The impact of social media on dental practice promotion and professionalism amongst general dental practitioners and specialists in KSA.

OBJECTIVE: This study primarily assesses the social media use patterns of general dental practitioners and specialists in KSA. To fulfil its secondary objective, the study evaluates the social media preferences of the selected cohort for promoting their practice, and their extent of professionalism while using social media. METHOD: An electronic questionnaire was developed and administered to all registered dentists and specialists in KSA through the Saudi Dental Association platform. The questionnaire comprised closed-ended items with a choice of predefined answers that covered demographics, reasons for using social media, and the ways in which social networking might affect professionalism. RESULTS: A total of 238 general dental practitioners and specialists from various age groups answered the questionnaire. The data revealed that 41% of the respondents used social media equally for personal, professional, and business purposes. Instagram was the most commonly used social media platform for dental practice promotion, and also regarded as the most powerful platform by all respondents (p = 0.0009). Thirty-four percent of the respondents rarely posted their own clinical cases on social media. However, a significant difference was observed amongst the specialities (p = 0.01). CONCLUSION: Inappropriate use of social media can cause ethical issues regarding patient confidentiality and data protection that may lead to negative perceptions of dental professionalism. Therefore, guidelines and policies should be established to regulate dental practitioners' use of social media for sharing clinical data.

What the dental practitioner needs to know about pharmaco-therapeutic modalities of COVID-19 treatment: A review.

BACKGROUND/PURPOSE: Several pharmacotherapeutic methods have been used for the treatment of COVID-19 with varying degrees of success. No definitive treatment or vaccine has been officially approved to-date. This review aimed to highlight COVID-19 pharmacotherapeutic agents that are relevant to dental practice in terms of their clinical indications in COVID-19 and dental practice, as well as their adverse effects as they impact the dental patient. MATERIAL AND METHODS: Systematic search was performed using the following keywords combinations: Pharmacotherapy AND COVID-19 OR Pharmacotherapy AND SARS-CoV-2 OR Treatment AND COVID-19. Studies were categorized according to the type of pharmacotherapy used. Pharmacotherapeutic agents were extracted and only those relevant to dental practice were included for review. RESULTS: For analysis, a total of 79 clinical trials research articles were included that included COVID-19 pharmacotherapeutic agents relevant to dental practice. Those were analgesics (paracetamol; non-steroidal anti-inflammatory agents); antibiotics (azithromycin, doxycycline, metronidazole); antivirals (penciclovir); and immunomodulatory agents (hydroxychloroquine, corticosteroids). While some COVID-19 drugs are less relevant to dental practice, as antivirals and hydroxychloroquine, their association with long-term adverse effects requires adequate knowledge among dental practitioners. CONCLUSION: Many of COVID-19 pharmacotherapeutic agents are used to treat oral diseases particularly orofacial pain and inflammatory conditions. Furthermore, some of these drugs may induce adverse effects that complicate dental treatment. Thorough knowledge of COVID-19 therapy and its dental implications is essential for dental practitioners, and is expected to contribute to a better understanding and effective utilization of these therapeutic agents.

Awareness, attitude and ethical concern of dental practitioners about stem cells: a cross-sectional study / Consciência, atitude e preocupação ética dos dentistas sobre as células-tronco: um estudo transversal

Objective: To evaluate the level of awareness and attitude among dental practitioners regarding the use of stem cells in dentistry and to determine their knowledge of ethical concerns related to the recent therapy. Material and Methods: A cross-sectional survey-based study was conducted at Taibah University Dental College and Hospital. Medina and at governmental and private dental clinics at the western region of Saudi Arabia. Responses of dental practitioners who completed the survey were recorded between March 2019 and July 2019 without containing any personal identifiers. Level of awareness and attitude and knowledge about ethical issues in relation to stem cell therapy was established. Results: A total of 214 male and female dental practitioners participated in this study and the majority were registered at the Saudi Commission for Health Specialists 128 (59.8%). Dental consultants reported the highest percentage of awareness about dental stem cells (96%, p= 0.005), whereas general dental practitioners (56.2%, p= 0.005) and specialists (52%, p= 0.005), respectively had a lower percentage. When ethical concerns were determined, dental consultants had the highest percentage of knowledge (56%, p= 0.005), whereas dental practitioners (71.2%, p= 0.005) with < 5 years of experience (69.1, p= 0.002) lacked information about related ethical issues. Conclusion: Ways to increase stem cell awareness among dental practitioners in this study recommended including stem cell topics in the dental curriculum and organizing frequent seminars and conferences on this subject. (AU)

Objetivo: Avaliar o nível de consciência e a atitude dos dentistas em relação ao uso de células-tronco na odontologia, e determinar o conhecimento desses profissionais sobre as questões éticas relacionadas à terapia recente. Material e Métodos: Um estudo transversal baseado em pesquisa foi conduzido na Faculdade e Hospital de Odontologia da Universidade Taibah de Medina e em clínicas odontológicas governamentais e privadas na região oeste da Arábia Saudita. As respostas dos dentistas que responderam à pesquisa foram registradas entre março de 2019 e julho de 2019, sem conter nenhum identificador pessoal. Foi estabelecido o nível de consciência, atitude e conhecimento sobre questões éticas em relação à terapia com células-tronco. Resultados: Um total de 214 dentistas do sexo masculino e feminino participaram deste estudo, sendo 128 (59,8%) desses cadastrada na Comissão Saudita de Especialistas em Saúde. Os consultores em odontologia relataram o maior percentual de conhecimento sobre as células-tronco dentárias (96%, p = 0,005), enquanto os dentistas gerais (56,2%, p = 0,005) e especialistas (52%, p = 0,005) tiveram um percentual menor. Quando as questões éticas foram determinadas, os consultores em odontologia tiveram o maior percentual de conhecimento (56%, p = 0,005), enquanto os dentistas (71,2%, p = 0,005) com menos de 5 anos de experiência (69,1%, p = 0,002) tinham menos informações sobre questões éticas relacionadas. Conclusão: Formas de aumentar a conscientização sobre as células-tronco entre os dentistas deste estudo incluem tópicos sobre células-tronco no currículo de odontologia, além de frequentemente organizar seminários e conferências sobre o assunto. (AU)

How Successful is Supplemental Intraseptal and Buccal Infiltration Anaesthesia in the Mandibular Molars of Patients Undergoing Root Canal Treatment or Tooth Extraction?

OBJECTIVES: To investigate the success rate of supplemental intraseptal and buccal infiltration anaesthesia in mandibular molars undergoing endodontic therapy/extraction when the inferior alveolar nerve block has failed. MATERIAL AND METHODS: A prospective clinical trial including 200 patients undergoing lower molar root canal treatment/teeth extraction was conducted. Only 80 patients of the participants who had profound lower lip anaesthesia after the administration of inferior alveolar nerve block (IANB) were in pain within treatment. Patients experiencing moderate to severe pain upon using elevators, forceps, bur, or endodontic file were randomly allocated to the 2% lidocaine intraseptal injection and 4% articaine buccal infiltration groups. Level of pain was assessed every 2 to 10 min on standard 100 mm visual analogue scales. RESULTS: Overall, 55 (69%) of patients who were given either intraseptal injection of 2% lidocaine or buccal infiltration of 4% articaine had successful anaesthesia of lower molar teeth within 10 min. However, 25 (31%) of participating patients in the buccal infiltration and the intraseptal groups had failed anaesthesia within the study duration (10 min), and they received additional local anaesthetic. IANBs were more painful than buccal and intraseptal injections. However, buccal articaine injections were significantly more comfortable than intraseptal lidocaine injections (P > 0.001). CONCLUSIONS: Supplemental intraseptal injection of 2% lidocaine and buccal infiltration of 4% articaine achieved profound pulpal anaesthesia in 69% of patients when the inferior alveolar nerve block failed. Recommendations can be given to dental practitioners to use infiltration of 4% articaine in conjunction with intraseptal injection of 2% lidocaine to anaesthetize the lower molar teeth when inferior alveolar nerve block fails.

Impact of maxillary teeth morphology on the failure rate of local anesthesia.

OBJECTIVE: To investigate the effect of maxillary single and multiple rooted teeth on the success rate of buccal infiltration anesthesia. SUBJECTS AND METHODS: This clinical study was performed by dividing the participants into three groups. Group one included 30 patients with upper anterior teeth, group two 23 patients with upper premolars teeth and group three 39 patients with upper molars for extraction. Onset time of anesthtic action was evaluted by using electronic pulp tester. Pulp testing assessments were carried out immediately before the injection and at the intervals of 2 mins following the injection until the anesthetic success obtains. RESULTS: Seventy-nine patients in this study secured anesthetic success within study duration time (10 min). However, there were 13 patients with dental anesthesia failures (3 patients with single rooted teeth and 10 patients with multiple rooted teeth). There were no significant differences in the mean onset time of pulpal anesthesia between the anterior, middle and posterior teeth (P value = 0.449). Clinically, patients with single rooted teeth reported faster dental anesthesia and earlier teeth extraction than patients with multiple rooted teeth. CONCLUSION: This study showed that the single rooted teeth have faster pulpal anesthesia and early extraction than teeth with multiple roots but not statistically significant. Administration of extra local anesthetic cartridge or using intraseptal injection technique can be a solution to overcome the failure of anesthesia in the maxillary posterior teeth.

2% lidocaine versus 3% prilocaine for oral and maxillofacial surgery.

OBJECTIVE: To investigate the speed of action and injection discomfort of 2% lidocaine and 3% prilocaine for upper teeth extractions. MATERIALS AND METHODS: Forty-six patients were included in the prilocaine 3% group, and 46 in the lidocaine 2% control group. After all injections, soft and hard tissue numbness was objectively gauged by dental probe at intervals of 15 s. Moreover, the pain of the injections was recorded by the patients after each treatment on standard 100 mm visual analog scales, tagged at the endpoints with "no pain" (0 mm) and "unbearable pain" (100 mm). RESULTS: There were no significant differences in the meantime of first numbness to associated buccal, palatal mucosa, and tooth of patients in the lidocaine and prilocaine buccal infiltration groups (P = 0.56, 0.37, and 0.33). However, clinically, the patients in prilocaine group recorded earlier buccal, palatal mucosa, and teeth numbness than those in lidocaine group. With regards to the discomfort of the needle injections, there was a significant difference for lidocaine and prilocaine groups when comparing the post buccal scores with the post palatal injection scores (t-test: P < 0.001). Lidocaine and prilocaine buccal injections were significantly more comfortable than palatal injections. CONCLUSIONS: Using 2% lidocaine and 3% prilocaine for extractions of upper maxillary teeth produces similarly successful anesthesia. Clinically, prilocaine has slightly rapid onset of action, earlier buccal mucosa, hard palate, and teeth numbness. Prilocaine and lidocaine buccal injection was significantly more comfortable than palatal injection.

Antibiotic Self-Medication for Oral Conditions: Characteristics and Associated Factors

Objective: To investigate the prevalence and contributing factors of antibiotic selfmedication for oral conditions in dental patients. Material and Methods: A questionnaire was distributed to 501 patients attending Taibah University Dental College and Hospital, Al Madinah, Saudi Arabia during late 2016. Questions were on socio-demographic characteristics, and pattern of antibiotic self-medication for oral disease. Statistical analysis was performed using IBM SPSS software version 21. Statistical significance level was set at p ≤.05. Results: Age range was 15-64 years (29.08±9.32 years) with 297 females (59.3%) and 204 males (40.7%). 135 patients (27%) self-medicated with antibiotics for oral disease. This practice was statistically significantly associated with the older adults (p=0.001), lack of medical or dental insurance (p=0.014 and 0.007, respectively), and poor dental attendance (p=0.021). A number of 26 (25.7%) perceived analgesics as antibiotics. Amoxicillin-clavulanic acid was the most commonly cited antibiotic by 18 patients (17.8%). Dental pain was the most frequently reported oral condition. Pharmacists were the most common source for antibiotic prescription cited by 58 (57.4%). Conclusion: Antibiotic self-medication for oral disease is associated with the use of broad-spectrum antibiotics for non-indicated clinical oral conditions. The practice was encouraged by lenient behavior of pharmacists, lack of health insurance, and poor dental attendance.

Differential Properties of Human ALP+ Periodontal Ligament Stem Cells vs Their ALP- Counterparts.

Characterizing subpopulations of stem cells is important to understand stem cell properties. Tissue-nonspecific alkaline phosphatase (ALP) is associated with mineral tissue forming cells as well as stem cells. Information regarding ALP subpopulation of human periodontal ligament stem cells (hPDLSCs) is limited. In the present study, we examined ALP+ and ALP- hPDLSC subpopulations, their surface markers STRO-1 and CD146, and the expression of stemness genes at various cell passages. We found that ALP+ subpopulation had higher levels of STRO-1 (30.6 ± 5.6%) and CD146 (90.4 ± 3.3%) compared to ALP- (STRO-1: 0.5 ± 0.1%; CD146: 75.3 ± 7.2%). ALP+ cells expressed significantly higher levels of stemness associated genes, NANOG, OCT4 and SOX than ALP- cells at low cell passages of 2-3 (p<0.05). ALP+ and ALP- cells had similar osteogenic, chondrogenic and neurogenic potential while ALP-, not ALP+ cells, lacked adipogenic potential. Upon continuous culturing and passaging, ALP+ continued to express higher stemness genes and STRO-1 and CD146 than ALP- cells at ≥passage 19. Under conditions (over-confluence and vitamin C treatment) when ALP+ subpopulation was increased, the stemness gene levels of ALP+ was no longer significantly higher than those in ALP- cells. In conclusion, ALP+ hPDLSCs possess differential properties from their ALP- counterparts.