Oral Health Needs and Barriers to Care in Children with Learning Difficulties

@#Introduction: Children with learning difficulties (LD) have poorer oral health compared to those without LD due to barriers in maintaining oral care. However, the scarcity of data for this population in Malaysia has left a huge gap in understanding their problems and how to overcome those barriers. Therefore, this study was conducted to evaluate the unmet dental needs and barriers to care perceived by the guardians of children with learning difficulties (CWLD) attending the Special Education Integrated Programmes of a mainstream primary school, in comparison to children without learning difficulties. Methods: This cross-sectional study surveyed the guardians of CWLD (case) and those without LD (control), aged 6-12 years old. A total of 225 questionnaires were distributed to the guardians with a response rate of 40.4% (N=91). Unmet dental needs and barriers in both groups were analysed using the chi-square test. Barriers with significant Chi-square results were further tested with logistic regression to investigate possible confounders. Results: Unmet dental needs of 23.1% of CWLD were found. Most of the guardians agreed that regular dental check-ups were the most needed dental treatment (27.1%) compared to other treatments. The child’s behaviour and the unwillingness of the dentists to treat were among the significant barriers to dental care within the CWLD group. Conclusion: Despite regular dental visits, guardians of CWLD perceived that their children had the most unmet dental needs compared to other children without LD, with significant barriers in terms of accessing professional dental services.

Effect of Resin Coating on Surface Roughness and Microhardness of High Viscous Glass Ionomer Cements

ABSTRACT@#High viscous glass ionomer cement (HVGIC) was recently developed for atraumatic restorative treatment (ART). However, its moisture sensitivity remains a limitation thus protective coating application is recommended. This study investigated the effect of resin coating on the surface roughness and microhardness of two HVGICs (Riva Self Cure HVGIC [RV] and Equia® Forte Fil [EQ]) conditioned in food-simulating liquids (FSLs). Fifty standard disc-shaped samples were fabricated using customised stainless-steel mould (10 × 2 mm). Coating was applied on top surface of all samples and subsequently divided into five groups: air (control), distilled water, 0.02 N citric acid, heptane and 50% ethanol-water solution. The samples were conditioned in FSLs at 37°C for seven days. Subsequently, the surface roughness and microhardness of samples were measured using optical profilometry and microhardness tester, respectively. SEM analysis was done for qualitative observation of surface morphological changes. Data were analysed using one-way ANOVA, two-way ANOVA and posthoc Tukey’s test (α = 0.05). Interestingly, the results revealed that surface roughness was significantly influenced by FSLs immersion, presence of coating and the materials itself (p < 0.001). The lowest surface roughness was found on control coated samples: RV (50.98±4.25) nm and EQ (62.77±3.92) nm, while the highest values seen on uncoated surfaces in citric acid: RV (505.26±31.10) nm and EQ (350.33±15.36) nm. RV samples had the lowest microhardness of 54.97±2.48 Vickers hardness number (VHN) post-immersion in citric acid. In conclusion, with the exception of RV conditioned in heptane and ethanol, the uncoated HVGICs generally had higher surface roughness than the coated HVGICs. HVGICs conditioned in citric acid showed the most significant increase in surface roughness and reduction in microhardness.

Evaluation of internal adaptation of flowable and bulk-fill resin-based composites

@#This study aimed to evaluate and compare the internal adaptation of bulk-fill resin-based composite restorative materials with flowable composites as lining materials using self-etch adhesive system. Class I cavities (2mmx4mm) were prepared on flattened occlusal surfaces of fifty extracted human premolars and randomly assigned into five groups (n=10) according to the materials used: Beautifil Bulk-fill Restorative (BR); Beautifil Bulk-fill Flowable (BF); Beautifil Flow Flowable F10 (BF10); and Self-etch adhesive (SEA). Group A: SEA+BR; Group B: SEA+BF10+BR; Group C: SEA+BF+BR; Group D: SEA+BF10+SEA+BR and Group E: SEA+BF+SEA+BR. The samples were thermocycled for 500 cycles, then sectioned mesiodistally, polished and pre-treated prior to scanning electron microscopy (SEM) evaluation. From SEM images, measurement of adhesive and cohesive adaptation failures was recorded at multiple sites of the pulpal floor and in between materials. Data were analysed using one-way ANOVA and post-hoc Tukey tests (p<0.05). Cohesive failure in SEA was observed at the pulpal floor with the lowest percentage in Group A (5.14%), and highest in Group C and E (>16%). However, there were no significant difference among all groups. Adhesive failure was seen at the pulpal floor between SEA+BF/BF10/BR and between SEA+dentine with the highest percentage of gaps formed in Group A between SEA+dentine (6.62%) and SEA+BR (5.30%). Nonetheless, no significant differences were observed among all groups with p=0.89 and p=0.70, respectively. With the use of BF/BF10 at the pulpal floor, adhesive failure was reduced but resulted in increased of cohesive failure. However, both adaptation failures were absent between materials (BF/BF10 and BR) regardless with or without application of SEA.