Clinical Evaluation of Short Tuberosity Implants among Type 2 Diabetic and Non-Diabetic Patients: A 5 Year Follow-Up.

Aim: To assess clinical and radiographic parameters including bleeding on probing (BoP); probing depth (PD), plaque index (PI) and crestal bone loss (CBL) around short tuberosity implants (STI) supporting fixed partial dentures in patients with Type 2 diabetes mellitus (T2DM) and non-diabetics. Material and Methods: Participants with T2DM and without T2DM with at least one STI (6 mm) posteriorly restored with a fixed partial denture splinting premolar implant were included. A questionnaire collected demographic details including gender, age, duration of diabetes, habits of brushing, the total number of dental implants and location, implant loading after placement, restoration type, and family history of DM. Clinical and radiographic assessment of peri-implant parameters, i.e., bleeding on probing (BoP), probing depth (PD), plaque index (PI), and crestal bone loss (CBL) was performed. The restorative success of STI was determined by no sensation of the foreign body, lack of pain and dysesthesia, lack of infection, no radiolucency around the implant, and no mobility. The Kruskal-Wallis test was used for statistical analysis. A p-value of less than 0.05 was considered statistically significant. Results: Twenty-five T2DM (19 males and 6 females) and 25 non-diabetic (18 males and 7 females) participants were included. The number of STIs in T2DM was 41, whereas in non-diabetic it was 38. At 1 year follow-up, mean PI% in T2DM participants was 18.9% (19.2-21.4%) and in non-diabetics it was 17.6% (16.3-18.5%). The mean PD was recorded in diabetics (1.3 ± 5.0 mm) and non-diabetics (1.1 ± 3.2 mm). The BoP value in diabetics was 44.9% (39.8-46.4%) and 28.2% in non-diabetics (17.2-24.6%). At 5 years of follow-up, the mean PI% range in T2DM participants was 26.18% (25.4-29.1%) and 24.42% in non-diabetic (20.1-25.5%). The mean PD in millimeters around STI in T2DM was observed to be 2.3 ± 4.8 mm and 1.4 ± 3.4 mm in non-diabetics. In addition, BoP in diabetic participants was 39.54% (27.7-42.1%) and 24.42% in non-diabetics (20.1-25.5%). A total of six STIs failed, i.e., two in the non-diabetic and four in the T2DM group. Conclusions: Patients with T2DM have poor periodontal (BoP, PD, CBL) and restorative peri-implant parameters around STIs when compared to healthy (non-diabetic) participants at five years of follow-up. For long-term stability, glycemic control is pivotal along with following good plaque control.

Peri-implant clinicoradiographic status among betel-quid chewers and controls.

The aim of the present case-control observational study was to evaluate the peri-implant clinicoradiographic status among betel-quid chewers and controls. Self-reported betel-quid chewers and controls were included. Participants were categorized into 3 groups: Group-1: Individuals chewing betel-quid with tobacco; Group-2: Individuals chewing betel-quid without tobacco; and Group-3: Controls (individuals not using tobacco in any form). Demographic data was collected using a questionnaire. Periodontal and peri-implant clinicoradiologic parameters (plaque and gingival indices [PI and GI], probing depth [PD] and crestal bone loss/marginal bone loss [CBL/MBL]) were assessed. Clinical attachment loss (AL) around teeth was also assessed. Group comparisons were done using the one-way analysis of variance and Bonferroni Post-hoc adjustment tests. Correlation of periodontal and peri-implant inflammatory parameters with the duration of betel-quid chewing habit and duration of placement in the mouth were assessed using logistic regression analysis. P<0.05 was considered statistically significant. Thirty, 30 and 30 patients were included in groups 1, 2 and 3, respectively. Full-mouth PI (P<0.01), GI (P<0.01), clinical AL (P<0.01), PD (P<0.01) and mesial and distal MBL (P<0.01) were higher in groups 1 and 2 than Group-3. Peri-implant mPI (P<0.01), mGI (P<0.01), PD (P<0.01) and MBL/CBL (P<0.01) were significantly higher in groups 1 and 2 than Group-3 with no significant difference in groups 1 and 2. Betel-quid chewing habit either with or without tobacco is a risk-factor of peri-implant soft-tissue inflammation and CBL.

Peri-implant clinicoradiographic status among betel-quid chewers and controls

Abstract The aim of the present case-control observational study was to evaluate the peri-implant clinicoradiographic status among betel-quid chewers and controls. Self-reported betel-quid chewers and controls were included. Participants were categorized into 3 groups: Group-1: Individuals chewing betel-quid with tobacco; Group-2: Individuals chewing betel-quid without tobacco; and Group-3: Controls (individuals not using tobacco in any form). Demographic data was collected using a questionnaire. Periodontal and peri-implant clinicoradiologic parameters (plaque and gingival indices [PI and GI], probing depth [PD] and crestal bone loss/marginal bone loss [CBL/MBL]) were assessed. Clinical attachment loss (AL) around teeth was also assessed. Group comparisons were done using the one-way analysis of variance and Bonferroni Post-hoc adjustment tests. Correlation of periodontal and peri-implant inflammatory parameters with the duration of betel-quid chewing habit and duration of placement in the mouth were assessed using logistic regression analysis. P<0.05 was considered statistically significant. Thirty, 30 and 30 patients were included in groups 1, 2 and 3, respectively. Full-mouth PI (P<0.01), GI (P<0.01), clinical AL (P<0.01), PD (P<0.01) and mesial and distal MBL (P<0.01) were higher in groups 1 and 2 than Group-3. Peri-implant mPI (P<0.01), mGI (P<0.01), PD (P<0.01) and MBL/CBL (P<0.01) were significantly higher in groups 1 and 2 than Group-3 with no significant difference in groups 1 and 2. Betel-quid chewing habit either with or without tobacco is a risk-factor of peri-implant soft-tissue inflammation and CBL.

Resumo O objetivo do presente estudo observacional de casos-controles foi avaliar o estado clínico-radiográfico periimplantar dos usuários de bétele. Foram incluídos usuários que relataram utlizar a substância bétele como tabaco de mascar. Os participantes foram categorizados em 3 grupos: Grupo-1: Indivíduos que mascam bétele com tabaco; Grupo-2: Indivíduos que mascam bétele sem tabaco; e Grupo-3: Controle (indivíduos que não usam tabaco sob qualquer forma). Os dados demográficos foram recolhidos utilizando um questionário. Foram avaliados parâmetros clínico-radiográfico e periimplantares (índices placa e gengivais [IP e IG], profundidade de sondagem [PS] e perda de crista óssea/ perda óssea marginal [PCO/POM]). Também foi avaliada a perda inserção clínica (IC) em torno dos dentes. As comparações de grupo foram feitas utilizando a análise de variância unidireccional e os testes de ajustamento post-hoc de Bonferroni. A correlação dos parâmetros inflamatórios periodontais e periimplantares com a duração do hábito de mastigação da bétele e duração da colocação na boca foi avaliada utilizando a análise de regressão logística. P<0,05 foi considerado estatisticamente significativo. Foram utilizados 30 pacientes em cada grupo. O IP de boca inteira (P<0,01), IG (P<0,01), IC clínica (P<0,01), PS (P<0,01) e POM mesial e distal (P<0,01) foram mais elevados nos grupos 1 e 2 do que no grupo 3. O mPI peri-implantar (P<0,01), '(P<0,01), PD (P<0,01) e POM/PCO (P<0,01) foram significativamente mais elevados nos grupos 1 e 2 do que no grupo 3, sem diferença significativa nos grupos 1 e 2. O hábito de mastigar a substância bétele com ou sem tabaco é um fator de risco de inflamação dos tecidos moles periimplantares e PCO.

Anticandidal efficacy on polymide based denture resin using Photodynamic therapy, chemical and herbal disinfectants and their effect on surface roughness and hardness.

AIM: The present study aimed to evaluate the anticandidal effectiveness of PDT, DL, Triphala, CHX, and NE and their effects on Ra and the hardness of polyamide denture base colonized with C. Albicans. MATERIAL AND METHODS: A total of 50 thermo-injected polyamide denture resins were constructed and inoculated by the American Type Culture Collection (ATCC) of C. albicans in an in-vitro setup. The specimens were arbitrarily allocated into five groups, pre-candida count was measured then subjected to the diverse polyamide denture disinfection methodologies: Group 1: PDT, Group 2: Diode Laser, group 3: Triphala, group 4: 0.12% CHX (Control) and group 5 Neem extract. After disinfection protocol, post-candida count (CFU/ml) was assessed. Surface roughness and surface hardness of polyamide dentures were evaluated and statistical differences in the Ra and Vickers hardness was also assessed. Statistical analysis was performed for CFU/mL (log10) for exposed C. albicans by two-way ANOVA and Tukey's multiple test (p>0.05). For normality of the data, Kolmogorov Smirnov test was executed. RESULTS: The highest anti-microbial efficacy against Candida colonies was displayed by chemical control group 0.12% CHX (11.39 ± 1.8 CFU/ml). This was comparable to herbal NE (12.45 ± 2.9 CFU/ml) (p>0.05). There was no statistical difference found in the surface hardness values among the disinfected groups. Group 2: DL (1.32 ± 0.13 µm) showed the highest Ra value comparable to group 1: PDT (1.21 ± 0.22 µm) CONCLUSION: Polyamide denture base colonized with C. Albicans and disinfected with 0.12% Chlorhexidine and Neem extract demonstrated the highest antimicrobial efficacy with decreased surface roughness and no alteration in denture hardness.

Influence of Concentration Levels of ß-Tricalcium Phosphate on the Physical Properties of a Dental Adhesive.

Our study assessed the influence of integrating 5% and 10% tricalcium phosphate (ß-TCP-Ca3(PO4)2.) nanoparticles into a dental adhesive on the adhesive's bonding. To evaluate the filler nanoparticles, scanning electron microscopy (SEM), Energy Dispersive X-Ray (EDX) spectroscopy, Fourier-transform infrared (FTIR) spectroscopy, and micro-Raman spectroscopy techniques were used. Shear Bond strength (SBS) testing, degree of conversion (DC) analysis, investigation of the adhesive-dentin interface, and biofilm experiments were conducted. The SEM micrographs revealed non-uniform agglomerates, while the EDX demonstrated the existence of oxygen 'O' (24.2%), phosphorus 'P' (17.4%) and calcium 'Ca' (60.1%) in the ß-TCP nanoparticles. The FTIR and micro-Raman spectra indicated characteristic bands for ß-TCP containing materials. The 10 wt.% ß-TCP adhesive presented the highest SBS values (NTC-10 wt.% ß-TCP: 33.55 ± 3.73 MPa, TC-10 wt.% ß-TCP: 30.50 ± 3.25 MPa), followed by the 5 wt.% ß-TCP adhesive (NTC-5 wt.% ß-TCP: 32.37 ± 3.10 MPa, TC-5 wt.% ß-TCP: 27.75 ± 3.15 MPa). Most of the detected failures after bond strength testing were adhesive in nature. The ß-TCP adhesives demonstrated suitable dentin interaction by forming a hybrid layer (with few or no gaps) and resin tags. The ß-TCP adhesives (10 wt.%) revealed lower DC values compared to control. The incorporation of 5 and 10 wt.% concentrations of ß-TCP particles resulted in an increase in SBS values. A linear decline in DC values was witnessed when the nanoparticle concentration was increased. Further research focusing on exploring the influence of higher filler concentrations on adhesive's properties is recommended.

Analysis of recurrent esthetic dental proportion of natural maxillary anterior teeth: A systematic review.

STATEMENT OF PROBLEM: The recurrent esthetic dental (RED) proportion has been a benchmark for the rehabilitation of the maxillary anterior teeth of North American patients. While it has been evaluated in other populations, the global application of RED proportions in the rehabilitation of maxillary anterior teeth is unclear. PURPOSE: The purpose of this systematic review was to examine the existing evidence on dental proportion to evaluate the existence of RED proportions in the esthetic smile in different geographic regions. MATERIAL AND METHODS: A systematic search was conducted by reviewing different databases. The focused question was "Does RED proportion exist in esthetically pleasing smiles in different populations around the world?" The search included articles with a combination of MeSH keywords based on dental proportion from January 2000 to July 2020. The titles and abstracts were identified by using a search protocol. Full text of the articles was independently evaluated. The systematic review was modified to summarize the relevant data. The general characteristics, outcomes, and quality of studies were reviewed and analyzed systematically. RESULTS: Seventeen studies were selected from the reviewed articles. Three studies were conducted in Europe, 10 in South Asia, and 4 in Western Asia. Eleven studies found that the mean perceived ratio of anterior teeth was not constant when progressing distally. Five studies reported that the ratio was constant in a small percentage of their populations, and 1 suggested that the ratio was constant if it remains between 60% and 80%. The central-to-LI and Ca-to-LI proportion values were not constant. Overall, the Ca-to-LI proportion values were higher than the central-to-LI proportions. CONCLUSIONS: RED proportions were not found in the successive widths of maxillary anterior teeth among the reviewed data from different geographic regions. RED proportions are not the only standard for restoring esthetic smiles worldwide, and anterior tooth proportions differ among populations based on their race and ethnicity.

Surface Properties of Polymer Resins Fabricated with Subtractive and Additive Manufacturing Techniques.

This study aimed to compare the surface roughness, hardness, and flexure strength of interim indirect resin restorations fabricated with CAD-CAM (CC), 3D printing (3D), and conventional techniques (CV). Twenty disk (3 mm × Ø10 mm) and ten bar specimens (25 × 2 × 2 mm) were fabricated for the CC, 3D, and CV groups, to be used for surface roughness, micro-hardness, and flexural strength testing using standardized protocol. Three indentations for Vickers micro-hardness (VHN) were performed on each disk and an average was identified for each specimen. Surface micro-roughness (Ra) was calculated in micrometers (µm) using a 3D optical non-contact surface microscope. A three-point bending test with a universal testing machine was utilized for assessing flexural strength. The load was applied at a crosshead speed of 3 mm/min over a distance of 25 mm until fracture. Means and standard deviations were compared using ANOVA and post hoc Tukey-Kramer tests, and a p-value of ≤0.05 was considered statistically significant. Ra was significantly different among the study groups (p < 0.05). Surface roughness among the CC and CV groups was statistically comparable (p > 0.05). However, 3D showed significantly higher Ra compared to CC and CV samples (p < 0.05). Micro-hardness was significantly higher in 3D samples (p < 0.05) compared to CC and CV specimens. In addition, CC and CV showed comparable micro-hardness (p > 0.05). A significant difference in flexural strength was observed among the study groups (p < 0.05). CC and 3D showed comparable strength outcomes (p > 0.05), although CV specimens showed significantly lower (p < 0.05) strength compared to CC and 3D samples. The 3D-printed provisional restorative resins showed flexural strength and micro-hardness comparable to CAD-CAM fabricated specimens, and surface micro-roughness for printed specimens was considerably higher compared to CAD-CAM and conventional fabrication techniques.

Polymer-Based Bioactive Luting Agents for Cementation of All-Ceramic Crowns: An SEM, EDX, Microleakage, Fracture Strength, and Color Stability Study.

The aim of the study was to compare microleakage and fracture loads of all ceramic crowns luted with conventional polymer resins and polymeric bioactive cements and to assess the color stability of polymeric bioactive cements. Seventy-five extracted premolar teeth were tested for fracture loads and microleakage in all-ceramic crowns cemented with two types of polymeric bioactive cements and resin cements. In addition, the degree of color change for each cement with coffee was assessed. Thirty maxillary premolar teeth for fracture loads and thirty mandibular premolar teeth for microleakage were prepared; standardized teeth preparations were performed by a single experienced operator. All prepared specimens were randomly distributed to three groups (n = 20) based on the type of cement, Group 1: resin cement (Multilink N); Group 2: polymeric bioactive cement (ACTIVA); Group 3: polymeric bioactive cement (Ceramir). The cementation procedures for all cements (Multilink, ACTIVA, and Ceramir) were performed according to the manufacturers' instructions. All specimens were aged using thermocycling for 30,000 cycles (5-55 °C, dwell time 30 s). These specimens were tested using the universal testing machine for fracture strength and with a micro-CT for microleakage. For the color stability evaluation, the cement specimens were immersed in coffee and evaluated with a spectrometer. Results: The highest and lowest means for fracture loads were observed in resin cements (49.5 ± 8.85) and Ceramir (39.8 ± 9.16), respectively. Ceramir (2.563 ± 0.71) showed the highest microleakage compared to resin (0.70 ± 0.75) and ACTIVA (0.61 ± 0.56). ACTIVA cements showed comparable fracture loads, microleakage, and stain resistance compared to resin cements.

Comparison of adhesive bond strength among fiber reinforced post and core with different cementation techniques: In vitro study.

AIM: To investigate push-out bond strength (PBS) of fiber post to radicular dentin after using different cementation techniques. MATERIAL AND METHODS: Sixty single-rooted premolars were disinfected and cleaned by mechanical instrumentation. S1, S2, and SX were used for canal shaping and finishing of the canal was carried out using F1 and F2. This was followed by constant irrigation and smear layer removal using 17%EDTA. The canal was dried filled with gutta-percha and canal space was prepared using a peso reamer. Based on cementation techniques, samples were randomly allocated into six groups. Group 1: One-step Monoblock MC; Group 2: One-step, Monoblock MC-NA (no adhesive) GFP; Group 3: One-step, RX-MC-Monoblock; Group 4: Two-step, RX-MC; Group 5: Two-step, RX-FZ; and Group 6: Two-step RX-FZ-custom post. All specimens were mounted in polyvinyl pipes using acrylic resin up to cement enamel junction. All specimens were mounted in a universal testing machine subjected to push-out forces at a speed of 0.5 mm/min. Five samples from each group were sputter-coated with 6 nm gold thickness for 300 s at 250 mA. The coated specimens were assessed under the scanning electron microscope (SEM). Analysis of variance (ANOVA) and Tukey Kramer multiple comparisons tests were performed to compare means among groups maintaining the level of significance at (p < 0.001). RESULTS: The highest PBS was displayed in RX-MC-Monoblock (199.020 ± 21.432 MPa). Whereas, lowest PBS was found in Monoblock MC-NA (no adhesive)-GFP (76.440 ± 9.468 MPa). Among one-step groups, RX-MC Monoblock exhibited the highest PBS (199.020 ± 21.432 MPa) comparable to one-step Monoblock MC (134.28 ± 19.37 MPa) (p > 0.05). Similarly, among two-steps groups, two-step RX-MC demonstrated significantly higher PBS values than two-step RX-FZ (143.340 ± 23.68 MPa) and RX-FZ-custom post (86.90 ± 7.41 MPa) (p < 0.05). CONCLUSION: One-step RX-MC-Monoblock technique using self-adhesive cement and core foundation composite resin material multicore flow when cured simultaneously exhibited the highest bond integrity of post retention compared to other cementation technique.

Influence of TiO2 and ZrO2 Nanoparticles on Adhesive Bond Strength and Viscosity of Dentin Polymer: A Physical and Chemical Evaluation.

The present study aimed to formulate an experimental adhesive (EA) and reinforce it with 5 wt.% titanium dioxide (TiO2) or zirconium oxide (ZrO2) to yield 5% TiO2 and 5% ZrO2 adhesives, respectively, and then analyze the impact of this reinforcement on various mechanical properties of the adhesives. The EA contained a blend of monomers such as bisphenol A glycol dimethacrylate (BisGMA), triethylene glycol dimethacrylate (TEGDMA), 2-hydroxyethyl methacrylate (HEMA), and ethyl 4-dimethylamino benzoate and camphorquinone. The EA included ethyl 4-dimethylamino benzoate and camphorquinone photo-initiators, and diphenyliodonium hexafluorophosphate (DPIHP) was also included to act as an electron initiator. The TiO2 and ZrO2 nanoparticles were incorporated into the EA post-synthesis. To characterize the filler nanoparticles, scanning electron microscopy (SEM) and line-energy dispersive X-ray (EDX) spectroscopy were performed. The adhesives were characterized by analyzing their rheological properties, shear-bond strength (SBS), and interfacial failure types. Further, the resin-dentin interface was also analyzed via SEM. The TiO2 nanoparticles were spherically shaped on the SEM micrographs, while the ZrO2 nanoparticles were seen as non-uniformly shaped agglomerates. The EDX mapping demonstrated the presence of Ti and oxygen for TiO2 and Zr and oxygen for the ZrO2 nanoparticles. Both 5% TiO2 and 5% ZrO2 adhesives revealed decreased viscosity as compared with the EA. The 5% TiO2 adhesive demonstrated higher SBS values for both non-thermocycled (NTC) and thermocycled samples (NTC: 25.35 ± 1.53, TC: 23.89 ± 1.95 MPa), followed by the 5% ZrO2 adhesive group (NTC: 23.10 ± 2.22, TC: 20.72 ± 1.32 MPa). The bulk of the failures (>70%) were of adhesive type in all groups. The SEM analysis of the resin-dentin interface revealed the development of a hybrid layer and resin tags (of variable depth) for the EA and 5% TiO2 groups. However, for the 5% ZrO2 group, the hybrid layer and resin tag establishment appeared compromised. Reinforcement of the EA with TiO2 or ZrO2 caused an increase in the adhesive's SBS (with the 5% TiO2 group demonstrating the highest values) in comparison with the EA (without nanoparticles). However, both nanoparticle-containing adhesives revealed decreased viscosity compared with the EA (without nanoparticles). Further studies investigating the impact of diverse filler concentrations on the properties of adhesives are suggested.

Immediate versus conventional loading of mandibular implant-supported fixed prostheses in edentulous patients: 10-year report of a randomised controlled trial.

PURPOSE: To compare the clinical outcomes of immediate versus conventional delayed loading of four dental implants in edentulous mandibles with fixed prostheses. MATERIALS AND METHODS: A blinded, two-arm, parallel group, randomised controlled trial was conducted. A total of 42 patients were included, and each received four Brånemark System implants with a TiUnite surface. The patients were randomly assigned to two study arms: 1) immediate-loading arm (IL), in which the mandibular denture was converted into an interim implant-supported fixed prosthesis (ISFP) on the day of surgery, with a permanent ISFP being inserted at least 3 months postsurgery; 2) conventional-loading arm (CL), in which the mandibular removable prosthesis was relieved at the implant site and relined with a soft tissue conditioner. Only implants with a minimum insertion torque of ≥ 35 Ncm were included in the IL group. Implants were loaded 4 to 6 months postsurgery. Independent, blind investigators assessed the patients at 2, 6 and 12 months and at 10 years. The outcome measures were prosthesis and implant success rates, type and frequency of complications and changes in peri-implant marginal bone levels. RESULTS: A total of 20 patients were allocated to the IL group and 22 to the CL group. However, one patient from the IL arm was excluded and three patients were reallocated to the CL arm. Two implants in one patient and one in another patient could not be placed with a ≥ 35 Ncm insertion torque, and a third patient developed severe sudden gag reflex and thus it was not possible to load the implants immediately. At a later stage, one of the patients who failed the initial stability test dropped out of the study. Therefore, initially, 24 patients were conventionally loaded and 16 patients were immediately loaded. At the 10-year follow-up, six patients dropped out from the IL arm and two from the CL arm. Also, at the 10-year-follow-up, the CL and IL study arms consisted of 22 and 10 participants, respectively, using the per-protocol (PP) analysis. Six implants failed in two patients of the CL arm (two implants in one patient and four implants in another patient), and three implants failed in three patients in the IL arm (PP analysis), respectively. The patient-level implant failure rate was 10% (intention-to-treat [ITT] analysis) and 14% (PP analysis) in the CL arm, and 25% (ITT) and 20% (PP) in the IL arm. The difference was not statistically significant (95% CI from -0.18 to 0.39, P = 0.65). The failure rate at the implant level was 8% (ITT) and 8% (PP) in the CL arm, and 6% (ITT) and 5% (PP) in the IL arm. The difference was not statistically significant (95% CI from -0.06 to 0.14, P = 0.44). Ten years after loading, patients in the IL arm lost an average of 0.55 ± 0.64 mm of peri-implant bone versus 0.41 ± 0.40 mm of peri-implant bone loss observed in the CL arm. The 10-year bone loss in both arms was statistically significant compared with the baseline (P < 0.001). However, there was no statistically significant difference between the two arms for peri-implant bone level changes (the difference between the arms was 0.14 mm ± 0.50 mm; 95% CI -0.23 to 0.52; P = 0.43). One prosthesis failed due to the loss of all four implants in one patient of the CL arm. Eight patients from the IL arm were affected by 13 complications (such as pain from fractures and inflammation) versus seven patients (10 complications) from the CL arm. The complication rate was 67% in the IL arm and 35% in the CL arm. The difference in complication proportions between the two arms was not statistically significant (difference in proportions = 0.32; 95% CI = -0.08 to 0.61; P = 0.14). All complications were managed successfully. CONCLUSIONS: Long-term data of immediate loading of four dental implants with a mandibular fixed prosthesis revealed comparable clinical outcomes to conventional loading. Therefore, immediate loading should be considered in the treatment of edentulous patients.

Gynecologists' Knowledge of the Association Between Periodontal Health and Female Sex Hormones.

OBJECTIVE: To assess gynecologists' knowledge of the association between female sex hormones and periodontal health. METHODS: A cross-sectional study was conducted on gynecologists at various hospitals across the five areas of Riyadh, Saudi Arabia. Data was collected using a self-administered questionnaire. The questionnaire was divided into three parts, covering the participants' demographics, their knowledge about the association between periodontal health and female sex hormones, and the participants' practices regarding medications prescribed to treat their patients. RESULTS: During the study period, 203 gynecologists agreed to take part in this study. The overall mean percentage of knowledge regarding the association between periodontal health and female sex hormones among participants was 66.8%. Only 53.0% of participants reported that periodontal disease is a risk factor for preterm deliveries; 50.0% indicated that gingival changes could be induced by the long-term use of oral contraceptives and 35.1% agreed that periodontal health checkups must be regularly carried out for pregnant women. CONCLUSIONS: Although the overall knowledge level of the gynecologists about periodontal health and female sex hormones was satisfactory, they showed an unsatisfactory level of knowledge about the association between periodontal disease and another aspect of women's health across their adult lifespan, such as the importance of a regular periodontal health checkup for pregnant women. Increased awareness amongst gynecologists may improve their level of knowledge about the effect and importance of periodontal health for women.

A comparative evaluation of the effect of phototherapy of fiber post on its bond strength to dental composite.

The aim of the study was to evaluate the effect of diode laser as a phototherapy on surface treatment of fiber post and its bond strength to resin core build-up material. In this in-vitro study fifty fiber post of 1 mm tip-diameter and 20 mm length were used. The posts were mounted and randomly divided into 5 groups (n = 10) according to different surface treatment methods i.e. Group 1: Control, Group 2: Application of 37% Phosphoric Acid, Group 3: Treated with 40% H2O2, Group 4: Sandblasted with 50 µm aluminium oxide particles and Group 5: treated with diode laser. In all specimens including control, a cylinder of resin composite around the fiber post was made. All Specimens were mounted in a universal testing machine. Push-out test was performed and bond strengths were calculated. Using analysis of variance (ANOVA) and post hoc Tukey multiple comparisons test, means of push out bond strength were compared among the study groups. The highest bond strength was shown among Sandblasted [50 µm, Aluminium Oxide (Al2O3)] group [139.86] and the lowest push-out bond strength was observed in Control specimens [75.73]. The bond strength values of fiber post treated with Diode laser [100.81] and 40% H2O2 [105.64] were comparable.

Quality of communication between dentists and dental laboratory technicians for fixed prosthodontics in Riyadh, Saudi Arabia.

The fabrication of a clinically acceptable dental prosthesis requires proper communication between the dentist and the dental technician. Prosthodontic educators have been concerned with this interaction and communication. Fixed prosthodontics laboratories revealed that the technicians are often dissatisfied with the information provided in work authorizations. OBJECTIVE: To evaluate the quality of communication between dentists and laboratory technicians via work authorizations for fixed prosthodontics in both governmental and private dental laboratories in Riyadh area from the technician's perspective. METHODS: A sample of 66 dental laboratories, including all government dental laboratories and a selected number of randomly chosen private dental laboratories from each district of Riyadh (40%), participated in the survey. A questionnaire was developed to include questions related to the following areas of work authorization: clarity and accuracy of instructions, patient information, type of prosthesis, choice of materials, design and shade of the prosthesis and type of porcelain glaze. The questionnaire was answered in a face-to-face interview by technicians who were qualified in fixed prosthetic work. Data were analyzed through parametric tests (T-test and one-way ANOVA) to identify significant values (P < 0.05). RESULTS: This survey showed a lack of communication between dentists and dental laboratories regarding the following: marginal design, pontic design, staining diagram, type of porcelain and glaze needed for the prosthesis. Significant differences were observed between the government and private dental laboratories. There was a greater lack of communication between the dentists and government laboratory technicians in Riyadh. There was no statistically significant difference between private laboratories of different areas in Riyadh city (P < 0.05). CONCLUSION: The quality of communication between dentists and dental technicians in Riyadh can sometimes be inadequate, and governmental laboratories have a lower level of communication.