The prevalence of tooth wear among a group of yemeni adults / La prevalencia del desgaste dental entre un grupo de adultos yemeníes

This study aimed at investigating tooth wear prevalence and determining the associated factors among a group of Yemeni adults. It is a preliminary cross-sectional and analytical investigation conducted on 600 participants aged 20­50 years. The participants were purposively selected from two main cities (Sana'a and Aden) with an equal sample size and divided equally by gender. For administering a questionnaire, interviews were conducted with all participants before clinically examining them. Using the Tooth Wear Index (TWI), tooth wear was assessed. Data were analyzed using the chi-square test to identify the relationship between tooth wear and associated factors., Tooth wear was prevalent among 78.67% of the participants; of which 64.83% were in anterior teeth, 63.83% in posterior teeth, 74% in maxillary teeth, and approximately 74.5% in mandibular teeth. It also was 100% prevalent in the 31-40 and 41-50 age groups, while it was 67.2% in the 20-30 age group. This showed that tooth wear prevalence was significantly higher in the two oldest groups than in the youngest group (p<0.001). Moreover, khat chewing, location, highly frequent consumption of foods and high frequency of acidic drinks consumption were critical indicators of tooth wear. Besides, a low education level, smoking and a low socio-economic status were associated with tooth wear. Finally, the study revealed that tooth wear is highly prevalent among adults in two Yemeni cities, and socio-behavioral risk indicators such as khat chewing and cigarette smoking have a significantly association with tooth wear.

Este estudio tuvo como objetivo investigar la prevalencia del desgaste dental y determinar los factores asociados en un grupo de adultos yemeníes. Es una investigación preliminar analítica y transversal que se lleva a cabo en 600 participantes de entre 20 y 50 años. Los participantes fueron seleccionados a propósito de dos ciudades principales (Sana'a y Aden) con un tamaño de muestra igual y divididos por igual por género. Para administrar un cuestionario, se realizaron entrevistas con todos los participantes antes de examinarlos clínicamente. Usando el Índice de Desgaste Dental, se evaluó el desgaste dental. Los datos se analizaron utilizando la prueba de chi-cuadrado para identificar la relación entre el desgaste dental y los factores asociados. El degaste dental tuvo una prevalencia del 78,67% de los participantes; de los cuales 64.83% en dientes anteriores, 63.83% en dientes posteriores, 74% en dientes maxilares y aproximadamente 74.5% en dientes mandibulares. Fue 100% prevalente en los grupos de edad 31-40 y 41-50, mientras que la prevalencia fue 67.2% en el grupo de edad 20-30. Esto demostró que la prevalencia del desgaste dental fue significativamente mayor en los dos grupos de personas mayores que en el grupo más joven (p<0.001). Además, mascar khat, la ubicación, el consumo muy frecuente de alimentos y la alta frecuencia de bebidas ácidas fueron indicadores críticos del desgaste dental. Además, el bajo nivel educativo, el tabaquismo y el bajo nivel socioeconómico se asociaron con el degaste dental. Finalmente, el estudio reveló que el desgaste dental es altamente prevalente entre los adultos en dos ciudades yemeníes, y los indicadores de riesgo socioconductual como la masticación de khat y el tabaquismo tienen una asociación significativa con el desgaste dental.

Perception and confidence levels among dental students and interns in performing various endodontic procedures / Niveles de percepción y confianza entre estudiantes de odontología y pasantes en la realización de diversos procedimientos de endodoncia

Aim: The present study aimed to collect information from senior students and new interns enrolled at the College of Dentistry, University of Science and Technology (UST), regarding their confidence levels in performing endodontic treatments. Materials and Methods: Anonymous surveys were distributed to 40 senior students and 37 new interns at UST, in Sana'a, Yemen. They were asked to indicate their self-confidence level using a Likert scoring system ranging from 1 and 5. Mann-Whitney U test and chi-squared test were used to determine statistical significance between the studied groups. Results: 37.5% of students and 35.1% of interns rated endodontic practice as difficult. Only 55% of students found that the number of treated cases were satisfactory, similar to that reported by interns (56.8%). There were no statistically significant differences between both groups regarding self-confidence levels for most endodontic procedures (p<0.05). Placing of a rubber dam, followed by managing inter-appointment flare-ups were procedures in which both groups reported the lowest confidence. On the other hand, both groups felt the lowest confidence in the treatment of maxillary followed by mandibular molars. Statistically significant differences were reported between the two groups for performing root canal treatments (RCT) (p< 0.05). Self-confidence levels on the management of most different indications showed no statistically significant differences between both groups (p>0.05) with exception to the management of irreversible pulpitis, necrotic pulp, asymptomatic apical periodontitis, chronic abscess, and traumatic cases, in which significant differences were noticed (p<0.05). Immature apices, root resorption, endodontic-periodontal (EP) lesions, trauma, symptomatic apical periodontitis and acute abscess were ranked as the cases in which both groups reported the lowest confidence. Canal blockage and ledge formation were the main mishaps encountered during practice among students and interns. Conclusion: Students and interns displayed neutral confidence in performing endodontic treatments.

Objetivo: El presente estudio tuvo como objetivo recopilar información de estudiantes de último año y nuevos pasantes inscritos en la Facultad de Odontología, Universidad de Ciencia y Tecnología (UST), con respecto a sus niveles de confianza en la realización de tratamientos de endodoncia. Materiales y métodos: se distribuyeron encuestas anónimas a 40 estudiantes de último año y 37 nuevos pasantes en UST, en Sana'a, Yemen. Se les pidió que indicaran su nivel de confianza en sí mismos utilizando un sistema de puntuación Likert que oscilaba entre 1 y 5. Se utilizaron la prueba U de Mann-Whitney y la prueba de ji al cuadrado para determinar la significación estadística entre los grupos estudiados. Resultados: el 37.5% de los estudiantes y el 35.1% de los pasantes calificaron la práctica de endodoncia como difícil. Solo el 55% de los estudiantes encontró que el número de casos tratados fue satisfactorio, similar al reportado por los pasantes (56.8%). No hubo diferencias estadísticamente significativas entre ambos grupos con respecto a los niveles de autoconfianza para la mayoría de los procedimientos de endodoncia (p<0.05). La colocación de una presa de goma, seguida de la gestión de brotes entre citas, fueron procedimientos en los que ambos grupos informaron la menor confianza. Por otro lado, ambos grupos sintieron la menor confianza en el tratamiento del maxilar seguido de los molares mandibulares. Se informaron diferencias estadísticamente significativas entre los dos grupos para realizar tratamientos de conducto radicular (ECA) (p<0.05). Los niveles de autoconfianza en el manejo de la mayoría de las indicaciones diferentes no mostraron diferencias estadísticamente significativas entre ambos grupos (p>0.05) con excepción del manejo de pulpitis irreversible, pulpa necrótica, periodontitis apical asintomática, absceso crónico y casos traumáticos, en los cuales se notaron diferencias (p<0.05). Los ápices inmaduros, la reabsorción radicular, las lesiones endodóncicas-periodontales (EP), los traumatismos, la periodontitis apical sintomática y el absceso agudo se clasificaron como los casos en que ambos grupos informaron la menor confianza. El bloqueo del canal y la formación de repisas fueron los principales percances encontrados durante la práctica entre estudiantes y pasantes. Conclusión: los estudiantes y los pasantes mostraron una confianza neutral en la realización de tratamientos de endodoncia.

Clinical efficacy of nanosilver and chlorhexidine in the treatment of plaque-induced gingivitis: a randomized controlled clinical trial

Aim: the present study aimed to assess the clinical efficacy of nanosilver (NS) mouthwash and compared with chlorhexidine (CHX) mouthwash for the treatment of plaque-induced gingivitis. materials and methods: sixty-two (28 males and 34 females) plaque-induced gingivitis patients were allocated into two groups and asked to rinse with 10ml of NS or CHX, immediately after brushing, for 1 min, in the morning and evening. the plaque, gingival, and papilla bleeding indices were taken at baseline, two weeks, and finally at four weeks for each patient. the statistical analysis between and within groups were performed using Mann-Whitney U-test and Wilcoxon signed rank test respectively. result: Intergroup comparison by Mann-Whitney U-test showed no statistically significant differences in the investigated groups at the baseline for all studied parameters. at 2 and 4 weeks follow up, the CHX group showed statistically significant lower plaque scores than the NS group (p<0.05). however, there is no statistically significant difference between NS and CHX groups for gingival and papilla bleeding scores (p>0.05). both groups showed statistically significant reductions in plaque, gingival and papilla bleeding scores after 2 weeks and 4 weeks of product use when compared to baseline (p<0.001). conclusion: both mouthwashes decreased plaque, gingival and papilla bleeding scores, however the reduction in plaque scores was higher for the CHX group compared to the NS group.

Tensile stress distribution in maxillary central incisors restored with cast-made and prefabricated dental posts

AIM: To analyze and compare the tensile stress distribution in endodontically treated teeth restored with cast-made (Ni-Cr and gold) and prefabricated (titanium and glass fibre) dental posts. METHODOLOGY: Four threedimensional finite element (FE) models of a maxillary central incisor restored with Ni-Cr cast-made (Model Ni-Cr), gold cast-made (Model GO), prefabricated titanium (Model TI) and prefabricated glass fibre (Model FP) posts were constructed. An oblique loading of 100N was applied to each three-dimensional model. Tensile stress distribution within the root dentine and at the post and surrounding structure interfaces were analysed. RESULTS: In all the FE models studied, a higher magnitude of tensile stresses was observed on the palatal aspect of the cervical dentin as compared to the labial aspect and progressively decreases from the outer to the inner part of the root. The gold cast-made and glass fibre post models showed significantly less tensile stress concentration in the post-core component than the other experimental models. The maximum tensile stress was seen on the palatal aspect of the Ni-Cr compared to other posts. The higher magnitude interfacial tensile stress concentration was observed in a pulpless tooth restored with a Ni-Cr cast-made post, followed by titanium and gold castmade posts, respectively. However, the minimum interfacial tensile stress was noticed in a pulpless tooth restored with a glass fibre post. CONCLUSION: Glass fibre posts tend to transfer tensile stress more homogenously within the tooth and at interfaces than the other types of investigated posts.

Management of temporomandibular joint ankylosis in yemeni children by metatarsal bone grafts

Aim: This study aimed to evaluate temporomandibular joint reconstruction in Yemeni children with metatarsal bone graft after release of ankylosis. Methodology: Ten patients ≤12 years of age, comprising eight unilateral and two bilaterally TMJ ankylosis, were selected for this study. These patients underwent reconstruction with 10 non-vascularized metatarsal grafts. The reconstructed joints were then followed for an average of 1 year. Measures of opening, symmetry, and clinical symptoms relating to the reconstructed joints were assessed. Results: Mean pre-operative interincisal aperture was 8.2mm, and immediate post-operative aperture 23.4mm. At the end of the follow-up period, acceptable results were achieved in 8 out of 10 cases, with adequate mouth opening of 35.6mm in 8 out of 10 patients and overall interincisal aperture of 30.3mm. Re-ankylosis occurred in two bilaterally-treated patients at the end of follow-up. Subjectively, 80 percent of the patients rated their function as satisfactory and were able to occlude and masticate without any difficulty. Conclusion: Reconstruction of TMJ after release of ankylosis utilizing metatarsal bone graft shows a satisfactory interincisal aperture in 80 percent of patients.

Cross-sectional assessment of the periapical status as related to quality of root canal fillings and coronal restorations in a Yemeni population

Aim: the present study aimed to examine the influence of the quality of root canal fillings and coronal restorations on the prevalence of periapical lesions. Materials and Methods: Two hundred digital panoramic radiographs were obtained from the archive of Al‑HamziDental Center in Sana’a, Yemen. The final sample consisted of 120 radiographs, and 675 root filled teeth.The quality of root canal fillings was scored according to criteria of length, homogeneity and taper. Coronal status (type of restoration, signs of marginal leakage or decay) was also evaluated. The periapical status was categorized on the basis of presence or absence of radiographical signs of apical periodontitis. Chi-square test was used to determine statistical significance between different parameters. Results: We found that 93.6 percent of root filled teeth were associated with apical periodontitis. Only 9.2 percent of root filled teeth were found to have an acceptable standard of root canal fillings, of which 32.3 percent was also associated to signs of periapical disease. In roots with an unacceptable root canal filling, 95.4 percent had periapical disease. Teeth with good (14.4 percent) and poor (32.9 percent) intra-coronal restorations had apical periodontitis in 93.8 percent and 97.7 percent of cases, respectively. Crown restorations were present in 52.7 percent of root filled teeth, of which 91.0 percent were associated with periapical lesions. Conclusion: The poor technical quality of root canal fillings and coronal restorations is consistent with a high prevalence of apical periodontitis.

Radiographic evaluation of root canal fillings in a selected Yemeni population: a retrospective study / Evaluación radiográfica de tratamientos de endodoncia realizados en una población Yemení: estudio retrospectivo

Abstract: aim: to assess the root canal filling quality performed by general dental practitioners in Yemen through radiographic evaluation. Materials and Methods: Four hundred fifty-five digital panoramic radiographs were selected from the archive of the Dental Health Center in Sana'a, Yemen. The final sample consisted of 221 patients, 685 teeth, and 977 root canals. The criteria for overall radiographic adequacy of root canal fillings were defined as the presence of adequate length, density and taper, and absence of iatrogenic errors (ledges, transportations and perforations). Chi-square test was used to determine statistical significance between different parameters. Results: This study considered only radiographic criteria for evaluation of the root canal fillings. The percentage of root canal fillings with adequate length, density and taper was 30.8 percent, 29.6 percent and 20.7 percent, respectively. Considering the incidence of iatrogenic errors, perforations were present in 12 root canals (1.2 percent), while the presence of transportations was observed in 20 root canals (2.0 percent). However, ledges were no detected in any root canals. Conclusion: The root canal filling quality performed by general dental practitioners in Yemen is poor.

Resumen: objetivo: evaluar a través de la evaluación radiográfica la calidad de los tratamientos de endodoncia realizados por odontólogos generales en Yemen. Materiales y Métodos: Cuatrocientos cincuenta y cinco radiografías panorámicas digitales fueron seleccionados desde el archivo del Centro de Salud Dental en Sana'a, Yemen. La muestra final fue de 221 pacientes, 685 dientes y 977 endodoncias. Los criterios de adecuación radiográfica general de los tratamientos de endodoncia se definieron como la presencia de longitud adecuada, la densidad y la forma cónica y la ausencia de errores iatrogénicos (proyecciones, transportaciones y perforaciones). Se utilizó la prueba de chi-cuadrado para determinar la significación estadística entre los diferentes parámetros. Resultados: En este estudio se consideró sólo criterios radiológicos para la evaluación de las obturaciones del conducto radicular. El porcentaje de obturaciones del conducto radicular con la longitud adecuada, la densidad y la forma cónica fue del 30,8 por ciento, 29,6 por ciento y 20,7 por ciento, respectivamente. Teniendo en cuenta la incidencia de errores iatrogénicos, las perforaciones estaban presentes en 12 tratamientos (1,2 por ciento), mientras que se observó la presencia de transportaciones en 20 tratamientos (2,0 por ciento). Sin embargo, las proyecciones no fueron detectadas en ningún tratamiento. Conclusión: La calidad de los tratamientos de endodoncia realizados por dentistas generales de Yemen es pobre.

Endodontic Repair Filling Materials: A Review Article.

The emergence of Mineral Trioxide Aggregate (MTA) as endodontic repair filling material has generated a lot of interest due to its superior sealing ability and biocompatibility. Although MTA possesses superior sealing ability to traditional endodontic repair filling materials, such as calcium hydroxide, but it has poor handling characteristics. A novel endodontic repair filling materials with similar chemical composition, but improved handling characteristics, was recently developed. Recently, BioAggregate repair filling materials is claimed as biocompatible material and promotes cementogenesis and forms a hermetic seal inside the root canal. More recently, Biodentine and EndoSequence endodontic repair materials introduced to the market. Both materials have recommended for perforation repair, apical surgery, apical plug, and pulp capping. This article focused about physical properties of endodontic repair filling materials.