Effect of the COVID-19 pandemic on dental interns in Saudi Arabia.

BACKGROUND: The coronavirus disease (COVID-19) has emerged as a global pandemic recognized by the World Health Organization. It has a significant impact on Saudi Arabia's educational process, resulting in several universities suspending on-campus teaching, exams, and training. OBJECTIVE: The study aimed to evaluate the effect of COVID-19 on dental students' examination, internship placement, and subsequent impact on preparedness and confidence. METHODS: A cross-sectional study was conducted to gather data from dental interns in Saudi Arabia using a pre-tested online questionnaire. Convenient sampling was applied to collect data from 5th September to 15th September 2020. Data were analyzed using SPSS version 23. Descriptive data were presented as frequency and percentages. The Chi-square test was used to evaluate the relationship between variables. RESULTS: Data of 409 dental interns from 8 dental schools reported that 209 (51%) participants' exams were affected as the format was changed to online examination. 130 (31.8%) dental interns strongly agreed that assistance in hospitals during the outbreak of COVID-19 would complement their learning opportunities. Whereas 115(28.1%) respondents strongly agreed that dental schools' measures to modify their curriculum were necessary.The impact of COVID-19 on dental intern preparedness discovered that the affected exams had a significant effect on final year students' readiness to begin the internship (p = 0.042). Considering students' confidence in starting the training earlier than expected, the student course had a statistically significant impact on their confidence (p = 0.002). CONCLUSION: The current study demonstrates that COVID-19 had disrupted dental interns' preparedness towards clinical rotation and decreased their confidence performing in the clinical setup. Due to being unprepared and having low confidence, most dental interns were not ready to start working in the hospital on time.

Evaluation of Quality of Endodontic Re-Treatment and Changes in Periapical Status.

BACKGROUND: The present study was conducted to assess quality of root canal (RC) filling before and after RC re-treatment. MATERIALS AND METHODS: Two hundred and thirty-eight radiographs of failed endodontic treatment were assessed. The periapical status of the endodontic treatment was evaluated with periapical index (PAI) scoring system. PAI <3 showed absence and PAI >3 showed presence of periapical lesion. RESULTS: There was a statistically significant increase in scores 1 and 3 and decrease in scores 2, 4, 5, and 6 after treatment (P < 0.05). PAI score >3 was seen in 37% before which decreased to 16% after endodontic retreatment. 34.6% obturation was homogenous and 65.4% was nonhomogenous before endodontic retreatment. After endodontic retreatment, 95.2% became homogenous and 4.8% nonhomogenous. The reason for endodontic failure was furcation in 2%, iatrogenic causes in 3%, loss of coronal seal in 16%, periapical pathology in 25%, and inadequate root filling in 54%. CONCLUSION: There was significant improvement and decrease in size of periapical lesions in re-endodontic cases as compared to primary RC treated teeth.

An In Vitro Stereomicroscopic Evaluation of Bioactivity between Neo MTA Plus, Pro Root MTA, BIODENTINE & Glass Ionomer Cement Using Dye Penetration Method.

The ideal root end filling material should form a tight seal in the root canal by adhering to the cavity walls. Several materials have been used for root end filling. The present study aims to find out and compare the bioactivity of Neo MTA Plus, Pro Root MTA White, BIODENTINE & glass ionomer cement as root end filling materials using 1% methylene blue as tracer. MATERIALS AND METHODS: 80 extracted human permanent maxillary anterior teeth were used in the study. They were divided into four groups. Specimens were sectioned transversely in the cervical area to separate the crown from the root. The root canal was obturated with gutta percha and zinc oxide eugenol sealers. Thereafter, each sample was resected apically by removing 3 mm of the apex and filled with different materials. Samples were kept in buffering solution at 37 °C until the recommended evaluation periods. The specimens were then suspended in 1% methylene blue for 24 h, prior to the analysis. The teeth were then sectioned, and dye penetration was examined, photographed, and evaluated under a stereomicroscope. RESULTS: Vertical dye penetration showed significant differences across different groups. The minimum dye penetration was seen in Neo MTA plus followed by BIODENTINE, Pro Root MTA and maximum in GIC. There was no significant difference in dye penetration between Neo MTA plus and BIODENTINE both at fifteen days and one-month intervals. CONCLUSION: The present study suggests Neo MTA plus and BIODENTINE should be the preferred material for root end filling.

Qualitative Analysis of Root Canal Treatments performed by Undergraduate Students: A Retrospective Study

ABSTRACT Objective: Toanalyze the technical quality of endodontic treatment carried out at the undergraduate dental clinics. Material and Methods: Random radiographic records of 92 patients' were selected who received endodontic treatment by the undergraduate students from June 2018 to July 2019. The quality of root canal filling was determined in relation to the adequate density, length, and taper. Statistical analysis was performed by using GraphPad (Prism 5), and to determine the association between different variables Chi-square test was used. Results: Adequate technical quality of canal obturation conducted by the undergraduate students was found in less than 65% of the cases. The frequency of adequate root canal taper was significantly greater in maxillary teeth (75%) as compared to mandibular teeth (33%); however, adequacy of acceptable density was found more in maxillary teeth (62%) as compared to mandibular teeth (55%).A statistically significant difference was seen in the quality of root canal fillings between anterior and posterior teeth (p=0.001). Conclusion: The root canal therapy performed by undergraduate students was less than optimum in terms of technical quality. Hence, it is suggested that the endodontic training courses delivered at pre-clinical and clinical levelsfor undergraduate students must be thoroughly revised.

Human salivary protein extraction from RNAPro·SAL™, Pure·SAL™, and passive drooling method.

OBJECTIVE: The aim of the current study was to carry out a preliminary validation of devices for standardized collection of whole mouth fluid (WMF) in comparison to the passive drooling method for protein analysis in healthy subjects. MATERIALS AND METHODS: A carefully designed sample collection/pretreatment protocol is crucial to the success of any saliva proteomics project. In this study, WMF was collected from healthy volunteers (n = 10, ages: 18-26 years). Individuals with any oral disease were excluded from the study group. In our study, we evaluated the following collection methods; the classical passive drooling method (unstimulated whole saliva) and standardized tools for saliva collection (Pure·SAL™, and RNAPro·SAL™) from Oasis Diagnostics® Corporation (Vancouver WA, USA). For estimation of protein levels, we used the bicinchoninic acid assay and protein assay kit (Thermo Fisher). The two-dimensional gel electrophoresis sample analysis was carried out for the estimation of proteins in one of the samples. RESULTS: When gels were compared, the difference was seen in the resolution of spots. Protein spots were fading from high- to low-molecular weight masses. Hence, advanced devices in comparison to spitting method resulted in much clearer protein spots which in turn prove the validation of devices. CONCLUSIONS: In this study, we concluded that protein extraction could be possible by both methods such as passive drooling method and through advanced saliva collection devices (Pure·SAL™ and RNAPro·SAL™).

Regenerative Potential of Platelet Rich Fibrin (PRF) for Curing Intrabony Periodontal Defects: A Systematic Review of Clinical Studies.

Platelet-rich fibrin (PRF) has been used in regenerative medicine and dentistry. Recently, its use has been advocated for regenerative periodontics and wound healing. The randomized control trials have assessed the regenerative efficacy of the PRF for restoring intrabony periodontal defects. The objectives are to critically analyze and appraise the currently available literature, focusing on the use of PRF in regenerating periodontal bone defects. An electronic search was conducted (PubMed/MEDLINE, Google Scholar, ISI-WOS). Various combinations of following keywords were used: 'platelet-rich fibrin', 'intrabony', 'periodontal', 'bone defect' and 'guided tissue regeneration'. A secondary search was conducted by analyzing the reference lists of the articles obtained in initial search. The final search resulted in 13 randomized controlled trials being included. In majority of studies, PRF resulted in better clinical/radiographic outcomes than open flap debridement and augmented therapeutic effects of bone grafts. The combination of bovine bone substitutes and PRF resulted in better performance compared to alone. Similarly better outcomes were observed while using PRF in combination with nanohydroxyapatite, metformin and demineralized freeze-dried bone allograft. It can be concluded that PRF produces better outcomes than open flap debridement alone and augments the regenerative effects of bone substitutes.