Evaluation of the trueness and precision of conventional impressions versus digital scans for the all-on-four treatment in the maxillary arch: An in vitro study.

PURPOSE: To compare the accuracy of digitizing conventional impressions to intraoral surface scans for all-on-four treatment in the maxillary arch. MATERIALS AND METHODS: An edentulous maxillary arch model with four implants placed in an all-on-four design was fabricated. Intraoral surface scans (n = 10) were obtained using an intraoral scanner after scan body insertion. For conventional polyvinylsiloxane impressions of the model, implant copings were inserted into the implant fixation for implant level, opened tray impressions (n = 10). The model and conventional impressions were digitized to obtain digital files. A reference file was created using a laboratory-scanned conventional standard tessellation language (STL) file with analog to scan the body using exocad software. STL datasets from the two digital and conventional impression groups were superimposed with reference files to assess the 3D deviations. Two-way ANOVA and paired-samples t-test was performed to assess the difference in trueness and examine the effects of impression technique and implant angulation on the deviation amount. RESULTS: No significant differences were found between the conventional impression and intraoral surface scan groups F(1, 76) = 2.705, p = 0.104. No significant differences were found between conventional straight and digital straight implants and between conventional and digital tilted implants F(1, 76) = .041, p = 0.841. No significant differences were found between conventional straight and conventional tilted implants p = 0.07 and between digital straight and digital tilted implants p = 0.08. CONCLUSION: Digital scans were more accurate than conventional impressions. The digital straight implants were more accurate than the conventional straight implants, and the digital tilted implants were more accurate than the conventional tilted implants, with higher accuracy for digital straight implants.

A Feasible and Innovative Method of Investing Wax Pattern for Removable Partial Dentures: An In Vitro Study.

Background A dental prosthesis called a removable partial denture (RPD) is used to fill the gaps left by one or more lost teeth. It serves as an option to fixed bridges and restorations supported by implants. This research was on a simple and effective method of investing RPD wax pattern and an in vitro investigation into the creation of a cutting-edge RPD technique. Methodology The method outlines the straightforward steps for waxing an RPD and validating the precision of the cast framework. The use of a laminated paper ring rather than a metallic one for investing the wax patterns is the main distinction between the novel method and the traditional ringless technique. Results A total of 30 samples were considered for investigation, with 15 in the traditional and 15 in the experimental group. The innovative wax pattern investment method exhibited a higher mean geometric orientation (9.23 ± 0.42) compared to traditional investment casting (8.90 ± 0.37 mm). Conversely, the dimensional accuracy mean was lower for the innovative wax pattern investment method (0.28 ± 0.03 mm) compared to traditional investment casting (0.31 ± 0.05 mm). The p-value was less than 0.001 for both parameters, signifying that the differences between the means of the two methods were statistically significant. The statistical power (1-ß) was the probability of rejecting the null hypothesis when it was false. The statistical power was 0.999 for both geometric orientation and dimensional accuracy, indicating that the study had a very high power to detect differences between the two methods. Conclusions This innovative method does away with the requirement for a commercially available plastic ring, reduces the price and time needed for RPD manufacturing, and offers decent marginal accuracy. However, it has some restrictions, such as the challenge of cutting and preparing the paper ring after investing, which could lower the finished product's quality.

Peri-implantitis and systemic inflammation: A critical update.

Peri-implantitis is an inflammatory condition induced by bacterial biofilm that affects the soft and hard tissues surrounding dental implants, compromising the success of implant therapy. Recent studies have highlighted the potential links between peri-implant health and systemic inflammation, including uncontrolled diabetes mellitus, psychological stress, cardiovascular disease, obesity, and infectious diseases such as COVID-19. As an inflammatory disease, peri-implantitis may trigger systemic inflammation by elevating circulating levels of pro-inflammatory cytokines, which could have unknown impacts on overall health. While the relationship between periodontal health and systemic conditions is better understood, the association between peri-implant disease and systemic inflammation remains unclear. Therefore, this comprehensive review aims to summarize the most recent evidence on the relationship between peri-implantitis and systemic inflammation, focusing on biological complications, microbiology, and biomarkers. This review aims to enhance our understanding of the links between peri-implantitis and systemic inflammation and promote further research in this field by discussing the latest insights and clinical implications.

ACCURACY OF INTRAORAL SCANNERS VERSUS TRADITIONAL IMPRESSIONS: A RAPID UMBRELLA REVIEW.

PURPOSE: This study aimed to (1) report the trueness and precision of intraoral scanning (IOS) in dentistry based on recent secondary sources and to (2) appraise the reporting quality of the titles and abstracts of the included literature. MATERIALS AND METHODS: This rapid overview searched the PubMed/Medline and Cochrane Database of Systematic Reviews in March 2021 to identify reviews reporting on the accuracy of IOS. The reference list from the eligible studies was also screened for identification of other potentially eligible studies. The inclusion criteria consisted of English language systematic reviews or meta-analyses published between 2019 and 2021. The exclusion criteria were primary studies, narrative review, and extraoral scanners. The assessment of reporting quality of abstracts of systematic reviews was performed using the reporting checklist PRISMA extension for Abstracts (PRISMA-A). This was a self-funded research project. RESULTS: Out of the full text screened 25 records, 11 reviews were included. Most studies supported the IOS approach being as precise and accurate as the conventional one. Only one study significantly favored the conventional approach over the IOS, and two studies abstained from making a recommendation. The IOS was significantly superior to the traditional technique in terms of patient preference and time efficiency. After applying PRISMA-A, recommendations for improvements on titles and abstracts of future reviews of IOS and conventional impressions are provided. CONCLUSION: Laboratory data indicated similar accuracy between IOS and conventional impressions, whereas clinical data found the same in less than 4-unit fixed dental prostheses. For more extensive definitive fixed solutions or removable prostheses, the conventional approach is recommended. IOS was superior in terms of patient preference and time reduction. More clinical trials are required to determine the clinical effectiveness of incorporating IOS in broader scenarios. Better quality of reporting secondary sources abstract is advised.

Efficacy of Rose Bengal and Curcumin mediated photodynamic therapy for the treatment of denture stomatitis in patients with habitual cigarette smoking: A randomized controlled clinical trial.

BACKGROUND: Cigarette smoking in conjugation with bad oral hygiene is considered a typical predisposing factor for many oral diseases including denture stomatitis. This study investigated the effect of Rose Bengal (RB)-and Curcumin (CUR)-mediated photodynamic therapy (PDT) in comparison with nystatin therapy in the intervention of denture stomatitis in cigarette smokers. METHODS: Overall, 45 habitual cigarette smokers aged ~58 years having denture stomatitis were categorized into three groups: Group-I - RB-mediated PDT, Group-II - CUR-mediated PDT, and Group-III - Nystatin therapy. The primary outcome of the interest was: counts of Candida colony from denture surface and palatal mucosa, calculated as CFU/mL, whereas the prevalence of Candida species determined in 3 research groups comprised the secondary outcome. Oral swab specimens were gathered from the denture surfaces and palatal mucosa. All clinical assessments were performed at baseline, 6 weeks, and 12 weeks. RESULTS: C. albicans was the most prevalent yeast identified on both denture surfaces and palatal mucosa, followed by C. tropicalis and C. glabrata. A considerable decrease in the CFU/mL scores were observed in Group-I and Group-II at the end of the interventions and on the 12-week follow-up (p<0.05). Group-I, II, and III demonstrated clinical efficacy rates of 53%, 51%, and 49%, respectively. CONCLUSION: CUR-and RB-mediated PDT was found to be as effective as topical Nystatin therapy for the intervention of denture stomatitis among cigarette smokers.

Clinical, bacterial, and inflammatory outcomes of indocyanine green-mediated photodynamic therapy for treating periimplantitis among diabetic patients: A randomized controlled clinical trial.

Background This 6-months randomized controlled clinical trial aimed to assess the efficacy of indocyanine green mediated photodynamic therapy (ICG-PDT) as an adjunct to peri­implant manual debridement (PIMD) versus PIMD alone among Diabetes Mellitus (DM) patients in the treatment of peri­implantitis. Methods A total of 48 DM patients having 64 implants were treated with either ICG-PDT + PIMD (n = 35 implants) or PIMD alone (n = 29 implants). Clinical (probing depth [PD], bleeding on probing [BOP], and plaque index [PI]) and radiographic (peri­implant crestal bone loss [PCBL]) peri­implant variables were recorded. Bacterial species including Porphyromonas gingivalis and Treponema denticola were evaluated from peri­implant plaque biofilms. Levels of interleukin (IL)-1ß and IL-6 were assessed after the collection of peri­implant sulcular fluid. All the evaluations were carried out at baseline, 3- and 6-months. The significance level was set to p < 0.05. Results All clinical parameters significantly reduced within both treatment groups (P<0.05). Intra-group comparison indicates that there was statistically significant reduction in PD and suppuration for ICG-PDT group (P<0.05). There was a statistically significant difference in the BOP between ICG-PDT and PIMD groups at both follow-up periods (P<0.001). However, there was a significant difference for PD (P = 0.001), suppuration (P = 0.01), and PCBL (P = 0.04) on 6 months follow-up between ICG-PDT and PIMD groups, respectively. Only ICG-PDT showed a significant reduction in P. gingivalis and T. denticola on both 3 months and 6 months follow-up compared to baseline. PIMD showed a statistically significant reduction only on 3 months follow-up compared to baseline. This reduction was maintained for both the species when dental implants were treated with ICG-PDT. However, PIMD failed to maintain this reduction until 6 months. Only at 3 months assessment that both treatment groups showed statistically significant reduction in IL-1ß and IL-6 with no significant difference between the groups. Both biomarkers failed to maintain the reduction in both groups and significantly increased levels for IL-1ß was noted at 6 months follow up Conclusion Multiple application of indocyanine-green mediated photodynamic therapy resulted in improved clinical and microbial parameters among type 2 DM subjects in the treatment of peri­implantitis. This clinical trial was registered in the ClinicalTrials.gov Protocol Registration and Results System with registration record number: NCT04833569.

Aesthetic Parameters and Patient-Perspective Assessment Tools for Maxillary Anterior Single Implants.

BACKGROUND: This review aimed to concisely describe the current aesthetic objective indices for a single-implant maxillary anterior crown. The secondary aim was to propose introducing a unified, standardized questionnaire for adequately collecting patient-reported outcome measures (PROMs) in implant dentistry. MATERIALS AND METHODS: A literature review was conducted using both EMBASE/Ovid and MEDLINE/PubMed databases by combining keywords and Emtree/Mesh terms related to "Esthetics," "Self-Assessment or Surveys and Questionnaires," and "Single-Tooth Dental Implants." RESULTS: The most meaningful aesthetic objective indices for single implants in the literature are the Pink Esthetic Score (PES), the Papilla Presence Index (PPI), Peri-Implant and Crown Index (PICI), PES/White Esthetic Score (PES/WES), the Implant Crown Aesthetic Index (ICAI), and a modified version of the ICAI (mod-ICAI) index. Clearly, PES/WES is still the most widely accepted tool. It is encouraging to observe that there is an increasing tendency in recent years to report PROMs more frequently in the implant dentistry literature. We proposed the implementation of a unified, standardized questionnaire using a self-administered visual analogue scale (VAS) scoring system, which evaluates overall satisfaction, comfort, tooth appearance, gingival appearance, function, and hygiene complexity. This tool should be validated in the oral implantology research context for its regular implementation or further development. CONCLUSIONS: Conducting qualitative studies among dental implant patients who received few implants or single-tooth implant reconstructions in the aesthetic zone may help dental researchers understand better how to efficiently develop and validate a quantitative instrument. This standard tool would reduce heterogeneity bias by providing comparable data between studies.

Role of antimicrobial photodynamic therapy in reducing whole salivary oral yeasts colonization in type-2 diabetic and non-diabetic patients with and without dental implants.

OBJECTIVE: The aim was to assess the impact of antimicrobial photodynamic therapy (aPDT) in reducing whole salivary oral yeasts colonization in type-2 diabetic and non-diabetic patients with dental implants. METHODS: Type-2 diabetic and self-reported non-diabetic patients were included. Participants were divided into the following groups: Group-1: Type-2 diabetic patients with dental implants; Group-2: Non-diabetic patients with dental implants; Group-3: Type-2 diabetic patients without dental prostheses; Group-4: Non-diabetic patients without dental prostheses. In each group, participants were subdivided into 2-sub-groups. In the test-subgroup, participants received routine oral hygiene maintenance instructions (OHMI) and underwent full mouth disinfection using aPDT; and in the control-group, participants received OHMI alone. Unstimulated whole saliva samples were collected, hemoglobin A1c levels were measured and yeast colonization was assessed at baseline and at 3-months' follow-up in all groups. Sample-size estimation was done and group-comparisons were done. P-values <0.01 were considered statistically significant. RESULTS: At baseline, the mean oral yeasts colonization was significantly higher among patients in Group-1 (P < 0.001) and 3 (P < 0.001) compared with individuals in groups 2 (P < 0.001) and 4 (P < 0.001). At baseline and at 3-months of follow-up, the mean HbA1c levels and oral yeasts colonization were significantly higher among patients in Group-1 (P < 0.001) and 3 (P < 0.001) compared with individuals in groups 2 (P < 0.001) and 4 (P < 0.001). CONCLUSION: In the short-term, routine OHMI with adjunct aPDT is more effective in reducing whole salivary oral yeasts counts than OHMI alone in patients with and without dental implants.

Evaluating factors associated with fear and anxiety to dental treatment-A systematic review.

INTRODUCTION: Dental anxiety refers to a set of complex psychological issues bearing a significant impact in individual's lives reflecting in the form of dental visit avoidance, poor dental health status and decreases oral health related quality of life. Hence, it is imperative to consider those factors associated with dental anxiety so as to treat and promote better oral health. The review aimed to assess various factors associated with dental fear and anxiety. MATERIALS AND METHODS: Literature search was done from Pubmed and Google scholar search engines to identify publications which explored factors associated with dental fear and anxiety. RESULTS: Research evidence pointed a significant relationship of age, gender, maternal anxiety, previous dental experience, and number of siblings with dental fear and anxiety (DFA). CONCLUSION: Findings of the review clearly suggest that a better understanding of factors causing dental anxiety and phobia will help preventing dental avoidance and providing better care.

Antimicrobial capacity of photodynamic therapy on oral health-related quality of life and halitosis among elderly patients wearing removal dentures.

PURPOSE: The aim of the present clinical trial was to evaluate the efficacy of antimicrobial photodynamic therapy (PDT) for the treatment of halitosis in elderly patients wearing dentures. METHODS: Elderly patients (>60 years age) wearing complete dentures and diagnosed with halitosis (H2S levels >112 ppb) were divided into two groups: patients undergoing treatment with tongue scraper and full mouth disinfection (Group I) and patients undergoing treatment with tongue scraper, full mouth disinfection and single application of PDT (Group II). Oral health related quality of life (OHRQoL) was assessed using a 14-point Likert scale used in oral health impact profile (OHIP). The assessment of halitosis was done with the help of a device called Oral Chroma™. Microbial sampling for detection of Porphyromonas gingivalis (P. gingivalis) was performed from the dorsum of the tongue using a sterile swab at baseline and after treatment on day 5, 15 and 30 and quantified using polymerase chain reaction. RESULTS: Forty elderly patients with halitosis completed the trial. The mean age in Group I and Group II was estimated to be 66.42 years and 67.91 years, respectively. Group II participants also maintained good OHRQoL in the post-operative period that reported statistically significant difference when compared with the control group (p < 0.01). Group II showed significant improvement in H2S concentration values at final analysis compared to Group-I (p = 0.001). P. gingivalis showed statistically significant reduction on day 5 only with PDT in Group II (p < 0.05). CONCLUSION: Antimicrobial PDT helped in reducing H2S gas concentration and improving quality of life in elderly patients wearing dentures. A significant reduction of P. gingivalis occurred only in the short-term follow-up.

Bite Force and Occlusal Patterns in the Mixed Dentition of Children with Down Syndrome.

PURPOSE: Oral function in Down Syndrome (DS) patients has been of interest to clinicians and researchers. This study aimed to evaluate the parameters of occlusal force and pattern of children with Down syndrome (DS) during mixed dentition when compared to age and gender-matched controls. MATERIALS AND METHODS: Thirty DS and 30 healthy children, aged 7 to 12 years, participated in the evaluation of the parameters of the occlusal pattern and occlusal force distribution analysis. Both groups underwent clinical examination, occlusal force and pattern measurements using a computerized occlusal analysis system (T-Scan 8 occlusal analysis, Tekscan, Inc., S. Boston, MA). Occlusion time, percentage of force distribution, force outliers, center of force target area, center of force trajectory and evaluation of closure arc were compared between the two groups using the Pearson's Chi Square test. RESULTS: Children with DS had more occlusal and vertical malocclusion compared to the control group (p < 0.001). The occlusion time for DS group (0.75 ± 0.7s) was significantly longer than the control group (0.015 ± 0.05s) (p < 0.001). The closure arc for DS group was mostly irregular (53%), while the control group showed ideal closure arc. In control group, the age had a significant influence on the occlusion time, while height, weight, and BMI had a significant influence on the mouth opening. None of these variables had such effect on children with DS. CONCLUSIONS: The results of this study showed high prevalence of orofacial dysfunction among DS population. The occlusal analysis showed that children with DS had longer occlusion time and a lack of ideal occlusion pattern compared to age matched controls.

A 22-Year Follow Up of Immediate Implant Placement without Bone Augmentation: A Case Series Study.

PURPOSE: To retrospectively evaluate the treatment outcome of immediate implants placed in fresh extraction sockets without bone augmentation after 22 years of function. MATERIALS AND METHODS: The study group received implant therapy in 1997, including surgical placement and prosthodontic rehabilitation. The mean age of the subjects at the time of implant placement was 40 ± 5.54 years. A total of 35 subjects received 36 implants in fresh extraction sockets without bone augmentation. Definitive prostheses were placed 4 to 6 months after implant placement. Implant treatment outcomes were evaluated using clinical and radiographic parameters obtained during follow-up visits at 1, 5, 10, 15, 20, and 22 years after prosthetic loading. RESULTS: Among the 35 treated subjects, five patients moved out of the country and could not be evaluated at the follow-up times. A total of 29 subjects were included in the study with a drop-out rate of 14.1%. Of these, one patient lost the implant during the osseointegration period before prosthodontic treatment. No other implant failure or complication during the rest of the follow-up period was reported, thus giving a cumulative survival rate of 97.2% during the 22-year follow-up. The change in marginal bone level was less than 2 mm in most subjects at the 22-year examination. The mean bone loss from baseline to 22-year follow-up was 1.61 mm, and the mean bone level at the 22-year follow-up examination was situated at 2.13 ± 0.023 mm from the implant platform, which was used as the reference point. CONCLUSIONS: Immediate implant placement in extraction sockets exhibits excellent prognosis even when bone augmentation is not performed.

Patient Satisfaction in Medicine and Dentistry.

Health professionals, such as medical and dental clinicians, have scant understanding of patients' experiences and perceptions of satisfaction. Nevertheless, implementing a patient-reported outcome measures (PROMs) research practice in surgical sciences is necessary. Hence, the objective of this article was to better understand patients' satisfaction with their medical and dental care. The methods of the current article are based on a narrative review of the literature strategy. A literature review was conducted using both EMBASE and Medline databases up to July 12, 2020, by combining keywords and terms related to "satisfaction theories" and "patient satisfaction," and "medicine" or "dentistry/stomatology/odontology." Patient satisfaction's multidimensional nature has been established since the perceived reasons for satisfaction varied widely among patients. Many aspects of treatment influence participant satisfaction at different stages of the intervention process. An improved understanding of the basis for managing patients' expectations with information reiteratively and efficiently may ultimately reduce patients' potential for negative feelings toward the medical and dental treatment experience. Lastly, the consumerist method may misrepresent the still undertheorized concept of satisfaction in health service.

Reliability of mobile phone teledentistry in dental diagnosis and treatment planning in mixed dentition.

INTRODUCTION: The aim of the study was to test the reliability of mobile phone teledentistry in the diagnosis and treatment planning of dental caries of children in mixed dentition. METHODS: A total of 57 cases, aged 6-12 years, among six examiners were used yielding 342 comparisons. The patients were examined by a dentist who was calibrated in the recording of oral findings in children using the World Health Organization (WHO) oral health assessment form for children (version 2013), which served as the gold standard for diagnosis. Six paediatric dentists calibrated using the same WHO form served as the teledentistry group and made their diagnoses using only the images sent to them without the use of radiographs. The pictures obtained were stored on an online cloud platform (Google Drive). The sharing links for these pictures were forwarded to participating dentists using a social media application (WhatsApp Messenger, Facebook Corp., Mountain View, CA). RESULTS: This study showed greater sensitivity than specificity, and though both sensitivity and specificity were constantly above 80%, it can be stated that the current model has a higher chance of false positive results than false negative results. The reliability of teledentistry in this study is greater in primary teeth than in permanent teeth. DISCUSSION: Although the use of teledentistry without radiographs is not as accurate as clinical examination, mobile phone teledentistry offers acceptable reliability for the initial diagnosis of caries in children.

Knowledge, attitude, and practice regarding prosthodontic rehabilitation and factors affecting the patients visiting private clinics in Riyadh, Saudi Arabia: A cross-sectional study.

BACKGROUND: Prosthodontic rehabilitation maintains the esthetics, functional support, and the masticatory function of the oral cavity. The main aim of the present study was to explore the knowledge, attitude, and practice towards prosthodontic rehabilitation and factors affecting the KAP of patients. MATERIALS AND METHODS: The present research is a cross-sectional descriptive questionnaire study conducted among the patients visiting private hospitals in Riyadh City, Saudi Arabia. The city was divided into five directions; south, north, east, west, and central. From each direction, one hospital was included randomly with more than 50 patients in OPD per day. The interview was conducted among 121 patients from each hospital which made the sample size of 605. RESULTS: Among all study participants in the present study, majority (252 [41.67%]) of them were more than 50 years of age. Female study participants (318 [52.57%]) were more than (287 [47.43%]) the male participants. It was reported that 458 (75.70%) of the study participants have missing teeth ranging from 6 to 10. The main reason reported for absence of prosthesis was money constraints among the 121 (38.90%) study participants. Inadequate knowledge regarding prosthodontic rehabilitation was significantly associated (P-value ≤ 0.05*) with attitude and practice of the study participants. CONCLUSION: It was concluded that financial constraints were the major factors for not availing prosthodontic rehabilitation. Moreover, inadequate knowledge regarding prosthodontic rehabilitation significantly affects the attitude and practice of the study participants.

Evaluation Distal Caries of the Second Molars in the Presence of Third Molars among Saudi Patients.

OBJECTIVES: To evaluate the prevalence of distal caries in second permanent molars in the presence of third molar among patients attending university dental clinics in Riyadh City, Kingdom of Saudi Arabia. MATERIALS AND METHODS: Clinical and radiographic data (orthopantomographs and right and left bite wings) from 313 patients attending Riyadh Elm University dental clinics, department of oral diagnosis were collected and analyzed for the presence of third molars and caries on the distal surface of the second molar. Descriptive statistics of frequency distribution, mean and standard deviation, and binary logistic regression analysis were applied to assess the association between distal surface caries on second molars and impaction status of the teeth. RESULTS: The mean decayed, missing, and filled teeth score of the study participants was found to be very high, that is, 23. The prevalence of caries affecting the distal aspect of the second molar was 48.6% (n = 609) in the population. The prevalence of distal caries was significantly high in patients with fully erupted wisdom teeth followed by vertical, horizontal, and mesial impacted third molars (P < 0.05). Wisdom teeth with mesioangular, vertical, and horizontal impactions showed significant association with distal caries of second molars below the contact point, whereas, fully erupted and vertically impacted wisdom teeth showed significant association with distal surface caries of second molars above contact point. Similarly, vertically impacted wisdom teeth were found to have significant association with caries of distal surface of second molars on noncontact areas (P < 0.05). CONCLUSION: This study showed that the distal surface of the second molars is at risk of caries in the presence of third molars. However, this risk depends on eruption status, type of angulation, and contact between third and second molars. All the preventive measures should be taken to avoid caries on distal surface of second molar.

Oral Health Status, Treatment Needs and Oral Health Related Quality of Life among Hearing Impaired Adults in Riyadh City, Saudi Arabia.

AIM: The primary objective was to determine the oral health status and treatment needs among hearing-impaired (HI) adults. Second, to assess the relationship between the oral health variables and oral health-related quality of life (OHRQoL) by using General Oral Health Assessment Index (GOHAI)-Ar questionnaire among HI adults in Riyadh city, Saudi Arabia. MATERIALS AND METHODS: A total of 146 HI adults between the age groups of 18-21, 22-25, and >25 years were included in the study. A convenient sampling technique was used to obtain the study sample. Oral health condition was recorded by using oral hygiene index-simplified (OHI-S), plaque index (PI), and gingival index (GI). The WHO methodology was used to record dental caries and treatment needs. The Saudi Arabian version of GOHAI-Ar questionnaire was used to gather information with regard to OHRQoL. A sign language expert communicated information between HI and investigator while answering the questionnaire. RESULTS: More than half of the HI had fair OHI-S (55.2%) and PI score (54.2%), while 60.1% of HI had moderate gingival inflammation. The prevalence of dental caries (82.2%) and treatment needs (85.6%) were found to be high. Mean oral hygiene scores between Saudi and non-Saudi nationals [(1.64) vs (1.12), p = 0.041] showed significant differences. Missing and filled teeth showed significant differences across different age groups (p = 0.000). The mean GOHAI-Ar was found to be low (14.44 ± 9.59). Spearman's test showed a significant positive correlation between the GOHAI-Ar score and the toothbrushing method (r = 0.164, p = 0.047). Toothbrushing time, oral hygiene material, last visit to dentist, OHI-S score, PI score, decayed, missing, and decayed missing filled teeth (DMFT) scores were negatively correlated with GOHAI-Ar. Speech was the main concern for the HI. CONCLUSION: There was a fair oral hygiene, moderate gingival inflammation, high caries experience, and treatment needs with low GOHAI-Ar scores indicating poor OHRQoL among HI.

Efficacy of Artificial Salivary Substitutes in Treatment of Xerostomia: A Systematic Review.

AIM: To provide an update on artificial saliva used to maintain the health of the oral cavity of patients with severe hyposalivation. MATERIALS AND METHODS: A literature search was conducted in April 2018 in three electronic databases (The Cochrane Central Register of Controlled Trials [CENTRAL], PubMed, and Embase) by combining key words and terms related to the population and intervention of the topic. RESULTS: The databases search resulted in 455 titles and abstracts. Of these, 21 were judged to meet inclusion criteria and full texts were read. Finally, 10 clinical trials were included for qualitative synthesis. CONCLUSION: Published evidence suggests that all the artificial saliva products tested in included studies reduced symptoms of xerostomia. These products should specifically be selected according to the patients' concerns and needs. However, the included studies presented a wide range of products and suffered from high risk of bias. Therefore, long-term randomized controlled trials on effects of various products are required.

Validation of Arabic version of the Modified Dental Anxiety Scale (MDAS) and Kleinknecht's Dental Fear Survey Scale (DFS) and combined self-modified version of this two scales as Dental Fear Anxiety Scale (DFAS) among 12 to 15 year Saudi school students in Riyadh city.

AIMS: The aim of this study was to test the reliability and validity of the Arabic version of Modified Dental Anxiety Scale (MDAS), Dental Anxiety Scale (DAS), and a combined self-modified version of these scales and Dental Fear and Anxiety Scale (DFAS). We also aimed to assess the impact of dental fear and anxiety among Arabic-speaking 12-15-year-old Saudi students on their quality of life by correlating MDAS, DAS, and DFAS scores with other demographic data. MATERIALS AND METHODS: A cross-sectional study was conducted among 500 individuals (250 male and 250 female) in Riyadh city using a questionnaire. An unpaired t-test was used to check the mean difference between anxiety score among males and females, and one-way analysis of variance was used to check the mean difference between percentage anxiety score among different visit groups. Scheffe post hoc test was used to check the pairwise difference between the groups, and Cronbach's alpha was used to measure internal consistency of the questionnaire. RESULTS: Overall mean percentage DAS score was 51.1640 + 6.87358 and 55.2080 + 8.52805 for male and females, respectively. The overall mean percentage MDAS score was 51.6640 + 10.9478 and 58.3200 + 11.62990 for males and females, respectively. The overall mean total score was found to be 64.4080 + 11.80776 and 100.4680 + 12.34840 for males and females, respectively. All the above results were statistically significant by 5% (P < 0.001). Cronbach's alpha score for MDAS and DAS was found to be 0.843 and it was 0.960 for DFAS. It was found that removal of any item would have decreased the overall consistency, which indicated a high level of internal consistency for our scales. CONCLUSION: Saudi Arabian version of Arabic version of MDAS, DAS and DFAS have shown high validity and reliability, and can be used to assess the dental patient's anxiety and fear.

Dentists' Knowledge, Attitude, and Practice Regarding Evidence-Based Dentistry Practice in Riyadh, Saudi Arabia.

OBJECTIVE: The aim of this study was to assess the existing level knowledge and the use of evidence-based dentistry among dental clinicians. METHODS AND MATERIALS: A cross-sectional questionnaire-based survey was conducted among 400 male and female dental practitioner's working in academic, governmental, and private sectors in Riyadh, Saudi Arabia. RESULTS: In this study, a total of 400 subjects were recruited of whom 253 (63.3%) were male dental practitioners and 147 (36.8%) were female dental practitioners: 229 (57.3%) subjects belonged to 25-34 age group, 145 (36.3%) to 35-44 age group, 18 (4.5%) to 45-54 age group, and 8 (2%) to >55 age group. Among them, 202 (50.5%) were mixed practice, 91 (22.8%) were working in academics, 76 (19%) belonged to private practice, and 31 (7.8%) belonged to government practice. In addition, 225 (56.3%) were general practitioners and postgraduates, 86 (21.5%) were specialists, 47 (11.8%) were consultants, and 42 (10.5%) had other qualifications. In total, 221 (55.3%) subjects completed their qualification within before 1-5 years, 153 (38.3%) completed their qualification within before 6-10 years, 19 (4.8%) completed their qualification within before 11-15 years, and 7 (1.8%) completed their qualification within 16-20 years. CONCLUSION: This survey mirrors the necessity to conduct continuing dental education programs on evidence-based practice (EBP), so as to give the dentists of Riyadh better knowledge regarding EBP so that they can administer it in their daily clinical practice and deliver better quality care to their patients.