Comparison of mechanical properties and color stability of various vacuum-formed orthodontic retainers: An in vitro study.

Vacuum-formed retainer (VFR) is the most used retainer due to its higher aesthetic properties and lower cost, their mechanical properties of are important in determining the stability and long-term use of appliances made out of them. AIM: This study aimed to evaluate and compare the flexural modulus, surface hardness, and color stability of three different VFR materials. METHODS: Three different VFR materials, namely Duran, Keystone, and Zendura, of 1 mm thickness, were tested after thermoforming for flexural modulus, hardness, and color stability. They were formed over a stainless-steel model of 12 mm diameter and 6 mm height. RESULTS: There were significant statistical differences (p = 0.000) in the flexural modulus and hardness of the three materials. Regarding color stability, Zendura exhibited significantly higher ΔE* values than Keystone and Duran (p < 0.05). CONCLUSIONS: Zendura had the highest flexural modulus and hardness compared with Duran and Keystone; however, it is more susceptible to color change compared to the other tested materials.

Students' Perceptions of their Dental Curriculum and Education.

Objective: To evaluate the satisfaction of dental students toward their dental curriculum and education at dental colleges in the central region of Saudi Arabia. Methods: Two forms of the questionnaire were established, a paper version and an electronic internet-based survey (Google online form). Paper versions were distributed to interns graduated from universities in Riyadh. The electronic versions were used to obtain responses from students at dental colleges and universities outside of Riyadh, such as Prince Sattam bin Abdulaziz University (PSAU) and Majmaah University, by emailing the links to the participants who were dental interns that had graduated in the 2018/2019 academic year. Results: A total of 388 interns answered the questionnaire. Overall, 48.4% of the interns were highly satisfied with the Operative Department while regarding Orthodontic Department 16.9% were satisfied while 11.2% were highly satisfied. Regarding the non-clinical satisfaction score, the interns were mostly unsatisfied with their research skills (15.5%). Comparing the interns' satisfaction at different institutions, there was a statistically significant difference in the clinical satisfaction score (P ≤0.01), but there was no difference in the non-clinical satisfaction score (P > 0.05). Conclusion: Dental students need a greater focus and exposure to research skills during their dental school studies. To improve dental students' level of clinical satisfaction, it is more important for them to have early exposure to comprehensive clinical training than specialty-based clinical training.

Parents' Awareness of Early Orthodontic Consultation: A Cross-Sectional Study.

OBJECTIVE: The aim of this paper is to assess parents' knowledge about early orthodontic consultation and treatment, and to determine the association of this knowledge with number of children, monthly income, children's age and perceived dental problems. METHODS: A questionnaire was distributed to 3000 school children aged 6-11 years. The children were asked to take the questionnaire to their parents and bring it back the next day. It consisted of 13 questions. Some of these questions were related to the gender of the child, number of children, and parents' monthly income. The remaining questions assessed the parents' awareness of their children's need for orthodontic treatment. RESULTS: In total, 2538 parents completed the questionnaire. Of these, 2014 (79%) of the parents thought that their children's teeth would have a significant impact on their personality. Moreover, 1637 (64.5%) parents thought that their children had a problem with their teeth; 1080 (66%) of these parents consulted a dentist. Of these 1080 parents, 821 (76%) consulted an orthodontist, and of these 821 parents, 449 (55%) initiated the required orthodontic treatment. The number of children who visited an orthodontist was found to increase with an increase in age (p = 0.0057). Moreover, a perceived overjet was associated with a higher number of orthodontic consultations (p = 0.0326). CONCLUSION: Although parents' awareness regarding their children's orthodontic treatment is important, other factors, such as the age of the child, the severity of the malocclusion and the consulted dentist, play a role in initiating orthodontic treatment.

Estimation and comparative evaluation of teeth prominence values of Saudis for bracket prescription.

BACKGROUND: The racial and ethnic disparities in tooth morphology and alignment indicate the need for different orthodontic prescriptions. PURPOSE: This study aimed at utilizing the 3D digital models to measure the teeth prominence of Saudi adults and compare the results to previously published data. MATERIALS AND METHODS: The sample included 60 sets of 3D digital dental models of subjects who presented with non-orthodontic normal occlusion and balanced profile. Rhinoceros™ 3D modeling software was used to mark the midpoint of the clinical crown (LA) and the embrasure line and then to measure the prominence of the teeth. The collected data was analyzed using SPSS (IBM SPSS Inc., version 20, Chicago, IL, USA). The mean and SD scores were obtained for each measurement. Independent t-test, paired t-test, and student t-test were used for the comparison at a significant level of P ≤ 0.05. RESULT: Comparison between the right and the left sides, and between the male and female showed no significant differences, and hence the result data were combined. However, further comparison with the published data of the North American whites, Japanese, Indian, African and Italian showed significant differences in most of the teeth. CONCLUSION: Racial differences influence the teeth prominence values that should be considered in presenting orthodontic bracket prescriptions. More research in this field is needed.

Estimation and comparative evaluation of tip and torque values of Saudis for bracket prescription.

OBJECTIVES: The present study aimed at determining the tip and torque values of the teeth of Saudi adults with normal occlusion to develop orthodontic bracket prescription. In addition, we proposed to compare the results with published data of varied geographical distribution. MATERIALS AND METHODS: The study sample consisted of 60 upper and lower study models of Saudi adults (30 males and 30 females) with normal occlusion and a balanced facial profile. Evaluated by experts, the torque and tip of teeth were measured using a torque angulation device. The collected data was analyzed using SPSS (IBM SPSS Inc., version 20, Chicago, IL, USA). The mean, and standard deviation were obtained for each measurement. Paired t-test, Independent t-test and student t-test were used for the comparison at a significant level of (p ≤ 0.05). RESULT: The results of torque and tip of teeth for the Saudi adult population showed no significant differences between the right and the left quadrants of the analyzed study sample. In general, there was no significant observed difference between male and female samples, accordingly, the Saudi tip and torque data were combined. However, the comparisons of the combined Saudi data to the published data showed significant differences (p ≤ 0.05). CONCLUSION: Statistically Significant differences were found between the combined Saudi data when compared to North American, Italian, African, Japanese, and Indian data. We inferred, that racial differences should be considered when presenting bracket prescriptions.

Using bonding agent prior to pits and fissure sealant application enhances the microtensile bond strength and the interface morphology.

BACKGROUND: A pits and fissures sealant is an effective method for preventing dental caries. Using a bonding agent before applying the sealant may increase its retention. This study aimed to compare the microtensile strength (µTBS) of a fissure sealant with and without a bonding agent and to characterize the enamel-sealant interface using confocal laser scanning microscopy (CLSM). The null hypothesis was that the use of a bonding agent before fissure sealant application would not change the microtensile strength or the enamel-sealant interface. MATERIALS AND METHODS: Twenty caries-free premolars were used. Each tooth was divided into four parts. The first two parts were assigned to the bonded group, where a bonding system was used before sealant application. The remaining two parts were treated only with a fissure sealant (i.e., the nonbonded group). In each group, the µTBS was examined after 24 h (n = 20) and after a 3-month aging period (n = 20). Five other caries-free extracted premolars were used to assess the enamel-sealant interface using CLSM. Two-way analysis of variance (ANOVA) and Pearson chi-square statistical analysis tests were used to analyze the µTBS and the enamel-sealant interface, respectively. RESULTS: The mean µTBS for the bonded group was significantly higher (p = 0.001) in the immediate group (36.87 ± 14.95 MPa) and the aged group (31.08 ± 15.88 MPa) than in the respective nonbonded groups (19.77 ± 9.67 MPa and 19.52 ± 14.14 MPa). The µTBS was not significantly different in either group after aging (p = 0.46 [bonded group] and p = 0.98 [nonbonded group]). In addition, using a dental adhesive, before applying a fissure sealant resulted in a significantly higher (53%) resin penetration into the enamel with the continuous integrity of the resin. CONCLUSION: The use of a bonding agent before the application of fissure sealant resulted in superior microtensile bond strength immediately and after aging. In addition, the enamel-sealant interface characteristics were improved.

Assessment of Occupational Stress Among Oral and Maxillofacial Surgeons and Residents in Saudi Arabia: A Cross-Sectional Study.

PURPOSE: Considering the important role of oral and maxillofacial surgeons in healthcare services and the stressful nature of their job, this study aimed to assess the occupational stress among oral and maxillofacial surgeons and residents in Saudi Arabia. MATERIALS AND METHODS: Cross-sectional questionnaires were developed, and they included the perceived stress scale and questions about potential sources of stress. A sample size of 180 was determined using a 0.05 level of significance and a precision of ±8%. The survey was distributed using a consecutive non-random sampling method to all oral and maxillofacial surgeons and residents in all regions in Saudi Arabia from May to December 2019. RESULTS: One hundred and seventy-two responses were received. Males were the predominant gender. The perceived stress scale revealed a moderate stress level among surgeons and residents. However, residents had a significantly higher score (P = 0.005). Increased working days were significantly associated with higher stress levels (P = 0.006). Long on-call periods were significantly and positively correlated with increased stress levels among residents since their work schedule was not flexible (P = 0.000). The majority of surgeons and residents believe that they have unconducive and stressful work environments and that working as a maxillofacial surgeon is stressful. CONCLUSION: The study results suggest that there is increased occupational stress among oral and maxillofacial surgeons and residents in Saudi Arabia. This study highlights the need for stress management programs to minimize stress factors at the workplace and to ensure a healthy working environment for the practitioners.

Occupational Stress among Orthodontists in Saudi Arabia.

AIM: The aim of this study was to identify potential occupational stressors among orthodontists practicing in Saudi Arabia, and to evaluate their relationship to personal and professional characteristics. MATERIALS AND METHODS: Using a validated occupational stress assessment (OSA) questionnaire, demographic information and data pertaining to potential occupational stressors and professional characteristics of the participants were collected. The OSA questionnaire was adopted and modified based on Cooper et al. classification of potential stressors. To assure anonymity of the protocol, the respondents were given the OSA questionnaire at their clinical settings or scientific meetings and requested to return the filled copy of the questionnaire without any personal disclosures. The severity of stressors was assessed using a five-point Likert scale, and individual scores were summed to obtain the overall severity score. The collected data were coded, tabulated, and analyzed using statistical software. RESULTS: Samples of 253 orthodontists were evaluated with a response rate of 82.6% (209) and a higher proportion of male participants (75.1%). The mean severity score for stress was higher among orthodontists of age less than 30 years when compared with those more than 50 years of age (F = 3.486; P = 0.017). Similarly, the mean severity score was higher among orthodontists who had completed their residency program in Saudi Arabia, Arab countries, and Asian countries (F = 5.425; P < 0.0001). Further categorization of the stressors based on patient-, time-, staff-, work-, referral-, and income-related factors were carried out. Although patient-related factors (mean = 3.38) were considered the most stressful, referral- and income-related factors (mean = 2.39) were considered the least stressful. CONCLUSION: Pronounced variation was evident in assessing the potential stressors among orthodontists. Nevertheless, time management and proper patient education can address the most concerning stressors among orthodontists in Saudi Arabia.

Evaluation of the airway space changes after extraction of four second premolars and orthodontic space closure in adult female patients with bimaxillary protrusion - A retrospective study.

BACKGROUND & OBJECTIVES: Previous studies have found that first premolar extractions during orthodontic treatment may alter the upper airway dimensions. The objective of this study is to investigate the effects of second premolar extraction during orthodontic treatment on the dimensions of the upper airway in a sample of female adults. METHODS: Twenty-nine female adult patients with ages between 18 and 30 years old and incisor bimaxillary protrusion were included in this study. They were treated with comprehensive orthodontic treatment which included the extraction of four second premolars. Pre and post cephalometric radiographs were analyzed using Dolphin imaging software for changes in tongue length and height, soft palate thickness and length, the superior, middle, and inferior airway space, and vertical airway length. Descriptive statistics were used to characterize measurements. Student's paired t-test was preformed to compare the pre- and post-test mean values of the dimensions. RESULTS: A significant increase in the vertical airway length was observed after the extraction of the second premolars (p = 0.02). The soft palate length showed a tendency towards an increase that did not reach statistical significance (p = 0.053). No other significant changes in the airway soft tissue measurements were observed. The proclination and protrusion of the upper and lower incisors were significantly decreased compared to pre-treatment measurements.Interpretation & conclusions.Orthodontic treatment involving the extraction of all four second premolars in females with bimaxillary protrusion increases the vertical airway length, which is the amount of distance between base of the tongue and posterior nasal spine. No other significant alterations in the upper airway measurements were observed.

Changes in the mandibular dental arch during the late mixed dentition stage: Experimental study.

OBJECTIVE: To determine the dimensional changes in the mandibular arch of untreated subjects during the late mixed dentition stage. METHODS: The cross-sectional study was conducted over three years starting March 2013 at the College of Dentistry, King Saud University, Riyadh, Saudi Arabia, and comprised consecutive models taken annually of subjects seeking dental treatment. They were aged 9 years at baseline and dimensional changes were calculated at 9, 10 and 11 years of age. Measurements taken each year were overjet, overbite; inter-canine width, canine length, inter-first deciduous molar width, inter-first premolar width, inter-first permanent molar width, arch length, molar depth, incisor irregularity, and available anterior space. SPSS 16 was used for data analysis. RESULTS: Of the 15 subjects, 10(66.6%) were girls and 5(33.3%) were boys. Of all the variables, the mean values of overbite (p=0.006) and inter-canine width (p=0.001) increased significantly over the period, while the mean irregularity index values decreased significantly (p<0.0001).. CONCLUSIONS: An increase in overbite and inter-canine width, and a reduction in the irregularity index of teeth was detected during the mixed dentition phase.

Dento-skeletal characteristics of cleft patients with missing teeth.

OBJECTIVE: The objective of this study was to compare the cephalometric skeletal and dental characteristics of unilateral complete cleft lip and palate (UCCLP) subjects with and without missing teeth. DESIGN: A retrospective records review was conducted for patients who are being treated at the cleft lip and palate (CLP) clinics in the College of Dentistry. METHODS: Ninety-six consecutive records of non-syndromic UCCLP subjects were recruited (33 subjects without missing teeth, 50 subjects with only one missing tooth, and 13 subjects with two or more missing teeth). Skeletal and dental characteristics were assessed using lateral cephalometric radiographs in UCCLP subjects with missing teeth and compared to the group with no missing teeth. A total of 25 linear and angular measurements were analyzed and compared between the sample groups. RESULTS: Of the dental variables tested, overjet was significantly different between the three groups. The UCCLP subjects with multiple missing teeth had the smallest overjet (-3.89±2.75 mm; P=0.015) among the three groups. None of the skeletal characteristics reached statistical significance. CONCLUSION: Missing teeth influence the dental but not skeletal characteristics of UCCLP. Overjet is significantly reduced in UCCLP subjects with multiple missing teeth. Future studies with larger sample sizes are warranted.

Elementary school staff knowledge about management of traumatic dental injuries.

AIM: This study investigated the knowledge of elementary school staff regarding the management of traumatic dental injuries (TDIs) in children. METHODS: The present cross-sectional study analyzed data collected between September 2016 and April 2017. The sample consisted of 2,027 elementary school staff members in Riyadh, Saudi Arabia. A stratified cluster random sampling technique was used to select the required sample. Those who agreed to participate in the study completed a 4-part self-administered questionnaire comprising questions regarding demographic data, knowledge on management of tooth fracture, and avulsion using photographs of TDI cases. RESULTS: The majority of the school staff showed inadequate basic knowledge regarding the importance of saving the broken piece of the tooth and identifying the tooth involved in the trauma (67% and 66.3%, respectively), P<0.05. However, they had a significantly high number of correct responses regarding the immediate management of TDIs for the 2 case scenarios presented in the questionnaire (P<0.05), and the majority (41%) reported normal saline as a suitable storage medium (P<0.01). CONCLUSION: This study revealed a lack of knowledge in certain aspects of TDIs among elementary school staff.

The characteristics of dental occlusion in patients with moderate to severe obstructive sleep apnea in Saudi Arabia.

OBJECTIVES: To evaluate characteristics of dental occlusion among non-obese Saudi adult patients suffering from moderate to severe obstructive sleep apnea(OSA). METHODS: Following ethical approval, a cross-sectional study was conducted at Sleep Disorders Center, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia, between January and March 2017. Non-obese adult Saudi patients with moderate/severe OSA (apnea-hypopnea index more than 15) and without history of malocclusion or edentulism were included with an estimated sample size of 50. Demographic details and severity of OSA as diagnosed by polysomnography were recorded. Characteristics of dental occlusion, namely molar, canine and incisor relationship, overjet, overbite, crossbite and arch form were obtained through calibrated examiners (kappa 0.81). Descriptive statistical analysis and Chi-square test, with 95% significance level (p less than 0.05), were used to identify relationships between the severity of OSA and characteristics of dental occlusion. RESULTS: A total of 51 patients (31 males, 20 females; mean age 49.45±10.35 years), were enrolled in the study. Severity of OSA was moderate in 17 patients and severe in 34 patients. Severe form of OSA was more among males (64.7%) and in patients with Class-II division-1 incisor relationship (94.1%). Neither the demographic characteristics, nor characteristics of dental occlusion showed statistically significant relationship with the severity of OSA. CONCLUSION: The results of the present cross-sectional study indicate that the characteristics of dental occlusion are not related to the severity of OSA among non-obese adult Saudi patients.

Knowledge on management of traumatic dental injuries among Saudi mothers.

OBJECTIVE: This study investigated the knowledge of Saudi mothers regarding the management of traumatic dental injuries (TDIs) in children. MATERIALS AND METHODS: A cross-sectional study using structured questionnaires was employed for mothers chosen by stratified-cluster random sampling technique from primary health care centers in Riyadh, Saudi Arabia, over a period of 12 months (July 2016-June 2017). The questionnaire surveyed mothers' background and knowledge on management of tooth fracture and avulsion using photographs of TDI cases. RESULTS: The sample consisted of 3,367 Saudi mothers. More than half of the mothers (55.3%) gave the correct response, which was to send the child with tooth fracture immediately to the dentist (p<0.01). The majority of mothers (41.6%) gave the correct response for the immediate mode of action, which was to save the avulsed tooth in storage medium and send the child to the dentist immediately (p<0.001). However, they prioritized the immediate management of TDIs, and most reported saline as a suitable storage medium (p<0.001). The mothers expressed a positive interest in further education. CONCLUSION: Educational programs and TDI protocols must be implemented to increase mothers' awareness and improve the prognosis of children with TDIs.

An assessment of job satisfaction: A cross-sectional study among orthodontists of Saudi Arabia.

AIM OF THE STUDY: The main objective of the present study was to investigate the level of job satisfaction among professional orthodontists in relation to some significant intrinsic and extrinsic factors that generally affect their performance. MATERIALS AND METHODS: A cross-sectional study was conducted among orthodontists working in the Kingdom of Saudi Arabia using an online survey questionnaire through Survey Monkey. A total of 161 responses were received; among those, 57.8% of the respondents were Saudi and 42.2% were non-Saudi. RESULTS: On an overall satisfaction basis, a majority of orthodontists (80.7%) were satisfied with orthodontics as their profession irrespective of their gender. Only 4.4% showed dissatisfaction, whereas the remaining 14.9% were moderately satisfied with orthodontics as a profession. In-depth analysis revealed that a majority of the respondents (56.2%) showed reservations over having ample time for their family life. 52.8% of the respondents strongly agreed that they are assigned significant paperwork. Likewise, 66.5% of the orthodontists showed moderate to dissatisfaction over time adherence by the patients. CONCLUSION: The findings of the present investigations depicted a higher level of passion and commitment among the male and female respondents for the profession in spite of the fact that they do not have adequate time for their personal life. The working efficiency of orthodontists may be significantly enhanced by sparing them from too much paperwork and ensuring that their patients appear on time.

Learning style preferences of dental students at a single institution in Riyadh, Saudi Arabia, evaluated using the VARK questionnaire.

BACKGROUND: Students differ in their preferred methods of acquiring, processing, and recalling new information. The aim of this study was to investigate the learning style preferences of undergraduate dental students and examine the influence of gender, Grade Point Average (GPA), and academic year levels on these preferences. METHODS: The Arabic version of the visual, aural, read/write, and kinesthetic (VARK) questionnaire was administered to 491 students from the first- to the fifth-year academic classes at the College of Dentistry, King Saud University. Descriptive statistics were used to characterize the learning styles of the students, and Chi-square test and Fisher's test were used to compare the learning preferences between genders and among academic years. Significance was set at a p-value of <0.05. RESULTS: A total of 368 dental students completed the questionnaire. The multimodal learning style was preferred by 63.04% of the respondents, with the remaining 36% having a unimodal style preference. The aural (A) and the kinesthetic (K) styles were the most preferred unimodal styles. The most common style overall was the quadmodal (VARK) style with 23.64% having this preference. These differences did not reach statistical significance (p>0.05). Females were more likely to prefer a bimodal learning style over a unimodal style (relative risk =2.37). Students with a GPA of "C" were less likely to have a bimodal or a quadmodal style preference compared to students with a GPA of "A" (relative risk =0.34 and 0.36, respectively). Second-year students were less likely to prefer a bimodal over a unimodal style compared to first-year students (relative risk =0.34). CONCLUSION: The quadmodal VARK style is the preferred learning method chosen by dental students, followed by unimodal aural and kinesthetic styles. Gender was found to influence learning style preferences. Students with a "C" GPA tend to prefer unimodal learning style preferences. The VARK questionnaire is a relatively quick and simple tool to reveal the learning style preferences on an individual or a group level. Dental educators should adjust their delivery methods to approximate the learning preferences of their students. Dental students are encouraged to adapt a multimodal style of learning to improve their academic results.

Learning preferences among dental students using the VARK questionnaire: A comparison between different academic levels and gender.

OBJECTIVE: To examine the learning style preferences of undergraduate dental students and determine the influence of gender on their selection. METHODS: This descriptive, cross-sectional study was conducted at the College of Dentistry, King Saud University, in Riyadh, Saudi Arabia, from September 2016 to January 2017.The Arabic version of visual, audio, read/write, and kinaesthetic questionnaire was administered to students from the first to the fifth academic year. Data was analysed using SPSS 21. P<0.05 was considered significant. RESULTS: Of the 491 students, 368(75.1%) completed the questionnaire. Of them, 269(73.1%) were males and 99(26.9%) were females. Significant differences were found when learning styles were compared (p<0.05). No significant differences could be found when the models were assessed as in the unimodal, bimodal, trimodal or quadmodal methods (p>0.05). A significant difference was found between genders when learning styles were compared (p=0.05). Males preferred the unimodal style, while females preferred the bimodal and quadmodal styles almost equally (p<0.05). CONCLUSIONS: Most dental undergraduate students preferred multi-modal learning.

Cephalometric Soft Tissue Characteristics of Unilateral Cleft Lip and Palate Patients in Relation to Missing Teeth.

OBJECTIVE: This study aimed to evaluate cephalometric soft tissue characteristics in individuals with unilateral complete cleft lip and palate (UCCLP) both with and without missing teeth. DESIGN: A retrospective investigation of patient records, who are being treated at the cleft lip and palate (CLP) clinics at the College of Dentistry. Ninety-six consecutive records of nonsyndromic UCCLP subjects were recruited (33 subjects without missing teeth and 63 subjects with missing teeth). Linear and angular soft tissue measurements obtained from lateral cephalometric radiographs were evaluated and compared among the studied samples. RESULTS: Lower lip was significantly retruded and shorter (p = 0.037), p = 0.015, respectively; in addition to the fact that shallower mentolabial sulcus (p = 0.05) was found in the subjects with missing teeth, the rest of the soft tissue was not significantly different between the two groups. CONCLUSION: In subjects with a UCCLP anomaly, missing teeth have an effect on lower lip position and length, which influenced the mentolabial sulcus. Lower lip position and length differ between cleft patients who present with either multiple missing teeth or with no missing teeth, and this needs to be considered during orthodontic treatment planning and surgical management for the cleft defect.

Comparison of two analgesics used for pain relief after placement of orthodontic separators.

OBJECTIVE: The purpose of this study was to assess the possible effect of two analgesics: paracetamol (500 mg) and ibuprofen (400 mg) on pain and routine life of the patients after placement of orthodontic separators. METHODOLOGY: Ninety patients aged 11-41 years undergoing fixed comprehensive orthodontic treatment requiring placement of different orthodontic separators participated in the study. Following placement of separators, the participants were randomly assigned to 1 of 3 groups: paracetamol (500 mg) given every 6 h for 3 days, ibuprofen (400 mg) given every 8 h for 2 days and control group in which no analgesic was given. A questionnaire comprising of 7 questions was distributed to the participants and were asked to report their feeling of pain. The collected data were tabulated and the statistical analysis was performed using ANOVA, chi-square test, and t-test with a significance level of p < 0.05. RESULTS: In general, the level of pain was high for all groups in the first three days. Then it was gradually reduced until the 7th day of the study. Few patients reported feeling of pain during their sleep whereas a significant reduction of the pain was reported during eating and chewing after the 3rd day of separators. However, some participants felt continuous pain on the 1st and 2nd days and it was reduced gradually on the 3rd day until the 7th day following application of separators. CONCLUSION: The patients prescribed ibuprofen did not report any problem with tooth movement along with significant reduction in pain as compared to paracetamol. Pain relief medication after placement of separators should be taken only if patient feels intolerable pain but not as routine practice.

Retention practices and factors affecting retainer choice among orthodontists in Saudi Arabia.

OBJECTIVES: To identify the retention protocols practiced by orthodontists in Saudi Arabia, and the factors affecting retainer choice.  METHODS: This cross-sectional study took place between February and March of 2015 at the College of Dentistry, University of Dammam, Dammam, Saudi Arabia. A previously tested electronic survey of 34 items was sent to all 1,200 orthodontic members of the Saudi Orthodontic Society. The questionnaire elicited data on the subjects' demographics, orthodontic treatment practices, retention, and post-retention protocols.   RESULTS: One hundred and sixty-seven (13.9%) responses were received during the study period. The results showed predominant use of Hawley in the maxillary arch (61.3%), and fixed lingual in the mandibular arch (58.5%). Approximately 90.3% recommended full-time maxillary removable retainer wear. Overall, orthodontists who performed fewer extractions tended to use fixed retainers, and those who performed more extractions used removable retainers (p=0.018). Interproximal enamel reduction was used by 28% of the respondents as an adjunct procedure to enhance retention. Approximately 64% practiced a post-retention phase of retainer wear. Participants who used removable retainers most commonly prescribed lifetime retention.  CONCLUSION: Hawley in the maxilla, and fixed lingual in the mandible were the most common retention protocols prescribed. Lifetime retention was the most common choice for participants who used removable retainers, especially when extractions were carried out.