Psychosocial Impact of Malocclusion and Self-Perceived Orthodontic Treatment Need among Young Adult Dental Patients.

OBJECTIVES: To investigate the psychosocial impact of malocclusion and self-rated and clinician-rated orthodontic treatment need on young adult patients in the Western Province of Saudi Arabia. MATERIALS AND METHODS: Eighteen- to 30-year-old patients (n=355) attending a tertiary dental care facility were included. Three instruments were used for data collection: (1) Psychosocial Impact of Dental Aesthetic Questionnaire (PIDAQ), (2) aesthetic component of the Index of Orthodontic Treatment Need (IOTN-AC), self-rated and clinician-rated, and (3) clinician-rated Dental Aesthetic Index (DAI). Data analysis included descriptive statistics, Kruskal-Wallis test, Mann-Whitney U-test, and multiple linear regression analysis. RESULTS: Females were significantly more impacted than males on all domains with the exception of the dental self-consciousness domain. For both the self-rated and clinician-rated IOTN and the DAI, it was found that the more severe the malocclusion, the higher the impact on all domains except for the dental self-confidence domain, which showed that patients with mild malocclusions were more affected than those with moderate and severe malocclusions. Significant associations were observed between independent variables (age, sex, self-rated IOTN, and DAI) and total PIDAQ score. CONCLUSIONS: Perceived psychosocial impact of dental aesthetics is directly related to severity of malocclusion (self-rated and clinician-rated) for all domains of the PIDAQ accept the DSC, and females showed higher psychosocial impact than males. Clinicians should consider the impact of malocclusion and certain demographic characteristics on the psychosocial well-being of an individual when determining the orthodontic treatment need.

Effectiveness of Super Floss and Water Flosser in Plaque Removal for Patients Undergoing Orthodontic Treatment: A Randomized Controlled Trial.

Objectives: This study aimed to compare the effectiveness of super floss and water flosser in plaque removal for patients undergoing orthodontic treatment. Methods: A single-blind, randomized, controlled, parallel clinical trial with a split-mouth protocol was conducted on young adult orthodontic patients who were recruited from Riyadh Specialized Dental Center in Riyadh, Saudi Arabia. The type of floss used was randomly assigned to each side of the oral cavity; Super-Floss® (Oral-B) was used on one side, while the Waterpik® water flosser was used on the other. Patients' plaque level was assessed using Rustogi et al. modified navy plaque index (RMNPI) at baseline and immediately after cleaning. Results: A total of 62 subjects were screened; however, only 34 subjects were enrolled in the study with an equal number of males and females. Overall, the plaque score was significantly reduced from 0.56 ± 0.35 to 0.13 ± 0.26 in the super floss group and from 0.61 ± 0.35 to 0.13 ± 0.28 in the water flosser group. There was no significant difference between the mean difference of super floss and water flosser (p=0.951). On the other hand, there was no significant difference between both groups in terms of the preintervention plaque score (p=0.379). The water flosser had a greater effect size on plaque removal compared to super floss on distal interproximal surface of the molar tooth with a mean difference of (-0.21, 95% CI: 00.37 to -0.04, p=0.033). Conclusions: The use of super floss or water flosser as interproximal aids for plaque removal in patients undergoing orthodontic treatment are both effective. Trial registration. ISRCTN, ISRCTN83875016. Registered 12 September 2021-retrospectively registered, https://www.isrctn.com/ISRCTN83875016.

Silver diamine fluoride with delayed restoration reduces tooth discoloration.

Introduction: The standard treatment for caries is to apply silver diamine fluoride (SDF) to the tooth, followed by a composite resin or glass ionomer cement restoration (GIC). Tooth discolouration is an adverse effect of SDF. The aims of this study were to (1) determine whether applying a composite compared to a GIC restoration after SDF to caries-infected teeth results in less discoloration, and (2) determine whether immediate or delayed restoration application is associated with less discoloration. Methods: Sixty samples of caries-infected teeth were divided into five groups: (1) control (SDF alone), (2) SDF plus immediate composite restoration, (3) SDF plus immediate GIC restoration, (4) SDF plus delayed composite restoration, and (5) SDF plus delayed GIC restoration. The delay between SDF and restoration for groups 4 and 5 was two weeks. Tooth color was measured at three sites for each sample at baseline before SDF application and at multiple times. Results: When comparing the change between baseline color to the color at the last time measurement in all groups, we found that Group 4 (17.4 ± 4.3) and Group 5 (14.4 ± 5.3) changed the least compared to baseline and were not statistically significantly different from each other. Conclusion: Under laboratory conditions, delaying application of restoration for two weeks after SDF to samples of caries-infected teeth significantly reduced discoloration, with neither composite nor GIC being superior. If these findings are confirmed in a clinical setting, delaying restoration by two weeks could provide an inexpensive oral health strategy to reduce the negative aesthetic impact associated with SDF.

Screening of fluoride analysis as a biochemical parameter in the orthodontic treatment using fixed appliances.

Saliva is a critical and useful biological fluid necessary for good health and for the appropriate execution of mouth activities. Orthodontic biomaterials have a complex relationship with many components, including the oral environment. Treatment with fixed orthodontic appliances may causes dental caries. As a result, it is necessary to comprehend how orthodontic therapy and various fluoride regimens affect the chances of developing dental cavities as well as individual risk factors. Usage of fluoride will tend to reduce the caries in the patients diagnosed with the fixed orthodontic treatment. The aim of this study was to screen the biochemical parameter of the fluoride levels in the patients undergone and completed the treatment of orthodontic fixed appliances. In this study, 35 patients have been visited on day 1 as well as day 35 and categorized as T0 and T1 groups. Saliva samples were collected and fluoride levels were measured between T0 and T1 groups. Using the fluoride kit with the spectrophotometer, fluoride levels were measured. The results confirmed similar fluoride levels between T0 (26.11 ± 4.86) and T1 (27.71 ± 4.40) groups. There was no significant association observed in this study (p = 0.56). Fluoride might have no role in the patients undergoing orthodontic treatment.

An assessment of unstimulated salivary flow rate, IgA and clinical oral dryness among active and passive smokers.

OBJECTIVES: The aim of this study was to assess the impact of smoking on the whole salivary flow rate (SFR), IgA levels and clinical oral dryness (COD) among active and passive smokers. MATERIAL AND METHODS: The participants were categorized as active smokers (N = 54) or passive smokers (N = 163). Saliva was collected in tubes and placed in ice storage at -70°C. Salivary IgA levels were assessed in duplication using the enzyme linked immunosorbent assay (ELISA) method. Following the saliva sample collection, the subjects were assessed for COD using the COD score, SFR and caries. Chi-square test, the t-test and ANOVA were employed to compare the clinical impact of the smoking status associated with specific variables (smoking status, number of cigarettes, active caries, gender, age, COD score, IgA level and SFR). A p-value of <0.05 was considered significant. RESULTS: Two hundred and seventeen subjects with the mean age of 32.86±6.30 years, with 145 males (66.8%) and 72 females (33.2%), were included in the study. Among the active smokers, 88.8% were males compared to 11.2% females. The active smokers had the mean age of 32.52 years, a COD score of 1.43, an IgA level of 1.39 g/l, and a SFR of 0.37 ml/min. Among the passive smokers, 59.5% were males and 40.5% were females, with the mean age of 32.97 years, a COD score of 0.87 g/l, an IgA level of 1.47, and a SFR of 0.42 ml/min. Active caries showed a positive correlation with the number of cigarettes, with significance in the >35 years age group (p < 0.05). CONCLUSIONS: The study demonstrated significant differences in SFR, IgA and COD scores among the active and passive smokers. The number of cigarettes had a negative impact on saliva production, IgA levels, the oral health status, and the progression of caries with respect to age and gender. Smoking potentially leads to xerostomia associated with active caries. Int J Occup Med Environ Health. 2022;35(1):39-51.

Risk analysis of factors in clinical anxiety among undergraduate and postgraduate students in dentistry.

BACKGROUND: When anxiety is persistent among dental students, the consequence could be poor academic performance, ill health, lack of empathy, and exhaustion. OBJECTIVE: This study aimed to determine the level of anxiety along with anxiety-provoking factors among clinical dental students. METHODS: This study included dental undergraduate and postgraduate clinical students from a public university. A modified version of the self-administered Moss and McManus questionnaire, which consisted of 50 items, was utilized to evaluate the levels of anxiety. The results were analyzed using SPSS® version 24. The significance level was set at p < 0.05. RESULTS: Within 180 participants, 140 (77.77%) were undergraduate students, while 40 (22.22%) were postgraduate dental students. Overall, the top clinical anxiety-provoking factor included failure to pass the final examination, whereas the least clinical anxiety-provoking element was communicating with the opposite gender. Significant differences existed among male and female participants in the seven anxiety-provoking factors among the participants namely dealing with elderly patients, fail to pass finals, arresting post-extraction bleeding, patients asking difficult questions, fear of accidental pulp exposure, dealing with a child or non-cooperative patient, and fear of taking an incorrect impression. Postgraduate students showed lower anxiety scores in various clinical tasks as compared to undergraduate students. CONCLUSIONS: Postgraduate dental students share largely the same perspectives with undergraduate dental students on the clinical anxiety-provoking situations with slight variations. Being the future healthcare providers, dental students must learn techniques to help them manage their dental anxiety and fear as well as deal with anxiety related to treating patients.

Shear bond strength of resin modified glass ionomer cement following photodynamic therapy, Er,Cr:YSGG and chlorhexidine in hypoplastic primary teeth.

PURPOSE: This study investigates the micro shear bond strength of resin-modified glass ionomer cement (RMGIC) bonded to hypoplastic teeth after the application of chlorhexidine (CHX), sodium hypochlorite (NaOCl), Er;Cr:YSGG and methylene blue mediated antimicrobial photodynamic therapy (APDT). METHODS: A total sample of 60 erupted and extracted hypoplastic teeth collected from < 16 years children were subjected to different conditioning protocols including control group that involved bonding of hypoplastic teeth with RMGIC; CHX and NaOCl groups that included hypoplastic enamel being treated with 0.2% CHX and 2% NaOCl solution for 30 s followed by rinsing and drying for 5 s, MB-PDT group involved methylene blue photosensitizer and Er,Cr:YSGG group. All specimens were processed for microshear bond strength in a universal tester. The fractured surface was examined using a stereomicroscope at 40 × magnification and categorized under adhesive, cohesive and mixed. RESULTS: The highest microshear bond strength was noted for the control group (∼29 MPa). Whereas the specimens conditioned by NaOCl showed the lowest microshear bond strength (∼17 MPa). Among the treatment groups, APDT showed the highest bond strength values (∼22 MPa) as compared to chemical disinfection protocols. However, Er, Cr:YSGG showed slightly lower microshear bond strength as compared to APDT. No significant difference was noted between CHX and NaOCl groups (p > 0.05). There was a statistically significant difference when all the groups were compared together (p < 0.05). Microscopic analysis revealed that specimens bonded after APDT showed the highest adhesive failures (70%). The highest cohesive failures were seen in NaOCl group (40%). The mixed type of failures was seen in the control groups with none appearing for chemical disinfection protocols. CONCLUSIONS: This study concludes that APDT could be a potential therapeutic strategy for increasing the microshear bond strength of RMGIC to hypoplastic enamel.

Influence of Reinforcing Agents on the Mechanical Properties of Denture Base Resin: A Systematic Review.

Knowledge about the influence of fillers in denture base resin is vague. This systematic review aimed to report the reinforcing effect of fillers on the mechanical properties of denture base resin by following PRISMA guidelines. Two electronic databases (Pubmed/Medline & Web of Science) were searched for articles using the keywords: fibers in denture base, fillers in denture base, and reinforcement of denture base. Laboratory studies complying with the inclusion criteria were reviewed according to the set protocol. The established focus question was: "Do reinforcing fillers positively influence the mechanical properties of polymethyl methacrylate (PMMA) heat polymerized denture base material?" A total of twenty-nine relevant papers qualified for final inclusion. Of these, 24 were determined to have a moderate risk of bias. Micron or nano-sized metal/metal oxides particles and glass fibers were the frequently used reinforcing agents. The trend of evaluating fractural strength (FS) was common. Most of the studies limited the use of reinforcing agents up to 5 wt.%. FS, fracture toughness (FT), and impact strength (IS) tend to increase if the fillers are chemically bonded and well-dispersed in denture base resin. Though fillers with a higher elastic modulus increase the hardness of the reinforced denture base resin, they compromise other mechanical properties. Well-dispersed lower filler loading PMMA denture base resin can enhance the FS, FT, and other related mechanical properties.

Impact of Self-Perceived Dental Esthetic on Psycho-Social Well-Being and Dental Self Confidence: A Cross-Sectional Study Among Female Students in Riyadh City.

PURPOSE: To assess the self-perceived psychological impact of dental aesthetics among female university students and its relationship to various sociodemographic factors. PATIENTS AND METHODS: A cross-sectional study was conducted on a sample of 2400 female students from various departments of selected private and public universities in Riyadh City. Participants completed an Arabic translated version of the Psychosocial Impact of Dental Aesthetic Questionnaire (PIDAQ) and a short demographic sheet. Descriptive statistics was used to describe the sample's sociodemographic characteristics as well as the mean PIDAQ scores. Bivariate analysis (ANOVA) and linear regression were used to investigate the impact of the sociodemographic factors on the mean PIDAQ scores. RESULTS: The pilot test revealed the instruments' conceptual equivalence, semantic equivalence and ease of comprehension. Cronbach's alpha was 0.81, indicating good internal consistency. The total sample was 1845 with a mean age of 20.74 years. The total mean score for the (PIDAQ) was 58.10 (SD=11.41). Significant differences were detected between different university affiliation in the dental self-consciousness (<0.0001), social (<0.0001) and psychological impacts (0.0256) and the total PIDAQ scores (0.0024). Significant differences were also detected between different disciplines in the dental aesthetics (0.0110) and social (0.0195) domains as well as the total PIDAQ scores (0.0144). College level was also a significant factor where middle students were significantly impacted socially (0.0026) compared to junior level students. As for the impact of income, those with the highest income displayed greater social impact (0.0039), psychological impact (0.0046) and impact on aesthetic attitude (0.0037) when compared to students with lower income levels. CONCLUSION: Dental aesthetics was found to affect the psychological well-being of the subjects. University affiliation, faculty affiliation, college level, and level of income were all factors that significantly affected self-perceived aesthetics and psychosocial well-being.

Comparison of microleakage between bulk-fill flowable and nanofilled resin-based composites.

AIM: The objective was to compare the marginal leakage (silver nitrate uptake) of nanohybrid resin-based composite (RBC) and two bulk-fill flowable RBCs with specific clinical protocols. METHODS: Four experimental groups of RBC were investigated including conventional composite Filtek™ Supreme in 2 mm increment (FS2), Filtek™ Supreme in 4 mm increment (FS4), Filtek™ Supreme Flowable (BFF), and SureFil® SDR® flow (SDR). Class II box preparation (4 × 4 × 3 mm) in extracted intact human molars was carried out and restored using the experimental groups, all according to the manufacturers' recommendations except FS4. Samples were aged by thermocycling (2,000 cycles). Microleakage was calculated by measuring dye penetration in sectioned teeth using a stereomicroscope. Level of significance was set at P < 0.05. RESULTS: BFF and FS2 exhibited the least dye penetration and microleakage measurement with no significant difference between the two groups, followed by SDR. FS4 showed the highest microleakage with significant difference in comparison with BFF and FS2. Gingival microleakage was found to be significantly higher than occlusal microleakage. CONCLUSION: The microleakage of the bulk-fill composites BFF and SDR are comparable with conventional composite FS2; however, it is more predictable to use FS2.