach to extirpate the pulp tissue, 35% (n=6) of the endodontists were mostly used K-files. In regard to preparing the canals, 45.2% (n=109) general practitioners used rotary nickel titanium and 19.9% (n=48) used stainless steel hand files. 47% (n=8) specialists used rotary nickel titanium and none of them used stainless steel hand files. The most common technique used for obturation was lateral condensation among general practitioners 56.6% (n=136) and specialists 41% (n=7). Type of sealer mostly used was Resin based sealer (AH26, AH+) by GPs 63.3% (n=152) and endodontists 47% (n=8) and among most of the years of experiences. GP's 64%(n=154) and endodontist 47% (n=8) used commonly composite restoration as post obturation filling material.
.
Discussion:
Our study was conducted in private clinics only, because most specialists working in governmental institutes and dental schools are fallowing the quality guidelines of endodontic practice (Alfouzan, 2010). The response rate in this study was 64.5%, which considered representative of the current endodontic practice performed by the GPs and endodontists in private dental centers in Riyadh city in compared to study done by Khalid Alfouzan (Alfouzan, 2010). The questionnaire was hand delivered and collected in the same day, which obtained a higher response rate in comparable to online distribution (Nulty, 2008).
Conclusion
It is concluded that endodontic practice in a private sector in Riyadh city, the capital of Saudi Arabia where fewer endodontists and more GPs are there, is improving compared to other studies in the previous years like in using rubber dam isolation and when to prescribe antibiotics. However, they still need more education in many aspects. For example, giving informed consent before root canal treatment and using magnification.
Recommendation: to assure the competency of the practitioners in clinical practice, the continuous education, well-prepared courses and workshops should be mandatory in a regular basis in order to fill the gaps and to ensure updating knowledge and improving the attitude toward the standard endodontic practice.
Azzam Al-Jundi, Salah Sakka, Hicham Riba, Thaer Ward, Reem Hanna College of Dentistry, King Saud bin Abdulaziz University for Health Sciences.
Introduction:
The long duration of orthodontic treatment is a major patients' concern. A non invasive method of accelerating tooth movement in a physiological manner is needed.
Objectives
The aim of the study was to evaluate the effects of Er: YAG laser application during orthodontic treatment of deep bite and to evaluate its analgesic effect during that movement.
Methods
A prospective randomized controlled clinical trial (RCT) was performed on 30 patients with deep bite. Sample was divided into two groups:
(A), 15 patients (orthodontic treatment-control group) and
(B), 15 patients (orthodontic treatment and Er:YAG Laser - laser group).
The tooth movement was evaluated as the primary outcome variable by measuring angular and linear changes on three progress lateral cephalometric radiographs (T1, T2 and T3); Lateral cephalograms were taken before treatment (T1), immediately after finishing the stage of leveling and alignment (T2) and after completion of the intrusion stage (T3). Laser parameters used for hand-piece No 2062: 400 mj/10 Hz/4 W and for hand-piece No 2060: 400 mj/15 Hz/6 W. The levels of pain and discomfort were evaluated and ranked according to a visual analog scale. Paired t-tests or Wilcoxon matched-pairs signed-rank tests were used to detect significant differences.
Results
The main findings of the treatment were:
(1) Significant positive difference in the rates of tooth intrusion movement on the experimental group compared with the control group at the baseline to T2and T3 interval and the tooth movement rate was approximately 3 times faster in the experimental group.
(2) The pain score in the experimental group was significantly lower compared with the control group on day 3 as on day 7.
Discussion:
The present findings have shown that the Er:YAG laser therapy significantly accelerated tooth movement. The rate of tooth movement in the experimental group was 2 to 4 times greater than that in the control group. The resulting increased speed of incisors intrusion agrees with those from Iino et al ,in their animal study. The present findings have also corroborated the clinical observations of Wilcko et al and Hajji et al who reported similar significant reductions in treatment times.
In this study the mean time needed for intrusion of upper incisors in the control group was 95.8 days while in the experimental group was 59 days. Therefore, the time for treatment was 38.4% less compared with the control group. Similar findings were reported by Kawasaki and Shimizu and Yoshida et al. Ngan et al proved that, after an orthodontic procedure, pain and soreness occur after 24 to 48 hours. Thus the first follow up score after laser therapy was recorded on day 3.
This study found a highly significant decrease in pain scores in the experimental group on day 3 compared with day 1. Similar findings were reported by Fujiyama et al. as they observed significant pain reduction with laser therapy immediately after insertion of separators until day 4. Kim et al. also suggested that low level laser therapy might be an effective method of reducing orthodontic pain.
Conclusion:
The application of Er:YAG laser is an effective mean to speed orthodontic tooth movement with a significant reduction in pain and discomfort after application.
Ahmad Alsuawari, Hossam Almalki, Fahad Alotaibi, Abdulrahman Alrajhi, Ahmad Jadoh, Faisal Alghanem, Waleed Albaradie,1 Nwaf Alawad, Abdulelah Alotaibi, Nawaf Alotaibi, Mojahed Alfozan, Vidyulatha Krishna. College of Dentistry, King Saud Bin-Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Introduction:
Reviewing the dental literature, multiple studies have been conducted in the past to assess the level of knowledge related to oral cancer screening and prevention among medical and dental undergraduate students.1-3 In Saudi Arabia, very few studies 4-6 have been reported which assessed the level of knowledge related to oral cancer among undergraduate medical and dental students. However, there are no known studies till date that have been done to assess the differences in the knowledge and practices related to oral cancer among medical and dental practitioners in Riyadh.
Objectives
The aim of the study was to assess knowledge, practices and opinion related to oral cancer among medical and dental practitioners in Riyadh, Saudi Arabia
Methods
A total of 550 practitioners participated in the study. Convenient sampling technique was used to recruit participants. Practitioners who aren't involved in examination of oral cavity, were excluded from the study. Therefore, practitioners participating in the study were either general dentists, dental specialists, general medical practitioners or medical specialists. The knowledge, practices and opinions of the participants was assessed using a self-reported structured questionnaire, which was distributed at various private and government hospitals/polyclinics in Riyadh. Knowledge was assessed based on 19 items and then the mean scores were categorized into high (greater than equal to 14), medium (10-13) and low knowledge (greater than equal to 9). ANOVA was used to evaluate the differences in mean knowledge scores between the four groups and descriptive statistics was used to describe their practices and opinions.
Results
About 69% of the participants were males and 31% were females. The results showed that in general about 65% of medical professional and 63% of dental professional have moderate to high knowledge related to oral cancer.
Dental specialists and medical GP were the most knowledgeable professionals about oral cancer followed by medical specialist and the least knowledgeable professional were dental GP's. The difference was statistically significant (p=0.048).
The percentage knowledge scores was not related to training of oral cancer before graduation or training after gradations. The highest knowledge of oral cancer was reported among professional with less than 5 years of experience and those with more than 15 years of experience. (Table 1) The mean scores of knowledge related to oral cancer is presented in figure 1. Dental Specialist score the highest followed by medical and dental GP's while the medical specialist scores the lowest. When the practitioners were asked about their interest in receiving further training on the knowledge of oral cancer, the highest percentage were among medical specialist followed by dental specialists.
Conclusion
The study reported that knowledge about oral cancer risk factors and clinical presentation was low among more than one third of health care professionals. Furthermore, results shows that most health care professionals recognize their deficiencies and are interested in receiving additional training on oral cancer screening and prevention.
Meshael Abuabat, Resident, Saudi Board of Prosthodontics, National Guard Health Affairs, Riyadh
Introduction:
Congenital absence of one or more teeth has an adverse effect on esthetics, phonetics and function. This clinical situation is a challenge to prosthodontists, orthodontists and periodontists in terms of formulation of a treatment plan that will yield the best long-term outcomes.
Clinical Presentation:
This case report describes esthetic management of a 22-year old smoker patient with congenitally missing maxillary premolars who had a previous orthodontic treatment in which canines were distalized and implants were placed in its position.
Treatment Objectives:
- To achieve adequate peri-implant soft tissues contour by fabrication of provisional implant supported crowns with subsequent addition of flowable composite.
- To achieve esthetics by restoring the implants with canines and reshaping both canines into premolars as well as multiple veneers on the maxillary anterior teeth.
- To achieve function by establishing canine guidance to provide posterior disocclusion and by occlusal equilibration to eliminate undesirable interferences.
Treatment Outcome:
Although the implants were not in a favorable positioned, the use of customized zirconia abutments made it possible to obtain an acceptable esthetic result. One-month follow-up showed well-integrated restorations and the soft tissues appeared healthy
Conclusion:
This case report demonstrates that management of patients with congenitally missing teeth, particularly with anterior dental esthetic problems, should follow an interdisciplinary approach rather than a multidisciplinary approach to prevent possible complications and improve the treatment outcomes.
Rima A Safadi, Abdulaziz AlRomaizan, Rana Al Shagroud, Darshan Divakar, Saeed Alshieban. College of Dentistry, King Saud bin Abdulaziz for Health Sciences, Riyadh, Saudi Arabia
Introduction:
Great emphasis has been laid on enhancing the reliability and the accuracy of grading epithelial dysplasia since its severity has been correlated with the likelihood of malignant transformation and management protocols [1-5]. Although several grading systems have been proposed, epithelial dysplasia grading still suffers from intra and inter-examiner variability [6-15]. K19 is an intermediate cytoplasmic filament known to be expressed in stem cells and basal cell layer of stratified squamous epithelium. It has been strongly correlated with the presence of epithelial dysplasia [16-18 ]. K19 immunostain impact has not yet been assessed in terms of improving epithelial dysplasia grading systems reliability.
Objectives
This is the first study that aimed to assess the impact of utilizing K19 immunostain paired with hematoxylin and eosin (H and E) stain to enhance inter and intra-examiner reliability while assigning grades to dysplastic epithelial tissue of the upper aerodigestive tract.
Methods
The archives of the Department of Pathology at King Abdul Aziz Medical City/ King Fahad Hospital were searched for specimens histopathologically diagnosed with epithelial dysplasia of the upper aerodigestive tract for 2013-2018. The study sample consisted of 122 sections that fulfilled the inclusion criteria. Each paraffin block had three sections cut: one immunostained for K19 and two for H and E stain. Stained slides were rotated among the three examiners for 6 rounds: 3 grading based on H and E stain alone and 3 grading based on paired K19 and HandE stains. Keratinizing status of the epithelium was recorded. The results were analyzed using Krippendorff's alpha, ROC curve, Chi-square test and binary logistic regression.
Results
Upon the use of paired K19 and H and E stains, intra-examiner grading reliability coefficients were improved for examiners 1, 2, 3 from 0.70, 0.69, 0.78 to 0.73, 0.88, 0.91, respectively. Inter-examiner reliability coefficients were improved from 0.55 to 0.73 (Krippendorff alpha). The accuracy of identifying the diseased cases (high-grade dysplasia) increased from 0.82 to 0.94 (ROC curve). Binary logistic regression revealed that K19 positivity is significantly associated with the non- keratinizing status of surface epithelium (Bivariate logistic regression=0.001).
Conclusion
Paired K19 immunostain with H and E regular stains proved to increase intra and inter-examiner reliability and reduce grading variability by highlighting the extension of dysplastic epithelial cells within epithelial thickness thus identifying the involved epithelial third and assigning a more reliable and better reproducible grade. Requesting K19 immunostain for non keratinized dysplastic epithelium grading is thus strongly advised.
Khalid Al Bawardi, Sulaiman Al Sanea, Bassam Al Otaibi, Mashari Alanazi, Hussain Al Fifi, Faisal Al Shehri, Saud Al Saeed, Abdulkareem Al Ghamdi, Faisal Al Omran, Mohammed Alanazi, Abdullah alrushaid, Bahija Basheer. College of Dentistry, King Saud bin Abdulaziz for Health Sciences, Riyadh, Saudi Arabia.
Introduction:
There are high concerns about dental practitioners' perception, knowledge and attitude toward radiation protection especially with the variety of radiographs, their radiation doses and the effect on variety of patients. It is to be noted that there has been no internationally published data about the KAP of dental professionals in Riyadh, KSA regarding the biological hazards and radiographic protection techniques. Therefore, this has led to an increased interest to evaluate KAP towards radiation hazards and protection among dental professionals in Riyadh.
Objectives
To evaluate knowledge, attitude and perception among dental students, dentists and dental staff toward dental radiation and to assess the difference in knowledge between dental students, dentists and dental staff.
Methods
A cross-sectional study was designed to obtain information from dentists, dental staff, and dental students. 550 dental professionals participated in this study. The information was collected from each participant through a structured questionnaire consisting of 39 close-ended questions. Statistical analysis included Chi-square to test the association of KAP with gender, occupational sector and educational qualification and one-way analysis of variance to compare the difference in means of KAP between the three different groups of professionals.
Results
Out of the 550 dental professionals who participated in the study, 293(53%) were dental students, 83(15%) were dental staff, and 174(32%) were dentists. Dental students showed higher KAP values toward radiation hazards protection followed by dentists and dental staff.
Discussion:
Upon literature review, there was a lack of studies evaluating the knowledge of radiological hazards in Kingdom of Saudi Arabia especially in Riyadh. Previous studies such as the one by Arnout et. al,1(2014) included only dental students whom 87.5% of them considered x-rays to be harmful, yet the present study showed only 63.5% of dental students who considered x-rays to be harmful. In a study by Dölekoğlu et. al,2 (2011), 67% of dentists said that they use digital radiography, while in the present study only 27.6% of dentists are using digital radiography.
It can be inferred from this study that there is lack of knowledge in regard to radiation protection protocols and radiation hazards itself. However dental students showed the highest KAP values that could be attributed to new and fresh knowledge regarding radiology courses.
Conclusion
From the results obtained in the study, it was concluded that KAP level with regard to radiation protection was higher among dental students compared to dentists, and the least KAP level was found with dental staff. Considering the results of this study it is critical that all radiology departments need to continue professional development; by doing more radiation protection workshops and training courses, preparation and distribution of posters on the protection and safety against radiation in order to raise the awareness among dental professionals.
Ghaida AlMoqbel, Reem AlKaoud, Azzam AlMeshrafi, Shahad BinAteeq, Saleh Sonbol, Sharat Pani, College of Dentistry, King Saud bin Abdulaziz for Health Sciences, Riyadh, Saudi Arabia
Introduction:
Extensive dental care in children is often performed under general anesthesia (GA). The primary barrier for dental care under GA is cost, and daycare anesthesia reduces the cost of dental treatment. In Saudi Arabia, there is lack of information on the type of patients or pattern of dental procedures done under such single day settings.
Objectives
The aim of the study is to create a pattern chart, which will serve as a baseline indicator of procedures performed in a daycare general anesthesia setting.
Methods
A retrospective review of the hospital records of patients receiving dental treatment under GA between April 2013 and March 2018 were performed. The study included complete records of patients aged 14 years or younger. Age, gender, health condition, number of treated teeth, and type of procedure were obtained from the records. Uncompleted records were excluded. Of 575 files reviewed a total of 547 complete records were analyzed. Descriptive analyses were subjected to the Chi-Square test to examine significance
Results and discussion
The results of this study show that children with mild systemic disorders were treated safely under day care GA. Increased drug safety combined with increasing hospital costs, have meant that most dental procedures are now performed in a day-care anesthesia setting. 6,10,11 Most of our cases underwent comprehensive dental restorations and extractions. This seems to be correlated with the current level of caries experienced in Saudi Arabia. 14 Over the past six years there has been a significant reduction in the number of extractions and an increase in the number of zirconia crowns. However, Chen Y et al, (2016), found a pattern of an increase in the extraction of primary teeth.
Conclusion
Day care surgery is an effective means of providing dental care under GA. The reduction in the number of teeth being treated per patient over the past six years seems to suggest that the reduction of costs can increase access to dental care under GA.
Maha Alatyan, Atheer Aldaham, Afnan Alzomaili, Ghaida Abalhassan, Hend Almuziri, Mona AlJofan, Reem Al-Kaoud, Dr. Vidyullatha Gopalakrishna, Dr. Bahija Basheer. College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
Introduction:
Child Abuse and Neglect (CAN) is a major problem of concern worldwide including Saudi Arabia where most of the CAN cases are detected in hospitals. Child maltreatment in Saudi Arabia started to attract the attention of healthcare professionals after a number of cases were reported in the media in the early 1990s.1 As per the statistics given by the National Family Safety Program, in 2016, the prevalence of child neglect in Saudi Arabia was 51.5%, physical abuse was 33.7%, sexual abuse was 27.4% and emotional abuse was 16.8%.2
According to National Family Safety Program registry, most of cases of CAN in Saudi Arabia are detected in hospitals.2 However, few Saudi studies have been reported in relation to the knowledge and attitude toward CAN among healthcare professions.3,4,5 Thus, healthcare professionals play an important role in identifying and reporting CAN cases.
Objectives
To assess knowledge and attitudes towards Child Abuse and Neglect (CAN) among medical and dental undergraduate students and interns in Riyadh, Saudi Arabia.
Methods
This cross-sectional study recruited 351 participants using convenient sampling. The participants included undergraduate medical and dental students in the final year of their academic study and medical and dental interns. Data were collected through a self-administrated structured questionnaire . it is comprised of four sections as follows: Section one: Participants' socio-demographic and background details including age, gender and field of professional education. Section two: participants' knowledge about the social indicators and risk factors. Section three: participants' knowledge about clinical presentations associated with CAN. Section four: participants' attitudes and opinion on CAN. The data were statistically analyzed using IBM SPSS (version 22). Descriptive statistics, chi-square test and T-test were used to perform the statistical analysis. The significance level was set at 5%
Results
Among the 351 participants who met the inclusion criteria,179 (51%) were males and 172 (49%) were females. About 57.5% of the participants received formal training on CAN during their undergraduate study(Figure 1). Mean knowledge score related to CAN was 6.81+1.17 for medical participants and 6.35+1.35 for dental participants, and the difference was statistically significant (p=0.001) (Figure 2). Most participants believed that the main barrier for not reporting a suspected CAN is the fear of consequences (Medical=82.4%, Dental=68.5%, P= 0.01). About 77% of the participants agreed to the need for further training in dealing with CAN(Figure3).
Discussion
Formal training on CAN during undergraduate study period or later enhances the ability of health care professionals to detect and report suspicious cases. The mean score of knowledge among medical students and interns were significantly higher than dental students and interns (p=0.001). This result was similar to the findings by Deshpande et al.8 comparing medical and dental residents. Interestingly, the subjects in this study were more satisfied with the CAN knowledge background that was provided by the medical/dental schools, when compared with the previous studies by Mogaddam et al. and Hussein et al.3,6 This finding suggests that the new educational curriculums pays more attention to important social issues such as CAN. Furthermore, fear of family anger, fear of violence or unknown consequences to the child victim and lack of knowledge were considered as the main barriers to report CAN by both medical and dental participants. These results were relatively comparable to a study that was done by Al-Dabaan et al.5
Conclusion
This study showed that only two thirds of the participants have adequate knowledge regarding CAN. To increase the awareness about the diagnosis and referral procedures, academic institutes should consider seminars and continuous education courses instead of relying on lectures only.
Randa Ibrahim, Ali Abdullah, El-Refaie Kenawy, Hend El-Kafrawy College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh - Saudi Arabia)
Introduction:
Despite the fact that success in aesthetic restorations depends greatly upon adhesion success, the bonding interface still remains the weakest spot of dental restorations. Secondary caries and dental adhesives' poor durability are the two main reasons for the replacement of the resin-based restorations, a situation prompting the need for improvements to obtain multifunctional dental adhesives which are capable of simultaneously improving various performances.
Objectives
The present study focused on the development and characterization of novel bio-composite nanofiller with antibacterial properties; via formulating hydroxyapatite nanoparticles combined with quaternary ammonium salts of polyethylenimine (QPEI/Hap).
Methods
Hydroxyapatite (Hap) nanorods were produced by hydrothermal process and coated by Polyethyleneimine (PEI) via electrostatic adsorption, followed by two steps polymeric reaction for quaterisation. Powder characterization was done using XRD, FTIR and TEM before and after polymer coating, and bioactivity was evaluated using XRD after 7 days' soaking in simulated body fluid. An experimental ethanol–based one-bottle adhesive resin was formulated with 0.2, 0.5, 1, 2 and 5% QPEI/Hap nanofiller concentrations. The formulated adhesives were evaluated for their colloidal stability, antibacterial activity, Ultimate Tensile Strength, and Micro-Shear bond strength to dentin compared to commercial dental adhesives (Clearfil S3 Bond and Clearfil Protect Bond). The raw data was collected, tabulated and analyzed using one way analysis of variance test, followed by Paired T-test for Antibacterial activity, and Tukey HSD test for mechanical properties with significance at P less than equal to 0.05.
Results
Overall characterization measurements (FTIR, TEM, X-ray diffraction) confirmed successful surface modification of Nano hydroxyapatite particles with PEI polymer, with a mean particle size of 20.8 nm.
- The results of ADT reflected that samples with low filler content (0.2% QPEI-Hap) showed a significant bacterial reduction (p greater than 0.05) of approximately 82% against S. mutans and 29% against E. coli.
- Diametral compression test results showed greater mean values (47plus minus2.19- 43.2 plus minus 4.97 MPa) for samples containing 0.2–0.5 wt. % NPs which is about 15-25 % higher than that of the tested commercial filler (Clearfil S3 bond, 37.4 plus minus 3.28).
- Statistical analyses showed positive effect of filler type and concentration on the strength of dental adhesives bond (p greater than 0.05), with average micro-shear bond strength values for the experimentally prepared adhesive of 0.2% and 0.5% QPEI-Hap nanofiller, were 57-72 % higher than that of the control commercial bond CS3 (11.03 plus minus 1.843).
Discussion:
In this study polyethyleneimine (PEI) was used as a cationic surfactant coated on HAp nanoparticles instead of silanization process; to induce matrix/filler interaction and enhance dispersion properties of Hap nanoparticles in the organic liquid media (experimentally prepared bonding agent). Hydrophobicity of quaternary ammonium salts (QPEI) is considered to be beneficial to overcome the problems of high solubility and hygroscopic action of Hap nanoparticles to avoid filler deterioration. Its resilience as a polymer was also useful to counteract the brittleness and inferior mechanical properties of HAp for better durability. This surfactant gained additional advantage by further rendering the adhesive antibacterial against both Gram positive and negative bacteria.
Conclusion
Within the limitation of the present study, it can be concluded that QPEI-Hap nanoparticles may be regarded as a promising alternative to other fillers for dental adhesives. Henceforward, in vivo and in vitro experiments are necessary to evaluate the long-term antibacterial properties of this newly proposed single bottle self- etching dentin bonding system and to conclude the benefit of its antibacterial properties for other clinical applications.
Faisal Alzeghaibi, Abdulaziz Jammah, Abdulmohsen Bin Hassan, Ahmad Alanazi, Ali Alrezgi, Khalid Alotaibi, Khalid Alderaa, Muhannad Alotaibi, Waleed Alkhulaifi, Yasser Aloufi, Ziyad Alghmadi, Abeer Alrumayyan. College of Dentistry, King Saud bin Abdulaziz for Health Sciences, Riyadh, Saudi Arabia
Introduction:
Follow-up appointments are necessary for some conditions to ensure the effectiveness of the treatment. Studies have shown that distance can be a barrier to attend follow-up appointments which might be necessary for these conditions. For example, breast cancer treatment requires follow-up care, and can place a significant travel burden on patients.1 In Saudi Arabia Albarakati et al. found that women are more affected to miss their appointment, on other hand attendance to the appointments is less in the holy Ramadan month due to fasting.2 However, no studies have been conducted in regards to distance and transportation and their relationship with not attending dental appointments. Due to the high percentage of patients skipping dental appointment and the geographic location of MNG-HA and KSAU-HS college of dentistry dental clinics we think of conducting this study.
Objectives
The aim of this study is to see if the distance to the KSAU-HS dental clinics and MNG-HA dental clinics are a barrier to attend follow-up appointments. Also, to see what other factors might affect the attendance of patients to their morning or afternoon appointments, including cost of transportation and the time of the appointments.
Methods
According to the power calculation, a convenient sample was selected. the sample size was 550 participants in the KSAU-HS and MNG-HA waiting areas, in Riyadh, Saudi Arabia. The questionnaire consists three main parts. First, demographics, which includes age, gender, area of resistance. Second, transportation issues, such as, the time taken to reach the dental clinics and how many kilometers travelled to get there. Third, barriers of attending dental appointments were asked in a liker-scale, for instance, if the cost of transportation affected their attendance, or if they preferred a nearby privet clinic, plus if the time of the appointment played a role. Questionnaire was distributed to the participants alongside the informed consent form. Data was analyzed using SPSS IBM version 22 program using Chi-square test.
Results
Surprisingly, patients who lived in a distance between 16-30 km were the most group to attend their dental appointments and the least group of patients to be affected by the availability of transportation [figure 1]. In addition, the group of patients that needed 30-60 minutes were also the most group to attend their dental appointments and the least to be affected by the availability of transportation [figure2]. The majority of the patients disagreed when asked if the cost of transportation was causing them a barrier to attend dental appointments [figure 3]. However, most of them agreed that they preferred to go to a nearby privet dental clinic or attending an afternoon dental appointment than going to their dental appointments at morning times [figure 3]. Plus, the patients also agreed on that they would skip their dental appointment due to traffic jams on the way[figure 3].
Conclusion
Since there is a shortage of studies in that field we decided that we shall do a survey asking the patients if travel and transportation caused a burden to them to attend their appointments, and if that was the cause of the high percentage of patients skipping their appointments. In regard to our method we used a questionnaire that was handed to the patients in dental clinic at KSAU-HS and MNG-HA dental center as hard copy. The results revealed that people living between 16 to 30 Kilometers from the clinics were the most group to attend the appointments. Also, skipping dental appointments due to traffic was the most to be agreed on for attending the appointments. For future studies we recommend to include more question about barriers of attending appointments, such as, if they usually attend their appointments on time, and to shorten the questionnaire and lastly to reduce "Neutral" options as it is the easier choice for the patients to consider.
Nouf Albesher, Ashwag Alfadhel, Asma Alshareef, Manal Aljamal, Nourah Alaqaili, Thoraia Kinani, Prof. Abed Al-Hadi Hamasha. College of Dentistry, King Saud bin Abdulaziz for Health Sciences, Riyadh, Saudi Arabia.
Introduction:
The risk of developing dental caries by exposure to Secondhand smoke (SHS) may be explained by three major mechanisms. 1) Direct exposure of the developing teeth buds to chemicals of smoke, leading to delay formation and impair mineralization. 2) Damaging the salivary glands by chemicals of smoke resulting in a decreased salivary flow which affect buffering capacity and cleansing. 3) SHS impairs immune system of children and increases colonization of Streptococcus mutants which have been attributed in the formation of dental caries.
Reviewing the international dental literature, there no agreement on the relationship of SHS with dental caries. This is the first Saudi Study to address this issue among Saudi Children.
Objectives
To explore the relationship between dental caries and exposure to SHS among Saudi children in primary, mixed and permanent teeth.
Methods
The present study was approved by the IRB of King Abdullah International Medical Research Center, Saudi Arabia [SP 18/ 436/R]. The target sample was children aged between 6-13 years old in their mixed dentition stage, from different regions in Riyadh, Saudi Arabia. Children who did not provide consent forms singed by their legal guardians, children with systemic syndromes, and children who are wearing fixed orthodontic appliances were excluded from the study.
The study was conducted using questionnaire and clinical dental examination. The questionnaire included demographic data, oral hygiene practice and children's general health. Smoking status of parents including type and duration of smoking, as well as in-house smoking were also questioned.
Clinical examinations were conducted by six calibrated senior dental students by means of a mouth mirror and dental explorers under artificial light using the DMF index of the World Health Organization's basic methods. Inter-examiner reliability was checked by Kappa statistics.
Data was analyzed using the IBM SPSS statistical program version 23. Statistical tests included independent samples t-test to compare the different in means of DMFT among children with or without secondhand smoking status..
Results
Of the 301 participating children, 43.4% were males and 56.6 were females. The mean age was 9.16 years. The mean DMFT of primary, mixed, and permanent teeth were 4.83, 6.36, and 1.53 teeth respectively. (Figure 1)
The results showed that only 8 mothers (2.7%) were smokers, 7 of them smoke inside their house. Higher numbers of fathers were smokers 110 (37%) and 82% smoke inside their houses. Cigarettes were the commonly used. In addition 17% of the sample has other family members (other than parents) who are smokers and 7% smoke inside the house. (Figure 2)
The mean number of DMFT in primary, mixed and permanent dentition was higher in children with smoking fathers, mothers and smoking others; however the difference did not reach a statistically significant level except in smoking mothers in permanent teeth (p = 0.005). (Figure 3).
Discussion and Conclusion
The results of this study indicated an increased number of smoking mothers and fathers reaching 37%. This increase number of smoking parents is coupled with higher percentage of smokers inside homes and among their children (85%).
Raneem Nafesah, Shahad Quwayhis, Shahad Meaigel, Raghad Almedlej, Rana Alolieq, Malak Almutairi, Shahd Alzamil, Abeer Alrumayyan. College of Dentistry, King Saud bin Abdulaziz for Health Sciences, Riyadh, Saudi Arabia.
Introduction:
Missing teeth are routinely replaced with fixed dental prostheses (FDP); thus, knowing the patient's oral health related quality of life (OHRQoL) after placement of FDP and factors that could affect patients' quality of life in addition to their oral hygiene practice is important.
Aims and objectives:
This study aims to measure the relationship between OHRQoL in relation to fixed dental prostheses and oral hygiene practice of adults in Riyadh, Saudi Arabia.
Materials and Methods:
A survey was distributed in hard and soft copy forms. Target subjects were adults above the age of 18 years who have FDP and living in Riyadh. The questionnaire contained 4 domains: demographic data, medical history, characteristics of the prostheses and oral hygiene practice as well as OHIP-14 questionnaire which measures OHRQoL. The data was descriptively analyzed. Chi-square was used to evaluate the relationship between the four domains and OHRQoL. One-way ANOVA was used to compare between the means of OHIP-14 scores and the other categorical variables.
Results:
The study included 528 subjects. More than half of the participants (56.9%) have poor OHRQoL which was associated with female gender, full time employment and low income. The presence of toothache, periodontal diseases, oral abscess and broken teeth were all associated with poor OHRQoL. Diabetic participants were also found to have poor OHRQoL. As for oral hygiene practice, 47% of the subjects did not receive oral hygiene instructions after placement of their FDP. It was also found that 53.4% of the study population brush only once daily. Moreover, the majority of the subjects have never used interdental brush or super-floss.
Discussion:
Most studies focused on a specific type of prosthesis such as implants and measured patients' OHRQoL in relation to that specific type.1-7 To our knowledge, this is the first study to measure oral hygiene practice and patient's OHRQoL with FDP in Riyadh, Saudi Arabia. In this study, majority of the participants had poor OHRQoL which comes in disagreement with other studies.8,9 Most of the subjects with poor OHRQoL were females, suggesting that females are more critical about their dentofacial appearance.10,11 Most of the participants didn't receive oral hygiene instructions after prostheses placement. Moreover, brushing using toothbrush and toothpaste was the most commonly used method for teeth cleaning, and other oral hygiene aids were never or rarely used by the subjects.
Conclusion and Recommendations:
The results of this study show that the majority of the study population have poor OHRQoL. Some local factors as well as systemic diseases such as diabetes have negatively affected participants' OHRQoL. Additionally, a large number of the subjects didn't receive oral hygiene instructions after prostheses placement; therefore, dentists' awareness regarding giving postoperative oral hygiene instructions should be increased to ensure the durability of the prosthodontic appliances and improve patients' oral health related quality of life. Further studies are recommended in different areas of Saudi Arabia to identify other risk factors affecting OHRQoL.
Sarah Alhusseini, Nouf Alqahtani, Hind Alfehaid, Rasha Alomar, Nouf Almayouf, Norah Aljuhaimi, Atheer Almasoud, Abed Al-Hadi Hamasha. College of Dentistry, King Saud bin Abdulaziz for Health Sciences, Riyadh, Saudi Arabia.
Introduction:
The knowledge of prevalence of different traits of malocclusion among specific population is essential for planning the need and provision for orthodontic service to enhance quality of life. Dental malocclusion is considered the third highest prevalence among oral pathologies. Although dental malocclusion is not a life-threatening condition, the impaired mastication, the psychosocial distress and its effect on periodontal conditions increase the need for exploring the prevalence and its associated risk factors. The aim of this study is to detect prevalence of malocclusions in population of Saudi Arabia using WHO index.
Objectives:
The aim of this study is to detect the prevalence of malocclusion among Saudi adults population in order to establish a baseline and a reliable reference point, thus increasing the population awareness and implement solutions that proportionate with the extent of the problem.
Methods:
An observational cross-sectional study of the prevalence of adults with malocclusion in Riyadh, Saudi Arabia. The study was conducted in waiting areas of King Abdulaziz Medical City (KAMC) and College of Dentistry at KSAU-HS by using questionnaires and clinical examinations by using WHO index which is consisted of 14 different occlusal characteristics. The observed data was recorded in a prepared form by seven experienced examiners. All the examiners involved in the study were calibrated, and inter-examiner reliability was calculated. Data analysis using SAS, including frequency and chi-square test. P-value of less than 0.05 was considered significant.
Results:
Among a total of 350 subjects, 30% male and 70% female were examined and assessed for prevalence of malocclusion and associated risk indicators. Figure 1 shows the distribution of the sample according to the prevalence of malocclusions. Out of 350 adults, the most prevalent occlusal trait was increased overjet (42.5%) followed by crowding of anterior teeth (41.5%), whereas anterior open bite was the least prevalent characteristic (4%). Association of some occlusal traits with different risk indicators from demographics and habits have been found. Oral habits showed in Figure 2 were present in 204 subjects (58.2%), with subjects showing more than one habit. Mouth breathing was present in (42.3%), followed by tongue thrusting, speech problems and thumb sucking with a rate of (11%), (5.7%) and (5.3%) respectively.
Conclusion:
Our study showed that some malocclusion characteristics are more prevalent than other and some oral habits might play an important role in the development of malocclusion. This reflects the need of increasing awareness among citizens and their dental practitioners regarding malocclusion. That can be accomplished by advocating interceptive orthodontic treatment or early corrective orthodontics before reaching adulthood using social media and campaigns. This will improve facial and dental appearance and thus reduce the stigma that some people feel about their teeth . Other studies are recommended to be done in not only Saudi Arabia, but also worldwide using the WHO index to give results that are more accurate .To identify any other risk indicators for malocclusion.
Shahad Meaigel, Nouf Al Qahtani, Latifa AlGudaibi, Naila A.Shaheen, Ali Aboalela, College of Dentistry, King Saud bin Abdulaziz for Health Sciences, Riyadh, Saudi Arabia
Objectives:
The aim of this study is to assess dental and medical practitioners; clinical examination habits, current knowledge, attitude and the pattern of referral of patients with oral and oropharyngeal cancer (OC/OPC) in Riyadh.
Methods:
This cross-sectional study was conducted using self-reported questionnaire that was distributed randomly among dental and medical practitioners in MNGHA, Riyadh. The questionnaire was consisted of six main sections: demographic data, knowledge, detection and examination habits, pattern of referral, preventive role and training needs. Data analysis was preformed using SAS, including frequency and chi-square test. P - value of less than 0.05 was considered significant.
Results:
A total of 174 completed questionnaires were received. Medical and dental practitioners showed comparable results regarding their knowledge about alcohol, smoking and age as risk factors for oral and oropharyngeal cancer. There was a difference in the pattern of referral between groups in terms of their chosen departments of referrals (figure 1), and duration of intra-oral ulcer necessitating urgent referral (figure 2). For examination habits, significantly higher proportion of medical doctors (47%) would never examine the patient in the course of initial examination when compared to dental practitioners (17%). Most of the participants consider pre-existing lesion, alcohol and smoking as factors that would influence their decision to perform an examination of OC/OPC. Most common sites to examine are shown in (figure 3).
Conclusion:
Medical and dental practitioners showed differences in practice, knowledge and attitude of OC/OPC. if addressed and improved, these practices can lead to better treatment outcomes with reduced morbidity and mortality rates. OC/OPC patients would benefit from early diagnosis and immediate referral to specialist care. Therefore, there is a need for both groups to obtain systemic educational updates.
Sundus Altuwayjiri, Azhar Alanazi, Hussah Alodwene, Samar Alarfaj, Nouf Alhamlan, Najla Alrejeye, Samar Al Hayek, Emad Masuadi, Mohammad Awawdeh. College of Dentistry, King Saud bin Abdulaziz for Health Sciences, Riyadh, Saudi Arabia.
Introduction:
Direct bonding technique is the method of applying orthodontic brackets directly onto the patient`s teeth individually or sectional. Indirect bonding technique is when the operator positions the bracket on all teeth at once, using prefabricated guide trays prepared from a working cast in the laboratory where the brackets are positioned accurately on the models in the first step. The aim of this study is to compare between direct and indirect bracket bonding techniques in terms of accuracy and efficiency while utilizing 3D Technology for models reproduction of identical models for both techniques.
Methods:
10 pairs of casts have been randomly chosen to compare direct and indirect bracket bonding techniques. They have been scanned by Ceramill map 400 digital scanner and saved in STL format. The file was printed utilizing a 3D printer (ProJet MJP 3600). Five independent operators have received 2 cases for the direct bonding technique and their identical duplicate for the indirect bonding technique. Double silicon technique was used for the indirect technique, the trays were made by vacuum machines (Plast Vac P7) and (BIOSTAR, Scheu). All operators are novel in the field of orthodontics (third year dental students) and have received the same training. All models were blindly evaluated by two different independent assessors. Each assessor repeated the evaluation at two different occasions with minimum interval of 72 hours.
Results:
The accuracy in positioning the brackets in the correct place using the indirect method was as good as the direct bonding method with no statistical significant difference between the two groups (Paired sample t-test; p greater than 0.05).
The study data showed that longer total time was needed to place the brackets in the indirect technique compared to the direct approach. However, when taking only the clinical time in consideration; the indirect method needed 50% less time.
No significant differences was detected both in Inter and intra assessor grading, however the junior assessor scores seemed to be consistently higher, the more senior assessor evaluation was more consistent in both reading.
Conclusion:
Indirect bonding takes almost double the total time, but shorter clinical time and as accurate as the direct bonding technique. The indirect method saved almost 50 % of the clinician's time, but was more demanding on the lab technicians. This study concluded that indirect bonding techniques should be utilized much more as it save more than 50% of clinic time and produce accurate bracket positions. Further In Vivo studies arerecommended to confirm these findings.
Maram AL-Jabry, Mohammed Awawdeh, Dr. Khulud Alkadi, Nawaf Alshahrani Graduated student of Health Informatics, King Saud bin Abdulaziz for Health Sciences, Riyadh, Saudi Arabia.
Objectives
The aim of this study was to evaluate the patient's knowledge, understanding and comprehension of the information given to them at the start of the treatment regarding the instruction of oral hygiene (OHI) during Orthodontics treatment, the risks of orthodontic treatment and the care of the fixed orthodontics appliance.
The specific objectives of the study were:
- To compare between two educational methods and evaluate them through which one patient understands best the risks of orthodontic treatment, OHI and instruction related to Orthodontic treatment.
- To evaluate if their comprehension is related to their age, gender and socioeconomic class.
Methods
The sample groups were in the range of 12-16 years old. There was 49 participant (23 received teaching through leaflet; 26 received teaching via Augmented Reality) The population were paired in similar age, gender and school grades. Then they were randomly allocated to one of the two teaching method (Augmented reality or Leaflet). The Augmented Reality (AR) technique was used to educate half of the sample, while the other half was educated via traditional methods using paper-based leaflets. Comprehension of the oral hygiene Instructions among participants, and their awareness of the risks of orthodontics treatment, was then assessed. The study tool was a validated survey which was knowledge-based. The survey was used in previous similar study in English. Validation of the Arabic translation was done through various stages inclusive of content and face validation. The Questionnaire was filled twice; before and after the educational intervention. The first occasion was the base line for the study. The data acquired from the patients was analyzed using Paired samples t-test (SPSS ver. 24).
Results
The results showed that the educational material played via AR have higher impact (205 %) on teenage patients compared to leaflet. Also, by observing behaviors of the patients while reading or being engaged with AR in the clinic, it was obvious that patients were more focused while engaged with AR than reading the leaflet. The feedback from participating patients was highly positive and favorable toward AR. The improvement in the AR group was statistically significantly higher than that for the group using the traditional methods (Paired samples t-test shows significant between AR and leaflet; p = 0.003) The increase of mean score of the patients in the knowledge based survey in the videos was 4.35 points, while for the leaflet it was 2.13 points.
Conclusion
Using AR had greater impact on educating Orthodontic patients than leaflets. AR is an affordable and effective method for educating Orthodontic patients. Utilization of trending technologies to enhance the educational experience in healthcare is foreseen.
Noura Alghurairi, Reuof Alessa, Rahaf Alalwan, Huda Alaqail, Mohammed Awawdeh, Emad Masuadi. College of Dentistry, King Saud bin Abdulaziz for Health Sciences, Riyadh, Saudi Arabia
Introduction
Obtaining dental records is crucial in dentistry. Throughout the years a lot of companies had produced and improved intraoral 3D (three-dimensional) scanners to capture 3D virtual images of the teeth. Both Sirona and KaVo companies produced 3D lab scanners that have high-quality standards of optical measuring systems. These scanners were used in dental labs to scan dental casts and impressions. Since these systems had recently been introduced to the market, not enough studies had evaluated their accuracy and efficiency. This study aimed to evaluate the precision and validity of two new 3D lab scanners in producing duplicated digital impressions, compared to the traditional method of dental cast duplications.
Materials and Methods
Pair of dental casts (upper and lower) were duplicated by using elastic putty mould to make ten copies of each. Following that the total of twenty models were scanned in each scanner (Sirona and KaVo) separately by three different calibrated operators. Each operator repeated the scan with an interval of 48 hours. This allowed assessing inter and intra operator variation. fifteen measurements of each model were obtained in the three different planes (vertical, horizontal, and transfers) following the same protocol. Measurements were obtained manually using a Boley gauge and digitally by the scanner company software. The two scanners that were assessed were; inEos X5 Sirona Scanner and KaVo SMD ARCTICA CAD/CAM Scanner.
Results
The coefficient of variations was between 1% - 8% although statistically significant in some groups, but clinically the differences were insignificant and within the accepted range. Repeated Measurements ANOVA and Paired t-test confirmed these findings. Correlations between the inter and Intra operator reliability were assessed using the Intraclass Correlation Coefficient (ICC). The reliability of the increased distance of the measurement seems more consistent. The variations of Correlations among operators increased as the distance measured decreased, despite the fact that all operators were calibrated respectively. This was explained by the fact that both manual and digital measurements relied heavily on the operators identifying specific landmarks. Operators' feedback were that KaVo was easier to learn. However, time-wise Sirona seemed more efficient. As the average time for the Sirona scanner was less by half a minute with average scanner time (4.3 and 3.8). In all cases, the average second time was always less than the first time. Based upon various parameters recorded, both scanners proved to be accurate with no clinically significant differences detected between the groups.
Conclusion
These two scanners were reliable tools to scan and reproduce digital dental records. One system seemed to be more efficient time-wise than the other. Clinical measurements obtained by the clinicians could vary and be less reliable with small distances. Further studies are needed to utilize 3D superimpositions software to determine the precision of these systems.
