3D CBCT morphometric assessment of mental foramen in Arabic population and global comparison: imperative for invasive and non-invasive procedures in mandible.

BACKGROUND: Recent advancements in clinical dentistry have increased the possibilities of surgical procedures in the mental region. A detailed knowledge of mental foramen (MF) morphometry is significant to preserve integrity of the mental nerve trunk in surgical interventions such as orthognathic surgery, implant placement and anaesthetic block. OBJECTIVE: The aim of this study was to determine the most accurate position of the mental foramen by using new assessment approach in a sample of dental patients presenting to the specialist dental clinic, College of Dentistry, Al Jouf University, Saudi Arabia. STUDY DESIGN: A retrospective study was performed using cone beam computed tomography (CBCT) of 600 patients (40.1 ± 11.78 years old). Following inclusion and exclusion criteria, 395 CBCT were finally obtained and analyzed for the most accurate position of the mental foramen (MF) by OnDemand 3D software (Seoul, Korea). Prevalence of shape of MF and accessory MF were also assessed. Pearson chi-square test was employed to test significant differences between genders and races. RESULTS: The most common horizontal and vertical position of the mental foramen was in line with the long axis of 2nd premolar (41.3%) and below the root apex level (93.2%), respectively. The most common shape of MF was round type (72.66%). The prevalence of accessory 2MF and 3MF was 2.28% and 0.25%, respectively. CONCLUSION: New information about MF presented in this article can help anatomists, prosthodontists, orthodontists, surgeons, forensic odontologists and paleoanthropologists to predict the position of the MF and perform safer surgeries.

Influence of time and different tooth widths on masticatory efficiency and muscular activity in bilateral free-end saddles.

PURPOSE: To evaluate the influence of time on masticatory efficiency and muscular activity during mastication of different types of test foods in participants fitted with a lower bilateral free-end saddle removable partial denture (RPD) with wide or narrow teeth. METHODS: Thirty-six participants consented to undergo evaluation of their masticatory efficiency and recording of their muscular activity, while they wore an RPD with a unified bilateral design, during mastication of different types of test foods. The width of the artificial teeth was changed as follows. Initially (A), the length was adjusted so that the distal end of the mandibular second molars occluded with the distal end of the maxillary second molar (buccolingual width of 7-8 mm). Next (B), the width was decreased to half the maxillary second molars (buccolingual width of only 5 mm). A statistical analysis was performed using SAS software. One-way analysis of variance (ANOVA) was performed followed by Duncan's multiple range tests. RESULTS: At the 2-month follow-up visit, wider teeth demonstrated greater masticatory efficiency than narrower teeth. However, after 4 months, no significant differences were observed between the two tooth widths. No significant differences in muscular activity were observed. CONCLUSION: A reduction of the occlusal table width in free-end saddle RPDs resulted in decreased masticatory efficiency 2 months after denture fabrication, but there was no significant difference in muscular activity between narrow and wide teeth. However, after 4 months, the masticatory efficiency of the participants with narrower teeth improved without any changes in muscular activity.

Relationship between impact of maxillary anterior fixed prosthodontic rehabilitation on daily living, satisfaction, and personality profiles.

STATEMENT OF PROBLEM: Personality profiles may affect the impact of dental treatment on daily living and patient satisfaction. PURPOSE: The purpose of this clinical trial was to evaluate the impact of maxillary anterior fixed prosthodontic rehabilitation on daily living and the satisfaction of patients and to investigate its relationship with personality profiles. MATERIAL AND METHODS: Fifty-nine participants (25 men and 34 women; mean age 32.4 ± 6.9 years) received maxillary anterior partial fixed dental prostheses. The clinical success of the prostheses was evaluated following specific criteria. The Dental Impact on Daily Living (DIDL) questionnaire was used to measure satisfaction with the prostheses and their impact on daily living. The Neuroticism-Extraversion-Openness Five-Factor Inventory (NEO-FFI) was used to measure patients' personality profiles. The paired sample t test was used to compare satisfaction and personality scores before and after treatment (α=.05). RESULTS: Participants' total satisfaction and their satisfaction with appearance, pain tolerance, oral comfort, general performance, and eating improved after treatment (P<.05). Before treatment, women were less satisfied with general performance (P=.047) and scored higher on the Neuroticism score (P=.039); however, after treatment, women were more satisfied with appearance (P=.004). Age and sex had no significant correlation with personality profiles after treatment. Before treatment, Neuroticism, Openness, and Conscientiousness scores were associated with dental satisfaction and impact on daily life (P<.05). After treatment, Neuroticism, Openness, and Extraversion scores were associated with dental satisfaction and impact on daily life (P<.05). CONCLUSIONS: Patient satisfaction with their oral condition improved after partial fixed dental prosthetic rehabilitation in the maxillary anterior esthetic zone. Psychological profiles (Neuroticism, Extraversion, Openness, and Conscientiousness) may be involved in and explain the impact on daily living and the degree of patient satisfaction with their prostheses.

Intraoral versus extraoral measurement of the height of the interproximal contact area in maxillary anterior teeth.

OBJECTIVES: This study aimed to clinically quantify the apicoincisal height of the upper interproximal areas directly in patients' mouths compared to measurements on stone models. SUBJECTS AND METHODS: One hundred and fifty participants (75 females and 75 males, age range 20-45 years) were recruited for this study. A digital caliper was used to measure the anterior maxillary interproximal contact areas directly in patients' mouths and on stone models. The digital caliper accuracy was up to 0.01. The Statistical Package for Social Sciences software (SPSS, version 19.0, Chicago, Ill., USA) was used for statistical analysis. Statistical significance was based on probability values <0.05. RESULTS: The intraoral measurement of proximal contacts as well as the measurement on stone models showed that the dimensions of interproximal contacts on both sides of each tooth were significantly different (p < 0.001) and that the dimension of the mesial contact point was larger than that of the distal contact point of each tooth. The largest contact point was the one between the central incisors (direct intraoral measurement = 2.9-6.49 mm; model measurement = 3.31-6.91 mm). On the other hand, the contact point between the canine and first premolar was the smallest on both sides of the arch (0.63-2.52 mm intraorally, 0.98-2.88 mm on models). The intraoral measurement of contact points was more accurate than model measurements, and the differences were statistically significant (p < 0.001). CONCLUSIONS: The clinical evaluation of contact point dimensions using a digital caliper was more precise than measuring contact points on stone models; hence, it is a viable, quick and adequate method to be used routinely.

Fracture Resistance and Mode of Failure of Ceramic versus Titanium Implant Abutments and Single Implant-Supported Restorations.

BACKGROUND: The material of choice for implant-supported restorations is affected by esthetic requirements and type of abutment. PURPOSE: This study compares the fracture resistance of different types of implant abutments and implant-supported restorations and their mode of failure. MATERIALS AND METHODS: Forty-five Oraltronics Pitt-Easy implants (Oraltronics Dental Implant Technology GmbH, Bremen, Germany) (4 mm diameter, 10 mm length) were embedded in clear autopolymerizing acrylic resin. The implants were randomly divided into three groups, A, B and C, of 15 implants each. In group A, titanium abutments and metal-ceramic crowns were used. In group B, zirconia ceramic abutments and In-Ceram Alumina crowns were used. In group C, zirconia ceramic abutments and IPS Empress Esthetic crowns were used. Specimens were tested to failure by applying load at 130° from horizontal plane using an Instron Universal Testing Machine. Subsequently, the mode of failure of each specimen was identified. RESULTS: Fracture resistance was significantly different between groups (p < .05). The highest fracture loads were associated with metal-ceramic crowns supported by titanium abutments (p = .000). IPS Empress crowns supported by zirconia abutments had the lowest fracture loads (p = .000). Fracture modes of metal-ceramic crowns supported by titanium abutments included screw fracture and screw bending. Fracture of both crown and abutment was the dominant mode of failure of In-Ceram/IPS Empress crowns supported by zirconia abutments. CONCLUSIONS: Metal-ceramic crowns supported by titanium abutments were more resistant to fracture than In-Ceram crowns supported by zirconia abutments, which in turn were more resistant to fracture than IPS Empress crowns supported by zirconia abutments. In addition, failure modes of restorations supported by zirconia abutments were more catastrophic than those for restorations supported by titanium abutments.

A Survey of Standard Protocols for Endodontic Treatment in North of KSA.

The objective of this study was to collect information regarding methods, materials, and attitudes employed during the endodontic treatment by dentists in north of Saudi Arabia. A questionnaire was designed and distributed among 300 dentists in north of Saudi Arabia to collect the data about the standard protocols of endodontic treatment. The collected data was analyzed by using the SPSS 10 computer software. Out of a total of 300 surveyed dentists, the 66% response rate showed that this study was true representation of the endodontic treatment performed by the dentists in north of Saudi Arabia. 152 (76%) were general dentists and 48 (24%) were endodontists. 18 (9%) were using rubber dam as the method of isolation during endodontic treatment. 173 (86.5%) were using only measurement radiographs for working length determination and 27 (13.5%) were using both electronic apex locator and measurement radiographs. 95 (47.5%) of the respondents were using standardized technique and 25 (12.5%) were using step-down as a root canal preparation technique. 127 (63.5%) of the respondents were using lateral condensation technique, with gutta percha points for root canal obturation.

Relationship between impacts of removable prosthodontic rehabilitation on daily living, satisfaction and personality profiles.

OBJECTIVES: To investigate dental impacts on daily living and satisfaction with removable complete and partial prosthodontic rehabilitations, and to identify their relationship with personality profiles. METHODS: Sixty-eight patients (38 males and 30 females; mean age=53.2±11.8 years) received removable prostheses (32 complete dentures and 36 removable partial dentures). Clinical success of prostheses was assessed according specific criteria. The Dental Impact on Daily Living (DIDL) questionnaire was utilized to assess satisfaction with prostheses and impacts on daily living. NEO Five Factor Inventory (NEO-FFI) was utilized to assess patients' personality profiles. RESULTS: Participants' total satisfaction and satisfaction with appearance, pain tolerance, oral comfort, and eating improved after treatment (p<.05). Position of prosthesis and age had no significant relationships with satisfaction or personality scores (p>.05). Females were less satisfied with appearance (p<.05). Patients who received partial dentures were more satisfied with eating and scored higher total satisfaction scores than those who had complete dentures (p<.05). Before treatment; Neuroticism and Openness scores were associated with dental satisfaction and impacts (p<.05). After treatment, Conscientiousness and Extraversion scores were associated with dental satisfaction and impacts (p<.05). CONCLUSIONS: Patients satisfaction with oral condition improved following using removable prosthetic rehabilitation with RPD having better impacts than CD. Psychological profiles (e.g. Neuroticism, Extraversion, Openness and Conscientiousness) might play a role and explain prosthetic impacts on daily living and patients' satisfaction with prostheses.

Quantification of incisal tooth wear in upper anterior teeth: conventional vs new method using toolmakers microscope and a three-dimensional measuring technique.

OBJECTIVES: This study aimed to quantify tooth wear in upper anterior teeth using a new CAD-CAM Laser scanning machine, tool maker microscope and conventional tooth wear index. METHODS: Fifty participants (25 males and 25 females, mean age = 25 ± 4 years) were assessed for incisal tooth wear of upper anterior teeth using Smith and Knight clinical tooth wear index (TWI) on two occasions, the study baseline and 1 year later. Stone dies for each tooth were prepared and scanned using the CAD-CAM Laser Cercon System. Scanned images were printed and examined under a toolmaker microscope to quantify tooth wear and then the dies were directly assessed under the microscope to measure tooth wear. The Wilcoxon Signed Ranks Test was used to analyze the data. RESULTS: TWI scores for incisal edges were 0-3 and were similar at both occasions. Score 4 was not detected. Wear values measured by directly assessing the dies under the toolmaker microscope (range = 113 - 150 µm, mean = 130 ± 20 µm) were significantly more than those measured from Cercon Digital Machine images (range=52-80 µm, mean = 68 ± 23 µm) and both showed significant differences between the two occasions. CONCLUSIONS: Wear progression in upper anterior teeth was effectively detected by directly measuring the dies or the images of dies under toolmaker microscope. Measuring the dies of worn dentition directly under tool maker microscope enabled detection of wear progression more accurately than measuring die images obtained with Cercon Digital Machine. Conventional method was the least sensitive for tooth wear quantification and was unable to identify wear progression in most cases.

Anxiety due to Dental Treatment and Procedures among University Students and Its Correlation with Their Gender and Field of Study.

Aim of Study. To investigate dental anxiety levels among university students and its relation with their specialty and gender. Materials and Methods. 850 undergraduate university students were recruited into the study. The Modified Corah Dental Anxiety Scale (MDAS) was used to measure the levels of their dental anxiety. 700 questionnaires were returned, 390 females and 310 males (response rate of 0.92% among females, 0.73% among males). The MDAS score ranged from 5 to 25. Patients were considered to suffer from high dental anxiety if they scored 13 to 20 points. Statistical analysis significance was set at P ≤ 0.05. Results. Seven hundred students participated in this study including 13% of medical students, 10% of dental students, 58% of arts students, and 18% of computer science students. Medical and dental students were less anxious than arts and computer science students (P < 0.05). Local anesthesia injection was the most fearful dental procedure (P < 0.05). Females were more anxious than males (P < 0.05). Conclusion. Male students were less anxious than female students. Students from medical background faculties were less anxious than students from nonmedical faculties. Lack of adequate dental health education may result in a higher level of dental anxiety among nonmedical students in Saudi Arabia.

Clinical measurement of the height of the interproximal contact area in maxillary anterior teeth.

OBJECTIVES: To clinically quantify the apicoincisal height of interproximal areas directly in patients' mouths. METHODOLOGY: Thirty participants (11 females and 9 males, mean age=26±1.5 years) were recruited into this study. Measurement of interproximal contact areas was carried out directly in patients' mouths using digital caliper (TERENSA, USA) with measuring accuracy of 0.01 mm. The interproximal contact areas that were measured are: central incisor to central incisor, central incisor to lateral incisor, lateral incisor to canine, and canine to first premolar on both sides of the jaw. Statistical significance was based on probability values less than 0.05 (p<0.05). RESULTS: The largest contact point was the one present between central incisors and it ranged from 2.9 to 6.5 mm. On the other hand, the contact point between canine and first premolar was the smallest on both sides of the arch and ranged from 0.6 to 2.5 mm. The dimensions of the contact points declined as we move from anterior area backwards. Statistical analysis using t-test showed that there were significant differences between the measurements of interproximal points of each tooth (P<0.05). CONCLUSIONS: the apicogingival dimension of the contact point decreased as we moved from anterior to posterior teeth. The contact area between the central incisors was largest and the one between canine and premolar was the smallest. This study is the first to report direct intra-oral clinical measurement of contact points. Clinical evaluation of contact point dimensions using digital caliber is a viable, quick and accurate method to use.